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Four Quadrants of Functional Diagnosis
by Dicken Weatherby, ND

My colleague, Dr. Scott Ferguson, and I developed the four quadrants of functional diagnosis to represent the different methods by which patients can be assessed from a functional perspective. The first quadrant takes a critical look at the myriad of signs and symptoms a patient presents with. Using a comprehensive questionnaire we can look at the symptom burden in specific systems of the body, address some of the more obscure symptoms people have, and track changes over time. For example, did you know that sensitivity to diesel fumes was a sign of molybdenum insufficiency and a weakness in the phase 2 sulfation/sulfoxidation pathway in the liver? The symptom analysis system we have developed is an efficient way to gather, organize, and make sense of the overall state of a patient’s health.

The second quadrant takes a more comprehensive approach to the standard physical exam. Using a series of palpation and reflex techniques from Osteopathy, Naturopathy, and Chiropractic, along with a variety of other special tests we can quickly and accurately assess, monitor, and treat the majority of functional disturbances that affect our patients. This method of physical examination incorporates a powerful biofeedback testing system called Neuro-Lingual Testing, a hands-on technique that requires no special equipment, and allows the practitioner to individualize the treatment protocol. Involving patients in direct feedback is a powerful method of interaction and increases compliance.

The third quadrant incorporates a series of in-office tests that allow the practitioner to assess for functional disturbances in their patient’s inner environment or terrain. By analyzing easily collected bodily fluids, such as saliva and urine, you can measure the key bio-markers that show the body’s ability to regulate pH, oxidation/reduction, mineral balance, digestive competence, gut integrity, enzyme kinetics, nutrient delivery, waste removal, etc. One of the benefits of this system of testing is that the testing is done in the office, allowing the patient to be tested and assessed in one office visit. Reassessments are easy and convenient to perform, and will enhance patient compliance.

The fourth quadrant looks at out-sourced labs. The main lab we order is a standard blood chemistry and CBC panel. Most practitioners use the standard reference ranges for their blood test interpretation. Unfortunately these ranges are designed to identify and diagnose disease states and pathology in the sickest 5% of the population. The other 95% are not adequately assessed using this method. We use a system based on optimal values that are more representative of optimal physiology. This method of analysis allows us to look for optimum function and thus increase our ability to detect dysfunction long before disease manifests.

Gathering patient data from all four quadrants allows a practitioner to answer 4 essential questions:

  1. Where is the dysfunction in the body,
  2. What are the sources of this dysfunction,
  3. What individualized treatments are needed,
  4. When has function been restored.

We have a number of tools and reference resources on all four quadrants of functional diagnosis. Please click here for more details.

© 2004 Dicken Weatherby, ND


Dr. Dicken Weatherby is a graduate of the National College of Naturopathic Medicine in Portland, Oregon. He is the co-author of the best-selling book "Blood Chemistry and CBC Analysis- Clinical Laboratory Testing from a Functional Perspective". To learn more about Dr. Weatherby's functional diagnosis books and sign up for FREE functional diagnosis tips, tools, and techniques, visit his web site at

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Blood Chemistry Analysis

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