In This Chapter
^ Understanding complementary medicine diagnosis
^ Asking questions about your health
^ Examining the tongue and pulse for clues to your health
^ Exploring complementary medicine testing and diagnostic devices
^ Looking at the evidence for diagnoses
Complementary medicine practitioners use a range of techniques to assess your health and diagnose the root cause of your illness or imbalance. They use this diagnostic information to determine the best course of treatment for you.
Some diagnostic approaches are more art than science, with their roots going back hundreds or even thousands of years. These approaches include tongue and pulse diagnoses, as used by practitioners of traditional Chinese, Japanese, Tibetan, and Ayurvedic (Indian) medicine. These diagnostic methods involve great sensitivity and skill on behalf of the practitioners who claim they’re really useful tools in ‘reading’ the body. However, many modern medics reject these techniques because they haven’t been scientifically proven.
Other diagnostic methods are more firmly rooted in science and some 21st century complementary medicine practitioners use many diagnostic techniques that are also used by orthodox medical doctors, such as laboratory tests, blood analyses, and x-rays.
In this chapter, I give you a guided tour of the different types of complementary medicine diagnosis and point out how reliable they may (or may not) be.
Finding Out about Diagnosis in Complementary Medicine
In this section, I discuss the following main forms of diagnosis used by complementary practitioners:
U Questioning: Includes questions about your physical and emotional health, symptoms, lifestyle, diet, and sleep patterns
U Observation: Includes examination of your tongue, your general appearance, and gait, as well as iris diagnosis and micro-diagnosis
U Palpation: Includes checking pulse and pressure points, Hara (abdominal) diagnosis, and foot reflexology
U Physical diagnosis: Includes muscle testing and mobility testing
U* Clinical signs: Includes examining changes in the appearance of your skin, hair, nails, and eyes
U Charting and calculations: Includes food diaries, sleep diaries, and Tibetan medical astrology
U Testing: Includes laboratory tests and electro-diagnostic measurement devices
U* ‘Energetic’ diagnosis: Includes methods for sensing the electro-magnetic field around your body
Questioning
Many practitioners start by asking you to describe any current symptoms that you’re concerned about. They’re interested in when the symptoms started, their nature and severity, and what alleviates or aggravates them. Your practitioner will also want to know of any treatment you may have had so far and its effect. The practitioner will also ask about your medical history, including any previous ailments, accidents, or surgery, and details of any present or past medication.
Always remember to inform your practitioner of any pharmaceutical drugs, nutritional supplements, and herbal, homeopathic, or other medicine you’re currently taking, or any other therapies you’re undergoing, in case of any possible interactions.
Jane came to see me suffering from persistent, unexplained tiredness (a common medical syndrome called TATT, or ‘tired all the time’). Her doctor had carried out various medical investigations but nothing abnormal had revealed. Jane had been advised to take some time off and get some rest. She’d followed this advice but felt no better. A dietary analysis showed that she was eating and drinking a huge amount of energy-sapping foods, that is, foods that are low in nutrients and high in stimulants. She lived on coffee, fizzy drinks, sugary sweets, pizzas, and ready meals. She was also unhappy in her job and felt stressed because she had the workload of two people after a colleague had left and not been replaced. Her sleep habits were also erratic because she often worked late into the night.
Tongue diagnosis revealed nodules at the rear and a red tip, which are signs in Traditional Chinese Medicine (TCM) that the person is under stress and has kidney/adrenal weakness. The adrenals are small glands that sit on top of your kidneys and control the release of the hormone adrenalin, which speeds up your heart rate and increases the oxygen supply to the muscles in times of need such as fight, flight, or fright.
Palpation of the pulse revealed a weak pulse overall and a deep, faint pulse in both the ‘kidney positions’ on her wrists (TCM practitioners take pulses for each of the internal organs at different points on the wrist). A laboratory saliva test confirmed that she had adrenal insufficiency – that is, her adrenals were worn out due to continued over-stimulation from dietary stimulants and stress.
Thus, from a holistic point of view her tiredness could be seen as due to a combination of (i) dietary insufficiency (a lack of essential nutrients), (ii) adrenal insufficiency (over-stimulation of the adrenal glands due to stress and dietary stimulants), (iii) inadequate rest and poor sleep, and (iv) work stress and job dissatisfaction.
Jane’s immediate symptoms were remedied by means of dietary change, nutritional supplementation, adrenal support, and natural sleep aids. Jane also made the decision to change her job and to join a gym. Within a month she was bursting with energy, her tongue and pulse were normal, her sleep was good, and she was happily in training for a charity trek on Mount Kilimanjaro!
