Wednesday, February 22, 2012

Generalities to Guide Clinical Practice (A Quick Guide)

There are certain answers that come up frequently during the “inquiry” phase of the diagnostic interaction in Chinese medicine.
For instance, whenever you see secretions or excretions that are yellow, no matter where they appear, the diagnostic significance always points to heat. The same can be said of clear or white secretions, they indicate cold. That can be speaking of urine, phlegm, or any secretions, even ejaculate. (I should note that ejaculation *should* be white, but not clear which might indicate a Kidney deficiency such as yang deficiency in which case we could say this indication suggests internal cold of the deficiency type.)
As is the case with all of Chinese medicine diagnostics, these findings need to be triangulated (quadrangulated?) with the three other pillars of diagnosis, namely palpation (including pulse diagnosis), observation (including tongue diagnosis), and “listening/smelling”.
These generalities can easily guide a practitioner toward relevant, accurate, and efficacious diagnosis. Enjoy.

GLOBAL GENERALITIES
Discharges
Clear and copiouscold
Yellow and scantyheat
Cloudydamp
Pustoxicity
Yellow to greenheat
Thin and wateryphlegm damp
Hard and difficult to expectoratedry phlegm
Pale pink, red, or purple urinebleeding
Sounds
Loudexcess
Softdeficiency
Aggravation
worse with reststagnation
worse with fatiguedeficiency
worse with heatheat
worse with coldcold
worse with damp weatherdamp in the channels
worse with pressureexcess
increases by eatingexcess
after sexkidney deficiency
with stressLiver Qi stagnation
before periodLiver Qi stagnation
after periodBlood deficiency
Amelioration
better with restdeficiency
better with movementstagnation
better with heatcold
better with coldheat
better with pressuredeficiency
diminishes with eatingdeficiency
Appearances
Redheat
Pale and flacciddeficiency
Pink or pale redyin deficiency
Nodular or lumpystagnation of Qi, Blood, or phlegm (or combination of the three)
Red with pusheat with toxicity
Pain
pain migratesWind in the channels
red, swollen, hot jointsheat in the channels
dull, distended, larger areaqi stagnation
sharp, fixed, smaller areablood stagnation
heavy paindamp
cramping paincold
burning painheat
Onset
Acute onset, short durationexterior
Slow onset, chronic durationinterior
excess pathologies tend to run their course quickly and are more intense.
deficiency pathologies tend to run chronically and are low-grade.
Times ‘O The Day
Dawnshao yang
Middaytai yang
Afternoon to duskyang ming
Dusk to midnightshao yin
Midnight to 3 amtai yin
3 am to dawnjue yin
Age
elderlytend to suffer from deficiencies
youthtend to suffer from excesses
childrencan be excessive or deficient
Liver Signs
Pathologies that are coincidental to the periodgenerally indicate a Liver involvement.
Pathologies that are stress inducedgenerally indicate a Liver involvement.
Gender Specific Issues
Women tend to suffer from a deficiency of Blood (through menopause, then Yin)
Men tend to suffer from a deficiency of Yin or Yang or Jing
Food and Drink
desire for warmcold
desire for coldwarm
Areas of Domination
flanksgall bladder
hypochondrium (includes back and front)Liver
lumbus (low back)Kidney
epigastric region (below ribs on midline)Stomach
“alternating” thingsShao Yang (GB)
one sided thingsShao Yang (GB)
File under “Duh”
coughLungs
palpitationsHeart
diarrheaSpleen

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