Michael Tierra L.Ac, O.M.D.
A. Origins and means
Diagnosis in scientific medicine (derived from the word "discern" in
Greek) is based on patient's history and physical examination and on
laboratory testing. Case history taking is a tradition dating back to the
time of Hippocrates and a good physician is skilled at how and when to ask
the right questions. I have concurred with Andrew Weil when he states, "
More than one skillful physician has said that if one asks the right
questions, the patient will make the diagnosis for you in his or her own
words." Physical examination is also an ancient art which has changed
dramatically since the advent of instruments in the 19th century.
Laboratory testing is a radical contemporary innovation that is rapidly
becoming the mainstay of contemporary Western medical scientific diagnoses
and along with expensive technological diagnostic procedures threatens to
replace the traditional art of case taking and direct observation and
While previous diagnostic methods used by Western physicians were similar
to the so-called Four Diagnosis of Traditional Chinese Medicine, the use of
diagnostic instruments dates back to 1819, with the introduction of the
stethoscope by the French physician, Rene Laennec (1781-1826). An explosion
of diagnostic technology occurred in the late 1800s with the mushrooming
appearance of four types of procedures and inventions:
or means of visualizing gross anatomical structures, including the opthalmoscope, laryngoscope, and X-ray;
medical use of the microscope to
correlate specific diseases with specific germs and tissue changes;
devices for measuring body function in momanometer, and electrocardiogram;
chemical tests of body fluids and tissues.
In 1954 the Yale-New Haven Hospital performed forty-eight thousand
laboratory procedures; in 1959, ninety-eight thousand; and in 1964, two
hundred thousand, while the patient census increased only slightly in the
same period. In the US as a whole, about 2 billion laboratory diagnostic
tests were done in 1971, 3 billion in 1974, and 4.5 billion in 1976
(Stanley Joel Reiser, Medicine and the reign of Technology (Cambridge,
Eng.: Cambridge University Press, 1978), 159).
The increasing reliance on expensive diagnostic procedures and testing is
sometimes called by some critics "defensive medicine,' because its intent
seems more to protect the doctor than to help the patient. With the
increase of malpractice suits by dissatisfied patients, doctors have been
forced to resort to such extensive and expensive high tech diagnostic
procedures in attempt to protect themselves.
Nevertheless, the best diagnosticians remain highly trained observers who
have learned to rely on intuition based on subtle observations. Andrew Weil
describes "an old clinician in Boston who could "guess" the blood pressure
of patients in the hospital by watching them lying in their beds. His
guesses were usually right to within a few points."
Urinalysis, X-rays, and standard blood tests may clinch an intuited
diagnosis or provide useful clues to prompt one and generally do not cause
much discomfort or damage. "Newer tests," according to Andrew Weil, "are
directly productive of illness --- iatrogenic illness, that is,
doctor-caused (from iatros, the doctor of ancient Greece)." Some of the
procedures that may injure or even kill significant percentages of patients
include, sampling pieces of liver, lung, and kidney, infecting radiopaque
dyes into arteries, exposing patients to great numbers of diagnostic
X-rays, injecting powerful drugs for diagnosis.
Criticism by the AMA leveled at the few possible mishaps which have
occurred in chiropractic and traditional medicine must be compared to the
large numbers of mistakes which have been caused by medical doctors not in
the course of treatment but simply as part of contemporary diagnostic
procedures. These may include such methods as pneumoencephalography
(injecting air into the ventricles of the brain for diagnostic X-rays),
angiography (putting catheters and dyes into major arteries), and many
other techniques counted as standard procedure in every Western allopathic
B: Level of Reliability
a. A nationwide, 32 hospital study compared 1800 clinical diagnoses made
on living patients to anatomical diagnoses made at autopsy. They found the
error rate was nearly 20 percent. About half of those mistakes probably led
to death. (Washington University in St. Louis Feature Service, September 1985)
With an 800 billion dollar a year U.S. medical bill, much of which is
simply involved with the process of diagnosis, we see how such extreme
reliance on high tech diagnostic procedures, not treatment contributes the
largest percentage of that bill.
One is reminded of a statement by the German philosopher, Immanuel Kant,
"Physicians think they are doing something for you if they label it as a
1. Applied kinesiology --- Dr. George Goodheart saw a relationship between
each large muscle of the body to a body organ. He posited the idea that
weakness in a muscle usually meant that there was a problem at the energy
level in the associated organ. He found that by treating the muscle in a
variety of ways and making it strong, he was able to improve the
functioning of the organ.
One of the methods used Dr. Goodheart to strengthen a muscle was through
nutrition. Thus is a particular nutritional supplement was given to a
patient and the muscle tested strong, it was the right supplement; if it
tested weak, it was not. Other methods of treatment could be similarly
evaluated such as physical manipulations.
Basically this was a good bad method based upon the subjectively
evaluation by the practitioner as to whether a particular muscle felt
stronger or weaker when influenced by a particular substance, event or
One of Dr. Goodheart's students was Dr. John Diamond, M.D. who was an
Australian psychiatrist who relocated himself in the United States. After
studying Dr. Goodheart's methods, Dr. Diamond, seeing tremendous
psychological value in the concepts of Applied kinesiology and developed
his own more psychological approach which he called Behavior Kinesiology
2. Behavioral psychology, according to Dr. diamond is based on the
physiological feedback loop of the Thymus gland. While previously, before
the 1950's, little was understood about the thymus since then with the
increasing recognition, largely with the dawn of AIDS, of the immune
system, the thymus has risen in importance as the special area of the body
where bone marrow generated lymphocytes, are transformed by thymus hormones
into generations of lymphocytes called T-cells.
While B cells are antibodies originating in the bone marrow and secreted
by plasma cells to protect the body against external invasions of bacteria
and viruses, T-cells are B-cells which have been transformed in the thymus
by a secretion called thymosin or thymopoietin, into cytotoxic T-cells. The
job of T-cells is to destroy cells which have become cancerous or infected
Understood in the light of BK, the thymus gland creates T-cells
specifically to "distinguish self from non-self, friend from foe, and to
destroy foreign cells." These T-cells perform a vital immunological
surveillance that is directly concerned with the body's ability to resist
infections and cancer.
In all mammalian species there is a tendency for thymus activity to
diminish with age with a correspond risk of deadly diseases such as cancer.
The thymus gland, itself, is very stress sensitive. Within a day after
undergoing a severe physical or emotional stress, millions of lymphocytes
are destroyed and the thymus shrinks to half its size.
It is specifically this internal ability of the body to recognize viruses,
bacteria, diseases and cancerous cells as "friend or foe" that is at the
heart of Diamond's Behavioral Kinesiology. He hypothesizes that if certain
cells created by the thymus, can recognize foreign or non-foreign
substances as useful or not, than the mind of the individual must also be
capable of such a recognition. In many instances, this recognition is at
the subconscious "energetic" level so that the therapist using BK must find
a way to access this "inner knowing." This is done by first establishing a
normal resistance of a muscle group, usually, because of convenience, the
middle part of the deltoid and then comparing this muscular strength or
resistance while pointing to, thinking about or otherwise allowing the
influence of a specific bodily area, food, supplement, herb or other
The basic purpose of BK is to test the positive, "good-bad" effects of a
substance or experience first on the thymus gland as the primary center of
the immune system. In fact, according to Dr. Diamond, the method can be
used to diagnose the condition of specific organs or functions in the body
as well as determine the effect of specific substances and experiences on
any or all other areas of the body.
The value of this diagnostic system, if indeed it can be regarded as such,
is that it generates information from the "inner" subconscious knowing of
the patient. The therapist only becomes a facilitator of this process. This
approach, in itself, has considerable therapeutic benefit whether in fact,
the information indeed originates within the patient or from various
subjective or objective evaluations of the practitioner.
Using such a system, begins by indirectly centering and empowering the
patient to an understanding that he or she is responsible for his or her
own well being. That there are specific foods, supplements or herbs one can
take that will prove to be uniquely relatively beneficial or harmful. The
therapist serves as a facilitator to help the patient access this obvious fact.
The method is especially beneficial if the therapy one uses is largely
dependent on the patient's cooperation in affecting certain psychological
and life style change. It metaphorically informs the patient through
suggestion that if he or she, thinks, acts or eats differently for
instance, he or she can expect first an immediate positive response by
demonstrating a stronger muscular response through BK, secondarily a
stronger and more positive response in terms of all other physiological
muscles and organs as well as all mental process.
The negative aspect of this approach is first that it confines itself to
an implied "good-bad" methodology. Secondly that results while taking off
from pseudo objective scientific theories cased on, for instance, the
immediate response of the thymus gland to the mere thought of a "good or
bad" substance or experience, has little control over the influence of
other experiences that may be simultaneously influencing or might I say,
distracting, the patient while being tested.
