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To show how a Traditional Chinese Medicine (TCM) doctor compliments a patient’s particular medical condition with herbal remedies, I will use as an example my personal experience of being examined by a licensed TCM doctor in Hangzhou, P.R.China and the subsequent herbal treatment that I underwent. The doctor who evaluated and diagnosed me was Dr. Greg Livingston, a native of the United States, who is currently working on his PhD at Zhejiang University and practicing Traditional Chinese Medicine at the North American Hospital of Hangzhou.
By Wade Shepard of http://www.VagabondJourney.com
I went in to Dr. Livingston because of a persistent condition in which my body did not seem to heal minor wounds, which has penchantly resulted in unnecessary infection, and also for a seemingly minor stomach condition. In the process of coming up with a diagnoses for which herbs can be prescribed (if necessary), TCM doctors follow a step by step process known as the four methods of examination. Dr. Livingston describes this process as being the way in which a TCM doctor is guided into his diagnoses. The first step of this procedure is looking; which encompasses observations of the, “patients physical shape, the patient's manner, the way he or she behaves during the Examination” the tone of the face, the characteristics of the tongue (which includes its “moss” covering), and bodily secretions and excretions. The second method of examination is, listening and smelling. In this step the doctor listens to the patient’s voice, respiration, signs of mucus, and takes notice of his or her general smell. The third step in this procedure is, basically, asking. This is where the doctor is able to check his observations, derived from, the first two examination phases against the patient’s medical history, current and past symptoms, eating habits, urine and stool properties, and sleep patterns: all of which will provide clues as to the disharmony that the doctor is attempting to comprehend. The last method of examination is, touching. According to Kaptchuck, this is the most important stage in the whole diagnoses process. This step involves touching various acupuncture points and manipulating certain parts of the body to determine their outward qualities as well as to gauge the patient’s reaction (pain, discomfort etc. . . ). The “touching” phase of examination also includes analysis of the radial pulse. This is probably the most active part of an examination and is the action for which TCM has become known for. In Kapchuck’s book, The Web That Has No Weaver, he states that, “Chinese patients often speak of going to the doctor as ‘going to have my pulse felt.’” Even though this practice, most often, reveals the greatest amount of information in the examination procedure, it is by no means the only action that the doctor is performing; as many of the doctor’s other observations are taken so subtly that the patient usual does not notice. The actual mechanics of pulse analysis will be furthered explained latter on in this study.
When I entered Dr. Livingston’s practice area, I was told to sit upon a chair and to place my arm, forearm up, upon the examination table. Upon doing so, Dr. Livingston picked up my left wrist and began feeling for my pulse. Once found, he place his first three fingers side by side along my radial artery, on the thumb side of my wrist, and applied pressure. A very intense, meditative, look came over his face and he stared off intently as he took my pulse for three or four minutes. He regularly increased and decreased the pressure that he placed upon my pulse artery and alternated between fingers as he did so. Dr. Livingston then released his grip and then, without comment, went on to the radial artery of my right arm.
The practice of taking a pulse in a TCM examination is very intense and subtle procedure in which the doctor must rely upon his experiential faculties to arrive at a diagnoses. Each of the three finger positions on both wrist give indications of the conditions of different parts of the body. Different types of pulses that indicate various conditions can be labeled as being slippery, strong, heavy, thready, weak, short, long, etc. . . There are thirty different designations that describe the feel of a pulse. The doctor who practices pulse diagnoses must be able to feel for even the slightest of signs in the pulse that may indicate what part of a patient is in disharmony. On this Kaptchuk wrote, “When the physician takes a pulse, he or she is alert to a tremendous array of sensations that must be expertly understood and arranged as a unity- the ‘feel’ of an individual pulse.”
Dr. Livingston then tilted my head back into the sunlight and began looking for signs on my face that may reveal my symptoms. The face is one of the main areas that TCM doctors look for clues as to where of a patient may have a disharmony. Dr. Livingston pointed out to me that the “liver” section of my face, which is located on the upper bridge of the nose, looked a little jaundice and also that the “kidney” area, under the eyes, appeared to also be blemished. This observation was directly in accordance with TCM theory; as the kidney and liver are directly connected within the body and if there is a disharmony with one it is usually manifested by the other.
I was then told to open my mouth and stick out my tongue, which I did. A teacher of Ted Kaptchuk would, “describe the tongue as a piece of litmus paper that reveals the basic qualities of a disharmony.” Like the face, the tongue is divided into portions that directly relate to various organs. For example, the condition of the heart is indicated at the extreme tip, the lungs are just behind, with the gall bladder, spleen and stomach, and kidney following in that order towards the back (root) of the tongue. Whilst my tongue was outstretched to its full length, Dr. Livingston inspected it very closely and pointed out that certain parts of it were covered with moss; which is a white coating over the tongue that can be of various consistencies and in varying locations. This “moss” coating is also very indicative of a patient’s internal symbiosis. “It [the moss] can vary in thickness, color, texture, and general appearance.” Dr. Livingston commented that my “moss” was thick and moist which is indicative of “damp” conditions. From this inspection, the clues of my condition began coming together and seemed to be solidifying as he went on to the last stage of examination.
The doctor then sat down next to me and began asking me questions about my present and past medical conditions. His questions were very poignant and were based off of the signs that he had uncovered through the other three methods of examination. The questions were also worded so as to illicit direct responses that would allow him to piece together my current bodily symbiosis. I answered him without hesitation and he acted as if my responses fit perfectly into what he had already discovered from the examination.
Dr. Livingston was then quite sure of my diagnoses, which was damp heat Qi
stagnation, and wrote out a lengthy prescription that consisted of many herbs.
He told me that the herbs were of a bitter taste and were intended to dry out my
dampness. I was then told to take the decoction two times a day for four days
and then to visit him again; so he could continue on with the treatment with an
adapted combination of herbs.
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