TCM in China
What actually happens in a TCM consultation
It does not look like a Western appointment, even in the same building. The practitioner asks about your sleep, appetite, digestion, sweating patterns and whether you feel hot or cold — often before asking much about the thing you came in for. Then they look at your tongue and feel your pulse at six positions. You leave with a written formula, not a scan report.
Reviewed 2026-09-21. Based on public hospital patient explainers, the TCM regulatory office of the Hong Kong Special Administrative Region, and the World Health Organization's own frequently-asked-questions page, all cited at the foot of this page. This is general information, not medical advice.
The four examinations
A TCM consultation is described as four examinations, and the rule attached to them is that they are used together — no single one is treated as sufficient on its own.
| Examination | What it involves |
|---|---|
| 望 — looking | Overall bearing, complexion, physical form and posture, the tongue, and the appearance of any discharges or excretions |
| 闻 — listening and smelling | Listening to the voice and to breathing, and noting odours |
| 问 — asking | How the problem started, current symptoms, and what has already been done about it — organised into a standard set of questions, below |
| 切 — feeling | Pulse examination at three positions on each wrist, plus palpation of the body |
The questions you will be asked
The standard question set is old enough to exist as a mnemonic in Chinese, and it is worth reading through before your appointment, because these are precisely the questions a visitor cannot improvise an answer to on the spot.
| Topic | What you will be asked, in practice |
|---|---|
| Cold and heat | Do you feel cold or hot? Do you have chills, or feverish spells? |
| Sweating | Do you sweat? When — at night, on exertion, not at all? |
| Diet and digestion | Appetite, how much you eat, whether you feel full, any discomfort after eating |
| Bowels and urine | Frequency, consistency, colour, any difficulty or pain |
| Head and body | Where it hurts, of what kind, and what makes it better or worse |
| Chest and breathing | Any tightness, breathlessness, palpitations |
| Hearing and thirst | Whether you are thirsty, what you want to drink, and any change in hearing or tinnitus |
| Sleep and energy | How you sleep, and how you feel across the day |
Two further lines of questioning only apply to certain patients — menstrual, leucorrhoea and childbirth history for women, and childhood rash and fever history for children. If either applies to you, it will be asked, and it is directly relevant to the practitioner.
Write your answers down before you go. This is not a courtesy; it is the highest-value preparation available to a patient who does not speak Chinese, because a written summary survives a language barrier that a spoken answer does not. The language page sets out where the gap hurts most, and the phrasebook has the everyday symptom vocabulary.
The pulse: six positions, three fingers, no number
This is the part that most surprises people who expect a reading. The practitioner places three fingers along the radial artery of one wrist and feels three positions along it; then does the same on the other wrist. What is being assessed is the character of the pulse as felt — not a rate in beats per minute, and not something the practitioner reads off a display.
Understanding that is the point. There is no number you can be given, because the finding is not a number. If you are expecting a readout you will feel something has been skipped. It has not; it is simply a different kind of examination.
One practical consequence, from a public hospital's patient explainer: do not exercise and do not drink alcohol before the examination, because both change what the pulse feels like.
The tongue
The practitioner looks at the tongue in natural light, and assesses two things separately: the tongue body itself, and the coating on it. The classic formulation in Chinese states that the tongue body indicates the state of the internal organs, while the coating indicates the character of whatever is affecting the patient from outside.
That sentence is TCM theory, and it is quoted here as theory — as what the practitioner is working from — not as a claim about what a tongue shows in any other framework. Where this page describes a mechanism, it is describing the tradition's own internal logic, and it stops there.
What the WHO chapter on traditional medicine does and does not mean
You will see the World Health Organization cited on both sides of the argument about TCM, and the citations are frequently wrong. The facts:
- In May 2019 the 72nd World Health Assembly adopted ICD-11, which for the first time included a chapter for traditional medicine originating in Chinese medicine — as a supplementary chapter, containing 150 disease entries and 196 pattern entries.
- The chapter is for optional use, and within that, for optional dual coding in morbidity data collection. The WHO states explicitly that it is not used for mortality statistics.
- And the sentence that decides the argument, in the WHO's own words: "The Traditional Medicine Chapter is neither judging nor endorsing the scientific validity of any Traditional Medicine practice or the efficacy of any Traditional Medicine intervention."
The WHO's stated purpose for the chapter is to make counting and comparison possible — it says the tool provides the means for research and evaluation to establish efficacy. That is the opposite of a verdict. Anyone telling you the WHO has endorsed TCM is misreading the document, and anyone telling you the WHO has condemned it is misreading it in the other direction. Inclusion was about classification.
Practical preparation
- Write your symptom history down — onset, location, what makes it better or worse, and the answers to the question list above. Bring it in Chinese as well as English.
- Bring your full medication list with doses, including anything over-the-counter. Do not stop prescribed medication on your own.
- Bring any recent test results or imaging you already have. They are not wasted on a TCM practitioner, and public hospital guidance is explicit that modern practice does not reject them.
- Do not smoke, drink alcohol or exercise in the hours beforehand if you want the examinations to reflect your normal state.
- Ask for the consultation record before you leave. You will need it for a travel insurance claim and for follow-up care at home.
The honest version
The most common complaint from foreign patients about TCM consultations is not that the treatment was wrong. It is that they did not understand what had just happened to them — ten minutes of unusual questions, a look at the tongue, a hand on each wrist, and a prescription. Once you know what each of those steps is, the appointment stops feeling arbitrary.
What this page cannot tell you is whether any of it will help your particular problem. That is a medical question, and it belongs to a clinician who has examined you — not to a page about process.
Spotted something inaccurate? Tell me and it gets corrected.
Sources
Everything factual on this page traces to the following. Where a rule is time-limited or still in draft, that is stated in the entry.
Most of these are Chinese government or hospital pages. A few of them load slowly outside China, or refuse requests from non-Chinese networks. If a link does not open, search the document's title or its reference number — for example 鄂医保发〔2026〕22号 — and you will find the same document elsewhere.
- Macheng People's Hospital — how TCM diagnoses and treats (中医是怎样看病的) — the four examinations and the standard question set, the instruction not to exercise or drink alcohol before the pulse examination, the principle that the four are used together, and the statement that modern TCM practice does not exclude modern medical testing or Western medicines
- Traditional Chinese Medicine Regulatory Office, Department of Health, Hong Kong Special Administrative Region of China — methods and characteristics of TCM diagnosis (PDF) — the four examinations and their scope, and the structure of the pulse examination
- World Health Organization — International Classification of Diseases, traditional medicine chapter: frequently asked questions — the verbatim position that the chapter neither judges nor endorses scientific validity or efficacy; that it is a separate chapter for optional use; that it applies only to optional dual coding in morbidity data; and that it is not used for the mortality use case
- CCTV News — the 72nd World Health Assembly adopts ICD-11, including a traditional medicine chapter for the first time — adoption on 25 May 2019, and the 150 disease entries and 196 pattern entries in the chapter
Reviewed 2026-09-21.
This page is informational only and is not medical advice. It describes what happens in an appointment and how the diagnostic tradition describes itself; it makes no claim about whether any treatment works. Where TCM theory is quoted, it is labelled as the tradition's own framework rather than as an established finding. Last reviewed: 2026-09-21.