Tom* has been coming to our clinic off and on for four years. Every time he walks through the door, it’s obvious to me how he’s doing. On the days when he’s feeling good, his eyes are bright, his gait is smooth, and his voice is strong. On his bad days, he walks through the door stooped over, his voice is hoarse, his eyes are dull, and he looks tired.
Diagnosing a patient in Chinese medicine is a long and complicated process. A complete diagnosis has four key ingredients: observation, listening, smelling (really!), and asking. While practitioners can determine their treatment plans primarily by asking a patient about their symptoms and health history, observation can often be more valuable in determining how to proceed.
When Tom walks into the clinic, he is giving me a clue as to the nature of his energy or vitality. It’s clear when he’s feeling tired and in pain—I don’t even have to ask. On his good days, however, his vitality is apparent—his face lights up, he stands up a little straighter, and he cracks a few jokes about his upcoming treatment.
Frequently, color can tell a practitioner about what is going on. The color red is usually associated with some kind of heat, such as infection, inflamed arthritis, or the red cheeks of a woman with hot flashes. Conversely, white or pale skin color is an indicator of cold in your body, such as joint pain that’s aggravated by the cold. Dampness (the inability to metabolize moisture well), is indicated by the color yellow—think jaundice or an oozing sore; and purple shows up when there is some kind of stagnation. For example, a purple bruise is a kind of blood stagnation, and in the extreme, someone who has difficulty breathing or is having a heart attack will have purple lips or a purple complexion.
The general shape of your body and your posture are also telling me something about your health. If you are carrying around a lot of excess weight, you most likely have some dampness and frequently struggle with phlegm conditions like sinus problems or asthma. When a patient comes in who has weak or atrophied muscles, I will suspect that their digestion isn’t up to par. Also, people who are in great pain will sit in unnatural positions in order to be comfortable.
Your face, skin and nails give up all kinds of information, too. Dry, flaky skin and/or brittle nails, suggest depletion of your body’s moistening substances—Yin and/or Blood. Acne is usually associated with heat, and rashes can vary, depending on the color, moisture, and itchiness.
Every once in a while I’ll see an actor on TV or in a movie open their mouth wide enough to get a good look at their tongue—and know more than I want to about their health. In Chinese medicine, the appearance of your tongue (or anyone’s) can give up all kinds of information. The color, coat, and shape of your tongue are all indicators of the internal landscape of your body. For more on tongue diagnosis, go here.
*Names and identifying details have been changed.
