Palm diagnosis in the Chinese medicine tradition is based on the concept that what occurs inside the body can be reflected on its surface and that the whole body is contained in each of its parts (the Taiji concept). The body’s systems are interconnected and interact with one another. When there is a pathology in one system, it sends information to related systems. The hand, in particular, accumulates a significant amount of information from the whole body, including both normal and abnormal activity.

When Master Tung introduced the 12 zones in his book (Tung, 1973), he began with Zone 11, the fingers, which may not be a coincidence. Master Tung’s acupuncture is based on the Five Zang organs, and with five fingers on each hand, each finger represents one of the five organs: the first finger represents the Spleen, the second represents the Lungs, the third represents the Heart, the fourth represents the Liver, and the fifth represents the Kidneys.

Lai Jin-Xiong was the first of Master Tung’s students to publish information about hand diagnosis. In his book, (Lai, 1987), he discussed the relationship between Master Tung’s points and the Five Phases, published a map of the hand, and explained the use of the pulse diagnosis when selecting points for treatment. In 1986, Hu Bing Quan, Huo Wen Zhi’s brother and student, published another map of the hand (Hu, 1986). In 1981, Lee Kuo Cheng, another student of Hu Wen Zhi, also published a map. In 2013, Chuan Min Wang (Wang, 2013) published a map based on Master Tung’s five channels, where each channel of the hand extends from one of the fingers (see Illustration The Five Organs on the Palm).

The map presented in this book combines these previously published maps with the 114 points of the hand and the palmar aspect of the fingers, reflecting the clear relationship between the diagnostic areas and points. For instance, the era corresponding to the chest contains points 22.01-02 Chong Zi/Xian, which is significant for treating chest and lung diseases (Illustration Palm Diagnosis). These points extend from the second finger, which is related to the Lungs. The San Yang (11) points, significant for treating male reproductive disorders, are located in the diagnostic area for the male reproductive system, while the Feng Chao (11) points, significant for treating female reproductive disorders, are in the diagnostic area for the female reproductive system. Points 22.08-09 Wan Shun Yi/Er, used for treating spinal and Kidney disorders, are also diagnostic points for the spine and Kidneys. The San Huo (22) points, which extend from the third finger, related to the Heart, treat Heart conditions. In many cases, there is a clear relationship between the indications for the points within a given diagnostic zone and the diagnostic zone itself. The map presented (Illustration Palm Diagnosis) is based on this relationship.

The external expression of the disease reveals itself on the body’s surface, through changes that appear on the hand. Some areas have points that can treat the external expression of the disease detected in that area. Thus, the external expression of the disease, the Dao Ma groups, and the diagnosis are interconnected.

When performing a Palm diagnosis, we look for color changes, the appearance of veins, and any areas that are more prominent or sunken. In traditional hand diagnosis, the creases of the hand are observed, but to my knowledge, these have no significance in Master Tung’s acupuncture.

Colors or color stains on the hand provide clues based on their location according to the diagnostic map:

• White – Coldness, deficiency.
• Red – Heat, excess.
• Green-blue – Coldness, deficiency. The darker and closer to black, the more severe the condition.
• Red and purple – Heat, inflammation.
• Red and yellow – Heat.
• Light black – Dampness and Coldness.
• Blue and black – Pain.
• Purple stains – Blood stagnation.

The appearance of veins on the hand also provides diagnostic clues based on their location according to the map:

• Green-blue – Coldness, deficiency. The darker the color, the more severe the condition (most patients present with green-blue veins).
• Red and purple – Heat and inflammation.
• Floating veins – An acute, mild illness.
• Sunken veins – A chronic, more severe illness.

Degenerative changes in the muscles of the hand indicate deficiencies in the corresponding area. For example:

• A depression in the area 22.06 Zhong Bai and 22.07 Xia Bai on the dorsal aspect of the hand indicates Spleen deficiency.
• A depression at points 22.08-09 Wan Shun Er/Yi indicates Kidney deficiency.
• Degeneration in the area of 22.05 Ling Gu to Zhong Kui (22) suggests weakness of Qi and Blood as the underlying cause of the degeneration.
• Stiff finger – Qi stagnation leading to Yin-fluid stagnation, where there are not enough fluids to moisten the finger.
• Folded, bent, or swollen finger – Chronic Yin stagnation.

