Traditional Chinese medicine uses four main diagnostic methods to detect disease: observation, auscultation and olfaction, inquiry, and palpation. Observation includes examining the patient's complexion and tongue; palpation includes taking the patient's pulse and conducting a physical examination. The article also states that these methods reflect the pathological and physiological changes that occur during disease development.

The review notes that, in traditional practice, tongue and pulse diagnosis and functional evaluation by pressure sensitivity and physical examination may be regarded as part of TCM diagnostic assessment. This supports the claim that TCM diagnosis uses multiple external examinations to infer internal patterns.

The article explains that traditional Chinese medicine (TCM) "uses a comprehensive approach that integrates observation, inquiry, pulse palpation, and tongue diagnosis." It notes that tongue and pulse findings are used together to identify TCM "syndromes" or patterns, describing that syndrome differentiation is based on information from these diagnostic methods to assess internal imbalances and guide treatment.

The article explains that "Traditional Chinese Medicine uses a conceptual framework that formulates signs and symptoms into patterns." It states that "the four diagnostic methods commonly used in an ancient and modern patient intake examination include observation (or inspection), auscultation and olfaction, questioning, and palpation (which may include abdominal, meridian and various pulses)." These methods are used to derive traditional medicine "patterns" that then correspond to various health problems.

WHO describes the ICD-11 Traditional Medicine Chapter as providing "a list of diagnostic categories to collect and report on Traditional Medicine conditions in a standardized and internationally comparable manner." It notes that the scope covers "traditional medicine conditions which originated in ancient China and are now commonly used in China, Japan, Korea and elsewhere" (Module I). The FAQ explains that this chapter allows coding of "Traditional Medicine conditions" and their diagnostic "patterns" alongside conventional medicine diagnoses, reflecting how such patterns are used to describe health status and imbalance in these systems.

The basic diagnostics of traditional Chinese medicine is mainly based on the 4-diagnostic (‘si zhen’), including questioning ‘wen zhen’, listening and smelling ‘wen zhen’, observation ‘wang zhen’, and palpation ‘qie zhen’. Traditionally, **tongue and pulse diagnosis and the functional evaluation of action points by pressure sensitivity and physical examination** may be regarded as unique features of traditional Chinese medicine. The 4-diagnostic are used in combination for syndrome differentiation and to determine the therapeutic principle.

The article describes pure TCM practitioners as using four non-device-aided diagnostic techniques, including inspection of countenance and tongue color, along with auscultation and other methods. This aligns with the claim that TCM practitioners assess health through visual and hands-on examination rather than laboratory tests alone.

The ICD‑11 Traditional Medicine chapter describes that diagnostic information is gathered using multiple methods: "methods, including inspection such as tongue examination, history taking (inquiry), listening and smelling examination, palpation such as pulse taking, abdominal examination, and other methods." Individual pattern descriptions frequently include tongue and pulse findings, e.g. a pattern may be characterized by symptoms plus "slippery and greasy tongue" or a "feeble or irregular pulse." These pattern descriptions show how signs from tongue observation and pulse palpation are combined into named patterns of imbalance (such as qi, blood, yin–yang, organ, and pathogenic factor patterns).

This peer-reviewed study on traditional Korean medicine, a close relative of TCM, explains that pattern identification (PI) types such as Qi-deficiency, Yin-deficiency, dampness-phlegm (DP), and fire-heat are core diagnostic categories. It investigates the relationship between these PI patterns and variables from tongue and pulse diagnosis, noting that different patterns cluster with specific pulse qualities (e.g., fine or slippery pulses) and tongue characteristics. The analysis shows that tongue and pulse features are used as objective indicators in determining these traditional patterns of imbalance.

In Traditional Chinese Medicine, practitioners perform a detailed intake and examination to understand the patient’s whole-body health. This often includes **inspection of the tongue and palpation of the pulse**, along with questions about sleep, digestion, emotions, and other systems. Practitioners then interpret this information according to TCM theory to **identify patterns of imbalance in the flow of Qi and the organ systems**, which guides acupuncture, herbal, and lifestyle treatments.

