Introduction of the Inspection method of TCM Diagnostics.

Introduction of TCM Diagnostic Methods ✵The Inspection is one of the four examinations of TCM Diagnostic methods, examination by using the eyes, including inspection of vitality, complexion, expression, behavior, body surface, tongue, excreta, secretions, etc.

 The main content of Inspection are introduced as:, , , , , , , , , , .

Introduction of Inspection:Inspection of vitality

 Inspection Icon 01 Introduction about the Inspection of vitality: The Inspection of vitality is an inspection of the state and power of living, especially the general condition of mental and physical activities such as consciousness, thinking, facial expression, speech, and response to external stimuli.

 ✵Presence of vitality: one's general state marked by fullness of vigor, with lustrous eyes, resonant voice, radiant face, easy breathing, and quick movement.

 ✵Lack of vitality:one's general state marked by listlessness, with dull eyes, reluctance to talk, and slow movements, also known as insufficiency of vital Qi.

 ✵Loss of vitality:one's general state marked by apathy and inertness, with dim eyes, incoherent speech, difficulty in movement, and even impaired consciousness.

 ✵False vitality: transient spiritedness in a critical case, often indicating impending death with manifestation of divorced yang.

 ✵Flash of lucidity of the dying:momentary recovery of consciousness just before death.

 ✵Clouding of consciousness:a form of mental state with impairment of the cognitive function and reduced awareness of the environment.Also known as disordered consciousness.

 ✵Loss of consciousness:a state of unconsciousness from which the patient cannot be aroused.

 ✵Floccillation:aimless semiconscious fumbling and picking at the bedclothes by a critically ill patient.

 ✵Mental disturbance:derangement of the mind and abnormal mentality.

 ✵Delirium:disturbance of consciousness characterized by confusion, disordered speech, and hallucination.

 ✵Mania:type of mental disorder characterized by expansiveness, elation, agitation, hyperactivity and hyperexcitability.

 ✵Vexation-restlessness:vexation followed by restlessness, either due to yang deficiency or yin excess.

 ✵Restlessness-vexation:restlessness following by vexation, seen in a critical case of yin deficiency.

 ✵Distress in the heart:distressing heat sensation in the heart and chest.

 ✵Vexation:state of being vexed, often indicating depressed heat in the heart.

Introduction of Inspection:Inspection of Color

 Inspection Icon 01 Introduction about the Inspection of Color: the inspection of color is the observation of the patient's skin color, particularly the color of the face.

 ✵Complexion:natural color and appearance of the face.

 ✵Normal color:normal color of the skin of the face.

 ✵Individual's normal color:one's normal natural color of the skin of the face.

 ✵Varied normal color:climatically varied normal natural color of the skin od the face.

 ✵Morbid color:abnormal color of the face caused by disease.

 ✵Favorable color:complexion indicating a favorable prognosis.

 ✵Unfavorable color:complexion indicating an unfavorable prognosis.

 ✵Sallow complexion with emaciation:a complexion often seen in a chronically debilitated patient with consumption of Qi and blood.

 ✵Pallid complexion:a complexion often indicating blood deficiency or loss of blood.

 ✵Pale complexion:a complexion often caused by yang collapse or exuberance of cold.

 ✵Bright pale complexion:a complexion often seen in cases of yang deficiency.

 ✵Darkish complexion:a complexion indicating kidney insufficiency, cold syndrome, or blood stasis.

 ✵Flushed face:a sign indicating the presence of heat.

 ✵Dusty complexion:dark-gray complexion as if covered with dust, which indicates latent pathogens in excess syndromes, and consumption of liver and kidney yin in deficiency syndromes.

 ✵Five colors:blue(or green), red, yellow, white and black, which, according to the theory of the five elements, corresponding to the liver(wood), heart(fire), spleen(earth), lung(metal) and kidney(water), respectively.

 ✵Bluish discoloration:cyanosis of the skin or complexion, usually due to stagnant blood circulation, seen in cold syndrome, and cases of severe pain, Qi stagnation, blood stasis, and convulsions.

 ✵Yellow discoloration:A yellow complexion suggests spleen insufficiency or presence of dampness; yellow discoloration of the whole body surface including the sclera,i.e., jaundice, signifies the presence of damp-heat if the color is bright yellow, and the presence of cold-damp if the color is dark yellow.