Dr. Diamond cites how one will test negative to white sugar, coffee, loud
rock music, a disturbing color, picture, odor or any other experience. How
can the therapist be sure that the BK results are confined to the
particular stimulus being tested.
The only answer, is that while intending to base one's results on the
"inner knowing" of the patient, the therapist, in fact is bringing to bear
a lifetime's worth of personal experience and prejudices which will have a
decisive influence on the ultimate results. First, we must bear in mind
that it it not so easy to objectively determine the relative strength or
weakness of a muscle. There are, as Dr. Diamond readily admits, many
influences that will influence a patient's response. some of these are from
the patient such as:
The will or determination of the patient to offer or not significant
muscular resistance is capable of being influenced by various factors. One
is the well known tendency of patients to want to please their therapist or
otherwise make him or her right," which the patient unconsciously sees to
be for his or her own benefit. This is greatly aided by various indirect
non-verbal cues from the therapist who may have a particular preconceived
opinion or prejudice such as "alcohol and white sugar is not good for you,"
The personal determination of the therapist to motivate the patient to
make those changes that he or she knows or senses would be in the best
interests of the patient. This can be an unconscious evaluation on the part
of the therapist testing the strength of th muscle or a secret conscious
determination based upon the therapist believing that he or she knows what
is best for the patient. In any case, such considerations would certainly
compromise any shred of objectivity on the part of the therapist.
Simple muscle fatigue from continues and repeated pressure will
influence the relative strength of a muscle, especially if the determination
is within a relatively small degree.
Kinesiology has become a very popular diagnostic modality by many
holistic therapists including chiropractors, some osteopaths, occasional
maverick holistic medical doctors, herbalists, nutritionists, naturopaths
and acupuncturists. For some it serves as an obvious trick to motivate and
empower the patient to make those changes that the therapist already has
determined will be good for the patient. For others it offers an efficient
right brain exercise that is a welcome relief from the labyrinthine
theoretical considerations unique to the discipline of each therapeutic
modality. The danger, is that the therapist abandons his system of
knowledge and skill, which admittedly requires continues practice and study
for a non-system approach which may be far more inaccurate and certainly
deprives the therapist from gaining deeper understanding of his particular
By confining one's self to a good-bad feedback mechanism, the breadth of
understanding that is possible from a more balanced understanding based on
physiological homeostasis in Western medicine, yin yang balance in
Traditional Chinese Medicine or Tridosha theory in Ayurvedic medicine is
lacking in kinesiology. The danger then is to prescribe diet and
supplements based on an overly simplistic understanding of differences of
constitution and disease manifestations between people. Using a good-bad
determination, offers little recognition for the possibility that is equally
a part of holistic medicine and traditional medicine that particular
symptoms or disease patterns is often a manifestation of the best and
therefore most healthy response to an unhealthy stimuli or condition. The
job of the therapist from this point of view is to attempt first to
understand the unique expression of the patient without any preconceived
good-bad prejudicial considerations and help the body complete the process
it is in the process of manifesting. This is most obvious in the case of a
rash or measles, which in traditional herbal systems is best treated by
taking herbs that help them ripen and complete their cycle of expression.
Given the fact of all the complex variables described above, it is
impossible to apply the rigorous double-blind testing that medical modern
science requires, one would have to say that kinesiology as a diagnostic
tool would fall more under the classification of shamanistic rather than
clinical. As with any of these systems, the value of diagnostic evidence
from muscle testing is absolutely dependent on the skills and "other"
knowledge that the therapist possesses rather than confirmable diagnostic
Recently, some acupuncturists, inspired by a Japanese therapist, use a
system called "O" ring testing. This is done by testing the muscular
resistance of the thumb and index finger when firmly locked together to
form an O.
As with other, holistic diagnostic systems, a good deal of the success of
patients treated based on kinesiology is the broader an more general value
of the more wholesome foods, supplements, physio-therapies that accompany
it. Just as it is impossible to limit the effects of a vitamin such as
vitamin C or an herb such as ginseng to a particular part of the body, it
is also impossible to isolate the effects of a particular acupuncture point
or spinal manipulation. This is not offered so much as a criticism of
kinesiology as a diagnostic system but more to place it into perspective.
It is my personal opinion, however, that it is very dangerous for a
practitioner to abandon the diagnostic discipline of his own particular
therapeutic modality solely on the basis of kinesiological diagnosis.
According to the admittedly questionable legend of the origin of iridology
as told by Bernard Jensen, it all began as follows: during the mid 1800's a
ten year old boy destined to become Dr. Ignatz von Peczely of Egervar,
Hungary, was playing with his pet owl. Accidentally one of the owl's legs
was broken. The young boy remembered noticing a curious dark stripe form in
the lower region of the iris of the bird which he later realized
corresponded to the area of the leg. Eventually the black stripe became a
tiny black spot which gradually filled in with white lines and shading.
This youthful incident made a lasting impression on the boy so that when he
later grew into a successful doctor working in hospital surgical wards at
the college hospital he had the opportunity to observe the irises of
patients after accidents and operation. From this he was able to develop
the first iridology chart outlining corresponding areas of the iris of the
eye with all parts of the body.
Doctor von Peczely published his first book called "Discovery in the Realm
of Nature and Art of Healing" in 1866. The work was first promoted in
Germany by August Zoeppritz. Later, Dr. Emil Schlegel of Tuebingen
published a book on the results of von Peczely's establishing the Germans
ongoing interest and evolution of iridology or the method of diagnosing the
body by study of the iris of the eye.
A Swedish homeopath, Nils Liljequist, further improved the methods of iris
diagnosis and introduced it to America. A two volume set based on a
translation of his writings was called "Diagnosis from the Eye."
Dr. Henry Edward Lane, a native of Austria, moved to this country and
taught iridology to Dr. Henry Lindlahr of Chicago. Dr. Lindlahr practiced
iridology and wrote about his experiences in his many books. Dr. Lindlahr
was famous for emphasizing the importance of the "law of Cure" based on
retracing prior acute symptoms which he believed were the beginning of all
One of the greatest iridologists of recent times is Peter Johannes Thiel
of Germany. A detailed and outstanding textbook was by Dr. J. Haskell
Kritzer. The late Dr. John Raymond Christopher and Dr. Bernard Jensen both
have been popular exponents of this system which in turn has been adopted
by thousands of their followers and students.
As a student and protégé of the beloved Dr. Christopher, I began my career
as an herbalist using iridology as the sole diagnostic method. The reasons
why and the fact that after three years I abandoned it in favor of
traditional Chinese and Ayurvedic diagnostic systems, is based upon certain
deficiencies I personally felt and experienced with iridology.
I say this despite the fact that many of my respected herbal colleagues
still strongly rely on iridology as their primary system of diagnosis and
obviously must be getting, as I did, some positive results in their
prescribed herbal and dietary treatments based on iris diagnosis. What
ultimately persuaded me to give up the practice and teaching of iris
diagnosis was its inaccuracy and the tendency to provide the same kind of
limited unholistic good-bad negative information to the majority of
patients. In this I was reminded of how I felt when I personally attended
Dr. Christopher's readings and heard him say essentially the same thing to
every patient and subsequently prescribe the same diet and at least one of
his formulas for each major organ in the body. Dr. Christopher also got
very good results, but I feel certain that, despite his statement to the
contrary, his results had little to do with his iris diagnosis and
everything to do with the generally beneficial nature of his dietary regime
for the majority of patients he was seeing at the time and the broadly
beneficial effects of his herbal formulas.
My own misgivings about iridology became especially apparent when giving a
seminar at Esalen and I was casually socializing and sitting with several
of my students on the living room floor of Pfeiffer house one evening when
they all requested that I read their irises. I must have read from twelve
to fifteen sets of irises over the course of an hour. It was at that time
that I was confronted with questions about the accuracy and ethics of a
system that authoritively told somebody based on a single piece of rather
inconclusive evidence, that they were essentially sick or nearly sick. I
heard myself reciting the standard litany of iridology, "nerve rings here,
prolapsed colon there, heart lesions, etc." -- even to the point of
suggesting cancerous or precancerous conditions any or all of which may or
may not have actually existed!
One positive outcome for them was that they became motivated, hopefully,
to a better lifestyle and dietary regime. For me and hopefully for them,
that they had the experience of purchasing several of Dr. Christopher's
excellent formulas which I just happened to be selling and might experience
the many health benefits from following a relatively balanced herbal program.
