Differential Diagnosis

What Is Differential Diagnosis?


In Chinese Medicine practitioners do not diagnose Western pathologies/diseases. Acupuncturists diagnose patients based on a system of balances and imbalances – principles of Chinese Medicine that are thousands of years old and are every bit as viable today as they were in 1,000 BCE.

Of course, Western Allopathic Medicine is the most widely used medicine worldwide today and therefore acupuncturists have to receive training in Western pathology and diagnosis, anatomy and physiology, and have to have an understanding of the classifications of Western pharmacology, as well, in order to understand their patients’ medications and their doctor’s diagnosis. Because today’s conventional pharmaceutical medications are so prevalent in patient care, acupuncturists are acutely aware of allopathic treatment methods.


What does Allopathy mean?


Allopathy is the term for conventional Western Medicine. Allopathic refers to the treatment of symptoms. Allopathy has its strengths and weaknesses, as does holistic medicines, like Chinese Medicine. The advantages and reasons for the necessity of Allopathy is in its amazing emergency and crisis abilities, modern diagnostic tools and laboratory testing, surgical procedures, life-saving pharmaceutical medicines, and research.  These procedures are a necessity.


Why is Holistic medicine valuable?


Holistic refers to the treatment of the whole person. Chinese Medicine is sometimes referred to as ‘root and branch’ medicine because acupuncturists diagnose a patient’s symptoms and the cause of those symptoms at the same time. This diagnosis is complete, allowing for a holistic treatment method to be followed. When the ‘root’ of the problem has been treated effectively, acupuncturists and their patients will often see multiple, seemingly unrelated, symptoms begin to get better and/or resolve. The acupuncturist will still address symptoms giving the patient discomfort, but the differential diagnosis that is built into the medical model requires treatment of both root and branch.


Can you provide an example of Differential Diagnosis?


Of course! Let’s pretend that Acupuncturist Scott receives four new patients on Tuesday, and all four of them that morning, funniest thing, are looking for help with migraine headaches! They are all tired of taking medication for their headaches because it doesn’t ever seem to fix the problem, and they’d just like some help to make them just go away! Well, Acu Scott knows that he is looking at four different people with chronic recurring headache. It’s unlikely that they all will get better with the same treatment because they could each have a different reason for their recurring headaches…. Fortunately for Scott he uses differential diagnosis, which allows for him to discover the reason(root cause) each of them is suffering.

As it turns out, Patient A always starts out with left posteriorly related orbital pain (behind the left eye pain) and her headache always seems to occur this time of the month, about 5-7 days before her menstrual period begins. So, she has Chronic Cyclical Headache due to Liver Blood Deficiency. Patient B has a non-cyclical headache that starts in his neck and these headaches began right after he was struck hard from behind while sitting in rush-hour bumper to bumper traffic. His headaches are classic Taiyang Occipital Headache due to local Qi & Blood Stagnation in Bladder Meridian(back of head and neck). Patient C always knows that he is going to get a headache because ha has an aura before it begins(a physiologic/symptomatic precursory sign), and his aura is a twitch in the outer corner of his left eye with a hint of indigestion/acid reflux. His headache is temporal(side of the head) and can be ipsilateral or bilateral (one side or both). Today he woke with a bitter taste in his mouth, a splitting headache on his left side, and before bed last night his left eye was twitching near the outer canthus. When Scott presses him for information about his diet it is learned that this headache seems to coincide with consumption of rich foods. His headache diagnosis is Shaoyang Damp-Heat Headache due to Dampness and Heat Blockage in Shaoyang Gall Bladder and Triple Warmer Meridians. Patient D has a recurring headache that hits her right at the top of her head, and she ‘s never sure when it will hit her but sometimes it happens when she’s feeling really stressed. She works in commission sales and has to meet revenue targets on a regular basis. She also complains that she gets hot at night, often has dry red irritated eyes that she takes lubricating drops for every day, doesn’t sleep through the night, and can get cramps during the night in her calves and feet. Her diagnosis is Jueyin Headache with Liver Yang Rising due to Liver and Kidney Yin Deficiency with Yin-Deficiency Heat.


Differential Diagnosis leads to proper Chinese Medicine (W)Holistic Treatment


A proper differential diagnosis provides the acupuncturist with an exact treatment principle and protocol. For example, with Patient D above – her diagnosis is a very clear one. Jueyin Headache with Liver Yang Rising due to Liver and Kidney Yin Deficiency with Yin-Deficiency Heat. The treatment principle is already in the diagnosis. (Jueyin refers to the location of the headache, being the apex of the head and the location of the apex of the Liver Meridian) Acupuncturist Scott knows that he needs to Sedate Liver Yang, Nourish Liver and Kidney Yin, and Clear Deficiency-Heat. And, of course, stop the pain – but this treatment plan, when executed properly with acupuncture treatment and the correct related Chinese herbal formula (‘Tian Ma Gou Teng Yin Tang San’ in this case), will not only sedate her headache today but will resolve these headaches for the long term because Scott has also resolved the cause of her recurring headaches.