The reading
四诊
A reading is made from three of Chinese medicine's four examinations. You answer thirty questions and send one photograph of your tongue. A physician licensed in China matches your answers to a pattern, writes the reasoning in Chinese, and it reaches you in English as a PDF within forty-eight hours. The fourth examination, the pulse, cannot cross an ocean, and we say so.
The method
The four examinations are not a brand and not a philosophy. They are a checklist: ask, look, listen and smell, feel the pulse. They appear in the Huangdi Neijing, compiled around 200 BCE in two parts of eighty-one chapters each, and they have organised every clinical encounter in Chinese medicine since. Nothing in your report comes from anywhere else.
What follows is the whole of what we do, in the order we do it. If any of it sounds thinner than you expected, that is the point of writing it down.
The superior physician attends to what is not yet illness; the inferior physician attends to what is already illness.
01
Thirty questions, and a box at the end for anything you would rather say in your own words. They cover sleep and waking, thirst and appetite, the temperature of your hands and feet, digestion, energy across the day, sweat, mood, and — if it applies to you — the monthly cycle.
The order is not ours. Zhang Jingyue set the examination down as a rhyme of ten questions in the Jingyue Quanshu, completed in 1624, and every intake form used in a Chinese clinic today is still that rhyme, unrolled. We have unrolled it a little further, because we cannot lean across a desk and ask you what you meant.
Fifteen to twenty minutes. You can leave and come back; the form keeps your place.
02
One photograph of your tongue, taken in daylight. The physician reads four things in it: the colour of the body underneath, the coating on top — its thickness, its colour, how wet it is — the shape of the whole, and the edges, where teeth leave marks when the tissue is swollen.
This is the examination that survives a camera best. Colour, coating and shape are exactly what a lens records, and a photograph can be looked at twice, three days apart, which a tongue in a consulting room cannot.
Six rules for the photograph are set out further down this page. Most people get it right first time.
03
The physician reads the whole intake twice and asks one question of it: which pattern does this fit? 辨证 — literally, to distinguish the presentation. A pattern is not a disease and it is not a deficit. It is a description of how one particular system is running this month: warm or cold, dry or damp, moving freely or held up somewhere.
The method is old and precise. Zhang Zhongjing built it clause by clause in the Shanghan Lun around 200 CE — 398 numbered clauses, each of the form this presentation, therefore that response. What has survived two thousand years is not the herbs. It is the habit of matching the whole picture rather than the loudest symptom.
Most people are not one clean pattern. The report names the one carrying most of the weight, then says what else is in play.
04
Your report is written in Chinese first, by the physician who read you, because that is the language the reasoning happens in. It is then put into English by a bilingual member of the house and checked back against the Chinese line by line, so that nothing arrives softer or grander than it left.
What comes back is a PDF of roughly two thousand words in seven parts: what you told us, what the tongue showed, the pattern, the shape of a day, what to eat and what to ease off, two points you can reach with your own thumb, and the season ahead. It is signed, with a licence number.
Yours to keep. One round of questions by email is included for thirty days after it arrives.
The fourth examination
Chinese medicine has looked at people the same four ways since the Han dynasty: ask, look, listen and smell, and feel the pulse. We can do three of them from Hangzhou. The fourth needs your wrist under three of our fingers, and no photograph, no video call and no watch on the market can stand in for it. So we do not pretend.
Three fingers rest on the radial artery of each wrist, in three named positions, and each position is read at three depths — floating, middle, and pressed to the bone. That is eighteen readings, taken in about a minute, of a thing that changes while you are taking it. Wang Shuhe fixed the method in the Mai Jing around 280 CE and named twenty-four pulse images; by 1564 Li Shizhen had described twenty-seven.
We widen the questions instead. Several of the thirty are there only because the pulse is missing: how cold your feet get at night, whether your heartbeat is something you notice lying down, how quickly you warm up after a shower. None of them replaces a finger on an artery. Together they narrow the field.
Then we say so in writing. Where the missing examination would have decided between two readings of the same person, your report says which two, and which one we have leaned toward, and why. A reading that admits its own edge is more use to you than one that sounds certain.
If what you need is a pulse taken, what you need is a room with a practitioner in it. Ask us and we will say so.
The pulse is subtle and hard to understand; its forms are easily confused. Where the finger is placed decides what is found.
