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Traditional Chinese Medicine (TCM) and Ayurveda use
similar diagnostic procedures. In TCM, a constant flow of qi, which is the
life force that flows through our bodies and the universe – is central to
good health. When there is too little, too much, or stagnating qi, illness
results. This same basic concept applies to the system of Ayurvedic
Medicine, where the human body is viewed as a series of channels and disease
is seen as an impairment to the flow of energy through these channels. Both
TCM and Ayurvedic practitioners perform a series of examinations and
observations which include: looking, listening, smelling, asking, and
touching. Each symptom means very little by itself, and only when viewed in
conjunction with other signs can a proper diagnoses come about. Both systems
base diagnosis on an individual’s body type. TCM bases its analysis of body
type on a Yin, Yang theory, which refers to polar opposites in the universe
- like hot and cold, dry and damp. TCM practitioners see the body as a
unified whole with opposing aspects-every element, function and feeling has
a complementary opposite. They see illness as a result of yin/yang
imbalance. A patient possessing Yin (being cold), qualities would exhibit a
passive, quiet manner, whereas a Yang (being hot), individual would show an
outwardly aggressive, talkative, irritated manner. Ayurvedic's
classification of an individual's body type is based on Doshas. All
individuals possess three doshas; however, at birth one dosha is usually
predominant, and this dosha becomes that individual’s body type throughout
their lives. The three doshas are Vata, Pitta and Kapha. A patient with
mostly Vata (air-ether) traits could be tall, or short with a thin frame and
prominent bones due to under-developed muscles. Their extremities tend to be
cold, and eyes are small with thin lashes. They suffer from dryness of the
skin, eyes and nails being brittle, they are nervous, active and alert.
Pitta individuals are generally medium height with a moderate weight frame.
The skin is soft and warm and not as dry as Vata types and they have sharp
and penetrating eyes. Pitta types can be aggressive and intelligent,
determined, irritable and at times jealous. Kapha individuals tend to have
large, heavy frames and cool skin, which is on the pale and oily side. They
usually have big attractive eyes with thick lashes and their minds are calm,
slow and receptive. They can be greedy, attached and self-contented, but
also steadfast and loyal. Appearance also is a factor in TCM, where a strong
robust appearance indicates strong organs, and a weak looking, frail
appearance would indicate weak organs. The order of examination is of the
utmost importance and some signs are far more significant than others in
diagnosis, such as the pulse and tongue. This diagnostic emphasis on the
pulse and tongue common to both TCM and Ayurvedic systems. Both systems
believe that the best time to take a pulse is in the morning when the body
is at rest and the pulse is cool. The best time is before 10 a.m. after
expelling stool and urine and before eating. TCM suggests taking a pulse at
the radial artery near the wrist, although it may be felt at various points
of the body. Ayurvedic Medicine also suggests taking the pulse at the radial
artery, but has different points of location on the wrist for each of the
three doshas. Finger positioning is the same in both systems, where the
index, middle and ring finger drape over the top of the wrist and rest on
the underside of the wrist, with the index finger closest to the palm of the
hand. Both systems distinguish between various types of pulse. In TCM they
are based on speed, width, strength, shape and quality, length, and rhythm.
TCM has about eighteen primary types of pulses which are very important in
determining possible disharmonies. Ayurvedic Medicine categorizes the
different pulses by types of ailments. For example, an asthmatic individual
would have a thin, steady, accelerated, hard, speedy, intense, hollow pulse
that could be felt under all three fingers. By contrast, an obese person
would have a thick, slow pulse which is the same as a person with excess
phlegm in the system. According to Ayurvedic Medicine, a healthy pulse
should be continuously cool and slow in the morning, hot at noon, and fast
in the evening. In TCM various areas on the wrists correspond with different
organs. For Example, first position on the left wrist corresponds to the
heart, but on the right wrist it corresponds to the lungs, or second
position on the left wrist corresponds to the liver, and on the right it
corresponds to the spleen and so on. This same system of “wrist/organ
correspondence” is also true in Ayurveda, where the three wrist positions
reveal the health of twelve different body organs. This correspondence is
possible because certain “meridian” or energy lines connect the organ energy
currents to corresponding wrist positions. The tongue is another important
factor in determining an individual’s health. In TCM, the tongue’s color is
of the utmost importance, a normal tongue would appear pale red and somewhat
moist. A pale tongue would indicate that there is deficient blood, qi, or
excess cold. A red tongue would be a sign of a heat condition in the body,
and scarlet would signify extreme heat. A purple tongue indicates that qi
and blood are not flowing harmoniously and pale purple signifies an
obstruction related to cold. In general, a lack of flow due to cold makes
the tongue appear moist, and a heat condition would result in a dryness of
the tongue. The coating, fur, or moss on the surface of the tongue is the
result of spleen activity. The tongue moss covers the whole surface or
patches of the surface of the tongue and can vary in thickness, color,
texture or general appearance. In a healthy individual the density of moss
is relatively uniform, although it may be slightly thicker in the tongue’s
center. The moss is thin, whitish, and moist, and the tongue’s surface can
be seen through it. A thin moss can be normal, but during an illness it may
be a sign of deficiency. A very thick moss is nearly always a sign of
excess. Ayurvedic medicine is very similar its observation of the tongue.
