Authentic Chinese Herbs & Acupuncture

The diagnosis of a patient’s condition in TCM consists of three activities: an extensive interview, pulse diagnosis, and a tongue examination.

Interview: The first step in diagnosing a patient’s condition is an extensive interview by the TCM practitioner.  In addition to seeking information about the patient’s complaints, the practitioner will ask detailed questions about such issues as quality of sleep, dreams, appetite, preferred foods, and stress.  The practitioner is also trained to use the senses of observation, listening, and smelling.  Although smell is often amouflaged in the West by perfumes, deodorants, and breath mints, the Chinese believe it provides further knowledge about a person's health.  In the Five Element Theory, each element has a corresponding smell associated with it.

Pulse Diagnosis: Whereas Western doctors locate one pulse on the radial artery in the wrist, a practitioner of TCM feels for six pulses in each wrist: three superficial and three deep at specific points along the radial artery. The twelve pulses correspond to the internal organs.   For example, a deep pulse reading on the left wrist corresponds, top to bottom, to the heart, liver and kidney. Practitioners note the quality of the pulse in terms of frequency, rhythm, and volume and the Chinese have developed an elaborate vocabulary to describe a pulse, such as floating, thready, and slippery. Pulse taking requires years of training to master and is considered one of the most important diagnostic tools in Chinese medicine.

Tongue Examination: In addition to the pulse, the Chinese believe that the tongue is a strong barometer of human health. They developed an elaborate system to describe the condition of the tongue, including the color, texture, shape, size, and coating.  A very red tongue indicates a fever or inflammation and is described in TCM as an excessive internal heat or dampness condition. A white tongue indicates some kind of deficiency of energy (Qi), blood, or moisture. In this system, each part of the tongue corresponds to the condition of an organ. The tip of the tongue, for example, represents the heart and lung organs.

All three diagnostic techniques -- interview, pulse, and tongue -- provide useful information to the TCM practitioner regarding the nature of a patient’s condition.
 

THE FIVE ELEMENT THEORY

The five element theory, also called the five-phase theory, holds that everything in the universe, including our health, is governed by five natural elements: wood, fire, earth, metal and water. This theory underscores the Chinese belief that human beings, both physically and mentally, are intertwined with nature. Although it is difficult for Westerners to relate this philosophy to the Western approach to medicine, it is fundamental to the understanding of Traditional Chinese Medicine.

In the five element theory, each of the five elements has a season and particular organs and senses associated with it, such as taste, color, sound. The wood element, for example, is associated with spring, the liver, and the gall bladder.   Similarly, the fire element is associated with early summer, the heart, and small intestines; the earth element corresponds to late summer, the stomach and spleen; metal is associated with autumn, the lungs and large intestine; and water is associated with winter, the kidneys and bladder.

In contrast to Western medicine's teaching of a separation between the mind and

body, TCM views each organ as having particular body and mind functions, as illustrated in the belief that the liver is involved in planning, and in the storage of anger, while the gall bladder is the organ of decision-making.

To determine a patient’s composition of the five elements, a TCM practitioner asks many detailed questions that will provide clues as to the nature of their imbalances. They will ask about the person’s occupation, stress associated with it, what they like to eat, what physical problems they are experiencing, etc. Although a person may be oriented towards a particular element -- a person who is aggressive might be described as having a "wood" personality -- the Chinese believe that aspects of each of the five elements are present in every person at different times.

THE EIGHT GUIDING PRINCIPLES

In addition to the theory of the five elements, TCM practitioners employ the Eight Guiding Principles to analyze and differentiate the energetic imbalances in the body or the nature of a patient’s condition. The eight guiding principles actually consist of four polar opposites: yin/yang, cold/heat, deficiency (xu)/excess (shi), and interior/exterior.

In/Yang: These principles are the generalization of the above principles, and a condition can be categorized in terms of the relative dominance of either yin or yang.  In Chinese medicine, all organisms have both yin and yang qualities and a balance of the two are necessary for good health. In general, yin energy is associated with cold, female energy, and represents the solid organs.  Yang is associated with hot, male energy, and represents the hollow organs.  Chronic illness is seen as yin, while acute illness is seen as yang.

Cold/Heat: This principle is used to determine the overall energy of the patient. A cold condition would be one marked by a slow metabolism, chills, pale skin, and a low-grade fever, while a hot condition would be characterized by a heightened metabolism, sensations of heat in the body, high fevers, and a flushed complexion.

Deficiency/Excess: This principle describes the strength of an illness. In TCM, a deficient condition would be viewed as a lack of blood (such as in anemia), energy (Qi), heat, or fluids. Chronic illness would fall in this category. An excess condition, by contrast, means that the body has too much of something, such as Qi or blood. In TCM, an acute condition would be seen as an excess condition.

Interior/Exterior: This principle describes symptoms in terms of the location of the patient’s problem. Exterior conditions are those caused by the invasion of the body by pathogens, and are usually acute and superficially located with a short duration. Exterior symptoms are those that affect the hair, skin, muscles, joints, peripheral nerves and blood vessels. Interior conditions result from pathogens that enter the interior of the body. Interior symptoms affect the organs, deep vessels and nerves, brain, spinal cord, and bones.

According to TCM, the combination of these principles determine the nature or quality of the three constituents of the body, which are energy (Qi), moisture, and blood.  As described above, Qi is vital life energy.  Moisture is the liquid medium which protects, nurtures, and lubricates tissue, and blood is the material foundation out of which we create bones, nerves, skin, muscles, and organs.

TCM practitioners diagnose health problems using various combinations of the eight guiding principles.  For example, a patient might be diagnosed as having an "internal cold" or "external heat" condition. Used in conjunction with the five element theory, the eight guiding principles give the TCM practitioner a more complete picture of a patient’s energy imbalances and determine the treatment to be pursued through acupuncture, herbs, diet, and exercise.