III. Listening and Smelling
Auscultation is a diagnostic method whereby the doctor listens to the patient's speech, respiration, cough, and special sounds like vomit, hiccough etc. Healthy sounds are natural, balanced and smooth, which reflect harmony in organs and sufficient qi (vital energy) and blood. In general if the sound is rough and sonorous and its form is strong, then it is a excess (shi) type; it the sound is low and weak and the breath is timorous then it is a deficiency (xu) type.
The smelling examination includes abnormal odors emitted from the patient's body, excretions and secretions. Foul or rotten odor usually indicates heat syndromes of excess (shi) type while fishy odor indicates cold syndromes of deficiency (xu) type. For example, thick sputum with a foul smell indicates heat in the lungs while dilute, clear and odorless sputum indicates cold in the lungs. Foul breath indicates heat in the stomach or food retention.