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  • Dr. Lisabeth Detwiler, DOM

Diagnosing Skin Diseases in Chinese Medicine

Traditional Chinese Medicine (TCM) Dermatology is one of the oldest medical specialties in the world, dating back to 300-200 BCE. Over thousands of years, we have developed an incredibly refined system of diagnosing skin diseases, understanding disease processes, and administering treatment to restore the body and the skin back to a state of harmony.

One of the things that makes TCM so powerful and effective is our concept of “disease identification and pattern differentiation.” It’s always necessary to first identify which skin disease we’re dealing with. A fungal infection of the skin will, of course, need an entirely different treatment than an autoimmune skin disease. This is very well known in TCM (in fact, by 1644 we had identified 360 different skin diseases, including diagnostic features and treatment strategies).

The second step in diagnosis is to identify the “pattern,” or cluster of associated symptoms. This takes into account details of how the disease is presenting on the skin (dry, flakey, weepy, crusty, upper body, lower body, itchy, painful, macular (flat), papular (bumpy), spreading, stable) as well as internal health (constipation, loose stool, feeling chilled, hot at night, fatigued, agitated). So one person with eczema may feel easily chilled, have their sleep disturbed by itching, bleed easily when they scratch, and tend to have constipation. Another person with eczema may feel fatigued, have crusty lesions on the lower body, get bloated easily, and feel hot and sweaty at night. These two patients have the same disease (eczema), but different patterns, and therefore require different treatment.

Tailoring a patient’s treatment to address both the disease and the pattern is one of the most important features of the TCM approach. As we say, “different diseases, same treatment; same disease, different treatment (yì bìng tóng zhì, tóng bìng yì zhì 异病同治,同病异治).”

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