Diagnosis in Chinese Medicine

Diagnostic work in Chinese medicine does not rely on the use of any instruments. It relies on experience and theories, primarily based upon the observation and examination of the human body. Thus, the accuracy of a physician's diagnostic work can only be determined by the value of his or her experience and the validity of his or her theories.

It is important that the physician and considers all of the details of a patient's condition. The procedures that are most useful in conducting a diagnosis are looking, listening, asking and feeling. These are processes that involve uniform observation and examination with the physician observing the patient's behavior, and then feeling parts of the body and the pulse. By looking, listening, and asking one can get an idea of an illness as one does when using the stethoscope. Feeling the pulse the pulse and the abdomen is like an x-ray, determining the location of an illness and its seriousness.

Looking entails close observation of a patient's mannerisms, their eyes, the color of their face and their tongue. Behavior and mannerism often display the state of their internal organs, as does the condition of their eyes. The color of their face reveals the state of blood circulation. The body and coating of the tongue are crucial elements in diagnosis indicating problems with internal organs, blood circulation, and the digestive tract.

A patient's voice, its deepness or shallowness, and the smell of the breath also can tell about a patient's condition. Equally important is the history of the patient's illness, including the emotional and physical reactions.

There are 24 kinds of pulses, based on the heart rate, that tell about different kinds of illnesses. The pulses are situated in three locations at both wrists. For example, the six pulse positions on the two forearms are related to different parts of the internal organs.

The most important thing in feeling the pulses lies in the judgment of the pulses since these vary from individual to individual, with different physiques and physical states. Further, the pulses cannot be judged individually according to their positions, but all of them must be considered together and judged as a whole.

A physicians fingers are trained to possess great sensitivity because the differences between two pulses can be extremely slight. The fingers also must be in the right places, with each finger distinguishing pulses in five different directions.

There are four fundamental kinds of pulses. The floating pulse is like a log floating on water and can be felt with a slight touch and reflects a superficial illness. The deep pulse can only be felt with a firm touch and are indicative of illnesses in the internal organs. For each age group there is a normal pulse rate. Four counts lower than the normal rate is considered a slow pulse that indicates problems with circulation, usually coldness in the body due to malfunctioning of internal organs. A rapid pulse means a rapidity in the blood circulation due possibility to an increase in body temperature, tension, or inflammation of the internal organs.

Diagnosis in Chinese Medicine is a subtle activity, requiring that the doctor keep a clear head so as to be able to receive deeper impressions in their mind.

Based on Chinese Medicine by Dr. John H.F. Shen

Two Anecdotes from Dr. Shen