The purpose of this article is to discuss the importance of symptoms in Chinese medicine. It is meant to clarify the purpose of symptom evaluation, and to distinguish this from “symptomatic treatment”. The reason I am writing this is because it is sometimes paraphrased back to me by patients, that I do not care what is causing their problem because I only treat the symptoms. This is incorrect.
Chinese medicine considers the individual presentation of symptoms to be a direct expression of the disease mechanisms at work. The only way to make a correct diagnosis and to administer an effective treatment is to properly evaluate symptoms. In fact, in Chinese medicine, proper assessment of symptoms leads directly to the appropriate treatment. This stands in contrast to Western medicine, where it is possible to consider only the general symptoms which define a disease, and then possibly administer a treatment that has nothing to do with the diagnosis.
For example, in Western medicine there are neither diagnostic criteria nor specific treatment for a common cold. If a person has a few symptoms such as sneezing and a scratchy throat, they might be diagnosed with a cold. The treatment might be a decongestant and some aspirin, meant to address some of the discomfort the person is experiencing. This is symptomatic treatment, as it is neither specific to the condition nor does it not address the cause of the illness.
Chinese medicine would be concerned with the onset of symptoms and the weather and time of year. Questions such as the following would also be important: Are there chills or sensations of heat? If so, what time of day do they occur? Do they come at the same time, different times, or do they alternate? Is the throat hot, scratchy, or dry? Is there discomfort on one side of the throat or both? Is there a change in thirst, hunger, urination, or bowels? If the person is thirsty, is the thirst for warm or for cold? Does the liquid quench the thirst? Are there any headaches or body aches? Is the nose runny or stuffy? Is the mucus thick or thin, and is it clear, white, yellow, green, or brown? Is the shade pale or bright, light or dark? Is there any blood, and if so, what color and texture is it? This list goes on. I consider this to be symptom evaluation. It leads to a pattern diagnosis such as Wind Cold with transformative Heat in the Lungs, in addition to the disease diagnosis of “common cold”. The difference between pattern and disease diagnosis is the consideration in the former of a person’s unique symptom presentation, including those symptoms unrelated to the most immediate problem. One disease may have many different pattern presentations, and therefore many different treatments.
The proper evaluation of specific symptoms will lead to specific treatment, and consideration of only general symptoms will lead to a more generalized treatment. There is nothing wrong with treating symptoms, but the treatment will always be more effective if those symptoms are well examined. As a practitioner of Chinese medicine, I care about both what is causing a person’s symptoms and what those symptoms are. My job is to evaluate both from the perspective of Chinese medicine, so that I can treat from the perspective of Chinese medicine.