* This page is presented for informational purposes only. In all cases of serious illness it is recommended that a qualified practitioner be consulted.

Diagnosis is of crucial importance in any medical or healing system that works on the body. Metaphysical healing systems tend to pay far less attention to the body assuming that removing emotional and mental causes will automatically remove the physical symptom. While this is a legitimate approach, in the meantime, the body still needs to be looked after. The following is a brief overview of the diagnostic approach of Traditional Chinese Medicine.

The point of diagnosing is to design a treatment. An improper diagnosis will lead to an improper treatment and as often as not a worsening of the conditions.

Even though the approach of TCM seems fairly straightforward, the fact is that most often one encounters numerous and often contradictory symptoms in the same patient.

There is a lot more to diagnosing then, than simple observation of symptoms. One must take account of the relative strengths of symptoms, whether they are getting stronger or weaker in relation to other symptoms, the relative strength of the patient, and other such intangibles. Intuition is as important a diagnostic tool as knowledge and experience.

 

The most common method of diagnosis in Traditional Chinese Medicine is the so-called 8 Principals. Diagnosing a disharmony consists of asking whether the condition is Internal or External, Hot or Cold, a Deficiency or an Excess, whether it has a Yin character or a Yang character.

Causes of Disease According to Traditional Chinese Medicine.

There are many factors that can cause disease. In Chinese medicine in fact illness is characterized as a 'syndrome.' That is a collection of symptoms that together make up a pattern of disharmony in the body. Nor are these symptoms restricted to the body. Along with physical symptoms, emotional and even mental states are considered in the diagnosing of a syndrome.

Causes of disease generally speaking fall into a number of general categories.

There are;
a) 6 Exogenous Factors,
b) 7 Endogenous (emotional) factors,
c) conditions arising from improper diet,
d) too much activity (hyperactivity),
e) too little activity stagnation,
f) traumatic injury,
g) insect, animal or reptile bite.

Within each category there are a number of differentiating categories to look at. For example the 6 Exogenous factors are;

1.Wind,

2. Cold,

3. Heat,

4. Fire,

5. Dampness,

6. Dryness.

These will quickly be recognized as conditions that exist in nature. Under ordinary circumstances these are not pathological to the human body, but become so when conditions are extreme, sudden or the body's resistance is low.

Exogenous factors are seen as those that enter the body from the exterior and are closely related to seasonal changes.

For example what we call Colds and Flu, seen most often in the fall when seasons are changing, are characterized in TCM as invasions of Wind, invasions of Wind/Cold, or invasions of Wind/Heat, depending on the severity of symptoms and depth of penetration into the body.

Heat and Fire Syndromes are seen most often in the summer. Dampness syndromes are seen most often in later summer. Dryness is seen most often in Autumn. Cold Syndromes are seen most often in the Winter.

Ambient pain in the muscles and joints called by various names in Western medicine is characterized in Chinese Medicine as 'Bi Syndrome' caused by invasion of Wind/Cold/Dampness.

 

There are several different kinds of 'Bi Syndrome.'

Ancient physicians, of course had little notion of invading microscopic organisms like bacteria or viruses and while treatment options do include 'expulsion of pathogenic factors' it is not enough to simply expel the particular factor. Proper treatment most often includes tonifying specific organs or the body as a whole both to help with expelling the invading pathogen and to speed recovery.

 

Signs and Symptoms of; External cause - characterized by sudden onset affecting the exterior of the body, sensitivity to Cold or Wind, slight fever, thin coating on the tongue and a superficial pulse. Internal cause - characterized by longer term onset as the pathogen works its way into the interior of the body. In most cases the internal organs are affected and signs and symptoms of channel and organ disharmony are seen. See below for symptoms of each organ system disharmony. Cold - characterized by aversion to Cold, pale tongue, preference for hot drinks, pale face, thin pulse. Heat - characterized by aversion to heat, red tongue, preference for cold drinks, flushed face, full pulse. Deficiency - deficiency refers to not enough Qi to ward off pathogenic factors. Deficiency manifests in the body in different ways including deficiency of Qi, deficiency of Blood, Deficiency of Yin or Yang. Symptoms are varied but include; emaciation, listlessness, feeble breathing, loss of strength, shortness of breath, spontaneous sweating, night sweats, incontinence, and pain that is alleviated by pressure. Excess - refers to hyperactivity of Qi in the body. Excess manifests in the body in different ways including excess Qi, excess Blood, Excess Yin or Yang. Again symptoms are varied but include; agitation, loud voice, heavy breathing, fullness and/or bloating in the chest and/or abdomen, pain aggravated by pressure, constipation, irritability, thick tongue coating and full pulse. Yin & Yang are a pair of principals used to generalize categories of syndromes. Once we have looked at all the symptoms presented we can say whether a condition is mostly Yin or mostly Yang. *see Yin/Yang Theory page. For example Cold syndromes are Yin in character. Heat syndromes are Yang in character. Deficiency syndromes are Yin in character. Excess syndromes are Yang in character. External syndromes are Yang in character. Internal syndromes are Yin in character. It is rare of course that one finds a condition that is purely Yin or purely Yang, but from a diagnostic perspective one may be able to gauge the relative strength and direction of movement in the body. This is important information for designing treatments. For Yang syndromes we need to reduce. For Yin syndromes we need to tonify.

