1WARNING!Thisbookcontainsprovocativematerial not for children or the sexually immatureISBN 978-615-5169-35-9 Tongue, Face and Body Diagnosis2 3Solearnthesesimpletechniquesofdiagnosisbutdontbetoopresumptveanddontbetoo assumptve and learn to take it easy. If you are licensed to diagnose then you can use any tool or observaton to make your diagnosis withinyourscopeofpractce.Pleasestaywithinyourscopeofpractce.Ifyouarealicensed biofeedbacktherapistthenyoucanidentfy,detect,andrecognizestress.Youcanhelpyour patent deal with stress. The tools in this book can help you see areas where stress has afected your patent. So stck to your scope of practce and resist the urge to diagnose beyond it.Disclaimer for DiagnosisAs we study medicine we see we do not have to diagnosis or treat disease to treat or help people. DiagnosisisnotanExactScienceandtherearealwaysMultpleProblemsForUstoConsider. Correctngthehealthproblemsandstabilizingbiologyaremoreimportantthansymptom reducton. Diagnosishasbeenshowntobefarlessthanaccurate.Thereisalwaysafractalofcausesof disease involved with all patents. We do not need to diagnosis to treat or help people. We only need to diagnose to get insurance payment. As that medicine has become a proft industry based solely on the sale of SINthetc drugs. And to prescribe a drug Diagnosis is needed. Thisbookgivesyoumanymedicaltpsondiagnosisthatarenotessentalformedicinebutare insightul in helping your patents. So please study them and realize that diagnosis is not essental for treatng and helping patents. 4 56 78 9Table of ContentsDisclaimer for Diagnosis2Face Head Feet Body Diagnosis39Face - Organ Map39Phrenology43THE SIGNIFICANCE OF TRADITIONAL PULSE DIAGNOSIS IN THE MODERN PRACTICE OF CHINESE MEDICINE60INTRODUCTION60THE ORIGINAL PLACE OF PULSE DIAGNOSIS IN THE CHINESE TRADITION60THE PULSE CLASSIC62AIM AND METHOD OF PULSE DIAGNOSIS63PULSE CATEGORIES64TRADITIONAL PULSE TAKING METHODS72FACTORS TO CONSIDER BEFORE AND DURING PULSE EXAMINATION74PULSE AS AN AID TO OTHER DIAGNOSTICS76THE POTENTIAL ROLE OF PULSE DIAGNOSIS IN MODERN PRACTICE OF TCM78ALTERED USE OF PULSE DIAGNOSIS80ATTEMPTS TO MAKE PULSE DIAGNOSIS OBJECTIVE82RECENT INVESTIGATIONS OF PULSE82CONCLUSION83REFERENCES83Nail Diagnosis88VINDICATE90Polyarterits nodosa94Angiomas94Nail Diseases and Disorders 95OCD & HANDS102Nail clubbing108HPOA110Expectng a Baby? Expect Some Changes In Your Hair, Skin, and Nails110Ayurveda Diagnosis tps112Facial and Body Diagnosis in TCM Acupuncture Theory117Sounds (Listening) and Odors (Smelling) in TCM Acupuncture Theory117The cost of this book is 32 Euro. The copyright is owned by QX Ltd., all rights reserved.Please pay to the pay pal under desifm.net under donatons. All of the books have low res for size and hi res versions for clarity. If you do not have the money pay what you can, and if you cannot pay anything please pay the cosmos back with good deeds to others. Pass on the good karma by being good to others and helping them the way I am helping you. Pass it on.AbranchoftheSanJiaomusclechannel links with the root of the tongue. Tongueareasastheycorrespondto internal organs in Chinese MedicineTongue Diagnosis Method and CautonsLightngSunlightwillgivethemostaccuratecolorof thetonguebodyandcoat.Ifsunlightisnot available, use a second light source such as a smallfashlighttocomparethetonguecolor to the original light source.PositonThetongueshouldbeextendedinarelaxed manner,andshouldnotbeheldoutforan extended duraton.Food and DrinkFoodanddrink,suchascofee,greentea, andcandymayalterthecolorofthetongue coatng.Brushed TongueSomepatentsmaybrushtheirtongueto helpfreshentheirbreathorasanAyurvedic Diagnosis is always a guessing game. We want to make our best guess. The average medical doctor islessthan33%accurateinhisdiagnosis.Here aresomeobservatonaltpsfromTraditonaland HolistcMedicine,Acupuncture,Ayurveda,and others. If you study these you can learn to become abeterdoctorandlookforsub-clinicaltrends beforetheyareacrisis.Rememberbecareful and not too presumptve and also remember you dont have to diagnose to helpIntroductonThetonguehasmanyrelatonshipsand connectons in the body, both to the meridians andtheinternalorgans.Itisthereforevery usefulandimportantduringinspectonfor confrmingdiagnosis.Itcanpresentstrong visual indicators of a persons overall harmony ordisharmony.Thetonguehasaspecial relatonship with the Heart, in that the Heart opens to the tongue. The tongue is said to be anofshootoftheHeart,orfowersinto theHeart.ThenormaltongueinTraditonal ChineseMedicinehasalightredorpinkish body with a thin white coatng.ConnectonsChannels/Meridians Reaching the TongueHeart Channel (Hand Shaoyin)TheLuoconnectngchannelconnectsto the root of the tongue.Spleen Channel (Foot Taiyin)An internal branch of the primary channel spreadsovertheloversurfaceofthe tongue.ThetongueispenetratedbytheSpleen Divergent channel Kidney Channel (Foot Shaoyin)An internal branch of the primary channel terminates at the base of the tongue.Bladder Channel (Foot Taiyang)Abranchofthemuscle/sinewchannel binds to the root of the tongue.San Jiao Channel (Hand Shaoyang)10 1112 13Tongue Body ColorIndicatesthestateofBlood,Yinorgans,and Ying (Nutritve) Qi.Normal Tongue BodyPink or light red in colorBluish Purple or Reddish Purple Tongue BodyPurplecanindicatebothHeatandCold conditons.AreddishpurpletongueindicatesHeat and Blood Stagnaton.Adarkreddishpurpletonguethatisdry usuallyindicatesdepletedfuidsdueto Excess HeatAlightpurple,bluishpurple,orgreenish purpletonguebodycolorcanindicate Cold and Blood Stagnaton.Red Tongue BodyAredtonguebodyisdarkerthanthe normalred,whichispinkishincolor.It indicates either Defcient or Excess Heat.Aredtonguebodywithathickyellow coat or swollen buds indicates Excess HeatAredtonguebodywithabrightshiny coat,litlecoat,ornocoatngindicates Defcient Heat.Red TipHeat in the Heart ZangScarlet Tongue BodyAscarlettonguethatisalsopeeledor shinyindicatesYinDefciency,usuallyof theHeartand/orLungdependingonthe area of swelling.Dark Red Tongue BodyThe red is darker and more crimson in color. practce.Askthepatentnottobrushtheir tongue, at least the day of their TCM tongue diagnosis.Seasons of the Year InSummer,theremaybemoreDampness presentinthetonguecoatng,leaving itslightlythickerandlightyellow. InFallorAutumn,thetonguemaybe thinnerwithacoatngthatismoredry. InWinter,theremayalsobemoremoist ordamppresentnginthetongue. In Spring, the tongue should be normal.Time of DayThecoatngofthetongueusuallybecomes thinner as the day progresses, while the color ofthetonguebodybecomesmoreredand shiny.Patents Age Intheelderly,QiandBloodDefciency ismorecommon,sothetongue maypresentwithdrynessandcracks. Infantstendtohavewhitethick coatngthatiseasilyremoved, peeledtonguesarealsocommon. Overweightpatentsusuallyhavemore Dampand/orPhlegmandthereforetheir tonguesmaybelargerandlighterincolor. Thin patents tend towards redder tongues. Tongue Feature IndicatonsTongue Body ColorTongue Body ShapeTongue Body FeaturesTongue Body MoistureTongue CoatngTongue Coat ThicknessTongue Body CracksTongue Coat Root14 15is an indicaton of Excess, and ofen one of Internal Wind.If a stf tongue is accompanied by a bluish purple tongue body, this usually indicates potental or impending Wind-Stroke.If a stf tongue is accompanied by a bright redtonguebody,thisusuallyindicates heatintheHeartandPericardium disturbing the Shen (Spirit).Ifastftongueisaccompaniedbya thickstckytonguecoatng,thisusually indicates Phlegm Mistng the Heart.FlaccidThefaccidtongueistheoppositeofthe stf tongue. It is weak and lacks strength. ItusuallyindicatesDefciency.When heathasconsumedanddamagedbody fuids,theycannotrisetonourishthe tongue.ThiscanindicateYinDefciency, Qi Defciency and/or Blood Defciency.Afaccidtonguethatisalsopaleusually indicates Qi and Blood Defciency.A faccid tongue that is also dark red, dry, andhascracksusuallyindicatesextreme heat injuring fuids.Afaccidtonguebodywithascarlet tongue body usually indicates Exhauston of Yin.SwollenThisisaverylargetonguebodyandcan indicate both Excess and Defciency.Aswollentonguethatisalsopalecan indicate Qi DefciencyAswollentonguethatisalsobrightred and painful can indicate Heart and Spleen Heat.Thiscouldalsobeduetoexcess alcohol consumpton.Thistonguebodycanindicateinternal injurysuchastrauma(DeDa),invasion of external evil in the Ying (Nutritve) and Xue (blood) levels, or it can indicate Blood Stagnaton.If there are red spots with a thin coat, this usuallyindicatesdamagetotheYingor Xue level.Ifthetonguebodyalsohascracksand thereislitleornotonguecoat,this usuallyindicatesDefcientHeatdueto internal injury.Pale Tongue BodyIndicatesthequalityofBlood,refectng Blood and/or Qi Defciency or Cold.Ifthetonguebodyisalsomoist,tender, and swollen, this can indicate Yang Cold.A pale thin tongue body usually indicates Qi and Blood Defciency.Green Tongue BodyAgreentonguebodyusuallyindicates Excess Yin Cold or the presence of a strong Excess evil with weak Zheng Qi. The Yang isnotproperlymovingBloodandFluids and there is Stagnaton in the body.InternalWindmayalsopresentwitha green tongue body.Tongue Body ShapeThebodyshaperefectsthestateofBlood andYing(Nutritve)Qi,andindicatesExcess or Defciency. Consttuton can also afect the shape of the tongue body.StfAstforrigidtongueisdifculttomove (protrude,retract,sidetoside).This maycausespeechabnormalitessuchas slurring or mumbled speech. A stf tongue Thistongueisusuallyfoundinpatents withchronicLungandSpleenDefciency, whichtendstowardDampandPhlegm accumulaton.Swollen EdgesThistonguemayindicateSpleenQior yang Defciency.IfSpleenYangisDefcient,theedgeswill also be wet.Swollen TipWhen the very tp of the tongue is swollen, it usually indicates Heart problems.Ifthetongueisalsodeepred,thismay indicate Heart Fire.Ifthetongueisnormalincolororpale, this may indicate Heart Qi Defciency.Short and ContractedWhen the patent can not show the entre tongue, it usually indicates a more severe disease.Ifthetongueisalsomoistandpale,this indicatesstagnatonofCold(bluish/purple)inthemeridiansorSpleenYang Defciency.Ifacontractedtonguealsohasastcky tonguecoatng,thismayindicateTurbid-Phlegm blocking the channels.Ifthetongueisalsodeepredanddry, excessive heat has consumed Body Fluids and strred up internal Wind.A short, swollen, tender, and pale tongue usually indicates Qi and Blood Defciency.A short or small frenum may be inherited and is normal.LongThere is difculty in retractng the tongue.Big or Enlarged TongueAn enlarged tongue can indicate Phlegm, Damp, or Water Stagnaton.An enlarged tongue with a pale body and amoistcoatmayindicateSpleenand Kidney Yang DefciencyAnenlargedtonguewitharedbodyand agreasyyellowcoatmayindicateSpleen and Stomach Damp-Heat.Half the Tongue Is SwollenA half swollen tongue may indicate general weakness of the Channels.Hammer ShapedThis is where the front half or third of the tongue is enlarged at the sides.A hammer shaped tongue usually indicates Spleen, Stomach, and Kidney DefciencyThistongueisalmostalwaysindicatve ofaseriousconditon,andmayindicate mental illness.Local Swelling on One SideLocalized swelling of tongue with a normal tongue body color indicates Qi DefciencyLocalizedswellingoftonguewithared tonguebodycolorindicatesQiand/or Blood StagnatonSwollen