"One" represents the entire set of standard operations in Traditional Chinese medicine (TCM), from analysis and reasoning, treatment principles, to prescription and medication, all of which are consistently applied.
This set of operations consists of 8 groups of operators, which are "yin-yang, exterior-interior, cold-heat, deficiency-excess," collectively known as the "Eight Principles of Differentiation." The so-called "differentiation" is to analyze and determine the current abnormal systemic state of the patient, which is the "pattern." Whenever a TCM physician faces a patient, they initiate this operation. Understanding these, you have grasped the essence of TCM.
Why does the author refer to the "eight principles" as operators? Because each of them is like a logical knife that makes meaningful divisions of the human body and assigns specific meanings to each divided part.
Yin-yang: This is a universal set of operators. Any item or individual with opposing aspects can be divided into two by yin-yang. For example, the liver can be further divided into liver yin and liver yang. The former refers to the tangible aspects of the liver, the basic material aspects controlled by the liver, while the latter refers to the intangible aspects, the functional and physiological aspects of the liver.
Exterior-interior: Exterior-interior, also known as external-internal, is a relative concept that can refer to the location of a disease. For example, diseases of the skin and flesh belong to the exterior, while diseases of the internal organs belong to the interior. Exterior-interior can also refer to the depth of the disease's development process. For instance, symptoms like fever, headache, and chills in the initial stage of a common cold are called exterior symptoms in TCM. If they develop into pneumonia or meningitis, they are called interior symptoms. If the two-part division of exterior-interior is not detailed enough, it can be further subdivided. For example, warm diseases subdivide the disease process from exterior to interior into defense, qi, nutrient, and blood stages, which are four more detailed operators. As for simple internal diseases, the interior can be further subdivided into five zang and six fu-organs, totaling 11 detailed operators.
Cold-heat: Used to classify the nature of diseases, it is the outline of all related attributes. If these two operators are not sufficient, they can be further subdivided into wind, cold, heat, dampness, dryness, and fire, which are six more detailed operators. They can represent the excessive attributes of external climates, such as the cold of winter or the dampness of summer, or the excessive attributes within the body, such as excessive internal heat or dampness.Deficiency and excess: Commonly used to define the strength and weakness of healthy qi and pathogenic qi in the human body. Deficiency represents weak healthy qi, while excess represents strong exterior pathogen qi. Broadly, pathogenic qi includes various microorganisms that invade the human body and excessive environmental cold, heat, and dampness. The accumulation of pathological metabolic waste in the body can also be called excess, such as edema or phlegm accumulation. Low bodily functions or insufficient materials can be considered deficiency, while overactive bodily functions or excessive materials can be considered excess.
How does a TCM physician use these 8 groups of operators when facing a patient? Here are a few examples.
For example, if a patient works outdoors in freezing weather and develops a fever, headache, and runny nose, the TCM physician would diagnose it as "external contraction of wind-cold" or "exterior affected by wind-cold" or "exterior affected by cold pathogen." Because this cold comes from outside the body, it is called "external contraction" or "exterior affected." Because this cold is excessive and harmful to the body, it is called "cold pathogen." The prescription would be to use pungent-warm and exterior-releasing medicinals to help the patient disperse the cold from the body surface. Note! The diagnosis result of the TCM physician is not simply "common cold," but the current systemic pathological state of the patient. Even though different people with different body states may exhibit different symptoms and severity when exposed to cold, TCM treats the pathological state of the entire human system, not just the symptoms.
Another example, there is a patient who sits in front of a computer screen working, staying up for three days without sleep, resulting in a swollen and painful head, reddened whites of the eyes, dry eyes, dry mouth and throat, and an inability to sleep despite wanting to. The TCM physician diagnoses this as "yin deficiency with yang hyperactivity" or "yin deficiency with yang excess." Yin generally refers to a group of subtle substances in the body used for nourishment and as fuel, while yang refers to the body's oxidative energy production, heat generation, and various physiological functions. The patient's body is excessively burning energy, and the stored resources have been depleted, unable to continue supporting such operations, thus leading to various symptoms. The prescription involves giving the patient some medicinal materials containing multiple nutrients to replenish the excessively depleted "yin." These types of medicinals are collectively referred to as "yin-tonifying medicinal." Additionally, some medicinals that can reduce the body's energy production rate are used to cool down the patient's over-excited functions. These types of medicinals are called "deficiency-heat-clearing medicinal" or "deficiency-heat-clearing medicinal." Please note! The TCM physician diagnoses and treats the patient's systemic pathology at the moment, not just the symptoms.Therefore, although the diagnosis result of a TCM physician may consist of only a few simple words, it resembles a beautiful ancient poem, fully describing the pathological state of the patient's entire system at that moment. The treatment by the TCM physician aims to help the patient expel pathogenic qi and correct the imbalanced pathological state.
TCM treats systemic pathology, not just individual symptoms. For example, if Park A is suffering from water shortage, the symptoms might be fallen leaves and withered trees; Park B also suffers from water shortage, but since it is planted with cholla stems, there won't be fallen leaves everywhere. However, the treatment for both parks is to water them regularly. Thus, even if two patients do not have exactly the same symptoms, as long as their "pattern", that is, the systemic pathology, is the same, the treatment approach will be similar or identical. This is known in TCM as "treating different diseases with the same method."Conversely, even if different patients have the same symptoms, if their "patterns" differ, the treatment prescriptions will be completely different. This is known in TCM as "treating the same disease with different methods." For instance, if Park A suddenly has fallen leaves everywhere and the diagnosis reveals a lack of irrigation, the treatment would be to water it regularly. If Park B also suddenly has fallen leaves everywhere, but the diagnosis reveals that a group of mischievous kids are practicing sword techniques with sticks, causing the leaves to fall, the treatment would be to drive these kids away.
Therefore, when you come across terms like "spleen deficiency with dampness retention", "heart yang deficiency", "spleen and lung qi deficiency", "bladder dampness-heat", "summer heat damaging the lungs", and so on, you can understand that these are concrete descriptions used in TCM to depict the current difficult situation (i.e., the systemic pathology) of the human body as a vast system.
Almost all diseases can be analyzed and categorized using the multiple combinations of "yin-yang, exterior-interior, cold-heat, deficiency-excess" and their more detailed expanded operators. Their combinations can number in the thousands, tens of thousands, or more. Once the differentiation is completed, the corresponding treatment principles and methods naturally emerge. This is the secret of TCM in governing myriad diseases with "one."
A qualified TCM physician, proficient in the above eight principles of differentiation, can almost handle all common conditions in modern medicine's departments of hepatology, gastroenterology, thoracic medicine, family medicine, pediatrics, gynecology, urology, and more. All physicians of TCM should take pride in their profession.
The diagnosis result of TCM, that is, the name of the pattern, not only concretely describes the current systemic pathology of the human body but also serves as a classification system governing hundreds of thousands of symptoms and diseases. Compared to modern medicine's mechanical classification, which has tens of thousands of disease names and keeps increasing every year, and from which the disease cause and mechanism are not apparent, it is indeed difficult for doctors to apply flexibly. The superiority of TCM over modern medicine is clear at a glance.
