By Shihan Mary Bolz
Licensed Acupuncturist
Master of Science Oriental Medicine
Doctoral Fellow, FBU
Master Martial Arts Instructor
Imagine this real-life scenario which is more typical than atypical. The Eastern medicine doctor is discussing the progression, or lack thereof, of one of her/his patients with a State Workers Compensation adjuster. The adjuster is a very amiable gentleman, efficient at processing his clients claims and very attentive to what the Eastern medicine doctor is saying about the patient’s condition and progress in the patient’s acupuncture treatments. The Eastern doctor (acupuncturist and Traditional Chinese Medicine practitioner) is stating that she/he has noticed a great improvement in the patient since having the treatments. The patient is experiencing much less pain, meaning there is less intensity, frequency, and duration of the pain. The practitioner states that she/he notices much less swelling, less tightness and hardness of the muscles, tendons and soft tissue on palpation and there is more stability when the patient is walking. This conversation is being held because the Eastern medicine doctor is asking for continued treatments on a regular basis for this patient to prevent flare-ups and to continue the healing process.
When a patient experiences less pain, has more mobility without pain, and even feels less stressed, this is a sign that healing is taking place. Eastern (Oriental) medicine is like that. What acupuncture and Traditional Chinese Medicine does, in a nutshell, is encourage and instigate the natural healing powers of the body which has not been taking place due to blockages in the blood and energy flow within the person. When a patient experiences less pain or no pain after a course of acupuncture treatments, it is because the body is or has healed. Acupuncture is not just palliative treatment. Indeed, in TCM (Traditional Chinese Medicine), the goal of the TCM doctor is to heal the patients, not just provide palliative relief. Of course, some cases may be so longstanding and so difficult that it becomes long-term pain management with moderate permanent healing. But, in the majority of cases, the patient heals because nature heals. That is the “nature of nature,” so to speak. Continuing this scenario of the discussion between the Eastern medicine practitioner and the State Workers Compensation adjustor, the practitioner also mentions that the patient’s level of anxiety and frustration has improved since she first came in. The patient had been a bundle to handle on the emotional level. The adjustor comments that her allopathic medicine doctor for the State Workers Compensation examination board goes by visual studies such as the MRI, x-rays, and laboratory studies of various serums and components in the blood, and NOT BY JUST WHAT THE PATIENT SAYS. The Eastern doctor states that she/he understands that and that she/he is very familiar with these tests because in the state of California at least, acupuncturists are primary health care professionals and are fully qualified to order x-rays, MRIs, CAT scans, lab tests, etc. and understands how to interpret them and understands well the radiologists reports, the laboratory reports, etc. Allopathic medicine is very much a portion of the training of an Eastern medicine doctor, as well as some courses in an understanding of pharmacology and prescription pharmaceuticals. The Eastern medicine doctor mentions to the adjuster that this is very valid medical analysis also and must not be overlooked. She/he also states that these tests can not measure the integrity of the soft tissue and the hardness of them in the way that a skilled practitioner with palpation skills can. Technology cannot measure the things that the hands of a healer can feel. The conversation went well and the adjustor agreed to pay for two treatments per month for the patient and no more and the other treatments the patient would have to pay for. Fair enough. This case went reasonably well. Both ended the conversation with mutual respect. After hanging up the phone; here is what really went through the Eastern medicine practitioner’s mind. “This is exactly the part that allopathic medicine is missing, just what the adjustor said, the medical doctor goes by certain tests and not by WHAT THE PATIENT Says” That is one of the great faults of Western (allopathic) medicine. By not fully listening to the patient and by not taking that to heart, they are missing clues as to how to help their patient get well. In Eastern medicine, it IS important to listen to the patient. Furthermore, not just listen as a friend would. No, with the ears, eyes, and heart of a trained TCM practitioner, because this provides the clues that can help in the diagnosis and treatment and begin the healing process. Take a look at the practitioner’s oath from the Meiji College of Oriental Medicine which was in Berkeley, California (no longer in the U.S., there is a very large Meiji College of International Integrative Medicine near Kyoto City, Japan and another sister school in Osaka, Japan which had originally sponsored the U.S. school). The author of this article graduated from the Meiji College of Oriental Medicine, Berkeley. The Meiji College Practitioner’s Oath is as follows:
I solemnly promise to view the prevention, diagnosis and treatment of health disturbances as my highest calling and duty.
I will remain open to new developments in Oriental Medicine and strive to continually develop my knowledge and skills throughout my professional lifetime.
I will use the techniques of Oriental Medicine to encourage the innate healing powers of my patients and to serve the public good.
I will listen to my patients attentively and with compassions and will maintain their communications in the strictest confidence.
Each of these oaths is equally important, but one which vividly remains in the mind of this author when treating patients is the part, “I will listen to my patients.” This is very important. Listening to the descriptions of how the person feels and the descriptions of the pain and sensations and the emotional feelings as well as the physical feelings provides good insight to the imbalance or problem within that person. This is invaluable in diagnosis and treatment. Of course, just listening to the patient alone is not enough.