 ✵Sallowness:sallow color of the skin, especially the face, which usually occurs in cases of spleen Qi deficiency.

 ✵Red discoloration:reddening of the complexion usually indicates the presence of heat.

 ✵White discoloration:white complexion usually indicates cold or deficiency.

 ✵Black discoloration:black or dark gray complexion is often seen in severe and chronic cases of blood stasis, pain, and kidney yang deficiency.

 ✵Diagnostic significance of the five colors:(1).The five colors-blue(or green), red, yellow, white, and black- indicate disorders of the liver, heart, spleen, lung and kidney respectively. (2).Blue indicates wind, cold, pain, convulsion, or blood stasis; red indicates the presence of heat; yellow reveals dampness; white implies deficiency of Qi and blood or presence of cold; black indicates pain, exhaustion or blood stasis.

 ✵Visceral-exhaustion color:color reflected in the face indicating exhaustion of essence and Qi of Zang viscera with unfavorable prognosis.

Introduction of Inspection:Observation of physical build and posture

 Inspection Icon 02 Introduction about the Observation of physical build and posture: The observation of physical build is a method of detecting the nature of a disease by observation of the patient's stature, constitution, and body pattern. The observation of posture is a method of finding out the patient's condition by observing his(her) posture, gesture, and movement.

 ✵Lying supine with legs stretched:a posture often taken by a patient with excessive heat.

 ✵Lying on the side with the knees drawn up:a posture often taken by a patient with deficiency-cold.

 ✵Wriggling of the extremities:a type of involuntary movement of the extremities, usually indicating stirring of internal wind due to Yin deficiency.

 ✵Trembling of the extremities:a type of involuntary movement of the extremities, often due to blood deficiency involving the tendons or chronic alcoholism, but sometimes being a premonitory sign of convulsion.

 ✵Nape rigidity:stiffness or inflexibility of the back of the neck.

 ✵Opishotonus:a form of spasm consisting of extreme hyperextension of the body, with the head and the heels bent backward and the body bowed forward.

 ✵Systremma:a cramp in the muscles of the calf of the leg.

 ✵Contracture:a condition of high resistance to the passive stretch of a muscle.

 ✵Contraction:shortening of a muscle or muscles with increased tonicity.

 ✵Spasm:a sudden, violent, involuntary contraction of a muscle or group of muscles.

 ✵Twitching of the muscle:a condition of short spastic muscular contractions.

 ✵Twitching of the body:sudden rapid involuntary movement of the body.

 ✵Tonic convulsion:convulsion accompanied by regidity of the neck and even opishotonos, occuring in cases of febrile disease.

 ✵Wry mouth:deviation of the angle of the mouth to one side.

 ✵Deviation of eye and mouth:a sign indicating attack of wind-phlegm to the meridian.

Introduction of Inspection:Inspection of the eyes

 Inspection Icon 03 Introduction about the Inspection of the eyes: the inspection of the eyes is the inspection including observation of the luster, color, appearance, and motility of the eyes, not only for diagnosing eye diseases but also for determining the condition of the Zang-fu viscera. Also known as an examination of the eyes.

 ✵Mild edema of the eyelids:an early sign of edematous disease.

 ✵Puffiness under the eyes:sign of edema due to spleen insufficiency.

 ✵Edema of eyelids:sign of edema due to spleen insufficiency, as the eyelids pertain to the spleen.

 ✵Edema under the eyes:a synonym for puffiness under the eyes.

 ✵Edema of the eye sockets:a synony for edema of the eyelids.

 ✵Luterless eyes:eyes without luster and sluggish in motion, often seen in a seriously ill person.

 ✵Spiritless eyes:eyes without spirit, dull, clouded and inflexible in motion, often seen in a critically ill person.

 ✵Dryness of the eyes:a condition of the eyes that lack secretion and tears, indicating consumption of body fluids in cases of febrile disease.

 ✵Strabismus:also known as squint, deviation of the eye which the patient cannot overcome.

 ✵Sunken eyes:a sign indicating consumption of body fluids or deficiency of Qi and blood.

