Posts Tagged ‘diagnosis’

Diagnosis – Part 2: Listening

Tuesday, March 31st, 2015

Listening 150x150 Diagnosis   Part 2: Listening

In Traditional Oriental Medicine, all of the practitioner’s senses are used during diagnosis in order to help determine patterns of imbalance which may be causing sickness and symptoms in a person’s health.

As previously seen in Part 1, visual diagnosis was the first of four diagnostic examination methods described in the earliest textbooks of acupuncture written 2,000 years ago.

The second method is that of listening diagnosis. Although it is probably the least commonly used of the four main methods, it can still provide valuable information especially in helping to determine a person’s constitution body type.

For example, one aspect of listening diagnosis is observing the predominant characteristics of someone’s normal speaking voice. According to the Five Phase theory of Traditional Oriental Medicine, certain vocal tones or types of speech correspond to particular organ systems:

  • Liver – brusque, commanding
  • Heart – muttering
  • Spleen-Pancreas – variable pitch, sing-song
  • Lung – whiny, entreating
  • Kidney – raspy, groaning

Most people have a mixture of all of these vocal qualities, but usually one or two tend to dominate their normal speech patterns and can provide insight into which organ systems might have a predisposition toward becoming imbalanced.

In addition, the way a person enunciates certain vowel or consonant sounds while speaking can also provide meaningful information about their natural body type.

Although never solely relied upon, listening diagnosis, when combined with the other diagnostic tools of Traditional Oriental Medicine, can be useful for determining patterns of weaknesses and imbalances in a person’s body which can then be strengthened and regulated through acupuncture and other treatment methods to help improve their health.

Diagnosis – Part 1: Looking

Tuesday, June 24th, 2014

Looking 150x150 Diagnosis   Part 1: Looking

Traditional Oriental Medicine is unique in that it is not just disease or sickness which is looked at during diagnosis, but also the underlying imbalances within a person’s body which may have contributed to the symptoms in the first place.

Looking, or visual diagnosis, is the first of four main diagnostic methods described in the earliest textbooks. For example, the Huang Di Nei Jing (The Yellow Emperor’s Classic of Medicine), written over 2,000 years ago, mentions about observing both the patient’s colour as well as their Shin, or spirit.

This first aspect of visual diagnosis, that of looking at the colour of the patient, is a reference to observing various parts of the body but especially the face – in particular the area around the eyes, forehead, nose, and mouth.

According to the Five Phase theory of Traditional Oriental Medicine, certain colours correspond to particular organ systems:

  • Liver – blue/green
  • Heart – red
  • Spleen-Pancreas – yellow
  • Lung – white
  • Kidney – black

A predominance of one or more colours, often subtle to the untrained eye, can frequently be associated with a person’s constitutional tendency toward an imbalance in that corresponding organ or acupuncture meridian system. However, it can also be an indication of a more acute or advanced state of disease, for example in extreme cases the yellowish colour of jaundice or the dark, ashen complexion of a late-stage cancer patient.

In children, these underlying colours of skin tone are often more easily noted than in adults and in fact is one of the main diagnostic methods used in a specialized form of pediatric acupuncture known as Shonishin, especially when treating infants and younger children who might otherwise be unable to communicate their symptoms.

A second aspect of visual diagnosis is that of observing the patient’s Shin (sometimes translated as spirit, heart, or mind). This is most commonly done by paying attention to the person’s eyes and face – a certain amount of vitality, aliveness, sparkle, brightness, and strength of life force can be seen in a healthy person.

As a part of visual diagnosis, making note of the general physique, skeletal structure, muscle tone, and skin luster can also provide important information about a person’s overall vitality and health.

All of these visual observations are used, along with the other diagnostic methods of Traditional Oriental Medicine, to help determine patterns of weaknesses and imbalances in a person’s body.

Treatment, whether it is through acupuncture and moxibustion, shiatsu massage, herbal medicine, or other techniques, is then aimed to strengthen and regulate the various organ systems, to correct underlying imbalances, and to help enhance the body’s own healing abilities.

