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TCM Detective Series 2: “The Case of the Girl in the Grocery Store” or “Acne: A Speculation”

by Arwen Careaga, L.Ac., MSTOM 

I saw a young lady today. Some of her symptoms were obvious, others I surmised. But wait, there’s a catch!

The patient: female, approximately 22 years old

The symptoms:

  • loose bowel movements, occasionally urgent and burning
  • acne along the jawline
  • thirst for cold beverages with no desire to drink anything

The diagnosis: damp heat in the stomach
The catch: She’s not my patient – I just saw her for the first time today, in the grocery store.

*This is where the record stops with a scratchy sound and you, dear reader, do a double take!

“But Arwen,” you interject, “How could you diagnose someone you only saw in the grocery store? Surely you didn’t ask her about her bowel movements? Are you a magician?”

Friend, I tell you the truth: I have been practicing the rope trick ever since my son got a magic kit for his birthday. However, this is unrelated to my deductive skills from the grocery store! I was able to diagnose this young lady using only information that she gave me, and I didn’t ask any questions, especially not about bowel movements. It just so happened that she said “Hi” to me as I entered her check-out lane, and then it just so happened that I noticed her tongue.

Let me pause briefly to answer the question I’m pretty sure you are mentally asking…the answer is yes. Yes, I look at every tongue I see – in magazines, in pictures, in person. Based on all the conjecture and articles that come from acupuncturists when celebrities are photographed with their tongues hanging out, I’m pretty sure we all do it. It comes with the territory, I think.

The tongue of this particular young lady did not have the thin white coat I generally hope to see. It was, instead, a thick and slippery looking yellow. The thickness and slipperiness suggest dampness, and the yellow tells of heat. The tongue is a very useful diagnostic tool in Chinese medicine and the coat essentially presents the condition of the stomach right before our very eyes.

The second clue was also right before my eyes, along her jawline: acne, following precisely the path the Stomach channel takes on its way from the eye area down and through the body, including the stomach organ as well, where the symptoms of gastrointestinal discomfort would continue. This is also why she would have likely had thirst for cold beverages (because there’s heat inside) but had no interest in drinking anything – the thought of adding any liquid would be uncomfortable because there is already “dampness” present!

Dampness and heat can come from many sources, and can be treated effectively. But that is another article for another time. I share with you this casual observation to remind you that seemingly unrelated symptoms (see above) actually fit together in a very sensible, understandable and approachable manner when they are viewed through the lens of Chinese Medicine. That is the first take-away. The second is this: if you have a friend who is an acupuncturist and you are at a party together, hide your tongue. Because you’d better believe they’re looking!

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