TCM Diagnostic Methods


Traditional Chinese Medicine (TCM) has been a study of the human condition and its interaction with the environment for many centuries. The diagnostics methods used are based on a sophisticated study of the theories, methods and techniques of diagnosis. Its foundation is a rich and substantial collection of records gained from centuries of experience. A western doctor examination may take 15 minutes. A TCM doctor determines a patient’s health by observing and analyzing specialized information using TCM diagnostic methods including family history, your environment, and mental or emotional state. These methods are comprised of the theories, methods and diagnosis techniques passed down for generations and are re-examined constantly. Some techniques are unique to TCM while others are similar to those used in Western medicine.

Over the centuries, TCM physician’s careful study of the human body determined that if pathological changes occur in the organs or any part of the body, a tender point would appear in the corresponding acupuncture pressure point. If this tender point can be determined by pressing, it can be inferred which internal organ or part of the body has also undergone pathological changes. The Yin/Yang theory tells us that the internal is related with the external, and the exterior with the interior. TCM physicians see this as "determining the internal disturbance by observing external signs.” "Pathological changes inside the human body are reflected externally as abnormalities of the complexion, spirit, appearance of the tongue, and pulse.

Diagnostic First Step

First, a TCM doctor sees the human body as an organic whole then diagnoses an illness or imbalance.

  1. The focus is always on the interrelation and interaction between local pathological changes and maladjustments of the body. External diseases may penetrate the interior or diseases of the organs may have external manifestations. Local pathological changes affecting the whole body are likely to be reflected in another part.
  2. The doctor may observe the patient in his or her surroundings. When changes occur in the weather or environment, and the human body fails to adapt to these changes, pathological changes are likely to occur.

Let’s look at the two most common approaches.

  • Modern Western (Osteopaths) doctors identify a disease based on the signs, symptoms, and clinical evaluation of a patient. (There are naturalist Western doctors who do take the TCM holistic approach).
  • The TCM physician identifies a syndrome, which is usually a complex pattern of indicators and symptoms that manifest at a given stage of the disease. Usually a TCM practitioner will diagnose both a disease and the syndrome. Syndrome identification is the premise and foundation of TCM treatment.
  • The name of a disease suggests its entire course of pathological changes.
  • The name of a syndrome reflects the pathology of a disease at a certain stage.

A well-trained TCM physician may use both their understanding of the course of a particular disease, followed by the differentiation and diagnosis of syndromes, when prescribing treatment.

A TCM doctor chooses a diagnosis relying heavily on his sensory perceptions. 

Diagnostic Second Step

The next step is to carefully gather clinical information and analyze and interpret this data to determine a treatment plan. He may or may not resort to any apparatus. Most TCM doctors can diagnose internal pathological (disease) changes through observation and analysis of external signs.

Most Holistic doctors, either Eastern or Western, believe the human body is an organic whole, and all parts are connected with each other through channels and collaterals. These collaterals otherwise known as meridians are discussed on this website). The internal has a symbiotic relationship with the external, and the exterior with the interior (Yin/Yang principal). Pathological changes inside the human body are shown externally as abnormalities of the complexion, emotions, appearance of the tongue, or pulse irregularities.

There are four examination methods:

  1. Questioning both about the symptoms and history taking
  2. Physical inspection and appearance
  3. Auscultation or listening (wheezing, coughing, etc.)
  4. Olfaction (smelling), and palpation (using the hands on the patient).

These four methods have their unique clinical uses. All are usually employed and cannot be replaced by one another. In some cases, a particular symptom may appear to indicate a symptom of a disease but is a false/negative, which emphasizes the importance of combining all the diagnostic methods. 
 

The doctor cannot determine the cause and origin of the problem from which his patient suffers without a thorough examination.

In many cases the causes of the symptoms are often found to be from exogenous evils that invade the body and disrupt its internal balance leading to illness. The external symptoms you experience can often indicate a problem with the internal organs, yin yang balance or Qi (vital energy) flow. Or, an illness can also start on the inside of the body and show symptoms on the outside. A well-trained TCM practitioner can determine the source of the problem and choose a healing course of action using thee right combination of high quality herbs.