When the Chinese herbalist is confronted with a new patient, he asks himself one question — “What is the cause?” In traditional Chinese medicine, there are considered to be five organ systems. The herbalist tries to deduce which organ system (or systems) is causing the illness, and what is causing the organ(s) to become imbalanced?
The basis of diagnosis is that from the outside, we can learn about the inside. Consequently, the herbalist follows four principles in patient diagnosis: Looking, Listening, Asking and Feeling (pulse taking).
Looking at the patient involves noticing every outward detail possible. From the time the patient walks in the office, his/her posture, mannerisms, movements, and dispositions are noted. The severity of the problem(s) can be seen from the patient’s complexion: the skin reveals the functioning of the organ systems. For example, if the patient shows redness on the sides of the nose, we know that the lungs are having problems. The degree of redness in comparison to the rest of the face reveals the severity.
In Chinese medicine, the eyes are associated with the liver; they show a patient’s emotions. The look of the eyes can reveal a lot about the whole system as well. The type of sparkle or fire in the eyes, as well as the shape, color, and texture of the skin around the eyes reveals aspects of the inner condition.
The patient’s lips and mouth inform as well. This is especially true in reference to the stomach, since the lips and mouth correspond according to Chinese principles. For example, when the stomach is having digestive problems, it reveals itself by the lower lip becoming swollen upon the sides underneath. The appearance of the swollen under-lip can tell us something about the severity and length of the stomach problem.
The tongue is an extremely important diagnostic tool in Chinese medicine. The line down the middle of the tongue reveals how long a patient has had an illness; the deeper the center crack, the longer the patient has had the illness. The herbalist will note that it is common for Americans to have a tongue that appears a bit sandy and coated. This is from a diet of excessively rich foods and overeating in general. A healthy condition shows itself in a pink, even-colored smooth tongue. In Chinese medical diagnosis, there are 36 categories in which the appearance of the tongue can be placed.
For children under five years of age, the veins of the hands are used as the diagnostic indicator of the body’s condition. By looking at the length and color of the veins, especially of the index finger, a lot can be learned of a child’s condition. After this age, the body develops to the point where the veins can no longer be seen adequately.
Listening to the patient is the second diagnostic principle. A patient’s expression and attitude can reveal a great deal. The tone of one’s voice, the emotional state, and the attitudes one brings forth are as much tied to the functioning of the system as are the body’s physical attributes. Emotions can give the herbalist an indication of severity, length, and areas of casualty.
To ask questions is the third principle the herbalist uses for diagnosis. The herbalist not only asks questions concerning the symptoms a patient is experiencing, but of the functioning of the body’s systems as well.
Hence, questions may be directed at the patient’s digestive condition; “How are your bowels moving?”, “Any gas?”, “Bloated stomach?”, “Any burping?”. Questions directed towards the body’s balance are also asked. For example, the herbalist may ask if the patient is typically hot or cold. He may ask if the patient is worried, under stress, is tired easily, has a low energy level, and so forth.
A few general questions are asked and considered. A patient’s age, weight, and occupation are generally asked, for these could have some bearing on diagnosis and treatment. Previous treatments and medications, perhaps given by other physicians, must be considered and dealt with. Usually a patient is asked to stop taking other medications while he/she is on herbal treatment. This is because other medical treatment could alter or stop the effectiveness of the herbs.
Feeling (Pulse Diagnosis)
The patient’s pulse is needed for a proper diagnosis. The herbalist checks for the strength of the pulse, how fast it beats, and the type of pauses (jumps or skips) between beats.
When all the diagnostic principles have been examined and considered, similar case studies from the past can be used for comparison. The herbalist then adds up all the variables and possible causes, and produces recommendations for the patient including herbal recipes and lifestyle changes.