By Douglas R. Briggs, DC, Dipl. Ac. (IAMA), DAAPM, EMT
I am sure we have all heard the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail." The idea being that you can become so focused on the thing you do that you forget that there are other options out there – other tools in the toolbox.
As acupuncturists, it becomes very easy to focus on the meridian system and direct all our attention there – Where is the blockage? What is the point to use? But the problem quickly becomes that we can miss much more information about our patient if we do not take the time to assess the whole person. Patients come to us with complaints looking for help - we are responsible for recognizing that our patient is a whole body – not just a meridian system.
For example, a patient presenting with wrist pain may be quickly diagnosed with carpal tunnel syndrome by the orthopedic surgeon. I have seen many patients who were diagnosed with or had surgery for carpal tunnel who never addressed the problems farther up. On the other hand, a chiropractic physician may very well recognize neck and shoulder components to the condition causing radicular symptoms down the path of the median nerve. But what about the elbow? Overuse strain of the forearm extensors can easily cause pain, limited motion, and irritation along the path of the median nerve. I have also seen patients with radicular arm pain who never had their elbow evaluated or addressed. Remember the body is an integrated whole. I recall my acupuncture mentor saying: "anything can cause anything." Keep an open mind and be willing to step outside of the box.
One of the fascinating aspects of traditional medicine is the attention to seemingly random physical details. It is my impression that not much attention is given to this skill in most western medicine. Much can be learned from simple observation of the body. The hands are a wonderful example.
Just looking at the hands:
Palm color – the color in the center of the palm suggests systemic body disorders
Red – circulation
Purple – Respiratory and Reproductive
Dark – excretory
Yellow – liver and gallbladder functions
If the palm is rigid and tight – this can be a sign of underactive digestive and circulatory functions.
Spacing between the closed, flat fingers is recognized as a sign of nutritional deficiencies and an imbalance in the physical constitution.
Holding the palms together and pushing the elbows up – the Reverse Phalen's Test – you should be able to get your wrists to a right angle – if not, this is a sign of stress and tension.
The wrist crease. Swelling at the wrist crease on the palmar side can also suggest metabolic issues.
Below the thumb – disorders of the lungs or large intestine
In the middle – disorders of circulation and the reproductive system
Below the pinkie – disorders of the heart and small intestine.
The Nails: The shape and contour of the nails (naturally – without polish) can also give great insight into the constitution.
Vertical ridges – suggest imbalanced nourishment
White dots – on the nails shows the body has been in a state of sugar elimination
Horizontal indentations or splitting – suggests a major dietary change
Rounding of the nail and bed – suggests lung and breathing isseus
Squaring of the nail and bed – may signify high blood pressure
Bump across the nail – is seen as a sign of intestinal parasites
Grooving – also suggests malnutrition from poor diet.
There is much more detail we could go into on this topic, but this should show how much you can infer from some quick simple observation of the body. Of course these methods were developed long before we had modern diagnostic techniques – no responsible practitioner today would formally diagnose high blood pressure simply from the shape of a fingernail, but we can gain great insight into a person's overall condition if we take the time to look. Other diagnostic testing may then be very reasonable and appropriate – know who to refer to. As always, take the time to document your observations, impressions, and plan.
Kushi, Michio. How to See Your Health: Book or Oriental Diagnosis. Japan Publications. 1980
Ohashi. Reading the Body. Penguin Arkana. 1991
Wild, Donna Burka. The Skin, Tongue, and Nails Speak. Unique Perspective Press. 2012
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