The photograph
The tongue has been read as a map of the interior for two thousand years, and a phone camera records almost everything a physician standing in front of you would see: the colour of the body, the coating and how wet it is, the shape, the edges. What it does not survive is bad light and a filter. Six rules cover it.
Stand near a window and turn the overhead light off. Colour is most of what the photograph carries, and a warm bulb will make a pale tongue look pink while a cool one will make a red tongue look ordinary. Grey weather is fine. Direct sun on the face is not.
Turn off anything on your phone that smooths, brightens or enhances automatically, and do not use the front camera if it has a beautify setting you cannot switch off. A filtered tongue is not a difficult reading. It is an impossible one.
First thing, before toothpaste, before coffee, before food. Brushing thins the coating and toothpaste tints it; the coating is half of what is being read. If you have already brushed, wait until tomorrow rather than sending us a scrubbed one.
Coffee, strong tea, curry, beetroot, red wine, coloured sweets and throat lozenges all dye the coating for hours. If you have had one of these, leave it until the next morning. A yellow coating that came out of a curry has sent more than one reading in the wrong direction.
Let the tongue rest out over the lower lip for two or three seconds, then take the photograph. Held out hard for ten seconds, a tongue goes red at the tip and narrows in the middle — you would be showing us the holding, not yourself.
Phone about a hand span away, whole tongue in the frame, camera level with your mouth. If you can manage a second frame from slightly above, send that too. And if you can lift the tip and photograph the veins underneath, send a third — it is not required.
If the photograph will not do, we email you and ask for another, at no charge. The forty-eight hours pause while we wait and start again when the new one arrives. Roughly one reading in nine needs a second photograph, and nobody has ever been charged for the second one.
Forty-eight hours
Two working days, counted from the acknowledgement email rather than from the moment we get round to it. Six stages, one of which exists only so that the wrong reader gets sent away quickly and paid back.
00hr
Payment and answers arrive together. You get an acknowledgement with a reference number, and the clock starts from that email rather than from whenever we next open the file. Hangzhou runs eight hours ahead of Greenwich, which is why the middle of your night is the middle of our working day.
00–02hr
Before anyone reads for a pattern, someone reads for the list on our boundaries page. If anything in your answers belongs in a consulting room this week rather than in a report, we email you within two hours, say which answer it was, and refund you in full. We would rather lose the thirty-nine dollars.
02–24hr
The physician reads the intake twice — once through, then again against the tongue photograph on a colour-managed screen. The free-text box is read last and slowest; it is where people tend to put the thing they were not asked about, which is often the thing that decides the reading.
24–36hr
The reasoning is written in the language it happened in. It is then put into English by a bilingual member of the house and checked back against the Chinese, line by line, by the physician who wrote it. Nothing is allowed to arrive in English sounding more certain than it was in Chinese.
36–44hr
A second physician of the house reads the finished report against your original answers. They are looking for two things: a suggestion that does not follow from what you actually said, and anything that reads like instruction rather than information. Disagreements go back to the first reader.
44–48hr
The report is set as a PDF, signed by the physician who wrote it with their name and licence number, and emailed to you. If we are going to miss forty-eight hours, you hear that before the forty-eight hours are up, not after.
Questions
We email you and ask for another, at no charge. The forty-eight hours pause while we wait and start again when the new photograph arrives. About one reading in nine needs a second attempt, usually because of an overhead light or a filter nobody knew was switched on.
No. We do not ask for reports, scans or blood work, and we do not read them if you send them. What is useful to us is what you write in the free-text box: what you have already been told, what medication you take, and what has changed recently. It changes what we would suggest you eat.
No. We write reports; we do not hold consultations. A call would look like clinical care across a border, which is exactly the line we stay behind. Everything we can responsibly say from thirty answers and a photograph is in the report, in writing, where you can reread it.
A physician licensed to practise Traditional Chinese Medicine in China, from the family practice that has run this clinic since 1987. Their name and licence number are printed on your report. A second physician of the house reads the finished report against your original answers before it is sent.
Most people do not fit one cleanly. The report names the pattern carrying most of the weight, then describes what else is in play and how the two interact. Where feeling your pulse would have decided between two readings, the report says which two, which one we leaned toward, and why.
Roughly two thousand words across seven parts, delivered as a PDF within 48 hours for US $39. It is yours to keep. One round of questions by email is included for thirty days, answered by the physician who wrote it.
The reading
You can read a complete sample report first. Most people do, and it is the fastest way to find out whether this is the sort of thing you want.