Chinese
Diagnosis
by
Jane Wurwand
Reprinted from Les
Nouvelles Esthetiques,
published in the United
States
Western medicine dictates that each organ of the human body stands alone, with medical specialists practicing in each of the different fields. It is the Chinese who see the body as a whole, where each organ is related to another--for example, the lungs and skin, liver and eyes, kidneys and ears, stomach and muscles are all sister organs, and it is the whole being that is treated and not just the symptoms. A health problem may not just be a physical problem, as the Chinese believe that a mental or spiritual imbalance could be the cause.
Presenting a subject such as Chinese Diagnosis offers an alternative and does not mean that one method is wrong or right, but it gives skin care therapists a different way of looking at skin analysis and consultations.
The earliest book on Chinese medical theory dates back to around 2500 B.C., the Inner Classic of the Yellow Emperor by Kwang-Ti. The book is called the Nei Jing, with the Chinese view seeing symptoms in relation to the whole body, not as isolated problems to be dealt with on an individual basis. Western medicine starts with a symptom, then searches for a cause, then determines a specific disease. Chinese medicine focuses attention on the complete physiological and psychological individual with all general characteristics woven together to establish a pattern of balance. Chinese medicine looks for disharmony of natural body energy, and does not seek a specific disease. The Chinese method is, therefore, holistic, based on the idea that no single part can be understood except in relationship to the whole.
The essential ideas of Chinese medicine are simple, they form a basis of a discussion of "what"s going on" in the body. They define the basic landscape of the body as:
Qi: Our basic life force and energy. Formed from maternal energy in the prenatal state, then replenished by food and breath. It directs and determines the body"s energy state, and is predominantly either Yin (passive) or Yang (active) in nature. It flows throughout the entire body via the meridian network of the body.
Blood: A liquid, Yin in nature, which nourishes and maintains the body parts.
Jing: Translated as essence of the body. Supportive and nutritive, it is the basis of reproduction, growth, ripening and withering. Ongoing development through life corresponds to changes in the body"s Jing.
Shen: Best translated as Spirit. An elusive concept in the medical tradition, human personality and consciousness indicates the presence of Shen. It is the capacity to form ideas and the desire to live life. Yang in nature.
Fluids: These are body liquids other than blood and includes sweat, urine, gastric juices and saliva. Their function is to moisten and lubricate the hair, skin, membranes, orifices, muscle, organs and flesh.
During a Chinese medical diagnosis, each of these elements of the body"s landscape is taken into account, and assessed through the "Four Examinations."
Yin and Yang
Before looking at the four examination process, you need to define Yin and Yang energy. All things have two aspects, a Yin aspect and a Yang aspect. Yin and Yang balance each other, and in a normal healthy state, there is a balance and harmony between Yin and Yang, their proportions moving smoothly in and out of each other.
When we expand and fill our chests with air, we are in the Yang phase of breathing. When we exhale and deflate our chests, we are in the Yin phase of breathing--Yang expands and Yin contracts. We constantly fill and empty our stomachs, lungs, hearts and minds. We are active (Yang), and lie quiet and rest (Yin).
The internal organs of the body, hidden and protected, are Yin in relation to the exposed skin and muscle which are Yang. The lower part of the body is in contact with the ground and is, therefore, rooted and more Yin. The upper body is able to move freely in the air, and is more Yang. The front of the body is protected by folding the arms and legs to enclose the chest and abdomen, whereas the back of the body is more exposed, hence the front is more Yin and the back is more Yang.Harmony
People can be characterized as being more Yin or Yang, depending on their character, attitudes and body structure, but these energies exist in harmony, so a person is never totally one or the other at all times, but may be predominantly one type at certain times. The key is to achieve balance, which means becoming diverse, moderate, flexible and in harmony with our body"s natural rhythms and needs. A Yang body is stronger, more tense, springy and muscular with a greater capacity for food and activity and a minimal requirement for rest. Yang people prefer and feel comfortable in a stimulating environment, and act quickly and impulsively. It is the characteristic of Yang to over- indulge without severe consequences and, when sick, suffer intensely and recover quickly. Yang types tend to become Yin deficient and in such cases have difficulty relaxing and calming down, verging on hysteria. A Yin body is more slender and sinewy, soft and dense rather than tense and wiry. To be Yin is to enjoy quiet, calm, simple environments and possess a more limited capacity for food, work and social interaction. It is a preference of Yin to avoid prolonged stress and to desire regular, adequate periods of rest and relaxation. Yin types become sick slowly and symptoms linger for longer. Yin types are more conservative and efficient, more like the tortoise than the hare. Yin types tend to become Yang deficient, and in such cases become demotivated, introspective and tend to depression.The four examinations
The Chinese examine the body through the four aspects of the person. The major qualities are Yin and Yang. Disharmonies always involve imbalances of Yin and Yang. The four examinations are:Looking: Called Bo-Shin. General appearance, including the physical shape, the person"s manner, the way they behave during the diagnosis and their general attitude, or Shen. We look at facial color, and how fluid and abundant the secretions of the skin are. In addition, the face can be divided into areas, which correspond with various areas in the body. Eruptions or lines in each area may indicate an imbalance in that area of the body. The Nei Jing states, "Yang is movement, Yin is quietness." This is the key to examining the person"s manner and emotions. A person who is agitated outward, talkative, aggressive and irritable is usually manifesting a Yang tendency. A passive, inward, quiet manner is usually Yin. Quick movement is usually part of a Yang pattern, and slow, deliberate movement is usually part of a Yin pattern. If the person, when on the couch, stretches their feet, removes the covers, or moves away from heat, they may well be suffering from excess Yang. If they curl up in the couch, like to be covered or want to be near heat, this indicates a deficiency of Yang, and the person is excessively Yin. The ideal facial appearance is moist and shining. A pale facial color, when compared to the rest of the body indicates deficient Yang, or excess Yin. Red coloring and heat indicates excess Yang, and needs calming.