 

Improper Diet

Key to Chinese thinking is balance and harmony. Everything must be balanced with everything else in order to achieve harmony. In the area of diet, the Chinese have separated all foods into 5 different categories according to taste. Each of these categories has a specific effect on the body and why Chinese cooking makes every effort to balance all five tastes. This is known as 5 Elements theory.

The five tastes are;

1. Sweet

2. Sour,

3. Bitter,

4. Salty,

5. Pungent,

For more information see *5 Elements Theory page

In theory, then one can eat pretty much what one wants as long it is balanced. By this though, I am not necessarily referring to the over processed sugar based packaged snacks so popular in the West these days. The food one eats must have at least some nutritive value.

So it is not so much that specific diets are bad for you, it is the overindulgence of specific kinds of diets that lead to illness. For example, overindulgence in a hot spicy diet will lead to symptoms of Heat or Fire and excess in the body. A strictly vegetarian diet of raw vegetables will lead to symptoms of Cold and Deficiency. A diet with too much Dairy in it will lead to symptoms of Cold and Phlegm.

For optimum health, though, certain diets are recommended.

As well as the kinds of foods that are consumed attention must also be paid to how food is prepared and how it is consumed. In Taoist philosophy there is a lot more to food than just eating it.

Each of the tastes characterized above, according to the 5 Elements theory is linked to a major organ system.

1. Sweet taste is linked to the Spleen/Stomach organ system.

2. Sour taste is linked to the Liver organ system,

3. Bitter taste is linked to Heart organ system,

4. Salty taste is linked to the Kidney organ system,

5. Pungent taste is linked to the Lung organ system.

It is often the case in Chinese medicine that appropriate treatment for an illness is a change in diet. The line between what is food and what is medicine is quite blurred, and many items that are considered food or spice in the west are consumed for their medicinal properties in the East. Among these, onions, garlic, pumpkin seeds, scallions, ginger, leeks, rhubarb, watermelon, mustard seeds, cinnamon, chives, and cloves.

Hyperactivity, Stagnation, Traumatic Injury, Insect, Animal or Reptile Bite,

These are all variations on a similar theme. Physical activity, beyond one's limit leads to injuries to muscles and tendons. These can be relatively minor or quite serious. Relatively minor injuries not treated and persistently aggravated can lead to serious injury over time.

Not enough physical activity leads to atrophy of muscles and tendons.

The treatment is either to slow down or speed up. In other words figure out what the appropriate amount of physical exercise is for you and do that.

We in North America tend to think being bitten by insects, animals or reptiles as little more than an annoyance. Certainly here in Southern Ontario where I am, there's nothing too dangerous. Still there are many parts of the world where this sort of thing is a serious concern and an important cause of illness that TCM concerns itself with.

Endogenous Causes Endogenous causes of illness are characterized in Chinese medicine as the 7 Emotions. They are; 1. Anger - associated with the Liver system 2. Joy - associated with the Heart system 3. Worry/ Overthinking - associated with the Spleen/Stomach system 4. Grief - associated with the Lung system 5. Sorrow - (chronic grief) associated with the Lung system 6. Fear - chronic condition (phobias) associated with the Kidney system 7. Fright - acute condition - associated with the Kidney system.

Emotional responses have an effect on the body. This is nothing new. When we are fearful or severely angry, the stomach tightens, we sweat, the heart pumps faster and stronger, we breathe faster, adrenaline and other chemicals are released into the blood to stimulate some organ systems and shut others down. When we are in grief or in joy we don’t feel much like eating, sleeping is difficult, we may have heart palpitations, or we may feel disoriented.

