6 Syndrome Diagnosis (Jing Fang)
Chinese Medicine sees disease through several different lenses. Among these is “the six-syndrome diagnostic” method.
This method was developed by the ancient physician Zhang Zhong Jing, but it still remains a jewel in the crown of Chinese medical thought.
When “TCM” was first systemized in the 1950s under Chairman Mao, it departed from classical schools of Chinese medical thought. Some people think that the new TCM model did not represent the best understandings of classical Chinese medicine. So that it may be worthwhile for any practitioner to return to these original writings, and in particular, the system of medicine referred to as JING FANG.
JING FANG diagnosis is based on three principles found in the Shang Han Za Bing Lun, the “eight-principle syndrome differentiation (BA GANG), the “six-syndrome identification” (LIU JING BIAN ZHENG), and “formula pattern identification” (FANG ZHENG). These three methods embody the classical approach found in the Shang Han Za Bing Lun and can be used to diagnose and treat any disease.
There is an obvious difference between practitioners using the TCM approach and practitioners using JING FANG classical diagnostic methods.
The doctor using classical thinking, first identifies the type and location of disease through the theory of the “eight principles”. They must determine if it is a hot or a cold disease, an internal or an external disease, or an excessive or a deficiency pattern, or if it is a half excess and half deficiency pattern. Secondly, we must identify which channel or channels have been affected according to the “six-channel pattern identification”. This will lead us directly to the “formula pattern” and guide us to the appropriate formula. Finally we will be able to make modifications to the ingredients and dosages according to the symptoms.
It is important to realize that the “six syndrome diagnosis” explains the location of the disease and has no relation to the location of the acupuncture channels.
- In the Tai Yang (exterior yang) layer: chills, fever, aversion to cold or wind, body heaviness or stiffness, pain the joints, skin diseases, headache and a floating pulse.
- In the Shao Yin (exterior yin) layer: drowsiness, chills, cold extremities, aversion to cold, joint and body pain with a deep and constrained pulse.
- In the Yang Ming (interior yang) layer: the disease characterized by internal excess heat condition with fever without chills, distended abdomen, irritability, easily emotional, constipation and a rapid pulse.
- In the Tai Yin (interior yin) layer: the symptoms include feeling of severe internal cold, chills, with a distended abdomen with occasional pain, diarrhea or loose stools.
- In the Shao Yang (half-exterior half-interior yang) layer: the symptoms are located in the chest or abdominal areas and can affect any organ or organs, with chest discomfort, pain or stiffness in the rib side, dry mouth, alternating chills and fever with a bitter taste in the mouth.
- In the Jue Yin (half-exterior half-interior yin) layer: the symptoms are located in the chest or abdominal areas and can affect any organ or organs, they are the counterpart of the Shao yang syndrome with an increase on the symptoms of heat in the upper area and severe cold in the lower limbs or the lower abdomen, thirst, difficult urination, physical weakness, lethargy with a deep and weak pulse.
Once the six syndrome or combination of syndromes have been identified, the next step in the medical approach of Jing Fang is to identify the appropriate formula pattern (方证 – Fang Zheng). This step is actually the key to clinical success with Jing Fang.
It is important to know that there are specific formula patterns which are classified according to each of the six syndrome of six layers of disease, and there are formula pattern that have been identified to treat multi layers or multiple syndromes at once. However these formula patterns have a very sensitive symbiosis and balance between the ingredients and the ratio of the ingredient and treat a particular combination of symptoms pattern. In this sense if you find the exact formula pattern for the presenting syndrome, your choice will be straightforward and successful.