What is Traditional Chinese Medicine (TCM) Diagnosis?
To put it in a simple and laymen language, TCM diagnosis is to help you understand your body and health situation through comprehensive information collection. TCM diagnosis is the most difficult yet most important fundamental core of traditional Chinese medicine. It is a multi-directional and systematic analysis process which is vital in any TCM treatment determination. Just common sense, if you don’t know how to diagnose, how can you understand the true cause of the problem and how can you come up with the right solution? So I hope to be able to introduce you the framework how it really works and through regular posts and blogs to pass such information to you. Little by little, you will acquire enough knowledge to understand your health situation and do self care or self healing. And even if you want to get treatment by any practitioner or doctor, you will know which treatment is good for you, whether it’s progressing towards the right direction.
Four Aspects of TCM Diagnosis
To come up with any TCM diagnosis, a practitioner needs to do the following combined medical information collection:
1. Collecting Medical Information through Inspection(Look-望), Smell/Listen (闻), Inquiry (Ask-问), Pulsing and Palpitation (切)-Diagnosis Foundation :
Look: Look at the spirit, color, body shape, body dynamics, face, head, eyes, nose, ears, tongue body, tongue coating, throat, lips, teeth and gum, hand, trunk, abdomen, skin, limbs, sputum, saliva, child’s finger venule, etc based on TCM indication guideline
Listen: Listen to a patient’s voice, language expression, breath, cough, sign, statement of his own complaint, etc.
Smell: Whether the patient has any special body odor, or any special mouth breath. So if you go to see a TCM doctor, you’d better not to wear any perfume or other special smelly thing which might affect the diagnosis.
Ask: A TCM doctor will ask about history of all complaints, heat or cold, any pain or uncomfortable place, thirst, urine, stool, sleeping, emotion, appetite, sweating situation, hand and feet temperature, child specific questions, female or male issues etc.
Pulsing: Based on the pulsing at Cun, Guan, Chi position around the wrist, to help confirm the diagnosis. It plays a very important role in most cases. Some TCM doctors might brag that they can diagnose just by pulsing so people will think they must be great doctors. Well, it might not be true. Contrary to that, as the famous doctor Ni, HaiXia mentioned: if there are conflicts between pulsing and the symptoms through Look/Listen/Smell/Ask, in most cases, you need to discard pulsing and rely on the symptoms and the patient’s feeling.
Palpating: Similar to the palpating method in western medicine, but with extended scope, including skin, chest, hypochondrium, abdomen, back shu acupuncture points
To come up with a good TCM diagnosis, all the information collected through the four steps need to be combined together. These are just the general types of medical information to collect. As to the detailed indication of each (e.g pale or red tongue color with possible indication), they will be explained in my posts or remedies when I talk about specific health problems.
2. Determine the Syndrome Differentiation Principles Based on the Combined Medical Information Collection- Diagnosis Principle:
Once all the medical symptoms and signs as well as any medical and treatment history information are collected, the practitioner then needs to determine the syndrome, e.g, common cold with wind-cold or wind-heat, or just wind as their clinical manifestation would be different, so as the treatment method. In order to come up with the right syndrome differentiation, the following diagnosis principle often used.
A: Eight-Principle Syndrome Differentiation: Exterior and Interior, Cold and Heat, Deficiency or Excess, Yin-Yang, with Yin-Yang as the general guiding principle
B: Disease-Cause Syndrome Differentiation: Six External Excesses (Wind, Cold, Summer-heat, Dampness, Dryness, Fire), Seven Internal Excessive Emotions (joy, Anger, Worry, Contemplation, Grief, Fear, Fright), Improper diet, Work or Rest etc.
C: Qi-Blood and Body Fluids Syndrome Differentiation: Qi Disease, Blood Disease, Body Fluid Disorder
D: Zang-Fu Organ Syndrome Differentiation: Heart and Small Intestine, Lung and Large Intestine, Spleen and Stomach, Liver and Gallbladder, Kidney and Urinary Bladder, complication among the Zang-Fu
E: Six-Meridian Channel Syndrome Differentiation: TaiYang, YangMing, ShaoYang, TaiYin, ShaoYin, JueYin- normally used to determine the pathological changes of externally contracted wind cold
F: Defense (Wei)-Qi-Nutrient(Ying)-Blood Syndrome Differentiation: Defense System, Qi System, Nutrient System,Blood System – mostly used to determine the pathological changes of externally contracted heat
G: Triple -Energizer Syndrome Differentiation: Upper Energizer, Middle Energizer, Lower Energizer- also used to determine the pathological changes of externally contracted heat disease
Don’t worry, I don’t intend to teach all the Chinese medicine diagnostic theory in a dull and abstract way. The systematic TCM training will be only offered to TCM practitioners later on. My main focus now is to help ordinary people to understand enough to be able to diagnose their own health problem and do related self care. I will discuss what kind of signs and symptoms related to specific health or disease in my posts or remedies so you can understand your problem better and do suggested self care or self healing, either through acupressure, moxibustion, cupping, herbal tea or formula, or just special TCM exercises.
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