Simply put, pattern differentiation is the hallmark of the TCM-style of Chinese medicine.  Other forms of traditional Asian medicine, such as Japanese Toyohari acupuncture or Korean Hand acupuncture do not usually employ the Chinese pattern differentiation system.  Although all medical systems have their strengths and weaknesses, the TCM model has a fundamental advantage over most other health care paradigms in its ability to match the special needs of each individual patient.  This characteristic is the result of emphasizing the treatment of patterns over the treatment of disease, a Chinese medical approach that gained favor during the Qing Dynasty (1644-1911 CE)*.

Diseases and Patterns

Almost all forms of medicine treat diseases.  Headache is a good example of a disease identified and treated in many medical systems.  Although the understanding of the cause of the headache differs from one medical model to another, the majority of remedies set relief of the head pain as the basic goal of treatment.

TCM style Chinese medicine, however, does not focus on the headache itself.  Instead, it sees the headache as the main manifestation of a complex of disharmony and aims not for the symptomatic branches but instead targets the root of the disharmony.  The symptomatic manifestations, including the headache, are treated at the same time as the root but are given less attention in the treatment strategy.  The Chinese term for this approach is bian zheng lun zhi or ‘treatment according to pattern differentiation’.

In order to clarify the concept of treatment according to pattern differentiation, let use compare the biomedical and Chinese approaches to a headache case.  Both Western and Chinese doctors begin by collecting data regarding the condition.  The M.D. will ask questions and employ testing and imaging when appropriate to form a differential diagnosis.  Signs and symptoms such as nausea, one-sided loss of vision, disorientation, lethargy, and occipital headache might point to a brain tumor, demanding further investigation such as an MRI, while a history of visual distortion that gives rise to a  severe, one-sided headache lasting for several days suggests migraine headache.  Once all of the other possibilities have been systematically eliminated, a differential disease diagnosis will allow the physician to select an appropriate treatment for the condition.  Correct disease diagnosis is the sine qua non of skillful biomedical practice.

The Difference Between Eastern and Western Diseases

Once an allopathic doctor has ruled out the diagnoses of cancer and other critical ailments, the Chinese doctor can offer a different point-of-view.  Instead of using modern technology to assess the case, the TCM practitioner relies on the traditional methods of tongue inspection, inquiry, and pulse palpation to identify the pattern.  He or she will utilize the Chinese disease of tou tong or headache as a guiding factor but is most interested in the underlying imbalances in the body.  The background is determined according to a broad constellation of signs and symptoms.  For example, a headache that is associated with a traumatic injury and manifests with fixed, stabbing pain, pain worse with pressure, a purple tongue body, and a rough pulse indicates a blood stasis pattern.  On the other hand, a headache with a feeling of tight pressure and distention, nausea and vomiting, profuse phlegm, a slimy tongue fur, and a slippery pulse suggests a phlegm-damp pattern.  For each case, after the primary pattern is identified, additional relevant patterns are isolated and prioritized.  Through this procedure,  a complex picture of an individual case is created.  This is a more patient-centered approach than the methodology used by the M.D.

The biomedical disease diagnosis is crucial for determining prognosis.  Obviously, expected outcomes for the brain tumor patient can be markedly different from the patient with migraine headaches.  The traditional Chinese disease of tou tong headache does nothing to shed light on this difference.  On the other hand, once the headache has been identified as a migraine headache, functional headache, or tension headache by your M.D., the Western medical treatment is determined according to the disease, with little attention paid to distinctions from patient to patient, and options for treatments are limited.  The biomedical treatment for all three of these types of headache, for example, will likely include nonsteroidal anti-inflammatory drugs.  In the case of migraines, research suggests that this approach may actually cause more frequent and more severe pain.  Additionally, NSAID’s are understood only as temporary, analgesic relief, and long-term use of some of the drugs may damage organ function.

Using Chinese Patterns in the Clinic

On the other hand, once the Chinese doctor has identified phlegm-damp as the primary pattern associated with the issue of headache and has determined, for example, that there is a spleen-kidney vacuity and liver depression qi stagnation,  a specific treatment can be designed to restore normal function.  The treatment, whether acupuncture or herbal, will target the main complaint, the primary pattern, and any other important patterns of disharmony.  This forms a very individualized response with a low risk of adverse effects.  As it is the ‘one-size-fits-all’ model in biomedicine that accounts for a wide variety of responses to medication, using the Chinese medical approach one can generally expect few side effects.  In addition, Chinese treatments are only used until the condition resolves satisfactorily, so patients do not have to be concerned with developing habituation to or dependency on Chinese medications.

Obviously, the public benefits from having access to both professional biomedical and Chinese health care.  Your M.D. will always be your primary health care provider and is the best place to start.  Many conditions, however, are not well-treated with Western medicine alone, and biomedical treatments are often costly and involve risk.  The less expensive, noninvasive, patient-specific Chinese approach may be the best option for your case.  We look forward to helping you make good decisions regarding your choice of treatments so that you can realize your human right to optimal health and well-being.

*The use of pattern differentiation in Chinese medicine has a very long history, dating back as far as the renowned Han dynasty physician Zhang Zhong-Jing (150 CE-219 CE).  According to the translators of this doctor’s famous work, On Cold Damage or the Shang Han Lun, ‘The Shang Han Lun is regarded as the basis of the approach to diagnosis and treatment that in the Qing dynasty came to be called ‘determining treatment on the basis of patterns identified’ which is now considered to be the quintessence of Chinese medical genius‘.