Observation of the Appearance

Appearance refers to the body shape which can be described as strong, weak, heavy or skinny ; and to the movement and posture related to disease.

Overweight with mental depression mostly suggests deficiency of qi and excess of phlegm damp. A thin person with dry skin indicates insufficiency of blood. Great loss of weight in the course of a long illness indicates the exhaustion of the essential qi.

The patient ' s movement and posture are outward manifestations of the pathological changes. There is a variation of movement and posture in different diseases. But on the whole, an active patient is usually manifesting a yang syndrome, whilst a passive manner is usually yin. For instance, a patient suffering from the lung syndrome of excess type with excessive phlegm is likely to sit there with the extended neck ; whilst a patient with deficiency of qi manifesting as shortness of breath and dislike of speaking tends to sit there facing downward.

Violent movement of the four limbs is mostly present in wind diseases such as tetanus, acute and chronic infantile convulsion. The occurrence of weakness, motor impairment and muscular atrophy of the limbs suggests wei syndromes. The presence of pain, soreness, heaviness and numbness in the tendons, bones and muscles accompanied by swelling and restricted movement of the joints points to bi syndromes. The appearance of numbness and impaired movement of the limbs on one side of the body indicates hemiplegia or wind stroke.