As I became more deeply interested in traditional Chinese herbal and
Ayurvedic differential diagnosis, I found iridology to be of little or no
value compared to the more comprehensive value of these Asian diagnostic
systems. My last consideration for the value of iridology was the hope that
I could monitor a patient's progress by observing the fabled "fine white
healing lines slowly filling in the dark lesions," which I never saw or the
eyes change to a lighter color, which I did observe and was supposed to
represent a cleansing or detoxification. The problem was that matching the
lighter eye shade that developed after a patient went on a cleansing,
vegetarian, mostly fruit and raw food diet for a few months, from the
perspective of Chinese differential diagnosis and based on other signs and
indications, represented blood deficiency or anemia.
Nevertheless, despite the fact that I was no longer using iridology but
relying solely on traditional diagnostic systems of Traditional Chinese
Medicine (i.e. acupuncture and Chinese herbalism) I was undaunted to try to
satisfy at least for myself the value and truth, if any of iridology. A
younger colleague fully equipped with the most up to date specialized
iridology equipment introduced himself and stated that he wanted to give
iridology readings at my clinic and at the same time monitor the course of
my patients over a period of six months.
Given the fact that for most of us as well my patients six months is quite
a long period, there was ample opportunity for many of these to go through
a variety of health related changes. Some people became well and got sick
again with either the same or perhaps a different set of symptoms, others
suffered injuries or operations. They all had their irises repeatedly
photographed and studied by my colleague and myself. Where was Peczely's owl
or the markings he claimed to observe in patients of the 19th century
Hungarian hospital ward? Were were the fine white healing lines that were
supposed to knit together the small dark lacunae corresponding to the
healing of operations and injuries of different parts of the body?
Our conclusion after six months: my colleague, trying to hold on to the
fast disappearing shred of belief in the validity of iridology sheepishly
and somewhat guiltily sold his camera to another would be iridology
enthusiast. I buried my official iridology magnifying head band in a box in
a dark, hopefully soon forgotten area of my office closet, where I must
confess it still remains after over 15 years, unopened.
Since that time and only last year I spoke with another herbalist,
colleague, Debra Nuzzi who worked as the editor of many of Dr. Bernard
Jensen's books, including his "The Science and Practice of Iridology." She
continues to hold Dr. Jensen in high esteem both as a teacher and dedicated
healer. Nevertheless in assembling the various photographs for his book,
she told me how she confronted Dr. Jensen with the fact that in the many
photographs she was editing to include in the book there were never any
fine white lines filling in dark areas that would exemplify healing and
recovery. It seemed that, like my colleague with the camera and myself,
attempts to discover positive signs of healing solely from iridology was
for Dr. Jensen more of a longed for hope than a reality.
As with kinesiology, I would not question the value of these "good-bad"
systems when used by an experienced and skilled practitioner. The problem
is when an inexperienced practitioner naively decides that he need not
study or practice any other diagnostic system. That he or she can know
everything solely from pushing a patients arm up or down or looking with a
magnifying glass in this or her eyes. As we shall see, even in Traditional
Chinese or Ayurvedic medicine few experienced practitioners would trust
themselves to rely solely on such highly respected systems as pulse or
tongue diagnosis. Rather these methods are part of a broader, more holistic
differential system which evaluates different diagnostic indications,
comparing them against each other and arriving at a differential hypothesis
for which to begin treatment.
Radionics is a diagnostic method and treatment that is done at the
distance from the patient. Psionic medicine is a simpler version of
radionics that is primarily based on the use of a device such as the
pendulum. Both these methods are based on a similar unified theory concept.
This concept was developed and exemplified through the teachings of a
distinguished physician, George Laurence, Mac Donagh and Rudolf Steiner and
it essentially affirms the interconnection of all life and phenomena as
understood in various Asian spiritual philosophies such as Yoga and
Buddhism. The concept of radionics and psionic medicine along with more
recent techniques such as crystal healing is based on the idea that by
clearing one aspect or part of the the self or universe through the force
of directed will and intention, another person or part of the universe will
also be cleared. Thus absent diagnosis and treatment of disease can be
accomplished by simply stilling the mind to a certain rate of vibration
(usually called "alpha" which is approximately seven brain cycles per
second) and focusing
inward one can determine and affect the condition of another individual
irregardless of their location in the world or universe.
Since many highly skilled and effective herbalists use a psionic methods
called "dowsing" with the use of a pendulum it is appropriate to consider
this approach as a prototype for a wide variety of so-called psychic or
shamanistic diagnostic methods. I must preface my discussion by saying that
I have absolute belief and first hand experience of the spiritual unified
field concept as well as the potential and power of a absent diagnosis and
treatment. I feel that such methods can be abused and misused and readily
admit of ingenuine charlatry and should be regarded, especially, it it the
only understanding one has of healing and health, with suspicion.
Radionic machines, including a wide variety of high priced
electro-diagnostic machines are being widely manufactured and sold and used
by very competent natural practitioners ranging from herbalists,
acupuncturists to radical medical doctors. I believe that such mercenary
sale and use of these pseudo-scientific devices are unnecessary since the
energy that is supposed to operate them is essentially mental. They may
have some definite "shamanistic" value as they constitute a material bridge
between the physical and mental worlds.
It is unfortunate and confusing at best, to substitute or mistake such
methods for appropriate understanding and study of herbal diagnosis and
healing. I have seen master herbalists such as the late Norma Myers of
Vancouver B.C. adroitly and expertly use a window shade string to determine
specific foods, herbs and amounts to include in an herbal formula for her
patients. I have confidence in her ability to do this because she had a
consummate knowledge of herbs and healing and would often use a pendulum to
check between a number of possibilities that she already considered might
be effective for a condition.
Since there is a big area for the influence of hypnotic suggestion and
placebo effect in such methodology, it is not always clear, nor, however,
do either the therapist or patient cares why something may be effective so
long as it is. The problem is that it may be unduplicatable in the hands of
another, unless one considers the implications of the use of Bach Flower
Essences as a manifestation of this same psychosomatic phenomena.
The general unreliableness of such an approach, plus its highly subjective
nature and tendency to be influenced by various external influences should
rule such methods of treatment as not inherent to the practice of herbal
medicine but useful as an adjunctive tool for diagnosis and treatment.
Spiritual medicine as a part of holistic healing has always been a part of
traditional herbalism in all cultures. We see this in the tendency to
combine shamanistic practices and rituals in Traditional Chinese herbalism
as influenced by the Taoists as well as the use of omens and talismans that
is a part of Ayurvedic medicine. further, herbs and diseases have been
classified in many traditional cultures according to astrological signs and
condition. This is seen in the writings of the famous sixteenth century
herbal physician, Nicholas Culpepper whose controversial statement as a
closing state of his famous Complete Herbal is "To such as study astrology
(who are the only men I know that are fit to study physic, physic, without
astrology, being like a lamp without oil."
The world's most renowned medical astrologist, Ingrid Naiman, achieves
phenomenal results in combining astrological-spiritual guidance together
with traditional herbal medicine for the treatment of cancer. I am honored
and proud of the fact that she has chosen to use my herbal Planetary
formulas, River of Life and The Complete Pau 'd Arco Combination along with
escharotic salves based on traditional Eclectic formulas to achieve her
The HERBAL TAROT developed by artist-herbalist Candice Cantin and myself
associates a single herb with each of the 78 cards of the Tarot. The major
arcana has a single herb assigned to each card that most represents the
energies and qualities while each of the four minor arcana or suites
corresponds to the four elements, the pentacles for the earth elements
using herbs that are good for digestion and assimilation; the swords for
the air element using herbs that are useful for treating the respiratory
and nervous systems; the cups for the water element assign herbs that are
good for the genito-urinary tract and finally the wands for the fire
element that combine herbs that both cool and stimulate circulation.
The traditional symbology of the cards are preserved to allow for the
subconscious mind to associate images that correspond to various stages and
states of one's conscious evolution. A particular spread can serve the same
purpose as a Navajo sand painting to help the patient get in touch with
different psycho-physiological aspects relating to their healing. The herbs
indicated can be used as talismans, essences or as "plant allies" that if
not specifically indicated for the patient, can help guide both the patient
and healer to an herbal combination that would be useful for their
Again, unless one were an Edgar Cayce, I would caution against the
inexperienced relying solely on such purely psychic or intuitive methods.
Usually it doesn't work if one's ego is involved and at times, it is very
difficult to remove one's ego sufficiently to achieve reliable results with
Western medical herbalism, unlike traditional Asian systems such As
Traditional Chinese Medicine, Ayurvedic and Unani or Tibb herbal medicine,
seems to lack a universally accepted traditional or school of herbal
medicine. Since the time of Henry VIII, with the signing of the herbalist
charter, herbal medicine has been protected in the UK and throughout the
Commonwealth (including Australia and New Zealand) against the type of
repression that has occurred in other countries, especially in the US.
