Diagnosis by Smell in TCM

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TCM healers start observing an analyzing from the time a client first walks

in the door. Does the person move slowly (possible Cold imbalance) or

rapidly (possible Heat imbalance)? Is the person's voice loud and forceful

(possible Excess) or quiet and hesitant (possible Deficiency)? Is the

complexion reddish (Heat), pale (possible Qi, Blood, or Yang Deficiency), or

yellowish (possible Dampness)? Or, are just the cheeks red or there's a

mottled redness in the face (possible Yin Deficiency)?

 

One of the things that the healer will be noting are any unusual smells.

 

The " Cliff Notes " version of the correspondences between the 5 Elements and

smells are Wood - rancid, Fire - burned or scorched, Earth - sweet, Metal -

rank, and Water - rotten or putrid.

 

These are just general guidelines. What these often translate to is a

rancid smell often will point to stagnation of Heat in the Liver. The Liver

is Yin Wood; the Gallbladder is Yang Wood.

 

A burned or scorched smell about the person often will point to Heart Fire.

The Heart is Yin Fire; the Small Intestine is Yang Fire.

 

A sweet smell often points to Spleen Deficiency and/or Dampness problems.

The Spleen (often called the Spleen-Pancreas by Western writers) is Yin

Earth; the Stomach is Yang Earth.

 

A rank smell often means chronic Phlegm retention in the Lungs. The Lungs

are Yin Metal; the Large Intestine is Yang Metal.

 

A rotten or putrid smell often points to Damp Heat in the Kidneys and/or

Bladder. The Kidneys are Yin Water; the Bladder is Yang Water.

 

These are very general guidelines to start out with. There are exceptions.

There is also fine-tuning. For example, Maciocia associates a leathery

smell with Damp Heat. A fishy smell often means Damp Cold (though not

always). (Foundations of , p. 30 and p. 153).

 

Healers also consider if the smell is generalized (permeates the entire

person and his/her clothes), or if the smell is localized (breath, urine,

feces, sputum from the lungs, mucus from the nose).

 

Maciocia adds that any strong, foul smell can indicate Heat in the body.

Stools or urine that has a strong smell usually will indicate Heat problems.

In the case of urine, a strong, foul smell also indicates Dampness

problems in the body.

 

The absence of smell can be Cold. One reason that there may be an absence

of any smell in some Cold conditions is that the Cold closes the pores.

There is no perspiration.

 

In contrast to Maciocia who associates a fishy odor with Damp Cold, Warner

J.W. Fan, MD, in A Manual of Chinese Herbal Medicine says that fishy and

malodorous sputum can indicate Heat in the Lungs.

 

Roger Wicke, PhD, in his first text books recognizes that when sweat smells

like fish, this can indicate Wind and Dampness or Stagnated Heat. Wicke

associates a general body odor with Heat, " sometimes with local infection. "

Bad breath can be caused by " tooth deay, gum degeneration and infection,

smoking, indigestion from Stomach Heat. " Wicke associates a rotting smell

not just with possible Kidney/ Bladder imbalances but with any " severe Organ

or Blood disharmony, internal abscesses. " (p. 178)

 

The reason why there are differences in terminology among authors is that

terminology for different smells can differ among individuals. The

experience of the smell also can differ among individuals (Just like the

taste of some herbs and foods can.) Everyone knows what a burned or

scorched smell is. The same for an abnormally sweet smell. But what

exactly is a rank smell? And who sticks around rotten or putrid smells long

enough to notice minor variations between them?

 

Victoria

 

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