Acupuncture Town hall

The Four Examinations (Si Zhen) are the diagnostic methods used by TCM practitioners to gather clinical information. Developed over millennia, they are: Inspection (Wang), Auscultation and Olfaction (Wen), Inquiry (Wen), and Palpation (Qie). Together, these provide a comprehensive picture of the patient's condition without relying on laboratory tests or imaging. Mastery of the Four Examinations is considered the hallmark of a skilled practitioner.

Inspection involves observing the patient's general appearance, complexion, body build, posture, movement, and especially the tongue (a detailed examination in itself). The practitioner notes the spirit (Shen) in the eyes, the colour and lustre of the face, and any visible abnormalities. Auscultation and Olfaction assess the quality of the voice, breathing, cough, and any body or breath odours — each providing clues about the internal condition.

Inquiry is a structured interview covering the patient's chief complaint, medical history, and ten key areas traditionally called the "Ten Questions" — including chills and fever, perspiration, appetite and thirst, sleep, pain, bowel and urinary function, and for women, menstrual history. Palpation includes pulse diagnosis (feeling the radial artery at three positions on each wrist) and palpation of the abdomen, meridians, and acupuncture points for tenderness or abnormality. The practitioner synthesises findings from all four methods to form the diagnosis.