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Diagnostics

Following a macro philosophy of disease, traditional Chinese diagnostics are based on overall observation of human symptoms rather than “micro” level laboratory tests. There are four types of TCM diagnostic methods: observe (望 wàng), hear and smell (闻/聞 wén), ask about background (问/問 wèn) and touching (切 qiè). The pulse-reading component of the touching examination is so important that Chinese patients may refer to going to the doctor as “Going to have my pulse felt.
Traditional Chinese medicine is considered to require considerable diagnostic skill. A training period of years or decades is said to be necessary for TCM practitioners to understand the full complexity of symptoms and dynamic balances. According to one Chinese saying, A good (TCM) doctor is also qualified to be a good prime minister in a country. Modern practitioners in China often use a traditional system in combination with Western methods.
Techniques
- Palpation of the patient’s radial artery pulse (pulse diagnosis) in six positions
- Observations of patient’s tongue, voice, hair, face, posture, gait, eyes, ears, vein on index finger of small children
- Palpation of the patient’s body (especially the abdomen, chest, back, and lumbar areas) for tenderness or comparison of relative warmth or coolness of different parts of the body
- Observation of the patient’s various odors
- Asking the patient about the effects of their problem.
- Anything else that can be observed without instruments and without harming the patient
- Asking detailed questions about their family, living environment, personal habits, food diet, emotions, menstrual cycle for women, child bearing history, sleep, exercise, and anything that may give insight into the balance or imbalance of an individual.
Methods of treatment
The following methods are considered to be part of Chinese medicine:
- Acupuncture(针 灸/針灸) (from the Latin word acus, “needle”, and pungere, meaning “prick”) is a technique in which the practitioner inserts fine needles into specific points on the patient’s body. Usually about a dozen acupoints are needled in one session, although the number of needles used may range anywhere from just one or two to 20 or more. The intended effect is to increase circulation and balance energy (Qi) within the body.
- Auriculotherapy (耳灼疗法/耳燭療法), which comes under the heading of Acupuncture and Moxibustion.
- Chinese food therapy (食疗/食療): Dietary recommendations are usually made according to the patient’s individual condition in relation to TCM theory. The “five flavors” (an important aspect of Chinese herbalism as well) indicate what function various types of food play in the body. A balanced diet, which leads to health, is when the five functional flavors are in balance. When one is diseased (and therefore unbalanced), certain foods and herbs are prescribed to restore balance to the body.
- Chinese herbal medicine (中草药/中药/中藥): In China, herbal medicine is considered as the primary therapeutic modality of internal medicine. Of the approximately 500 Chinese herbs that are in use today, 250 or so are very commonly used.Rather than being prescribed individually, single herbs are combined into formulas that are designed to adapt to the specific needs of individual patients. A herbal formula can contain anywhere from 3 to 25 herbs. As with diet therapy, each herb has one or more of the five flavors/functions and one of five “temperatures” (”Qi”) (hot, warm, neutral, cool, cold). After the herbalist determines the energetic temperature and functional state of the patient’s body, he or she prescribes a mixture of herbs tailored to balance disharmony.
- Cupping (拔罐): A type of Chinese massage, cupping consists of placing several glass “cups” (open spheres) on the body. A match is lit and placed inside the cup and then removed before placing the cup against the skin. As the air in the cup is heated, it expands, and after placing in the skin, cools down, creating a lower pressure inside the cup that allows the cup to stick to the skin via suction. When combined with massage oil, the cups can be slid around the back, offering what some practitioners think of as a reverse-pressure massage.
- Die-da or Tieh Ta (跌打) is usually practiced by martial artists who know aspects of Chinese medicine that apply to the treatment of trauma and injuries such as bone fractures, sprains, and bruises. Some of these specialists may also use or recommend other disciplines of Chinese medical therapies (or Western medicine in modern times) if serious injury is involved. Such practice of bone-setting (整骨) is not common in the West.
- Gua Sha (刮痧)
- Moxibustion: “Moxa,” often used in conjunction with acupuncture, consists in burning of dried Chinese mugwort (Artemisia vulgaris) on acupoints. “Direct Moxa” involves the pinching of clumps of the herb into cones that are placed on acupoints and lit until warm. Typically the burning cone is removed before burning the skin and is thought, after repeated use, to warm the body and increase circulation. Moxa can also be rolled into a cigar-shaped tube, lit, and held over an acupuncture point, or rolled into a ball and stuck onto the back end of an inserted needle for warming effect.
- Physical Qigong exercises such as Tai chi chuan (Taijiquan 太极拳/太極拳), Standing Meditation (站樁功), Yoga, Brocade BaDuanJin exercises (八段锦/八段錦) and other Chinese martial arts.
- Qigong (气功/氣功) and related breathing and meditation exercise.
- Tui na (推拿) massage: a form of massage akin to acupressure (from which shiatsu evolved). Oriental massage is typically administered with the patient fully clothed, without the application of grease or oils. Choreography often involves thumb presses, rubbing, percussion, and stretches.
- Some TCM doctors may also utilize esoteric methods that incorporate or reflect personal beliefs or specializations such as Fengshui (风水/風水) or Bazi (八字).
