This Is How INI Korean Medicine Clinic Diagnoses

The causes of pain and disease may be singular, or multiple factors may be intertwined in a complex manner. INI Korean Medicine Clinic deduces the causality by integrating Korean medicine pattern identification, Western medical structural and functional assessments, and complementary and alternative medicine assessments, and verifies the diagnosis after treatment by re-evaluating with the same criteria.

The Cause of Disease Is Not Singular

Hello. This is INI Korean Medicine Clinic.

There are various causes for why the body experiences pain or illness. While some conditions occur due to a single factor with a clear cause, like an ankle sprain, many cases arise from multiple factors where structural problems, functional imbalances, lifestyle habits, and psychological factors act together.

Causes can be categorized according to their roles:

• Precipitating factors: The trigger that first initiated the symptoms (trauma, overwork, sudden environmental changes, etc.)
• Aggravating factors: Conditions that make symptoms worse (specific movements, postures, lack of sleep, stress, etc.)
• Perpetuating factors: Conditions that prevent the symptoms from recovering and cause them to persist (entrenched habits, compensatory movements, decreased stamina, etc.)

Conditions often referred to as intractable are usually cases where these factors are intricately intertwined. If only a single factor is addressed, even if temporary improvement occurs, recurrence is likely due to the remaining other factors. Therefore, the more intractable a condition is, the more key to treatment it is to systematically untangle the intertwined causality.

Familiar Things Can Also Become the Cause

Causes are not necessarily just special abnormalities inside the body. In many cases, things that were too familiar to be considered causes become perpetuating factors.

• Habits: Sitting with legs crossed, chewing on only one side, irregular meals, and late-night snacking
• Mind: Worries and lingering grievances held for a long time, persistent tension of feeling that one 'must endure'
• Daily life: Work environment, sleep rhythm, exercise methods, burdens of caregiving and housework

These factors are not easily revealed by examination equipment. For this reason, INI Korean Medicine Clinic includes the patient's lifestyle and mind, along with the symptoms, within the scope of assessment.

Diagnosis Is a Process of Deducing Causality

There is no distinction between Western and Korean medicine when it comes to finding causality. It is the position of INI Korean Medicine Clinic that if it helps in understanding the patient's condition, the knowledge of Korean medicine, Western medicine, and complementary and alternative medicine should be utilized as much as possible. Each system explains the same body with different resolutions and criteria, and the more findings from multiple perspectives are cross-checked, the more accurately complex, intertwined causes are revealed.

The above evaluations are not performed uniformly on all patients. Necessary items are selected according to symptoms and medical history, and when additional tests such as imaging or blood tests are needed, we assess the necessity and guide you accordingly.

Medical Interview: Starting with the Chief Complaint and Medical History

Examination begins with the patient's story. We ask in detail about the most uncomfortable symptom (chief complaint), when and how it started, and what course it has taken (history of present illness).

• Pattern of symptoms: Area, nature, intensity, frequency, diurnal variation, aggravating and relieving factors
• Relationship with movement: In which direction movement causes discomfort, whether there is a difference between active and passive movement
• Past medical history and medication history: Pre-existing conditions, history of surgery/trauma, currently taken medications
• Lifestyle history: Sleep, diet, work, exercise, stress

Rather than machine testing, we search for causal clues centered around medical interviews, direct observation, palpation, and checking movement.

Korean Medicine Perspective: Viewing the Balance of the Whole Body Through Pattern Identification

The Four Examinations (四診)

In Korean medicine, the four diagnostic methods of inspection, auscultation and olfaction, inquiry, and palpation (望聞問切)—namely looking, listening/smelling, asking, and checking with the hands—are synthesized.

• Inspection (望診): Complexion, body type, posture, tongue color, shape, and coating (tongue diagnosis)
• Auscultation and Olfaction (聞診): Voice, respiration, cough, etc.
• Inquiry (問診): Cold and heat, sweating, sleep, appetite/digestion, urination and defecation, menstruation, emotional state
• Palpation (切診): Depth, rate, strength and weakness of the pulse (pulse diagnosis), abdominal tension, tenderness, and resistance (abdominal diagnosis), tenderness and response at acupoints

Pattern Identification Systems

Information obtained from the Four Examinations is interpreted through various pattern identification systems.

• Eight Principles Pattern Identification: Grasping the broad framework of the condition through Yin-Yang, Exterior-Interior, Cold-Heat, and Deficiency-Excess
• Zang-Fu Pattern Identification and Qi-Blood-Body Fluids Pattern Identification: Assessing the functional state of internal organs and the deficiency and stagnation of Qi, blood, and body fluids
• Meridian Pattern Identification: Analyzing the distribution of symptoms, meridian connections, acupoint responses, and the tension and movement of channel sinews (jingjin)
• Six-Stage Pattern Identification and Wei-Qi-Ying-Xue Pattern Identification: Interpreting the location and progression stage of disease from the perspectives of the Shanghan Lun (Treatise on Cold Damage Diseases), Jingui Yaolue (Essential Prescriptions from the Golden Cabinet), and Warm Disease Theory
• Sasang Constitutional Medicine: Considering physiological and pathological tendencies according to constitution
• Exterior-Interior and Zang-Fu Mutual Communication: Interpretations utilizing the mutual relationships between organs and meridians

The purpose of pattern identification is not merely to assign a label, but to clarify what symptoms and findings served as the basis for that judgment and to connect them to the direction of treatment. For reference, the "pulse system" refers to meridian diagnosis and is distinguished from pulse diagnosis that assesses pulse patterns at the wrist.

