The 10 Questions in TCM Diagnosis

A visit to a Traditional Chinese Medicine (TCM) practitioner or acupuncturist usually begins by answering a long list of questions. Some of the questions may seem irrelevant to patients who come in for treatment of a specific ailment. While patients may wonder why the practitioner needs to know all of this information when it appears to have nothing to do with their complaint, every piece of information is important to the practitioner in his or her analysis.

Traditional Chinese Medicine takes a holistic approach to healing. Rather than diagnosing and treating named diseases as in Western medicine, TCM looks at the person as a whole and determines where there are patterns of disharmony. While the initially focusing on the primary complaint, information about all aspects of the person's condition will allow the practitioner to discover the underlying root of the problem and recommend a treatment strategy to achieve optimal health.

The Ten Questions

The Ten Questions have been an integral part of TCM diagnosis for centuries. The first recorded list of ten questions was compiled by Zhang Jie-bing in 1624, during the Ming dynasty. The exact phrasing and number of the questions has varied over the years, but the following are general questions that a patient might expect to be asked on a visit to a TCM practitioner, and examples of what type of information they are looking for.

* Cold and Heat, Chills and Fever- whether the patient always feels cold, has cold hands and feet, cannot tolerate cold, or whether he or she generally feels too warm. In an acute illness, the severity of chills and fever and whether the fever fluctuates with the time of day.

* Perspiration- night sweats or spontaneous perspiration without physical activity, if the patient has a high fever but does not perspire, or sweating of palms and soles of feet

* Pains in Head and Body- the location of pain, such as lower back, knees, chest, front sides or back of the head; if there is an uncomfortable feeling of fullness in the chest or abdomen; type of pain (sharp, dull), and whether the pain is relieved or worsened by application of cold, heat or pressure. Dizziness would also fall under this category.

* Urine and Bowel Movements- frequency of bowel movements and urination (times per day), constipation, diarrhea, frequent copious urination, scanty dark urination, incontinence, or needing to get up one or more times at night to urinate.

* Diet and Appetite- lack of appetite, constant insatiable hunger, bloating after eating, desire for hot or cold foods, craving certain tastes such as sweet, sour, salty or spicy, habitual intake of sugar, caffeine or alcohol. This category also includes experiencing a particular taste in the mouth, such as metallic or bitter.

* Thirst- excessive thirst, lack of thirst, thirst with no desire to drink, or constant desire for cold drinks

* Mental or emotional state- TCM recognizes that the emotional and physical are interrelated, and emotional states such as grief, anger, worry or fear can affect the patient's physical well-being. Conversely, physical disharmonies can bring about emotional responses.

* Hearing- tinnitus (ringing or other sounds in the ears), sudden or gradual hearing loss

* Sleep- a desire to sleep excessively, difficulty falling asleep, or waking in the middle of the night and being unable to fall back asleep. Nightmares or dream-disturbed sleep are also included in this category.

* Gynecological issues- women would be asked whether the menses are early or late, irregular, if the flow is light or heavy, if the color is light or dark, and if they experience pain or cramps during menstruation

In addition to asking these or similar questions, the TCM practitioner will want to know about the patient's medical history and previous diseases or ailments, and will employ observation of the patient's overall demeanor, speaking voice, energy level, coloration, eyes, and other physical characteristics, as well as pulse and tongue diagnosis, in order to make an accurate analysis and choose the most effective treatment.

Sources

Tierra, Michael. The Way of Chinese Herbs. New York: Pocket Books, 1998.

Kaptchuk, Ted J. The Web That Has No Weaver: Understanding Chinese Medicine. New York: McGraw Hill, 2000.

This article originally appeared on Suite101.com
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