39. The Principles of Oriental Medicine : Observing the Exterior to Infer the Interior

Over 2,400 years ago, a physician named Bian Que was said to be able to see through a person’s internal organs just by looking at them, much like how a CT or MRA scan works today. This ability to diagnose illness based on outward appearance was called “divine” (神), while diagnosing through questioning was considered “skilled” (工), and through pulse diagnosis was “craftsmanship” (巧). One of the key principles of Oriental Medicine is precisely this: to observe external signs to deduce internal conditions (司外揣内).

A typical application of this principle is the Four Diagnostic Methods (四诊):

• Inspection (望診): observing the five facial colors to identify illness,

• Inquiry (問診): asking about the patient’s preferences among the five tastes to find the cause of disease,

• Palpation (脈診): feeling the pulse to determine the state of the organs and the flow of qi and blood.

There is a saying: “He who shakes the needle without understanding the pulse acts recklessly.” This refers to treating without knowing the root cause. Since acupuncture regulates meridians and qi, performing it without proper pulse diagnosis can be dangerous. That’s why practitioners trained only in a short time often limit themselves to inserting shallow needles in painful areas or along major meridians. The Huangdi Neijing (Yellow Emperor’s Inner Canon) describes pulse diagnosis in great detail. In my case, it took treating over a hundred patients a day for more than a year to internalize even a part of it.

In today’s world, full of sophisticated medical imaging tools, the ability to diagnose the inside from the outside is rare. It’s now difficult to find a cardiologist who can identify heart issues with just a stethoscope. Hippocrates, a contemporary of Bian Que and considered the father of Western medicine, said, “Before practicing medicine, diagnose the soul.”
Looking at the face and tongue, asking the right questions, and feeling the pulse—this is how we sense a patient’s energy. Oriental Medicine begins from there.

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Dr. Jin-man Kim, director of Peace Oriental Clinic