These descriptions are matched up with the objective findings in the diagnostic process. Two of the main diagnostic tools for the TCM practitioner are pulse palpation and visual tongue diagnosis. Pulse diagnosis is very sophisticated, fine, and difficult. Most practitioners of Oriental medicine in Japan will tell you that it takes 10 years of practice to be good at it. There are three pulse positions on each of the wrists; making six positions total. Pathologies of the different internal organs are reflected at the wrist pulse, and each organ has an individual position.
There are seven diagnostic techniques and nine conditions. The seven techniques of diagnosis include the superficial, middle, deep, upper, lower, left and right techniques. The nine conditions are diagnosed by applying pressure from the superficial through to the medium and deep levels in each of the three positions on each wrist. The pulse must be felt for at least five beats at each level to establish a clear pattern. The three levels at the three positions comprise the nine conditions. There are about 29 different qualities of the normal pulses from which the particular condition of the individual organs and organ systems can be understood. The second main objective diagnostic tool is tongue reading. To examine the tongue systematically, one must have a clear idea of what to look for.
There are five primary aspects to observe. The vitality of color, the body color, the body shape, the tongue coating, the tongue moisture. The tongue, like the pulses, can be divided into sections and further divided into subsections according to the tongue body topography. Being able to read the tongue body and the types of coating are paramount to getting an accurate diagnosis of what the underlying imbalance is in the patient’s body that is causing their symptoms. Further methods of palpation of the abdomen and other areas of the body, visual diagnosis of the skin, hair, nails, and eyes; are all important. These are the types of objective findings in Eastern medicine which can be matched up with the patient’s symptomatology to arrive at an Eastern medicine diagnosis. Changes in the body’s condition, whether getting better or worse can also be known by these techniques during the course of treatments.
In addition, TCM practitioners of today will use all the tools of modern allopathic medicine as well, the imaging studies, laboratory tests, neurological tests, etc. Thus, a well-rounded diagnosis can be obtained and understood through techniques of both practices of medicine.
The point of this article to the reader is to demonstrate that what is lacking in Western (allopathic medicine) is giving credence to what the patient is saying and taking seriously their feelings and descriptions. By overlooking this or even telling the patient that what is wrong with them is “in their head” and referring them to a psychiatrist to be put on antidepressants and psychotropic drugs is the wrong treatment in many, if not most, cases. What is in the head, is in the body and what is in the body is in the head and the spirit is involved also. We, as humans, are not a mind, which is here, and a spirit which is there, and a body which functions alone. No. The delineation cannot be made. It is intermixed and should not be separated in the way we practice medicine.
The other point that this author wishes to get across is that modern allopathic medicine has lost much of its ability in palpation skills. Ask a patient how many times the doctor has touched them and really palpated their areas of pain. Most modern medical doctors don’t even know what to feel for, or what the normal musculoskeletal tissue feels like versus abnormal or disturbed musculoskeletal tissue. The older medical doctors are the most likely to have this skill; the younger generation of medical doctors are the least likely. On the other hand, Eastern doctors can be and are extremely adept in palpation skills to detect pulses, internal organ imbalances and neuromusculoskeletal imbalances. Because Eastern medicine has been treating for several thousand years, anywhere from 3,500 to 5,000 years back until this day; the methods are well developed and well-taught. Of course, each individual practitioner will have some level of expertise greater than others, as in all professions. In this author’s experience, the MRI reports usually confirm what is already known as to where the problem is by palpation, symptomatology, and WHAT THE PATIENT SAYS. On the other hand, the Eastern doctor can palpate a problem without the patient saying anything in many cases.
The third point is, “WHAT THE PATIENT SAYS” is crucial in helping the doctor to initiate the healing process in the patient. Relying only on so-called objective tests misses many things. Healing is teamwork between nature (the greatest power), the doctor, and the patient (the second greatest power). The doctor is the conduit and instigator.
To truly improve the healthcare system in the United States, we must include the Eastern medicine practitioner with equal status (at a minimum) as the allopathic doctor. Eastern medicine has already been proven, for many more years than allopathic medicine. Allopathic medicine provides a valuable aspect of healthcare, and is not to be discredited. The conventional medical profession needs to learn more about the value of Eastern medicine and be able to refer their patients to Eastern medicine as readily as they refer patients to any other allopathic medical specialist. Eastern medicine is the one that can put all the pieces of the puzzle together from individual pieces of information the many specialists have gathered. Vice versa, Eastern medical doctors readily want their patients to consult allopathic medicine and keep their medical doctor. There should be no exclusion.
Lastly, diet, the single most important preventive measure, exercise, thinking, and lifestyle of our nation’s people must change; not who pays for it. Real health care and real preventive measures are your best health insurance and healthcare strategies.
