🌿 Folk Prescriptions

In long-term medical practice, TCM has developed four diagnostic methods: observation, auscultation, inquiry, and palpation. Observation means doctors use vision to examine changes in the patient’s overall or local appearance, spirit, color, shape, and features. Auscultation means doctors use hearing and olfaction to discern changes in the patient’s voice and odors. Inquiry means doctors obtain information about disease onset, progression, current symptoms, and other relevant details by asking the patient and family members. Palpation includes pulse-taking and physical examination—touching the patient’s pulse and skin, abdomen, limbs, and other areas to diagnose disease.
TCM believes that qi and blood circulation, sensory perception, and transmission can convey pathogens. The pathway reflecting disease is the meridians. Meridians connect zang-fu organs and limbs, linking the body into a unified whole like a telephone network. Thus, local changes can affect the entire body, and internal organ diseases can manifest externally—“what exists internally will inevitably appear externally.” Conversely, by observing external signs, internal organ changes can be inferred—forming the foundation and basis for TCM disease diagnosis.
Observation
Simply put, observation includes general observation and tongue diagnosis. General observation includes observing spirit, complexion, body shape, and features. Tongue diagnosis includes observing tongue body and coating. The first step in observation is assessing spirit. Spirit reflects the vitality of life. If consciousness is clear, speech fluent, eyes bright, and reactions sharp, it is called “having spirit”—indicating health or mild illness. If spirits are dull, expression indifferent, eyes dim, and responses sluggish, even unconsciousness, it is called “lacking spirit”—indicating serious illness. Assessing spirit allows estimation of the patient’s condition and prognosis, giving the doctor confidence.
Assessing complexion mainly involves observing facial color and luster. Different colors reflect the abundance or deficiency of qi and blood and disease progression. Normal Chinese complexion is slightly yellow, ruddy, and lustrous. Abnormal colors are called “pathological colors.” Common ones include: white—indicating deficiency, cold, or blood loss; yellow—indicating deficiency or dampness; blue-green—indicating cold, blood stasis, pain, or pediatric convulsions; red—indicating heat; black—indicating kidney deficiency.
Observing body shape and movement: for example, a plump body with poor appetite indicates spleen deficiency with phlegm. A thin body with frequent hunger indicates stomach fire. Lying still and preferring quietness suggests cold syndrome. Restlessness and agitation suggest heat syndrome. Mouth-opening and shoulder-lifting with shortness of breath unable to lie flat indicate asthma. Neck stiffness and arching backward indicate spasm. In chronic illness, wandering hands touching the bed and picking at threads indicate critical condition.
TCM experience holds that the five zang organs open to the five orifices, and the orifices correspond internally to the five zang organs. Observing the orifices can reveal internal organ diseases. For example, red and swollen eyes often indicate liver fire or wind-heat; upward rolling eyes, staring, or squinting indicate internal liver wind; dry, shriveled earlobes indicate kidney essence depletion; flaring nostrils indicate heat in the lungs; swollen gums with bleeding indicate excessive stomach heat.
Tongue diagnosis is a unique diagnostic method developed through long TCM practice. It mainly observes the tongue body and coating. The tongue body refers to the muscular part of the tongue; the coating is the film-like substance on the tongue surface. The tongue body reflects the condition of the five zang organs—deficiency or excess. The coating indicates the depth of external pathogens invading the body. A normal tongue is pale red with thin white coating. Pale tongue indicates deficiency or cold; red tongue indicates heat; purple tongue indicates blood stasis. White coating indicates exterior or cold syndrome; yellow coating indicates interior or heat syndrome. Thick, yellow, greasy coating indicates damp-heat or phlegm-heat. Thin coating indicates mild disease; thick coating indicates severe disease. Thickening of the coating indicates disease progression; thinning indicates improvement. Clinically, tongue body and coating changes are usually combined for comprehensive judgment. TCM experience generally holds that acute diseases emphasize the tongue, while chronic diseases emphasize the pulse—because the tongue image more accurately and promptly reflects the body’s physiological and pathological status. Masterful use of observation enables fast and accurate diagnosis. Thus, TCM says, “To know by observation is divine.”