Observation of the Five Sense Organs

Observation of the eye. The liver opens into the eye, and the essential qi of the five zang and six fu organs all goes up into the eye. Therefore, abnormal changes in the eye are not only associated with the liver, but also reflect the pathological changes of other zang - fu organs. Apart from the expression of the eye, attention should also be paid to the appearance, color and movement of the eye. For instance, redness and swelling of the eye are often due to wind heat or liver fire. Yellow sclera suggests jaundice. Ulceration of the canthus denotes damp heat. Upward, straight forward or sideways staring of the eye is mostly caused by disturbance of liver wind.

Observation of the nose. This is to observe the appearance and discharge of the nose. The flapping of the ala nasi is often present in asthmatic breathing due to either heat in the lung or deficiency of qi of both the lung and kidney. Clear nasal discharge is due to exposure to wind cold, whilst turbid nasal discharge to wind heat. Prolonged turbid nasal discharge with stinking smell suggests chronic rhinitis or chronic sinusitis.

Observation of the ear. Due attention is paid to the color of the ear and conditions of the internal ear. Dry and withered auricles, burnt black in color, present in the patient with a prolonged or severe illness, are due to consumption of the kidney essence not allowing it to nourish upwards. Purulent discharge in the ear, known as " Tin Er " ( suppurative infection of the ear ) , is mostly caused by damp heat of the liver and gallbladder.

Observation of the gums. Pale gums indicate deficiency of blood. Redness and swelling of the gums are due to flaring up of the stomach fire. If redness and swelling of the gums are accompanied by bleeding, it is due to injury of the vessels by the stomach fire.

Observation of the lips and mouth. This is to observe the changes of the lips and mouth in color, moisture and appearance. Pale lips denote deficiency of blood. Blue purplish lips suggest either retention of cold or stagnation of blood. Dry lips, deep red in color, indicate excessive heat. Sudden collapse with open mouth is deficiency, whilst sudden collapse with lock jaw is excess.

Observation of the throat. The focus is on abnormal changes of the throat in color and appearance. Redness and swelling of the throat with soreness denote accumulation of heat in the lung and stomach. Redness and swelling of the throat with yellow or white ulcer spots are due to excessive toxic heat in the lung and stomach. A bright red throat with a mild soreness suggests yin deficiency leading to hyperactivity of fire. If there occurs a false membrane over the throat, which is greyish white in color, hard to remove, bleeds following forceful rubbing and regrows immediately, it indicates diphtheria resulting from heat in the lung consuming yin.