There are no laws restricting the practice of herbal medicine in the UK by
anyone but there is the National Institute of Medical Herbalists who have a
four year curriculum with highly trained and qualified graduates who
practice professionally. The herbalism expounded by graduates of the NIMH
is a combination of humoral theory as represented in the Teachings of
Hippocrates and the Roman Galen, the lineage of medical herbalists that
have been a part of the rich herbal heritage of Great Britain, the
significant influence of North American Thompsonian herbal medicine as
transpoted from America to the U.K. by Dr. Coffin and last but not least,
orthodox scientific medicine.
Two of the leading exponents of British Medical Herbalism in North America
are David Hoffman and AManda McQuade. One of the most interesting and
important books specifically outlining the system, besides David Hoffman's
writings is Herbal Medication by A.W. Priest and L.R. Priest.
In terms of diagnosis, according to Stephen Fulder, "Modern Western
herbalists use much the same terminology and concepts as current orthodoxy
(referring to Western medical science), but they are interested in
detecting and restoring normal function rather than acting to stop a
pathology. The symptom is seen as a sign, if read correctly, point to the
seat of disorder. For example an infection may point in the first place to
'stagnation' of the affected tissues. Healthy tissues, like running water,
cannot suffer colonization by bacteria; such an invasion can only occur in
the histological equivalent of the brackish pond. Treatment of infections
then demands that the tissue be 'cleansed' and brought back into the vital
circulation. Antibiotics would only be necessary in this scheme if the
colonization was so excessive that there was real doubt as to the host's
ability to overcome it from vital resources, and then appropriate only if
underlying stagnation were treated as well. Using antibiotics alone is seen
as being as productive as pouring disinfectant into a brackish puddle and
pronouncing it 'clean'.
The same concern with underlying causes marks the herbal practitioner's
approach to other conditions. A spasmodic condition like asthma or colitis
speaks first of an irritant factor combined with a tendency to over-react.
AN inflammatory condition like skin disease or arthritis speaks of a
healthy but insufficient attempt to eliminate toxic accumulations.
Similarly, in dealing with migraine or the autoimmune conditions a primary
aim is to search for the source of toxicity, perhaps in defective digestive
or liver function or in inadequate elimination."
Medical herbal diagnosis uses the standard methods of Western medical
science to determine where the primary and secondary physiological
imbalances occur that may be the underlying cause for a particular disease
manifestation. There is a special emphasis on case history, taking into
account current stresses, dietary habits and lifestyle as well as
evaluating the main physiological functions of the body: digestive,
respiratory, genito-urinary, cardio-vascular, nervous and emotional. This
is done together with relative clinical assessments: general physical
examination, blood pressure, pulse, microscopic assessment of urine, blood
There are two predominant influences prevalent within the practice of
Western Medical Herbalism as represented in NIMH. These include
"physiomedicalism" and other systems based on Western physiology such as
"holistic herbalism" of David Hoffman.
Physiomedicalism originated from the teachings of Samuel Thompson
(1769-1843) and who himself was strongly influenced by Native American
healing practices, the use of their herbs but more important the use of the
vapour bath which was derived from the physio-spiritual teachings of the
Native American 'sweat Lodge', that combined the psycho-active principle of
prayer with physical therapies.
Samuel Thompson's system, at one time in 19th century North America
claimed up to three million adherents, later matured in the work of Wooster
Beach (the founder of Eclectic Medicine), W.H. Cook, T.J. Lyle and J.M.
Thurston. The essential emphasis of Thompson's system was based on the
Vitality of the organism and its ability to eliminate toxic waste
from the organs and tissues or the body. In this, there is considerable
similarity with the concept of "chi" in Traditional Chinese Medicine or
"prana" in Ayurveda. The major difference with Chinese herbal medicine is
in the emphasis on detoxification whereas Chinese herbal medicine has
tonification or the principle of to "first tonify the deficiencies," as its
founding maxim. Ayurveda emphasizes a balance of both elimination and
detoxification. Japanese-Chinese herbal medicine, called "kanpo" again sees
even the process of tonification as a way not only of building up the
deficiencies but to tonify or strengthen the bodies' eliminative power.
According to Herbal Medication, physiomedical diagnosis, while borrowing
the terms of Western pathology, aims at a deeper understanding or
functional organic states. Symptoms are evaluated in terms of their being
Symptoms: the subjective and objective superficial evidence of systemic
Functional disorders: variations from the normal standard of performance
or balance function in any organ or system, reflecting imbalance of
The true disease state involving organic changes in cells and tissues.
The limit of treatment is restoration to a state of relative functional
equilibrium and optimum trophic state, subject to the tendencies and
predispositions of the physiological and temperamental typology."
Peculiar to the diagnostic system of physiomedicalism as expounded by
Priest and Priest and others who representative of the the National
Institute of Medical Herbalists, is an assessment of underlying
necessary for effective herbal treatment. The vital state may be:
Positive: the symptoms represent positive eliminative or reconstructive
action--the healing crisis of Naturopathy.
Tolerant: relative equilibrium and compensation is established and the
encumbrance tolerated in various tissues.
Negative: the symptoms represent a forced reaction to a progressive
encroachment of obstructive conditions and pathological deterioration, but
ineffectually in ultimate result, leading to low-grade chronic symptoms---
the disease crisis of Naturopathy."
Disease is seen as a necessary compensation to an imbalanced condition.
Before disturbing the particular adaptation the body has made to, for
instance, an imbalanced diet, lack of sleep, various physical and emotional
stresses, one needs to evaluate the inherent strenght or weaknesses the
body has to make the necessary changes. A positive crisis assumes that the
body has sufficient vital energy to overcome the disease as in a simple
cold or flu for instance. All that is needed is proper management, to get
out of the body's way through rest and fasting or simple diet. A negative
disease crisis requires stronger support of relative vital functions in
order to prevent chronic soquelae from becoming established.
In terms of the Eliminative functions which especially include the colon
and kidneys, evaluations are made as to the bodies' ability to adequately
eliminate waste materials on three levels:
- intra=cellular: the interplay of electrolyte functions and the
diffusion of chemical ions across the cell membrane.
Organismic: the processes of intermediate metabolism.
- Special organis of excretion: specific functions to eliminate unusable
end products and chemical wastes."
The synthetic metabolic process of anabolism or the eliminative process of
catabolism results in some chemical by-product that requires elimination.
If for any reason, proper elimination cannot be achieved, the chemical
by-product is stored in the tissues of the body and gradually obstructs
other vital metabolic processes that lead to chronic degenerative disease.
It is for these kinds of conditions that alteratives are indicated to
promote elimination of various tissue wastes. These include herbs broadly
classed as blood purifiers by Western herbalists or 'heat clearing herbs'
in Chinese herbal medicine. also included are diuretics to eliminate fluid
wastes, purgatives to eliminate solid wastes and cholagogues to promote the
discharge of bile and general blood purification through the liver.
Following the principles of Thompsonian theory as the basis for
physiomedical practice, the patient is evaluated in terms of the need for
thermotaxis and hydration using the so-called vapour bath, to remove toxic
encombrances from the tissues of the body. In this, the American Samuel
Thompson (1769-1843), strongly influenced by Native American healing
practices, may have been imitating the universal practice of the "sweat
lodge" that integrated sweating and prayer to purify body, mind and spirit.
The underlying cause of disease according to Thompson and subsequent
physio-medical practices is chronic sub-thermal conditions that impeded or
slowed the eliminative processes of the body. From this, the use of warming
stimulants such as cayenne and ginger and the vapour bath became, as it
still is today in the legacy of the late Dr. Raymond Christopher, the
primary therapy of Thompsonian physiomedical herbalism.
The second characteristic is the use of the lobelia emetic for helping to
clean mucus from stomach and lungs. This practice has much in common with
similar emetic therapies recommended in Ayurvedic medicine that also uses
vomiting as a technique for clearing deep seated mucus called "kapha" and
in its more degenerative form "ama" from the tissues of the body.
Overall, there are many common elements in the practice of physiomedical
herbalism and older traditional systems, especially Ayurveda. The biggest
difference, as with most Western medical herbal systems, is in the more
subtle differential evaluation not only of bodily and emotional symptoms
but tongue, pulse, abdominal and palpation diagnosis as is characteristic
in Traditional Chinese, Ayurveda as well as the more highly developed art
of herbal tonification therapy used in these traditional Asian systems. It
seems that in Western medical herbal systems, while there is much regard
for what is called "vital force" there is little understanding of the herbs
and preparations that can be used directly to supplement these subtle
energies as with the Chinese use of herbs like ginseng, codonopsis, dang
quai, astragalus to name a few and the various tonics used in Ayurveda such
as the purified mercury compound called "Sidh Makaradwaj" or Chyavanprash.
