In Traditional Chinese Medicine (TCM), the Four to Six Diagnostic Methods are fundamental techniques traditionally used to understand patterns of balance and well-being. These methods are:
Observe
This process involves the visual assessment of characteristics such as complexion, posture, body structure, skin, eyes, tongue, and other external features.
Tongue Observation is a significant component of this methodology: the color, shape, coating, and moisture of the tongue are evaluated to gain insight into internal balance according to traditional principles.
Similarly, the observation of an individual’s demeanor, movement patterns, and breathing rhythm may provide indications regarding the concepts of Qi, Blood, and the harmony of organ systems within the traditional theoretical framework.
Listening & smelling
Within the traditional framework, attention is paid to auditory characteristics such as voice quality, breathing patterns, and other bodily sounds, as these may reflect patterns of energetic balance or variation. In traditional theory, a weak voice is often associated with a deficiency of Qi, while a loud or coarse voice may indicate a so-called excess pattern.
Olfactory characteristics also play a role: body scent and breath are considered during the assessment. A strong, pervasive scent is often linked in traditional interpretation to Heat patterns, whereas a heavy or stale scent may be associated with internal variations within the organ systems.
Asking questions
Within TCM, information is gathered by asking about a person’s daily experiences, lifestyle, emotions and general well-being. A traditional framework that is often used is the “Ten Questions”, which covers 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 tests
Within the traditional framework, information regarding specific physical characteristics is gathered through tactile methods. This includes:
Pulse Observation: Assessment of the radial pulse at both wrists, noting qualities such as rate, rhythm, depth, and strength. Traditional texts describe approximately 28 pulse patterns, including characteristics described as floating, sinking, slow, rapid, strong, or weak.
Abdominal Palpation: Observation of characteristics such as temperature variations or firmness in the abdominal region.
Acupoint Sensitivity: Gentle palpation of specific points or meridian pathways to observe reactions such as localized warmth, coolness, or sensitivity.