• A protruding or swollen area indicates an excess in the corresponding location on the map.
• A sunken area indicates a deficiency in the corresponding location on the map.

Master Tung’s Palm diagnosis diagram is based on the Five Zang organs, with each finger representing one of these organs. The first finger represents the Spleen, the second represents the Lungs, the third represents the Heart, the fourth represents the Liver, and the fifth represents the Kidneys. Lee Kuo Cheng’s diagram, which illustrates the correlation between the hand and trunk (including the neck and head), can be used to better understand this division into organs (see Illustration Palm Diagnosis the Five Zang organs). The thumb represents the head and Spleen, and the remaining fingers represent the Three Heaters: Upper Heater – second and third fingers (Lungs and Heart, respectively), Middle Heater – fourth finger (Liver and Spleen), and Lower Heater – fifth finger (Kidneys).

The neck is represented by the area where the thumb and first metacarpal bone meet, the Huai Ling (11) area. The appearance of blood vessels in this area can indicate Blood stagnation. When Hu Wen Zhi identifies blood vessels here, he often performs bloodletting on the neck.

The thumb and the first metacarpal bone represent the Spleen (see Illustration Palm Diagnosis). In Chinese medicine, the Spleen-pancreas has a significant relationship with the digestive system. Deficient Spleen Qi can cause digestive disorders. The digestive system is diagnosed at the first metacarpal bone. The small intestine is diagnosed at the base of the metacarpal bone, at the wrist, while the large intestine is diagnosed just above it, toward the thumb. The point 22.11 Tu Shui, which can treat Stomach and Intestine diseases, is also located in this area.

The second finger represents the Lungs, which are also diagnosed on the palm at the base of the second finger (see Palm Diagnosis). The throat and trachea are diagnosed on the radial aspect of the palm. Jin Xing (22), also located in the palm area, treats Lung diseases, including tuberculosis, emphysema, asthma, and bronchitis.

Allergic asthma is diagnosed on the radial aspect of the second finger, at the first section (Line B) (Illustrations Palm Diagnosis), where points 11.01-02 Da/Xiao Jian and Ce Jian (11), which can treat yellow mucus, are situated.

The diagnostic zone of the male reproductive system is located at the third segment of the second finger, on the radial aspect (Line A). San Yang (11), Nei/Chen Yin (11), important points for treating male reproductive disorders, are found in this zone.

Adjacent to the diagnostic area for the male reproductive system, along Line B, are points 11.03-04 Fu Wai Jian, which are used to treat inguinal hernias.

The digestive system is represented by the line that extends from the throat zone toward the wrist, running radially along the Life Line (Illustration Palm Diagnosis). As this line approaches the wrist, it curves toward the first metacarpal bone, ending at the thumb. The stomach is located at the upper part of the line, while the duodenum, small intestine, and large intestine are found before the curve toward the first metacarpal bone. Along this line are points for treating Stomach and Intestine diseases. In the Stomach zone are the San Mao (22) points, which treat stomach ulcers, duodenal ulcers, and stomach carcinoma. In the Intestine diagnostic zone are the 22.11 Tu Shui points, which treat intestinal and stomach diseases. San Mao (22) can also treat Lung diseases; they extend from the index finger, between the palm and wrist at the second metacarpal bone, an area associated with the Lungs. Gu Guan (22), located at the curve of the digestion line where the duodenum is diagnosed, treats acute inflammation in the duodenum.

The chest diagnostic zone is located radially to the Stomach line. Points 22.01-02 Chong Zi/Xian, which are important for treating chest diseases, are found within this zone.

The third finger represents the Heart. The Heart is diagnosed on the palm at the base of the finger. On the first segment of the finger, there are two significant groups of points for treating Heart diseases: 11.19 Xin Chang and Huo Long (11). Continuing down the finger, between the palm and wrist on the third metacarpal, are San Huo (22), which can treat arrhythmias and rheumatic heart disease.

