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.
Physical testing
In TCM, information about the body is also gathered through touch. During pulse observation, the radial pulse is felt on both wrists, noting characteristics such as tempo, rhythm, depth, and strength. TCM texts describe 28 distinct pulse types, such as floating, sinking, slow, fast, strong, or weak. Abdominal palpation involves observing characteristics such as temperature and firmness in the abdominal area. The sensitivity of acupoints is also assessed: by gently pressing acupuncture points or meridians, reactions such as warmth, coolness, or sensitivity can be observed.
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.
Asking 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.