Diagnosis in Chinese herbal gynaecology does not involve a gynaecological examination as performed in Western gynaecology, although the findings of such exams are taken into account in determining the nature of the problem (especially in modern Chinese herbal gynaecology).
This is because the results of such an exam describe the status of the structure of the tissues examined, while as we have seen the interest of the Chinese physician is directed primarily at the status of the functioning of the organism.
It is as if a house were inhabited by a quarrelling family. One would like to intervene before the structure of the house was damaged, the windows smashed, doors ripped from their hinges. And the earlier the intervention, the less drastic it need be. If one waits, however, until the house is burning down, a whole team of experts may be necessary to save it – or even merely a part of it.
Diagnosis of the functioning of the organism involves attention to the symptoms of the patient:
- what kind of pain or tension, where, and when;
- the presence of absence of thirst, perspiration, dizziness, tinnitus, emotional upset or stress;
- attention to food intake;
- functioning of bowels and urination;
- the menstrual flow;
- energy, sleep and condition of the eyes, ears, nose and mouth
- the condition of the home and work environment, etc.
These findings are combined with observations made by the physician of the complexion and build of the patient, the tongue, and later palpation of the pulse at both wrists, and possibly palpation of specific points around the body which become characteristically tender in certain diseases.
The correlation of all the results of such a procedure is accomplished by means of Chinese traditional medical theory. While the terms employed may sound prosaic in translation, they are in fact technical descriptions of the functional status of the organism, with precise definitions and applications. The use of these technical terms allows the choice to be made of therapeutic agents whose function is described in similar terms.
A woman with dysmenorrhea may complain of cold aching pain in the abdomen before and during her periods, coupled with a clotted unsteady menstrual flow, slow pulse, and a white tongue coat.
Such a woman may be described as suffering from ‘Cold in the uterus’ – a highly unusual diagnosis from a Western point of view, but one which in Chinese medicine terms allows the selection of herbs with a ‘warming’ action or a technique such as moxibustion, which can then be applied in such a way as to relieve the woman’s pain and aim to prevent its recurrence. But these are not the only options (see Treatment).