 ✵Protrusion of the eyeballs:a sign indicating obstruction of the lung by phlegm-turbidity if there is accompanying dyspnea, and indicating accumulation of phlegm and Qi if there is accompanying goiter.

 ✵Staring straight ahead:a sign that indicates that the patient is critically ill, particularly when there is loss of consciousness as well.

 ✵Staring sideways:a sign often occurring in the stirring-up of liver wind.

 ✵Supraduction:upward rotation of the eyes around the horizontal axis.

 ✵Blepharoptosis:dropping of one or both upper eyelids.

 ✵Lethargic sleeping with the eyes open:a sign indicating failure of the spleen and stomach in children with consumption of body fluids due to severe vomiting and diarrhea.

 ✵Inspection of the white of the eyes:observing the change in color of the white of the eye,e.g.,redness in lung fire or external contraction or wind-heat, yellowness in jaundice.

 ✵Yellow discoloration of the white of the eye:a major sign of jaundice.

 ✵Graphs for 5 circle of eyes:

Introduction of Inspection:Inspection of the ear

 Inspection Icon 04 Introduction about the Inspection of the ear: the inspection of the ear is a diagnostic method to detect not only local pathological changes but also the general condition, particularly the condition of the kidney and gallbladder.

 ✵Pale helix:frequently seen in cases of deficiency of Qi and blood.

 ✵Red swollen helix:seen in cases of damp-heat of the liver and gallbladder or attack of heat toxin.

 ✵Bluish dark helix:seen in cases of excessive interior cold or severe pain.

 ✵Withering of the helix:a sign of extreme consumption of kidney Yin.

 ✵Atrophy of the helix:a sign indicating exhaustion of kidney Qi in a critical case.

 ✵Scaly dry helix:a sign of blood stasis.

Introduction of Inspection:Inspection of the nose

 Inspection Icon 01 Introduction about the Inspection of the nose: the inspection of the nose is a diagnostic method to detect pathological changes in the lung, spleen, stomach, and other viscera by inspecting the color, form, structure, and discharge of the nose.

 ✵Flaring nares:a sign indicating dyspnea.

 ✵Thin nasal discharge:a symptom that usually occurs in cases of wind-cold.

 ✵Turbid nasal discharge:a symptom that usually occurs in cases of wind-heat.

 ✵Chronic turbid nasal discharge:a symptom that frequently appears in cases of nasal sinusitis.

 ✵Indications of the color of the nose:blue, yellow, white, red and grey indicate abdominal pain, damp-heat in the interior, loss of blood, heat in the spleen and lung, and retention of fluid, respectively.

 ✵Nosebleed:bleeding from the nose.

 ✵Epistaxis:bleeding from the nose, same as nosebleed.

Introduction of Inspection:Inspection of the tongue

 Inspection Icon 01 Introduction about the Inspection of the tongue: the inspection of the tongue is one of the most important contents of examinations for diagnosis, in which the tongue proper and its coating are carefully observed.

 ✵Tongue diagnosis:diagnosis made according to information obtained by inspection of the tongue.

 ✵Partition of the tongue:the tongue is usually divided into the following parts,i.e., the tip, middle, root and borders, revealing pathologic changes of the heart and lung, the spleen and stomach, the kidney, and the liver and gallbladder, respectively.

 ✵Tip of the tongue:often reflecting the condition of the heart and lung.

 ✵Borders of the tongue:often reflecting the condition of the liver and gall-bladder.

 ✵Middle part of the tongue:often reflecting the condition of the spleen and stomach.

 ✵Root of the tongue:often reflecting the condition of the kidney.Also known as base of the tongue.

 ✵Tongue proper:also known as tongue body, the muscular and vascular structures of the tongue.

 ✵Sublingual vein:the vein under the tongue on either side of the frenulum.

 ✵Tongue color:color of the tongue body, which reflects the condition of Qi and blood and functional state of the Zang-fu viscera.

 ✵Pale-red tongue:tongue of normal color.

 ✵Pale tongue:seen in cases of Qi and blood deficiency or yang deficiency.

 ✵Red tongue:tongue redder than normal, indicating presence of heat.

