DIAGNOSTIC APPROACH IN TIBB
PROF 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
The Tibb approach to
diagnosis
Temperamental
assessment
•Constitution
•Personality
Background
assessment
• Patient history
•Family history
•Present treatment
Clinical
assessment
•Signs & symptoms
Provisional Diagnosis
•Qualitative Frame/s
•Pathway/s
•Humoural imbalance/s
•Affected tissues and organs
Physical Examination
Pulse, tongue, urine, etc
In-house tests (BP,chol, urine etc)
External tests (lab, scan, sonar etc)
Differential diagnosis
Final Diagnosis
•Confirmation of illness frame/s, qualities,
humoural imbalance/s
Confirmation of affected systems or organs
Labeling of disorder/s (where applicable)
Lifestyle
assessment
•Lifestyle factors
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