Shindan 診段 Vibrant Health, Better Living and Longevity Through Knowing Your Oriental Medical Diagnosis 

Copyright 2011Cameron Bishop DAOM, L.Ac

As Seen In "Natural Awakening" Magazine. 

Two of the most difficult questions we are asked as acupuncturists are “How does it work?” and “What is the diagnosis?” The complexities of medicine make it difficult for any health care professional to explain the complex theory or chemistry. The years of training, education, experience, observation that cumulates in making a diagnosis is not easy to translate in a few words or concepts. The difference in language, culture, and concepts of Asian medicine further complicates the understanding. They both have their strong and weak points.   

We are used to having a definitive labeling in our culture - a mechanical conclusion. You have disease X or disorder Y.  While an Eastern diagnosis is more “flowing”. It is akin to measuring and observing the weather rather than “What’s wrong with the car?” Neither method is right or wrong. East and West are simply different. East tends to see the body as a garden and the West as a car - one to be cultivated and one to be fixed.


Within the Acupuncture field there are several schools of diagnosis. They differ but the base theory is the same. To find a compilation of findings in a grouping that corresponds to a “diagnosis”.  That being said it is fluid and may change daily or never. They call it the practice of medicine since it certainly is a practice and a set of skills to be honed. As we all know any skill is “operator dependent” whether driving, art, music, drawing, surgery, or acupuncture. It improves with practice, experience and some are gifted and some are not.


Western medicine is mechanical. If you are severely injured you want a mechanical thinking surgeon to put the pieces together, keep the blood flowing, numbers correct and infection non-opportunistic. In a regular “check up” your blood pressure maybe out of the norm and that number medicated to bring it back into a healthy range.


In Acupuncture Meridian therapy we look at many aspects of the person.  What the patient says, what the tongue looks like, what the abdomen feels like, findings in the pulse, and more. Books have been written about each of these and it is beyond the scope of this article to go into elaborate detail. In fact, the common questions I referenced above could be taught as semester long classes. Suffice to say, it is complex and has a two to three thousand year written history.


In the ideal world, each finding in the patient’s pulse, tongue, abdomen, answers, demeanor, would all correspond to the same physical imbalance. Let me give an example:  A fictional man, age fifty,  reports difficulty sleeping, slight cholesterol problems, easy irritability,  and a main complaint of left leg pain. He reports minor digestive and sweating problems. This gentleman also had a bad cut to his left leg that healed poorly, due to poor self care, and non-compliance to his physician’s advice.  His wife reports he has anger and control issues. He runs his own office like an “army general” but lately is more and more fatigued. He has a previous failed marriage, financial issues, frequently complains and files nuance law suits.


This information tends to make me think there is a possible “Liver Imbalance” but I am certain that a battery of western tests would not confirm a western liver disorder. To further confirm my diagnosis I would look for “Liver signs” in his tongue. This might include teeth marks on the side or pale sides in comparison to the rest of the tongue or even a slight purple color. I would look for a liver pulse quality which might be described as tight or wiry to touch. Western medicine looks for beats per minute and sometimes regularity. I would also examine the abdomen. The abdomen may have areas of weakness over the reflex zones for the liver and possibly kidney (the supporting organ to the liver). Eastern medicine looks for tendencies to a disharmony with hopes of fielding it off to keep it from edging into a western diagnosis. Western medicine would look for end stage diseases in the abdomen, such as an enlarged liver or acute rebound tenderness for appendicitis.


In the perfect clinical world his tongue, abdomen, symptoms, pulse would all match. We would then know his case would tend to be resolve quicker than if all the findings did not match the same liver pattern. The general consensus in Japan is that diagnoses and prognosis is becoming more difficult due to the increase use of medication, chemicals, preservatives and life stress. The concept of the liver is much broader in eastern medicine. It runs from the big toes to behind the eyes. It is a band of points intersecting associated organs and body parts. Western medicine associates gout, hormonal migraines, cholesterol, eye disorders and more loosely to the liver as do we.  It is beyond the scope of this article and a subject of many books, the intricacies of its functions. The liver system could be further depleted by use of alcohol, medications, drug, stress, lack of sleep, poor diet, and lack of exercise or plain poor genetics. If this gentleman continues to tax his liver system, the kidney system will need to use its resources to support it. His anger and mood swings could increase and in a poorly emotionally functional individual possible rages and irrational bursts of anger could occur.  In time diabetes, ED, low libido, and hypertension could manifest. If inclined more severe personality disorders may become more evident.


Our fictional patient basically ran on high throughout his life and is successful. His body is beginning to pay the price. Most wait till there is a disaster but this gentleman chose to come in for treatment. Through a series of acupuncture treatments we would expect his moods, stamina, libido, and pain to all stabilize. As his body system moves into a better state of health, the least stressed systems would return to optimal functioning. That means the easiest treatable symptoms correct first showing us we are on the right path. Sometimes the symptom the patient sought for treatment resolves the slowest since it is the most misaligned. The “easier” symptoms easing or disappearing is a prognosis we are going in the right direction. His digestion improvement would lead to better nutrients entering the blood. This “good fertilizer”, if you will, would lead to healthier tissue, and organ function and therefore better sleep, stamina, mood and wellness. Much like an overgrown vacant lot does not change into an abundant healthy organic food garden overnight so too the body does not resolve to complete wellness overnight. This man’s mechanical thinking may lead him to abandon a health altering series since his leg did not magically mend overnight. Magical thinking dominates in our culture. At this point in the patient's health we would expect a shift in the right direction; better weather and more days of it.


Each organ system in our medicine can be elaborated in great detail in the same way. We group symptoms into categories and treat them together. Seemingly one might be surprised that we would group some shoulder, intestine, and nasal allergy symptoms in the same organ system, but with the advancement of brain scans, embryological development studies, and other advanced scientific understandings we find more western links every day. For example - Neural cells are found both in the intestines and the brain. Eastern medicine has always associated both areas with the heart (kokoro). The concept of “heart” is different in both cultures. In western medicine it is an organ in the chest. In western language in also includes an attitude. In Japanese Acupuncture it is a concept that includes aspects of soul, spirit and organ. You can see the complexity of translating and describing this medicine.


The best result some day will be a combination of both medicines based in what is the most beneficial for optimal for the patient health care. A model could exist that reduces health care costs, increases efficacy and well being. We hope the average American sees their health as something they cultivate, guard and are proactive in its maintenance.