While modern medicine continues to scratch its head and wonders if emotional responses can actually have any lasting effect on the physical body, ancient Chinese physicians had a useful working model of just how emotions and the body are intricately linked and affect each other.

Using this system we are able to diagnose internal disharmonies according to external symptoms observed. The following are some of the major symptoms that one may observe, the organ system to which they apply and the emotion that is suggested by the symptom.

This exercise is intended to help you begin to understand what it is your body is telling you about your emotional state. As well it is to help you understand how your emotional state affects the body. The links between the body and the emotions are intimate and interactive. Physical symptoms indicate emotional disharmony and emotional expression indicates physical disharmonies. Strange as it may seem, I believe that most of us are not nearly as familiar with our emotions as we might think.

For example; Grief is housed in the Lungs. Grief would then be seen as an important aspect of Asthma. Any treatment of Asthma, to be effective from an Wholistic perspective would have to include reduction or release of Grief. In Acupuncture, the same point that is chosen to tonify the Lungs also helps to release Grief.

The following then is a list of symptoms, which are, in Chinese medicine indicators of disharmony in the five main organ systems, which according to the 5 elements theory suggests also an underlying emotional component.

 

Spleen/Worry.

The Spleen’s main function is to Transform water, food and air into Qi and Transport that Qi throughout the body.
Needless to say, this is an important function. If the body is properly nourished, the Spleen can do its job and good health is the result.
If the Spleen does not receive the proper raw materials it has to work that much harder to extract the Qi and transport it. As this function is critical to the organism as a whole, the key to any treatment for any kind of illness is to feed the body well. In severe illness this may involve herbal or pharmaceutical medication.
The emotion of the Spleen is Worry or Overthinking. The balance of Yin and Yang is always the goal.
It is recommended that one eat in peaceful surroundings without distractions. Some recommend that one not even talk to others while eating and certainly watching TV, reading, doing homework, or catching a bite on the run are not healthy things to do.

Of course, this becomes a vicious cycle. The more we worry, the more deficient the Spleen becomes which in turn causes us to worry still more.
Nourishing the body is absolutely primary in the recovery from any illness.

If the Spleen system is nourished properly, the better it can nourish all the other systems and their related emotions.
In the West, perhaps it is a stretch to grasp that simple changes to one’s diet can have far reaching emotional and physical consequences, but in the East it is a fundamental principal. You may take note of the fact that people who mainly 'think' for a living often have stomach problems.

The following physical symptoms suggest a Spleen dysfunction of some kind. Emotionally, they suggest Worry/Overthinking.

Fatigue/tiredness/listlessness;
Puffy eyelids and puffiness under the eyes
Bleeding gums
Craving for sweets
Drooling/excess saliva/saliva leaking
Anything to do with the mouth or lips
Prolapse of any vessel including uterus,scrotum,intestine,anus
Easy bruising or bleeding
Rashes of any kind
A thick or swollen tongue with teeth marks on the side.
Belching/hiccups –
Borborygmus or stomach/intestinal gurgling.
Painful, numb or tingling extremities, especially the feet.
Ulcers/hyperacidity/chronic heartburn/indigestion.
Stomach aches

It is often the case that these symptoms come and go related directly to our diet and our propensity for worry. Often we don’t pay much attention until something becomes chronic and starts to affect our lives. If a symptom is not too much of an inconvenience we either ignore it or cover it up and go on with what we were doing.

Since Fatigue is a major symptom of Spleen dysfunction, if you have Chronic Fatigue Syndrome it might be a good idea to look at your propensity to worry or over-think things, as well as your diet, not only what you eat but how you eat.

The Lungs. Disharmony in the Lungs takes 2 forms; a) acute such as the response to sudden loss of a family member, and b) chronic - characterized as 'sorrow' which may be held in the body for months or years. The Lungs are associated with the emotion of Grief. Symptoms indicating a Lung system disharmony and by association Grief as an underlying component include; Breathlessness Asthma/any kind of breathing problem Any kind of nasal problem (as the nose is associated with the Lungs) Phlegm in the lungs or sinuses Susceptibility to colds, flu, or other ambient infections Lungs govern the skin so any kind of skin problem may indicate Grief as an underlying component. Inability to urinate fully Fatigue/listlessness Foggy mind Sneezing (an explosive clearing of pathogenic factors) Sweating, especially spontaneous sweating in the absence of a cold or flu, indicates a Lung deficiency, or perhaps a clearing of grief along with other pathogenic factors. Spontaneous sweating is a common symptom of cleansing.

