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When you are sick, Qi circulation is irregular or abnormal. It has too much Yin or too much Yang. Because all Qi channels are connected to the surface of the body, stagnant or abnormal Qi flow will cause signs to show on the skin. Also, when you are sick, the sounds you make when speaking, coughing, or breathing are different than when you are healthy Therefore, Chinese doctors examine a patient's skin, particularly the forehead, eyes, ears, and tongue. They also pay close attention to the person's sounds. In addition, they ask a number of questions about daily habits, hobbies, and feelings to understand the background of the illness. Finally, the doctor feels the pulses and probes special spots on the body to further check the condition of specific channels. Thus, Chinese diagnosis is divided into four principal categories: 1. Looking (Wang Zhen, ); 2. Listening and Smelling (Wen Zhen, H ); 3. Asking (Wen Zhen, r-1^); and 4. Palpation (Qie Zhen, to«- ).
Obviously, Chinese medicine takes a somewhat different approach to diagnosis than Western medicine. Chinese doctors treat the body as a whole, analyzing the cause of the illness from the patient's appearance and behavior. Often what the Chinese physician considers important clues or causes are viewed by the Western doctor as symptomatic or irrelevant, and vice versa.
Next, we will briefly discuss the above four Chinese diagnostic techniques:
The doctor looks at the spirit and inspects the color of the patient.
General Appearance. The doctor examines the facial expression, muscle tone, posture, and general spirit of the patient.
Skin Color. The doctor examines the skin color of the injured area, if the problem is externally visible, like a bruise or pulled muscle. The doctor also examines the skin color of the face (Figure 4-1). Since some channels are connected to the face, its color reveals what organs are disordered or out of balance.
Tongue. The tongue is closely connected through Qi channels to the heart, kidney, stomach, liver, gall bladder, lungs, and spleen (Figure 4-2). In making a diagnosis, the Chinese doctor will check the shape, fur, color, and the body of the tongue to determine the condition of the organs.
Eyes. From the appearance of the eyes the doctor can tell the liver condition. For example, when the eyes are red, it means the liver has too much Yang. Also, black spots on the whites of the eyes (Figure 4-3), can tell of problems with the Qi circulation, degeneration of organs, or stagnancy due to an old injury.
Hair. The condition of the hair can indicate the health of the kidneys and the blood. For example, thin, dry hair indicates deficient kidney Qi or weak blood.
Lips and Gums. The color of the lips and their relative dryness indicates if the Qi is deficient or exhausted. Red, swollen, or bleeding gums can be caused by stomach fire. Pale, swollen gums and loose teeth might be a symptom of deficient kidneys.
Listening and Smelling (Wen Zhen, )
The doctor listens to the patient's breathing, mode of speech, and cough. For example, a dry, hacking cough is caused by dry heat in the lungs.
The doctor smells the odor of the patient's breath and excrement. For example, in the case of diseases caused by excessive heat, the various secretions and excretions of the body have a heavy, foul odor, while in diseases caused by excessive cold, they smell more like rotten fish.
Asking (Wen Zhen,
This is one of the most important sources of a successful diagnosis. The questions usually cover the patient's past medical history, present condition, habits and life style. Traditionally, there are ten subjects a Chinese doctor will focus on in this interview. They are:
1. Chills and fever
2. Head and body
3. Perspiration
4. Diet and appetite
5. Urine and stool
6. Chest and abdomen
7. Eyes and ears
8. Sleep
9. Medical history 10. Bearing and living habits
Palpation (Qie Zhen, inlfr)
There are three major forms of palpation (touching or feeling) in Chinese medicine:
1. The palpation of areas which feel painful, hot, swollen, etc. to determine the nature of the problem. For example, swelling and heat indicates there is too much Yang in the area.
Kidneys
Kidneys
Heart and Lungs'
Figure 4-2. Diagnosis by Inspecting the Condition of Tongue
Heart and Lungs'
Figure 4-2. Diagnosis by Inspecting the Condition of Tongue
Stomach
Triple Burner 7"9am Gall Bladder 9-11pm ! 11pm-1am ripie Bur 9-11pm
Ftericardium , 7-9 pm
Small Intestine 1-3pm
Large Intestine 5-7 am
Spleen Kidney 9-11am 5-7 pm
Stomach
Triple Burner 7"9am Gall Bladder 9-11pm ! 11pm-1am ripie Bur 9-11pm
Ftericardium , 7-9 pm
Heart _
11am-1pm
Small Intestine 1-3pm
Large Intestine 5-7 am
Liver 1-3am
Spleen Kidney 9-11am 5-7 pm
Large Intestine Lung
Large Intestine Lung
Small Intestine
Heart
Figure 4-3. Diagnosis by Inspecting the Black Spot in the Eyes
Small Intestine
Heart
Old Injury
2. The palpation of specific acupuncture points on the front and back of the trunk. For example, if the doctor senses a collapsed feeling, or the point is sore to touch, this indicates the possibility of disease in the organ with which the point is associated.
