OBSERVATION OF HEAD, FACE AND HAIR

Published on 22/06/2015 by admin

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Chapter 5

imageOBSERVATION OF HEAD, FACE AND HAIR

HEAD

In observation of the head, one should first of all make a general assessment of the patient’s constitution based on the facial features. A person with a good constitution will generally have a head with smooth features, a broad forehead and long ears with thick ear-lobes. A person with a poor constitution will have a head that is too small or with uneven features and small ears with small ear-lobes.

The features discussed are as follows:

Late closure of the fontanelles

Symptoms and Signs, Chapter 90

In babies, one should observe the fontanelles: late closure of the fontanelles indicates poor hereditary Kidney constitution. The posterior fontanelle usually closes about 2 months after birth, the sphenoid fontanelle closes at about 3 months, the mastoid fontanelle closes near the end of the first year, and the anterior fontanelle may not close completely until the middle or end of the second year.

Box 5.1 summarizes the head signs.

BOX 5.1   HEAD SIGNS

FACE

The most important aspect of observation of the face is the complexion colour, which has already been described in Chapter 3. Other diagnostic signs of the face include oedema, swelling, spots, ulcers and lines.

The following features are discussed:

Deviation of eye and mouth

Observation, Chapter 4; Symptoms and Signs, Chapter 55

A deviation of the eye and mouth that does not affect the eyebrows and forehead is due to internal Wind and is seen in patients suffering from Wind-stroke. A deviation of the eye and mouth with an inability to raise one eyebrow and furrowing of the forehead on one side indicates invasion of external Wind in the channels of the face and it is seen in Bell’s palsy.

Box 5.2 summarizes the face signs.

BOX 5.2   FACE SIGNS

HAIR

The development of the head and hair depends largely on the state of the Kidneys and Liver. The Kidneys influence the bones, which determine the structure of the head, and they govern the Marrow, which determines the normal development of the brain. Both Kidneys and Liver influence the growth of hair and therefore its normal growth, colour and consistency depend on the Liver and Kidneys.

The patterns causing each of the hair signs discussed below are listed in greater detail in Chapter 55.

The following conditions are discussed:

Hair falling out

Symptoms and Signs, Chapter 55

Clinical significance

The growth and the thickness of the hair depend largely on the state of the Liver and Kidneys and specifically on Liver-Blood and Kidney-Essence: therefore, a gradual loss of hair may be due to Liver-Blood deficiency or Kidney-Essence deficiency, or both. However, there are also Full causes of loss of hair and in particular Blood-Heat, which causes the hair to fall out by drying out the hair follicles; this Blood-Heat usually derives from Liver-Fire which rises up to the head causing the loss of hair.

Loss of hair frequently occurs after a serious disease that is either acute or chronic and lingering. Of course there may also be external causes of hair loss and an example of these is the loss occurring after a course of chemotherapy.

In some cases, baldness can occur in young people. If a young person shows no sign of Liver or Kidney deficiency and has a strong body, this means that the baldness is a hereditary trait and has no clinical significance.

Box 5.3 summarizes the causes of falling-out hair.

BOX 5.3   HAIR FALLING OUT

Dry and brittle hair

Symptoms and Signs, Chapter 55

Clinical significance

The most common cause of dry and brittle hair is deficiency of Liver-Blood or Kidney-Yin, or both; as the Liver and Kidneys are the main organs that nourish the hair, this makes the hair dry, thin and brittle.

A general deficiency of Qi and Blood, usually involving Liver-Blood, may also cause the hair to become dry and brittle for the same reasons indicated above.

A deficiency of Stomach and Spleen may cause the hair to become excessively thin and brittle when it is not nourished by the Food Essences produced by the Stomach. This condition is often caused by worry, pensiveness or excessive studying, which weakens the Spleen.

A chronic loss of blood, such as might happen in chronic menorrhagia, may also cause the hair to become dry and thin because there is not enough Blood to nourish it.

Box 5.5 summarizes the causes of dry and brittle hair.

BOX 5.5   DRY AND BRITTLE HAIR

Premature greying of the hair

Symptoms and Signs, Chapter 55

Clinical significance

The most common cause of premature greying of the hair is deficiency of Liver-Blood or Kidney-Essence, or both, which fail to nourish the hair properly. Another cause is a general Qi and Blood deficiency. Hair turning white suddenly is usually due to Liver- and Heart-Fire caused by a shock or a very intense emotional upset such as anger.

Premature greying of the hair in a young person who has a strong body and is in good health is purely hereditary and has no clinical significance.

Hair turning yellow and dry usually indicates deficiency of Blood and Essence.

Box 5.6 summarizes the causes of premature greying of hair.

BOX 5.6   PREMATURE GREYING OF THE HAIR

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