The paper explains that in TCM, "Syndrome differentiation is different from conventional diagnostic methodologies. It is a comprehensive analysis of clinical information obtained by the four main TCM diagnostic procedures: observation, listening, questioning, and palpation that includes pulse analyses." It continues that this differentiation is used "to guide the choice of TCM treatments" and describes a diagnostic roadmap: first assessing internal/external and deficiency/excess of yin, yang, qi, blood and body fluids to define "general status syndromes," then exploring signs and symptoms of the organs to ascertain which are unbalanced, and then classifying the syndromes in ICD‑11 patterns.

In traditional Chinese medicine (TCM), **pattern/syndrome differentiation refers to the process of identifying patterns of imbalance or disharmony in the body**. In clinical practice it is the process of identifying the specific pattern of disharmony or imbalance that is causing a patient’s symptoms and determining the appropriate treatment. Differential diagnosis involves a thorough evaluation of the patient’s symptoms and signs, **including their physical, emotional, and mental states, as well as their pulse and tongue**.

Diagnosis in traditional Chinese medicine is mainly based on the **four diagnostic methods: inspection, auscultation and olfaction, inquiry, and palpation**. Inspection includes observing the patient’s appearance and **especially the tongue**, while palpation refers largely to **pulse diagnosis at the wrists**. By synthesizing the findings from these examinations, the practitioner determines **patterns of disharmony or imbalance** that underlie the patient’s complaints.

The article describes that TCM diagnosis is based on "the four examinations": looking, touching, asking, and listening/smelling, and notes that "looking at the tongue and feeling the pulse are often considered the most important." It explains that when looking at a patient, an acupuncturist observes general appearance, physical shape, facial color and features, and the tongue "as insights into the state of health from vibrancy to illness." Deviations in tongue color, shape, and coating are said to "point to underlying conditions" such as heat, blood deficiency, pain, or dampness. It further states that the pulse is assessed for qualities like strength, depth, shape, and there are about 28 pulse qualities, with specific qualities (floating, deep and weak, wiry, slippery) interpreted as indicating particular internal imbalances or disease states.

This teaching article notes that in Chinese medicine, tongue diagnosis involves observing "the tongue's color, shape, and coating" to understand organ function and internal balance. It explains that pulse diagnosis involves feeling the pulse at different positions and depths on the wrists to evaluate qualities such as strength, rhythm, and texture, which are associated with organ systems and energetic states. The article emphasizes that these diagnostic tools are used to identify patterns of imbalance in Qi, blood, yin, and yang, rather than just measuring heart rate as in Western medicine.

The clinic explains that in Traditional Chinese Medicine, tongue and pulse diagnosis are "core diagnostic tools" used to assess health and detect imbalances in the body's systems. It states that practitioners observe the tongue's color, shape, and coating to gain insight into organ function and pathogenic factors such as heat, cold, dampness, or phlegm. Likewise, by palpating the pulse at three positions on each wrist and assessing depth, strength, and quality, practitioners infer the condition of different organs and the state of Qi and blood. The article notes that these observations are interpreted within a framework of pattern differentiation to guide individualized treatment.

The page says tongue diagnosis and pulse diagnosis are the most prevalent examination approaches, and that all information collected through the four diagnostic methods is analyzed within a Traditional Chinese Medicine pattern identification framework to determine the most suitable treatment plan. It also lists pattern categories such as Yin, Yang, Exterior, Interior, Cold, Heat, Deficiency, and Excess.

The article describes that in TCM, "the tongue and pulse serve as diagnostic tools that help practitioners assess the state of Qi and identify imbalances." It notes that the tongue is viewed as "a mirror reflecting the overall health of the body," and that practitioners observe its color, shape, coating, and moisture to gather insights into internal balance; for example, a pale tongue might indicate blood deficiency while a red tongue might suggest heat. It also states that pulse diagnosis involves assessing the quality, rhythm, and strength of the pulse at various wrist positions, with different pulse qualities such as wiry or slippery interpreted as indicating specific patterns like liver Qi stagnation or dampness.

