 |
 
 
|
AS SEEN IN THE SUMMER 2010 EDITION
How a Frederick Acupuncturist utilizes DiagnosisWhere Are You Going to Put Those Needles?! The
Art of Diagnosis in Chinese Medicine By Ryan Diener, L.Ac., Dipl. CH, MSOM, Holistic Health Associates
One
of the most common questions I receive as an acupuncturist is, “where
are you going to put
the needles?” It is a funny question in a way because so many factors
are taken into
account when deciding which acupuncture points to use, that a question
like where I will put
needles for headaches does not make much sense. Having been raised in Western culture, most of us assume that
there is one specific treatment for each ailment,
and this is understandable. Have a cough?
Take cough syrup. Headache? Excedrin. Joint Pain? Ibuprofin.
Chinese medicine, however, looks at the cause of disease through many different perspectives to determine a very detailed picture of what is happening in each person. There may be five people that are looking for treatment for headaches and five different acupuncture point prescriptions and herbal treatments. The practitioner was led to the different approaches by the diagnostic process. There are many techniques that acupuncturists can use to determine the best point selection for the patient. Most practitioners use a combination of techniques. It’s worth taking a closer look at the basics of Chinese medicine diagnostics that most acupuncturists employ. Roots and Branches Chinese
medicine has the concepts of the root of care, and the branch of care.
The root of care is
what we call the constitution of the patient and often involves chronic
patterns, general
health functionality, personality traits and diagnostic
interpretations. The branch of
care is the symptom they are presenting with. You can prune branches,
but if you don’t water
the roots your tree will not grow. The first time a patient comes in for acupuncture or herbs, most practitioners
spend an extended period of time with the patient
in order to determine the root of disease and discuss the branch.
The Initial Consultation The
initial consultation is when the practitioner can focus deeply on what
might be the best
course of action for the individual. Depending on the practitioner you
may or may not receive
an acupuncture treatment after this consultation. There generally will
be some
recommendations made to help you improve whatever situation we are
working on. These may
include lifestyle, diet, exercise and sleep considerations.
The first step to most treatments involves an extensive dialogue between patient and practitioner. Here the practitioner asks about the main complaint of the patient, family history, internal system functionality and other areas of health acupuncture may be able to help with. The practitioner assesses the answers given by the patient and the sound of the voice of the patient during each of the answers. For most practitioners this is a 30 – 45 minute process during the initial consultation and is one of the most comprehensive health histories you will have the privilege to participate in. Palpation Palpating,
or pressing different points with the fingers, allows a practitioner to
determine exactly
where a pain is located as well as the intensity of the discomfort with
varying degrees of
pressure. If there is not a clear pain situation an acupuncturist may
press on a few
areas to see if certain points are more reactive than others. The more
reactive ones are
often some of the points that are selected for needling as they show a
sensitivity or blockage
that can be improved with acupuncture. The most famous form of
palpation is a technique
called “Hara” which is pressure along different areas of the abdomen.
Discomfort at
particular points of pressure signify the need to “clear” particular blockages in the acupuncture system using
related points in other areas of the body.
Facial Diagnosis Facial
diagnosis involves the observation of color and color changes in
different areas of the
face during a given consultation. There are usually one or two colors
that appear in different
areas of the face and this becomes a foundation of treatment as colors
are representative of
acupuncture channels and indicate particular imbalances or patterns if the color or colors are prominent. These
colors may in fact change when the patient expresses different emotions and mainly show
up as a hue on the side or beneath the eye.
The Tongue Diagnosis The
tongue diagnosis is an inspection of the tongue in which the
 patient sticks out his/her tongue and allows the practitioner to see
the color of the tongue body, features on the tongue, moisture, cracks, coating and
thickness. Observing this information gives the practitioner
an invaluable idea as to inner organ function through the Chinese
medicine lens as well as determining relative levels of heat (red tongue body with a dry/yellow coating as one
example),cold, damp, dry and interior or exterior imbalances. The picture of the tongue to the right can give you a sense of what an acupuncturist is looking for in reference to the different acupuncture channels. The channel related to the Heart is located on the tip of the tongue, Lung behind it, Stomach/Spleen in the middle of the tongue, Liver/Gall Bladder on the sides of the tongue and Kidneys, Bladder and Intestines at the rear of the tongue. How the tongue looks in any one of these areas or as a whole will have a great impact on the diagnosis. The Pulse Diagnosis Sensing
the pulse may be the single most important and intricate technique to
master for determining
internal health as it relates to acupuncture and herbal therapy. A good
pulse diagnostician
will be able to determine many areas of focus simply by holding their fingertips
over the radial artery of the patient. An acupuncturist may hold on to
this pulse for
anywhere from 5 to 40 minutes during the initial consultations! Pulse
data includes the
rate, rhythm and intensity of the pulse which determines short and long
term heart issues by
measuring the relative stability of the heart and cardiovascular
system. There are over
30 qualities of the pulse on which data is recorded indicating relative
levels of resiliency,
vibration, width, hardness and consistency. These qualities are gauged
to determine emotional
stability as well as imbalances within the digestive system, hepatic system and reproductive system. The
information deduced from this diagnosis is revisited during each session and progress
is noted based on the changing qualities of the pulse over time.
There
are over 80 positions on the radial artery alone that an acupuncturist
can glean information
from. Many of these positions represent different internal organs in
the body and project a
general state of harmony or disharmony through the specific position.
In addition to the 80+
positions on the radial artery, some practitioners use the carotid
artery in the neck and
others measure certain diagnostics through the abdominal aortic artery.
These are some of the most commonly used diagnostic inputs acupuncturists will consider. There are other diagnostic techniques in Chinese medicine, especially as you explore various schools and lineages. But hopefully, understanding this sampling of these ancient traditions offers some insights into a complex process. So, if you’re tempted to ask, “Where are you going to put the needles?” you can be prepared for the much more involved answer that it evokes.
Ryan
Diener is an acupuncturist and herbalist who became cofounder and
Director of Holistic Health Associates in downtown Frederick. Ryan
enjoys teaching, counseling and working with his patients to improve
their mental and physical wellbeing, and engaging them to live up to
their highest potentials. He may be contacted at Acupuncture
Frederick MD or (301) 6201414.
Reprinted
with Permission.
|
||
 |