Listening: Called Bun-Shin. Coarse, strong breathing or loud excessive talking indicates excess Yang energy which needs "cooling." Weak, short breathing or low voice with little talking indicates excess Yin, which needs "heating."
Asking: Called Mon-Shin. Essential to establishing information. Covers topics such as sensations to heat and cold, skin secretions, thirst and appetite, sleep and waking patterns, pain threshold and medical background. Yang dominant people tend to feel cool and dislike cold and damp climates and environments. Excess skin secretions indicate a more Yin energy type. People whose aches and pains are diminished by heat and relieved by massage are Yin energy types. People whose aches and pains are diminished by cold packs and aggravated by massage are Yang energy types. Excess thirst is a sign of Yang energy, so is thirst without the desire to drink water. The Chinese call insomnia "Yang energy unable to enter Yin," alternatively, an excessive desire to sleep indicates an overly strong Yin energy.
Touching: Called Setsu-Shin. Is the skin cold, hot, dry or moist? Is pain diminished or aggravated by massage? To balance the other person"s energy with massage or touch, we must first determine what opposite energy-type they require to balance their own. In a medical diagnosis, the patient"s pulse would be felt. This pulse taking is not only of the blood, as in western medicine, but is a pulse taking of both the blood, and the Qi, or life force.Yang-type body energy diagnosis (yin deficient)
Looking: Agitated, restless, active manner, forceful movement, likes to stretch when they lie down. High complexion (tendency to redness)
Listening: Loud voice, talkative, exaggerates, loves drama. Many use mood-altering substances (tobacco, alcohol, caffeine). Left brain. Past orientated. Extreme Yin deficiency leads to aggression and irritability.
Asking: Feels warm. Dry thirst. Dislikes heat and touch. Prefers machines.
Touching: Skin feels warm. May be prone to inflamed breakouts, prone to rashes and dermatitis.
Key approach: (cool down) relax and de-stress. Cool beverage/relaxing herbal tea; sedating essential oils; gel masques, cooling contour masques; aromatherapy massage; reflexology. Begin facial with a back massage, for stress reduction. Needs a sanctuary to escape to. Responds to a simple and fast skin care regimen. Quickly loses interest and needs continual assessment and stimulation.Yin-type body energy diagnosis (yang deficient)
Looking: Quiet, withdrawn, tired. Likes to lie down and curl up. Low energy. Pale complexion. Lymph retentive. Sluggish skin, prone to be sallow.
Listening: Soft voice. Few words. Breathing may be shallow and weak. Right brain. Future orientated. Extreme Yang deficiency leads to demotivation and depression.
Asking: Feels cold. Desires warmth and touch. Enjoys massage. Likes hot drinks.
Touching: Skin is cool to the touch. May be dry and withered or, if oily, will tend to a sluggish, comedone prone type of condition.
Key approach: (heat up) motivate and excite. Warm beverage; blankets; infrared heat; steam; heated
mittens/booties; electrical brushing for cleansing; stimulating essential oils. European massage or lymph drainage (if puffy); paraffin wax treatments. Responds to orderly and systematic approach to skin care. Seeks harmony. Able to grasp kinetic treatments like aromatherapy.Genetic
A Chinese analysis looks at the person as an entire being, and not separated as in western medicine where the symptoms of a disease/ illness are treated, and also looks at the cause of the problem.Two elements are incorporated into the Chinese diagnosis, the constitution of the person--this being the genetic aspect, either passive or active and the condition of the personÐthis being the current condition which varies each day, month, year. Everything is about balance. The body wants to be a balance of health; we do not want to be ecstatically happy or depressed. There is a balance between work and rest, waking and sleeping, and if we are in perfect balance, then we are in perfect health.
The role of the skin care therapist fits within the stress stage. It is becoming realised how important a role therapists have, not only for skin and body care, but for relaxation and destress purposes, therefore,
delaying our journey in the disease and death stages. We do not treat distress or disease, and if we do not get the opportunity to restore balance where and when we can help, it will become the job of the hospital. The Chinese physician will be treating the cause and looking for the origin of imbalance, believing that energy flows through meridians in the body to keep the organ/system functioning. The system of meridians feed the organs and keep them energized and, if a problem occurs on a meridian, it will affect the related system.
