Basic Diagnostic Methods

When the Yin and Yang of a body fail to balance, or a disorder occurs in an organ, there are often  signs on the surface of the body. This is called  Internal pathological change and external manifestations. This reaction is partly conducted by the connection of the Meridian channels and points (these points are also called reaction points), and partly by the connection of the interior and exterior relationships of a body. The basic Chinese organic examination methods comprise four ways and eight principles.

1. Inspection: Observe appearance, movement, unusual colour on the face and on the body, inspection also includes the colour of sputum from a cough, discharge of fluid and blood, urine and stools.
2. Hearing and Smell: Basically to listen to the voice, the respiration and the cough. Smell the breath.
3. Question: the patient’s feelings, age, occupation, marriage, drinking and smoking habits, diet and sleep, menstruation and discharge, history of the illness, how, where and when. There are many questions that should be asked related to the symptoms.
4. Touch: Apply touching and pressure to certain areas of the body to detect anything unusual such as pulse, temperature of the body, tenderness and stiffness of the muscles and joints.

The analysis of the characteristics of the syndrome such as yin and yang, exterior and interior, cold and heat, deficiency and excess.

The direction of the development of a disease. The skin, hair, muscles and the superficial portion of meridians and collateral of the human body belong to the exterior, while the five Zang and six Fu organs pertain to the interior. Exterior syndromes refer to the invasion of a virus to the superficial portion of the body marked by sudden onset of symptoms with short duration, like the common cold or flu.

Interior syndromes are the result of the pathological development of the exterior syndromes. There are three pathological conditions which can invade and attack Zang-Fu organs directly:  1- drastic emotional changes, 2 – improper diet, 3- strain and stress. These affect Zang-Fu organs directly, and lead to functional disturbances. Emotional changes can give rise to stomach or gastric problems, while strain and stress can cause liver problems.

Cold and heat refers to distinguishing the nature and conditions of the disease. Some syndromes manifest as heat on the body, like inflammations, fever, sweating in winter, constipation, deep-yellow urine, red tongue with yellow and dry coating, and rapid pulse. These are the signs of the heat syndrome. Aversion to cold, tastelessness in the mouth, absence of thirst, cold limbs, loose stools, large amounts of clear urine, pale tongue with a white, moist coating, and a slow or tense pulse are the signs of cold syndrome. Cold and heat may be different natures of syndrome, but they also have a very close relationship; they can exist simultaneously, cold in the morning, and heat in the evening, or even heat in the upper half of the body, and cold in the lower half simultaneously, this is known as “heat above with cold below”. Sometime they can transform into each other. In general, the mutual transformation of cold and heat syndromes takes place in certain conditions, when cold changes to heat, that may indicate that health has been restored, while heat changed into cold may indicate the failure of treatments or the collapse of anti-pathogenic Chi.

These are two principles which  distinguish the relative strengths of the anti-pathogenic Chi and pathogenic factor. The determination of the treatment (promotion or elimination) of deficiency and excess syndromes is one of the basic practices in Chinese Medicine. The common deficiency and excess syndromes are Yin and Yang, or Chi and blood, others may be deficiency of certain proteins in the diet These may cause problems, and excess of sugar in the urine or in blood are the classic signs of diabetes.

The two opposites of energy – Yin chi and Yang chi of the body or positive and negative. Collapse of Yin chi can be seen in women as heavy menstruation, distension and tenderness of breasts and ribs, lower abdominal pain and dry stools. This may last more than 4 days. Patients of this type also can be seen to consume massive amounts of water. On the other hand, patients that suffer impotency, prolapsed Uterus or urinary incontinence are the result of the collapse of Yang chi. Yin and Yang are also used to summarise the other six principles. In addition, deficiency of Yin leads to excess of Yang, and that tells us heat syndrome is present. On the other hand, excess of Yin leads to deficiency of Yang, that tells us cold syndrome is present.