Qi, zang-fu (internal organs), and meridians are traditional pattern identification concepts in Korean medicine. They are not used synonymously with quantities of physical energy, anatomical organ pathology, or blood test values, and issues requiring separate confirmation are evaluated distinctly.

Western Medicine Perspective: Objectively evaluating structure and function

Physical Examination

We inspect and palpate the uncomfortable area to examine relevant structures such as joints, muscles, tendons/ligaments, and nerves.

• Range of Motion (ROM): Active and passive range of motion, differences between left and right, and angles at which pain occurs
• Muscle Strength and Resistance Tests: Pain upon exertion and the presence of muscle weakness
• Orthopedic Special Tests: Provocative tests tailored to the suspected structures
• Neurological Examination: Evaluation of sensation, deep tendon reflexes, and muscle strength when numbness or weakness is present

Posture and Functional Movement Analysis

We observe not only static posture but also functional movements such as walking, sitting to standing, trunk flexion, and arm elevation. By checking weight-bearing patterns, coordination between regions, and compensatory movements to avoid pain, we connect examination findings with everyday functional ability.

Evaluation of Circulation and General Systemic Status

If edema or coldness is present, we check skin color, skin temperature, peripheral pulses, and the distribution of swelling. Changes in fatigue, weight, digestion, bowel movements, sleep, and menstruation are also reviewed to the extent necessary to examine possibilities related to the vascular, lymphatic, and endocrine systems. However, hormone levels or internal organ diseases are not confirmed solely through palpation or symptoms, and specialized examinations are recommended when necessary.

Complementary and Alternative Medicine Perspective: Looking at inter-regional connections and reactions

Evaluation of Structural Connections and Responses

The methods below are complementary evaluations that examine how different parts of the body are connected to one another and how they respond to touch and movement.

• Myofascial Meridians: Analyzing connections between distant regions along the continuity of fascia
• Cranial, Temporomandibular Joint, Spine, and Pelvis Evaluation: Evaluations for CST (Craniosacral Therapy), SOT (Sacro-Occipital Technique), and whole-body adjustment
• Response-Based Evaluation: AK (Applied Kinesiology), CRA (Contact Reflex Analysis), Lovett Brother, transverse line diagnosis, manual palpation reflex diagnosis

For example, discomfort when raising an arm is not viewed as an issue solely of the shoulder; it is evaluated together with trunk movement, and we check how the same movement changes after touch or postural adjustments. At this time, responses palpated by the practitioner and changes in pain or movement felt by the patient are distinguished and recorded separately.

Integrative Interpretation of Body and Mind

We also consult traditional interpretations that view the body and mind together, such as energy axes, Ayurveda/chakras, Daoist perspectives, and Buddhist medicine/Buddhist psychology. This is particularly helpful in understanding the effects that prolonged tension or fixed mindsets have on the body. However, concepts from different traditions are not conflated into one, nor are they mapped one-to-one to abnormalities of specific organs.

Integrative Diagnosis: Weaving diverse findings into a single causal framework

Findings obtained from each perspective are not handled in isolation, but cross-checked against one another. By synthesizing Korean medicine pattern identification, structural and functional issues, inter-regional connections, as well as habits, mind, and daily life, we build a causal hypothesis regarding ‘Why is this patient feeling this discomfort right now?’

1. Identifying the Causal Structure: Distinguishing triggering, aggravating, and perpetuating factors, and organizing their relationships
2. Determining Treatment Priorities: Deciding what to resolve first and what to address together
3. Selecting Treatment Modalities: Designing acupuncture, herbal medicine, manual therapy, etc., along with lifestyle modification directions

Re-evaluation: Verifying the Diagnosis After Treatment

Diagnosis does not end before treatment. The movement that was uncomfortable before treatment is performed again, and the location and intensity of pain, range of motion, and performance level of daily activities are compared against the same criteria as before treatment. We also confirm together what change the patient values most.

Immediate responses following treatment and the sustainability of those changes are observed separately. We adjust our judgment by tracking conditions the next day, discomfort during work or walking, and changes in sleep and activities. If the anticipated change does not appear, we consider it a sign that there are factors not yet identified and re-examine the causal hypothesis. We do not explain that a cause or a long-term effect has been proven based solely on a single before-and-after response.

Conclusion

Diagnosis at INI Korean Medicine Clinic is a process of examining from multiple perspectives, explaining the observed rationale, and re-verifying judgments through post-treatment changes. For simple issues, clearly; for complex, intertwined issues, we will systematically trace causality as if unraveling a tangled skein of thread one by one.