SidesAtonguewithswellinginLiverand GallbladderareausuallyindicatesRising Liver Yang or Liver Fire.SwollenBetweentheTipandtheCentral SurfaceThisareacorrespondstotheLungarea andusuallypresentswithanormalor pale tongue body.16 17(Liver/Gallbladder area) may also indicate a more severe illness.Redspotsonthebackofthetongue (Kidneyarea)mayindicatetheadvanced stage or chronic nature of an illness.White SpotsWhitespotsareusuallyduetoSpleen and Stomach Qi Defciency together with excessheataccumulatnginthebody.In this case, the tongue may also have sores and pus.Black SpotsBlackspotsusuallyindicateQiandBlood Stagnaton or heat in the Blood.Ulcerated Tongue BodySuspect acid alkaline imbalance, vitamin K defciency, Iron excess, Numb Tongue BodyManganese defciency, Tardive DyskinesiaLoose Tongue Body Manganese defciency, Tardive Dyskinesia, loss of muscle tone, dystoniaDeviated Tongue BodyThisiswherethetonguetendstoward one side of the mouthThisisduetoWind,eitherfromexterior PathogenicWindorinternalWind-Damp paterns.Moving,Lolling,Wagging,PlayfulTongue BodyThisusuallyindicatesheatintheHeart andSpleenchannelsstrringupinternal Wind.Inchildren,thismayindicate developmental problems.ThisindicatesinteriorExcessHeat,Heart Fire, or Phlegm-Fire Mistng the Heart.Theremaybenumbnesswhichis associated withFront SwollenSwellingtowardsthefrontone-thirdof the tongue may indicate Phlegm retenton in the Lungs.ThinThiscanindicatethatQiandBloodare defcient and not able to properly nourish andmoisturizethetongue.Thetongue body will also usually be pale in color with Qi and Blood Defciency.A thin tongue that is also dark red and dry may indicate Yin Defcient Fire.Tongue Body FeaturesRough or Tender TextureAtendertonguethatappearssmooth, delicate, and is possibly swollen indicates defciency.A rough tongue that appears wrinkled and rough indicates Excess.Red SpotsRed spots may indicate Heat Toxins in the Blood or Heat Toxins atacking the Heart.Redspotscanindicatethepresenceof Damp-HeatintheXueLevel,wherethe internal organs are accumulatng toxins.Red spots on the Tip (Lung/Heart area) is usually not severe and may present in the beginning stages of illness.Redspotsontheentretonguemay indicate a more severe illness.Redspotsonthesidesofthetongue Tongue CoatngIndicatesthestateoftheYangorgans, especially the Stomach.White Tongue CoatA thin white tongue coatng is normal.Athinwhitetonguecoatngcanalso indicateexternalColdpaternswhen theappropriateclinicalsymptomsare present.Withamoistandpaletongue,athicker white coatng can indicate Damp-Cold.AdrywhitecoatngcanindicateCold turningtoHeatandstartngtodrybody fuids.White Like Powder Tongue CoatAwhiteandthicktonguecoatnglike powderindicatesturbidityandexternal pathogenicheat.Thiscoatngwillusually change to yellow afer a short tme if the patent is not treated.Ifthetonguebodyisdarkred,interior toxins may be present.White Like Snow Tongue CoatThismayindicateexhaustonofSpleen yang with Damp-Cold in the Middle JiaoYellow Tongue CoatAslightlyyellowcoatngindicatesWind-Heat or Wind-Cold turning to Wind-HeatA yellow tongue coat indicates an interior heatpatern.Thedeeperthecolorof yellow,themoresevereheat.Aburnt yellowindicatesfurtheraccumulatonof heat in the body.Ifthecoatngisyellowandmoistand thetonguebodyisswollenandtender, this indicates interior Damp-Heat or Yang Rolled Tongue BodyReacton to insectcides.Teeth Marks on Tongue Body (Scalloped)Ifthetonguebodyhasnormalcolor,this usually indicates Spleen Qi Defciency.Ifthereareteethmarkstogetherwitha swollentongue,thismayindicateSpleen Yang and/or Qi Defciency.Ifthetongueisalsopaleandmoist,itis morelikelySpleenYangDefciencyora Cold-Damp patern.Quivering or Trembling Tongue BodyTremblingofthetonguethatcannotbe controlled may be due to external febrile disease or excess heat consuming Yin. The excessheatstrsupInternalWind.The tongue body will be a deep red color and the pulse will be rapid.If the tongue body is pale and trembling, thisusuallyindicatesachronicconditon ofQiandBloodDefciency,wherethe tongue is not being nourished.Side efects of some western medicatons (pharmaceutcals) may cause trembling of the tongue.Sore Covered Tongue Body Side efects of some western medicatons Tongue Body MoistureReveals the state of Yin and Fluids in the body.Dry Tongue BodyDehydraton, lymphatc drainage disorderSlightly Dry Tongue BodySame progresive18 19BothGrayandBlacktonguecoatngcan indicateextremeCold(wettongue)or extreme Heat (dry tongue).Western drugs such as antbiotcs can also cause a black tongue coatng.Half Yellow, Half White (Longitudinally)This coatng may indicate Heat in the Liver and GallbladderYellow Root With A White TipThis may indicate that exterior Pathogenic Heatispenetratngmoredeeplyintothe interior of the body.BlackintheCenter,WhiteandSlipperyon the SidesThismayindicateSpleenYangDefciency with interior Damp-ColdTongue Coat ThicknessThin CoatngNormalIn disease, it indicates the disease is either external or an internal disease that is not severe.Ifthetonguecoatngchangesfromthick tothin,thisindicatespathogensare movingtotheexteriorofthebodyand the disease is waning.Thick CoatngAthickcoatngusuallyindicatesmoreof an internal disease that is more severe.Itmayalsoindicatethatexterior pathogenic factors have penetrated more deeply into the body.Athicktonguecoatngmayalsoindicate retenton of food.Ifthetonguecoatngchangesfromthin Defciency. In the case of Yang Defciency, the tongue is showing false heat signs, as the Yin has forced the Yang to the surface of the body.Dirty Yellow Tongue CoatThis tongue coatng may indicate Stomach and Intestnal Damp-HeatSimultaneousWhiteandYellowTongue CoatngCan indicate a Shaoyang paternCanindicateasimultaneousHeatand Cold patern, or a Cold patern turning to HeatCanindicateasimultaneousInteriorand Exterior paternGray Tongue CoatThistonguecoatngusuallyindicatesan internal patern of either Heat or Damp-Cold.A dry gray coatng can indicate internal Excess HeatscorchingBodyFluidsorYinDefcient Fire.A wet or moist gray coatng usually indicates Cold-DampStagnatonorDamp-Phlegm retenton.Black Tongue CoatSimilartotheGraycoatngabove,but more severe.Theblackcoatngusuallydevelopsfrom gray or a burnt yellow coatng.Adryblackcoatng(usuallywithcracks) may indicate excessive Heat burning body fuids.Amoistblackcoatngandapaletongue bodymayindicateYangDefciency, InternalExcessCold,withorwithoutthe presence of Dampness.ThenormaltonguecoatnghasRoot, which means that is rooted or atached tothesurfaceofthetonguebody.It cannot be easily scraped of or removed.Tongue Coat Has No RootA coatng without root rests on the surface of the tongue, but can easily be removed or scraped of.Acoatngwithoutrootusuallyindicates impairmentofSpleen,Stomach,and Kidneys.Tongue Diagnosisby Cathy WongChinesemedicinepracttonersbelievethe appearanceofyourtonguecanrevealalot about your health.Tonguediagnosisisanimportantpartof theChinesemedicalassessment.Duringan examinaton, the practtoner usually looks at theoveralltonguecoatng,shape,andcolor. Then he or she looks at specifc areas on the tongue.tothick,thisindicatespathogensare penetratng deeper into the interior of the body.Peeled, Mirrored, Shiny, No CoatngWithamirroredtongue,thereisno coatngonthetongue.Inlesssevere cases,theremaybeapartalcoatngon the tongue.Ifthebodyofthetongueisalsored,it usually indicates that Stomach Qi and Yin is severely damaged.Ifthetonguebodyisalsolightin color, this may indicate that Qi and Blood of the Spleen and Stomach is damaged and Defcient.Ifthetonguebodyisalsoredor dark,StomachandKidneyYinis damaged(bodyfuidsdriedup) due to heat.Tongue Body CracksShort Horizontal CracksVitamin B6 DefciencyLong Horizontal CracksVitamin B6, B12, B2 Defciency, Transverse Cracks On the Sides of the TongueVitamin B6, B12, B3 Defciency, Transverse Cracks Behind TipVitamin B6, B12, B2, B3 Defciency, Very Deep Ventral Cracks With Other Smaller CracksVitamin B6, B12, B2, B3, B5 Defciency, Tongue Coat RootTongue Coat Has Root20 21Tongue body color May be a sign ofPurpleStagnant qiStagnant blood if dark purple tongue body and/or red spots on the tongueWhat is the Tongue Shape?Normaltongueshapeisnottoothickor thin, and the tongue body is smooth with no cracks.Changesinthetongueshapeusually refectchronicillnessinvolvingblood,qi,or body fuids.Tongue shape May be a sign ofSwollen or pufySpleen qi defciency, especially if teeth marks on the sidesDamp heatThinBlood defciencyFluid defciencyTrembling Spleen qi defciencyElongatedHeart heatSides curled upLiver qi stagnatonIf the sides are swollen and red, it may indicate Liver FireCracksExcessheatoryin defciencyHeartimbalance, especiallyifthere isacrackdownthe middle of the tongue to the tpWhat does the Tongue Coatng Look Like?Diferentareasofthetonguearebelieved torefectthehealthofthediferentorgan systems. If there is an unusual color, coatng, and/orshapeinacertainarea,special atentonispaidtothecorrespondingorgan system.Aswithanyassessmentmethod,thedoctor doesntrelyontonguediagnosisalone,but usesittoprovideacompletepictureofa persons health.BelowaresomeoftheguidelinesChinese medical practtoners use to assess the tongue. This is only a selecton of many diferent types of paterns.What is the Tongue Color?Normal tongue color is light red, indicatng that a persons vital energy (called qi) is strong. It also refects the health of the internal organs and blood circulaton. Changes in the tongue color usually refect chronic illness.Tongue body color May be a sign ofPaleExcess cold, especially if thick white coatng.Spleen qi defciency, especially if thin white coatng.Blood defciency, especially if dull, pale face and lips.RedExcess heat, especially if there is a thick yellow tongue coatng.Yin defciency, especially if tongue body is thin and coatng is thin, absent or peeled.22 23vitamin C, and foods made with artfcial food coloring.Tongue self diagnosis Queston: Whichapertureofthebody refectstheinternalorgansrelatedto excretonandassimilaton?Anus,urinary tract, ears, nose, or mouth?Answer:Mouth.Yourtongueaccuratelyrefectsthestate ofyourdigestvesystem-fromrectumto esophagus,includingthestomach,small intestnes,colon(largeintestne),pancreas, spleen, liver and gall bladder. Imagine, you dont need a batery of tests to fnd out what part of your digestve tract is in stress.YoucandiagnosisthewholeGItract andcorrespondingorganintegrityallinone easy view- just stck your tongue out and take a good look at it.As a wholethe tongue refects the conditon ofthedigestvesystemandtheorgans associatedwithblood,nutrientassimilaton, andexcreton.Youcanalsoseehowhotor how cold your internal organs are. Therefore it has a high value as a diagnostc tool.Specifcsectonsofthetonguemirrorthe conditonofpartcularpartsofthedigestve systemandthedigestonrelatedinternal organs.Normaltonguecoatngisthinandwhite.A pale yellow and slightly thicker coatng at the backofthetonguemayalsobenormal.The tonguecoatngofenindicatesthehealthof thespleenandstomach.Italsoprovidesa good indicaton of acute illness, such as colds and digestve problems.Tongue coatng May be a sign ofThick ExcessYellow, thick, glossy Damp HeatDry, yellow Excess heatPeeled or absentDefcient yinHeartyindefciency if it's on the tp of the tongueKidney yin defciency ifit'salloverthe tongueoratthe backofthetongue and