Inspection of postures means to examine the patient’s postures in tranquility and action as well as abnormal activities. The postures of the patient in tranquility and action is closely related to the conditions of yin and yang of the body as well as natures of the illness as being cold or heat or asthenia or sthenia. The movement of the limbs is under the control of the heart spirit and in close relation with the functions of the bones, muscles, tendons and vessels. Therefore, the postures of the patient in tranquility and action as well as the abnormal activities are all the external manifestations of disease. Different diseases may be reflected by different postures and activities. Inspection of postures is helpful for deciding the natures of diseases and diagnosis of certain diseases.

1. Inspection of postures in tranquility and action
Yang governs action and yin tranquility. The sitting, lying and walking postures of the patient may be summarized like this. movement, supination and extension indicate that the disease of yang nature, usually manifesting as external syndrome, heat syndrome and sthenia syndrome; quietness, pronation and bending indicate the disease of yin nature, usually manifesting as internal syndrome, cold syndrome and asthenia syndrome.

Sitting:
Sitting with the head bending down, shortness of breath and no desire to speak usually indicates asthenia of pulmonary qi or failure of the kidney to receive qi; sitting with the head rising up and asthmatic breath signifies adverse flow of qi due to pulmonary sthenia; asthma with inability to lie down indicates pulmonary distension and retention of fluid in the chest and abdomen.

Lying:
Lying on bed facing the outward with the ability to turn the body freely usually indicates yang syndrome, heat syndrome and sthenia syndrome; lying on bed facing the inward with inability to turn the body freely indicates yin syndrome, cold syndrome and asthenia syndrome; lying on a supine position with the extension of the limbs and refusal to cover quilt and put on clothes indicates the syndrome of predominant yang and sthenic heat; huddling up when lying on bed with preference to put on more clothes indicates yin sthenia and yang asthenia or abdominal pain; inability to lie down due to cough usually occurs in autumn and winter, often caused by internal retention of fluid; lying on bed with inability to sit up (sitting up causes dizziness) indicates asthenia of both qi and blood.

Walking:
Unstable walking with tremor of the limbs usually occurs together with dizziness, usually caused by internal disturbance of liver wind or impairment of tendons and bones. Besides, deformity of the lower limbs, trauma and injury of joints all can lead to abnormal walking postures. In this case, diagnosis should be made with the aid of other ways of examination.

2. Inspection of abnormal movements
Abnormal movements of the patient’s limbs usually indicate the signs of certain diseases. For example, spasm of the limbs, stiff necks and opisthotonus indicate internal disturbance of liver wind due to extreme heat generating wind, usually seen in exogenous febrile disease at the stage of exuberant heat-tremor or peristalsis of fingers and toes indicates internal disturbance of asthenic wind, seen at the advanced stage of exogenous febrile disease due to deficiency of body fluid and malnutrition of tendons and vessels.

Such a problem seen in chronic disease due to internal impairment is often caused by insufficiency of qi and blood and malnutrition of the tendons and vessels. Pain of the limbs and joints, inflexibility of the joints or spasm of the hands and feet as well as swelling, stiffness and deformity of the joints usually suggest obstructive syndrome. Flabbiness of the limbs and difficulty in moving or atrophy of muscles is usually of flaccidity syndrome. Difficulty in moving or numbness of unilateral limbs indicates hemiplegia due to wind stroke.