 ✵Deep-red tongue:a sign of intense heat, also known as deep-redness of the tongue.

 ✵Purple tongue:a sign indicating impaired circulation of Qi and blood.

 ✵Blue tongue:a sign indicating congealing cold with blood stasis.

 ✵Cyanosis of the tongue:bluish purple discoloration of the tongue due to blood stasis, penetration of toxic heat into nutrient-blood, or Qi stagnation with sluggish blood flow.

 ✵Tongue with purple spots:a sign of blood stasis.

 ✵Tongue with ecchymosis:a sign of blood stasis.

 ✵Thin tongue:a tongue which is thinner than normal, usually due to deficiency of Qi and blood if the tongue is thin and pale, and due to yin deficiency if it is thin and red.

 ✵Enlarged tongue:a tongue larger than normal due to accumulation of fluid, often seen in deficiency of Qi or yang.

 ✵Plump tongue:a synonym for enlarged tongue.

 ✵Plump tongue body:a synonym for enlarged tongue.

 ✵Swollen tongue:a reddened tongue distended and larger than normal, often caused by exuberant fire of the heart and spleen or externally contracted damp-heat, but sometimes by congenital vascular anomaly.

 ✵Tooth-marked tongue:a tongue with dental identation on its edges, seen in cases of retention of water-damp when the tongue is enlarged as well.Also known as tongue with tooth-marks.

 ✵Speckled tongue:a tongue with red spots formed by swollen fungiform papillae, indicating the presence of exuberant heat.

 ✵Prickles on the tongue:thorn-like protruding swollen fungiform papillae formed on the surface of the tongue.

 ✵Prickled tongue:a tongue with thorn-like protrusion on its surface, indicating the presence of exuberant heat.

 ✵Cracked tongue:a tongue with cracks on its surface, often indicating consumtion of fluids or yin.

 ✵Fissured tongue:appearance of fissures on the surface of the tongue,cf. cracked tongue.

 ✵Swelling of the tongue:abnormal enlargement of the tongue,usually reddened in color,cf.swollen tongue.

 ✵Double tongue:hypertrophy of the bilateral sublingual glands resembling a smaller tongue lying under the original one.

 ✵Stiff tongue:a tongue difficult to move freely, seen in cases of high fever with impairment of consciousness or loss of fluid, and also in cases of apoplexy, also known as stiffness of the tongue.

 ✵Sluggish tongue:a curling tongue, sluggish in motion with difficulty in speaking.

 ✵Trembling tongue:a sign of wind caused by deficiency of Qi and blood, stirred up by extreme heat, or transformed from liver yang, also known as tremor of the tongue.

 ✵Tremor of the tongue:a synonym for trembling tongue.

 ✵Flaccid tongue:a tongue that is flabby and cannot move easily, seen in impairment of yin, or deficiency of Qi and blood.

 ✵Flaccidity of the tongue:a synonym for flaccid tongue.

 ✵Deviated tongue:a tongue that deviates to one side when extended, indicating the presence of liver wind with phlegm or obstruction of the meridian by phlegm and stagnant blood.

 ✵Deviation of the tongue:a synonym for deviated tongue.

 ✵Shortened tongue:a tongue that cannot be fully extended from the mouth and appears to be contracted, usually seen in critically ill patients.

 ✵Curled tongue and retracted testicles:a sign that may occur in a critical case of febrile disease or apoplexy.

 ✵Wooden tongue:a swollen, hard tongue resembling a piece of wood, seen in infantile glossitis.

 ✵Protruding tongue:tongue that extends out of the mouth, with licking of the lips.

 ✵Moving tongue:one which moves from one side to the other when extended, or moves without stopping.

 ✵Protruding and moving tongue:a sign seen in children with defective development of the brain, also in febrile diseases with stirring-up of wind.

 ✵Tongue coating:a layer of moss-like material covering the tongue, inspection of which can provide information about the nature, depth and location of the pathogenic factor, the strength and integrity of normal Qi, and the degree of fluid consumption.

 ✵Tongue coating color:the color of the tongue coating, which reflects not only the heat or cold nature of the condition, but also the interior or exterior characteristics and the degree of penetration of the disease.

 ✵White coating:a sign indicating presence of cold, but thin white coating often seen in normal persons.