the tongue body is red.Are there any Specifc Problem Areas?Eachareaofthetongueisconnectedto specifc internal organs.sides of the tongue - livertp of the tongue - heartcenter of the tongue - spleenback of the tongue - kidneyOther Tongue TipsSome disorders dont show up on the tongue.Tongueisusuallyexaminedfornolonger than15secondsatatme.Ifitsextended for longer, the tension may alter the shape or color.The tongue should be examined under natural light.Before examinaton, dont eat foods that may discolorthetongue,suchascofee,beets, Width:a wide tongue refects an overall balanced physical and psychological dispositon.a narrow tongue refects a lack of physical adaptabilitywithpronouncedstrengths andweaknesses.Mentally,thinkingmay be sharp but tend toward seeing a narrow view.averywidetonguerefectsagenerally looseandexpandedphysicalconditon and a tendency toward more psychological concerns.Tip:aroundedtprefectsafexibleyetfrm physical and mental conditon.a pointed tp refects a tght, perhaps even rigid physical conditon and an aggressive or even ofensive mentality.a very wide tp refects an overall weakness of the physical body and a faccid or even spaced out mental conditon.adividedtprefectsatendencytoward physicalandmentalimbalanceswiththe possibility of sharp fuctuatons in thinking and mood.Thickness:a fat tongue refects a balanced conditon andtheabilitytofexiblyadaptto circumstances.athintonguerefectsamoremental orientaton,withatendencytobemore gentle and easy going.athicktonguerefectsamorephysical orientaton,withthetendencytobe assertve or even aggressive.In comparison to structure, the conditon of the tongue is infuenced more by daily lifestyleandprovidesinformatonabout an individuals current state of health. Qualites to look for include:Thefollowingcorrespondencesexistinthis relatonship:A - the tp area refects the rectum and the descending colon.B-theperipheralarearefectsthelarge intestne.C-themiddleregioncorrespondstothe small intestne.D - the back edge region relates to the liver, gallbladder, duodenum, and pancreas.E-thenearbackregioncorrespondsto the stomach.F-thebackregion(therootofthe tongue) refects the esophagus.G-theundersideofthetonguerefects the quality of blood and lymph circulaton in each corresponding area.Structural characteristcsLikeeachpartcularareaofthebody,the tongue can be used to evaluate ones overall conditon.Zetsu Shin as it is called in Japanese, is one of themostimportantformsofdiagnosisused inChinesemedicine.Twomainaspectsare considered in tongue diagnosis.First is the structure of the tongue. Is it wide or narrow, thick or thin, pointed or rounded? Such qualites convey informaton concerning the individuals basic consttuton and overall strengths and weaknesses of body and mind.24 25tongue.a stf, tense, or infexible tongue.a loose or lolling tongue.atonguewithapronouncedslanttothe lef or right when it is extended.Pimples or projectons of the tongues surface indicatethedischargeoffat,protein,and sugar.Whereinthebodythisdischargeis coming from can be determined by the specifc areaofthetongueonwhichitappears.You can fnd the correlaton between the areas of the tongue and the digestve tract.Thesecondmajoraspectconsideredin tonguediagnosisisthecoatng, or moss, as it is called in Chinese medicine, on the tongues surface.Qualitesareagaindividedintoantagonistc pairs,andincludemoistanddry,excessive anddefcient,thickorthin.Thecolorof thecoatngrevealsapreciseinformaton concerning specifc internal conditons.Theguidelinesexplainedabove,partcularly concerning the aspects of locaton and color, canbeusedforageneralunderstandingof the diferent qualites of coatng found on the tongue.Theyareespeciallyextremelyusefulwhen fastng, cleansing or when one is ill. A precise understanding of the nature of the problems can be achieved in seconds.TongueDiagnosisinTCMAcupuncture TheoryOneofthemostcommonquestonsthat people ask about acupuncture is:Whydoesmyacupuncturistlookatmy tongue?Tongueandpulsediagnosisaretwoofthe moreimportantdiagnostctoolsinChinese medicine. They are both used to derive a TCM diagnosis for your conditon which is used to Color:Darkred:indicatesinfammaton; lesionsorulceraton;andsometmesa degeneraton of the related organ.White:indicatesstagnatonofblood;fat andmucusdeposits;oraweaknessin thebloodleadingtosuchconditonsas anemia.Yellow:indicatesadisorderoftheliver andgallbladder,resultnginanexcess secretonofbile;depositsofanimalfats, especiallyinthemiddleorgansofthe body; and possible infammaton.BlueorPurple:indicatesstagnatonof blood circulaton and a serious weakening ofthepartofthedigestvesystemthat correspondstotheareaofthetongue where the color appears.Thecolorontheundersideofthetongue canalsobeusedtodeterminetheinternal conditon.Ingeneral,thecolorsandtheir indicatonslistedabovearethesame,with the following exceptons:BlueorGreen:Inexcess,eitherofthese color refect disorders in the blood vessels and in blood quality and circulaton.Purple:Inexcess,thiscolorrefects disorders of the lymphatc and circulatory system.Itindicatesaweakeningofthe immune ability and of the blood vessels.Texture:a swollen or enlarged tongue: indicates a Jitsu, or full state.ashriveledorwithered-lookingtongue: indicates a Kyo, or empty state.Movement:Thefexibilityofthetonguealsorefects theconditonofthedigestvesystem. Characteristcs to look for include:afexible,supple,smoothlymoving CommonTongueGeographyandMeridian CorrelatonsLower JiaoTheBaseofthetonguecorrespondstothe Kidney,UrinaryBladder,LargeIntestneand Small Intestne Meridians.Middle JiaoThe sides of the tongue correspond to the Liver andGallBladdermeridians.Sometheories placetheGallBladderonthepatentslefsideandtheLiveronthepatentsrightside. The Middle of the tongue corresponds to the Stomach and Spleen Meridians.Upper JiaoThe Tip of the tongue corresponds to the Lung and the Heart Meridians.plan your treatment. Generally the tongue, is much easier to learn and less subjectve than pulsediagnosis.Itislessmeridianspecifc than the pulse, however, the tongue will show thedepthandnature(hot,cold,etc.)ofan imbalance and it is less efected by short-term infuences such as nervousness. The tongue is alsousefulasameasurementtooltogauge the progress of a disorder.Below you will fnd detailed informaton about tongue diagnosis and the clinical signifcance of the examinaton:Common Tongue Geography and Meridian CorrelatonsBody Colors and IndicatonsBody Shape and IndicatonsTongue Coatngs and IndicatonsSourcesAcupuncture Theory Related ResourcesDiscuss Acupuncture Theory26 27Tongue Body Colors and Clinical IndicatonsBody Color IndicatonsPink normal or mild disorderPaleyang, blood a/or qi defDefciency Cold+ thin & dry = blood def+ wet = qi def+ swollen = qi def+ swollen & wet = yang defRedheat+ no coatng = yin def empty heat+ yellow coat = excess heat+ wet = damp heat+ dry = injured fuidsDark Red (Scarlet, Cardinal)extreme heatmore severe conditons than redPurplestagnaton lv qi stagnaton is likely + pale = coldBlue severe internal cold stagnant bloodIndicatons Tongue Body Shapes and Clinical Body Shape Indicatonscrackedif develops during illness indicates chronic and severe, otherwise normallocaton of cracks relates to organ pathology+ red = empty heat consuming fuids+ pale = blood & qi defcrack runs from center to the tp = ht disorder or congenital ht problemshorizontal cracks = yin defdeviated (crooked) windfacciddefciency heat+ pale = blood & qi def+ dark red = yin collapselong heat in the htrigid stroke or early signs of strokeshort (contracted)serious conditonsblood defciencyht defciency+ pale or purple = cold or yang def+ swollen = damp orhlegm+ red = heat consuming the fuidsstfheat in the htht/sp heatphlegm obstructng the ht qi+ normal & pale = wind, strokeswollendefciency+ pale & wet - yang def + teethmarks & pale = qi def or excess fuids + dark red = excess heat usually ht/spthinblood or fuid defempty heat consuming fuids+ pale = blood & qi def+ red = yin defthorny (strawberry, granular)heat congealed blood + on tp = ht fre + on edges = lv/gb fre + on center = st a/or intestnes heattrembling (quivering)wind+ pale = qi def+ red = heat producing internal wind28 29Indicatons Tongue Coatngs and Clinical Tongue Coat Indicatonsthin normalexterior conditon, wind-coldthick excess damp/phlegmfood stagnatondry heat consuming yinexcess yang or fredefciency fuidsmoist normal or mild imbalancewet excess fuids from yang defdampnessstcky (greasy, creamy) dampness or phlegmretenton of foodCoat Coloraton Indicatonswhite internal or external coldif coat looks like cotage cheese = ST heat+ thin coat & body aches = exterior wind-cold+ thin coat & thorny = wind-heatyellow internal or external heatefected by cofee, tea a/or smoke intakegray hot or cold internal conditonretenton of phlegm heat+ dry = heat consuming body fuids+ moist = damp coldblack severe conditon involving hot or cold+ pale = excessive cold from yang def+ dry & possible thorny = consumpton of body fuidsCoat Rootng Indicatonsrootedmoss appears frmlz implantedstrong st/sp qirootlesmoss appears to foat on the surfacest/sp qi defpeeled sp qi defdefcient yin or fuids AReddish-Purpletonguebodycolour usuallyindicatesBloodstasisderivingfrom orassociatedwithHeat(whereasaBluish-Purple colour generally indicates Bloodstasis derivingfromCold).Inthiscase,thetongue colour is consistent over the whole tongue so Thetonguecoatisagoodindicatorofthe stateoftheStomachandSpleen.Italso showsthestrength,depthandtemperature of pathogenic factors.A normal tongue coat is thinnest at the edges, thicker in the center and thickest at the root. Itisthinandwhite,slightlymoistandhasa root.Learning ExamplesBody colour: Reddish-Purple. Body shape: Swollen and cracked. Coatng: peeled.30 31Bodycolour:Reddish-Purple,Bluish-Purple in the chest area on the right. Body shape: Stf, slightly Swollen. Coatng: stcky coatng without root. The overall body colour of this tongue is Purple, indicatngBloodstasis.Itispredominantly Reddish-Purple,whichindicatesBloodstasis deriving from or associated with Heat but the chest area on the right of the tongue is Bluish-Purple which indicates that there is also some ColdwhichhasleadtoBloodstasisinthe chest.The tongue is also Stf. A Stf tongue indicates eithersevereBloodstasisorinternalWind. As the tongue is also Purple, in this case it is most likely that it indicates Blood stasis. Thestckyconsistencyofthecoatngsimply indicates that there is Dampness (or together with the Swollen tongue body Damp-Phlegm), butthefactthatitisrootlessrefectsa defciency of Stomach-Yin. A rootless coatng refectsthebeginningstagesofStomach-Yin defciency.Example 3 - NEW Body colour: Slightly Red but Pale on the sides. Bodyshape:SwellingintheSpleenarea on the sides, Stomach cracks. Coatng: Peeled. This tongue shows clearly a relatvely common conditonofStomach-Yindefciency(leading we cannot determine from the tongue alone wheretheBloodstasisislocated.Thepulse andthesymptomscantellusthis.However, themostlikelypaternisthatofLiver-Blood stasis. The tongue body is also Swollen which indicatesthepresenceofPhlegm.TheLung andHeartareasofthetongueareespecially swollenwhichpointstowardsthefactthat thePhlegmispredominantlyintheUpper Burner.PhlegmandBloodstasisareofen seenexistngsidebyside,especiallyinolder