I often receive inquisitive queries regarding how I diagnose or determine a course of treatment for a patient within the realm of Traditional Chinese Medicine. I enjoy when people take an assertive approach into understanding their own wellness and what they can do to help speed up the healing process. The best treatment will always be a partnership, where I am doing my part utilizing Acupuncture, along with the patient following nutritional as well as other guidelines that are specific to them. This is where optimal health and wellness can be achieved.
Pulse diagnosis is an important diagnostic tool in Chinese Medicine. It is not merely the rate that is checked, but rather there are many different pulse qualities that can depict the root cause of the illness. If someone was running late to their appointment, or our parking lot was full and they had to circle the block to the building, their pulse may be running rapid for a reason that did not really represent their overall wellness, but just something that happened the few minutes prior.
Tongue diagnosis is an essential and primary diagnostic tool that I rely more heavily on. The tongue is a microcosm of the whole body and can therefore tell me precisely where the disparity lies. It can help guide me with an overall diagnosis, as well as the specific meridian imbalances that are causing the issue. What I love most about tongue diagnosis is how reliable it is.
As an objective diagnostic tool, the tongue is tried and true. I trust it and rely on it in conjunction with what a patient subjectively reports with regards to their symptoms. Combining both the subjective and objective components will lead to the most accurate diagnosis.
A few examples of the Tongue in relation to diagnosis are as follows. A patient had a thin coating on the tongue body everywhere except for both sides of the tongue which were peeled and without any coating. This area depicts the Liver and Gallbladder meridians. If you have heard the “Bubba Meissa” expression of “Calm your liver”, it is true! The liver meridian holds on to the stress and anxiety we feel. It is buddies with the Gallbladder meridian which often displays indecisiveness. In almost every case when I am treating someone who is suffering from stress or anxiety, their tongue is peeled on the sides. It guides me to understand those meridians that are the root cause of the issue and where I need to strengthen to have the patient be more relaxed on a day-to-day basis.
Another example would be when there is a crack running through the center of the tongue. This area corresponds to the Spleen and Stomach meridians, or rather the meridians responsible for proper digestion. Often when I treat individuals with gastrointestinal issues, such as IBS or irritable bowel syndrome, Crohn’s disease, constipation, diarrhea etc, I will see a crack here. Sometimes the crack is deep, wide, and has a yellow coating within the crack itself. This will show a more chronic condition which has caused heat in the digestive tract. I often see this with patients who suffer from Gerd, acid reflux, or bad breath which is coming from the heat and acid rising up from the stomach. In this example we would not only clear the heat from the GI tract, but we would strengthen the meridians responsible for digestion, and redirect the flow of Qi to descend stopping the acid from rising entirely.
Another common area of the tongue is when the front of the tongue is redder in color. This can help diagnose seasonal allergies relating to the Lung meridian. If seen on the actual tip of the tongue, it relates more the Heart meridian and can often depict an issue with the Heart that can be extremely important in balancing and preempting a cardiac episode.
In my initial intake when I first meet with a new patient and review their complete medical history, I always ask do you prefer room temperature or cold water? This is a simple question which can guide me to understand how yin and yang are balanced within the body. Someone who is yin deficient, may be dehydrated. They will often show fine cracks on their tongue as if it is the earth in the dessert. They will have signs of dry skin, they may also have night sweats. A person who has an excess of yang, may have a red ruddy complexion, they may prefer ice cold drinks and always be running hotter than other people in the same room. That person may be quick to have an emotional outburst or a temper tantrum. They may be compared to too much fire, with not enough water to put out the fire. You may see this in their red eyes, or as if they are going to have smoke rising up from their head. In these scenarios, we would either focus on supporting fluids, or squashing the fire to calm the temper for long term amelioration of the symptoms.
A person who dislikes drinking water or any liquid, will usually have dampness in the body. Just like an overly saturated sponge loses the ability to pick up more water until it is rung out, so too our bodies can feel like this. A person who is inflamed will be averse to drinking water. A classic example of this is someone with arthritis who has inflammation in multiple joints in the body. They know they should be drinking more water, but simply don’t want it and cannot bring themselves to drink it. These patients often have difficulty with stiffness in their joints that is worse the first twenty to thirty minutes upon waking. The fluid has settled in their joints overnight, whether it is a knee, or hip etc. It takes a little while for the fluid to disperse. Once they are moving about the stiffness can ease up. In this scenario we would focus on ridding the body of dampness to dispel the inflammation causing the joint pain.
The key is a compilation of all of the diagnostic methods. I utilize the essential subjective account the patient provides with regard to their lifestyle and the symptoms or illnesses plaguing them. In conjunction with the objective signs I can see such as the Pulse, observing the Tongue, or their preference for temperature or water, etc. This will provide a comprehensive picture. Having a clear understanding of what my patient is experiencing, and which meridians are involved in the imbalance at the root cause of the disease, will help me properly diagnose them and lead to faster results. Acupuncture builds on itself, and therefore my patients see the best results after a series of treatments. Correcting the imbalances, putting someone back into homeostasis, may take time but the wellness achieved is lasting and wholesome with no negative side effects. There are few true quick fixes in life. Taking a medication with side effects may initially appear to resolve the issue, but in reality, it is merely a band-aid masking the issue. With Acupuncture and Chinese medicine using proper diagnostic methods, we can get to the root of the issue and make room for true and lasting healing.