TCM Diagnosis by Listening (and Smelling) - One of the 4 Pillars
1. Listening
The Sound of the Voice
- A loud and course voice indicated an Excess pattern
- A weak and low voice indicates a Deficient pattern
- A lack of desire to speak indicates a Deficient Cold pattern
- Incessant talking indicates a Heat pattern
Hoarse Voice or Loss of Voice
- Acute onset of a hoarse voice is usually indicative of Exterior Pathogenic Wind, especially if the throat is red and sore.
- A chronic or recurrent hoarse voice usually indicates an interior disease such as Deficient Lung Qi or Lung Yin
- A gradual loss of voice also usually indicates Deficient Lung Qi or Yin
- This is usually accompanied by impaired mental function and indicates Heat is disturbing the Shen (Spirit/Mind)
5 Element Associations in the Voice
- Shouting is a Liver imbalance
- Constant Laughing is a Heart imbalance
- Chronic weeping, whimpering, sadness is an Spleen imbalance
- Groaning is a Kidney imbalance
Cough
Coughing is usually related to Lung's ability to properly disperse and descend Lung Qi, leading to rebellious Lung Qi
- Wheezing or rattling from the Lung is usually mucus or Phlegm in the Lung
- Explosive or very loud coughing indicates an excess pattern
- A weak cough indicates a Deficient pattern
- A dry hacking cough is usually indicative of Heat and Dryness in the Lung
- An unproductive cough with small amounts of sticky sputum indicates Heat scorching the fluids
Breathing
- Loud and coarse breathing indicates an Excess pattern
- Shortness of breath, weak and/or difficult breathing may indicate the Kidney is too weak to grasp the Qi. This would include a Deficient type asthma.
- Loud and coarse breathing with a preference for exhaling indicates pathogens retained in the Lung. This would include Excess type asthma.
Frequent Sighing
- Usually related to Liver Qi Stagnation
Hiccups
- Usually related to Rebellious Stomach Qi
BorBorygmus
- Usually related to Deficient Spleen Qi or Deficient Spleen Yang, especially if there is loose stools and bloating.
- This can also be due to Liver Qi Stagnation invading the Intestines
2. Smelling
In general, secretions and excretions related to Excess Heat type patterns have a foul odor. Less odorous secretions and excretions usually relate to Cold and Deficiency type patterns.
Odors
- Urgent diarrhea with foul stools indicates Damp-Heat in the Large Intestine.
- Belching with a foul or sour odor indicates retention of food.
- Leucorrhoea with a strong or foul odor indicates Damp-Heat in the Lower Jiao affecting the Uterus.
- Chronic Halitosis (Bad breath) indicates Stomach Heat
5 Element Associations of Smell
- Rancid "goatish" odors are related to the Liver
- Scorched or burned odors are related to the Heart
- Fragrant, sweet, or cloying odors are related to the Spleen
- Rank or Rotten odors are related to the Lung
- Putrid odors are related to the Kidney