patents, as they interact with and promote eachother.Bloodstasisstopsfuidsfrom being transported around the body smoothly thereforeencouragingtheproductonof Phlegm, while Phlegm blocks the smooth fow of Qi and Blood leading to stasis.The tongue is totally peeled (without coatng) andwithmanycracks,bothsignsofchronic Yin defciency. It is likely that the Yin defciency precededtheBloodstasis.ChronicYin defciency leads to Empty-Heat and we know in this case that the Blood stasis derives from Heat as the tongue is a Reddish-Purple colour. Although we cannot tell conclusively from the tongueonly,theYindefciencyismostlikely of the Stomach and Kidneys Therefore, in conclusion, we can say that this many sufers from Yin defciency with Empty-Heat,BloodstasisandPhlegmintheUpper Burner.Example 2 - NEW 32 33Body colour: slightly Red. Bodyshape:Swollen,especiallyinthe chest area with a Heart crack. Coatng: stcky coatng. This tongue is slightly unusual in that it clearly showsustheexactlocatonofapathogenic factor. The chest area is clearly more Swollen thantherestofthetongueindicatngthe presence of Phlegm in the Upper Burner. Asageneralrule,thetonguebodyshows more the presence of Phlegm and the coatng refectsthepresenceofDampness.When the tongue body is Swollen and the coatng is stcky, as in this case, it normally indicates the presence of Damp-Phlegm, in this case clearly in the Lungs.Example 5 - NEWBody colour: slightly Red. Bodyshape:Swollen,especiallyinthe chest area with a Heart crack. Coatng: stcky coatng. TheReddish-Purplecoatngismoredistnct onthesidesintheLiverareawhichpoints specifcallytowardsLiver-Bloodstasis.The LiverareaonthesidesisalsoSwollenwhich usually indicates severe or chronic Liver-Heat. TheLiver area beingRed andSwollensimply indicates a more severe degree of Liver-Heat than if the Liver area is just Red. The strips of a slightly thicker, white coatng on either side of the tongue indicate a Gall-Bladder pathology, most usually Dampness in the Gall-Bladder. tosomeHeat)andSpleen-Yangdefciency. ThecracksintheStomachareaindicate Stomach-Yin defciency and the overall colour of the tongue is slightly Red showing that this Yin defciency has lead to some Heat, but the sidesofthetongueintheSpleenareaare SwollenandPale.ThisrelectsSpleen-Qiand Yang defciency leading to Dampness. Itisimportanttodistnguishbetweenthe Liver and the Spleen areas on the sides of the tongue. The Liver area is a longer and thinner strip,coveringnearlythewholesideofthe tongue,whereastheSpleenareaisshorter and fater and in the middle of the side of the tongue. In the case of this patent, it would therefore benecessarytotreatbothYindefciency(of theStomach)andYangdefciency(ofthe Spleen).EventhoughtheYindefciency(and Empty-Heat) seem predominant because the main area of the tongue body is Red and it is peeled,itislikelythattheSpleendefciency camefrst.AstheSpleenandStomachare so closely connected, a long-standing case of Spleen-Qiand/orYangdefciencymaylead toadefciencyoftheStomach(whichhasa tendency to become Yin defcient).A suitable remedy for this conditon might be Shen Ling Bai Zhu San (Central Mansion in the Three Treasures remedies).Example 4 - NEWandtoemotonalproblems:thedeeperthe crack,thestrongerthispropensity.If,inthe presenceofaHeartcrack,thetonguetpis red,itindicatesthattherealreadyisaHeart paternusuallyfromemotonalproblems. Inotherwords,achangeincolourofthe tonguebodyindicatesthatthatpartcular consttutonaltendencytoHeartpaterns has manifested itself and generated an actual Heart patern. If we compare two people both with a red tp of the tongue, one with a Heart crack and the other without, the presence of aHeartcrackindicatesthatthatpersonhas aconsttutonaltendencytoHeartpaterns andthathisorherconditonisdeeperand more difcult to treat than that of the person without a Heart crack.Thesmall,transversecracksonthesides usuallyindicatesevere,chronicSpleen defciency.Thus,wecanconcludethatthis mansufersfromachronicSpleen-Yang defciency and Phlegm.Example 7Bodycolour:darkred,redderonthe sides.Bodyshape:swollenonthesides, Stomach crack.Coatng: white, rootless.Thedarkredbodycolourclearlyindicates intenseHeatandthereddercolourand swelling on the sides shows that the Heat is in the Liver. Thus, this patent has sufered from Although the tongue points towards the Blood stasis being especially in the Liver, treatment of this patent should focus equally on moving BloodintheHeart.ThepresenceofaHeart crackindicatesaconsttutonaltendencyto Heart paterns.Example 6Body colour: pale. Body shape: swollen, central Heart crack, transverse Spleen cracks on the sides.Coatng:thin-white(normal),slightly yellow in the centre.Thepaletongue-bocolourindicatesYang defciency(itmayalsoindicateBlood defciency,butinaman,itismorelikelyto be Yang defciency). It is not possible from the tongue only to establish which organ is mostly afectedinthiscasebytheYangdefciency: however, since the tongue body is also swody llen,whichusuallyindicatesPhlegm,itis more likely to be Spleen-Yang defciency. The centralcrackinthiscasecorrelateswiththe Heart.AHeartcrackisratherthinandlong, extending from near the root of the tongue to near the tp; a Stomach crack is rather wide andissituatedonlyinthemiddlesectonof thetongue,intheStomacharea.Whatdoes aHeartcrackindicate?Itdependsonits depthandonthecolourofthetonguetp. Generallyspeaking,aHeartcrackindicates aconsttutonalpropensitytoHeartpaterns 34 35Example 9Body colour: red, tending to purpleBody shape: very swollen, Stomach crack.Coatng: yellow, rootless, dry.TheredbodycolourindicatesHeatwhile itsslightlypurplehueindicatesthatthere issomeBloodstasis.Theveryswollenbody shape indicates the presence of Phlegm. The redcolour,togetherwiththeStomachcrack andtheyellowcoatng,indicatesthatthe Heat is located in the Stomach.Thisisconfrmedbytherootlesscoatng which indicates the beginning of Stomach-Yin defciency, presumably from the Heat injuring Yin. The dryness of the coatng confrms both theHeatandtheYindefciency(itcouldbe due to either).Thistonguehasarootlessbutrelatvely thickcoatng:thisisdoublybad.Why?The rootlessnessofthecoatngindicatesthat thereisthebeginningofYindefciencybut the relatve thickness of it indicates that there isapathogenicfactor,inthiscase,Stomach-Heat:thus,thispatentsufersfromaFull conditonoccurringagainstabackgroundof Stomach defciency.Inotherwords,itwouldhavebeenbeterif the coatng had been either rootless but thin (indicatngYindefciencybutnopathogenic factor)orthickwithroot(indicatngthe presenceofapathogenicfactorbutalsoa good state of the Stomach).Liver-Fire for a long tme (we can deduce it is a long tme from the dark-red colour) and the intense Fire has begun to injure Yin.Weknowthisfromthefactthatthecoatng is rootless:thisindicatesthebeginningofYin defciencyand,sincethetongueisdark-red and there is a coatng, we can deduce that it is the Fire that is injuring Yin rather thandefcientYingivingrisetoEmpty Heat.Example 8Bodycolour:redslightlytendingto purple, redder tp.Bodyshape:swollentp,tpcurlingup, Heart crack.Coatng:normalbutthereisaslightly peeledpatchwithoutcoatngonthelefside towards the root.TheredbodycolourindicatesHeatandthe slightpurplecolourindicatesthatthereis some Blood stasis. The red tp indicates Heart-Fire and the swelling of the tp and its curling up confrm and reinforce this diagnosis.The presence of the Heart crack indicates that thispatenthadaconsttutonaltendencyto Heartpaternsandtoemotonalproblems. The small patch without coatng indicates the beginning of Stomach-Yin defciency.Example 11Body colour: slightly pale, almost normalBody shape: very swollen, more so on the (patents) lef sideTonguecoatng:thick-white-rootless coatng.Theswellingofthetonguebodyindicates Phlegmwhilethepartalswellingonthe lefsideofenindicatesaweaknessofthe channelsonthatside.Suchweaknessmay derive either from a febrile disease with high temperature or from an accident to that side of the body.TherootlesscoatngindicatesStomach-Qi orStomach-Yindefciency,butitsthickness indicates the presence of a pathogenic factor, probablyDampness.Athick-rootlesscoatng isdoublybadbecause,ontheonehand Stomach-Yinisdefcient,but,ontheother, there is a pathogenic factor.Itisbeterforarootlesscoatngtobethin (indicatngStomach-Qidefciencybutno pathogenicfactor)orforathickcoatngto havearoot(indicatngthepresenceofa pathogenic factor but also intact Stomach-Qi).Example 10Body colour: reddish-purple, red sidesBodyshape:veryswollen,swollensides, Stomach crackTonguecoatng:stcky-yellow,stcky-dry-rough-yellow inside the Stomach crack.Thereddish-purplecolourofthetongue bodyindicatesBloodstasisderivingfrom orassociatedwithHeat.Therednesson thesidesindicatesHeatintheSpleenand/orStomach;inthiscase,therednessonthe sidesisnotrelatedtotheLiverbecauseit occupies a wider area than the Liver are and alsobecauseitisassociatedwithaSpleen-type of swelling on the sides.Thegeneralswellingofthetonguebody indicatesthepresenceofPhlegm,whilethe swelling on the sides is related to the Spleen and it indicates Dampness occurring against a background of chronic Spleen defciency.Thestcky-yellowcoatngconfrmsthe presenceofDampnesswhiletheStomach crack,togetherwiththestcky-dry-rough-yellowcoatnginsidesitindicatesPhlegm-Heat in the Stomach.Inconclusion,themainlocatonofthe disharmonyinthiscaseisintheMiddle Burner with Stomach and Spleen Heat, Damp-HeatandPhlegm-HeatintheStomach.The Blood stasis probably derives partly from the Heat and partly from the chronic retenton of Phlegm.36 37indicate a chronic conditon because this type ofswellingandthelackofcoatngdevelop over a long period of tme.It is not possible to tell from the tongue only which other organ (apart from the Stomach), if any, is afected by the Blood stasis and the Heat.Example 13Body colour: red, red tpBody shape: short.Tongue coatng: thin-white.Thisslideispresentedheremainlyasan example of a short tongue body. The patent could not stck the tongue out more than that. The red tp indicates Heart Heat.Example 12Body colour: reddish-purpleBody shape: swollen sidesTonguecoatng:thin-white-rootless coatng, peeled in patches.Thereddish-purplecolourindicatesBlood stasiswithHeat.Theswellingonthesides indicateschronicSpleendefciencyandthe rootlesscoatngmissinginpatchesindicates Stomach-Yin defciency.Thispatenttoosufersprimarilyfroma disharmonyintheMiddleBurnerwith chronicSpleen-QidefciencyandStomach-Yin defciency. Both the swelling on the sides (related to the Spleen) and the rootless coatng missinginpatches(relatedtoStomach-Yin) 38 39issue.InpartcularTCMhasadetailedmap ofthefaceincludinglines,organzonesand colourindicatons.UsingTCMfacialanalysis principles with relaton to skin conditons, the map and colours of the face can help indicate the underlying causes and support the choice of treatment.Skinconditonsthatafectthefacesuchas eczema, psoriasis, rosacea and acne dont usuallyafecttheentresurfaceoftheface. Theafectedareasareofenconfnedto partcularareasorzonessojustbylooking at your face you can fnd out more about the underlyingcauseofanyskinconditon.This technique is not confned to skin conditons. It can also be used as a tool to assess wellbeing or to improve skin tone in general.Face - Organ MapFace Head Feet Body DiagnosisDo you ever wonder why no mater