This system is another branch of British Medical Herbalism as presently
expounded in the writings of David Hoffman and the teachings of Amanda
McQuade. This approach is very similar to the preceding except there is not
such a strong influence of Thompsonian herbalism with the use of strong
stimulants such as cayenne, the vapour bath and the lobelia emetic.
Holistic medical herbalism represents an attempt to prescribe relative
simple herbs according to the condition of the barious biological organs
and physiological functions of the body. As with all the more evolved
systems of herbal medicine, the actual Western named disease, especially in
more chronic conditions is treated indirectly using herbs appropriate for
various systems, especially the digestive-eliminative systems, the
circulatory system and the nervous systems.
The method of evaluating the state of health is through standard case
history evaluation of symptoms, clinical evaluations and Western
microscopic tests. The term "holistic" refers not only to the relationship
of the body and mind but the inner relationship of the various organs and
Herbs, diet and various physical exercises are recommended to remove any
stagnations of toxins in any of these systems. By so doing, the body is
best able to strengthen and heal itself.
In America, herbalist, Michael Moore, has evolved his own unique medical
herbal system based on a profound and intimate understanding of Western
physiology and the actions of specific herbs. Michael's diagnostic approach
is generally based on observation of the the patient and his or her symptoms.
We need to mention Western scientific medicine, because some of the
diagnostic procedures of this approach are used by medical herbalists. The
most significant difference in the approach of orthodox Western medicine is
its emphasis on symptom suppression primarily through the use of surgery
and drugs. With the rapid rise of medical technology, there are
increasingly refined and expensive diagnostic tests which can supply a
seemingly inexhaustible series of criteria to support one's thesis
concerning a patient's condition.
There is, so far, little regard for holistic interrelationships between
the various internal organs. Thus the underlying cause of disease is of
little consequence and too often the most shallow understanding of a
particular condition, however couched it may be in scientific medical
jargon, is the result.
Treatments are prescribed according to the specific disease, often with
little regard for the nature and condition of the patient. The result is a
plethora of adverse reactions to treatment, rampant patient dissatisfaction
and skyrocketing medical costs.
Back in 1874, one of the great eclectic physicians, John M Scudder stated
in his book "Specific Diagnosis", "It is yet the opinion, that "diagnosis"
has reference to the classification of disease according to the received
nosology; that it means naming the affection "bilious fever," "typhoid
fever," "pneumonia," "nephritis," etc. And so it does with the genius
doctor, at large, and their souls travail in diagnosis until a suitable
name is delivered. And then they consult their memories and books for
recipes to throw at this name, which to them seems almost an entity."
Later Scudder is even more vitriolic as he states,"Do you mean to say,"
asks the reader, "that the present system of nosology is useless?" Yes, so
far as curing the sick is concerned, that is just what I mean to say. Not
only useless, but worthless--a curse to physician and patient--- preventing
the one from learning the healing art, and the other from getting well.----
The first lesson in pathology we want to learn is, that disease is wrong
life. The first lesson in diagnosis is, that this wrong finds a distinct
and uniform expression in the outward manifestations of life, cognizable by
our senses. The first lesson in therapeutics is, that all remedies are
uniform in their action; the conditions being the same, the action is
always the same."
In his two volumes "Specific Diagnosis" and Specific Medication" Scudder
outlines a system of differential diagnosis, including pulse, tongue and
other signs and symptoms that is amazingly like that of Traditional Chinese
and Ayurvedic medicine. Also like these traditional systems of remedy
classification, Scudder is opposed to isolating and separating the
classification from the specifically named disease. Like the indications of
traditional herbal systems, Scudder states that the "new diagnosis means
medicine, and must point out the cure for the particular case in hand."
Whereas Western medicine has tended to advance towards increasing
diagnostic technology, traditional medicine aims at sharpening the sensory
direct powers of observation, listening, feeling and interrogation of the
Specific Western diagnosis can be very misleading. The reason for this is
always in the subsequent treatment which usually aims at the most
superficial suppresion of symptoms. Usually what is best for suppressing
symptoms is usually harmful to the overall lifeforce of the individual. For
instance, an antidepressent sedative such as Haldol (haloperidol) is the
current drug of choice for dementia and Alzheimer patients. Its action is
aimed totally at suppressing aberrant behavior. Unfortunately it is well
known to cause irreversible damage to the brain and thus hastens the metal
degeneration. Similarly, various forms of corticosteroids are used for
treating a variety of chronic inflammatory diseases including diseases of
the respiratory tract, skin as well as various rheumatic and arthritic
The patient who takes corticosteroids today is generally quite aware of
the inevitable side effects from long term use. Nevertheless, this
particular class of drugs is remarkably effective in suppressing painful
inflammatory conditions. Whereas the intention of the Western medical
doctor is to fully supplant the body's natural capacity to produce
antiinflammatory hormones through the adrenals and endocrine system, the
traditional herbalist uses herbs that contain saponins which are used as
organic building blocks or hormone precursers by the body.
The use of antibiotics is well known to cause an indiscriminate
destruction not only of unfavorable bacteria but favorable ones as well.
Since the favorable flora and fauna seem to play an important immunological
function, the abuse of antibiotics has been attributed as the underlying
cause of many chronic immune dysfunctions that we se today. Just as
destroying a certain insect or animal in nature can upset the delicate
balance that exists there, so also the destruction of certain
microorganisms in the body can cause an imbalanced proliferation of others
such as candida albicans. One of the questions that I have not seen
addressed, however, is what other substances besides antibiotics can
imbalance favorable microorganisms in the body. Taking the perspective that
antibiotics have a cold energy, and that these are known to exert marked
antibiotic properties, we might see some broad relationship whereby other
cold natured substances such as a lack of calories, protein, excess of
vegetables, vitamins, expecially vitamin c might cause a similar imbalance.
The use of sulfisoksazole, a sulfonmide drug for urinary tract infections
while having the ability to overcome the infection, also has well
documented injurious effects on the kidneys. Since many who have problems
with urinary tract infections would be understood in TCM to have chronic
kidney-adrenal deficiency, to cure an infection in the urinary tract with a
drug that further injures the kidneys seems in the long run
counterproductive. The problem is compounded by the fact that medical
doctors are not usualy aware of underlying lifestyle causes that may be the
root of the problem. Some of these are the abuse of what is classified in
traditional medicine as "heating" substances such as sugar and other
stresses. To remove the acute pattern of disease without addressing the
underlying cause seems to be very short sighted to say the least.
It is interesting to note that such conditions as high cholesterol and
blood lipids may correspond to traditional imbalances described in the
ancient literature of Ayurveda. There is a definite correlation between
what is classified as "ama" in Ayurveda with high blood lipids. Ama is
described as a sticky substances that impairs circulation and is
accompanied with a wide variety of circulatory disorders. It is
particularly associated with aging and there certain herbal preparations
that are traditionally used in Ayurveda to help reduce Ama in the body. The
primary preparation is called "guggula" which is a preparation made from
the resin of commiphora guggul. Usually for excess ama it is combined with
triphala which combines three myrobolic fruits that together are revered as
the most precious of all herbal formulas in ayurveda because of their
balanced detoxifying effects. In Chinese medicine a similar diagnosis,
however at a more extreme stage of imbalance is called "invisible phlegm
masking the opening of the heart". This condition is usually associated
with insane or impaired mental function since the heart, in TCM governs the
It would seem that the biggest problem in Western medicine is that there
is little, if any, correspondence between diagnosis and cure as Scudder so
aptly noted. Western medicine generally takes a symptomatic mechanical
perspective to treatment while traditional herbal medicine takes a
nutritional approach based on attempting to discover what the body needs to
maintain better homeostasis. Drugs are used to mechanically inhibit certain
adverse so-called disease reactions, whereas herbs in the hands of a
traditional practitioner are used to empower vital organic processes so the
body heals itself.
There is a problem, with Traditional Western herbalism being corrupted
with the Western medical model. There is a danger in using herbs such as
mahuang in highly concentrated extracts to boost energy. There is also a
problem in over inflating through advertising specific herbs for a
specifically named pathological disease.
Because of their mild nature, herb work best when used holistically, in
harmony with all physiological functions and processes. With the
exagerrated emphasis on quality and potency, the public is misinformed to
believe that if an herb doesn't work in its whole form, it must be taken in
an concentrated extract before it will prove effective. While the question
on herb quality is of paramount importance to the producer of herb
products, the problem of selecting the correct herbal remedy is the primary
problem of the practitioner.
I would like to take a few examples from the current popular books and
literature on herbs to point out some of the misleading information that
does not corroborate traditional diagnostic systems with the herbal remedy.
St Johnswort (Hypericum Perforatum)
A recent book Christopher Hobbs is quoted as stating "In Europe, St.
Johnswort has a long history of use, particularly as a folk remedy in the
treatment of wounds, kidney and lung ailments, and depression."
