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What are the treatment methods in Traditional Chinese Medicine (TCM)?

Diagnosis in Traditional Chinese Medicine (TCM)

Traditional Chinese Medicine (TCM) follows a holistic approach to diagnosis, meaning that it considers not only the patient's internal condition but also external and environmental factors in identifying the root causes of illness. The holistic principles of TCM take into account the following aspects:

1. Examining both internal and external symptoms

"When there is an internal disorder, it manifests externally."
This means that any pathological changes inside the body will show signs on the outside. Even minor external symptoms can reveal the state of internal organs and systems.

2. Examining the relationship between human health and nature

Seasons and geography influence the prevalence of certain diseases. Sudden changes in weather and outbreaks of disease can all significantly affect human health. TCM considers these environmental factors essential in diagnosis.

3. Examining the relationship between human health and society

This focuses on psychological and emotional factors affecting health. Intense competition, high stress, and mental pressure in society contribute to a rise in mental and emotional disorders. TCM takes these social influences into account when evaluating a patient's condition.

Traditional Chinese Medicine utilizes a comprehensive diagnostic approach to identify the root causes of illness.
This involves the Four Diagnostic Methods, known as "Si Zhen" (四诊). Each method offers a unique perspective, and therefore, these four diagnostic approaches cannot replace one another, as they complement and reinforce each other to provide a complete picture of the patient's condition.

However, in practice, not all four methods may reveal symptoms in every individual case. Therefore, it is crucial for the practitioner to identify and focus on the key symptoms as a foundation for differentiating and diagnosing the illness.

Diagnosis in Traditional Chinese Medicine

The Four Diagnostic Methods are:

Observation (望诊 – Wàng Zhěn)
Listening and Smelling (听诊和闻诊 – Tīng Zhěn hé Wén Zhěn)
Inquiry (问诊 – Wèn Zhěn)
Palpation and Pulse-taking (切诊和按诊 – Qiè Zhěn hé Àn Zhěn)

Observation (望诊 – Wàng Zhěn)
Observation is a diagnostic method that involves examining external signs of the body for abnormalities or changes. This includes observing Shen (神) – the spirit or vitality seen through the facial expression, emotional display, complexion, posture, tongue appearance, and bodily secretions. The goal of this diagnostic method is to assess the pathological condition of internal organs as reflected through external physical changes. This helps the practitioner gain insight into the nature and severity of the illness. In particular, the face and the tongue are considered by Traditional Chinese Medicine to be closely connected to the internal organs, making them especially important areas for visual diagnosis.

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Listening (听诊 – Tīng Zhěn)
This involves analyzing various sounds made by the patient, such as:

Hoarseness
Tone and clarity of voice
Speech patterns
Wheezing or labored breathing
Vomiting sounds
Hiccups
Each sound provides clues about the functioning of internal organs and possible imbalances in the body.

Smelling (闻诊 – Wén Zhěn)
This involves detecting abnormal body odors that can reflect internal health conditions:

Bad breath with a sour, rotten smell may indicate Spleen Qi deficiency or indigestion.
A foul smell may be due to excess heat in the Stomach.
Nasal odor with thick, continuous mucus suggests sinus (nasal cavity) inflammation.
A foul body odor may result from infected or festering wounds.
Stool odors: A very foul smell indicates internal heat. A fishy smell suggests internal cold.

Note: Observation and inquiry should be used together with smelling. For example, if there is a rotten smell in the patient's room without visible wounds, it may indicate severe internal disease.
An ammonia-like smell (similar to urine) can appear in end-stage kidney disease with edema. A rotten apple smell is commonly associated with severe diabetic conditions.

Inquiry (问诊 – Wèn Zhěn)

In traditional Chinese medical history, the patient or their relatives are asked a set of 10 key questions:

Hot and cold (chills and fever)
Sweating
Head and torso conditions
Urination and bowel movements
Diet and taste preferences
Chest conditions
Sleep quality and hearing
Thirst
Past illness history
Causes of the illness

Additionally, for women, questions about menstrual history are included, and for children, questions about any history of rashes such as chickenpox or measles are asked. The inquiry is conducted with politeness, gentleness, and thoroughness. Building trust between the practitioner and the patient is essential for the practitioner to accurately understand the patient's condition.

Pulse Diagnosis (脉诊 – Mài Zhěn)

Pulse diagnosis has a long history spanning thousands of years in the People’s Republic of China. Traditional Chinese medicine practitioners use pulse-taking as a key method for diagnosing illness and determining treatment approaches, based on the principles of natural science and empirical observation on human beings. Around 2,500 years ago, a renowned Chinese physician named Bian Que (扁鹊) was known for his expertise in diagnosing diseases through pulse examination.

During the era of Emperor Huangdi (黄帝)

Emperor Huangdi composed the classic medical text Huangdi Neijing (黄帝内经 / 内经).

The Huangdi Neijing (Inner Canon of the Yellow Emperor) describes the concept of "San Bu Jiu Hou" (三部九候).

San Bu (三部) refers to the positions for pulse diagnosis on both wrists. Each wrist has three positions: Cun (寸) – closest to the wrist crease Guan (关) – in the middle Chi (尺) – furthest from the wrist crease

At each of these three positions, the pulse is felt with three levels of pressure: Fu (浮) – superficial or light pressure Zhong (中) – medium or moderate pressure Chen (沉) – deep or heavy pressure
These 3 positions combined with 3 levels of pressure make up 9 types of pulse observation, known as "San Bu Jiu Hou" (三部九候) Literal translation: Three sections and nine indicators

During the Han Dynasty – Zhang Zhongjing (张仲景)

During the Han Dynasty, Zhang Zhongjing authored important medical texts on disease diagnosis.
He concluded that accurate and complete diagnosis must be based on four diagnostic methods, which are: Observation (望 – Wàng) Inquiry (问 – Wèn) Listening and Smelling (闻 – Wén) Palpation (切诊 – Qiè zhěn)

Later, during the Western Jin Dynasty – Wang Shuhe (王叔和) During the Western Jin Dynasty, Wang Shuhe compiled the "Mai Jing" (脉经 – Pulse Classic).
This classic synthesized earlier works from before the Han Dynasty, including Huangdi Neijing (内经) Nanjing (难经) Medical texts by Zhang Zhongjing and Hua Tuo (华佗)
In the Mai Jing, Wang Shuhe classified 24 types of pulse. This became one of the most comprehensive and influential works on pulse diagnosis, and it was widely studied both in China and internationally.

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