TCM Campus

All lessons   Module 1: Foundations   Lesson 1

Module 1   Lesson 1   Bian Zheng Lun Zhi

How TCM thinks

Why do two people with the same diagnosis get a different treatment in Chinese medicine?

After this lesson you can explain why TCM treats a pattern rather than a disease label, read Yin and Yang as a relationship with four aspects, follow the four steps from complaint to principle in a case, and tell which tradition a practitioner reasons from.

complaint 1 findings 2 pattern 3 principle 4 methods Same diagnosis: IBS abdominal pain, erratic stools patient A pain, diarrhoea with stress sighs, irritable pulse tense (wiry) patient B tired, bloated after meals poor appetite, pale pale tongue, teeth marks Liver invading the Spleen stuck and empty at once Spleen-Qi deficiency too little harmonise the Liver, tonify the Spleen tonify Spleen-Qi points and herbs that move and tonify points and herbs that tonify
Schematic. One disease label, two patterns, two treatments. Read the arrows as a line of reasoning, not as cause and effect. Step 7 works through both patients.

Know by heart

  • Bian Zheng Lun Zhi. findings, pattern, principle, methods; the methods follow from the principle, not from the complaint; mnemonic: first see, then name, then choose, then do.
  • Bian Bing versus Bian Zheng. disease versus pattern; one disease, several patterns; one pattern, several diseases; mnemonic: Bing is the disease label, Zheng the pattern.
  • The Liver is not the liver. a functional network, hence the capital letter; correlative thinking: what goes with what.
  • Four Yin-Yang relationships. opposition, interdependence, mutual consumption, inter-transformation; always relative: Yin compared with what?; mnemonic: two poles that check each other, need each other, use each other up and flip at the extreme.
  • Consumption versus transformation. consumption shifts gradually and both poles remain; transformation is the flip at the extreme.
  • Four anchors. Huangdi Neijing (classical foundation), Shang Han Lun (around AD 200, Cold), Wen Bing school (17th and 18th centuries, Heat), "TCM" (1950s, People's Republic); mnemonic: Han is cold, Wen is warm, TCM is the youngest.
  • Five traditions and a neighbour. TCM following Maciocia, Five Element, Japanese, Master Tung, classical (Shang Han Lun); alongside them dry needling, not a TCM tradition; mnemonic: five Ps and a neighbour: Pattern, Phase, Palpation, Point system, Prescription, and next door Pinpoint needling without theory.

The rest of this lesson is reference.

How TCM thinks: Why do two people with the same diagnosis get a different treatment in Chinese medicine?
The chart as an image, to save or share

Three practice questions from this lesson

What does a pattern (zheng) describe?
  1. The name of the disease the doctor gives
  2. The picture of the whole person now
  3. The organ that is anatomically diseased

Answer: The picture of the whole person now. A pattern is the coherent picture of all the findings in one person at one moment. The disease label is bing; and the Liver is not the liver.

Two patients with IBS receive different treatments.
  1. Chance
  2. Bian Bing versus Bian Zheng
  3. A mistake: IBS calls for one treatment

Answer: Bian Bing versus Bian Zheng. One disease can show different patterns; what gets treated is the pattern. So the same disease does not get the same treatment in everyone.

Where do the points and herbs follow from?
  1. From the disease label
  2. From the worst complaint
  3. From the principle

Answer: From the principle. Findings, pattern, principle, methods. A 'point for IBS' skips the pattern and the principle; that is why patients A and B get something different.

The rest of this lesson

In the course you get the step-by-step explanation, 20 case-based practice questions, 30 spaced-repetition flashcards, the pitfalls and the bridge to physiology with evidence grades. This lesson belongs to module 1: Foundations.

Try three lessons freeSee the course