Next the author goes on to describe a clinical study of 15 women suffering
with depression who were given a standardized extract (promoting his
companies' product line), which "led to significant improvement in symptoms
Anxiety, depression, and feelings of worthlessness" according to a
German study. In addition, the extract greatly improved sleep quality
because it was effective in relieving both insomnia and hypersomnia
The problem with this from a clinical perspective is that there are many
causes of depression and related insomnia. It most certainly has an
emotional cause which is different for each individual. There are many who
tend to fall depressive slump for which, I suppose St Johnswort might be
effective. The question is how long must it be taken before such favorable
results are noticed and assuming that the depression comes in cycles, how
can we distinguish the difference between a self limiting cycle and the
effect of St Johnswort. Further, supposing that the cause of one
individual's chronic depression is traumatic memories of child abuse or
lack of self esteem perhaps aggravated by a recent separation, what is St.
Johnswort going to do about these causes for depression which usually take
time to resolve. It seems that in these circumstances we need to determine
whether published scientific research plays a significant "placebo" like
role in the popular use of St. Johnswort for depression on the European
Looking up Hypericum in Boericke's Materia Medica, a homeopathic materia
medica that tends to use a majority of low potency or mother tincture
herbal remedies, we find that St Johnswort is specific for nerve injuries
and symptoms associated with an injured nervous system. Certainly an
emotional shock with resultant depression would qualify as a possible
injury to the central nervous system. For that matter an injury to the
spine or the coccyx also qualifies as affecting the automatic nervous
system. There is a big distinction between depression caused by recent
shock or injury as opposed to chronic depression caused by more deep seated
psychological problems. I personally know how complex and difficult it is
to treat chronic depressive individuals and it is extremely misleading to
not specify the specific type and causes of depression for which St
Johnswort might be effective.
Taking one more example of the misrepresentation that results from trying
to validate a traditional herbal remedy solely from a superficial Western
alopathic medical perspective, the use of a standardized 24% extract of
flavonoid glycosides of Ginkgo biloba is described allopathically indicated
decreased blood supply to the brain
senility, ringing in the ears, dizziness
The same author describes the leaves as being traditionally used to
"benefit the brain". The overwhelming description of use for Ginkgo,
especially the nuts, is for the treament of asthma and coughs. There is
also a less frequent reference for the leaves as being used to treat coughs
and asthma. Other uses are as a digestive stimulant and antiparasite remedy.
The fruit is classified in Traditional Chinese Materia Medicas as an
astringent herb with sweet, bitter, slightly toxic and neutral properties.
It is used to expel phlegm from the lungs, luekorrhea, spermatorrhea,
frequent urination and urinary incontinence. No mention in traditional
medicine for the use of the leaves especially in a concentrated 24 to one
extract form to improve vascular circulation to the brain.
We can read voluminous information about the chemistry of 24% ginkgo
leaves as well as its effects of cells, neuronal cells, tissues, blood. We
read of studies that seem to point to the usefulness of gingko in the
treatment of Alzheimer's disease. The pressing question for the therapist
is how can he or she determine whether the whole flesh and blood person who
sits before him or her in a clinical setting is the one for whom 25% Ginkgo
extract is indicated? For an herbalist to give allopathically for any
conditions of the indicated key use is hardly worthy of the high art and
science of herbal medicine.
The indications are simply not specific enough to inform the practitioner
of the effectiveness of the remedy.
To make our diagnosis and prescribing more accurate and precise all we need
to do is inquire about the cause of the above stated indications or in a
word fill in the important question of who with the well known indications
for 24% ginkgo extract should get the remedy. This requires a lot more
thought and consideration on the part of the practitioner.
Decreased blood supply to the brain could be caused by simple lack of
blood or anemia for which ginkgo has little benefit. Its primary benefit,
if we are convinced by the scientific studies, is to improve circulation of
blood and nerve force not to directly tonify or nourish it. Ginkgo is a
circulatory stimulant so that it may be good for circulatory problems
related to all the above indications, making it a useful yang-moving tonic
but it is not good for patterns of deficiency chi, blood or yin-essence. In
fact, taken alone, it could further exhaust the body's reserves and deplete
blood and yin, which is a broad term that describes bodily fluids and
From these few examples, we see that there are some very real problems in
applying an alopathic diagnostic model
to the use of herbs. I personally hope, that herbalists will take a more
active role in condemning such dangerous and misleading herbal indications
by scientists and those who have made themselves spokespersons for the
simplistic allopathic style of herbal prescribing whose primary aim is to
cell herbal products rather than make them therapeutically useful agents.
Western Medical herbalists, however, have found good use for combining
Western diagnostic precedures with herbal medicine. They use such indexes
as blood pressure, microscopic lab tests, pulse, symptom evaluation and so
forth to arrive at a differential diagnosis of what organs and functions to
treat that is appropriate to the individual rather than the disease name.
TCM diagnosis is based on a differential system where several paramaters
are examined based on the four diagnosis, questioning, observation,
palpation and listening and the predominant concurring findings are taken
as the basis for the diagnosis. This is called 'differential' diagnosis and
strongly contrasts with the earlier simplistic iridology and kinesiological
"good-bad" systems and other overly simplistic diagnostic systems that are
based on one finding only. Western medical diagnosis is also based on a
differential system of evaluating several parameters before making a fully
authoritive diagnosis. The problem is that Western medicine aims only at
diagnosing the named pathology while Traditional diagnostic systems such as
Ayurveda and TCM aim at diagnosing dynamic functional organic systems
encompassed by the concepts of the ZangFu organ syndromes.
Chinese physiology takes quite a different perspective from Western
scientific physiology. First, the Chinese describe only twelve functional
organ systems of which the six transformative solid yin organs are the most
important. The remaining six yang hollow organs are merely considered as
vessels of transport and their function is usually directly related to the
function of the deeper Zang or yin organs.
The six Zang are heart, pericardium, spleen, lungs, kidney and liver.
There are corresponding diagnostic indications for each of these some of
which are obvious from a Western perspective such as palpitations and blood
vessels are indicative of heart, urinary problems are indicative of
kidney-bladder imbalances and cough, nasal conditions are indicative of
lung imbalances. Other indications are not so obvious from a Western
perspective such as the relationship of the ears or head hair to the
kidneys, insane or aberrant mental behavior and the tip of the tongue to
the heart, feelings of spaced out, ungroundedness to the spleen. There are
even assignments of physical postures and movements that are used to direct
the TCM physician to the troubled organ system such as problems with
stretching or walking being heart related, problems associated with sitting
being related to the spleen, problems with standing being associated with
the kidneys and so forth.
In fact, it might be said that the only limits to interpreting any given
symptom or sign is the knowledge and understanding of the physician.
Despite the sometimes colorfully obtuse language of Tcm it is my belief
that the major difference between Western and classical Chinese medical
physiology are semantic based upon two very different perspectives of the
body. To begin, traditional medicine is truly holistic in that it unites
all physical and mental symptoms in a common diagnostic system. The mind
and body are simply not separate according to Traditional medicine.
In TCM, various emotional states are aligned with each of the five
elements and their corresponding organs so that their is a corresponding
emotion and mental state for each element-organ. Similarly, Ayurveda
outlines gunas or states of consciousness with each of the three humours or
tridosha, which is the basis of Ayurvedic diagnosis. They are influenced by
food, herbs and various lifestyle factors and are sattva, a state of
peaceful equilibrium, rajas, a state of outgoing, aggressive action and
tamas, a state of inertia or dullness. Obviously, such conscious states and
their correspondences have a lot to do with one's health.
Both traditional systems see health as a state of balance or homeostasis.
TCM seeks to achieve a balance of yin-passive and yang-active physiological
function which equates to the concept of shiva-shakti in Ayurveda.
Ayurveda, nevertheless, emphasizes a balance in terms of three using the
tridosha or three humour system.
Both systems really accomplish Scudder's dictum that "diagnosis means
cure" since the specific diagnosis of each system is integrally linked with
a classification of foods, herbs, lifestyle, exercise that is intended to
counterbalance any perceived diagnostic imbalance.
The greatest difference with Western scientific diagnosis is again that
the objective of Western scientific diagnosis is to arrive at a
specifically named pathology for which a drug or surgery is usually
prescribed whose intent is to somehow inhibit the expression of the
pathological condition. Traditional herbal medicine, aims at providing
herbs and special foods whose purpose is to stimulate innate biological
functions that help the body heal itself. the difference between these two
systems is not really so black and white but represents a more general
tendency. With alopathic herbalism, the intention is to use herbs to stop
an itch, kill a virus, bacteria or yeast; with traditional herbalism herbs
may also be used 'allopathically' but there is always a dominance of
treating the underlying causes of imbalance.