The Liver/Anger

The Liver is responsible for the free flow of Qi in the body. It stores blood and is responsible for maintaining blood levels and efficiency. The emotion attached to the Liver is Anger.
Since the Liver’s responsibility is to move Qi in the body, a Liver disharmony will have an effect on all the other organ systems and their related emotions.
While the basis for the 5 Elements theory is precisely that all organ systems, their functions, and related emotions is in fact, that they are interconnected and affect each other, The Liver's effect is particularly pronounced.

This is consistent with the observation that Anger is a particularly strong, even primal emotion. Anger is often seen in combination with other emotions. We often get ourselves out of fear, grief, or worry, simply by getting angry, at ourselves or at another.

From a TCM perspective, this is very much, the body doing what it needs to do to promote Qi flow and return to wellness. While we tend to take a dim view of someone expressing Anger, in some situations, it is in fact the healthy thing to do. The expression of Anger, at least temporarily has the effect of promoting Qi flow and clearing stagnant blockages in the body. Suppressing Anger causes Qi to stagnate in the Liver and therefore affects Qi flow in the body as a whole.
Of course, we must emphasize that the expression of Anger in particular situations is only a temporary measure. It is what the Body does when all other measures fail.

Symptoms of Liver dysfunction include;

Pain or distention in the hypochondriac region, at the sides of the body around the diaphragm is a common sign of Liver disharmony.
Acute, stabbing pains anywhere in the body
Pain or distention in the eyes
Headaches at the sides of the head including Migraine headaches
Frequent and/or heavy sighing.

In Chinese Medicine, any kind of pain is considered to be Stagnation of Qi and or Blood. This means that the treatment principal for any kind pain is usually ‘move Qi & Blood.’ From a TCM perspective then, if you have Fibromyalgia or some other such condition characterized by 'mystery' pain, it would be a good idea to look at your Anger.

 

The Heart/Joy The heart houses the Mind in Chinese Medicine. The brain is considered an extraordinary Fu organ, that is an ‘empty sac’, which is a characteristic of Fu organs. The Brain is seen as a place to store and process raw data. It is in the Heart that a person’s essence and personality is kept. This is why, in Chinese Medicine, many mental problems are seen as disharmonies of the Heart. From a TCM perspective, then, there is a medical basis for the observation that lack of Joy or Love in a person’s life ultimately makes them crazy. When you speak from the Heart, you speak from Joy and the world is truly a brighter place. Physical Symptoms of a Heart disharmony include; Shortness of breath Sweating (in the absence of disease) Pallor or pale complexion Tiredness/listlessness Stuffiness in the chest Palpitations or irregular heart beat Dizziness Restlessness/agitation Anxiety/confusion Dream disturbed sleep Insomnia Poor memory Propensity to be startled Feelings of uneasiness Muttering to one’s self Mania

 

The Kidneys/Fear

The Kidney system is often seen in combination with dysfunctions of other organ systems. In TCM the Kidneys have the unique function of housing one’s corporeal essence or life force. One is born with YUAN QI, also called Primary Qi or Congenital Qi. According to the theory one is born with only so much Yuan Qi, which can never be added to, but which can be ‘topped up’ by Jing or Nutrient Qi from the Spleen.

Yuan Qi, may also be seen as the motive force of the Corporeal Soul which animates the body. When one’s Yuan Qi is all gone the body dies and the Corporeal soul dies with it releasing the Ethereal Soul.
Physical manifestations of weak Yuan Qi are birth defects, problems with birth, weak constitution, and susceptibility to childhood illness.
Strong healthy babies are said to have strong Yuan Qi.

Whether one has strong or weak Yuan Qi will affect one throughout life. Weak Yuan Qi, or essence, may lead to complications or illness later in life, premature aging, or death at a relatively young age.

A man’s essence is manifest in his semen. The sexual organs are seen as part of the Kidney organ system. Overindulgence in sex or masturbatory ejaculation are a couple of ways that Kidney essence may be depleted.

A woman’s essence is manifest in her menstrual blood and giving birth. Excessive menstrual flow, difficult pregnancies, and too many pregnancies will deplete a woman’s essence.

Excessive fear over a period of time will also deplete Kidney essence.
A severe fright or a particularly intense ejaculatory orgasm in a man, will deplete the Kidney’s essence almost instantaneously.

Physical symptoms of Kidney Disharmony include;

Weak or sore lower back.
Weak or sore knees.
Urinary dysfunction.
Darkness under the eyes.
Irregular or problematic menstrual flow.
Weak ejaculation.
Seminal emission.

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