Re-understand diagnosis methods in TCM
In the
Traditional Chinese Medicine (TCM), there are several major ways
for the diagnosis.
(1). Liu
Jing Bianzheng
(2). Ba Gang
Bianzheng
(3). Wei Qi
Ying Xue Bianzheng
(4).
Small-formula Bianzheng (Tongue diagnosis)
(1). Liu
Jing Bianzheng is the diagnosis method introduced in <<Shang Han
Lun>> by Dr.Zhang Zhongjin 2000 years ago. It is not taught in
TCM school now even in China TCM university.[1] Liu means
number 6 and Jing means meridian by the surface meaning of the
word but actually is also means outline. Bianzheng means
diagnosis. So Liu Jing Bianzheng means six-meridian diagnosis
system, or six outline diagnosis system.
The six
outline diagnosis system outline the diseases in body into six
major ones.
(1a). Tai
Yang Jing Bing.
(1b). Yang
Ming Jing Bing.
(1c). Shao
Yang Jing Bing.
(1d). Tai
Yin Jing Bing.
(1e). Shao
Yin Jing Bing.
(1f). Jue
Yin Jing Bing.
Bing here
means disease. Within each Jing Bing, there are more
sub-diseases need to be diagnosed. Also, person could have two
or more Jing Bing at the same time, so the various clinic
conditions can be outlined into the only 6 major disease groups.
From the 1a
to 1f, e.g. from the Tai Yang Jing Bing to the Jue Yin Jing
Bing, disorders becomes worse. On the other side, that a
disorder development from the Jue Yin to Tai Yang suggests that
it gets better. So, the six-outline diagnosis system reflects
the change of the disorder progression or regression course.
This is not well reflected by the following eight-outline
diagnosis or four-outline diagnosis systems (see below).
In the six
outline diagnosis system, each diagnosis is followed by a herbal
formula. It also shows how to change the herbal formula
according to the clinic condition variation and development. The
function of the herbs in this diagnosis system is interpreted
different from current diagnosis systems (see below).
Some people
may think that the six-outline system is only useful for
emergency conditions or tough clinic cases. This is totally
wrong. This system is useful for almost every aspect of the
disease conditions.
In our
clinic, we use this diagnosis system mostly. We completely agree
that this system is the most useful diagnosis system in whole
TCM. If you are TCM doctor but do not know the six-outline
diagnosis methods, you are not a complete TCM doctor at all.
(2). Ba Gang
Bianzheng and the Wei Qi Ying Xue Bianzheng are taught in every
TCM schools in China
or out of
China. We call it textbook TCM
system. If you are TCM students, I am sure that you have learned
these two systems when you are in TCM school. Ba means 8 and
Gang means outline. So Ba Gang Bianzheng means eight-outline
diagnosis system. The eight-outline diagnosis system is commonly
combined with a Five-element diagnosis system to localize the
spot of the disease.
In this
eight-outline diagnosis system, the diagnosis of Yin and Yang
becomes a theoretical goal, not a practical goal. It leaves the
disease condition diagnosis of surface level versus inner level;
Hot versus Cold, deficiency versus overwhelming, as the
obligation to build up a healing principle. Keeping the same
diagnosis, each doctor may use quite different herbs for the
treatment though the main function of the herbs are the same.
The dose of
each herb in this system (usually between 10 to 15 g) is less
than the herbs in herbal formula in six-outline diagnosis system
above (usually 15 to 45 or even to 90, 120 g), whereas the
number of the herbs in the formula in this eight-outline system
(usually more than 10) is much more than the above six-outline
system (less than 6, mostly even 4 or 2 only). It might be due
to the relatively poor clinic effectiveness by the eight-outline
system that makes the current TCM doctor use more number of
herbs in one formula and even higher dose for each herb too. It
is too bad trend in current textbook TCM.
There are
more difference between the eight-outline diagnosis system and
the six-outline diagnosis system above. If we say that the
six-outline diagnosis system is a dynamic, alive, mobile, active
diagnosis system, the eight-outline diagnosis system is only a
still, non-dynamic, non-active diagnosis system.
Therefore, if the
eight-outline diagnosis system GIVES YOU FISH, whereas the
six-outline diagnosis system TEACHES YOU HOW TO FISH.
(3). The Wei
Qi Ying Xue
diagnosis system can also be called four-outline diagnosis
system. Since it is used mostly in acute infectious diseases,
you may not commonly use it in your clinic work. The clinic
effective scope with this system is absolutely narrow. The
interpretation of herb functions in this system as the same as
the eight-outline diagnosis system.
(4).
Small-formula diagnosis system.
This is a
new diagnosis system. It is so new that no many people know it
yet. It is developed by Dr. Guo zhichen in recent years. It
picks up information mostly from the tongue of patients. The
understanding of the body function by this system is also much
different from the above traditional TCM system. The herb
formula used by this system is as its name indicated, very
small. It can be as small as each herb is only 4 gram and the
total number herbs in a formula is average 4. The interpretation
of the herbal function is also quite different from all of the
diagnosis system introduced above. The weakness for this
diagnosis system might be the fact that it has not come to
mature. The developer still modifies the diagnosis and
associated herbal formula.
There are
some other systems more or less than the above typical diagnosis
system. For example, there is a group of doctor, we call them “Hou
Sheng Pai” in Chinese. It means that these groups of doctors
prefer and also very skillful in the use of Hot herbs for the
clinic treatment. The herbs include, but not limited to, Fuzi,
Mahuang, Guizhi, Wutou, Liuhuang. In there diagnosis system,
they follow mostly the six-outline diagnosis system but much
more pay attention to the diagnosis of Yin and Yang condition.
As we mentioned above, the diagnosis of Yin and Yang has become
very weak in the above eight-outline diagnosis system, though
they claim it is the main outline among the whole eight
outlines.
It should be
reminded that TCM also have systematic treatment. It means that
doctors use herbs according to the symptoms, without any clear
diagnosis. There are
several cases for this kind of systematic treatment:
(1). Doctors
use some herbs based on special symptoms, among other herbs that
are used based on diagnosis.
(2).
Ordinary people use some herbs for their symptoms or for their
diseases that are diagnosed according to western medicine. For
example, they may use some herbal formula to treat hepatitis.
This is very typical in
Japan. They refuse to use the
typical TCM diagnosis methods, but tend to use herbs based on
the symptoms or western medicine diagnosis. They even want to
stop the TCM diagnosis but only keep the herbs and use the herbs
as drugs. This causes severe problem: they ask patients to take
some herbs for years without change the ingredients of the
herbal therapy. It is no wonder that there could be severe side
effects from the herbal therapy. They modify the TCM in a wrong
way.
If you want
to learn the TCM, you should learn the key of the TCM. It is not
easy, of course. Otherwise, you will only be a technician of
TCM, not a doctor. If you use the herbs as drugs, you destroy
the TCM. If you do it that way, you should call it another name,
not TCM.
[1] <<Shang Han Lun>> has become an
optional course in most TCM schools in China.
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