How does a Chinese medicine doctor diagnose? The four examination methods.

The Four Diagnostic Methods (四诊)

Traditional Chinese Medicine does not rely on laboratory tests and imaging, but rather on four traditional examination methods through which the physician gathers comprehensive information about the patient.

1. Observation (望诊) — Wang Zhen

What the physician observes:

• The face: color, luster, spots
• Paleness = qi/blood deficiency
• Redness = heat
• Yellowness = dampness/spleen
• Sallowness = cold/yang deficiency

• The tongue: the most important diagnostic tool!
• Body color: normal pink; red = heat; pale = cold
• Coating: white = cold; yellow = heat; thick = dampness
• Shape: swollen = dampness; thin = blood deficiency
• Edges: scalloped = dampness; red = liver heat

• The eyes: luster, whites, pupil
• Body shape: full/thin, walking posture

2. Listening (闻诊) — Wen Zhen

What the physician hears:

• Voice: strong = excess; weak = deficiency
• Breathing: rapid = heat; slow = cold; shallow = qi deficiency
• Cough: dry = dryness; wet = phlegm
• Body odor: sour = liver; sweet = spleen; scorched = heart; metallic = lung; putrid = kidney

3. Inquiry (问诊) — Wen Zhen

The ten traditional questions:

1. 1Heat and cold: Do you feel hot or cold?
2. 2Sweat: When and where? Night = yin deficiency; daytime = qi deficiency
3. 3Appetite and food: Good? Poor? Pain after eating?
4. 4Stool and urine: Color, frequency, form
5. 5Sleep: Ease of falling asleep? Waking at night? Dreams?
6. 6Pain: Location, type, time, factors that relieve/worsen
7. 7Menstruation (for women): Cycle, amount, color, pain
8. 8Emotions: Mood, tension, sadness, anger
9. 9Medical history: Previous illnesses, surgeries
10. 10Lifestyle: Work, exercise, diet

4. Palpation (切诊) — Qie Zhen

The wrist pulse (脉诊):

The TCM physician feels the pulse at three positions on the wrist (left and right), each position having two depths (superficial and deep).

• Left position: Heart (deep) / Small Intestine (superficial)
• Middle position: Liver (deep) / Gallbladder (superficial)
• Right position: Kidney (deep) / Bladder (superficial)

Main pulse types:

🏥 Important note: Chinese diagnosis is extremely precise — an experienced physician can identify the problem from the pulse and tongue alone. But this requires years of training.