how much sleep you get, the dark circles under your eyes neverseemtogetanybeter?Orwhyyour cheeksarefushedeveninwinter?Oreven why you seem to get blackheads on your nose and cant get rid of them no mater what topicalcreamsyouuse?Theseissuesare actually signs that your body is giving you, and usingfacialanalysis,youcanworkoutwhat the root cause of your dark circles and fushed cheeks and fnally do something about it.FromGreekmedicinetoAyurvedaand TraditonalChineseMedicine(TCM),facial analysishasbeenusedasanindicatonof the health of the organs or to provide useful clues as to the systems involved in any health 40 41Facial Zone Organ or System Forehead In descending order down the forehead: Bladder, Large Intestne,SmallIntestne.Usuallylinesacrossthe forehead refect an imbalance. Congeston or acne in this arearepresentsdigestvecongestonandpossiblypoor detoxifcaton.Redanddryorfakyskinisanindicaton of lack of fuids in the digestve tract.Between the Eyes This is the liver zone. A red patch between the eyes is a possibleindicatonofpoorliverdetoxifcatonandeven heavy metal toxicity (partcularly mercury). Vertcal lines in this zone indicate Liver imbalance.Under the Eyes Thetopoftheeyeanddirectlybelowtheeyesisthe kidneyzone.Pufnessandfuidretentoninthisareais asignthebodyisholdingontotoomuchfuid(watery andswollenwithabluetnge)orismucuscongested (faty and swollen with a yellow tnge). Salt intake should be monitored, as should excessive sugary drinks such as fruitjuiceandsofdrink.Toreducemucuscongeston, reducefatanddairyconsumpton.Bluecirclesorwhite under the eyes indicates tredness or even exhauston. A yellow tnge shows the liver and gallbladder are working too hard.Dry, faky or red skin in the creases above the eye shows liver stress.The Nose Thenosetpcorrespondstothelungswhilethebridge refects the health of the stomach. Congeston in the form of blackheads usually represents poor stomach digeston and possibly low hydrochloric acid levels.If the nose is red or has broken capillaries, this usually indicates excessive intake of heatng liquids including alcohol, cofee and tea.The Cheeks Represent the respiratory & circulatory systems. Pimples orcongestoninthisareaareofentheresultofahigh fatandmucusformingdiet(simplesugar,dairyand processedfoods).Palecheeksmaybeasignoflow ironlevelswhereasoverlyfushedcheeksshowpoor circulatonandtheconsumptonoftoomanyhotfoods such as alcohol, cofee and spices and poor eliminaton. A greenish tnge indicates liver congeston.the face and their associated organs. Included arekeyindicatonsaboutlinesandcolours that provide additonal informaton.Bumps on the top of the head can be related to diagnosis.As a guide, go over each zone of the face and lookforanychangesincolour(fromyour normal skin tone), deep lines (that arent part of the normal aging process), congeston (pimples,blackheads,milia,whiteheads)or pufness. Below is a guide to the key areas of Facial Zone Organ or System The Mouth Generally represents the digestve functon. White or very pale lips may indicate low iron levels and poor circulaton. Dry faky skin or wrinkles can indicate dehydraton.Cracks orsoresinthecornersofthemoutharesignsoflowB vitaminorironlevels.Red,hotorbleedinggumsarea signofahotorover-acidicstomachandsoanimalfats, simplesugarsandheatngfood&drinkneedstobe avoided.The Chin Correspondstothekidneysanddigestvesystem.Once again congeston in this area can be a sign of a diet high inprocessedfoods,sugarsandfats.Itcanalsoindicate unbalancedkidneyfuncton,whichisusuallytheresult of pushing the body by working too hard, stress or going beyond normal physical endurance.The Jaw and under the jaw line Ofenahormonalinfuence,partcularlyifworsens inaccordancewithmonthlycycles.Cystsratherthan pimplesmayindicatelymphatctoxicity,whichmay result from medicatons, environmental toxins or a highly processed and sugar rich diet.42 43feldssuchasanthropology/ethnology),and areallegedtohavesometmescompriseda sort of scientfc racism. HistoryAdefnitonofphrenologywithchartfrom WebstersAcademicDictonary,circa1895. Thefrstatemptstomeasureskullshape scientfcally,anditsallegedrelatonto character,wereperformedbytheGerman physician Franz Joseph Gall (1758-1828), who is considered the initator of phrenology. Gall wasoneofthefrstresearcherstoconsider the brain to be the source of all mental actvity.In1809Gallbeganwritnghisgreatest workTheAnatomyandPhysiologyofthe NervousSysteminGeneral,andofthe PhrenologyPhrenology(fromGreek:,phrn, mind;and,logos,knowledge)isa hypothesis statng that the personality traits of a person can be derived from the shape of the skull.Itisnowconsideredapseudoscience. DevelopedbyGermanphysicianFranz JosephGallin1796,thedisciplinewasvery popularinthe19thcentury.Theprincipal BritshcentreforphrenologywasEdinburgh, wheretheEdinburghPhrenologicalSociety wasestablishedin1820.In1843,Franois Magendie referred to phrenology as a pseudo-scienceofthepresentday.Phrenological thinkingwas,however,infuentalin19th-century psychiatry and modern neurosciencePhrenologyisbasedontheconceptthatthe brain is the organ of the mind, and that certain brainareashavelocalized,specifcfunctons ormodules(seemodularityofmind). Phrenologistsbelievedthatthemindhasa setofdiferentmentalfacultes,witheach partcularfacultyrepresentedinadiferent area of the brain. These areas were said to be proportonaltoapersonspropensites,and the importance of the given mental faculty. It was believed that the cranial bone conformed in order to accommodate the diferent sizes of these partcular areas of the brain in diferent individuals,sothatapersonscapacityfora givenpersonalitytraitcouldbedetermined simply by measuring the area of the skull that overlies the corresponding area of the brain. As a type of theory of personality, phrenology canbeconsideredtobeanadvanceover theoldmedicaltheoryofthefourhumours. Phrenology,whichfocusesonpersonality andcharacter,shouldbedistnguishedfrom craniometry,whichisthestudyofskullsize, weightandshape,andphysiognomy,the study of facial features. However, researchers ofthesedisciplineshaveclaimedtheability to predict personality traits or intelligence (in 44 45publisherRobertChambers,theastronomer JohnPringleNichol,theevolutonary environmentalist Hewet Cotrell Watson and asylum reformer William A.F. Browne. George Combewastheauthorofsomeofthemost popularworksonphrenologyandmental hygiene, e.g., The Consttuton of Man (1828) andElementsofPhrenology.TheAmerican brothersLorenzoNilesFowler(1811-1896) andOrsonSquireFowler(1809-1887)were leadingphrenologistsoftheirtme.Orson, togetherwithassociatesSamuelWellsand NelsonSizer,ranthephrenologicalbusiness and publishing house Fowlers & Wells in New YorkCity.Meanwhile,Lorenzospentmuch ofhislifeinEnglandwhereheinitatedthe famousphrenologicalpublishinghouse,L.N Fowler&Co.,andgainedconsiderablefame withhisphrenologyhead(achinahead showingthephrenologicalfacultes),which has become a symbol of the discipline.BraininPartcular,withObservatonsupon thepossibilityofascertainingtheseveral IntellectualandMoralDispositonsofMan andAnimal,bytheconfguratonoftheir Heads. It was not published untl 1819. In the introducton to this main work, Gall makes the following statement in regard to his doctrinal principles,whichcomprisetheintellectual basis of phrenology: Thatmoralandintellectualfacultesare innate Thattheirexerciseormanifestaton depends on organizaton Thatthebrainistheorganofallthe propensites, sentments and facultes Thatthebrainiscomposedofasmany partcular organs as there are propensites, sentmentsandfaculteswhichdifer essentally from each other. Thattheformoftheheadorcranium represents the form of the brain, and thus refectstherelatvedevelopmentofthe brain organs. Throughcarefulobservatonandextensive experimentaton,Gallbelievedhehad established a relatonship between aspects of character, called facultes, to precise organs in thebrain.Gallsmostimportantcollaborator wasJohannSpurzheim(1776-1832),who disseminatedphrenologysuccessfullyinthe UnitedKingdomandtheUnitedStates.He popularizedthetermphrenology(fromthe Greekwordphrenosmeaningbrain: compare with the word schizophrenia).Othersignifcantphrenologistsincluded theScotshbrothersGeorgeCombe(1788-1858)andAndrewCombe(1797-1847), whoinitatedthePhrenologicalSocietyof Edinburgh.ThisEdinburghgroupincluded anumberofextremelyinfuentalsocial reformersandintellectuals,includingthe reviewartclethatinitatedhisrealizaton thatphrenologycouldnotbeconsidereda serious science, and his later books refect his acceptance of Britsh psycho-physiology.Phrenologywasalsoverypopularinthe UnitedStates,whereautomatcdevicesfor phrenological analysis were devised. One such AutomatcElectricPhrenometerisdisplayed intheintheScienceMuseumofMinnesota in Saint Paul. Duringtheearly20thcentury,arevival ofinterestinphrenologyoccurredonthe fringe, partly because of studies of evoluton, criminology and anthropology (as pursued by CesareLombroso).ThemostfamousBritsh phrenologistofthe20thcenturywasthe London psychiatrist Bernard Hollander (1864-1934).Hismainworks,TheMentalFuncton of the Brain (1901) and Scientfc Phrenology (1902)areanappraisalofGallsteachings. Hollander introduced a quanttatve approach tothephrenologicaldiagnosis,defning amethodformeasuringtheskull,and comparing the measurements with statstcal averages. InBelgium,PaulBouts(1900-1999)began studyingphrenologyfromapedagogical background,usingthephrenologicalanalysis todefneanindividualpedagogy.Combining phrenologywithtypologyandgraphology, hecoinedaglobalapproachknownas psychognomy. Bouts,aRomanCatholicpriest,becamethe mainpromoterofrenewed20th-century interestinphrenologyandpsychognomy inBelgium.HewasalsoactveinBraziland Canada,wherehefoundedinsttutesfor characterology.HisworksPsychognomie andLesGrandiosesDestnesindividuelleet humaine dans la lumire de la Caractrologie etdelEvolutoncrbro-cranienneare consideredstandardworksinthefeld.In thelaterwork,whichexaminesthesubject 1848editonofAmericanPhrenological JournalpublishedbyFowlers&Wells,New York City.IntheVictorianage,phrenologyasa psychologywastakenseriouslyand permeatedtheliteratureandnovelsofthe day.Manyprominentpublicfguressuchas the Reverend Henry Ward Beecher (a college classmate and inital partner of Orson Fowler) promotedphrenologyactvelyasasource ofpsychologicalinsightandself-knowledge. Britsh Prime Minister David Lloyd George was known to have a keen interest in the subject, once contriving a meetng with C.P. Snow afer notcing that the author had an interestngly shaped head. Thousands of people consulted phrenologistsforadviceinvariousmaters, suchashiringpersonnelorfndingsuitable marriagepartners.Assuch,phrenologyasa brainsciencewanedbutdevelopedintothe popularpsychologyofthe19thcenturyand functoned in approximately the same way as psychoanalysis permeated social thought and relatonships a century later. Beginning during the1840s,phrenologyinNorthAmerica becamepartofacounter-culturemovement evidentintheappearanceofnewdress styles,communes,mesmerism,andarevival of herbal remedies. Orson Fowler himself was known for his octogonal house.Throughout,however,phrenologywas rejectedbymainstreamacademia,and wasforinstanceexcludedfromtheBritsh AssociatonfortheAdvancementofScience. Thepopularityofphrenologyfuctuated duringthe19thcentury,withsome