T HE LIVER is said to open into the eyes, and eye conditions often indicate the health of the Liver. A deficiency of Liver Blood can cause eye problems, while bright, clear eyes indicate healthy Liver, and also Heart-to which the Liver is closely related. Pain in the eyes can indicate Heart or Liver disharmony or an External Wind invasion.

"Floaters" and blurring of vision suggest Blood deficiency. (The Liver stores and

regulates Blood.) Eye pressure and/or dryness could suggest Kidney disharmony, since such disharmony is often characterized by dry conditions.

T HE LUNGS open into the nose and are the controllers of energy and breath, so their functioning is obviously related to the chest area and breathing. Problems of nose, throat, and chest therefore generally relate most directly to the Lungs, but also to the Heart, which influences the Lungs by governing the flow of the Blood. Pain in the chest may suggest stagnant Blood or Wind-Heat invasion if it is associated with coughing and offensive yellow phlegm. Chronic nasal blockage and stuffiness suggests Damp and phlegm.

T HE LIKELY cause of any pain or discomfort in the trunk or abdomen depends partly on the exact location of the problem. Several of the Zang organs may be involved.

Pain or discomfort in the hypochondrium area, located just below the ribs at either side, often relates to Liver and Gall Bladder conditions. Problems in the area of the epigastrium (the pit of the Stomach) generally relate to the Stomach and Spleen.

I N CHINESE medicine the head is the confluence of all the Yang channels. If there is an excess of Yang energy coming to the head, this can lead to problems such as headaches and dizziness. If there is a deficiency of Yang, then this can lead to

lightheadedness or possibly unconsciousness. A detailed differential description relating to channels and Zangfu involvement goes beyond the scope of this book, but suffice it to say that detailed information regarding disharmonies in the head area is very important in Chinese medicine.

T HE PATIENT'S account of any problems or idiosyncracies involving digestion are often a good guide to the condition of the Spleen and the Stomach, even if they do not seem to the patient to be linked to the main problem. To take extreme examples, lack of appetite suggests Spleen deficiency, whereas constant hunger suggests Stomach Heat. Other features can be linked also to other organs. For example, a taste in the mouth can point to a variety of possible disharmonies, usually of the Spleen and Stomach, but also of the Kidneys and the Liver.

T HE NATURE of bowel movements is an important indicator of possible disharmonies in the body, and acquiring detailed and accurate information about bowel movements is very important in Chinese medicine. The main organs involved are Spleen and Stomach. Deficiencies of their functioning and Cold or Damp excesses all affect this aspect of the digestive system. Kidneys and Liver disharmonies may also be indicated.

THE PATIENT'S thirst or lack of thirst, the type of liquid desired, and even the manner of drinking are all relevant to a diagnosis. The important thing for the physician to consider is the type and amount of fluids taken in. Generally:

A preference for drinking cold liquids suggests a Heat pattern, and a preferencefor drinking warm liquids suggests a Cold pattern. No thirst suggests a Spleen disharmony with Cold. Thirst but lacking a desire to drink suggests Damp-Heat. Sipping slowly usually suggests Yin deficiency.

F EATURES CONNECTED with urine are also of considerable importance and can be interpreted by the physician as part of the pattern of disharmonies; In particular, the color of the urine is observed. If clear, it suggests Cold, and if dark, it suggests Heat; Damp is suggested by cloudy urine. In addition, the way in which urineis passed is a useful indicator:

difficult urination suggests a Kidney or Bladder disharmony, and frequent urination suggests deficiency of Kidney Qi. Extremes in the amount of urine passed suggests a Kidney disharmony. Pain on urination suggests stagnation or Heat; pain after urination suggests a deficiency problem.

T he patient of the patient's sleep and energy are pointers toward the health of the Qi, Blood, and the Yin of the body. Patients may sleep restlessly, be unable to sleep, sleep at inappropriate times, or be unable to keep awake. This may be related to diet and lifestyle and may indicate Zangfu deficiencies or disharmonies.

T HE CHARACTERISTICS of any pattern of sweating, as described by the patient, can be very helpful in discriminating disharmonies. This can be further corroborated at the next stage of the diagnosis (palpation), when the practitioner feels the condition of the patient's skin. There are various important factors, and these include especially the area of the body affected, the time of day, and the types of sweat. The Heart Blood can be involved in any abnormal patterns of sweating-smelly, nervous sweat particularly indicates the Heart.

Sweating in the area of the head only suggests Stomach heat, and sweating in soles/palms/chest ("Five Palm Sweat") suggests Yin deficiency. As to time of day, daytime sweat suggests Yang deficiency; night sweats suggest Yin deficiency.

A S WE all know, there are many different types of pain, and the patient may feel pain over an extended period or in short sudden bursts. It is always important to ascertain the location, duration, and nature of any pain that the patient may be suffering. Again, a description of the full differential diagnostic features of pain goes beyond our discussions here, but some important aspects can be indicated.

Pain that is acute, sharp, and specific usually generalized usually indicates a deficiency indicates an Excess condition. It may be caused by condition. It may be caused by Qi or invasion by external factors such as Wind, Cold, Blood deficiency. Heat, or Damp; interior Cold or Heat; For all pain experienced, the location of the stagnation of Qi, Blood, or Phlegm due to an pain will give pointers to the affected channels external injury or a Zangfu disharmony, and can be of importance for both exterior and Pain that is dull, achy, more chronic, and more interior disharmonies.

T HIS AREA relates to climatic factors to which the patient may be subject, and to the way in which the individual responds to Heat, Cold, Damp, and Wind. Responses can differ greatly between individuals, and this can be a good guide to an understanding of any internal disharmonies in the patient. Dislike of Cold, with liking for Heat, suggests a Cold pattern, or a Yang deficiency (particularly common in older people), while dislike of Heat and liking for Cold suggests a Heat pattern, or a Yin deficiency. Adverse reaction to Damp suggests that the patient has a tendency to suffer from internal Dampness, and dislike of Wind may be indicative of a Liver disharmony, particularly in relation to Liver Wind.

I t is always important to try to ascertain any disharmonies that may be associated with the individual's emotional state. The seven emotions are central in Chinese medicine to the concept of how disharmonies occur, and an understanding of how the patient responds emotionally can indicate any potential area of disharmony and the Zangfu system that may be involved. In particular, anxiety may suggest Heart pattern and disturbed Shen; depression may suggest Lung or Heart disharmony; anger frustration may suggest a Liver disharmony; poor concentration may suggest a Spleen disharmony; fear may suggest a Kidney disharmony.

T HIS IS the area in which Chinese medicine and modern Western medicine have much in common. Most medical opinion stresses the importance of regular exercise and of balanced diet, with only a moderate consumption of alcohol; but Chinese medicine takes these matters a step further, in the light of its philosophical underpinnings.

T O GAIN an accurate diagnostic picture with women patients, it is important to explore the patterns of menstruation and any symptoms accompanying it. This is a detailed area in itself, which is beyond the scope of this book.

General points to be explored include the regularity or otherwise of the menstrual cycle, the amount of blood lost during a period, the color and consistency of blood, and the nature of the flow, whether there is any menstrual pain, and whether the patient experiences any other symptoms, such as bloating, headaches, food cravings, mood swings, or similar symptoms, either before or during a period.