Classical Chinese Medical philosophy views health and disease through “the eight-principle and six-

syndrome differentiation” methods. In ancient times, Chinese medical experts identified concurrent
symptoms as patterns and associated them with formulas to treat them. Eventually with repeated clinical
success they then recorded these patterns as “formula patterns”.

Later, during the Eastern Han Dynasty between 40 to 200 A.D., Zhang Zhong jing recorded all of these
clinical experience handed down from generations in the Shang Han Za Bing Lun (Treatise of Cold
Complicated Diseases- 伤寒杂病论) which was later edited and separated in the Shang Han
Lun (Treatise of Cold Damage- 伤寒论) and the Jin Gui Yao Lue (Prescriptions from the Golden Cabinet -
金匮要略).

These classics clearly state the appropriate clinical application of a group of symptoms with
corresponding formulas as well as suggest modifications according to the change of the disease. This
medical legacy from Zhang Zhong jing is clearly a gem for Chinese medicine clinicians. The only two
major issues we have had since then is maintaining these classics intact (and original) and understanding
them correctly while using them effectively in clinic. Since modern “TCM” was systemized in the 1950s
under the Regime of the People’s Republic of China,we have steered further and further away from the
classical origins and meanings of Chinese medicine. However, with the help of some tenacious classical
Chinese medical experts, we have the chance to keep the classical thinking alive and active. Every
dedicated classical Chinese physician always reminds themselves and their colleagues to go back to the
original scriptures and find the answers in the original writings. Meanwhile, these experts also know very
well that it takes decades to perfect the skills of classical thinking and clinical application.

To begin to understand the philosophy and clinical approach of the classical thinking, we must open our
mind to a different way of viewing health and diseases. For the purpose of this article we will shortly state
that the Shang Han Za Bing Lun approach varies greatly from the Huang Di Nei jing (Yellow Emperor
Inner Canon – 黄帝内径) and its five-element approach. Dr. Feng Shi Lun (冯世纶) even says that these
medical classics belong to two different systems of looking at health and diseases. Needless to say the
classical thinking also differs greatly from the systemized TCM zang fu approach. The Shang Han Za
Bing Lun is based on the “eight-principle syndrome differentiation” called “ba gang” (八纲) and “six-
syndrome identification” (六经辩证- liu jing bian zheng). Another strong differentiation we have in the
Shang Han Za Bing Lun is the “formula pattern identification” (方证 - fang zheng). These three main
methods to treat diseases in clinic embody the classical approach of the Shang Han Za Bing Lun and can
be used to diagnose and treat any disease no matter the disease name. By using the symptoms to
differentiate the syndrome and formula pattern we are ot limited to the name or western medical
diagnosis to treat our patients.

In China, there is a clear difference between the Chinese medical practitioners that use the TCM zang
fu approach in their practice and the ones that use “pure” classical thinking. Both Dr. Hu Xi Shu (胡希恕)
and Professor Feng Shi Lun (冯世纶), like many other classical masters, have spent their life researching
and developing the understanding of the Shang Han Lun and Jin Gui Yao Lue. Together they have
written over 20 books using different methodology to understand the application of the classics. They
have both greatly contributed to the survival of classical thinking.

Being a classical Chinese practitioner and treating diseases according to the classical thinking, we must
first identify the type of disease through the “eight principles”. We must determine if it is a hot or a cold
disease, or a mixture of hot and cold disease. We must identify if it is an internal or an external disease
or a half internal and half external disease. We must identify if it is 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.

Since the “eight principle” identification is part of the basic Chinese medical system we will explain the “six
syndrome identification” in more details. It is very important to realize that the “six syndrome identification”
 explains the location of the disease in a layer and depth format and has absolutely no relation to the
location of the acupuncture channels. Even if the channels hold the same name they relate to two
completely different sets of ideas and applications. In this case, the channel pattern identifies the
symptoms and severity of the disease.

 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 to 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.

Classical expert, Dr. Feng Shi Lun says that we must understand the mechanism behind the formula
pattern to fully grasp its effect on the body and how they affect the symptoms to get a deeper
understanding of the Jing Fang approach to medicine. This is done through many years of clinical
practice and deep contemplation. We have the chance to have Dr. Feng insight and learn from his 50
years of clinical experience. Join our Shang Han Lun live Webinar to learn more