DIAGNOSTIC METHODS

“The exterior reflects the interior.” This is the guiding principle in diagnosis. Traditional Chinese Medicine practitioners utilize many parts of the body which are directly accessible by touch or sight. Since the balance of the whole organism is the basis of the medicine, a useful diagnosis will account for the condition of all parts (and their relationships) of the human being. This requires gathering enough information to understand the context of the person. Listening to both what is said and how it’s said are also of primary importance. The examination is thus very thorough and includes an extensive interview.

QUESTIONING
The interview is of prime importance. It is how the majority of signs and
symptoms of the specific complaint and underlying systemic imbalance are
discovered and classified. The interview is often referred to as The 10 Questions. In reality there are approximately 10 categories and 100 questions. If you have already filled out the Online Diagnosis questionnaire you’ll probably recognize the “10 Categories” below

TEMPERATURE

URINE

PERSPIRATION

THIRST

DIGESTION

APPETITE

SLEEP ENERGY

REPRODUCTION

EXERCISE

STOOLS (feces)

TONGUE DIAGNOSIS

Tongue diagnosis dates to the Shang Dynasty which began c.1600 B.C. and ended c.1000.
Throughout the time since it has evolved into a very important tool of diagnosis.

The tongue is considered to be an exterior part of the body because it’s in almost
contact with the air – the exterior. This is certainly different from the
American view but extremely productive. An acupuncturist or herbalist will, in
the mind’s eye, overlay a tongue with several different maps. Each map is
shaped by the diagnostic model or system which it represents.

The diagram on the left represents the internal organs. The center diagram
represents the body as having three parts – upper burner, middle burner, and
lower burner. The diagram on the right represents the body as having two parts
- interior and exterior.

The practitioner examines the general and local shape, and the color of both the
tongue body and coat. A healthy tongue will be pink (like a kitten or puppy’s
tongue) and moist with a thin clear or white coat. Thin is defined as a coat
through which the tongue body can be seen. Some signs of imbalance or pathology
are red body, yellow coat, thick coat like mozzarella cheese, very dry body or
cracks in the coat or body itself.

PULSE DIAGNOSIS

The oldest known book to focus specifically on pulse diagnosis is The Pulse Classic
by Dr. Wang Shu-He which dates to sometime in the first century C.E. A
compilation of pulse knowledge, it is tersely worded but still over 350 pages
in length.

These days pulses are felt at the inside of the wrist where the hand and arm meet.
More precisely the first pulse is at the wrist crease on the radial side of the
medial aspect of the forearThe Chinese Medicine Sampler m over the radial
artery. The other two are just proximal (toward the elbow) to the first.

In addition to three positions there are three depths. Together they total nine
places with valuable diagnostic information on each wrist. There are
twenty-eight qualities of pulse which a practitioner must be alert for.
Different combinations of pulses also have diagnostic significance. The number
of possibilities allows fine distinctions in interpreting the gathered
information.

Many in the profession consider pulse-reading an art that demands assiduous study
and innate talent. Certainly the skill of a physician who can tell a patient’s
lifetime medical history from pulse-reading is not common. But pulse-reading
skill varies like skill with a musical instrument. Study and talent are both
factors but their proportions differ from person to person. Contrary to myth, a
practitioner need not have spent twenty years in apprenticeship in order to
make productive use of pulse-reading.
VISUAL DIAGNOSIS
This method dates to at least 300 BC – 500 BC. Visual characteristics are mentioned in
The Yellow Emperor’s Classic of Internal Medicine. The practitioner observes
the entire body. The most general criterion for significance is abnormality.
Raises and depressions in places they should not be are significant. Dry or
damp patches mean imbalance. Facial colors than glowing pink are a sign of
imbalance. General and local color are also important. For instance, a saffron
like yellow around the navel indicates severe deficiency of the spleen.

There are also systems of correspondence between the face and other parts of the body.
For example, one system associates the major regions of the face with the Yin
organs. The Heart is reflected by the forehead and the Kidneys are reflected by
the chin. Another system uses the area surrounding the eyes and yet another is
based on regions on the eye itself. Nails are also thoroughly observed.

LISTENING DIAGNOSIS

This method is also mentioned in The Yellow Emperor’s Classic of Internal Medicine.
The practitioner listens to the respiration and voice. Both are a reflection of
the Lung functions and the state of the Qi. A strong voice indicates a healthy
amount of Qi and a weak voice indicates Qi Deficiency. Smooth as opposed to
halting speech or inability to speak at all reflects the Heart or Liver
condition. The Five Element qualities
shouting-laughing-singing-crying-groaning, give strong signs about the balance
of the elements.

LISTENING DIAGNOSIS
This method is also mentioned in The Yellow Emperor’s Classic of Internal Medicine.
The practitioner listens to the respiration and voice. Both are a reflection of
the Lung functions and the state of the Qi. A strong voice indicates a healthy
amount of Qi and a weak voice indicates Qi Deficiency. Smooth as opposed to halting
speech or inability to speak at all reflects the Heart or Liver condition. The
Five Element qualities shouting-laughing-singing-crying-groaning, give strong
signs about the balance of the elements.

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