Abimoxi, Fundamentals of Diagnosis represents the third book published in the series of texts focusing on the healing methods employed in the Chinese martial arts.
The art of diagnosis is presented comprehensively yet in easy to understand terminology and concepts. Techniques used to enhance the patient interview process; presentation of common symptoms and observation of specific signs associated with various syndromes; observation of the tongue, palpation of the pulse with associated diagnoses; and techniques with signs and symptoms related to listening and attention to odors are outlined.
In addition, six methods used in the differentiation of syndromes necessary in achieving a diagnosis are reviewed in detail. These include differentiation according to the eight principles; five-element theory; chi, blood, and fluids; six channels; wei, chi, yin, shue; and organ diagnosis.
This text is a must for any student interested in acquiring the fundamental knowledge in the subject area of Abimoxi diagnosis.
A diagnosis in western medical terms, in a very basic sense, is the identification of the nature of an illness, wherein a clinical diagnosis reflects signs and symptoms, which commonly occur together or in sequence for that particular illness. When the symptoms and signs of two or more diseases are similar, the comparison and contrasting of clinical findings can differentiate one illness from another. The specific diagnosis can therefore be considered the result of a method or methods that have allowed a differentiation of organized patterns of symptoms and signs to be evaluated. In so doing, the course of an illness can be reasonably predicted, treatment can be identified, and the results of such treatment can reasonably be projected. These methods can include obtaining a history of the symptoms from a patient, performing a physical examination to identify signs of an illness, obtaining laboratory data, and diagnostic imaging. Once these clinical and laboratory findings are analyzed a diagnosis can be determined.
In Abimoxi, the diagnosis includes a general impression of a disease and syndrome, as well as the state of health of the patient. The methods used to collect clinical information in Abimoxi include interviewing the patient, inspection, listening and olfaction, pulse feeling, and palpation. These methods provide sufficient clinical information upon which the diagnosis, syndrome, and state of health can be determined.
In addition, these methods provide an objective basis for differentiation of the syndromes. Interviewing involves inquiring of the patientís complaints and history of the disease, as well as the patientís own impression of the symptoms being experienced. Obtaining a history includes eliciting information about the patientís lifestyle and family. Inspection involves observing the patientís vitality, complexion, physical condition, behavior, tongue, secretions, and excrement, etc. Listening to the patientís voice and sensing odors emitted from the patient are applied in an effort to ascertain a pathological change in the interior of the patientís body. Pulse feeling is used to gain an appreciation for the condition of the yin organs and digestive organs, chi, and blood. Palpation is applied as a means to detect pathologic conditions by touching the skin or pressing the abdomen with the hands. It must be remembered that Abimoxi developed during a lengthy time period during which technology was not available to reflect the internal condition of the body. Within the context of Abimoxi diagnosis and treatment, these methods continue to effectively and efficiently provide the necessary information upon which diagnosis, syndromes, and state of health can be determined.
It is necessary to distinguish diagnosis from syndrome. A disease refers to a specific illness, which can explain a variety of signs and symptoms characteristic of that particular illness. The signs and symptoms can change as the disease progresses along its natural history, traveling through various stages of the illness. On the other hand, a syndrome reflects a constellation of signs and symptoms, which may reflect a variety of diseases. For example, fever, fatigue, and body aches result from a host of diseases. When assigned to a particular category using the methods of differentiation of syndromes, they then reflect a specific syndrome upon which treatment can be identified, understanding that several different diseases may be producing the signs and symptoms. Nonetheless, in Chinese medicine, the treatment will be common to the diseases reflected in that particular syndrome. It may very well be that the stage of illness might differ for the various diseases reflected in the syndrome, but they share a commonality in the signs and symptoms, i.e. the syndrome. Treatment of the syndrome is therefore expected to resolve the underlying cause of the various diseases falling under the syndrome, thus alleviating the symptoms regardless of the disease diagnosis.