Smelling Disease

Tuesday, November 26th, 2013

Many of the diagnostic methods used in Traditional Japanese acupuncture are based on the practitioner using their physical sensory organs to detect changes and imbalances in their patients.

For example, diagnosis by smelling body odours is a fundamental technique and was recorded in medical textbooks over 2,000 years ago.

Certain odours were linked to particular organs according to Five Phase theory:

  • Liver – rancid, like raw meat
  • Heart – scorched, like burnt cooking
  • Spleen-Pancreas – fragrant, like sweet incense
  • Lung – fleshy, like fish
  • Kidney – rotten, like fermenting food

Nowadays, even with the widespread use of perfume, deodorant, toothpaste, and other hygiene products which can mask the body’s natural odours, observing scents can still provide useful information for diagnosis and acupuncture treatment.

It is interesting to note then that modern medical science is attempting to also make use of smells in diagnosing disease. For example, there is new research into odour-based early detection of ovarian cancer using high-tech sensors to capture the signature “smells” of certain cancer-related cells taken from blood samples of patients. It is hoped that someday these types of screenings might provide earlier warning and detection than is possible with current conventional testing.

Perhaps on closer examination and study, many of the time-tested concepts of Traditional Oriental Medicine aren’t so strange after all.

Causes of Disease – Part 2: Emotions and the Body

Tuesday, June 4th, 2013

As was previously seen in Part 1, Eastern medicine has long observed that our emotional states can have a significant impact on our health.

However, which comes first? Is it an imbalance in the body that produces negative emotions, or is it the emotions having an effect on the body?

Traditional Oriental Medicine doesn’t draw artificial boundaries between the body, mind, and spirit, but instead sees a close connection between them. Specific emotional states correspond to particular physical organs in the body; an imbalance in one area can affect all other aspects of our health and often cannot be described in a simple cause-and-effect manner.

5PhasesEmotionalStates 257x300 Causes of Disease   Part 2: Emotions and the Body

For example, the Liver system, which in Eastern medicine regulates the blood and energy circulation throughout the body, is linked to anger, frustration, irritability, and other similar feelings.

In certain situations such as the mood swings and irritability often associated with PMS, the physiological changes occurring within the body are disrupting the Liver system and its ability to properly regulate the emotions.

For other situations, emotional stressors appear to be a primary cause or trigger for the physical symptoms as is frequently seen in gastrointestinal disorders including Irritable Bowel Syndrome (IBS) and colitis.

Diagnosis and treatment can vary depending on each individual case. For example, some patients have a more nervous temperament with a tendency towards over-thinking, worry, and anxiety, which according to Eastern medicine often indicates a weakness in the Spleen-Pancreas system that needs to be strengthened and supported.

For other people, stress, frustration, unresolved anger, or other similar emotions are the more dominant ones and can exert a negative influence on the digestive system according to the Restraining Cycle of the Five Phases and so it’s the Liver system that needs to be calmed and more properly regulated.

These types of emotional imbalances are also commonly seen when dealing with children’s health issues with a specialized form of pediatric acupuncture known as Shonishin. For example, there are some cases of infant colic that don’t receive much noticeable improvement with the typical dietary recommendations usually indicated, but the symptoms are resolved when the emotional components are addressed using appropriate treatment.

In yet other complicated cases such as anxiety and depression, Eastern medicine recognizes both a physical and a mental component to the conditions, with imbalances in the body affecting the emotions and the out-of-balance emotions likewise having a direct effect on the body, sometimes leading to a mutually-reinforcing downward spiral.

Because of Traditional Oriental Medicine’s wholistic approach to health, treatment modalities including acupuncture and moxibustion can be an integral part of therapy due to their balancing and regulating influence on the entire person, not just on the physical body.

Causes of Disease – Part 1: Emotions and Environment

Wednesday, August 15th, 2012

“So what caused the health problem?” This is a common question asked by patients in my acupuncture clinic.

For Western minds, we’re used to explaining and understanding things in a direct linear cause-and-effect manner. However, Eastern medicine has observed that natural phenomena in the real world, including our own health, is not always simple or black and white; many factors can contribute and interact with each other to create imbalance and disease pathology in our lives.