The fourth finger represents the Liver. The Liver is diagnosed on the palm below the base of the finger, and in the region of San He (22), on the palm below the fourth and fifth fingers. The San He (22) points treat Gallbladder diseases. In Chinese medicine, there is a significant relationship between the Liver and Spleen, especially concerning the digestive system. On the fourth finger, we find representations of both organs. On the ulnar side of the finger (Line D), we find the 11.20 Mu Yan points, which can treat hepatitis, liver cirrhosis, and enlarged liver. On the opposite side (Line B) we find 11.21 San Yan, which treat digestive disorders. Further down, between the palm and wrist on the fourth metacarpal bone, are points like San Xing (22), which can treat hypochondrium pain, jaundice, hepatitis, and a bitter taste in the mouth.

The diagnostic zone for the female reproductive system is located on the lateral-radial side of the first segment of the fourth finger (Line A). Feng Chao (11), important points for treating the female reproductive system, are also found in this area.

Another diagnostic area for the female reproductive system is the distal part of the forearm, from the wrist to points Xin Ling (33). The Uterus is diagnosed at the center of this area, and the ovaries are on either side.

The fifth finger represents the Kidneys. The diagnostic zone for the Kidneys is on the palm below the finger and slightly beyond, on the fifth metacarpal bone (Illustration 17). Points like Fen Shui (11) and Shui Qing (11), which can treat Kidney diseases, are located on the fifth finger. Between the palm and wrist on the fifth metacarpal bone, there are the San Hai (22) points, which can treat Kidney diseases and Bladder disorders.

At the center of the space between the fourth and fifth metacarpal bones is a small area where the Spleen is diagnosed (Illustration Palm Diagnosis). Blood vessels are often found in this area, indicating Spleen-related illnesses.

The diagnostic zone for the spine and Kidneys is on the ulnar aspect of the fifth metacarpal bone, where 22.08-09 Wan Shun Yi/Er are located. The upper spine is diagnosed near the base of the finger (22.08 Wan Shun Yi), while the lower spine is diagnosed near the wrist (22.09 Wan Shun Er). However, my clinical experience suggests that the division into upper and lower is not always clear-cut. For instance, individuals with lower spine disorders may also exhibit findings near the fingers, and vice versa. Depressions, color changes, and changes in the blood vessels can indicate weak Kidneys or spinal disorders.

Dark vessels at the joints between the first and second segments of the third and fourth fingers are used to diagnose the Heart, Liver, and Spleen. The third finger is associated with the Heart, the fourth finger is associated with the Liver and Spleen; Line B is associated with the Spleen, while Line D is associated with the Liver.

The use of VAS in Master Tung’s acupuncture opened a new pathway for me. Initially, I incorporated VAS into Palm diagnosis because of the many similarities between hand diagnosis and Auriculotherapy; both methods are used for treatment and diagnosis and involve searching for blood vessels and skin color changes. Additionally, both involve using body imaging techniques. The representations of the ear and hand in the homunculus^[1] of the cerebral cortex are large compared to other organs, and the highest electrical potential is in the head and hands. In both methods, the patient can be left with seeds that apply pressure to a point or hypodermic needles. Given the similarities between hand diagnosis and Auriculotherapy, and the challenges of learning hand diagnosis without guidance from a teacher familiar with the method, I began by scanning the hand with a Bahr 3V hammer. I started with the assumption that I would detect VAS in the active parts of the hand where diagnostic indications appear. I found that in most patients, VAS was detected at Pc-8 Lao Gong (below the Heart diagnostic area at the ball of the hand) at varying intensities. I scanned the hands of my patients, and each time I sensed VAS, I checked for changes in the tissue. Over time, I began to understand what specific changes to look for. When using VAS, the question being asked is essentially: Is the area active? This is a binary question with a “yes” or “no” answer. If VAS is present, the answer is “yes”; if there is no response, the answer is “no.” This tool became my guide, helping to validate whether my findings were relevant. As I continued working with VAS, I identified important changes in the tissue, and after two years, I reached a point where I no longer needed to rely on VAS to diagnose the hand.

