DIAGNOSTIC APPROACH IN TIBBPROF RASHID BHIKHA JULY 2011

ABSTRACT

• This presentation looks at the complexities faced by Tibb practitioners when making a diagnosis according to Tibb philosophy. It seeks to explore the many advancements in technology regarding investigative procedures and devices both in the orthodox sphere as well as in that of complementary medicine. While many of the devices and procedures used in making a diagnosis are often overused and greatly depended upon by medical doctors, it is something that we as Tibb practitioners should use to confirm, strengthen or support the diagnosis made. However, not all clinical diagnosis will conform with that of the 6 frames and so it remains imperative that the clinical findings are looked upon as part of the overall picture presented by the patient.

PRESENTATION OVERVIEW

•Introduction and background •Development of diagnosis in Tibb •Critical considerations in making a diagnosis •Tibb Diagnosis flow chart

•Summary and conclusion

INTRODUCTION AND BACKGROUND

“Life is short and the Art of medicine long, the occasion fleeting, experience

fallacious and judgement difficult.” [Hippocrates]

• Historical developments in diagnosis:

From interpreting signs & symptoms within the context of physical examination, pulse, tongue, urine and stool, to in-house equipment (stethoscope, BP, BS, ECG etc), as well as path lab assays and sophisticated imaging techniques (X-rays, sonars, MR scans) -

Complementary medicine: development of equipment measuring energy/magnetic fields.

• Resulting - From holistic intuitive diagnosis to impersonal paper based reports (not necessary always accurate)

DEVELOPMENT OF DIAGNOSIS IN TIBB

• Incorporating latest (allopathic) diagnostic techniques – whilst interpreting information according to the Tibb principles of temperament, qualities and humors

• Made possible by the concepts of qualities – the common denominator between: temperament, governing/ lifestyle factors, signs & symptoms, pathological pathways, and illness conditions

• Integrative approach required matching the Tibb diagnostic principles with the terminology of “illness labels” used in allopathic medicine – resulted in identifying qualities associated with illness conditions according to Six Qualitative Frames

CRITICAL CONSIDERATIONS

• The terminology of “labels” used in allopathic medicine did not originate within the context of the Tibb principles. Clinical disorders will therefore not always be accurate with respect to the Six Qualitative Frames. Fitting a round hole into a square plug.

This has to be taken into account –

• Many symptoms have different causes – dizziness (ear infection, anaemia, tumour)

• Changes occurs to qualities with progression of illnesses – (rheumatoid arthritis)

• Not forgetting Physis response

PULSE & TONGUE DIAGNOSIS

• Pulse Diagnosis

Pulse diagnosis subject to fluctuation and sudden changes from - diet, emotions, etc

requires years of practice

• Tongue diagnosis

Subject to less fluctuation and sudden changes - More reliable/accurate than pulse diagnosis

DIAGNOSIS CHART

Backgroundassessment• Patient history •Family history •Present treatment

Lifestyleassessment •Lifestyle factors Clinical

assessment •Signs & symptoms

Temperamental assessment•Constitution•Personality

The Tibb approach to diagnosis

Provisional Diagnosis •Qualitative Frame/s •Pathway/s •Humoural imbalance/s •Affected tissues and organs

Final Diagnosis

•Confirmation of illness frame/s, qualities, humoural imbalance/s

Confirmation of affected systems or organsLabeling of disorder/s (where applicable)

Physical Examination

Pulse, tongue, urine, etc In-house tests (BP,chol, urine etc)External tests (lab, scan, sonar etc)Differential diagnosis

CONCLUSION

• Impossible for all diagnostic approaches to show conformity – especially within the context of the Six Qualitative Frames

• The Qualitative Frames in patients with various illness conditions can be confusing, – as illness conditions can fall into different frames – even opposite Frames

• Rely on the clinical findings as well as the overall picture

• Maintain balance between technology, and the art of holistic diagnosis (which includes intuition )

THE END

THANK YOU