Diagnosis by Traditional Chinese Medicine

Like any medical system, Traditional Chinese Medicine (TCM) makes its diagnosis based on both subjective and objective data.

Subjective data: doctors will ask your illness history, how you get the disease, what kinds of treatment you have before, especially what kinds of herbs you have taking. They will also need to know your feelings. Unlike the conventional medicine, your current feeling is one of the most factors contributing to the final diagnosis. For example, if you have a headache, the doctor in conventional medicine may soon turn to use MRI, CT, or X – ray, or check your blood pressure and any other lab tests to make diagnosis, or check you eyes, nose to see if it is related to any problem there. In TCM, the doctors need to know more. They need to know which part your headache is. Is it continuously there, or comes in a fixed time of the day, or seasons. Is it accompanied by nausea, vomiting, or happens after eating, or with feeling or fever, or cold …… Quite often they will need to know the information about your other part of the body, to build a whole picture about your current condition.

Objective data: Chinese medicine doctors do not subscribe any lab tests or X – ray. The doctors will pay attention to your mobility, your overall spiritual aspect, the color of your face (your eyes, nose, lips, ear lops, hair), and hairs. So remember do not make any make-up before go to TCM doctor!

The most important objective data are collected from the tongue and pulse.

(1). The tongue. They will pay attention to your tongue for its shape, size, color, smell, dryness or wetness. They will also remember the color, the thickness of the tongue covering.

(2). The pulse. Doctors will not only need to know the times per minute the pulse is, how strong the beat is, but also need to feel how the pulse feels like. Does it feel like smooth, or not smooth, smooth as beard moving, or as hard as feels a string, or strong as a wave, or as thin as a thin string…… See the picture below to see the difference between a pretty normal tongue and a tongue from a patient:

After collection of all data, the doctors have to establish the TCM diagnosis. Several major questions they need to clear out:

(1). What’s the reasons are the illness. Is it caused by Fire, Wind, Cold, Hot, Dryness, such external factors (they are termed as pathological evils)? Or is it caused by over-exhaust due to physical work or due to emotional stress, or by over-sexual activity, or by emotional stress (over depress, over exciting, over sadness, over scared ……)…..

(2). Where is the illness. Is it mostly in the Heart system, Liver system, Spleen, Kidney or Lung system. Note: the names of inside organs here does mean exactly the same as they are used in conventional medicine. For example, the Liver system in TCM includes the function of liver, as well as the gall bladder, tendons, emotion, eyes, etc. The kidney system includes the functions of the urinary system (kidney and urine bladder), the sexual and the reproduction system, the bone density and structure, the brain (so the memory ability), the hair, the ear, tooth, etc.

(3). What’s the local condition now. Is it an accumulation of Cold, Wetness, Phlegm, or Fire… Or is it with stagnation of blood circulation? Or is there short of vital energy or blood? The Traditional Chinese Medicine does not pay attention to the pathological reasons as cared by the conventional medicine, such as bacteria, or virus, or fungus, or others.

Traditional Chinese Medicine does not pay attention too much to specific bacteria or virus. It focuses much more on the RESULT of the attach by the bacteria or virus or others. It summaries the result and use the terms of Fire, Wetness, Cold, Stagnation of blood, Weakness of Vital energy, etc. This is important, since the herbs that are going to be used for the treatment, are also grouped as their ability to remove extra Fire, Wetness, Cold, Stagnated blood, or supplies more Vital Energy to the body.

The clinic demonstration of each pathological Evil is different. For example, if there is pain in joints, if it is caused by Fire evil, the pain feels hot, as burning. If it is due to accumulation of Cold evil, the pain would feel like contract, and it could be released to some level by warm patch, by worsen by using hot patch. If it is due to the accumulation of Wetness evil, the pain feels like heavy and numbness. Different pain needs the use of different herbal groups. Of course, most times, the pain could be caused by more than one factors (evils).

That the Traditional Chinese medicine pays much more to the results of the evil invasion but not the exact bacteria or virus makes it is possible that no matter how comes the mutation of the bacteria, virus, Chlamydiales, or mycoplasma, this medical system always have ways to make diagnosis and start treatment. This is well proven in the treatment of SARS in year 2003. For the conventional medicine, before verify the cause of SARS, the treatment can not really started. The death rate was not reduced and the spread of SARS is hard to stop.

There are also some aspects the Traditional Chinese Medicine pays much attention to make diagnosis:

(1). It pays attention very much to the times when the disease start, becomes worse or released. The time could be 24 hours in a day, or it means four seasons in a year. Disease starts and becomes worse during day time suggests that it is related to heart, kidney and spleen system (note: we means the system, or the specific organ). Whereas if it starts or becomes worse at night suggests disease in the lung, urine bladder, gall bladder or large intestine system. Similarly, disease in the kidney, liver or heart system could become relatively quiet in the winter, but worse in the summer (again, we mean the system in the Traditional Chinese Medicine system, not the organs).  Did you notice that the common cold (cough, pluged nose, and fever..) usually becomes worse at night? You may laugh that it is so clear that the disease is in the lung system and it is useless to pay attention to the time. But, in clinic, there are so many times when the reason for a fever, a swelling, a cough, an insomnia (poor sleep) is hard to found to be due to which system. The time when the disease becomes worse or released is one of the very useful ways to help diagnosis and treatment.

(2). It also pays much attention to the geographic location where the disease start, becomes worse or released. A disease that started and becomes worse in the sought side suggests the reasons is due to Hot and/or Wetness evil. Whereas if it happens in the north side of the earth, it may be related to Cold and Dryness evil. In clinic, the pattern of the disease distribution is largely variable according to the geographic locations. For this reason, we can well understand that for an arthritis occurs in Vancouver and in summer, may need more or less different herbs for the treatment than that occurs in Edmonton (dry and cold environment). We usually noticed that someone has their disease released or worsen after traveling to other cities. If it is worse, you may think that it is because tired physically of the patient. What about if they get better?

(3). It pays to the body shape as well.