There are four methods used in diagnosing a patient in Chinese
medicine. The four methods are:

Pulse diagnosis,
Inspection of the patient’s facial expression, skin color, skin
texture, appearance as well as the shape, color, and markings of the
tongue including the coating if any along with any oral odors or body
odors.

Listening to the speech (volume of voice, how rapid the person speaks,
and how response they are to questions), the sounds of the
respiration, any noticeable sounds of illness such as coughing, or
gurgling of the intestinal tract.

Inquiring of the patient regarding the medical history, especially
about any symptoms or signs of illness.

A Chinese doctor will gather information from all of these methods in
order to make a diagnosis.

The pulse diagnosis method is described in many ancient texts.

A pulse can be too strong or too weak and if this were the case it
would mean there is illness in the individual.

The pulse diagnosis is used in conjunction with the other methods and
not by itself. Front and rear pulses must be taken.

There are 26 different pulse types:

The Scattered pulse is an irregular pulse that occurs in critical
cases where qi is exhausted.

Intermittent pulse is a slow pulse that has pauses at regular
intervals. This is seen in severe trauma.

The swift pulse is a fast pulse (120 - 140 beats per minute).

The hollow pulse feels floating, large, soft and hollow and is seen in
cases where there is a large blood volume loss.

A faint pulse is thready and soft, hardly noticeable.

A surging pulse is a forceful rising and gradual falling pulse.

A hidden pulse is observed when someone is in severe pain and can only
be felt when pressing almost close to the bone.

The knotted pulse is a slow pulse that is irregular and is often a
sign of stagnation of qi and stagnation of blood.

Hurried pulse is a rapid pulse that has irregular intermittence beats,
occurring with excessive heat, retention of phlegm or undigested
food.

Long pulse is a lengthy, prolonged pulse.

A short pulse is short and forceful.

A find pulse is like a fine thread and usually results in a state of
deficiency.

Hesitant pulse is a choppy pulse that indicates a sluggish blood
flow.

Slippery pulse can be found in normal individuals as well as those who
are pregnant, who have food stagnation and those with phlegm-damp.

A relaxed pulse occurs with diminished tension, or someone with spleen
insufficiency.

A moderate pulse is a pulse that has a even rhythm to it and has
moderate tension, which is indicative of a normal condition.

Tense pulse is a tightly stretched pulse that may indicate the
individual has a cold or possibly in pain.

A stringy pulse is like a musical instrument, feeling straight and
long. Individual in severe pain will have a stringy pulse or those
having liver disorders.

A replete pulse is a very vigorous and forceful pulse.

A weak pulse is deep and soft, and due to deficiency of qi and blood.

A soggy pulse is a very thin, soft pulse.

A feeble pulse is a pulse that feels feeble which may indicate a loss
of qi or blood or some other impairment of body fluid.

Rapid pulse is one that has increased frequency of more than 90 beats
per minute.

A slow pulse is a pulse that has reduced frequency - meaning less than
60 beats per minute.

A sinking pulse is only felt while pressing down hard and is
indicative of illness that is located deep in the interior of the
body.

A floating pulse can be felt by pressing lightly and grows faint if
pressure is applied. This is indicative of an illness that is in the
exterior of the body.

Traditional Chinese Medicine’s view of pain is that it is caused by
qi stagnation, blood stagnation or the occurrence of both within the
body. The answer to pain is to activate qi and blood by removing the
stagnation, which requires the use of herbs. Traditional Chinese
Medicines prescribes herbal remedies by way of “formulas”.

Formulas allow for the treatment of ailments and symptoms with a
balance of herbs instead of just one. This balance dispels any
unwanted side effects or complications that may arise with a single
application of treatment.

When locating pain in traditional Chinese medicine (TCM) there are
three main keys used in diagnostic procedures. The three keys are:
location, type and cause.

Where is the pain located exactly on the body (upper, lower, external,
internal)? What type of pain is the patient experiencing (sharp, dull,
stabbing, fixed or spreading)?

What is the cause of the pain (muscle spasms, injury like a structural
damage)?

A complete evaluation of these three factors is critical to arriving
at a correct diagnosis.

Headache pain can be complicated, especially that of a migraine.
Location can be tricky as the pain can be located in the occiput,
vertex, orbital or in the sinuses. There are several herbs used for
headache pain including corydalis and pueraria root as well as cnidium
nd tea formula (chuan xiong cha tiao san).

Pain from neck or shoulder injuries can be in two categories: acute or
chronic. The symptoms that present in acute pain are usually redness,
inflammation, swelling and the presense of a sharp pain. Chronic
injuries have symptoms of stiffness, discomfort, numbness and a dull
pain. Acute pain can be caused by accidents, bad sleeping positions,
and also bad posture when reading. Herbs like corydalis are used to
relieve pain and promote good blood circulation. Chronic pain is
treated can be treated by corydalis and the lindera formula (wu yao
shunqi san) for shoulder pain and atractylodes and arisaema combined
to relieve the pain of neck and shoulder disorders.

There is also acute and chronic pain associated with back pain. Tuhuo
and loranthus combination is used to relieve acute back pain. Herbal
formulas are geared towards whether the pain is a kidney yin
deficiency, a kidney yang deficiency or both kidney yin and yang;
different formulas for different deficiency.

Musculoskeletal pain can have both cold and hot etiologies. Gentiana
macrophylla root is a popular treatment for musculoskeletal pain. When
spasms are involved white peony and licorice have properties for
relieving them.

