Philosophy and Approach
Diagnosing is very much like solving a puzzle.
Sometimes the puzzle is straight-forward and the answers are obvious, but very often that is not the case. Obviously, the more insight and more definitive findings we have, the better we can diagnose the problem. Traditionally, acupuncturists rely on reading the tongue and pulse to determine the patient’s state of being. Though tongue and pulse diagnoses are both valuable in their own rights, particularly in assessing digestive functions and cardiovascular conditions, respectively. There are practical limitations with these two techniques, especially when it comes to pain assessments, musculoskeletal injuries, and gynecological dysfunctions – examples of the most commonly treated conditions by acupuncture.
As a result, I rely heavily on abdominal palpations for general constitution evaluations and physical examinations (PE) for orthopedic and sports injuries as our primary diagnostic tools. For abdominal palpation, I extensively leverage Kiiko Matsumoto’s Japanese Hara techniques to systematically look for any tender or painful spots around the patient’s abdomen. The trouble spots can be either a subjective pain reported by the patient and/or an objective hardened spot detected by the examiner’s touch; most of the time, the patients are not even aware of having pains at the abdomen. Based on our findings, appropriate points are selected for needle insertion. The advantage of this “closed-loop” approach is that the diagnosis and treatment are tightly coupled, so the points are chosen and needles are inserted based on immediate patient feedback, not on theories.
The palpation/PE approach places a premium on the practitioner’s clinical and communication skills, point selection and needling accuracy and precision, while treating the patients in a real-time, evidence-based fashion. It is a much more intensive and time-consuming framework, but the treatment outcome is consistently superior.
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