In TCM this is expressed in the concept of supporting the Righteous chi
while eliminating the evil chi. Bob flaws in his article published in
American Herbalism, described the difference in TCM when he says, " Bian
bing means to differentiate various named diseases and recognized
pathological signs and symptoms. Bian zheng, on the other hand, means to
discriminate varius professionally recognized patterns of disharmony."
Since traditional diagnosis always leads to cure, there is the concept of
"Tong bing yi zhi, Yi bing tong zhi -- One disease, different treatments;
Different diseases, same treatment".
The fundamental difference therefore between Western and traditional
diagnostic systems is the difference between "form and function." Western
medicine, being more material is based on form whereas traditional medicine
is more energetic and is based on function.
There are several similar diagnostic criteria used in traditional
diagnostic systems but one of the most characteristic and enigmatic to
Western practitioners is that of the pulse. Pulse diagnosis is of paramount
importance in is the hallmark of a classical physician. The pulse is a
direct manifestation of the circulatory energy of the body and in the hands
of an expert physician, is best for describing the internal function of the
body mind complex. In Tibetan culture, they use a system of pulse diagnosis
that is strongly influenced by the Chinese, it is so ingrained amongst the
people that upon first contact with a physician, the patient automatically
holds out his arms for a pulse reading. It is expected that a qualified
physician, without any further questioning, will be able to tell the
patient something that is relevant to their condition. Failing to do this,
patients would have no faith in the doctor's qualifications. Nevertheless,
despite its high regard in traditional cultures, in dialectical
materialistic TCM, the pulse is taken as being of secondary importance with
interrogation being primary.
The reason, obviously, is the illusive nature and the profound experience
required to accurately and effectively read the traditional pulses. While a
traditional student would have confined himself to following the model of
his experienced teacher, today, with the advent of publishing and
communication, the study of pulses is further complicated by the different
styles and ways that it is taken. This is true not only between cultural
lines but even within each tradition between different schools of
One of the most interesting statements of a highly respected Taiwan trained
practitioner in the San Francisco Bay area, Michael Broffman is that the
classical five phase pulse correspondences on the wrist are only the norm
but that, in clinical practice, the pulse must be assessed on an individual
basis with the actual organ locations on the wrist being idiosyncratic for
The idea that the meaning of the pulses in terms of their location may be
different for each individual makes such a rational understanding of pulse
diagnostics by a linear thought oriented Western student an almost
insurmountable leap of faith.
Despite the fact that pulse diagnosis is such a distinctive aspect of TCM
diagnosis, it is generally considered to be only about 40% reliable as a
sole diagnostic method by most TCM practitioners. It is the experienced
masters who are able to accurate physiological and lifestyle analysis based
on pulse reading. Then, of course, considering that observation of the
patient's complexion, voice, manner is also able to provide a great deal of
information about the patient that may be either consciously or not noted
by the practitioner.
Unlike other diagnostic criteria, the pulse is very reactive and reflects
the most current state of the individual. The practice of taking the pulse
on the radial artery of the wrist was first expounded in the "Nan Jing" or
"Classic of Difficulties". Before that the pulse was taken at nine
different arteries, three on the head, three on the hands and three on the
legs, each reflecting the condition of the upper, middle and lower burners,
respectively. The triple burner refers to the organs that are located
within the upper, middle and lower parts of the body.
An old common saying concerning the difficulty of learning pulse diagnosis
is: "In the mind quite certain, under the finger unsure". The idea is to
unite the knowledge of pulse taking with the actual process of feeling.
Three fingers are placed on three different positions beginning at the
base of the wrist with the index finger representing the upper warmer
including the heart and lungs, the middle fingers over the thenar
prominence indicating the liver-gall bladder on the left and the
spleen-stomach on the right, the ring finger higher just proximal to the
thenar prominence with the kidney-bladder on the left and the triple
warmer-pericardium on the right.
Ideally the pulses are studied in the early morning taking about 15
minutes to study each wrist. The patients are should be horizontal at the
level of the heart. The breath of the practitioner should be equalized and
the mind stilled.
This later indication has two functions. Traditionally, without a second
hand on a watch, the speed of the pulse could only be measured by counting
the number of beats per normal respiration of the physician. Less than four
beats per complete respiration indicates a slow pulse while more than five
indicates a fast pulse.
Another reason for stilling the mind is that pulse diagnosis is a subtle
intuitive art requiring an empty, open and receptive mental state. The fact
is that the best pulse diagnosticians combine a balance of rational
observation with intuitive thought processes. One great ancient clinician
states that "The essential when watching a patient is to preserve the mind
and turn the thoughts within, to quiet the breath and turn inward one's
gaze, to keep the heart attentive - showing a line of fine inquiry: then
one can reachthe spiritual light, search through all obscurities, and
decide upon the question of life and death, without one single mistake in a
Most individuals are able to discern six relatively easily verifiable
qualities which form the basis for pulse study. These form the basis of the
eight principles which allows one to evaluate overall yin-yang homeostasis
and metabolic function.
Following are the six basic pulse qualities:
WEAK OR EMPTY PULSE= an empty pulse may feel rather big but soft. The
pulse may be rather big but empty on slightly stronger pressure. This type
of pulse signifies deficient chi. A weak pulse can also feel thin or
thready which signifies deficient blood.
FULL PULSE= this pulse feels full, big, rather hard and long. If the
pulse is full and rapid it represent excess heat, if it is full and slow it
indicates excess cold.
SLOW=COLD (less than four beats per complete respiration of the
practitioner or less than 60 beats a minute)-- a slow and empty pulse
indicates empty-cold from deficient yang, a slow and full pulse indicates
full-cold from excess yin.
FAST=HEAT (more than 5 beats per respiration of the practitioner or 80
or more beats per minute)
surface or floating=exterior or acute disease or in rarer cases, it will
appear as floating for internal deficient conditions such as anemia, cancer
or yin-wasting diseases. This pulse is felt with a light pressure of the
fingers, just resting on the artery.
DEEP PULSE= This pulse requires a deeper pressure to discern. It must be
felt with a heavy pressure of the fingers close to the bone. A deep and
weak pulse indicates deficiency of chi and yang, a deep and full pulse
indicates stagnation of chi or blood in the interior, or internal cold or
FLOATING OR SUPERFICIAL PULSE= This is opposite of the previous. the
pulse is felt with a light pressure of the fingers just resting on the
artery. A floating pulse indicates a surface condition or in chronic
disease, an exhaustion of the internal (yin) organs. A floating and fast
pulse indicates surface heat while a floating, slow pulse indicates surface
cold. Most often a floating pulse indicates a superficial acute condition
such as a cold, cough or flu. If the pulse feels floating and slow one
would prescribe warming and stimulating diaphoretics such as cayenne pepper
or ginger for instance. If it is floating and fast, one might give relaxing
diaphoretics such as lemon balm or catnip to relieve the external condition.
If the pulse feels weak and deficient, one would not use eliminative or
strong heat clearing but rather emphasize the use of tonics. If it feels
strong and full, one would prescribe some type of clearing or eliminative
strategy. If it feels slow which signifies cold, one would prescribe
warming and stimulating herbs; if fast, cooling and sedating remedies. If
it is floating one would use some type of surface relieving diaphoretic
herbs. If it is floating at the superficial level but empty at the deep
level, it indicates yin deficiency and would require yin-nutritive tonics.
If the pulse feel deep one would treat internal organ conditions. If deep
and weak, it is a deficiency of chi and yang and would require tonics. If
it is deep and full, it indicates stagnation of chi and blood and one would
use emmenagogue herbs and foods that would promote blood circulation or
carminative herbs that promote circulation of chi.
Ayurvedic medicine attempts to correlate the pulse to the tridosha or
three humours. The pulse closest to the wrist which is taken by the index
finger of the physician corresponds to the vata-air or nerve oriented
humour, the middle position taken with the middle finger corresponds to the
pitta-fire or digestive and circulatory humour; the third position taken
with by the ring finger corresponds to the kapha-fluid or bodily substance
The individual qualities of the pulse are described in terms of several
animals. A vata or air predominant pulse is compared with the movement of a
snake or leech. Usually this pulse feels faster and indicates indigestion,
nervous problems, fever, etc. In Chinese medicine it might be classified as
A pitta or fire predominant pulse is described as resembling the jerky
movement of a frog, a sparrow or a crow. Since these are generally a jerky
or jumpy movement, it can indicate insomnia, diarrhea, vertigo,
hypertension, heat of the skin, palms, soles and burning eyes.
A kapha or water predominant pulse is described as the movement of a swan,
cock or peacock. This is generally a slow pulse and indicates the presence
of phlegm coughs, a melancholic disposition, etc.