In hand diagnosis, there is a direct relationship between the zones of the hand and acupuncture points within those zones. The indications for specific points often relate to treating a pathology of the organ associated with that zone. The Dao Ma groups and the external expression of the disease are interconnected. During illness, changes in the skin and connective tissue may appear in the areas of Dao Ma groups. Similarly, signs that manifest on the hand during illness represent the external expression of the disease. If blood vessels (Luo channels) are found on the hand in the same places as acupuncture points, they can needled or bled. Thus, not only are the external expression of the disease and acupuncture points intertwined, but the diagnostic zones are also closely connected. Therefore, the Dao Ma groups and acupuncture points located within each of the 12 Zones may be considered during diagnosis. Diagnosis is not limited to the hand or face; it can encompass the whole body.

Therefore, in addition to hand diagnosis, I also scan Zones 77 and 88 to identify the root of the disease. These zones contain Dao Ma groups and bloodletting regions that can treat the Five Zang organs. Zone 77 and 88 are particularly important in Master Tung’s acupuncture for treating disorders of the internal organs, especially the Five Zang organs.

Within Zone 88, each of the Five Zang organs has a corresponding Dao Ma group. The external expression of the disease can often be found within these groups. The locations of these findings aid in diagnosis; because the external expression of the disease, diagnosis, and acupuncture points are interconnected, I use bloodletting on the Luo channels and needle the points where the findings are detected. In Zone 77, the Dao Ma groups and bloodletting regions are also associated with the Five Zang organs. Therefore, as with Zone 88, I also scan Zone 77 during diagnosis and treat the areas where the findings are discovered.

In addition to examining these zones through observation and touch, I use VAS to identify active areas. I examine the Dao Ma groups in Zone 77 and 88 using a 3V Bahr hammer to detect active areas. As mentioned in the section “Finding the External Expression of the Disease,” this technique revealed surface changes at points that I had previously overlooked, and these findings are now an integral part of my diagnostic practice.

Certain symptoms can be tied to specific mechanisms of the disease. Chapter 74 of the Basic Questions includes a symptomatic description of these mechanisms, as follows: “[Physicians should] carefully investigate the trigger underlying a disease, they must not miss what befits a qi” (Unschuld, Tessenow, 2011). Qi Bo then describes each of the Five Zang organs in disease:

Any disease involving Wind that causes involuntary movements and dizziness, without exception, is related to the Liver.

This refers to internal Wind. In Master Tung’s acupuncture, the primary Dao Ma group for treating internal Wind is 88.12-14 Shang San Huang.

Every disease involving Coldness that causes contraction and pulling, without exception, is connected to the Kidneys.

Wang Bing, an interpreter of the Su Wen, wrote that Coldness contracts like the Qi of Water. Zhang Jiebin also noted that the Kidneys are associated with Water, and their transformation is linked to Coldness. When Yang Qi cannot penetrate, Wei Qi stagnates, resulting in a state of deficient Kidney Yang.

In Master Tung’s acupuncture, the primary point for treating deficient Kidney Yang is 77.18 Shen Guan. The Dao Ma group 88.09-11 Tong Shen/Wei/Bei can also be used.

Spleen

Any disease involving Dampness that causes bloating and fullness, without exception, is connected to the Spleen.

In Master Tung’s acupuncture, the primary point for treating Dampness is 77.05-07 San Zhong.

Any pain and disease involving itching and sores, without exception, is connected to the Heart. One of the primary points in Master Tung’s acupuncture for treating pain and itching is 22.10 Shou Jie. The point innervates the Kidneys, not the Heart; its principle of operation is based on the Five Phase restraining sequence, where Water controls Fire.

Lungs

Every disease with dammed up Qi and stagnation, without exception, is connected to the Lungs.

In Master Tung’s acupuncture, stagnation and dammed up Qi are treated through the Lungs. The primary Dao Ma group for this purpose is 22.05 Ling Gu together with 22.04 Da Bai.

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[1] Homunculus (from Latin: little man) is a distorted representation of the human body whose purpose is to illustrate how the different body parts are reflected in the processing of neural information in the cerebral cortex.