There are 12 meridians in the body and there are approximately 365 acupressure (tsubo) points lying on the meridians. These can be identified as they have measurably lower electrical resistance thus enabling the therapist to pinpoint them. We can treat by applying energy to the tsubo point. We can stimulate with acupuncture (placing a needle into the tsubo point) which is a fast way to gain relief, acupressure (finger and pressure) which takes longer to gain results and moxibustion--a heat treatment process. All three methods can be used, and it is also possible to manipulate the point and block energy on the meridian, thereby achieving a numbing effect as no energy reaches a specific part of the body.Oriental facial skin analysis
In traditional Chinese medicine, the face is an indicator of health or disease. By studying skin conditions and changes, we can determine inner imbalances and stressed areas of the body. Because each area of the face is said to relate to an internal body area, disharmony in that internal area will, in turn, lead to a change in the complexion, texture or moisture of the corresponding facial area. In general, red, pustular breakouts are indicative of a Yang-type energy, and oily, comedone-prone breakouts are indicative of a Yin-type energy. Lines indicate a long-term imbalance or stress, breakouts indicate a more short-term imbalance or stress. This information is not intended formedical diagnosis, but merely to illustrate the Chinese approach to facial diagnosis.
Forehead: Linked to digestion. Upper forehead linked to bladder, lower forehead to the intestines. Check elimination/constipation.
Eyebrows: Coarse hair of the eyebrows indicated adrenal stress. The adrenal glands are our Òfight or flightÓ response and secrete over 40 hormones and steroids. Overactive adrenal glands are commonly linked with stress. Thick eyebrows are Yang. Thin eyebrows are Yin. Lines stemming from the start of the eyebrow are linked with long term adrenal stress, and may correlate with tightness in the shoulder area, which is a referred pain area.
Between the eyes: Linked with the liver. Eyes and liver are ÒsisterÓ organs in Chinese medicine. Check history of hepatitis/jaundice/liver stress.
Eyes: Linked with the liver. Eyes set wide apart are Yin. Large eyes are Yin. Eyes close together are Yang. Smaller eyes are Yang. Long eye-lashes are Yin. White showing underneath the iris of the eye is Yin. Eyelid allergies are linked with allergies and lung stress.
Under the eyes: Links with the kidneys. May be puffy (Yin) or darker (Yang). There is a need to improve water intake and/or lymph drainage if they suffer puffiness and fluid retention. Grittiness under the eyes links with an excess of uric acid, common in Yin energy types. A pale white appearance of the inner lid indicates a Yin energy, while red inner lid area indicates Yang energy.
Nose: A long nose is more Yin, and a small nose, pointing upwards is more Yang. Naturally large and open nostrils indicate strong lungs. Smaller or flaring nostrils indicate lung stress, allergies and asthma types. Numerous comedones and oiliness over the nose indicates a Yin energy, prone to colds and bronchitis. Redness, broken capillaries and puffiness over the nose, indicates a Yang energy, prone to allergies, respiratory stress and sinus problems (hayfever, sensitivity to smoke, etc.).
Cheeks: Link to lung area. Broken capillaries across the upper cheeks indicate a tendency to allergies and sinus congestion. Comedones and congestion beneath the surface indicates a Yin condition. Red, inflamed and pustular breakouts indicate a more Yang condition. Pustular breakouts in line with the teeth may indicate sinus or gum inflammation and infection.
Mouth: Cracking and dry lips are Yang, and link with stomach/gastric stress. The upper lip links with the stomach, and a turned upper lip indicates stomach acid, indigestion or a nervous stomach (Yang-type energy).
The lower lip links with the large intestine, and a pouty, full lower lip links with constipation and poor
elimination (Yin-type energy).
Chin: Links with the reproductive organs. Breakouts in this area are often associated with the menstrual cycle in women. Micro-comedones are often present at the sides of the chin, and may erupt into papules or
pustules at the onset of menstruation.
A complete skin analysis routine
1. Review the consultation card and discuss with the client--determine general skin type/personality.
2. Look at the skin while client is sitting--view face-to-face-- paleness, eye/nose shape, mouth shape.
3. Look at skin through magnifier, scan the surface thoroughly.
4. Feel the skin as you check it section by section--skin temperature, under the surface texture.
5. Check congestion/areas-- comedones vs. pustules, which area of face?
6. Check dryness/areas/type of dehydration vs. oil/dryness.
7. Check redness/couperose, rashes, eczema, broken capillaries vs. pale.
8. Check skin tone and elasticity-- puffiness under eyes, lymph retention, muscle tone.
9. Check hair growth--eyebrows, below chin, adrenal stress, pregnancy etc.
10. Check pigmentation--where? check adrenal stress, pregnancy etc.
11. Determine Yin vs. Yang energy type and ensure treatment compatibility--design treatment for skin condition and energy type.
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