Diagnosing by Visual Inspection In Traditional Chinese Medicine

Chinese traditional doctors learn by feeling the pulse, observing the person’s facial complexion and looking at the tongue, which all lead to the diagnosis of the root cause of illnesses. (Image: via  pixabay /  CC0 1.0)
Chinese traditional doctors learn by feeling the pulse, observing the person’s facial complexion and looking at the tongue, which all lead to the diagnosis of the root cause of illnesses. (Image: via pixabay / CC0 1.0)

Chinese doctors who practiced traditional Chinese medicine had once mastered the method of health diagnosis by visual inspection; some still have the knowledge. Recently, I went to the local pharmacy in Taiwan to buy a prescription drug. I noticed that one of the medical attendants was examining the two small fingers of a female patient. After a while he asked the patient:

My curiosity made me ask the doctor: “How were you able to come to that conclusion?” He merely gave me a glance and did not answer my question. Instead, he went on to talk about how bad the practices of many doctors are who perform surgery without adequate caution.

The above was an interesting example of diagnosis by visual inspection. Traditional Chinese medicine uses four methods of diagnosis:

  1. Inspection and observation
  2. Listening
  3. Asking questions
  4. Pulse analysis

Records of ancient scriptures state:

“Knowing from inspection is supreme”

“Knowing by listening is sublime”

“Knowing from the pulse is artful”

“Knowing from enquiring is skillful”

These four methods are the tools a traditional practitioner of medicine had to master.

In ancient times, when an accomplished doctor went out to treat patients, he was always accompanied by an apprentice, back then called a disciple, who assisted him and also carried the medicine box.

The disciple would help the master gather medicinal herbs in the mountains and assist in the preparation and brewing of the herbs. This way, the apprentice gained practical knowledge and received training throughout the procedure of treating patients.

Nowadays, however, the teaching of traditional Chinese medicine (TCM) is different. There are colleges and medical schools that focus on theory and passing standardized exams. This has resulted in the loss of important traditional hands-on skills.

As a physician and practitioner of traditional Chinese medicine, I also use the skill of diagnosis by inspection. For example, a teenage girl came to my clinic for treatment. I inspected her nails first and asked her: “Is it right that you suffer from menstrual cramps?”

She was surprised and asked: “How did you know?” Her mother then told me that her menstrual pain was so serious that her friends had to take her home from school when it happened.

Traditional Chinese medicine considers the fingernails and hair to be closely connected to the blood, calling them “the remnants of blood.” When the condition of blood changes due to illness, it shows changes in the nails. Some of the girl’s nails showed a pattern, which repeated every month, and therefore my diagnosis was that this was due to her menstrual pain.

I might ask a patient whether he fell sick three months ago. Some patients would be able to recall after thinking it over, while some young people would not remember. When I pop a question like whether they broke up with someone, they look startled and ask me how I could possibly know.

These things are not advanced science, but if nobody has taught you, you won’t be able to find it in standard course books. Chinese traditional doctors learn by feeling the pulse, observing the person’s facial complexion and looking at the tongue, which all lead to the diagnosis of the root cause of illnesses.

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