Because of this, Traditional Chinese Medicine groups the etiology, or causes of disease, into several main categories.

1) Internal causes – Eastern medicine recognizes that emotions, especially when they are prolonged, have a significant impact on our health, with each emotional state corresponding to a particular internal organ:

  • anger
  • excessive joy
  • pensiveness
  • grief
  • sorrow
  • fear
  • fright

It is interesting to note that even Western medicine is discovering and acknowledging the role of emotions on our health through certain modern fields of medical research such as psychoneuroimmunology.

2) External causes – Traditional Chinese Medicine also recognizes that our environment, including changes in temperature, air pressure, and humidity (classically described as Wind, Cold, Heat, Dampness, and Dryness), can have an impact on our health.

For example, many people who live here in the cold and damp temperate rain forest climate of Vancouver, British Columbia, Canada notice that their rheumatic joint pain improves when they travel down south to a warm and dry climate and returns when they come back home. For others, a fluctuation of symptoms that they experience may also be related to certain times of the year or changes in the seasons.

3) Other causes – the third and final category is wide ranging and includes many other factors such as:

  • diet
  • overwork
  • fatigue
  • trauma
  • pathogen infections

All of these causes can create specific patterns of signs and symptoms in a person’s health. By recognizing and addressing the causes and patterns of imbalance, the healing ability of the body can be nurtured to help regain a healthier state of balance.

Five Phases of Transformation – Part 3: Feedback Inhibition

Thursday, May 10th, 2012

As mentioned in previous articles, one of the most important theories in Traditional Japanese acupuncture and shiatsu massage is that of the “Five Phases of Transformation”. Part 1 described how these five phases known as Wood, Fire, Earth, Metal, and Water are used to categorize a wide variety of natural phenomena. Part 2 explained the Generating Cycle, the first of several relationships which describe how the various phases inter-relate to each other in Nature.

The second of these inter-relationships is called the Restraining Cycle (sometimes also referred to as the Control Cycle). In a healthy system, the Restraining Cycle helps to maintain order and balance

5PhasesRestrainingCycle 257x300 Five Phases of Transformation   Part 3: Feedback Inhibition

By observing Nature

  • Wood restrains Earth by providing a healthy covering of plant life to prevent soil erosion
  • Earth restrains Water by forming embankments to keep the rivers and irrigation ditches from overflowing and flooding
  • Water restrains Fire by preventing overheating
  • Fire restrains Metal by purifying and refining during metalworking
  • Metal restrains Wood by using farming implements and other tools to keep overgrowth in proper check, and the entire cycle repeats

However, when one phase begins to dominate, the system can become unhealthy and out of balance and the Restraining Cycle gives way to Destruction

  • Wood destroys Earth by degrading the soil with over-intensive farming and not letting the land properly fallow with rotating crops
  • Earth destroys Water by blocking and damming up the waterways
  • Water destroys Fire by completely extinguishing the flames
  • Fire destroys Metal by over-tempering during metalworking
  • Metal destroys Wood by using farming implements and other tools to clearcut the forests and overwork the farmland, and the entire cycle repeats

The inter-relationships in Nature that are metaphorically described by the Restraining Cycle have clinical value when applied to the human body, much like the similar Western scientific idea of a feedback inhibition loop, often referred to as homeostasis in biological terminology.

An example of this would be seen when dealing with digestive health conditions such as Irritable Bowel Syndrome (IBS). According to Traditional Chinese Medicine, various stressors, including unresolved anger and other emotional issues, can cause the Liver system to become overactive and domineering. This then has an unbalancing and destructive effect on the digestive system (known as the Spleen-Pancreas system in TCM), explained by the Restraining Cycle as Wood overacting on Earth.

In this case, treatment would be focused on regulating and calming down the Liver system to reduce its negative controlling effect on the Spleen-Pancreas system, and the digestion is then better able to strengthen and recover.

