Diagnosis is based on the pattern of presenting symptoms, examination of the tongue and a subtle and highly skilled art of pulse-taking. A full medical history will be taken on the first consultation. The patient will be asked about current symptoms, medical history, diet, digestive system, sleeping patterns and emotional state. The practitioner is able to make a precise diagnosis, and subsequently devise an acupuncture treatment or herbal formula which is individually tailored according to the precise needs of the patient. Dietary and lifestyle advice may also be given. The exact pattern and degree of disharmony is unique to each individual.

The practitioner will make an assessment of the state of the individual organs. They may be suffering from a state of Deficiency or Excess, or perhaps a combination of the two. In Chinese medical theory, there are 12 main organs, each divided into Yin/Yang pairs. So, for instance, the Kidney and Bladder form a pair, Kidney being the Yin organ, and Bladder being the Yang counterpart. Each organ in itself has a Yin and a Yang aspect to it, and, when in a state of good health, these should be balanced.

Besides the Yin and the Yang of each organ, the practitioner will also assess the relative strength of the Qi and Blood, and how well they are flowing.

Chinese Medicine views the human body as a microcosm of the wider macrocosm. So the Chinese medical practitioner will identify in the body ‘pathogenic factors’ similar to those seen in nature,  such as Heat, Cold, Damp, Wind, Dryness and Fire.

The 12 organs are divided into 5 Elements, Fire, Earth, Metal, Water and Wood. The 5 elements make up a cycle, similar to the cycle of the seasons, as one transforms into another. These too should be in a state of harmony when in good health. Each element feeds the next element in the cycle (see diagram i) and keeps in check the next but one (see diagram ii). Any imbalance can be identified by the practitioner and used in their diagnosis.

Claire Battersby Chinese Herbal Medicine Generating and Controlling Sequence

Diagram (i) and (ii)

Each element has a particular inherent quality, and each is associated with a particular emotion, colour, taste, organ, season, sound, etc.


The practitioner feels 3 positions on each wrist along the radial artery. These are felt at 2 (or more) different levels, so altogether the pulse is felt in at least 12 different positions, relating to the 12 organs of the Chinese medical system. The pulse rate, rhythm, size and quality of the pulse express the integrity of the Qi and Blood, Body Fluids, and the functional activity of the organs.

The healthy pulse is regular with four to five beats per cycles of respiration and a smooth, flowing feeling as it rises and falls. It is both elastic and resilient, evoking a sense of relaxed and vigorous rhythm and harmony.

As many as 28 pulse qualities are described in the classical texts, each indicating a particular type of disturbance. For example, the pulse may be Wiry €“ ie. Taut like a wire €“ indicating that the Qi is not circulating properly; or it may be Thin, indicating a Deficiency of Qi or Blood; or it may be Deep, indicating a Deficiency of Yang energy; or Rapid, indicating Heat.


Tongue diagnosis is one of the most important diagnostic tools in Chinese Medicine. The texture, colour, shape, coating and size of the tongue, in particular, reflect the strength and functional capacity of the individual.

For instance, a very red tongue indicates the presence of Heat, whilst a pale tongue indicates chronic Deficiency of Blood, Qi and Yang, and a purple tongue may indicate Stagnation of Qi and/or Blood.

In Chinese medical terms, the tongue coating is a physiological by-product of the Stomach’s digestion of food and fluids. A thin tongue coating indicates healthy digestion. If there is a thick tongue coating, this may indicate the presence of ‘damp, phlegm or food stagnation’ due to poor digestion. If the coating is yellow, there is the additional presence of Heat.

The shape of the tongue is also significant. For example, a thin tongue indicates Blood Deficiency, whilst a swollen tongue indicates that the foods and fluids are not being properly ‘transformed and transported’.

Other factors to be taken into consideration include red spots on the tongue, indicating Qi Stagnation and Heat; cracks indicating Yin Deficiency and Dryness; and dips in the tongue indicating deficiency.

The tongue is like a map of the human body. Different parts of the tongue relate to different parts of the body (see diagram below). The tip of the tongue, for instance, relates to the Heart, the centre to the Stomach, the sides to the Liver and Gallbladder and the back of the tongue relates to the lower part of the body, including the Bladder, Intestines, and Kidneys.

Claire Battersby Chinese Herbal Medicine Tongue Diagnosis