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Traditional Chinese Medicine Diagnosis

Use of Sound and Smell in Traditional Chinese Medicine Diagnosis

The use of sound and smell in traditional Chinese medicine can garner information when diagnosing a patient. The two diagnostic tools are grouped together because the same Chinese word is used for both of them. In this diagnostic area, the practitioner listens to the various sounds emanating from the patient and pays attention to any unusual smells. A wealth of information can be gleaned from these perceptions, and they give the physician some clues to pursue later on during the initial interview.


A person under attack by an external pathogen speaks softly at first, with the voice gradually becoming louder. With an internal deficiency, the voice gets softer over time due to a lack of energy. People with cold syndromes tend to be quiet, while heat syndromes are associated with excessive talking. It is the nature of cold to slow functions and movement, while heat speeds them up.

A person with an excess condition tends to have a loud, strong voice, while a soft, weak voice is associated with deficiency patterns. Repeated sighing is often a sign of liver qi stagnation; it is an attempt by the body to release pent-up emotion while expanding the chest muscles that tighten due to the stagnation.

Breathing: Weak and shallow breathing that is difficult to hear is associated with deficiency, especially of the lungs and kidneys. Loud and heavy breathing indicates an excess condition that constricts the air passages. The source of asthmatic wheezing can also be differentiated by its sounds. In a deficiency pattern, the sound is soft and the patient experiences difficulty inhaling due to the kidneys' inability to "grasp the qi."

In a lung excess syndrome, the wheezing is coarse and loud and the patient has difficulty exhaling. A loud cough is a sign of excess, while a weak, slow cough is due to deficiency. A dry, hacking sound can indicate dryness or yin deficiency, while gurgling sounds are a sign of phlegm.

Gastrointestinal Signs: Vomiting due to an excess condition is loud and strong, while a deficiency condition causes vomiting that is weak and painful. Hiccups are known as "rebellious stomach qi" in traditional Chinese diagnosis. If they are due to excess, the sound is loud and short, while deficiency hiccups have a weak sound and last longer. If hiccups show up in an illness after a few days, it is an indication of a collapse of stomach qi. Loud belching is a sign of excess; if there is heat, a sour smell accompanies the belching. Deficiency belching has a softer sound with no sour smell.


In general, strong smells are due to heat, while a lack of aroma is a sign of cold. This applies to the breath, urine, stools, vomit, sweat, and any discharges. Some specific smells are linked to organs; for example, a sweet smell is linked to the spleen, a urine-like smell is associated with a kidney problem, and a smell like rotten apples is a sign of diabetes ("wasting and thirsting syndrome").


This is an exceptionally important aspect of diagnosis, for Western as well as traditional Chinese practitioners. When interviewing the patient, the traditional Chinese practitioner accumulates enough information to formulate a diagnosis based on the condition of the internal organs, pernicious influences, and vital substances.

The traditional Chinese practitioner also delves further into information that he or she uncovered while "looking, listening, and smelling." In addition, the practitioner attempts to get an accurate picture of the person's past medical history, lifestyle, and present area of complaint, gradually building a complete diagnostic picture.

On the next page, learn more about how a practitioner observes physical factors, such as perspiration or eye movements, in order to help make a diagnosis.

For more about traditional Chinese medicine, treatments, cures, beliefs, and other interesting topics, see: