Eight Principles Introduction

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Eight Principles

Introduction

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Identification of Patterns

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Pattern Identification and administration of treatment is one of the primary distinguishing features of Chinese medicine diagnosis and treatment

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Refers to the gathering of data with the four examinations and the use of the eight principles or some other pattern identification method to determine and differentiate the pattern of the disease

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Inspection (looking)

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Auscultation and Olfaction (listening/smelling)

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Inquiring (questioning)

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Palpation (touching)

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Treatment principles are determined based on the identification of the pattern

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Therefore, principles of examination and of the treatment of disease must be such that the physician can accurately examine and investigate the manifestation of every sign and symptom of the disease and simultaneously precisely summarize, analyze and pursue the root nature so that the treatment can be in accordance with the pattern

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Western Medicine - Differential Diagnosis

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Chinese Medicine - Identification of Patterns

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Identifying the basic disharmony that underlies all clinical manifestations

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This is essentially a picture formed by the clinical manifestations of the patient that point to the character, the site and the pathology of the condition

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Ex) Poor appetite, loose stool, tiredness, weak voice, propensity of catching colds and dislike of speaking

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Two patterns presented here

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Spleen Qi deficiency

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Lung Qi deficiency

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Pathology - Qi deficiency

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Site of disease - Spleen and Lung

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How they differ

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Chinese medicine takes all the signs and symptoms into consideration to form an overall picture of disharmony

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Pattern differentiation does not indicate the cause of the disease, but, instead, the disharmony underlying the disease

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Cause can be considered after the pattern is determined

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One disease, many patterns; One pattern, many diseases

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Tong Bing Yi Zhi, Yi Bing Tong Zhi

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Same disease, different treatment; Different disease, same treatment

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Fundamental principle in Chinese medicine

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The same disease (painful periods, for instance) can manifest with different patterns and the same pattern may apply to many different diseases

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Ex) Painful periods

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Depending on the other signs and symptoms, can be seen in the following patterns

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Qi stagnation, Blood stasis, Cold in the Uterus, Damp-Heat in the Uterus, etc.)

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Also, one pattern can apply to multiple diseases

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Ex) Liver-Qi stagnation may be the pattern for those complain of the following diseases

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Painful periods, premenstrual syndrome, epigastric pain, abdominal pain, hypocondrial pain, back pain, etc.

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This same principle can correspond to relationships between Western disease and Chinese patterns

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Ex) High Blood Pressure

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Eight Priciples Introduction

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The term 'Ba Gang' or Eight Principles is relatively recent in Chinese medicine

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Orginally appear in this form in the 17th century

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First appeared as eight principles (Ba Gang) in 'The Essential Comprehension of Medical Studies' by Cheng Zong Ling

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However, the main aspects appear very early and where discussed in the 'Yellow Emperor's Classic of Internal Medicine' and in the 'Discussion on Cold-Induced Disease'

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Orginally called the six changes (included internal/external, hot/cold, excess/deficiency)

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In the analysis of any disease, eight principle differentiation can be used to understand the disease

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8 Priciples is the foundation for all the other methods of pattern formulation

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Identification of patterns according to channels is applicable only in channel problems, that according to internal organs in organ problems (Macioca-Foundations of TCM)

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Identification according to eight principles is applicable in every case because it allows us to distinguish exterior from interior, hot from cold and full from empty

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No condition is too complex to fall outside the scope of identification occcording to the eight principles

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8 Principles are the summation of all other modes of identification and are applicable in all cases

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Divided into internal/external, cold/heat, excess/deficiency (full/empty, repletion/vacuity), yin/yang

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Therefore, the 8 principles can aid in understanding the location and nature of pathological change, the course of the disease and the strength of the evil and right

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Exterior/Interior describes the location of the disease

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Hot/Cold describes the nature of the disease

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Excess/Deficient (Xu/Shi) describes the presence or absence of pathogenic factors, and also the strength of the pathogen in relation to the strenght of the body

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Yin/Yang is a summation of the other 6 principles and describes the overall quality of the disease

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These two principles serve as the guiding concept of the eight principles

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Exterior, heat, excess (repletion) are ascribed to yang

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Interior, cold, and deficiency (vacuity) are ascribed to yin

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When used clinically, these principles are combined together and cannot be seperated

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For instance, when differenctiating exterior and interior, it is necessary to combine this with hot and cold and vacuity and repletion

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However, 8 Priciples should not be seen as 'either-or'

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Patterns can be mix

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Exterior-Interior

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Excess-Deficient, Full-Empty, Repletion-Vacuity

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The purpose of the 8 principles is to understand the disharmonies genesis and nature

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Not every condition needs to have all four characteristic

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Ex) Blood deficiency

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Can have heat signs with blood deficiency

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However, it might not be a hot or cold condition

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Blood deficiency can often lead to wind, so there might exist an excess/deficient condition

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8 Principles allows the practitioner to identify the location and nature of the disharmony, as well as establish the priciple of treatment