TCM- Patterns of Illness (Test 1)

A pattern is a collection or group of signs and symptoms (otherwise known as clinical manifestations) that point to the character, site and pathology of a condition (or disharmony). The pattern or patterns are determined through a thorough examination of the patient using the 4 pillars of diagnosis.

Signs and Symptoms:
The TCM concept of 'symptoms and signs' (also referred to as clinical manifestations) differs somewhat to that in western medicine. Signs and symptoms in TCM are broader and inclusive of manifestations that western medicine would not typically make note of as being significant to the diagnosis of the presenting problem. This includes manifestations such as bodily functions that are in addition to the presenting symptoms (urination, bowel movements, thirst, etc. ), emotional and psychological traits, facial and bodily signs and so on.

Relationship in TCM between Patterns and Diseases:
1. One Chinese disease (eg abdominal pain) corresponds to different Chinese patterns (eg, SP Qi deficiency LV invading SP, ST Heat, etc. )
2. One Chinese pattern (eg. LV Qi stagnation) corresponds to different Chinese diseases (eg. Headache, Painful periods, abdominal pain, etc.)

Relationship between Chinese & Western Diseases:
1. One Chinese disease (eg. Abdominal Pain) corresponds to different Western diseases (eg. ulcerative colitis, irritable bowel, diverticulitis).
2. One Western disease corresponds to different Chinese diseases )eg. Dizziness, Headaches, Tinnitus)

Identifying Patterns:

Each symptoms and sign has a meaning only in relation to all the other symptoms and signs ; therefore one symptom can mean different things in different situations.

Identifying patterns also follows the typical way of Chinese natural philosophy, which looks for relationship rather than causes.

Identifying the pattern allows us to find the nature and character of the condition, the site of the disease, the treatment principle and the prognosis.

Pattern Differention Methods:
1. 8 Principles

• Interior/Exterior
• Hot/ Cold
• Excess/Deficient ( Full /Empty)
• Yin / Yang

2. Qi, Blood, Body Fluids
3. Zang-Fu
4. Pathogenic Factor
5. 6 Stages/Channels
6. 4 Levels/Aspects
7. 3 Burners
8. 12 Channels
9. 8 Extraordinary Vessels
10. Five Elements

Although the term '8 principles' is relatively recent in Chinese Medicine (early Qing dynasty), their main aspects were discussed both in the "Yellow Emperor Classic of Internal Medicine" and in the "Discussion on Cold-induced Diseases". Both these classics contain many references to Interior/Exterior, Hot/Cold, Full/Empty and Yin/Yang characters of diseases.

The method of identification of patterns according to the 8 principles differs from all the others in so far as it is the theoretical basis for all of them and is applicable in every case.

The 8 principles should not be seen in terms of either or. It is not at all unusual to see conditions that are Exterior or Interior simultaneously, or Hot and Cold, or Full and Empty or Yin and Yang. It is even possible for a condition to be all of these at the same time. The purpose of applying the 8 principles is not to categorize the disharmony, but to understand its genesis and nature. It is only by understanding this that we can decide on treatment for a particular disharmony.

Moreover, not every condition need have all four characteristics. For example, a condition need not necessarily be either hot or cold. Deficiency of Blood is a case in point, as it does not involve and hot or cold symptoms.