Traumatic injury is another type of pain; that of broken bones,
sprains, surgical incisions, internal trauma or physical traumas.
Cinnamon and hoelen formula (gui zhi fu ling wan) is used for internal
bleeding after trauma and persica and rhubarb for the treatment of
subcutaneous bleeding that accompanies swelling and pain.

Any herbal treatment is prescribed in formulas that are individually
designed based on symptom and location. No two treatments are the same
as symptoms and locations can differ. Pain can differ depending on
cause and type of pain.

Chinese medicine was established over two millennia ago. There is much
of this ancient medical knowledge that has been preserved in the
pre-Chin (221 - 207 B.C.), Inner Cannon (Nei Ching), and Han dynasty
(206 B.C. - 220 A.D.) eras. The Ming dynasty combiled one of the
best-known Chinese medical works called the “Materia Medica” (Pen
Tspao Kang Mu). This work brought about a new era in the world of
pharmacology because it contained 1,892 different kinds of medicines.
It was translated into several languages and had a dramatic influence
on both East Asian and European countries.

The major philosophy behind Chinese medicine is that the human man
lives between heaven and earth and is of himself a unique universe. A
unique universe different from all others and must be treated as a
whole concerning matters of health. The chinese believe that there are
five centers of the body:

1. The heart, which is the command center of the body.

2. The lungs which are the respiratory system, which also regulates
various intrinsic, functions and maintains the cybernetic balance of
the body.

3. The liver, which in Chinese terms includes the limbs and trunk of
the body and contains the emotional response to external factors and
the actions of the organs.

4. The spleen, which regulates the distribution of nutrition for the
body, as well as metabolism, strength and vigor of the physical body.

5. The kidneys are responsible for regulating the storage of
nutrition, how energy is used.

The life force depends largely on the health of these five centers of
the body.

Good health is also connected to external and internal factors that
are affected by changes in the weather and changes in the emotional
status of the individual. The external factors that influence the body
the most are: wind (feng), cold (han), heat (shu), mosture (shih),
dryness (tsao), and internal heat (huo). The internal factors that can
affect the health of the body are: happiness (hsi), anger (nu), worry
(yu), pensiveness (szu), grief (pei), fear (kpung), and shock (ching).
If these internal factors are experienced to an extreme they can cause
harm to the body according to Chinese medicine. There is an
interaction between the external factors and the internal factors that
then form a foundation for the health status of the individual. When
these factors cause an imbalance, the Chinese doctor will prescribe a
treatment to restore the balance, which may include acupuncture and
Chinese herbs.

The past history of Chinese medicine has a profound influence on the
modern day practice of medicine. The western world also utilizes
Chinese medicine in the practice of acupuncture, and the use of herbs
in cooking. Many pharmaceutical companies are manufacturing
combinations of Chinese herbs for commercial distribution

Herbal medicine is an intricate part of Traditional Chinese Medicine.
The diagnosis is made to distinguish the pattern of disharmony.
Acupuncture treatments usually follow to restore harmony. Following
treatment, a doctor of Traditional Chinese Medicine (TCM) will write
an herbal formula for the patient to use.

Herbs are classified into three groups. The first group is “food
herbs” and the other two groups are “medicinal herbs”. Food herbs
are used in Chinese medicine for general fortification, illness
prevention and to maintain good health. Medicinal herbs are given to
each patient based on the patient’s constitution, medical condition
and the environment in which he/she lives. Medicinal herbal therapy
works well with acupuncture because it provides the nutritional
support for the energy need to do the “re-programming” and
“re-balancing” that is a part of acupuncture.

To understand the use of herbs in Chinese medicine, one has to
understand “formulas”. Formulas are based on principles, which
contain four or more herbs. Very few Chinese herbs are used by alone.
The reasons that are given for the use of combined herbs is that the
combination benefits the affect on the secondary issue with the
illness, prevents side effects by balancing out the effects of each
herb, and to strengthen the total effect on the pathology of the
illness. Each role in the formula has a role with a design much like
the one for the monarchical form of government with a king or emperor
at the top and ministers or deputies next, and last are assistants or
adjutants. Each herb has a hierarchy of importance and a role to play
in the healing process. Any herb can fill any of the necessary roles
in the formula. The “King Herb” is the herb, which has the most
direct effect on the imbalance/pathology. The “Minister Herb” is the
one that is directed at the main imbalance/pathology and also to the
secondary imbalance/pathology. The “Assistant herb” consists of
three types of herb:

Helpful Assistant - which strengthens the effect of the King.

Corrective Assistant - which is used to reduce or eliminate the harsh
or toxic effects of the King or the Minister herb.

Opposing Assistant - to decrease the effect that the King herb has
when there is a complex combination of imbalances or pathologies.

There can also be a Guide, Envoy or Messenger Herb with the role to
focus on actions of the other herbs in the formula to channel them to
particular areas of the body.

Herbs are selected for the formula also based on a KMAG template of
characteristics that include the herb temperature, 5 elements taste
associated with the herb, direction of the herb and channels from
which the herb enters that can affect the connected organs and regions
of the body.

Herb temperature can be hot, warm, neutral, cool or cold. The 5
elements of taste are water, which is salty; wood, which is sour;
fire, which is bitter; earth that is sweet and metal which is spicy.
The direction of the herb can be up, down, outward or inward.

The use of Chinese medicinal herbs is complex and should not be
undertaken except with the advice of a professional.