Chapter contents

INTRODUCTION

Observation of the hands has always formed a relatively important aspect of diagnosis and it is mentioned in several chapters of the ‘Simple Questions’ and ‘Spiritual Axis’ as well as in the ‘Discussion of Origin of Symptoms in Diseases’ (Zhu Bing Yuan Huo Lun, AD610 by Chao Yuan Fang).¹ The description of index finger diagnosis in children was discussed by the Tang dynasty doctor Wang Chao in the book ‘Illustrated Formula of the Water Mirror’ (Shui Jing Tu Jue).²

A more detailed description of the hand signs and symptoms described below can be found in Part 5, Chapter 65.

ABNORMAL COLOUR

VENULES ON THE THENAR EMINENCE

Symptoms and Signs, Chapter 65

The thenar eminence shows the state of the Stomach. Chapter 10 of the ‘Spiritual Axis’ relates the colour of the thenar eminence to the state of the Stomach and says: ‘When the Stomach has Cold, the thenar eminence is bluish; when the Stomach has Heat, the thenar eminence is reddish; if it is suddenly black, it indicates chronic Painful Obstruction Syndrome; if it is sometimes red, sometimes dark and sometimes bluish it indicates alternation of Heat and Cold; if it is bluish and short, it indicates deficiency of Qi.’³ Chapter 74 of the same book says: ‘When the thenar eminence has bluish venules, it indicates Cold in the Stomach.’⁴

Bluish or bluish-purple venules on the thenar eminence generally indicate Cold in the Stomach; if they are bluish but short they indicate deficiency of Qi or Empty-Cold from Stomach-Yang deficiency. Reddish venules indicate either Full-Heat or Empty-Heat (usually of the Stomach and/or Lungs), if they are reddish-purple they may indicate Blood stasis in the Stomach; and if yellowish-red, there is Damp-Heat in the Stomach.

ATROPHY OF THE THENAR EMINENCE

Symptoms and Signs, Chapter 65

The size and consistency of the thenar eminence are related to the state of the Stomach. When the thenar eminence is full, the state of the Stomach is good.

Atrophy of the thenar eminence may be due to deficiency of Yang of the Stomach, Spleen and Kidneys, or deficiency of Yin of the Stomach, Liver and Kidneys.

ATROPHY OF THE MUSCLES OF THE DORSUM OF THE HANDS

Symptoms and Signs, Chapter 65

Atrophy of the muscles of the dorsum may be due to deficiency of Liver-Blood, deficiency of Kidney-Yin or deficiency of Qi of the Stomach and Spleen.

TREMOR OF THE HANDS

Symptoms and Signs, Chapter 65

Tremor of the hands is a sign of internal Wind, which may be of the Full or Empty type. Internal Wind is always related to the Liver, and Liver-Wind or Wind-Phlegm in the Liver are the most frequent cause of tremor of the hands. Empty-Wind of the Liver causes a fine tremor of the hands; it may derive from Blood or Yin deficiency. Internal Wind, which may develop suddenly following a deep shock or a great fright, may also cause tremor of the hands.

In alcoholics, a fine tremor of the hands is caused by Phlegm-Heat. In rare cases, retention of Dampness in the muscles and sinews of the hands may also cause a fine tremor.

Box 14.1 summarizes patterns underlying hand tremor.