The color, size shape and coating help in diagnostic procedures. A blackish
brown color shows Vata disorders. Yellow, green or reddish colors suggest
Pitta problems in the liver or gall bladder. Kapha problems are revealed by
a whitish color. Blue may suggest heart problems, whereas blue or purple
would indicate stagnation or liver disorders. The coating of the tongue
suggests toxins in the system, e.g. when only a thin coating is on the
tongue, the person is generally healthy. A thick, white coating indicates
Kapha. Thick greasy, yellow or inflamed tongues suggest fermentation or
Pitta conditions. Both TCM and Ayurveda use the tongue as a map to the
diagnosis of various organs. The specific areas of various “tongue/organ
correspondences” are remarkably similar in both systems of diagnoses e.g.
the heart being at the very tip, the stomach in the middle and kidneys
located in the back area of the tongue. While both tongue and pulse play an
important role in determining illness, other factors such as facial color
also need to be considered. In TCM the color of the face and it’s moistness
are closely related to the body’s Qi and blood. The Nei Jing states that,
“all the Qi and Blood of the Meridians pour upward into the face.” Normal
and healthy facial color would appear shiny and moist. White is associated
with disharmonies of deficiency or of Cold, whereas a darkness or blackness,
usually the greatest under the eyes, is associated with deficient kidneys
and congealed blood. In Ayurveda, facial observation deals mostly with the
expressions of the individual. For example, liver lines between the eyebrows
are a sign of repressed anger, whereas worry lines across the forehead
signify excess Vata or worry, and dark under eye rings suggest a kidney
disorder. Observation of the eyes in diagnoses is also very important to
both healing systems. TCM states that although it is the liver that opens
into the eyes, the health of all the organs is reflected in them because the
pure Qi of all the organs, “pours through the eyes.” Lively eyes indicate
that the Qi is uninjured, stiff “wooden,” inflexible eyes show either a Wind
or a deficient condition, and if the whites of the eyes are red, it is a
sign of a Heat condition caused by external pernicious influences or excess
heat of an organ. Ayurveda believes that the eyes help to show an
individual’s dosha, (Vata, Pitta, or Kapha). Generally, Vata eyes are small
and unsteady, Pitta eyes are sharp and piercing, reddish or bloodshot, and
Kapha eyes appear large, wide and white. Healthy eyes are characterized as,
“serene, cheerful, and beautiful.” Observation of an individual’s secretions
and excretions is another necessary step when diagnosing an illness in both
TCM and Ayurveda. In TCM, the principal secretions and excretions are
phlegm, vomit, urine and stool. Because the physician may see phlegm and
vomit, they are considered part of the “Looking Examination”. Urine and
stool are usually discussed with the patient and are therefore covered in
the “Asking Examination”. The same is true in Ayurveda where by asking and
observing, a physician can gain knowledge of an individual’s constitution
through the type of secretions and excretions they exhibit. By taking all of
these signs into consideration, weighing and comparing them to other signs
in the examination, an accurate diagnoses is eventually attained. Although
TCM and Ayurveda practice many of the same diagnostic techniques, this
thesis also illustrated how each system is distinct through its discussion
of Doshas and Qi. Both TCM and Ayurveda are ancient healing systems of the
East which are finally being valued for their non-invasive techniques here
in the West. In contrast to Allopathic medicine which simply treats specific
symptoms, both Eastern systems view the patient as a unique individual whose
habits and lifestyle must be taken into consideration when making a
diagnosis and prescribing treatment. As a result of this individualized,
holistic approach, both TCM and Ayurveda offer patients a viable alternative
to traditional Western medicine.
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