Chapter 7.4–7.5: Not only should we listen to what the patient says, but how they say it. We should also be aware of breathing, coughing, and other sounds throughout the consultation.
Speech
The way a person speaks reveals their Heart energy state:
Fast and much
Heart Yang excess
Loud and aggressive
Liver Yang excess
Slow, halting, shaky voice
Heart Qi deficiency
Rough or hoarse voice
Heart Yin deficiency
Soft voice
Liver Yang/Qi deficiency
Stammering
Heart Yin deficiency, Yang excess; Liver Yin deficiency
Slurring speech
Heart Yang/Qi deficiency
Voice
Cough
Strong and urgent
Lung Yang excess
Dry and urgent
Lung Yin deficiency, Yang excess
With a lot of mucus
Lung damp stagnation
Weak, soft
Lung Yin deficiency, Qi deficiency
Breathing
Full, noisy breathing
Lung Yin excess (damp stagnation)
Dry, squeaky sounds (obstructive)
Yang excess (broncho-spasm)
Olfaction (Smelling)
In the Western world, bombarded with perfumes and cosmetics, it's difficult to smell the patient. But sometimes patients complain of stinking urine or smelly feet:
Burnt smell (especially axilla)
Heat, Yin deficiency, Yang excess (fire-heat)
Foul breath
Stomach Yang excess
Smelly feet
Kidney Yin deficiency
Smelly urine
Kidney Yin deficiency, Yang excess
Heart (burnt flesh)
Heart organ system imbalance
Spleen (cooking rice)
Spleen organ system imbalance
Liver (rotten fruit)
Liver organ system imbalance
Lung (burning spices)
Lung organ system imbalance
Kidney (rotting fish)
Kidney organ system imbalance
Key Principle
All secretions and emanations tend to get more concentrated and strong-smelling if Yin is weak. Secretions become more watery and less smelly when their water content increases.
Listening & Smelling
Match speech, cough, breathing, and odor to diagnostic significance.
Speech
Cough
Breathing
Olfaction (Smell)
What did your voice quality and body scent reveal? Are your secretions concentrated (Yin weak) or watery?