researcherscomparingthefeldtoastrology, chiromancy, or merely a fairground atracton, whileotherswroteseriousscientfcartcles onthesubject.Thelastphrenologybookin Englishtoreceiveseriousconsideratonby mainstreamsciencewasTheBrainandIts Physiology(1846)byDanielNoble,buthis friend,WilliamCarpenter,wrotealengthy 46 47hisworkhasbeencontnuedbytheDutch foundatonPPP(PerPulchritudinemin Pulchritudine),operatedbyAneteMller, one of Bouts students.During the 1930s, Belgian colonial authorites in Rwanda used phrenology to explain the so-called superiority of Tutsis over Hutus.Empiricalrefutatoninducedmostscientsts ofpaleoanthropology,Boutsdeveloped ateleologicalandorthogenetcalviewon aperfectngevoluton,fromthepaleo-encephalicalskullshapesofprehistoric man,whichheconsideredstllprevalentin criminals and savages, towards a higher form ofmankind,thusperpetuatngphrenologys problematc racializing of the human frame.BoutsdiedonMarch7,1999,aferwhich 48 49MethodPhrenologywasacomplexprocessthat involvedfeelingthebumpsintheskullto determineanindividualspsychological atributes.FranzJosephGallfrstbelieved thatthebrainwasmadeupof27individual organsthatcreatedonespersonality,with the frst 19 of these organs believed to exist inotheranimalspecies.Phrenologistswould run their fngertps and palms over the skulls oftheirpatentstofeelforenlargementsor indentatons. The phrenologist would usually takemeasurementsoftheoverallheadsize toabandonphrenologyasasciencebythe early 20th century. For example, various cases wereobservedofclearlyaggressivepersons displayingawell-developedbenevolent organ, fndings that contradicted the logic of thediscipline.Withadvancesinthestudies of psychology and psychiatry, many scientsts becameskeptcaloftheclaimthathuman charactercanbedeterminedbysimple, external measures.OnMonday,October1,2007theStateof Michigan began to impose a tax on phrenology services. Vanity;ambiton;loveofglory(aquality benefcentfortheindividualandfor society). Circumspecton; forethought. Thememoryofthings;thememoryof facts; educability; perfectbility. The sense of places; of space proportons, of tme. Thememoryofpeople;thesenseof people. The memory of words. The sense of language; of speech. The sense of colours. The sense of sounds; the gif of music. Thesenseofconnectednessbetween numbers. Thesenseofmechanics,ofconstructon; the talent for architecture. Comparatve sagacity.The sense of metaphysics. The sense of satre; the sense of witcism. The poetcal talent. Kindness;benevolence;gentleness; compassion; sensitvity; moral sense. The faculty to imitate; the mimic. The organ of religion. Thefrmnessofpurpose;constancy; perseverance; obstnacy.usingacaliper.Withthisinformaton,the phrenologistwouldassessthecharacterand temperament of the patent and address each of the 27 brain organs. This type of analysis was used to predict the kinds of relatonships andbehaviorstowhichthepatentwas prone. In its heyday during the 1820s-1840s, phrenology was ofen used to predict a childs futurelife,toassessprospectvemarriage partnersandtoprovidebackgroundchecks for job applicants.Gallslistofthebrainorganswaslengthy and specifc, as he believed that each bump or indentatoninapatentsskullcorresponded to his brain map. An enlarged bump meant that the patent utlized that partcular organ extensively.The27+areaswerevariedin functon, from sense of color, to the likelihood ofreligiosity,tothepotentaltocommit murder.Eachofthe27+brainorganswas locatedinaspecifcareaoftheskull.Asa phrenologistfelttheskull,hecouldreferto anumbereddiagramshowingwhereeach functonal area was believed to be located. The27brainorganswere:Theinstnctofreproducton(locatedin the cerebellum). The love of ones ofspring. Afecton and friendship. Theinstnctofself-defenseandcourage; the tendency to get into fghts. The carnivorous instnct; the tendency to murder.Guile; acuteness; cleverness. Thefeelingofproperty;theinstnct ofstockinguponfood(inanimals); covetousness; the tendency to steal. Pride;arrogance;haughtness;loveof authority; lofiness. 50 5152 53efectsofFootRefexologythetherapists healingtouchprovidesimprovementsin structure(helpingtostreamlinethebodys lines),increasesfexibility(producing healthier feet), and lowers stress and relaxes thebody(whichreleasesstoredtoxinsand restores the bodys chemical balance.Depending on the nature of the issues being addressed, the sensaton will vary widely from stretching to a nerve-like pinch to needle-like sensatons where it might feel like fngernails arebeingstuckintoyourfeet.Theseare simplystressreactonsofyourbodyandwill changedramatcallyasyourfeetbecome healthier.ManyofmyfootRefexologyclientsstart byneedingtoaddressfootpain.Overtme, Ivemodifedtheapproachforthoseclients toincorporatesomeelementsofRolfngto more efectvely and more holistcally correct underlying issues.Those Refexology clients have almost always tendedtomigratetoregularRefexology sessionsevenafertheprimaryissueswere resolvedbecauseduringtheearlytherapy, Refexologyclientsgenerallyalsoexperience the benefts of lower stress and higher levels of relaxaton throughout themselves. Footrefexologyisanefectvemethodof addressingspecifcareasofachesandpains andisawonderfulwayofrelaxing.Itwill keepyourfeetfexibleandingreathealth, minimizingthechancesthattheoriginal issues will recur and supportng a lower stress level in your day to day living.NaplesRolfngCertfedAdvancedRolfng and Natonally Licensed Deep Tissue Massage Therapy now in Madison Wisconsin.ManypeoplebelievethatRefexologydates backtoancientEgyptandChina.Thereare manyreferencesbacktoanoldEgyptan hieroglyphdepictngsomeonemanipulatng anotherpersonsfoot.Thehieroglyphics roughlytranslatetoDonthurtmewitha responseofIshallactsoyoupraiseme. However,therehasntbeenanydirect explanatonofwhatwasbeingdonetothe foot.Modern day Refexology, as best we can trace it,appearedtohavebeenformalizedbya PhysiotherapistnamedEuniceInghamwho, throughobservaton,createdamappingof diferentareasofthefeettoorgansofthe body,proposingthatunderlyingissuescould behelpedbyworkingtherefectedorgan inthefeet.Today,Refexologyisprimarily performed on the feet and hands and involves the applicaton of pressure to specifc points. Therehavenotbeenmanyclinicalstudies onRefexologybutpeopleappearto unequivocably beneft from some fundamental 54 5556 57painintheears,shouldersorbackofen disappears within minutes.Ifthereisaseriousoracuteproblem,use refexologyseveraltmesaday.However, thistreatmentmaystmulateachronically weakorgantoincreasedactvityanditmay becometenderforawhiletogetherwithits refex areas. Generally, deep, strong and slow pressure is sedatng and pain relieving, while light,quicktappingorcirclingisstmulatng. Selectwhicheverisappropriate.Forsome pointsaso-calledC-clampisefectve:press withthethumbfromunderneaththefoot andwiththeindexfngerfromthetop.This may be used for the liver, spleen and thymus.Anothermethodofapplyingpressureto fngersandtoesistoputtghtrubberbands around them or to use clothes pegs to clamp the digits. Rubber bands should never be lefon for more than a few minutes at a tme. In additon, you may frmly grasp a metal comb, pressing its teeth into the palm or the fngers. A metal comb or a brush may also be used to sweep the backs of the hands and lower arms up to the elbows in quick upward strokes. Five minutesofthiswillstmulatethecirculaton and invigorate the body.Methods of TreatmentTheeasiestandmostcommonformof treatment is to apply pressure on sore points withthepadofafnger,thethumb,with aknuckleorwithabluntinstrument(for example, the blunt end of a pencil or a pen). Ifitisquitesore,pressstraightdown,with only light pressure at frst. Gradually increase the pressure as the pain lessens. Finally, when evenstrongpressurecanbetolerated,you mayapplythepressureinaslowcircular motoninordertorelaxthedeepermuscles and ligaments.Forself-treatmentunderneaththefeet,it willusuallybemoreconvenienttopressor rollthesorepointsonagolfball,astoneor another suitable object. To press refex areas inthepalmsofthehands,itisusuallymore convenienttouseaknuckleorasuitable blunt instrument than the pad of the thumb. Usually, the pain begins to subside afer a few minutes of pressing. If this happens, increase the pressure for a while, but if the pain instead increases,stopthetreatment.Theefecton relatedbodypartscanbesurprisinglyquick: Important Areas to TreatThe foot and hand charts will give you a good indicaton of where to fnd suitable points for treatngspecifccomplaints.Forbestresults work on all the major refex areas: hands, feet, earsandmouth.Alwaystreatinthesame zoneinwhichtheproblemarises.Yourlefinner ear, for example is in zone 4. Therefore, totreatityouwillmanipulatethelefring fngerthethirdtoeincludingitsrootonthe lef side, the ear points of the lef ear and the outer lef side of the tongue and palate. Workfrequentlyaroundthejointsoffngers andtoes,especiallydiggingunderneaththe lowestjointsofthethumbsandbigtoes. Rubber bands or clothes pegs may be placed for fve to 10 minutes on the tps of the digits, oronorbetweenthejoints,depending onwherethereismoresensitvity.Lymph drainage can be improved by press-massaging the area of the upper chest on top of the feet just below the toes.Generally, treat a sensitve area for fve to 10 Furtherefectveareasfortreatmentare thetongue,the-insidewallofthemouth, especially the palate (top), under the tongue andthebackofthemouth(pharynx).You may press with the pad of a fnger or thumb or use a suitable instrument.Pressureonthetonguemaybeappliedby bitng or pressing with the handle of a spoon. This is efectve for treatng problems in other areas of the body belonging to the same zone.In additon, the tongue may be pulled out for several minutes by grasping it with a cloth and moving it around. Alternatvely, you may poke itoutasfaraspossibleandholditinplace withyourteeth.Youmayalsoworkaround the angles of the jaw and chin.Becauseofthesensitvityofthemouth, thistreatmentisofenmoreefectvethan handandfootrefexology,especiallyforall problems related to the head and throat.58 59byDrJohnWhitmanRayitisrecommended to work in a certain sequence for regeneratng thebody.Startwiththeso-calledSTO-point: pressintothevalleybetweenthemuscles frombothsidesofthespineandthenup undertheskull(occiput).Thisistoimprove the nerve transmission to all parts of the body.Then start working on points in the following order:pinealgland,hypothalamus,pituitary, medulla, thyroid, thymus, heart, solar plexus, pancreas,adrenals,spleen,gonads(uterus, ovaries,prostate,testcles),liver,kidneys, gallbladder,bladder,smallintestne,large intestne.minutes at a tme. For an acute problem, you may treat it several tmes daily, while chronic problemsmaybetreatedonceaday.For general health improvement you may select a diferent area each day untl you return to the same area afer one or two weeks. This process maycontnueforyears,asformerlyweak areasbecomeactvatedandcauseincreased sensitvity in their corresponding refex areas. Walking barefoot on rough ground provides a natural foot massage - make good use of it.The BrainForgeneralhealthimprovementand regeneratonworkfrequentlyonthebrain, especiallythepituitarygland,thepineal gland,thehypothalamusandthemedulla (oblongata).Thepituitaryrefexofenfeelslikeasharp boneprotrusion;pressitinthedirectonof