The 24 Hour Clock

Monday, March 12th, 2012

Love it or hate it, Daylight Savings Time (DST) is here upon us. However, as critics point out, there seems to be some evidence that this sudden change in time can create various health problems associated with a disruption and stress to our natural circadian rhythm, including fatigue, sleeping difficulties, mood changes, and even an increase in traffic accidents.

Long before the western scientific discovery of circadian rhythm, did you know that Traditional Chinese Medicine also described a 24-hour cycle in the human body?

The following table lists the windows of time in which the various organs and their corresponding meridian pathways are the most active according to time acupuncture theory:

  • 3 am – 5 am Lung
  • 5 am – 7 am Large Intestine
  • 7 am – 9 am Stomach
  • 9 am – 11 am Spleen-Pancreas
  • 11 am – 1 pm Heart
  • 1 pm – 3 pm Small Intestine
  • 3 pm – 5 pm Bladder
  • 5 pm – 7 pm Kidney
  • 7 pm – 9 pm Pericardium
  • 9 pm – 11 pm Triple Burner
  • 11 pm – 1 am Gallbladder
  • 1 am – 3 am Liver

This information can be clinically valuable. For example, if someone is suffering from insomnia and tends to wake up at 3am every morning, often acupuncture points related to the Lung and Liver meridians can be useful for treatment.

For others, sometimes they experience an aggravation of symptoms at a specific time of day, such as always getting a headache late in the afternoon. Again, acupuncture points on the corresponding meridian pathways associated with that particular time of day can be used during acupuncture treatment to help the body regain balance and experience an improvement in symptoms.

Western medicine is becoming more aware of the influence that time of day has on various biological processes, something that Traditional Chinese Medicine has recognized for thousands of years.

Five Phases of Transformation – Part 2: Positive Feedback

Tuesday, November 15th, 2011

One of the most important theories in Traditional Japanese acupuncture and shiatsu is that of the “Five Phases of Transformation”, sometimes also referred to as the Five Elements. As described in Part 1, these five phases are known as Wood, Fire, Earth, Metal, and Water and are used to categorize a wide range of dynamic processes of transformation and change within Nature.

Besides being used to classify and categorize various natural phenomena, Five Phase theory also makes use of several relationships which describe how these phases influence and interact with one another.

The first of these relationships is called the Generating Cycle (sometimes also referred to as the Creation Cycle)

5PhasesGeneratingCycle 257x300 Five Phases of Transformation   Part 2: Positive Feedback

By observing Nature

  • Wood generates Fire by providing the fuel to be burned
  • Fire generates Earth by producing wood ash which then enriches the soil
  • Earth generates Metal by supplying the raw ore to be further refined
  • Metal generates Water by attracting surface condensation of moisture
  • Water generates Wood by nourishing the tree roots, and the entire cycle repeats

Although intended to be taken more symbolic than literal, the inter-relationships in Nature that are described by the Generating Cycle have much clinical value when applied to the human body.

For example, when dealing with health conditions such as asthma, allergies, or sinus problems, Traditional Chinese Medicine often focuses on the Lung system. However, treatment may also include working on the digestive system (known as the Spleen-Pancreas system in TCM), particularly in cases involving a buildup of mucous and phlegm, which is regarded as a byproduct of weak digestion.

This clinically useful approach can be explained by the Generating Cycle. Strengthening the Spleen-Pancreas to have a beneficial effect on the Lungs is applying the principle of Earth generating Metal.

The concept of the Generating Cycle is not unique to Eastern science; in Western science, this idea can be thought of as a positive-feedback loop. A common example of this would be the high-pitched squeal of feedback from a PA system where a microphone picks up sound from a speaker, amplifies it back into the sound system, out through the speaker again, and back into the microphone in a continuously repeating cycle.

In Western medicine, the positive-feedback loop is responsible for many biological processes. However, these types of systems tend to become unstable and escalate out of control without a feedback inhibition mechanism; in Five Phase theory this is called the Restraining Cycle and will be discussed in Part 3.

