How Does Diagnosis Work in a Chinese Medicine Gynaecology Consultation?
Diagnosis in Chinese gynaecology does not involve a gynaecological examination as performed in Western gynaecology, although the findings of such exams are taken into account in determining the nature of the problem (especially in modern Chinese gynaecology). This is because the results of such an exam describe the status of the structure of the tissues examined, while as we have seen the interest of the Chinese physician is directed primarily at the status of the functioning of the organism.
"It is as if a house were inhabited by a quarrelling family. One would like to intervene before the structure of the house was damaged, the windows smashed, doors ripped from their hinges. And the earlier the intervention, the less drastic it need be. If one waits, however, until the house is burning down, a whole team of experts may be necessary to save it – or even merely a part of it."
Diagnosis of the functioning of the organism involves attention to the symptoms of the patient: what kind of pain or tension, where, and when; the presence of absence of thirst, perspiration, dizziness, tinnitus, emotional upset or stress; attention to food intake; functioning of bowels and urination; the menstrual flow; the condition of the home and work environment, etc.
These findings are combined with observations made by the physician of the complexion and build of the patient, the tongue, and later palpation of the pulse at both wrists, and possibly palpation of specific points around the body which become characteristically tender in certain diseases.
The correlation of all the results of such a procedure is accomplished by means of Chinese medical theory. While the terms employed may sound prosaic in translation, they are in fact technical descriptions of the functional status of the organism, with precise definitions and applications. The use of these technical terms allows the choice to be made of therapeutic agents whose function is described in similar terms.
A woman with dysmenorrhea may complain of cold aching pain in the abdomen before and during her periods, coupled with a clotted unsteady menstrual flow, slow pulse, and a white tongue coat. Such a woman may be described as suffering from ‘Cold in the uterus’ – a highly unusual diagnosis from a Western point of view, but one which in Chinese medicine terms allows the selection of herbs with a ‘warming’ action or a technique such as moxibustion, which can then be applied in such a way as to relieve the woman’s pain and prevent its recurrence. Nor are these the only options.
Chinese medicine has a wide range of therapeutic technique at its disposal, including herbs, acupuncture, moxibustion, diet, massage, and specialized exercises, some of which involve breath training. Each of these techniques is a field of study with its own specialists, although the training of every Chinese doctor includes at least some introduction to their principles and applications.
Herbs (and acupuncture), however, are by far the predominant modes of therapy in Chinese medicine. Herbs can be applied in decoction (like soups), in powders, pills, plasters, tinctures, and syrups. Modern dosage forms include ‘instant’ preparations, ampoules, capsules, and even I.V. drip for emergencies. The most common form, however, remains the decoction.
Chinese herbs are rarely prescribed singly. Following diagnosis, a standard formula is chosen for the condition, and then ‘sculpted’ by the addition or deletion of different but related herbs until the prescription exactly suits the state of the individual patient. The effect of the prescription upon the patient is determined at the next consultation and the herbs again adjusted accordingly.
For the reasons outlined above, Chinese gynaecology can be seen to provide a viable complement to Western medicine in an area where it is much needed (see scientific research on: infertility, endometriosis, gynaecological pain, menopause and post-menopause osteoporosis) . It supplies a comprehensive framework for the classification and treatment of the ‘vague’ amorphous symptoms accompanying a functional disorder, by re-establishing the proper functioning of the organism with methods both more gentle and more subtle than contemporary medicine can offer. Moreover, when necessary, it's non-invasive, conservative treatment combines well with Western medical techniques, as for example in the treatment of structural diseases or the side effects of more drastic therapies.
Length of Treatment
Length of a course of treatment ranges from as short as one or two weeks in cases like simple vaginal discharge, to three or four months for dysmenorrhea, or even up to a year or longer in treatments for endometriosis or infertility. Yet while on average treatments may be slower than with Western medicine because of the more conservative methods employed by the physicians of Chinese gynaecology, and while no treatment, Western or Chinese, can ever claim 100% success, still it is generally conceded in that of all the departments of Chinese medicine, gynaecology obtains the best results.
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