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Sunday, November 16, 2008

TCM-Tongue Diagnosis (Test 6)

The tongue is a useful gauge for monitoring the improvement or decline of the patient's condition.
The tongue is also useful to determine the location of disharmony related to the organ systems.

Important points for Tongue examination:

  • Proper lighting is critical
    • Natural lighting is the best, but if it's not available, examine the tongue close to a window
  • Proper tongue extension
    • patient should extend the tongue as much as possible without excessive force
  • Duration of tongue extension
    • extend the tongue for 15-20 seconds only
  • Food consumption prior to treatment

TCM- Diagnosis in Chinese Medicine (Test 6)

2 Fundamental Diagnosis Principles:

  • Inspect the exterior to examine the interior- outward signs and symptoms reflect the condition of the Internal Organs.
  • A part reflects the whole- the state of the whole organism can be determined from examination of a part of it.
4 methods of examination:
  1. Observation (Looking)
  2. Auscultation (Hearing and Smelling)
  3. Interrogation (Asking)
  4. Palpation (Touching)
2 Important things to keep in mind:
  1. Correspondence between an Individual Part and the Whole- One of the principles on which diagnosis by observation is based on is that each single, small part of the body reflect the whole. Important example of this are the face, tongue, pulse, and ear.
  2. Observation of Constitutional Traits- Why is it important to observe constitutional traits?
    1. a constitutional type indicated the tendency to certain disharmonies and it allows us to forecast, and prevent a possible pathological development.
    2. allows for us to put the presenting disharmony into perspective, helping up to gauge its severity
Diagnosis by Observation involves looking at the following aspects:
  • nose
  • ears
  • mouth
  • teeth
  • tongue
  • and...
Spirit:
  1. In a general sense, it indicates a general state of vitality; if this is thriving, the person has spirit. The presence or absence of spirit can be observed in the complexion, eyes, state of the mind, and the breathing.
      1. With spirit----> complexion is healthy, the muscles are firm, the face color is clear, the eyes have glitter and reveal inner vitality, mind is clear and breathing is even.
      2. Without spirit----> complexion is dull, muscles are withered, face color is dark, eyes move uncontrollably, show no inner vitality or are not clear, the mind is unclear and breathing is labored or shallow.
  2. Spirit of a person also refers to the mental-emotional-spiritual state of the person.
      1. Strong spirit----> clear voice that projects outwards well, the eyes and the complexion have luster, expression is lively, mind is clear and alert, person walks with an erect posture and has a naturally optimistic, enthusiastic and mentally strong attitude.

Body:
3 aspects to consider when examining the physical appearance of a patient:
  • Constitutional Type
  • Long tern changes in physical appearance
  • short term changes

Demeanor:
This includes the way that a person moves, and also movement of individual parts of the body, such as eyes, face, mouth, limbs, and fingers.
  • General principle:
  • Excess of movement, or rapid and jerky movements --> Yang, Full, or Hot patterns
  • Lack of movement, or slow movements ---> Yin, Empty or Cold patterns
Movements such as tremors or convulsions always indicate the presence of interior Wind of the Liver.


Head and Face:
4 Attributes of a normal complexion:
  • Luster
    • slightly shiny
    • vibrant in color
  • Subtle, slightly reddish hue
    • reddish hue indicates a good supply of heart blood and a good state of mind
  • a 'contained' 'veiled' color
  • Moisture
Pathological Colors of Complexion

White:
  • Dull White- blood dificiency
  • bright white- yang deficiency
  • bluish white- yang deficiency with cold
Red:
  • Whole face red- full heat
  • red cheekbones- empty- heat
Yellow:
  • Sallow yellow- ST and SP deficiency or blood deficiency
Green:
  • Green face- liver patterns, interior cold, pain or interior wind
  • green complexion with red eyes- liver fire
  • dark reddish green complexion- stagnant liver qi turning into heat
Blue:
  • white bluish - cold, or chronic pain
Black:
  • cold, pain or kidney disease usually kidney tin
  • black and moist0 cold
  • black and dried up, heat
A moist color is a sign of good prognosis , while a dry color is a sign of poor prognosis




Incomplete post!













TCM- Miscellaneous Causes of Disease-Part 2 (Test 6)

Excessive Physical Work (and lack of exercise):
Excessive physical work most often impacts the Spleen and the Liver. Excessive use of one part of the body will also cause stagnation of Qi in that particular part.
Lack of exercise is also a cause of disease. Regular exercise is essential for a proper circulation of Qi. Lack of exercise will lead to stagnation of Qi and , in some cases, Dampness. In particular, exercise such as Yoga or Tai Ji Quan aimed at developing Qi rather than just the muscles, are very beneficial and should be recommended to patients suffering from deficiency of Qi who do not have enough energy to undertake Western-type exercise.

