Diagnosis: The 8 Principle Patterns

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This is a post for the list members who are new to TCM and for the

list members who are beginning students.

 

There are several diagnostic models used in TCM. One of the most

basic is called The 8 Principle Patterns.

 

The 8 Principle Patterns analyzes according to 4 pairs of factors:

Exterior/ Interior, Excess/ Deficiency, Heat/ Cold, and Yang/ Yin.

 

The first thing to consider when analyzing using the 8 Principle

Patterns is if the condition is Exterior or Interior. In TCM,

Exterior refers to the head, neck, upper shoulders, arms, legs,

skin, muscles, meridians, and bones. The " Interior " refers to the

trunk of the body, specifically the Organs.

 

Symptoms and signs of an Exterior problem includes things like runny

or stuffy nose, stiff neck, watery eyes, itching, muscular and bone

aches and pains, and a Floating Pulse. A Floating Pulse is one that

can be felt the easiest with the least amount of pressure on the

client's wrists.

 

In contrast, when a condition is Interior, the functions of the

organs/ Organs will be affected. There will be changes in

urination, digestion, breathing, appetite, thirst, bowel movements,

etc. There may be behavioral changes. A Deep Pulse is a sign of an

Interior condition (though not the only sign). A Deep Pulse is one

that can only be felt when the healer puts a lot of pressure on the

client's wrists.

 

In general, Exterior conditions are not as serious as Interior

conditions and are easier to treat. BUT this does not mean that

Exterior conditions can't be extremely painful and debilitating.

Consider arthritis as an example of an Exterior problem that can be

very painful and even debilitating.

 

The next pair is Excess/ Deficiency. Excess (aka Full, aka Replete)

problems are problems that are caused by there being too much of

something. The weather got too hot, the person consumed too many

foods and herbs with a cooling effect on the body, or the person has

Dampness, Qi Stagnation, Blood Stasis, etc., any of which is too

much.

 

In contrast, Deficiency (aka Empty, aka Vacuity) problems are those

caused by there not being enough of something. For example, there

is not enough Yin to properly cool, calm, and moisten the body.

There is not enough Yang to properly warm, activate, and dry the

body. There is not enough Qi or enough Blood or enough Fluids.

 

The treatment prinicples are that you remove Excess and you tonify

(increase) what the person is Defiient in.

 

If a condition is Excess, the coating on the tongue will be thick.

A good exsmple is the thick coating seen on the tongues of people

who suffer from Dampness. Any Dampness is too much, so Dampness is

classified as Excess.

 

The tongue coating in people who suffer from Deficiency tends to be

thin (which also is normal) or absent.

 

People whose problems primarily are Excess will tend to have very

forceful movements and voice. And a loud voice. On the other hand,

people with Deficiency problems will tend to have weak movements and

voice. And a low voice.

 

The third pair is Heat/ Cold. In general, in Heat cases the

complexion and the tongue tissue will be red. The tongue coating

will be yellow. In Cold cases, they will be pale or blue. The tongue

coating will be white (which also is normal). Heat speeds things up,

so the movement and speech will be rapid. Cold slows things down,

so the person will move and speak slowly.

 

The final consideration is Yang/ Yin. Again, keep in mind that Yang

warms, activates, and dries. Yin cools, calms, and moistens. Heat

can be due to Excess, or it can be due to Deficiency (i.e., Yin

Deficiency - not enough Yin to properly cool the body). Cold can be

due to Excess, or it can be Deficiency Cold (i.e., Yang Deficiency -

not enough Yang to warm the body properly). The signs and symptoms

tell the healer which it is.

 

In your studies, you'll learn more symptoms of Yang and Yin, but for

now I just want to give a broad overview of the 8 Principle Patterns.

 

There are other diagnostic models of patterns. For example, the

healer considers the state of the Vital Substances: Qi, Blood,

Fluids, and Essence (Jing). The healer also looks at any Pernicious

Evils: Heat, Cold, Wind, Dampness, and Dryness. Pernicious Evils can

invade from the environment - like what happens in cases of

arthritis when Wind, Cold, and/or Damp invades. Or, they can arise

in the Interior. Like what happens when Blood Deficiency triggers

Interior Wind.

 

Another model looks at what's happening to the Organs. For example,

Heart Blood Deficiency, Kidney Yin Deficiency, Spleen Yang

Deficiency, Liver Qi Stagnation, etc.

 

5 Element Theory is another model. I highly recommend that healers

learn the basics of 5 Elements Theory because knowing 5 Elements can

give that little extra diagnostic and treatment edge that can mean

the difference between succesful treatment and treatment that leaves

a lot to be desired.

 

There are some other models like the 6-Stages of Cold-Induced Evils

and the 4 Levels of Virulent Heat. You'll be learning about these

when you study diseases. TCM recognizes far more than Western

allopathic medicine does that there are stages or levels of

infectious diseases (and other conditions). Treatment will vary

according to the stage or level. For example, the treatment that is

correct when the person is in the 1st or 2nd stage of the 6-Stages

would make a person in another stage sicker.

 

When one analyzes in TCM, one uses all the models. The more one

learns, the more practice one has, the quicker one zooms in on the

correct diagnosis or diagnoses.

 

It is common for people to have combination of problems. For

example, a person who is too Cold overall nevertheless can have Heat

in the Lungs and Heart. A person can have both Excess and Deficiency

problems. A classic example is how Spleen Qi Deficiency can lead to

the Excess of Dampness because there's not enough Spleen Qi to

properly tranport and tranform fluids.

 

I want to mention something you'll see when you start to study The 8

Prinicple Patterns. You'll see a category called Exterior Excess

and one called Exterior Deficiency. The Exterior Excess is easy to

understand. It gets too hot, and a person gets heat exhaustion.

Excess Heat. A person gets too cold, and develops hypothermia or a

lot of other problems before the hypothermia state is reached.

Excess Cold. The wind blows, and the person develops migrating pains

in the muscles and joints. Or the person develops allergy-like

symptoms like a runny nose. I mean wouldn't all Exterior patterns be

Excess problems by definition? Yes and no.

 

The classification Exterior Deficiency is an example of the Chinese

fine-tuning diagnosis and treatment. The title means that the

problems in the Exterior are occuring because of an underlying

problem of long-term Qi and/or Blood Deficiency (or in some cases

long-term Yang Deficiency). For example, acute episodes of arthritis

are Exterior Excess problems. The person's Protective Qi temporarily

was deficient, and Cold, Wind, and/or Dampness invaded. On the

other hand, chronic arthritis is an Exterior Deficiency problem.

There's no temporary Deficiency of Protective Qi. A long-standing

problem with Qi and/or Blood Deficiency has rendered the person

unusually sensitive to Pernicious Evils in the Environment. It

doesn't even have to be very Cold, Windy, or Damp for the person to

be affected.