The observation has two distinct aspects. On the one hand, the systematic examination of certain areas of the body (the tongue in particular), on the other hand, and more subjectively, the observation of the patient’s non-verbal: gait, posture, movements , the look, etc.

Traditional Chinese Medicine (TCM) has identified five areas of the body that are particularly helpful at the time of diagnosis. Indeed, each of these zones, which we call sensory or somatic openings, is in a way a privileged opening giving access to one of the five Organs (see the table of the Five Elements), and being able to inform us about its state. Here we recognize the concept of the microcosm – macrocosm: a small external part of the body giving access to a global understanding of internal processes.

The five Sensory Openings and their associated Organs are:

• the eyes: the liver;
• the language: the Heart;
• the mouth: the Spleen / Pancreas;
• the nose: the Lung;
• the ears: the Kidneys.

Each of the Openings provides specific information about its associated Organ, as well as more general information. For example, the eyes tell us about the state of the liver. Bloodshot eyes signal an Excess Fire to the Liver (see Headache) while dry eyes are a reflection of a Yin Void of the Liver. In addition, careful examination of the external components of the eye can tell us about various viscera: the upper eyelid on the Spleen / Pancreas, the lower eyelid on the Stomach, or the white of the eye on the Lung. Most often, however, it is the overall aspect of the sensory opening that is taken into account, as in the case of the ears which, associated with the Kidneys, reveal the strength of the Essences (see Heredity).

Observation of the tongue is one of the oldest diagnostic tools in Chinese medicine. Since the tongue is the sensory Opening of the Heart, it is the mirror of the distribution of Qi and Blood throughout the body. It is considered to be a very reliable source of information and makes it possible to confirm or invalidate an energy diagnosis. Indeed, the state of the tongue is little affected by one-off or recent events, unlike the pulses (see Palpation) which are very variable and which can even change simply because the patient is being examined. Examining the tongue also has the advantage of being much less subjective than taking a pulse. In addition, the topography of the tongue and the interpretation of its various assessment scales (shape, color, distribution and texture of the coating) are generally recognized by all practitioners.

The tongue is divided into multiple zones so that each Viscera appears there (see photo); it also provides information on the multiple Yin Yang dualities (see the Eight Rules grid) and on Substances. Certain characteristics of the language are particularly revealing:

• The shape of the body of the tongue tells us about the state of Void or Excess: a thin tongue denotes Void.
• The color is indicative of Heat or Cold: a red tongue (figure 1) expresses the presence of Heat, while a pale tongue is a sign of Cold or chronicity of the disease.
• The coating of the tongue is examined from the point of view of its distribution (figure 2) and its texture: it generally provides information on the humidity of the body. Moreover, if the coating is distributed unevenly, giving the appearance of a geographical map (figure 3), it is a sign that the Yin is reduced.
• Red dots usually indicate the presence of heat. For example, if it is found at the tip of the tongue, in the area of ​​the heart, it indicates insomnia attributable to Heat.
• The teeth marks (figure 4) on each side of the tongue testify to a weakness of the Qi of the Spleen / Pancreas, which can no longer fulfill its role of maintaining the structures in place. We then say that the tongue is indented.
• The sides of the tongue, areas of the Liver and Gallbladder, may denote a rise in the Yang of the Liver when swollen and red.

In fact, examining the tongue can be so precise that an energy diagnosis can be made with this one tool.

In TCM, emotions are identified as a specific cause of illness (see Causes – Internal). They particularly affect the Spirit, this element bringing together the personality, the vitality as well as the emotional and spiritual states of an individual. However, in Chinese culture, it is inappropriate to openly express one’s emotional states. Rather, it is by observing the radiance of the complexion and the eyes, as well as the consistency of speech and body movements, that one assesses the emotional state and vitality of a person. A radiant complexion and shining eyes, as well as a coherent, “full of spirit” speech and harmonious body movements announce great vitality. On the other hand, darkened eyes, a restless gaze, a dull complexion, scattered speech and jerky movements reveal darkened emotions and Mind, or reduced vitality.