Excessive Sexual Activity:
By 'excessive sexual activity' is meant actual ejaculation for mend and orgasm for women. Sexual activities not culminating in orgasm are not though to be depleting to the Kidney Essence.
One can, however define sexual activity as 'excessive' it if results in marked fatigue, and even more so if it causes certain other specific symptoms, such as dizziness, blurred vision, a lower back ache, weak knees and frequent urination. The important thing to realize is that sexual activity should be adjusted according to age, physical condition, and even the seasons.
Sexual activity should be reduced if there is a deficiency of Qi or Blood, and particularly a deficiency of the Kidneys.
Many sexual problems, such as impotence or premature ejaculation often require a decrease in sexual activity first, for there to be successful treatment.
Chinese medicine also considers the circumstances in which sexual activity takes place. For example, having sexual intercourse in a state of drunkenness is considered extremely harmful to any resulting fetus. Catching a cold after sexual intercourse can severely weaken KH Yang. As the energy of the Kidneys is temporarily weakened after intercourse, it is important not to be exposed to any cold at this time.

Differences Between Men's and Women's Sexuality:
There are some important differences between men and women's genital physiology from TCM perspective. It could be said that men's sexual energy is more directly related to the Kidney-Essence, whereas women's sexual energy is more directly related to Blood. The Red Field in men contains the Room of Essence, whereas in women it contains the Uterus. It follows that ejaculation is a more direct loss of Kidney-Essence than orgasms for women (even though there is some loss of Essence in women also) as there is not menstrual blood loss during orgasms for women.
Insufficient Sex as a cause: Sexual desire depends on the Minister Fire, and a healthy sexual appetite indicates that this Fire is abundant. When sexual desire builds up, the Minister Fire blazes up and Yang increase. The orgasm is a release of this accumulated Yang energy and it is a beneficial discharge of Yang Qi and it promotes the free flow of Qi. When sexual desire builds up, the Minister Fire is stirred; this affects the Mind and the organs, specifically the Heart and Pericardium. The Heart is connected to the Uterus via the Uterus Vessel and the orgasmic contractions of the uterus discharge the accumulated Yang energy of the Minister Fire.
When sexual desire is present but does not have an outlet in sexual activity and orgasm, the Minister Fire can accumulate and give rise to both Blood Heat and to stagnation of Qi in the Lower Warmer. This accumulated Heat will stir the Minister Fire further and harass the Mind, while the stagnation of Qi in the lower warmer can give rise to GYN problems such as dysmenorrhea.
Sexual Desire:
Sexual desire itself is also related to the Kidney energy. A healthy sexual desire reflects a good and strong kidney energy. It the Kidneys are weak, and if, in particular the Kidney yang is deficient, there may be a lack of sexual desire or inability to enjoy sex and reach an orgasm. On the other hand, if Kidney Yin is severely deficient leading to rising of Empty-Fire, there may be an excessive sexual desire with inability to be ever satisfied. The person may also have vivid sexual dreams resulting in nocturnal emissions in men and orgasms in women. For this reason, lack of sexual desire can be stimulated by strengthening Kidney yang and the Gate of Vitality, and excessive sexual desire can be dampened by nourishing Kidney-Yin.
Beneficial Effects of Sexual Activity:
Finally, it should be stressed that what has been said so far only concerns the relation between excessive sexual activity and the Kidney energy, and that many other factors are included in determining a happy sex life Although Chinese Medicine is mostly concerned with excessive sexual activity as a cause of disease, an unhappy sexual life with inability to reach orgasm or lacking in warmth and affection is also an important and frequent cause of disease. This often causes deep unhappiness or anxiety that become causes of disease in themselves.

Diet:
Insufficient Eating:
Malnutrition is an obvious cause of disease. In its broad sense, malnutrition exists not only in poor third world countries, but also in rich industrialized countries where it is present in certain less obvious forms. People amy suffer from a more mild form of malnutrition by adhering rigidly to very strict 'diets', the number and variety of which is becoming mind-boggling. Some of those who adhere to such strict diets may unwittingly lack essential nutrients in their diet.
Cold Foods:
Excessive consumption of what Chinese medicine considers to be cold-energy foods and raw foods may weaken the Spleen, in particular the Spleen Yang, However, from the Chinese point of view , the spleen likes dryness and warmth in food and dislikes excess of fluids and cold: an excessive consumption of the above foods will be very difficult to digest and may weaken Spleen-Yang causing diarrhea, chilliness, cold mucus, abdominal pain and distention. This, particularly those who have a tendency to Spleen deficiency should not consume raw and cold foods in excess.
Sweet Foods and Sugar:
Excessive consumption of sweet foods and sugar, also extremely common in our society, clocks the Spleen function of transformation and transportation and gives rise to Dampness, with such symptoms as upper respiratory catarrh, abdominal distention and fullness, mucus in the stools and vaginal discharges.
Hot foods:
Excessive consumption of hot energy and spicy foods gives rise to heat symptoms, especially of the Stomach and Liver, such as a bitter taste, a burning sensation in the epigastrium and thirst.

Trauma:
Physical traumas cause local stagnation of Qi or Blood in the area. A slight trauma causes stagnation of Qi and a severe one causes stasis of Blood. In either case, it gives rise to pain, bruising and swelling. Although trauma may seem only a transient cause of disease, in practice, the effect of trauma can linger for a long time manifesting with local stagnation of Qi and/or Blood in the area affected.
Old traumas can also become a concurrent cause of disease together with a later one. For example, a trauma to a knee may seem to have cleared up completely, but when the person later in life contracts Painful Obstruction Syndrome cause by exposure to cold and damp condition, the exterior pathogenic factor often will settle in that knee.