Auscultation And Olfaction

Listening

Listening to the speech

In general, speaking lustily indicates syndromes of excess type, while speaking feebly and in low tones indicates those of deficiency type. A hoarse voice or loss of voice in a severe case may be of deficiency type or of excess type. If they are present in exogenous diseases with a sudden onset, they are of excess type. Chronic or recurrent onset in endogenous diseases are of deficiency type.

Incoherent speech in loud voice accompanied by impaired consciousness indicates a syndrome of excess type due to disturbance of the mind by heat. Repeated speech in feeble voice accompanied by listlessness suggests a syndrome of deficiency type of the heart resulting from severe damage of the heart qi.

Listening to the respiration

Feeble breathing indicates deficiency of qi. Forceful and coarse breathing accompanied by a loud voice suggests a syndrome of excess type due to excessive pathogenic heat in the interior.

Feeble asthmatic breathing accompanied by shortness of breath indicates deficiency of the qi of the lung and kidney, pertaining to deficiency type asthma. Coarse asthmatic breathing in loud tones with the preference for exhalation suggests retention of pathogenic factor in the lung impairing the functions of qi. This belongs to asthma of excess type.

Listening to the cough.

Cough is the manifestation of dysfunction of the lung in dispersing and descending leading to upward perversion of qi. Cough in a coarse voice indicates a syndrome of excess type, cough in a feeble voice suggests a syndrome of deficiency type. Unproductive cough or cough with a small amount of thick sputum implies injury of the lung by pathogenic dryness or dryness of the lung due to yin deficiency.

Smelling

Stench smell of a secretion or excretion usually indicates heat syndromes of excess type ; less stinking smell suggests cold syndromes of deficiency type ; foul and sour smell implies retention of food. Different odorous should be identified in order to deduce the nature of the disease. The source of the odor should also be traced for determining the locality of the disease.