Sv—
The practitioner may also be interested to know about the health history of your immediate family (in particular your parents, grandparents, and siblings), and may use this to determine your health risk factors and predisposition to disease. For example, women who have more than one female relative diagnosed with breast cancer have an increased risk of developing it themselves. In these situations, the practitioner can then advise you on steps to take to decrease whatever your risk may be. In some traditional medical systems, such as Traditional Chinese Medicine (TCM), knowledge of your parents’ and grandparents’ health history, and the order of your birth in relation to your siblings, is used to determine how much ‘source Qi (pronounced Chee) - that is, core vitality – you have.
Other questions are likely to cover your diet, lifestyle, stress levels, mental and emotional health, and your daily habits such as sleep, exercise, and recreation. Homeopaths, for example, use answers to lifestyle questions to build a picture of your ideal constitutional remedy (for more about this, see Chapter 10 on homeopathy).
Most complementary practitioners consider you from a holistic viewpoint. They use these different bits of information to build a picture of your current symptoms in the context of your overall health and well-being.
You don’t have to have a health complaint to go to a complementary medicine practitioner. Some people are symptom-free but choose complementary medicine because they believe that it can help them optimise their health and prevent disease. In such cases, the questioning may be more focused on your existing lifestyle and health and desired optimal health goals.
Observation
In observational diagnosis, the practitioner may examine a particular part of the body to identify signs that reflect something going on in another part of the body, or may observe the movement and appearance of the whole body to determine more general underlying factors. This section includes descriptions of some of the more common types of observational diagnosis.
Tongue diagnosis
Tongue diagnosis is used by most traditional Chinese, Japanese, Tibetan, and Ayurvedic (Indian) medicine practitioners. You’re asked to stick out your tongue so that the practitioner can observe its shape, colour, coating, and any movement. According to these traditional medicine systems, different tongue shapes and appearances can give valuable information about specific internal organ function as well as general health. For example, a thick, yellow coating in the middle of the tongue is considered indicative of sluggish bowels and constipation.
Chinese and Japanese tongue diagnoses are the most detailed, with more than 100 different types of tongues identified, all relating to different patterns of individual organ balance. Tibetan and Ayurvedic medicine use a more simplified form of tongue diagnosis that concentrates on establishing the general balance within the body’s constitution, rather than focusing on individual internal organs. Western medicine also uses a simple form of tongue diagnosis.
Little scientific evidence supports the more detailed form of tongue diagnosis used in the traditional medical systems and by many complementary medicine practitioners today. Chapter 3 has more details on tongue diagnosis.
Iris diagnosis
Also known as Iridology, In this form of diagnosis the practitioner examines your iris (the coloured part of your eye) by means of either a special measurement device or a hand-held magnifying glass designed for eye inspection.
The practitioner looks for specific marks and signs in particular parts of the iris that are believed to correspond with specific parts of the body. This form of diagnosis is often used by naturopaths or nature cure practitioners and sometimes by people solely trained in this technique. Some slight evidence supports the use of this technique but more research is needed.
For more about this intriguing form of diagnosis, read Chapters 8 and 13 on nature cure and naturopathy.
Micro-diagnosis
The face, ears, abdomen, back, feet, fingers, and toes can be used diagnostically to reflect the body as a whole. This is called Micro-diagnosis. For example, in TCM face diagnosis, the areas under the eyes are linked to the kidneys, so grey bags under the eyes are believed to be indicative of adrenal exhaustion. In Japanese finger diagnosis the thumbs are linked to the lungs, so deformed or weak thumb nails may be indicative of past or underlying lung conditions such as asthma. However, the evidence for this is only anecdotal so this form of diagnosis is not accepted by many doctors.
More on this type of diagnosis appears in Chapter 7 on Japanese medicine.
Appearance and gait
Before diagnosis, the practitioner observes you from the moment you enter the room, noticing your gait and general appearance in case either has a bearing on your symptoms. For example, you may visit an osteopath because of back pain and as you walk in, the practitioner may observe that you have a very lopsided gait. Further physical investigation may reveal that one leg is longer than the other and that this leg discrepancy causes pelvic and lower-back imbalance, which causes the back pain. By re-adjusting pelvic alignment and recommending the use of special inner soles for your shoes, called Orthotics, Your back pain may be dramatically relieved.
Alternatively, a practitioner may observe that a person’s gait is very stooped and their appearance dishevelled, prompting the practitioner to ask questions about mood and self-care. This combination of observational diagnoses and questioning may reveal that the person is actually suffering from depression even though this had not been mentioned as a symptom. Depression can then be addressed by the practitioner.
