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Millwoods Acupuncture Center
102, 2603 Hewes Way
Edmonton AB,   Canada

Phone: (780) 466-8683



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.