Abstract

With my own TCM practitioner’s knowledge and experience, I do not think different opinion have obvious correctness or wrong. Only efficacy really matter. It relies on the individual’s situation and whichever method with better effectiveness than the other should be brought to application.
I personally believe that if it is a simple case, we stress the importance of diagnosis of Zheng-syndrome in TCM with support of disease diagnosis of conventional medicine. Takes common cold as example, it does matter if it is a wind-heat type or wind-cold type, we usually apply Daqingye or Banglangen because its anti-virus effect. Last issue I recommend Ganmao Qingre Keli plus Banglanggen Chongji for common cold and flu, which is on basis of this theory.

When we treat a very complicated case or condition or syndrome without biomedical diagnosis, we should follow TCM Zheng-syndrome differentiation. It is not uncommon that for some cases there is no diagnosis in conventional medicine. This is where we need to rely on our knowledge and experience of TCM. Takes a patient with main complain of eczema, accompanying with hay fever, asthma and IBS, we should deal with all four condition in one prescription, rather than dealing the four conditions separately like conventional medicine, in order to achieve the best result.

<<Yellow Emperor’s Canon of Internal Medicine>>(Neijing) tells us to ‘search a cure from the root of illness’. The root is usually identified by TCM Zheng-syndrome differentiation, which enables us to establish a treatment principles. On basis of the treatment principle we are able to decide formulae and choice of medicines or acupoints. Dealing with this kind of complicated cases by applying TCM syndrome differentiation shows the strengths of TCM. Not only me, but all well qualified TCM practitioner, are armed with this strength.
In addition, we should mainly rely on disease diagnosis of conventional medicine if it is definite but without any symptoms. For example, hepatitis B virus carrier or pre-clinical diabetes patient, we have no choice but to deal with it on basis of the diagnosis from conventional medicine.

Take common cold as an example. To a child, an old, a young strong me or a young pregnancy women catching a cold, the treatment should be different for them, also cold occurring in different season or different region should be treated differently. Although we can apply formula to cover most cases of cold, we still need to take individual’s condition into consideration to tailor our prescription.
To simplify a complicated case, we should apply four diagnostic techniques and eight principle differentiation to lead to a unique syndrome pattern, i.e. Zheng of bian zheng lun zhi. In one word, syndrome differentiation is core of TCM practice and the essence of art in TCM system.
　
In essential, this is a question how to deal with the relationship between TCM and conventional medicine. I remembered when I participated in editorial work of a TCM pediatrics textbook in 1990s’, a question was raised to my supervisor Prof. Shaochuan Li on whether the contents of the book should be categorized by diseases of conventional medicine or TCM syndromes. Professor Li’s answer was using diseases of conventional medicine as titles and supplemented by TCM syndromes. As a famous clinician in TCM for sixty years, Profs Li had an open-mind to accept conventional medicine as main stream. In practice he always applied TCM theory into practice and he never gave up TCM principles and techniques. He always believed that TCM and conventional medicine should learn from each other in order to achieve best result for our patients. As early as in 1960s, Mr Li had published research reports about TCM treatment on children’s acute nephritis and nephritic syndrome. Both of acute nephritis and nephritic syndrome belongs to edema-syndrome in TCM but their treatment is quite different.

There are so many different methods of TCM syndrome differentiation based on eight principles, zang-fu-theory, Channels (Jingluo), six-channel syndromes (liujing), defence-qi-nutriention-blood system (wei qi ying xue system), three-warmers. If we add a new method like selection of treatment on basis of diagnosis from conventional medicine, I believe it would be a good way for TCM to further develop. This is actually from ancient tradition reflected in Dr Zhang Zhongjing’s <<Shanghan Zagbing Lun>> 1800 years ago.

Eight and half years ago, when I came to the UK, this is the first question I asked Dr Junkun Bai. Coincidentally, my friend Dr Mingjing Cai, he asked me the same question when he came to the UK one and half years ago. I am hoping my answer have a little help to Dr Cai and my reader who are interested in this topic.