The 4 Ways Traditional Chinese Medicine Diagnoses Disease

When you go to a traditional doctor, you're used to getting blood drawn or maybe some physical exams, but when you go to a traditional Chinese medicine doctor, throughout history we've used something called the four examinations. In this video, I thought I would talk about what these are and how we diagnose disease in TCM. Hey guys, I'm Dr. Alex Hein, author of the health book Master of the Day and doctor of acupuncture and traditional Chinese medicine. So before we jump into this video, there are two very important links right below the video. The first is if you'd like to become a patient of mine locally in Los Angeles or virtually via telemedicine, you can reach out to my private practice and clinic right below this video. And the second is for a free guide, which is four daily rituals that can potentially help you add years to your life with traditional Chinese medicine. So they're both below this video. So our methods of diagnosis in traditional Chinese medicine exist independent of any labs. So traditional Chinese medicine is an entire health system or entire medical system, I should say. Meaning that with a few exceptions, that most internal medicine conditions we can diagnose independently of your traditional physician and treat independently of your traditional physician. Now that may seem far-fetched to the average person, but I thought I would explain some of the methods of diagnosis that we use because when I first heard about this, I found it to be very, very interesting. So the four examinations, as they are sometimes called, are first of all inspection or asking, listening and smelling, inquiry and palpation. So when we talk about inspection or asking, there are a few different ways that we can interpret this, but the first and most obvious is just looking at the patient or looking at the person in front of you. So for example, when you look at someone and their complexion is white and pale like mine, that pale complexion is diagnostic also within traditional medicine. You know, you have some patients that come in with anemia and they are ghost white. You have people in shock, they go ghost white. And you have, for example, later stage cancer patients that have an ashen complexion, a certain kind of pallor that does not look good. And these are diagnostic conditions, sometimes on their own and very often with other methods of diagnosis. But that's true within my field as well. But one of the first things we look for is what people call shen or the spirit. You look into someone's eyes and all of us know, maybe not in words, but the feeling of when you look into the bright, sparkling eyes of a little kid running around energized or the passionate eyes of someone doing what they love and the difference between looking into the eyes of someone who's on their deathbed or an elderly person that's completely checked out. All humans instinctively recognize that feeling they get when they see that look in the eyes. That is what we call the state of the spirit. The spirit as a general concept, well-spirited or lacking this kind of luster and brightness. So everyone knows that feeling because we've all seen that in someone's eyes. That's one way of diagnosing the state of the spirit. Now on top of that, you have the body appearance on its own. The person's body shape and where they carry their weight also can be diagnostic. Eye color or eye discoloration can be diagnostic. The yellow eyes of someone with jaundice is very, very diagnostic. You don't see it often in daily life, but an internal medicine doctor, I'm sure, has seen that. On top of that, we say the skin, the hair, and the nails are diagnostic. Very often, the nails, the skin, and the hair are the status of what we consider the blood. So the blood is almost the moisturizing quality, sometimes related to hormones, sometimes related to other factors. But these can indicate certain deficiencies or certain patterns of pathology. Now the second examination is what's sometimes translated as listening or smelling. Now there's a whole branch of Chinese medicine called five element or five E that utilizes, for example, the color around the person's face, often around the eyes, the odor they give off, the dominant smell, which can be, for example, putrid or vinegary as a method of diagnosis. Now the color and the smell of someone, like one of the ancient texts describes a person with diabetes as smelling like rotten apples. And if you've ever smelled someone who's basically in a state of ketosis or someone sometimes who's diabetic, there can be a very distinctly fragrant smell that you do not smell on the average person. So for some people, the smell by itself is very diagnostic, but sometimes the sound of their own voice. Again, five element practitioners utilize the patient's voice as a method of diagnosis to diagnose which of the phases is out of balance. So it's very, very interesting, all these many ways of assessing pathology. In the short run, easy in terms of a clinical method, you can easily see where someone is in terms of exhaustion based on the sound of their voice. If you've ever talked to someone who's severely depressed, the voice sounds very different from someone who's completely manic. So these can lead us in a certain direction. The third examination is called inquiry, and this is where traditionally we've used what are called the 10 questions. So if you come into my practice and you're a patient, the patient questionnaire for a first patient, a new patient, will say things like, do you sweat easily? Do you never sweat? Are you able to sleep well, or do you have a hard time falling asleep? Are you having a daily bowel movement, or are bowel movements once a week? Are they hard, or are they more loose? So all of these are methods of assessing where the person is in terms of a pathological standard deviation from the norm. So a daily bowel movement is very different from a once a week bowel movement, or some people who have a few bowel movements in a month if it's really serious. All of these help us assess where you are in terms of this is the healthy state, and this is one deviation, or two, or 10 from being a healthy state. Now the fourth method of diagnosis is called palpation. And palpation, the most obvious forms of palpation we do are the palpation of the radial artery, the pulse, palpation of the abdomen in general. So abdominal palpation helps us understand what organs are chronically having problems, and what pathological factors we're observing in the abdomen as well. And on top of that, channel palpation involves actually palpating some of the channels. For example, in the forearm, or around the wrist, in the palm, or very commonly in the abdomen or on the radial artery there. These four methods of diagnosis help us understand what pathology is present. And the etiology, for example, for some people, that you can have anemia that has the same cause as a certain kind of headache that Chinese medicine might consider blood deficiency. And we can pull in all this information from, in particular, these four examinations. Now other doctors may use blood work, or they may use different kinds of labs or imaging on top of that, but these four examinations are staggeringly effective at treating most internal medicine issues. So that is very often how a TCM doctor diagnoses and treats what's going on in your body. That's what I have for you today, guys. Again, check out those two related links right below this video, and I'll see you soon. Bye-bye.