thetpofthetoe.Thehypothalamusand medullaarepressedfromtheinsidesofthe big toes. For general health improvement it is best to start with actvatng these parts of the brain and then contnue with the other glands and organs.In the system of Body Electronics as developed 60 61gonetoendlessseminars,buttheoryisnt doingitforme.Allthetheoryisuselessif youre unsure of your diagnosis. What I need isanexperiencedpracttonertoworkwith who can and will tell me if what Im seeing on the tongue and feeling in the pulse is correct. Otherwise,IfeelasifImfantasizingallthe tme.IsthatwhatChinesemedicineisall about?Thispracttonerhasrecognizedsomething thatmanyothers,whofeelmoreconfdent despitelimitedtraining,mayignore:there isagreatpotentaltosimplyfantasize thediagnostcsigns,thatis,toreadintoit something that is not really present. But, this is not what Chinese medicine is about; rather, thereisaclearlydefnedmethodofpulse taking(andtongueexaminaton,aswellas otherimportantdiagnostctechniques)that can lead to reasonably well-defned syndrome determinaton. The informaton presented below is aimed at examiningthetraditonalandmodernroles ofpulsediagnosis,thetechniquesfortaking the pulse, the interpretaton of various pulse forms,andsomeofthecontroversiesthat exist regarding the use of pulse diagnosis. THE ORIGINAL PLACE OF PULSE DIAGNOSIS IN THE CHINESE TRADITIONPulse diagnosis is one of the original set of four diagnostcmethodsthataredescribedasan essentalpartoftraditonalChinesemedical practce(1).Theotherthreediagnostc methods are:inspecton:generalobservatonsofthe patent,includingfacialexpression;skin colorandtexture;generalappearance, andtheshape,color,anddistnctve markingsofthetongueandthenature THE SIGNIFICANCE OF TRADITIONAL PULSE DIAGNOSIS IN THE MODERN PRACTICE OF CHINESE MEDICINEEssaybySubhutDharmananda,Ph.D., Director,InsttuteforTraditonalMedicine, Portland, OregonINTRODUCTIONThechangingsetnginwhichChinese medicine is practced in modern versus ancient tmes, especially with the advent of advanced technologicalmedicaldiagnostcs,hasraised questonsastothevalueofpulsediagnosis. Shoulditsusebelimitedtoconfrminga diagnosisreachedbyothermeans?Or,does the pulse informaton add critcal informaton that can greatly alter the treatment strategy? Traininginpulsediagnosisisofenquite limited; further, the requisites for carrying out atraditonalstylediagnosisaresometmes absentfromtheclinicalsetng,makingthe resultsofthepulsetakinglesscertain.How doesonegetthedesiredinformatonunder such circumstances?Several years ago, an acupuncturist in the U.S. wrote to me saying:Ivebeenpractcingforoverfveyearsnow andhaveabusypractce;but,Imtotally disheartenedaboutmyabilites.Thebiggest difcultesarediagnostc.Igraduatedschool asoneofthebeststudentsinmyclass,yet neitherInoranyofmyclassmateshadany clear sense of tongue or pulse diagnosis. Ive A yin pulse that shows no stomach qi is called thepulseofzhenzang[decayingpulse]and the prognosis is usually death. Why? Because a yin pulse refects absence of yang and thus absenceoflifeactvity.Ifyoucandistnguish the presence or absence of the stomach pulse, you can know where the disease is located and give the prognosis for life or death, and even knowwhendeathmightoccur....Whenyang pulses are absent in a patent, the yin or the decaying pulse of the liver is like a thin thread onthevergeofbreaking,orlikeatghtly woundwireabouttosnap.Thepatentwill die within eighteen days. If the decaying pulse oftheheartislikeathinfragilethread,the patent will surely die within nine days. If this pulseisfoundinthelungpulse,thepatent will not survive longer than twelve days. If it is found in the kidney pulse, the patent will die in seven days. If it is found in the spleen pulse, the patent will die in four days.A more complete prognosis involves coupling theinformatonaboutthepulsewiththe examinaton of the facial color and the spirit expressed by the facial expressions (especially theeyes).IntheNeijing,itissaidthat:In diagnosis, observaton of the spirit and facial color,andpalpatonofthepulses,arethe twomethodsthatwereemphasizedbythe ancientemperorsandreveredteachers.... Asatextexpoundingonthevirtuesofthe ancientteachers,therewerecomplaints aboutfailingsofthemodernpracttonersin theirdiagnostcwork,whichechoesforward tothemodernera.Thepracttonersofthe tme were encouraged not to forget the other necessarydiagnostcmethods,especially inquiry:Today,doctorsdeviatefrom[thetreatment methodsofancienttmes].Theycannot evenfollowthechangesinthefour seasons[thatinfuencethepulseandother bodyconditons].Theydonotknowthe importance and principles of the complexion ofitscoatng;andsmelling(notngany unusualsmellofthebody,mouth,or urine); listening:tothequalityofspeech (includingresponsivenesstoquestons, rapidityoftalking,volumeofthevoice); totherespiraton;andtosoundsof illness,suchascoughing,gurglingfrom the intestnes; and inquiring:obtaininginformatonabout thepatentsmedicalhistoryandtheir symptomsandsigns,suchaschills/fever, perspiraton,appetteanddietaryhabits, eliminaton,sleep,andanypains;also, for women inquiring about menstruaton, pregnancy,leukorrheaandothergyno-obstetric concerns.Allofthesediagnostcmethodsyield informatonthathelpstodeterminethe syndromeandconsttutontobetreated. While the Chinese pulse and tongue diagnosis methods,becauseoftheirfrequentmenton andsomewhatuniquequalityamong traditonalmedicalsystems,receivemuch atenton,theotheraspectsofdiagnosis cannot be ignored or downplayed.The Chinese term indicatng a blood vessel or a meridian (which are two interlinked concepts; seeDrawingaconcept:jingluo)ismai,and the same term is used to describe the pulse. Pulse feeling is called qiemai, which is part of the general diagnostc method of palpatng or feeling the body: qiezhen [feeling method].Pulse diagnosis is mentoned in ancient texts, such as the Huangdi Neijing and the Huangdi NeijingoftheHanDynastyperiod,butwith only sporadic menton of various pulse forms andtheirmeaning.IntheHuangdiNeijing, pulseisdepictedprimarilyasameans ofprognosisforimpendingdeath.Asan example, in the secton of the book on yin and yang it is said that (2):62 63Physicians today do not thoroughly study the medical classics before they begin to practce, butmerelyfollowtheirpredecessorswith noatempttoimproveage-oldforms....They takethefrontpulse,butnottherear;check the hands, but not the feet; and do not make adiagnosisofthecompleteupper,middle, and lower parts of the body. How can a pulse aloneandcarelessobservatontellaboutall the syndromes and diseases?The concern is about incomplete and careless diagnosis,partcularlywherethepulseis theprimarydiagnostcmethod(omitngor minimizing the others), and failure to carry out thefullpulsetaking(frontandrearpulses). Thisisathemethatpersiststhroughout Chinesemedicalhistory,andappliesto modernmedicaldiagnostcsaswell(where medical doctors are chided for having missed adiagnosisbynotperformingallnecessary testsorbycarelesslyinterpretngthetest results).TheproclaimedfailingsintheHan Dynasty tmes, an era regarded by subsequent authorsasoneofthehighpointsofChinese medicine, illustrate that the reverence for the pastisaimedatthewiseinstructonsofthe small number of highly accomplished scholar physicians (who lef behind the classic texts), ratherthanthestateofmedicalpractce asawhole.Thedesire,whichcanonlybe professedandneverfullyaccomplished,is thatallphysiciansshouldatainthehighest possiblestandardandshouldmasterthe diagnostc methods through diligent study of the classics and contnual atenton to detail.THE PULSE CLASSICThesubjectofpulsediagnosiswasfrst tackledinanorganizedmannerbyWang Shuhe, who lived during the 3rd century A.D. (just afer the fall of the Han Dynasty). Wang was responsible for recovering and organizing theHuangdiNeijing(see:Amodernview andpulses....Doctorstodayshouldeliminate theirbadhabitsandignorance,opentheir minds,andlearntheessenceofpulseand color diagnosis [i.e., analysis of facial colors]. Onlybydoingsowilltheyeversucceedin reachingtheleveloftheancientsages....Thereisoneotherimportantthing.Thatis the interrogaton of the patent, the inquiry....Selectaquietenvironment;closealldoors andwindows;gainthetrustofyourpatent sothatthepatentcancompletelyconvey everything that is pertnent to the conditon. Be thorough and diferentate the truth.IntheHuangdiNeijing(3),thepulseis mentoned briefy and simply among a list of symptomsthatwouldindicateapartcular diseasestageorcategory;thus,forthe taiyangdisease,thepulseisfoatng,fora yangmingdisease,thepulseislarge,and forthejueyindisease,thepulseisfeeble.In thecompanionvolumeJinguiYaolue,there ismoredescriptonofthepulsesandsome explanaton of their meaning. For example, it issaidthat:Apulsetoostrongortooweak denotes illness. A minute pulse on the cun site andachordalpulseonthechisiteportends thoracic debility and aching because it refects anextremelyweakconditonofyanginthe upper warmer. Heart pain follows the thriving yinevilascharacterizedbythedeepchordal pulse.Thepresentatonofdiagnostcinformaton intheseworksofZhangZhongjingconfrms theimportanceofinquiry,sinceitisbythis meansthatonelearnstheessentalfeatures describedthroughoutmostofthetext,such aslocatonofpain,duratonofdisease,and other factors that determine the selecton of herbs(thirst,mentalconditons,urinaton, etc.).InhisprefacetotheHuangdiNeijing, Zhangcontnuesthecomplaintexpressedin theNeijingaboutpracttonersinhistme, acenturyormoreafertheNeijingwas produced in the form we have currently: AfertheproductonoftheMaiJing,many diferentconceptonsofpulsediagnosis aroseandledtoagreatdealofconfusion about interpretng what was being felt by the physician.XuDachun(1693-1771)produced achapterontheMaiJinginhisbookYixue Yuanliu Lun (12), commentng that: Thoseexpertswhodiscussedthepulse throughtheageshaveallcontradictedone another,andtheyalldiferedinwhatthey consideredrightandwrong.Theyallclingto theirspecifcdoctrine,andtheiradvantages anderrorsbalanceeachother....Students readingtheMaiJingmustconsulttheNei Jing, the Nan Jing, and the doctrines of Zhang Zhongjing [Huangdi Neijing, Jingui Yaolue].Inotherwords,theclassictextsofthe HanDynastyhavethebasicdoctrinesof importance,andtheymustallbestudiedin order for the Mai Jing to be fully meaningful. The digressions in the theory and practce of pulse diagnosis that were made later should, accordingtoXu,beignored,becausethey introduceconfusionratherthanclarifcaton. AllthebooksmentonedbyXuintheabove quote are now available in English translaton (see:SomeselectedChinesemedicaltexts intranslaton),refectngthecommonview that they are essental to the study of Chinese medical doctrines.AIM AND METHOD OF PULSE DIAGNOSISTheaimofpulsediagnosis,liketheother methodsofdiagnosis,hasalwaysbeento obtain useful informaton about what goes on inside the body, what has caused disease, what mightbedonetorectfytheproblem,and whatarethechancesofsuccess.According totheChineseunderstanding,thepulsecan revealwhetherasyndromeisofhotorcold nature,whetheritisofexcessordefciency oftheHuangdiNeijing);hemayhavefully rewritenthefrstthreecritcalchapters. Histextonpulsediagnosisbecameknown astheMaiJing(PulseClassic).Althoughthe texthadbeenregardedasquitedifcultto understand, and was therefore ofen replaced by simpler, derivatve tracts, it has, in modern