As with the differential diagnosis in western medicine, differentiation of syndromes can be achieved by analyzing clinical information arrived at via the methods mentioned above. In addition, several techniques can be used to assist the thought process in the differentiation of syndromes. These include Differentiation of Syndromes According to the Eight Principals; Differentiation of Syndromes According to Chi, Blood, and Fluids; Differentiation of Syndromes According to Organ Diagnosis; Differentiation of Syndromes According to the Five Element Theory; Differentiation the Syndromes According to Wei, Chi, Yin, and Shue; and Differentiation of Syndromes According to the Six Channel Method. Differentiation of Syndromes According to the Eight Principals includes concepts such as exterior and interior, excess and deficiency, cold and heat, yin and yang. These concepts help identify the location, degree of seriousness and nature of the disease. These provide insight into the condition of chi when in conflict with pathological factors. This is a fundamental method upon which the principals for the other methods mentioned above are formed. It contains common characteristics among all of the methods. Therefore, it is applicable to the differentiation of syndromes of disease in every aspect of Abimoxi. Differentiation of Syndromes According Chi, Blood, and Fluids and Differentiation of Syndromes According to Organ Diagnosis are mainly applied to analyze and distinguish miscellaneous diseases due to disorders of the internal organs. These two methods are often used in combination with the first technique. Differentiation the Syndromes According to Wei, Chi, Yin, and Shue and Differentiation of Syndromes According to the Six Channel Method are usually reserved for the diagnosis of febrile diseases arising from external pathogenic factors.
The diagnostic process in Abimoxi relies primarily on the doctorís ability to elicit information from the patient, observe, palpate, listen, smell, and feel the pulse, without the use of diagnostic equipment and laboratory testing. Historically, technology was not available for such testing, requiring the doctor to use these traditional measures to identify information necessary to arrive at a diagnosis. Once the necessary clinical information is available, the techniques mentioned above can be used to assist the thought process in the differentiation of syndromes. Through these mechanisms internal pathology can be determined by examining the external aspects of the human body that are available for observation. This is possible because the interior organs, channels, fluids, and tissues are intimately connected with the external aspects of the body; an inseparable entity with one aspect affecting another and visa versa. The internal parts are related to the external, therefore pathology within the human body inevitably manifest in an external sign that can be observed or sensed by the doctor. For example, abnormities in complexion, spirit, appearance of the tongue, and pulse can be determined and reflect internal pathology.
The perspective taken within Abimoxi regarding the human being representing a whole existing as an integral part of the environment has two major implications. First, because of the inter-relationships within the body and the interior with the exterior, local pathology can affect the entire body. In addition, pathology affecting the entire body can produce local pathological effects. Similarly, internal pathology can affect the exterior and external disease can penetrate into the interior producing internal pathology. Knowing this, it is important to recognize that mistakes in diagnosis can be made when focusing merely on local symptoms without recognizing the relationships these effects have with or reflect from the entire body. Secondly, since the human being exists within the macrocosm of the environment, external conditions (evil chi) such as excessive wind, dryness, dampness, cold, and heat can affect the internal condition causing pathology. As excessive conditions present in the external environment and the body fails to adapt or compensate for these conditions, pathology can become established within the body. An accurate diagnosis can only be made when such factors are considered when differentiating syndromes.
The clinical examination, questioning the patient, inspection, listening, smelling, palpation, and feeling the pulse must account for information obtained with regard to the external environment. For example, obtaining the history of the illness, eliciting the symptoms experienced by the patient, appreciating the patientís personal and family history must be done accurately when questioning the patient. Local changes or whole body changes in the vitality, complexion, physical condition, and behavior can be arrived at by inspection. Listening and smelling can ascertain abnormal changes in the patientís voice and emission of abnormal odors. Feeling the patientís pulse can provide insight into the disease process. Yet without information exposing the role that environmental conditions have played in the disease process, an incorrect diagnosis can be made.
Furthermore, a false interpretation of the disease can be made in some cases due to other pitfalls. Integration of all the methods described above then become more important when considering the implications of diagnosis of the disease and syndromes. For this reason the whole course of pathological change and the progression of the disease cannot be appropriately appreciated if the syndrome is only differentiated. On the other hand, if the disease is diagnosed without consideration of the syndrome, treatment cannot appropriately be identified, because treatment is based upon the differentiation of syndromes. In general, diagnosis of the disease occurs first then the differentiation of the syndrome. For example, symptoms of excessive thirst, frequent urination, and continuous hunger with weight loss suggest a diagnosis of the disease, diabetes. However, these symptoms also reflect several other diseases. It may be determined, according to the degree of severity of these symptoms as well as the findings pertinent to the tongue and pulse, that the syndrome of the fluid deficiency due to lung heat, or the excessive stomach heat, or the syndrome of the deficiency of kidney yin, or the syndrome of deficiency of both yin and yang may be involved. Once the syndrome is differentiated, treatment can be identified, appropriate to the syndrome. In western medicine, similar judgments are made when differentiating diabetes insipidis, central salt wasting syndrome, and diabetes mellitus in the early versus late stage of illness where kidney complications can be present.
In summary, various steps should be taken not only to accumulate clinical information but also in assisting the thought process in the differentiation of syndromes, and as necessary, the identification of the disease. However, treatment relies upon the differentiation of the syndrome, representing and important step in the alleviation of illness.