Part 1 can be found here

Part 2 can be found here

Part 3 can be found here

Part 4 can be found here

TCM Physiology - continued.

Disharmony or Disease.

The key to disease is disharmony! Disharmony is the failure of the body to maintain its normal functional balance. The symptoms of disease are a result of the imbalance itself, or the body's attempt to restore normal harmonious function again.

Every minute the body is in a constant state of interaction with its environment. It continuously adjusts and monitors its own internal cycles accordingly. For example as the temperature of the air rises our body produces perspiration to cool it, when it is cold we shiver to get warm. When the sun strikes our skin we develop a tan to protect it. When it is dark our pupil expands to let more light in. When we see something humorous we laugh and relax. These are a few of the thousands of ways we are constantly interacting with our environment.

Equally important though is our maintenance of an internal balance. The kidneys must regulate the amount of fluid in our body. The lungs the amount of air we breath. The heart the speed of our blood circulation. The mind our reaction to emotions.

But how do we know when our balance is disturbed when we are moving into disharmony?

To make a diagnosis in TCM requires that the practitioner collect all the relevant signs and symptoms about the patient and then integrate them with TCM knowledge of Disharmony (disease) and normal TCM physiology.

Collecting the signs.

Collection of the signs and symptoms is based on what has been traditionally been called the four examinations. The four examinations are Looking, Listening/smelling, Asking and Touching. Together these methods collect all the information about a patients state which is then synthesized into a diagnosis.

In Looking the TCM practitioner observes the patient and particular importance is paid to the tongue, the complexion, any secretions or excretions and the general appearance.

In Listening particular attention is paid to the sound of the voice, the breathing, presence of cough and abdominal noises. With smell attention is paid to the type of smell from the breath, body odour and the odour of excretions.

Asking is the collecting of information that may not be readily apparent but that the patient can describe. It covers many areas such as pain, perspiration, appetite, bowel actions and sleep to mention a few.

Finally touching involves examination of the various structures physically. This involves palpating Acupuncture points, feeling for heat or cold, dampness or dryness, testing of strength, and sensation, and examination of the pulse.

Two areas of the above diagnosis are of unique importance to the TCM practitioner they are the appearance of the tongue and the examination of the pulse. TCM has developed a unique understanding of the information that can be gained from the tongue and pulse. Both are capable of providing information on the state of the internal Zang-Fu (organs), Qi and Xue (Blood) in the body. As well the presence and nature of pathogens (such as Heat or Damp) affecting the health.

A practitioner pays attention to the shape and color of the tongue body, to cracks and marks on the body and to the quality and color of the coating on the toungue.

With the Pulse the practitioner may use various pulse positions on the body and frequently uses the wrist pulse. With the wrist pulse they look at much more than the pulse rate it involves both wrists, three finger positions and different pressure levels to perform correctly.

Traditional Chinese Medicine places great emphasis on these methods of diagnosis. Much practice is required to learn correct use of Tongue and even more is required for effective Pulse diagnosis. Having collected the signs and symptoms the practitioner then applies various methods to integrate them into a diagnosis.

Arriving at a diagnosis.

TCM has developed several systems to help the practitioner determine imbalances within the person, and in relation to the environment. Each of these systems relates the persons presenting symptoms, signs, with the functions of the Substances and Organs. Some of the methods of describing imbalance are;

• The Six Evils - how external influences such as bacteria cause illness.
• The Seven Emotions - internal influences that can unbalance us.
• The Eight Principles - a method of quantifying or describing imbalance.
• The Five Phases - used to understand dynamic system relationships and their impact on disharmony.

In the following parts of this series we will examine the basics of each of these ways of describing and understanding disease.