 ✵Yellow coating:a sign indicating presence of heat.

 ✵Thin white coating:a form of tongue coating often seen in normal persons or in the early stage of an exterior syndrome.

 ✵Thin yellow coating:a form of tongue coating often seen in cases of exterior heat syndrome or early stage of interior heat.

 ✵White geasy coating:a form of tongue coating indicating damp-phlegm or retained food.

 ✵Yellow geasy coating:a form of tongue coating indicating accumulation of damp-heat, phlegm-heat or retained food with heat.

 ✵Black coating:a tongue coating indicating either excessive cold(if the coating is moistened and the tongue body pale), or extreme heat(if the coating is dry and the tongue body reddened).

 ✵Gray coating:a tongue coating with similar clinical significance to black coating.

 ✵Stained coating:often caused by food or medicine.

 ✵Thickness of the tongue coating:a thin coating usually indicates absence of severe illness or only the exterior portion of the body being attacked by pathogenic factors, while a thick coating suggests inward penetration of pathogenic factors or presence of retained food or phlegm.

 ✵Moisture of the tongue coating:a moist coating indicates that the body fluid is not impaired, while a dry coating is a sign of impairment of body fluid.

 ✵Curdy coating:a coating consisting of coarse granules like bean dregs, capable of being wiped off, reflecting retention of food in the stomach.

 ✵Greasy coating:a dense, sticky, slimy tongue coating, thick in the center, thin on the sides, and hard to wipe off, indicating presence of phlegm-damp or stagnancy of food.

 ✵Slippery coating:a moist tongue coating with excessive fluid and an oily appearance, indicating presence of dampness.

 ✵Dry coating:a sign generally indicative of damage to the body fluids.

 ✵Rough coating:a tongue coating that is so dry that it looks rough, indicating severe damage to the body fluids.

 ✵White sandy coating:white, thick and dry tongue coating as rough as sand, indicating rapid transformation of heat into dryness with severe impairment of body fluids before the coating turns yellow.

 ✵Peeled coating:a tongue with its coating peeled off.

 ✵Peeling of tongue coating:complete or partial peeling of the tongue coating, usually due to impairment of stomach Qi, consumption of stomach Yin, deficiency of Qi and blood, or general debility.

 ✵Sudden peeling of coating:a tongue with its coating suddenly peeled, usually indicative of exhaustion of stomach yin and severe damage to stomach Qi.

 ✵Mirror-like tongue:a completely peeled tongue resembling a mirror, indicating collapse of stomach Qi or exhaustion of stomach yin.

 ✵Rooted coating:tongue coating with root, closely attached to the tongue surface.

 ✵Rootless coating:tongue coating without root,which can be easily wiped or scraped off.

 ✵Cracked lips:a sign of impairment of body fluids by dryness-heat or yin deficiency.

 ✵Dripping from the corner of the mouth:excessive flow of saliva from the corner of the mouth, often due to spleen dampness or stomach heat in children, or appearing in stroke patients with a wry mouth.

 ✵Erosion of lips:a sign of upward steaming of accumulated heat in the spleen and stomach.

 ✵Opened mouth:one that is puckered open, like the mouth of a fish, indicating failure of the spleen.

 ✵Lockjaw:inability to open the mouth, mainly caused by liver wind, seen in cases of convulsive diseases and tenaus.

 ✵Tightening of the lips:a sign of infantile convulsion.

 ✵Trembling of the lips:a sign of violent struggle between normal and pathogenic Qi.

 ✵Moving mouth:one that opens and closes frequently and involuntarily, signifying weakness of stomach Qi.

 ✵Purple lips:a sign of blood stasis in patients with decline of heart yang and severe dyspnea.

Introduction of Inspection:Inspection of the teeth

 Inspection Icon 01 Introduction about the Inspection of the teeth: the inspection of the teeth including the gums, not only for diagnosing local illness, but also for detecting diseases of the internal viscera, particularly disorders of the kidney and stomach, and impairment of body fluids.

 ✵Dryness of the teeth:a sign of excessive fire in the lung and stomach with severe consumption of fluid in acute cases, or serious impairment of kidney yin in chronic cases.