NCCIH describes how TCM practitioners evaluate patients: "Practitioners of TCM use a variety of practices, including acupuncture, herbal medicines, and tai chi, as well as lifestyle and dietary recommendations." In discussing diagnosis, NCCIH notes that TCM practitioners typically assess "the patient’s symptoms, appearance, tongue, and pulse" in order to determine *patterns of disharmony* (for example related to qi, blood, yin-yang, and organ systems) rather than focusing solely on a single disease entity as in conventional biomedicine.

The page states that traditional Chinese medicine diagnosis involves assessing the tongue and pulse to uncover the root causes of health issues. This directly supports the claim that pulse and tongue observation are core TCM diagnostic methods.

A clinical overview for primary care notes that TCM uses a syndrome-based approach: "Diagnosis is made by identifying patterns of disharmony within the body, rather than a specific disease entity." It explains that traditional practitioners "use four main diagnostic methods – inspection (including observation of the tongue), listening and smelling, inquiry, and palpation (including pulse taking)." Tongue appearance and pulse quality are described as important signs that, together with other clinical findings, help to identify the pattern of imbalance.

In describing TCM diagnostic methods, the paper states that patients "were diagnosed according to the principles of traditional Chinese medicine using the four standard diagnostic methods of inspection, listening/smelling, inquiry and palpation." It notes that "inspection included observation of the tongue," and palpation included "pulse diagnosis at the radial artery." On this basis, patients were assigned to specific TCM patterns such as "Lung qi deficiency" or "Spleen qi deficiency," demonstrating how tongue and pulse findings contribute to pattern identification rather than Western-style disease labelling.

The page states that pulse diagnosis is one method of determining the internal conditions of patients in order to decide upon a therapeutic regimen. This is consistent with TCM practice linking pulse findings to internal health assessment.

MedlinePlus explains that in TCM, "practitioners look at the tongue, feel the pulse, and ask detailed questions about health, diet, sleep, and emotional state" as part of the diagnostic process. It notes that rather than diagnosing diseases in the Western biomedical sense, they "identify patterns of energy imbalance" in qi, blood, yin, yang, and organ systems, which then guide the selection of treatments such as herbs and acupuncture.

Johns Hopkins Medicine notes that TCM practitioners perform a detailed assessment that may include "looking at the patient's tongue, taking the pulse at several positions, and asking many questions about symptoms and lifestyle." These observations are combined to determine a "pattern diagnosis" that reflects imbalances in qi, blood, yin/yang, and organ systems. Treatment is then individualized based on this pattern rather than solely on a named Western disease.

The article says that among the four examinations in TCM diagnostics, pulse and tongue are the most objective and time-tested tools, and that practitioners use pattern differentiation to examine clusters of signs and symptoms rather than isolated metrics. It also describes pulse-taking at three wrist positions and tongue observation of color, shape, coating, moisture, and movement.

In standard TCM theory, the 'four examinations' are inspection, auscultation/olfaction, inquiry, and palpation. Inspection includes looking at the tongue, while palpation includes pulse-taking; practitioners then synthesize these findings to identify pattern differentiations or 'zheng' (patterns of imbalance).

In this educational video on Chinese medicine, the speaker outlines that tongue diagnosis is based on four items: "the tongue body colour," which indicates the condition of blood, Qi and Yin organs; "the tongue body shape," which indicates the state of blood and nutritive Qi; "the tongue coating," which reflects the state of the yang organs and pathogens; and "the moisture," which indicates the state of body fluids. The lecture emphasizes that these tongue features are integrated to determine internal patterns such as heat, cold, dampness, and deficiency, forming part of the broader TCM pattern differentiation system.