Eastern medicine, which is based on a completely different philosophy from Western medicine, does share something in common with the latter. One of the very first things we learn in acupuncture is how to perform a physical exam. Just like what we are taught in vet school, we need to do physical exam in a systemic manner and be consistent with the way we do it. Conventionally, we would follow the order of certain organ systems, such as integumentary, musculoskeletal, cardiopulmonary, etc. There are so many organ systems in an animal’s body, so everyone kind of needs to figure out a way that’s easiest for them so as not to skip around and miss anything. In Eastern medicine, we simply categorize it into four aspects – inspection, smelling, inquiry, palpation.
Inspection is basically observation of the animal. Hair coat, skin, spiritual status, gaits, and so on are things we are so used to looking at. In addition, we examine things differently in Eastern medicine. One of the excellent examples is the examination of the tongue. We look at the tongue color, coating, texture, and moisture because it tells a lot from just looking at it, which is not the most popular area to look at in Western medicine. Another unique thing to evaluate is the behavior of the animal. Animals of one specific constitution possess characteristic personalities and are more susceptible to certain disease conditions, which can be mirrored by their behavior in the exam room.
Smelling and inquiry is quite straightforward, and they are no big difference from what we do with Western medicine. As for palpation, my favorite part of a physical exam, it requires us to palpate regions like the ear and the back to feel the body temperature, because we base our needling technique on the body temperature of the animal. The most challenging but useful part of palpation is palpating certain specific acupuncture points. If the animal shows some kind of painful reaction on some acupuncture points, it would greatly increase our suspicion of certain organ systems, and we can do acupuncture on these points so they are both diagnostic and therapeutic. But you really need to have a fairly good understanding of the diagnosis and treatment principles of Eastern medicine to utilize this palpation skill smoothly.
One thing noteworthy is that even though we are looking at the same aspect of the body, the way it’s interpreted truly reflects the difference between Eastern and Western medicine.