Five Phases of Transformation – Part 1: Interacting with Nature

Sunday, June 19th, 2011

All the principles of heaven and earth are living inside you. Life itself is the truth, and this will never change. Everything in heaven and earth breathes. Breath is the thread that ties creation together.“

Ueshiba Morihei – The Art of Peace

One of the unique aspects of Traditional Oriental Medicine is the concept that human beings are a microcosm of the universe. By careful observation of the relationships and interactions occurring in Nature, this knowledge can then be applied to the human body for the diagnosis, treatment, and prevention of health problems.

Based on this Eastern approach of observing natural phenomena, one of the most important theories in Traditional Japanese acupuncture and shiatsu is that of the “Five Phases of Transformation”, sometimes also referred to as the Five Elements.

Like the theory of Yin – Yang, or polar opposites, Five Phase theory was originally taken from ancient Chinese science and philosophy and was important in everyday life, from farming and agriculture to military strategy and the martial arts.

Five Phase theory demonstrates dynamic processes of transformation and change within Nature, with these phases being traditionally classified as Wood, Fire, Earth, Metal, and Water.

For example, the Wood phase relates to centrifugal movement, similar to the sprouting new growth of plant life in the springtime. In addition, during this time of year the wind comes from the eastern part of China and the green and unripe fruits growing in the region have a sour taste. In Eastern medicine, the Liver corresponds to the Wood phase because of its quality of helping the blood circulation spread outwards throughout the body, especially that of supplying nourishment to the tendons and ligaments which control the movements of the muscles. Finally, a severe windstorm can cause massive destruction, similar to how the Liver’s associated emotion of anger and rage can easily become unrestrained.

Fire, with its image of flickering flames, is associated with the southern part of China and its hot tropical summer climate. In addition, extreme heat burns and scorches food, producing bitter flavours. The Heart corresponds to the Fire phase, as it regulates the circulation throughout the blood vessels and its associated emotion is mania and overexcitement, resembling a fire burning out of control.

The Earth phase has a stable quality to it and describes the central agricultural regions of China with their damp paddy fields, filled with rich and nourishing yellow mud, being harvested in the late summertime. In Traditional Chinese Medicine, the digestive system of the Spleen-Pancreas is a central foundation to good health, and the sweet flavour of rice and other whole grains are nourishing for the muscles. A healthy and stable Earth phase results in someone who is “grounded” whereas an imbalance produces worry and overthinking.

Metal ore is found in the arid desert mountains of western China, with the autumn season being especially dry in the region. The Lungs are associated with this phase, the actions of inhalation and exhalation resembling that of bellows used in forging and metalwork. The skin is regarded as being a “third lung” supporting the respiratory system and the corresponding emotion is that of sadness and grief.

Water, the fifth and final phase, has the characteristics of dissolving and sinking and is associated with the cold, dark, ocean waters to the north, especially in the wintertime. In the body, the Water phase is regulated and kept in balance by the Kidneys, and the mineral-rich salty flavour of seaweed helps to nourish and strengthen the bones.

Phase Wood Fire Earth Metal Water
Season Spring Summer Late summer Autumn Winter
Direction East South Centre West North
Climate Wind Heat Dampness Dryness Cold
Colour Green Red Yellow White Black
Flavour Sour Bitter Sweet Pungent Salty
Organ Liver Heart Spleen-Pancreas Lung Kidney
Body tissue Tendons/ligaments Blood vessels Muscles Skin Bones
Emotion Anger Joy Worry Grief Fear

The above table summarizes some of the qualities associated with the Five Phases and demonstrates how a wide range of natural phenomena can be categorized.

However, the true value and purpose of the Five Phase theory is in observing how these systems influence and interact with each other throughout all of Nature. In turn, this knowledge can then be applied to the human body and is discussed in more detail in Part 2.

Losing Touch

Monday, January 24th, 2011

With an ever increasing reliance on diagnostic technology for medical imaging and testing, some Western medical doctors are realizing that an important part of their medicine is missing: human touch.

Fortunately, these practitioners are promoting a return to a more hands on approach for diagnosis and treatment, skills that have long been valued in the Eastern systems of healthcare.

Palpation, or examining by touch, is still 1 of the 4 main methods of diagnosis used in Traditional Japanese acupuncture (particularly the styles collectively known as Keiraku Chiryo, or Meridian Therapy).

