四診 Si Zhen

The Four Methods of Diagnosis

TCM diagnosis relies on four methods: Inspection, Auscultation, Inquiry, and Palpation.

Inspection (Looking)

Observing appearance, demeanor, complexion, tongue, and body condition.

Key Aspects

  • Spirit Observation: Assessing vitality through eyes and demeanor
  • Complexion: Color of face indicating organ health
  • Body Build: Constitution, posture, movement patterns
  • Tongue Diagnosis: Color, shape, coating, moisture

Tongue Areas and Corresponding Organs

TipHeart/Lung
SidesLiver/Gallbladder
CenterSpleen/Stomach
RootKidney/Bladder

Auscultation and Olfaction

Listening to sounds and smelling odors.

Listening

  • Voice quality
  • Breathing sounds
  • Digestive sounds
  • Emotional sounds

Five Element Sounds

WoodShouting
FireLaughing
EarthSinging
MetalWeeping
WaterGroaning

Inquiry (Asking)

Systematic questioning about symptoms, history, and lifestyle.

The Ten Questions

  1. Chills and fever
  2. Perspiration
  3. Head and body
  4. Chest and abdomen
  5. Food and taste
  6. Defecation and urination
  7. Sleep
  8. Ears and eyes
  9. Past history
  10. Present symptoms

Palpation (Touching)

Feeling the pulse and palpating the body.

Pulse Positions and Corresponding Organs

Left CunHeart
Left GuanLiver
Left ChiKidney Yin
Right CunLung
Right GuanSpleen
Right ChiKidney Yang

Pulse Qualities and Their Indications

FloatingExterior conditions
DeepInterior conditions
SlowCold patterns
RapidHeat patterns
EmptyDeficiency
FullExcess
SlipperyPhlegm, pregnancy
WiryLiver problems, pain
Note: TCM diagnosis requires extensive training. Always consult qualified practitioners for accurate diagnosis and treatment.