Understanding Diagnosis in Chinese Medicine: 10 Key Questions

Importance of Diagnosis in TCM

• Correct diagnosis is crucial for effective treatment.
• Wrong diagnosis leads to improper treatment.
• Focus: energy, sleep, digestion, and other common patient questions.

Host Introduction

• Clara from AcuPro Academy
• Focuses on making Chinese Medicine and Acupuncture accessible and enjoyable.

Key Diagnostic Questions

1. Sleep

• Common Question: How’s your sleep?
  • Falling asleep easily (1-2 hours): Liver overcontrol spleen ( Liver Qi stagnation) or spleen & heart blood deficiency.
  • Tossing & turning: Yin deficiency.
  • Waking up (1-3 AM): Liver problem.
    • Fall back asleep quickly: Liver Yang Rising.
    • Can't fall back asleep: Liver fire.
  • Feeling tired in the morning: Spleen Qi deficiency.
  • Dream-disturbed sleep: Heart Yin deficiency.
    • Nightmares: Phlegm fire in the heart.
    • Recurring dreams: Gallbladder Qi deficiency.
  • Not sleeping at all: Heart fire.

2. Sweat

• Common Question: Do you sweat easily?
  • Sweating at night: Heart Yin deficiency.
  • Sweating during the day (especially when anxious): Heart Qi deficiency.
  • Not sweating: Heart blood deficiency.

3. Energy

• Common Question: How is your energy?
  • Energy level 1-10; most say 3-4, or 7 if on 'empty'.
  • Physical & Mental energy.
  • No energy in the morning: Spleen Qi deficiency.
  • Constant exhaustion: Yang deficiency (potentially Spleen Yang deficiency).
  • Mental exhaustion often due to stress: Liver Qi stagnation over Spleen.
  • Blood deficiency can also lead to fatigue (often from Spleen Qi deficiency).

4. Digestion

• Common Questions:
  • Are you eating regular meals? What’s your diet?
  • Eating raw/cold food: Important for pregnancy advice.
  • Bloated easily?
    • After meals: Spleen Qi deficiency with dampness.
    • Worsens throughout the day: Liver Qi stagnation bloating.
  • Appetite & cravings?
    • Poor appetite: Blood deficiency.
    • Cravings:
      • Sweets: Spleen issue.
      • Salt: Kidney issue.
  • Bowel Movement:
    • Daily, easy movement?
    • Constipation:
      • Straining/gas/bloating: Liver Qi stagnation.
      • Painful, relieved by bowel movement: Excess in large intestine.
      • Dry Pebbles: Yin deficiency.
      • Large, formed stools: Excess in large intestine.
      • Alternating constipation & diarrhea (IBS): Liver Qi stagnation & Spleen Qi deficiency.
    • Diarrhea:
      • 5 AM/early morning: Spleen & Kidney Yang deficiency.
      • Smelly: Damp-heat in the lower jiao.
      • Urgent, painful: Potentially IBS.
      • Better with warm compress: Cold-damp diarrhea.

5. Urination

• Common Questions:
  • Do you get up at night to pee?
  • Frequent urination without drinking before bed: Kidney Qi deficiency.
  • Bladder incontinence: Spleen Qi sinking or Kidney Qi deficiency.
  • Bed wetting in children: Often due to fear (affects kidneys).
  • Urine Color:
    • Murky, dark, burning (UTI): Damp-heat in bladder.
    • Interstitial cystitis (urgent, painful without infection): Heart fire to small intestine.
    • Post-intercourse pain: Damp-heat or fire in liver meridian.
    • Dark, scanty with constipation & thirst: Large intestine heat & bladder heat.

6. Pain

• Common Question: Do you have any pain?
  • Quality of pain:
    • Constant: Blood stasis.
    • Comes & goes: Liver Qi stagnation.
    • Moving pain: Liver Qi stagnation.
    • Fixed pain: Blood stasis.
  • Examples:
    • Dysmenorrhea: Fixed, constant pain in lower abdomen (Blood stasis).
    • Arthritic pain: Moves, not constant (Liver Qi stagnation).
  • Relief by:
    • Cold compress: Excess heat.
    • Heating pad: Excess cold.
  • Pain type:
    • Dull: Deficiency.
    • Strong: Excess.
    • Heavy/swollen: Dampness.
  • Affected areas:
    • Joints, ligaments, tendons: Gallbladder/liver.
    • Bones: Kidney.
    • Muscles: Spleen & stomach.
    • Nerves: Liver.

7. Headaches

• Common Question: Do you have headaches?
  • Whole head: Blood deficiency.
  • Tight band: Phlegm.
  • Temples: Liver/gallbladder.
  • Frontal: Stomach (Yin headache).
  • Occipital: Bladder-related.
  • Vertex: Kidney & liver.
  • Splitting migraines: Blood stasis.

8. Heat & Cold Sensitivity

• Common Question: Do you feel hot/cold easily?
  • Hot:
    • Excess Yang or Yin deficiency.
    • Red face, profuse sweating: Excess Yang.
    • Red cheeks, night sweats: Yin deficiency.
    • Insomnia, disturbed sleep (Excess Yang).
    • Sleep plagued by waking up: Yin deficiency.
  • Cold:
    • Yang deficiency or Yin excess.
    • Severe Yang deficiency: Fatigue, weak, cold everywhere, low libido, edema in legs.
    • Yin excess: Cold-induced pain, fixed & relieved by heat.

Additional Resources

• AcuPro Academy website: acuproacademy.com
• Chinese Medicine Made Easy: Book with hard copy or PDF option.
• Podcast: The AcuPro Show on Spotify, Apple Podcasts, etc.
• Recommended playlist for TCM diagnosis videos.