A major hurdle for Westerners

[Guest guest]

One of the biggest surprises for Westerners is how much TCM relies on what the

patient reports. We're not used to this. We're used to being treated like idiots

by Western doctors who don't believe anything we say unless it can be verified

by objective testing. Not only do Western doctors tend to disregard anything

observed and reported by patients unless revealed by " objective " tests, they

also tend to disregard and discount their own powers of observation.

 

Chinese medicine is very different from Western medicine in the way patients are

regarded as well as a number of other things (like being careful to identify and

treat root causes instead of merely treating symptoms as Western medicine does).

A great deal of successful TCM diagnosis rests on listening to what the patient

says.

 

One of the interesting things about listening to patients is that they

frequently will use some of the same terminology to describe some things

regardless of cultural differences. There are some cultural differences. For

example, you won't hear many Westerners describing a pain as " distending " , but

many of the other descriptions won't vary a lot across cultures.

 

When you start to read a lot about TCM and look at diagnostic criteria, in a lot

of books you will see criteria arranged according to " Symptoms " and " Signs " . A

symptom is what the patient reports. A sign is what the healer can observe. The

condition of the tongue and pulse automatically are grouped under " Signs "

because the healer does a tongue and a pulse diagnosis. Some of the symptoms

will also be signs because the healer can observe these things too. For example,

if the patient complains of abdominal muscles being rigid, the doctor often can

feel this when s/he palpates the abdomen.

 

But, most of the criteria will be listed under symptoms because TCM relies very

heavily on what the patient reports.

 

When it comes to judging Heat and Cold in TCM, what counts the most is what the

patient reports. As used in TCM, this actually is a lot more sophiticated and

revealing than the Western reliance on what the thermometer says. Many Western

doctors mistakenly believe that a high thermometer reading equals infection and

a " normal " or even below normal reading equals no infection. Even within the

framework of Western medicine, this is not always true. For example, some viral

infections can be associated with below normal body temperatures. The patient

will report feeling hot and feverish even though the body temperature is below

normal. White blood cell counts may be abnormally elevated or significantly

below normal. Titers to infectious agents may be very elevated. In short, every

indication exists of infection except the body temperature is below normal when

measured by a thermometer. Under these conditions, many Western doctors will

discount the possibility of an infection. TCM healers will not. What counts the

most is what the patient reports. If the patient reports feeling too hot, the

TCM healer is going to listen and use this information to zero in on identifying

the root. Depending on the other TCM symptoms and signs, there may well be an

infection in the body that does require herbs with anti-bacterial or anti-viral

actions. There may be a Heat condtion but no infection in which case other

strategies are called for. Or, the healer may be dealing with a case of True

Cold, False Heat in which the healing strategies need to be directed toward

warming the body even though the patient feels hot.

 

The bottom line is that in TCM patients are listened to very carefully. They're

also observed very carefully by the healer. If you see a TCM healer - doctor,

herbalist, acupuncturist, etc. - from the time you walk in the door, the healer

is observing and analyzing you. Things such as how loud or soft your voice is,

how firm or limpid your handshake is, your posture, if you make eye contact, if

you appear passive and withdrawn or assertive, the tint of you complexion, the

sparkle or lack of sparkle in your eyes, etc. are being noted and filed away

mentally in order to arrive at the correct diagnosis. When you start to speak,

the TCM healer is paying attention to everything you say plus your way of saying

it. Do you speak rapidly or slowly? Do you tend to stare off into one spot in

space or are your eyes darting around the room? All these things and more are

helping the healer to determine the root cause(s) of your problem and the

appropriate treatment strategy.

 

TCM healers do not to just treating symptoms or one size fits all

treatments. Everything is individualized. If you go to a TCM healer complaining

of nausea or breathing problems or any other symptom or medical condition, the

TCM healer is not going to automatically give you one herb or treatment that

s/he gives to any patient who walks in with the same complaint. The TCM healer

is going to want to know WHY you have nausea or breathing problems. Only when

the root is known will the TCM healer treat the condtion.

 

Western medical conditions and TCM syndromes rarely correspond. The common cold

does correspond to Wind Cold (though it's not the only Western medical condition

to do so). Arthritis and some rheumatic condtions do correspond to what the

Chinese call Bi Syndromes. But when it comes to most conditions defined by

Western medicine, they do not correspond to TCM syndromes. Instead, any number

of TCM syndromes can manifest as the Western-defined medical condition. For

example, the root cause of asthma or other breathing problems may be in the

lungs or Lung meridian or Lung system as defined by TCM. But, the root cause of

asthma and other breathing problems may lie in the Kidney. (Kidney Refusing to

Grasp Lung Qi.) Or, in some cases the problem may lie in the Liver (as in Liver

Invades Stomach, Stomach Qi starts flowing in the wrong direction, acid reflux

results, the acid reflux up the esophagus causes the muscles in the area to

spasm which in turn causes breathing problems and in extreme cases if untreated

over a period of time the acid contents of the stomach may be aspirated into the

lungs where it damages the lungs and creates breathing problems and may even

result in death eventually). The treatment will vary according to what the root

cause is. There are no one size fits all treatments in TCM.

 

I also want to stress that what TCM healers treat are not Western-defined

medical conditions but TCM syndromes - imbalances as defined by TCM. When the

root is corrected, this often has the effect of making some Western-defined

medical conditions disappear altogether or enabling the person to require less

Western treatment. For example, diabetics may require less insulin or now be

able to control the diabetes by diet. Or, the diabetic has to continue to take

insulin but no longer experiences the wide swings in blood sugar from up to down

that many diabetics on insulin experience.

 

Victoria

 

 

 

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