The importance of the role of pattern differentiation in Chinese medicine cannot be overstated. Some go so far as to say that Classical Chinese Medicine is “pattern medicine.” What on Earth can that mean? I think about it in a few ways. First, Chinese medicine takes patterns very seriously.
I don’t think most Chinese medicine physicians have theoretical discussions about what constitutes causality. Nor do they seem to be interested in carrying out complex calculations about the distribution of particular disease states across space or time.
Despite this apparent failure, Chinese medicine practitioners through history have been interested in the correlation between disease states and other features of the human environment. They have taken a keen interest in the rise and fall of particular conditions in particular places at particular times. Second, a strong feature of our medicine is the perception of subtle patterns in a seemingly hopelessly complex tangle of symptoms and subjective feelings.
Where other medical systems throw out the pieces that don’t fit, good Chinese medicine practitioners are always mindful of the “stray” symptoms. They always seem to come into play at some point. Finally, Chinese medicine relies on patterning to allow relatively quick training of practitioners. This can go too far, as it has in many iterations of contemporary Chinese medicine.
Taking all of this into consideration, I find the idea of patterns to be an interesting one. Recently in a class about pharmacology, we began to discuss the role of the imagination in medicine. All human beings have imagination – though some of us are more skilled in using ours than others seem to be. Our professor began to get us thinking about imagination as being especially useful in becoming aware of patterns. How does that make sense to me? Well, let’s look briefly into the meaning of “imagination”:
imagination |iˌmajəˈnā sh ən|
the faculty or action of forming new ideas, or images or concepts of external objects not present to the senses
ORIGIN Middle English : via Old French from Latin imaginatio(n-), from the verb imaginari ‘picture to oneself,’ from imago, imagin- ‘image.’
Taking this definition at face value, what my professor was saying makes lots of sense. The pattern is not present to the senses. Which is to say that I cannot point to anything that is, for instance, “Yang Ming disease.” I do take in a large amount of data (pulse, tongue, color, sound, odor, presenting emotion, symptoms, lab results, subtle information heretofore undefined) through my various senses, but this thing Yang Ming disease is never taken in.
It is a concept, an organizing concept. In some real sense, Yang Ming disease is not there. It is an unbelievably useful structure that I can use to order the data I am taking in and craft a treatment that is a response to the disease state being presented by my patient. My ability to grasp this imaginative construct is crucial in my efficacy.
We can take this further, though I get a little weak in the knees as I depart from that relatively solid conceptual ground. We can use structures like Yang Ming disease in a way that is imaginative, or we can turn them into prisons from which no healing can escape. Let’s take Yang Ming disease as an example. The defining line of Yang Ming disease in the Shang Han Lun states:
In Yang Ming disease, the Stomach family is full.
Boy, talk about a range of possible interpretations. We can look deeply into the characters, we can look at all instances in the history of Chinese medical texts of those characters, we can look at all the Yang Ming formulas and see how they treat this “fullness” of the “Stomach family,” we can do many things in order to understand the statement.
But, if we don’t let our imagination run free, our efforts may never bear fruit. Once we have obtained all of that data as I listed above, we must let our minds explore. What would the Stomach family being full do in terms of psycho-emotional disturbance? What images come to mind when we consider the Stomach family being full? What is our subjective experience of this disease state?
I believe this kind of activity, while perhaps not good material for scholarly publication, is crucial to my development as a Chinese medicine practitioner. It helps me to understand the formulas and point protocols more fully, not to mention nourishing me deeply as a human being. I also believe that the use of imaginative faculties is, at least in part, behind the brilliance of ancient Chinese medical theory.
I’m interested in hearing how others think about this issue. It’s a small thing, perhaps, but interesting to consider.
About Eric Grey
Hi - I'm the founder of this site and the primary master of all functions here. When I'm not writing, you can find me reaching out to the Chinese Medicine community across the web and in my own backyard. I currently teach Chinese herbs at my alma mater, the National College of Natural Medicine. Additionally, I'm the founder of Watershed Wellness, a thriving local clinic in Southeast Portland in Oregon. No matter where I'm working, you'll find my focus on the Classical approach to Chinese medicine laced throughout everything I do.