Four-Six Diagnosis System
Observe, listen, ask questions, and feel: one complete TCM diagnostic system.
Looking beyond complaints
Four to six diagnostic systems in TCM form the basis for how a TCM therapist assesses your health. It focuses not only on the symptoms, but on the overall pattern of balance and imbalance. Through systematic observation, listening, questioning, and feeling, a complete picture of Qi, blood, and the organ systems is created.
Observe
This involves visually examining, among other things, facial color, posture, physique, skin, eyes, tongue, and other external characteristics.
Tongue observation is an important part of this method: the color, shape, coating, and moisture of the tongue are assessed in order to gain insight into the internal balance according to TCM principles.
Observing a person’s state of mind, movement, and breathing can also provide clues about Qi, blood, and the harmony of organ systems within TCM theory.
Listening & smelling
In TCM, attention is paid to the sound of a person’s voice, breathing, coughing, and other bodily sounds, as these patterns can reflect balance or imbalance. A weak voice is often associated with Qi deficiency in TCM theory. A loud, hoarse voice may indicate a so-called excess pattern.
Smell also plays a role: body odor, breath, and secretions are taken into account in the assessment. A strong, pungent odor is often associated with heat in TCM interpretation. A heavy or foul odor can be associated with internal imbalance in the organ systems.
Ask questions
Within TCM, information is gathered by asking about a person’s daily experiences, lifestyle, emotions, and general well-being. The “Ten Questions” cover topics such as:
Feeling of warmth or cold
Sweating patterns
Head and body sensations
Urination and bowel movements
Appetite, thirst, and taste preferences
Feelings in the chest and abdomen
Hearing and vision
Sleep quality
Emotional well-being
Menstrual and reproductive health (in women)
Physical testing
In TCM, information about certain physical characteristics is gathered through touch. This includes:
Pulse observation: Feeling the radial pulse on both wrists, noting characteristics such as tempo, rhythm, depth, and strength. TCM texts describe 28 pulse types, such as floating, sinking, slow, fast, strong, or weak.
Abdominal palpation: Observing characteristics such as temperature or firmness in the abdominal area.
Sensitivity of acupoints: Gently pressing acupuncture points or meridians to observe reactions such as warmth, coolness, or sensitivity.