Chinese Medicine Net

Diagnosis is Essential to Good Medicine

Doctors cannot treat without a diagnosis.  Diagnosis means, literally, “complete knowledge.”  The TCM practitioner will conduct a thorough interview, history, and physical exam in order to get this complete knowledge of their patient.  They will ask you questions about everything from your bowel movements and menstruation to your typical emotional states.  They will be paying attention to your skin color, listening to the tone of your voice, noting your choice of words and rate of speech, and watching how much or how little you move, among other things.  All of these data are used to narrow down the diagnosis to a pattern or combination of patterns.

Diagnostic patterns are like constellations – signs and symptoms are the stars.

A Down to Earth Example

Let’s imagine someone who is a bit overweight, somewhat slow and sing-songy in their speech, tends to worry a lot (perhaps is even obsessive), loves to eat sweets, gets tired after eating, and is easily overwhelmed. With this little information, a TCM practitioner is well on their way to a diagnosis. This person would be called an ‘Earth’ type in TCM 5 element theory. They tend to have problems with the Spleen System which is responsible for digestion and academic thought, among other things. This is not nearly as specific as a TCM diagnosis must become before treatment begins, but it gives you an idea.

Once a diagnosis is made that includes an understanding of the underlying causes, it is possible to think about treatment.  Before we can discuss this, we need to define a couple more terms.  In TCM, the symptom about which a patient complains (e.g. headache) is considered the branch, while the root of the condition is explained by the diagnosis.  The difference between TCM and biomedicine in treatment is that TCM can almost always treat the branch AND the root.  Biomedicine often must resort solely to branch (palliative or symptomatic) treatment, leaving the root problem to resolve on its own or linger indefinitely.  Some conditions that are treated in this superficial way by biomedicine, but can often be effectively resolved at a deep level by TCM are asthma, rheumatoid arthritis, attention deficit/hyperactivity disorder, depression, and anxiety.

Herbal Formulas

One treatment method is the use of herb formulas.  These formulas contain from 2-15 herbs in very specific proportions and are based on centuries of clinical success.  Once the TCM practitioner makes a pattern diagnosis, they can choose one or several classical herbal formulas that address the problem. 

Because the pattern diagnosis and the herbal formulas are so specific, they rarely produce side-effects.

The Power of Personalization

Then, they can personalize the formula even further for that patient.  Because the pattern diagnosis and the herbal formulas are so specific, they rarely produce side-effects.  The presence of an uncomfortable effect of the herbal formula can be used by the practitioner to make their diagnosis even more accurate, and treatment more effective.  From this perspective, pharmaceutical-prescribing MD’s seem like novice herbalists, and the rampant side-effects experienced by patients become unacceptable.  Some forward-thinking MD’s (like Jay Goldstein) today are combining pharmaceuticals into ‘cocktails’ not unlike traditional chinese herbal formulas.  TCM herbalists today are continuing a 5000 year tradition by prescribing effective, personalized herbal medicines.