3. The palpation of pulse: Traditionally, the radial area pulse on the wrist (Figure 4-4) is the principal site for pulse diagnosis. Although the pulse is specially related to the lungs and controlled by the heart, it refers the condition of all organs (Table 4-1). The doctor checks the following: the depth (floating or submerged), the pace (slow or fast), the length (long or short), the strength (weak or strong), and the quality (slippery, rough, wiry, tight, huge, fine, or irregular). Usually it takes several years and hundreds of cases to become expert in the palpation of pulse.
Recently, inspection of skin eruptions on the ears has been used in Chinese diagnosis. A number of sites have been found on the ear (Figure 4-5) which become spontaneously tender or otherwise react to disease or injury somewhere in the body. Stimulation of these ear points in turn exerts certain therapeutic effects on those parts of the body with which they are associated. Moreover, many Western diagnostic methods, such as X-rays, have also been adopted in coordination with Chinese diagnosis.
This section serves only as a brief introduction to Chinese medical diagnosis. Interested readers should refer to books about Chinese medicine for more information.
Table 4-f
Left Hand |
Organs |
Rear |
Kidney Yin |
Middle |
Liver |
Front |
Heart |
Right Hand |
Organs |
Rear |
Kidney Vang |
Middle |
Spleen |
Front |
Lungs |
Figure 4-4. Locations Used for Pulse Palpation
Gall Bladder
Lung Glands
Teeth
2. Pt. Tonsllla
3. Pt. Ganyang
4. Helix
5. Pt. Ganyang
6. Pt. Tonsilla
7. Pt. Tonsilla
8. Pt. Auris Interna
9. Pt. Faciei and Bucca
10. Pt. Tonsilla
11. Pt. Oculus
12. Anesthetic points for tooth extraction
13. Pt. upper and lower Mandible
16. Pt. Vertex
19. Pt. Emphysema
20. Pt. Oculus (Astigmatism)
22. Pt. Hormone
23. Pt. Oculus (Glaucoma)
26. Pt. Testis
27. Pt. Excitation
28. Pt. Nervus
29. Pt. Occiput
30. Pt. Encephalon
31. Pt. Vertigo
32. Pt. Brain Stem
Thyroidea
35. Pt. Clavicula
36. Pt. Endocrine
37. Pt. Hypertension
39. Pt. Glandula Suprarenale «0. Pt. Hunger »2. Pt. Thirsty »3. Pt. Ovarium »<|. Pt. Tragic Apex 43. Pt. Pharyngo Larynx «6. Pt. Cor (Xinzang) 67. Pt. Auris Externa 48. Pt. Sanjiao »9. Pt. Bronchus 50. Pt. Glandula Parotis 31. Pt. Cardla
54. Pt. Ventriculum
55. Pt. Ptosis
56. Pt. Fulcram
57. Pt. Diaphragm
58. Pt. Mid-crus Helicis
59. Pt. 3isong
61. Pt. Uterine Appendages
62. Pt. Lowering Blood Pressure
63. Pt. Duodenum
64. Pt. Intestinum tenue
65. Pt. Appendix Vermiformis
66. Pt. Intestinum Crassum
67. Prostata
68. Pt. Vesica Urinaria
69. Pt. Ureter
71. Pt. Pancreas and Gall Bladder
72. Pt Shoulder
73. Pt. Glandula Mammarla
74. Pt. Art. Humeri 73. Pt. Thorax Externa
76. Pt. Shoulder Ache
77. Pt. Subaxill*
78. Pt. Thorax
79. Pt. Abdomen
80. Pt. Appendix Vermiformis
81. Pt. Lumbago
82. Pt. Appendix Vermiiormis
83. Pt. Cubitus
85. Pt. N. Ischiadicus
86. Abdomen
87. Pt. Lower Abdomen
90. Pt. Cavum Pelvis
91. Pt. Popliteal Fossa
93. Pt. Shenmen
94. Pt. Hepatitus
95. Pt. Guguan
96. Pt. Carpus
97. Pt. Allergy
99. Pt. Di&itas Manus
100. Pt. Appendix Vermiformis
101. Pt. Dlgitum Pedis
102. Pt. Malleolus
103. Pt. Asthma
105. Pt. Uterus
106. Pt. Esophagus
108. Pt. Hemorrhoid
109. Pt. N. Sympathetica
110. Pt. Organa Genitalia Externa
111. Pt. Urethra
113. Pt. Lower Rectum
114. Pt. Nasus Internus
Gall Bladder
Intostine Small Intestine Rectum
Lung Glands
Teeth
Figure 4-5. Acupuncture Points in the Ear
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