As part of palpation diagnosis, areas of the body, especially the abdomen, back, and extremities, are examined during acupuncture and shiatsu treatment for various changes including:

  • tenderness and pain
  • tension and areas of hardness
  • slackness and areas of weakness
  • temperature differences
  • skin moisture or dryness
  • other palpatory findings

These changes often correspond to specific acupuncture points or meridian pathways, and provide guidance to the acupuncturist during treatments.

It is interesting to note that even for health conditions that are primarily emotional, such as anxiety or depression, the body will still manifest specific patterns that can be physically observed through the sense of touch.

As our society becomes more and more technologically based, Traditional Oriental Medicine wisely reminds us of the importance and value of human touch in our lives.

Yin Yang – Part 3: Constant change

Tuesday, November 23rd, 2010

The theory of Yin – Yang is the most important concept in Traditional Oriental Medicine, as all of its more complex medical knowledge derives from this basic foundation.

In Part 1, it was seen how all natural phenomena can be classified into opposite pairs of Yin & Yang, and Part 2 described how these opposite pairs can influence each other in sickness or health.

Another aspect of Yin – Yang is that of constant change – nothing in nature is truly static and unchanging but instead is always in a state of transformation from one extreme towards the other. When these changes occur within set boundaries, it produces stability and order rather than instability and chaos.

YinYangChange Yin Yang   Part 3: Constant change

A common example of this would be the regulation of your body temperature. Although it normally appears to be stable, the temperature is in fact constantly increasing and decreasing within a small range, similar to how a thermostat controls a heater.

In Western medicine, this concept is known as homeostasis and is responsible for keeping all of your body’s systems in healthy balance between extremes, ranging from the oxygen – carbon dioxide levels of the respiratory system to the acid – base pH of the blood.

(more…)

Yin Yang – Part 2: The see-saw effect

Wednesday, September 23rd, 2009

In a previous article, we looked at the concept of Yin and Yang, and how Traditional Oriental Medicine classifies things in opposite pairings (as in the example of pain, is it at a fixed location or does it move around, does it improve with rest or with movement, is it better with heat or cold, etc.)

To add further to this concept is what can be described as the “see-saw” effect – when one side of something increases, the opposite side tends to decrease in the opposite direction.

In Eastern science, this was most clearly seen observing things in nature such as the sun and moon – as the sun came up in the morning, the moon lowered below the horizon, and mid-day was the brightest when the sun reached the highest point in the sky. The exact opposite then happened as the sun disappeared below the horizon and the moon came up and reached its peak at night.

Although it appears to be a simple concept, it has extremely important clinical value in acupuncture. One common example of this is in the treatment of migraine headaches. The acupuncture pathway usually corresponding to the headaches is called the Gallbladder meridian – this pathway starts at the eyes, travels through the temple area and the sides of the head, down the neck and the tops of the shoulders, and then down the body and legs, ending at the feet. In Traditional Oriental Medicine, it views migraine headaches as usually being caused by stagnant and congested circulation along this Gallbladder pathway. (more…)

Yin Yang – Part 1: It’s all about balance

Monday, May 18th, 2009

You’ve probably seen it before, and may have even wondered what it meant – the Yin Yang symbol, that strange looking circle with a couple of dots and squiggly lines:

YinYang 150x150 Yin Yang   Part 1: Its all about balance
Yin Yang Symbol

Yin – Yang is actually a concept that comes from ancient Chinese science and philosophy and was an important part of their approach to viewing nature. Originally meaning “the shady side of the mountain” and “the sunny side of the mountain”, Yin and Yang came to symbolize opposing forces of Nature, such as:

  • Moon & Sun
  • Winter & Summer
  • Darkness & Light
  • Water & Fire

(It is interesting to note that much of Western science is also based on this concept, such as positive & negative terminals for electricity, north & south poles for magnetism, acids & bases for chemistry, etc.)

This Eastern way of categorizing everything in Nature as Yin and Yang was later introduced into their system of medicine, and is one of the main ways that both sickness and health is analyzed. (more…)