Other Observations

Chills and Fever

When they appear together, chills and fever indicate exterior conditions.
If chills are stronger, it is a Wind-Cold disease
If fever is stronger, it is a Wind-Hot disease
Fever without chills indicates the disease has moved inwards
When the heat enters the stomach and intestines, there is continual fever that is worse in the evenings
If a fever gets worse during the night, the situation is grave.

A patient with a sever yin deficiency develops a low grade fever every day, or a feeling of heat in the soles and palms in the afternoons and evenings, which subsides after a heavy sweat.

Irregular periods of low fever with lassitude indicated deficient Qi.
Chills and coldness in the limbs are symptoms of deficient Yang of the Kidneys

If the back of the hand is hotter than the palm it is excessive  yang
If the palm is hotter than the back of the hand, it is deficient yin.

Perspiration

If an exterior disorder has no perspiration, then the excess is confined in the Protective Qi, which is expelling the excess.
If there is sweating but no lowering of the fever, this indicates the protective Qi is too weak to expel the excess.
If there is excess sweating during the day, or spontaneous sweating, it indicates Deficient Qi.
If there is heavy sweating at night signifies Yin excess.
Continuous sweating through the day producing cold, clammy skin is a bad prognostic sign.

Head, Sense organs and other Parts of the Body

Acute headaches are usually Exterior Excess
Chronic headaches are due to Internal factors.
Violent headaches are Excess.
Dull headaches are Deficient
Headaches increased by exposure to cold are from Wind Cold
Headaches increased by hot conditions are from hyperactive Liver Yang
If the head feels like it is in a vice, the cause is Dampness (pressure)
Frontal headaches are associated with yang Brightness (St and Li)
Headaches behind the hairline are associated with Greater Yang (Si and Bl)
Headaches at the top of the head are from Liver dysfunction.
Headaches with eye dysfunctions (auras) are from Liver dysfunction.

Three Kinds of Vertigo

Hyperactive Liver Yang, feels as though one is walking on an unsteady ship.
Wind and Phlegm causes all objects to be spinning around.
Insufficient Qi and Blood causes dizziness, blurring of the vision and ringing in the ears.

Pain/Uncomfortable

Pain can indicate either a local disorder or an channel disorder.
Pain that moves around is due to Wind or Stagnant Qi.
Pain that remains in one place is from Cold, dampness or congealed blood
Pain that feels better with pressure is Deficient
Pain that feels worse with pressure is Excess.
Dampness makes the body feel heavy, swollen and lethargic
Insufficient Blood and Qi causes soreness in the muscles and tendons.

Urine/Stools

Excess urine at night is Deficient Kidney Yang, which if severe, can lead to incotinence.
Sparse urine can be caused by heat drying up the fluids, or by Bladder Qi too weak to pass the urine.
Deficient Kidney can result in dribbling urine.

When heat penetrates the body and enters the Stomach and Intestines, the abdomen feels distended and painful, constipation results.
In deficient Yin where there is an absence of fluids, constipation occurs without feeling distension.


Massive and sudden diarrhea is an Excess condition.
Chronic diarrhea is deficient spleen
Frequent diarrhea with small stools each time and immediate feeling to evacuate again as in dysentery (tenesmus) is caused by damp heat in the small intestine.
Diarrhea with pain in the abdomen that diminishes after diarrhea is congestion of food.  This arises from a Spleen/Stomach disorder that affects the functions of transformation and transportation of food.
Diarrhea with pain that does not diminish with evacuation with emotional stress is usually an imbalance between the spleen and the liver.
Diarrhea every morning at dawn is caused by deficient spleen and kidney qi.  


Diet and Appetite


Not thirsty or desiring warm drinks indicates cold.
Thirsty or desire of cold drinks indicates heat.
Absence of thirst, or only slight thirst, or spitting out immediately after drinking indicates Dampness.  This indicates weak digestion as well.

A good appetite indicates that a disease is not serious.
Lack of appetite with a distended feeling after meals is either weak spleen or damp heat in the sanjiao.
Heat in the stomach can cause one to overeat and be constantly hungry.

Certain tastes in the mouth indicate conditions of the five phases

• Bitterness - heat
• Sweetness or blandness - dampness or weak spleen
• Lack of taste - congestion of food
• Sour - dysfunction of the liver

Chest and Abdomen

Generally the same as in the head.

Compression in the chest with shortness of breath is deficient Qi.

Swollen and painful chest and sides indicates dysfunction of the liver or gall bladder.

Distension in the abdomen relieved by belching or passing gas is from stagnation of either Qi or food.

Eyes and Ears

Eyes and liver generally go together.  

Red inflammed eyes are caused by hyperactive liver yang

Loss of vision with dry, dull eyes are deficient liver and kidney yin

Ears and kidney generally go together

Progressive loss of hearing or tinnitus is usually a weakness in the kidneys.

The lesser Yang paths of Gb and Sj travel around the ear.  Hot external disease often enter the body from these areas and cause loss of hearing.

Sleep

Insufficient Heart Blood can cause insufficient sleep, heavy dreaming and palpitations of the heart.

Deficient Heart Yin makes one irritable and difficult to fall asleep

Excessive sleep can be heat in the pericardium, phlegm obstructing the opening of the energy pathways to the heart, or general deficient yang.

Medical History

The history should be noted carefully, as this puts everything into perspective, and will often reveal a weakness in a given organ or yin or yang.  General lifestyle anomalies can be brought to light (diet habits, bowel habits etc) and suggestions can be made to help the general health of the patient.

Palpation

Pressing and touching areas to determine if they are painful, inflamed, swollen, hot or cold can help determine the nature of the disorder.

Swellings that are hot and painful are yang Heat.

Cold to the touch is dampness or yin.

Hard nodules are congealed blood

Nodules with elasticity and ill-defined borders are stagnant qi. 

 

Palpation at the acupuncture points of the mu-shu points can also determine which organs are in distress.  Palpation of these acupuncture points in an area can reveal a "collapsed" feeling, or tender to the touch.

The last form of palpation is pulse diagnosis, which needs it's own entry here.