tmes,beendeemedaclassicworthyof preservaton.AtranslatonoftheMaiJing, basedonamodernChineseeditedversion, has been published by Blue Poppy Press (4). In the Mai Jing, a broad spectrum of applicatons forpulsediagnosisisdelineated,including etologyofdisease,natureofthedisease, and prognosis. As an example of etology and diseasedevelopment,itissaidthat:Ifthe pulseisbowstring,tght,choppy,slippery, foatng, or deep, these six point to murderous evilswhicharecapableofcausingdiseasein variouschannels.Asanexampleofdisease analysis,thefollowingpulsecharacteristcs and implicatons are given: Ifitsemergingandsubmergingareequal, thisisanormalstate;ifitssubmergingis twice as long as its emerging, this is shaoyin. Ifitssubmergingisthreetmeaslongasits emerging,thisistaiyin.Ifitssubmerging isfourtmesaslongasitsemerging,thisis jueyin.Ifitsemergingistwiceaslongasits submerging,thisisshaoyang.Ifitsemerging isthreetmesaslongassubmerging,thisis yangming. If its emerging is four tmes as long as its submerging, this is taiyang.Astoprognosis,anexamplewithgreat specifcity is: If, on the seventh or eighth day, a febrile disease exhibits a pulse which is not grasping-like but beatng rapidly at a constant pace,thereoughttoariseadiseaseofloss ofvoice.Perspiratonisexpectedtocomein three days. If it fails to come then, death will occur on the fourth day. As before, the main prognostc value of the pulse was in relaton to impending death (or, if the pulse is favorable, recovery from the disease).64 65from24-28diferentpulseforms,depending ontherecitaton(sometmesapulse typeissubdividedintotwo;sometmesa complexpulsetypeisnotincluded),though simplifedsetsareofengiveninlessformal presentatons.Despitethenumerous descriptons of pulse forms in the lengthy Mai Jing,thepracttonerisreallybeingaskedto becomefamiliarwiththismodestsizedand basic set of pulse categories, which were frst outlinedintheopeningchapteroftheMai Jing. In the English language translaton of the book,thedescriptonofthesefundamental pulsecategoriestakeupjust3pagesoutof 360.PULSE CATEGORIESInarecentartcledescribingthestandard pulsecategoriesbyterminologyexpert XieZhufan(7),26basicpulsetypeswere outlinedandgivenupdatedEnglish languageinterpretatons(twoofthetypes havethesameChinesenamebutdiferent descriptons).Table1presentsthesepulse categories. Inthetable,theEnglishtranslatonterm isgivenfrst;inafewcases,alternatve Englishnamesaregivenforthesame traditonalcategoryindicatedbyasingle Chineseterm(giveninpinyin).Thenaming andinterpretatonofthepulseistaken directlyfromtheartcleSelectedterms intraditonalChinesemedicineandtheir interpretatons (7). The comments are added herebythecurrentauthor,withreference alsotoinformatonfromtheDictonaryof Traditonal Chinese Medicine (8). The 7 pulses presented frst (scatered, intermitent, swif, hollow,faint,surging,andhidden)areones thatmayhavelitlerelevancetopractceof traditonalmedicineinthemodernsetng. Theother19pulsesappearmorelikelyto helpthepracttonerdetermineimbalances type,whichofthehumors(qi,moisture, blood) are afected, and which organ systems suferfromdysfuncton.Inordertomake thesedeterminatons,thephysicianmust feelthepulseundertheproperconditons-followingtheestablishedprocedures-and mustthentranslatetheuniquepulsethat isfeltintooneormoreofthecategoriesof pulse form.In his book reviewing pulse diagnosis (5), Bob Flaws emphasizes the importance of learning thebasicpulsecategoriesinorderforpulse diagnosis to be conducted efectvely. He says:In my experience, the secret of Chinese pulse examinatonisexactlythis:Onecannotfeel apulseimageunlessonecanconsciously andaccuratelystatethestandard,textbook defniton of that pulse image.In supportof this contenton, he alsoquotes Manfred Porkert (6):This, precisely, is the critcal issue: there is no point in atemptng practcal training in pulse diagnosisunlessallpertnenttheoryand, moreimportant,thecompleteiconography [setofimagecategories]ofthepulsehas previously been absorbed intellectually.Chinesemedicaltextsdonotdescribewhat thepracttonerexperienceis(orshould be)duringpulsediagnosis;thisisleftobe passed on from accomplished practtoner to student.Incontrast,theseWesternscholars are trying to relate to their Western readers, inwritenform,thestepsbywhichonecan masterthediagnostcmethod.Thebasic premiseoutlinedbyFlawsandPorkert-that one must master the categories frst-appears tobesupportedintheChineseliteratureby thealmostuniversalpractceofintroducing pulsediagnosisbylistnganddescribingthe basic set of pulse categories. Themoststandardinconographyinvolves hardpressure,usuallyseenincaseswith accumulatonofcoldpathogenicfactors yielding formaton of a frm mass; and damai (large pulse), is a high pulse wave that lifs the fnger to a greater height then normal. Damai iseitherforceful(hasalargemassbehindit, indicatng excess heat with damaged internal organfuncton)orweak(indicatnglitle force,seenincasesofgeneraldebility,with foatngyang).Manyauthorsregardthese pulsesascompositesoftwoormorebasic pulses rather than unique pulse types.Table 1: Pulse Categories in Translaton.that relate to the selecton of traditonal style therapeutcs(i.e.,acupuncturepointsand individualherbs).Severalofthe pulseslisted inthetablerepresentpairsdepictngyin/yangopposites,suchas:foatngvs.sinking (surface/interior);slowvs.rapid(cold/hot); weakvs.replete(defciency/excess);and shortvs.long(alsoindicatngdefciency/excess).Therearethreeadditonalpulse typesreportedintheDictonary(8):gemai (hardandhollowpulse),islargeandtaut yetfeelshollowliketouchingthesurfaceof a drum, indicatng loss of blood and essence; itmayalsooccurwithhypertension;laomai (aforcefulandtautpulse)isfeltonlyby Pulse Type Interpretaton CommentsScatered pulse [sanmai]An irregular pulse, hardly perceptble, occurring in critcal cases showing exhauston of qi.These are cases where the patent is critcally ill, perhaps near death; such patents are normally hospitalized (or sent home to die) and their diagnosis is usually well-established. The pulse only tells that the patent is severely debilitated; it difuses on light touch and is faint with heavy pressure.Intermitent pulse [daimai]A slow pulse pausing at regular intervals, ofen occurring in exhauston of zangfu organs, severe trauma, or being seized by terror.As with the scatered pulse, this pulse type is usually only seen in cases where the person is hospitalized or otherwise in an advanced disease stage. It is expected to occur, for example, with those having serious heart disease.Swif pulse [jimai] A pulse feeling hasty and swif, 120-140 beats per minute, ofen occurring in severe acute febrile disease or consumptve conditons.This pulse is so rapid (twice the normal speed) that it is easily detected; the acute febrile disease involves an easily measured high temperature and is usually subject of pathogen testng. Consumptve conditons with such high pulse rates are generally under emergency medical care.66 67Pulse Type Interpretaton CommentsHollow pulse [koumai]A pulse that feels foatng, large, sof, and hollow, like a scallion stalk, occurring in massive loss of blood.Massive blood loss can easily be reported. This pulse is felt lightly at the superfcial level and lightly at the deep level, but barely felt at the intermediate level. The light pulse is like the fexible scallion material, with a hollow center. It means that there is stll some fow of qi at the vessel surface, but not much blood.Faint pulse [weimai] A pulse feeling thready and sof, scarcely perceptble, showing extreme exhauston.Extreme exhauston is obvious to both the patent and the practtoner. The pulse, lacking substance, volume, and strength, simply reveals the exhauston of the body essences. It is weaker than the thready (faint) pulse.Surging pulse [hongmai]A pulse beatng like dashing waves with forceful rising and gradual decline, indicatng excessive heat.Excess heat syndromes are rarely difcult to detect, so this pulse type adds litle informaton. The force of the pulse indicates that the conditon is pathologically excessive, the gradual decline shows that the syndrome is primarily one of heat (qi excess) rather than fuid excess. The pulse is sometmes described as a "full pulse" indicatng the excess conditon.Hidden pulse [fumai] A pulse that can only be felt by pressing to the bone, located even deeper than the sinking pulse, ofen appearing in syncope or severe pain.This pulse is quite extreme, in that one can barely detect it except by applying deep pressure; it gives the sense that the pulse is hidden in the muscles. If there is litle musculature, it is as if it is restng on the surface of the bone. The conditons for which it is typical, syncome (faintng) and severe pain, can easily be determined without taking the pulse.Knoted pulse [jiemai]A slow pulse pausing at irregular intervals, ofen occurring in stagnaton of qi and blood. Qi and blood stasis represents a traditonal diagnostc category that does not have a direct correlaton with modern diagnostcs. In this pulse, the irregularity and slowness is due to obstructon.Pulse Type Interpretaton CommentsHurried pulse [cumai] A rapid pulse with irregular intermitence, ofen due to excessive heat with stagnaton of qi and blood, or retenton of phlegm or undigested food. This is the excess version of the knoted pulse. It is sometmes called the "running" or "abrupt" pulse. The rapidity indicates heat and the irregularity indicates the blockage caused by stagnaton and/or accumulaton.Long pulse [changmai]A pulse with lengthy extent and prolonged stroke. A long pulse with moderate tension may be found in normal persons, but a long and stringy pulse indicates excess of yang, especially liver yang.Partcularly in young people, the pulse is felt rather easily across all three fnger positons, as is characteristc of the long pulse. The prolonged stroke shows that the vessels are both strong and fexible. A stringy quality indicates a certain level of tension, that corresponds with a liver syndrome. In cases of acute disease, a long pulse will occur when there is a strong confrontaton between the body's resistance and the pathogenic factor.Short pulse [duanmai]A pulse with short extent. A short and forceful pulse is ofen found in qi stagnaton and a short and weak pulse implies consumpton of qi.The short pulse seems to deteriorate from the central pulse positon towards the two adjacent pulse positons. It strikes the middle fnger sharply and leaves quickly. On the one hand, this can represent contracton of the qi, as in liver qi stagnaton, or it can represent defciency of the qi.Fine pulse [ximai] or Thready pulse [ximai]A pulse felt like a fne thread, but always distnctly perceptble, indicatng defciency of qi and blood or other defciency states.Although the defciency can be easily detected by other means, some patents can show an artfcially robust exterior appearance, while having notable defciency. Essence defciency, the result of chronic illness, can give rise to this pulse type.Hesitant pulse [semai] or Uneven pulse [semai] or Choppy pulse [semai] A pulse coming and going choppily with small, fne, slow, joggling tempo like scraping bamboo with a knife, indicatng sluggish blood circulaton due to defciency of blood or stagnaton of qi and blood.This has a more irregular patern than