Western medical diagnosis also recognizes various pulse indications that
correlate with disease factors. For instance:
A fast pulse indicates fever or inflammation
A slow pulse indicates inaction, weak digestion,
A small or weak pulse indicates general debility and possible anemia.
There are literally dozens of other pulse indications that once were part
of the medical doctors training and are seldom used today in modern
clinical practice except for the speed.
Like Traditional Chinese Medicine, Ayurvedic Medicine, the ancient,
traditional medical system of India dating from around 2000 to 1500 BC, is
based on an energetic model where the native constitution of the patient,
diseases, herbs, foods, remedies and treatments are all classified as
hot-cold, moist-dry, light-heavy, coarse-smooth, weak-strong, etc. The
entire system is based on what is called Tridosha or the Three Humours. In
the sense of Ayurveda, a 'dosha' means 'fault', a quality or substance that
is controlled neutralized by the elusive balance of each other.
Tridosha could be considered the distinctive and founding principle of
Ayurveda and is comparable in importance to Yin and Yang in TCM. It is
interesting that as Ayurveda has a dual system called "shiva-shakti" as
part of its philosophy it is not strongly emphasized as the Three Humours.
In TCM, there is also a Three Humour diagnostic classification, probably
originating from India, while it is important to the system, it is remains
as only one approach to the classification of diseases and herbal
treatments. The early Greco-Roman humoural system expounded by Hippocrates
to Galen, is probably more closely based on the Ayurvedic model.
Ayurveda also has a Five Element model as a cornerstone of its theory. It
is similar to the TCM Five Elements and to the Greco-European Four Elements
although there are differences probably based on social, cultural and
geographical characteristics unique to each area and society. The Chinese
Five Elements are Fire, Earth, Metal, Water and Wood; the Ayurvedic Five
Elements are Fire, Earth, Water, Air and Ether and the Greco-Roman is Fire,
Air, Water and Earth. The differences are even less if we consider that in
both the Chinese and Ayurvedic systems, Earth may not have been a
distinctive element but was the center for the outer four. We may also
consider that the Chinese having Metal and Wood for two of its elements is
more an expression of its earth centered agrarian philosophy while Air and
Ether of Ayurveda perhaps is an expression of the more spiritually centered
philosophy so characteristic of ancient and modern India. In any case, the
similarities of the Humoral and Elemental systems of these three great
cultures, strongly suggests that there was a dynamic exchange of knowledge
between all the great civilizations of the ancient world and that the
knowledge of India was probably a root for all of them.
In Ayurveda, diagnosis and treatment is centered around the understanding
of Tridosha or Three Humours which are: Vata or Air, Pitta or Fire and
Kapha or Earth.
Motor nerve functions|
Sensory nerve functions
(Chart derived from Ayurveda: The Ancient indian Healing Art by Scott
Gerson MD, Publ Element Press)
Like TCM, the Ayurvedic doctor diagnosis by evaluation of symptoms and
direct sensory experience of touch (pulse and body palpation), listening
(sound of voice and body sounds), observation (the body and facial
appearance and tongue) and smell (body odors). A major difference between
TCM and Ayurveda is that the latter places a greater emphasis on
constitution while TCM at least as it is currently practiced in China and
the West is more disease oriented. This difference offers the possibility
of combining the two systems effectively since at least in my opinion,
Ayurveda is better at constitutional analysis while TCM is better at
disease diagnosis. In all cases the qualitative difference between the two
lies in their ability to produce the most reliable and effective treatment
Ayurveda also expresses an important concept where "agni" or "life fire"
eventually vitiates tridosha leading to impaired digestion. This eventually
creates "Ama" which is an accumulation that begins in the GI tract and
eventually congests and blocks the "srotas" or channels (roughly equivalent
to the TCM meridians) involving the blood vessels, capillaries and lymphatic
system. In contemporary Western thought the is roughly equivalent to
hypercholesterol and/or hyperlipidemia which is considered an important
predisposing condition leading to heart failure and stroke, the leading
causes of death.
Ama generally burdens the system and can impair various other systems that
eventually manifest as chronic diseases including gallstones, bronchitis,
cancer, depression, arthritis and so forth.
Like TCM, Ayurveda posits two general types of disease: exogenous, or
diseases that originate outside the body, and endogenous or diseases that
are more chronic and originate inside the body. While external climatic
factors are the cause of exogenous diseases such as fevers, colds and flus,
Ama is the root of more endogenous diseases such as arthritis, heart
disease and cancer. When Ama accumulates in the digestive tract it can be
observed as a thicker than normal whitish coat on the tongue. In TCM, this
is viewed as cold stagnation which being an obstruction can eventually
change to heat and a variety of chronic inflammatory conditions. When it
changes to heat, the coating will appear yellowish.
Ama is viewed as the very death or "harbinger of misery, the cause of
disease" as described by Scott Gerson. In contrast to TCM, which views
various and particular imbalances with no great overriding emphasis on one,
Ama, in Ayurveda, becomes a general cause for all chronic disease. The
measures used to balance the doshas and eliminate Ama in Ayurveda include
lifestyle changes, dietary, herbal, physiotherapeutic and a system of
profound detoxification called "Panchkarmas". "Panch", meaning "five" and
"karmas" meaning "tasks" or "jobs" relates to five methods that are
systematically performed over a concentrated period of time of say a month
or more alternating 1. sweating, 2. oiling, 3. bleeding, 4. vomiting and 5.
This is mostly unique to Ayurvedic Medicine as most of these methods are
not emphasized in contemporary TCM practice although they do have some
historical tradition of their use in Chinese medicine. In any case,
Panchkarma is another powerful adjunct therapy that can easily be added to
the practice of TCM or any other alternative healing practice with great
Some important Ayurvedic herbal therapies is the use of Triphala which
consists of three myrobalans or fruits each having the property to regulate
each of the respective Tridoshas. Thus Amla (Emblic myrobalan) regulates
fire or Pitta humour, Bibhitaki (Beleric myrobalan) regulates water-earth
or Kapha humous, Haritaki (Chebulic myrobalan) regulates air or Vata
humour. The overall effect is to clear the entire GI tract, regulate the
bowels and improve digestion and generally eliminate Ama from the GI tract.
It is taken for constipation or diarrhea and as a foundation for gently
detoxifying the entire body without causing and weakness or deficiencies.
Guggul is another important Ayurvedic preparation made from the purified
resin of the guggul plant which is closely related to myrrh. Guggul is
specific for eliminating hypercholesterol and hyperlipidemia. It is
indicated for all circulatory and arthritic conditions.
As the West and various countries of the world adopt various traditional
systems of healing such as TCM and Ayurveda, as well as forming some
diagnostic methods of their own, we will see a tendency for these various
traditions to be either corrupted or enriched, depending upon one's point
of view. In any case, the mutual influence between Western scientific
medicine and traditional medical systems such as TCM and Ayurveda is
inevitable and are being taught side by side in colleges in each of their
respective countries. Just as the more holistic influence of traditional
healing systems are a welcome perspective to the practice of conventional
Western medicine, so also should the influence of Western scientific
understanding be harmonious with the tenets of traditional medical systems.
Diagnosis will always be a challenge in every healing system. Because of
this, intuition will always be a vital part of practice of any good
physician. Some Western approaches such as kinesiology, radionics and in my
opinion, iridology, focus more on the intuitive side of diagnosis. As with
any diagnostic method, the approach used is as good as the practitioner.
However, the concept of differential diagnosis, meaning to evaluate an
individual from different criteria should remain important as a check and
balance to lessen the possibility of error.
My approach is to evaluate all that is possible of the known and continue
to extend gradually to the stages of the more intuitive level of knowing. I
think it is dangerous for most practitioners to start from the intuitive or
unknown to the known because at the very least, a sound intuitive judgment
must be dependent on a level of inner clarity that may not always be
present. In traditional systems such as pulse and tongue diagnosis there
are the verifiable pulses and tongue signs and there are the less
verifiable indications based on assigning individual organs or humors to
areas within a half inch of each other on the radial artery of the wrist or
interpreting individual areas of the tongue as belonging to specific organs
of the body. Intuition is less obvious in modern today's technological
Western medicine, however, the qualitative difference between one doctor and
the next may be the one with the best hunch.
Dr. Michael Tierra is a California state licensed acupuncturist with a 30
year clinical practice in Santa Cruz, California. He is the author of
several books including The Way of Herbs (publ by Pocket Books, a division
of simon and Schuster), Planetary Herbology (publ by Lotus Press), coauthor
with his wife, Lesley of a text on Chinese Herbal Medicine (publ. by Lotus
Press), Magnet Healing (publ by Lotus Press). He is also the author of the
East West Herb Course which is based both in the US and in the UK. Michael
has an extensive line of Planetary Herb Products that are available both in
the US and in the UK. Please visit