This type of observational diagnosis can have preliminary importance but then needs to be backed up with other diagnosis to confirm the significance of the observation.
Palpation
Palpation Involves applying light pressure to different parts of the body to determine the body’s response, or to feel for areas of tenderness, pain, heat, and so on. The most commonly used forms of palpation are pulse diagnosis, pressure point diagnosis, and abdominal diagnosis.
Pulse diagnosis
Traditional Chinese, Japanese, Ayurvedic, and Tibetan medicine practitioners rely strongly on pulse diagnosis. In Western medicine, only a single pulse is taken at the wrist to determine the rate of blood flow with each heartbeat. However, in the traditional medical systems, pulses are taken at three points on each wrist and at different depths. Each position is said to correspond to a different internal organ and to give information about its functioning.
The well-known Tibetan physician, Dr Yeshe Donden, was invited to carry out a ward round at an American hospital. He was presented with patients without being given any information about their medical condition or medical history and invited to diagnose them simply with his pulse-taking skills. The American doctors were amazed when, without any questions to the patients, Dr Donden was able to accurately diagnose health problems, including a faulty heart valve.
Western medicine finds it hard to comprehend this concept of tuning into the body using just the artery on the wrist and because this technique is difficult to measure and verify scientifically, many medics dismiss it.
More information on different types of pulse-taking appears in the chapters of Part II.
Pressure points
^W-f^ Many complementary medicine practitioners palpate the skin in order to determine points of sensitivity or pain known as Pressure points. Pressure ‘ A ‘ points can give information about the condition of underlying tissues and organs but may also be used to give information about related internal organs according to Meridian Or other body maps. For example:
Osteopaths, chiropractors, and massage therapists palpate to locate areas of inflammation and to get information about structural alignment and the health of the joints and surrounding tissues.
IU Reflexologists use painful points on the feet to diagnose internal organ health according to a zone system that links specific points on the feet with specific internal organs and body parts.
I Acupuncturists palpate to locate points where the flow of vital energy, or Qi, May be blocked in the acupuncture meridians (energy channels).
Painful pressure at certain points is believed to indicate malfunction in related internal organs. For example, a point on the upper side of the foot, above the groove between the big and the fourth toes (known as the Liver 3 point) is said to become very sensitive if a person has a hangover and a weakened liver due to excess alcohol!
Little evidence supports these forms of diagnosis, other than the fact that they’ve been used for thousands of years. Many medics reject these forms of diagnosis, and more research is needed.
For more on these approaches see the relevant chapters that cover osteopathy, acupuncture, and reflexology.
Abdominal palpation
Another form of palpation is Abdominal diagnosis, Also known as Hara Diagnosis or Ampuku. This involves firm pressure to different parts of the abdomen, which is used both diagnostically and to give treatment. No real scientific evidence supports the use of this technique, although it’s been used clinically for hundreds of years, which many feel is a testimony to its effectiveness.
For more on abdominal diagnosis check out Chapter 7 on Japanese medicine.
Physical diagnosis
Physical examination is an important part of diagnosis for several types of practitioners, especially osteopaths and chiropractors. These practitioners usually ask you to bend your spine and move your joints in different ways to determine your level of mobility and your range of movement.
Kinesiologists and Touch for Health practitioners use muscle testing as part of their examination. This testing involves ‘challenging’ a muscle by applying gentle pressure that you have to resist. Kinesiologists believe that the muscles are linked to specific internal organs and body systems and that muscle weakness reflects internal organ or body system weakness.
Chapters 14 and 15 cover osteopathy and chiropractic, and Chapter 16 explains kinesiology.
Clinical signs
Clinical signs are like signposts on the road to a destination (the diagnosis). These signs may be changes in the appearance of your skin, hair, nails, eyes, and so on, or perhaps a bloated abdomen or swollen glands. All these signs may be linked to specific diseases or imbalances according to the various complementary medicine approaches. So, for a practitioner of Traditional Chinese Medicine, spots around the mouth would be linked to problems with the large intestine and digestion, according to the meridian pathways. Ridged nails may indicate a zinc deficiency to a nutritionist.
Complementary medical practitioners who’ve completed a full, professional training course of several years (usually a degree course that also includes practical training in clinical skills) are also carefully trained to recognise specific physical, emotional, or mental signs that may indicate serious diseases requiring medical attention – for example, excessive thirst and weight loss are potentially linked to diabetes, while chest pain and breathlessness may be linked to heart disease.
Sometimes, clinical signs may all be linked together to confirm a diagnosis. To an acupuncturist, for example, headaches, irritability, abdominal fullness and bloating, a love of sour foods, and an aggravation of symptoms in the spring are all linked to a liver imbalance. This diagnosis is according to the system of correspondences of Five Element Theory (to find out more about this, see Chapter 4) and makes perfect sense to a TCM practitioner, but wouldn’t make a lot of sense to an orthodox medic with no background in TCM.