 ✵Withering of the teeth:a sign of exhaustion of kidney yin, seen in febrile diseases at the late stage.

 ✵Scorching of the teeth:a sign of severe loss of fluid in critical cases.

 ✵Bleeding from the gums:

 ✵Looseness of teeth:often suggesting kidney insufficiency.

 ✵Painful swelling of the gums:often indicating excessive heat in the stomach.

Introduction of Inspection:Inspection of sputum

 Inspection Icon 01 Introduction about the Inspection of sputum: the inspection of sputum is the examination of the color, quality and quantity of the sputum to detect conditions of the viscera and features of pathogenic factors.

 ✵Thin sputum:phlegm of cold nature.

 ✵Frothy sputum:indicating presence of cold.

 ✵Profuse sputum:usually indicating dampness, also known as abundant expectoration.

 ✵Yellow sputum:phlegm of heat nature.

 ✵Hemoptysis:expectoration of blood or blood-stained sputum.

 ✵Coughing of blood:bringing-up of blood or bloody sputum when coughing.

 ✵Bloody sputum:sputum containing blood.

 ✵Blood-streaked sputum:sputum containing streaks of blood.

Introduction of Inspection:Inspection of finger venules

 Inspection Icon 01 Introduction about the Inspection of finger venules: the inspection of finger venules, is a diagnostic method for children under 3, in which the extension and color of the superficial venules on the palmar side of the index finger are examined and taken as reference for diagnosis,e.g., red venules with yellowish tint, faintly visible, not extending beyond the proximal segment of the finger indicating health, deep red venules suggesting presence of heat, dark venules signifying blood stasis, purple and blue venules often occurring in cases of convulsion and pain.

 ✵Three passes:a collective term for the three segments of the index finger used for measuring the extension of the visible venules, i.e., "wind pass"(the proximal segment),"Qi pass"(the middle segment) and "life pass"(the distal segment).Venules only visible at the wind pass usually indicate a mild disease. The farther the venules extend, the more serious is the case.

 ✵Wind pass:the proximal segment of the index finger.

 ✵Qi pass:the middle segment of the index finger.

 ✵Life pass:the distal segment of the index finger.

 ✵Extension(of visible venules) through the passes toward the nail:often indicating that a child is critically ill, also known as shooting through the passes to the nail.

Introduction of Inspection:Inspection of the skin

 Inspection Icon 01 Introduction about the Inspection of the skin: inspection of the skin is an examination not only for skin diseases, but also for the condition of Qi, blood and viscera.

 ✵Swelling:an abnormal protuberance or distension of a body part or area.

 ✵Edema:an abnormal excess accumulation of fluid under the skin, often showing prolonged existence of the pits produced by pressure.

 ✵Edema of the lower extremities:a sign indicating yin edema.

 ✵Instep edema:edema of the upper surface of the foot in front of the ankle joint.

 ✵Yellow discoloration:a condition in which the skin and the whites of the eyes become abnormally yellow, usually referring to jaundice.

 ✵Yellow puffiness:yellow tinge of the skin with puffy face and ankle edema.

 ✵Macula:a deep red or dark purple spot on the skin that is not elevated above the surface and does not fade under pressure.

 ✵Yang macula:macula red-purple in color, accompanied by fever and other manifestations of excess heat, often occurring in cases of epidemic febrile diseases.

 ✵Yin macula:macula dark purple in color, accompanied by pallor, cold limbs and other manifestations of deficiency cold, often due to spleen insufficiency or decline of yang.

 ✵Papula:a small circumscribed, superficial, solid elevation of the skin, which fades upon pressure.

 ✵Maculo-papula:a collective term for skin eruptions in a generalized disease.

 ✵Vesicle:a small circumscribed epidermal elevation containing fluid.

 ✵Miliaria alba:skin eruption of fine white crystalline vesicles appearing on the neck and chest, and sometimes on the limbs, in the course of acute febrile diseases.

 ✵Sudamina crystallina:fine white crystalline vesicles appearing on the skin surface due to retention of sweat.

 ✵Squamous skin:dried, roughened, and scaling skin, indicating blood stasis.

  • 1.Introduction of the Inspection method of TCM Diagnostics.

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