Charting and calculations
Several complementary medicine disciplines use charting or paper calculations as part of their diagnosis. A nutritionist is likely to ask you to complete a food diary and uses it to analyse your nutritional status and the suitability of your diet. Tibetan and Ayurvedic physicians sometimes calculate your birth chart and use astrology to determine what sort of diseases you may be predisposed to. Naturopaths may ask you to keep sleep, food, and lifestyle records that may be analysed for patterns as part of the diagnostic process.
Testing
Laboratory or home-kit testing used by complementary practitioners can include blood, saliva, hair, urine, and stool tests. These tests may be used to determine many things including vitamin and mineral status, allergies, food intolerance, hormone balance, the presence of parasites, and more.
Manipulative therapists, such as osteopaths and chiropractors, may use x-rays and scans to check on structural balance; they may also use equipment to check blood pressure or small hammers to test muscle reflexes.
Many of these forms of testing are also used by medical doctors and are well-accepted in orthodox medicine although some of the newer tests, such as tests for food intolerances remain controversial despite growing scientific evidence to support their use.
Other methods of testing may involve specially designed devices such as the equipment used to examine the eyes in iridology or the electro-acupuncture devices used to measure the flow of vital energy (qi) In the acupuncture meridians (see Chapter 22 for details on these energy medicine devices). These are less well-accepted in orthodox medicine and have little scientific evidence to support their use.
Energetic diagnosis
Energetic diagnosis involves assessing the Aura Or electro-magnetic field believed to surround each person and may be determined using the hands or a measurement device.
In manual diagnosis the practitioner runs their hands above the surface of your body to detect subtle changes in the electro-magnetic field according to changes in sensations felt in the hands that may indicate health problems.
In other cases a diagnostic measurement device may be used. An example of this is Kirlian photography, whereby images of the energetic field around the body are alleged to be captured photographically, (see Chapter 22 for more about such energy medicine techniques).
These methods of ‘energetic’ diagnosis are controversial and aren’t accepted within conventional medicine because no real scientific evidence supports them.
Complementary versus Orthodox Medical Diagnosis
Many different forms of diagnosis are used in complementary medicine. Different therapies employ different techniques and the diagnoses may not always agree. The diagnoses can also be quite different from orthodox medical ones.
Practitioners must take great care to ensure that they don’t miss spotting any serious medical conditions.
Met
Taking the necessary precautions
Certain symptoms are regarded as red flags that require proper medical investigation. A well-trained complementary medicine professional should spot these and refer you on to your GP or other medical specialist. However some complementary therapists who have only undergone a very short training, such as a short course in a particular type of massage, may not know how to spot these warning signs.
If you have any of the symptoms listed below, or are in any doubt about a diagnosis you’ve been given, seek a second opinion from a medical practitioner or another well-qualified complementary medicine practitioner:
I Chest pain or discomfort, especially if accompanied by sudden shortness of breath.
I Persistent cough or coughing up of blood.
I Prolonged difficulty breathing or swallowing.
Unexplained bleeding, such as from the vagina or anus. I Persistent headaches or head pain.
Blurred vision or other persistent visual disturbance.
Unexplained lumps, swellings, or persistent pain.
I Changes in size or appearance, or presence of lumps, in breasts or testicles, plus any discharge.
I Unexplained dizziness, mental changes, or memory loss.
I Persistent stomach or abdominal pain.
I Changes in size, shape, or colour of any mole on the skin or any sudden itching or bleeding from a mole.
I Sudden skin changes, such as a rash, especially if accompanied by high fever.
I Unexplained swelling of the legs or abdomen.
I Severe allergic reactions.
Prolonged, unexplained weight loss and/or loss of appetite and/or excessive thirst.
I Difficulty urinating, such as experiencing blockage and being unable to maintain flow (men) or increased frequency and painful, burning urination (women).
I High fever or loss of consciousness.
I Prolonged, unexplained fatigue.
I Compulsive repetition of simple daily tasks, excessive mood swings, paranoia, or delusions.
All these symptoms may be indicative of serious health conditions and need to be investigated fully.
Weighing up the evidence
Although many of the complementary medicine diagnostic techniques have little, or no, scientific evidence to support their use, don’t forget that many of them have been used for hundreds or even thousands of years.
Many practitioners who’ve practised for years to refine these diagnostic skills are convinced of their effectiveness and feel it may be only a matter of time before scientific research is able to confirm their accuracy.
