Editing Traditional Chinese medicine (section)

===Patterns===
In TCM, "pattern" ({{zh|c=证|labels=no|p=zhèng}}) refers to a "pattern of disharmony" or "functional disturbance" within the functional entities of which the TCM model of the body is composed.<ref name="Ergil 2009" /> There are disharmony patterns of qi, xuě, the body fluids, the zàng-fǔ, and the [[#Jing-luo|meridians]].<ref name="Clavey 1995" /> They are ultimately defined by their symptoms and signs (i.e., for example, pulse and tongue findings).<ref name="Flaws 1996" />

In clinical practice, the identified pattern usually involves a combination of affected entities<ref name="Flaws 1990">Flaws, Bob (1990): [https://books.google.com/books?id=hID3SfkAuzUC&q=tcm+ba+gang+diagnosis&pg=PA5 "Sticking to the Point"] {{Webarchive|url=https://web.archive.org/web/20170320195338/https://books.google.com/books?id=hID3SfkAuzUC&pg=PA5&dq=tcm+ba+gang+diagnosis&hl=zh-CN#v=onepage&q=tcm%20ba%20gang%20diagnosis&f=false |date=20 March 2017}} Blue Poppy Press. 10th Printing, 2007. {{ISBN|978-0-936185-17-0}}</ref> (compare with [[#Typical examples of patterns|typical examples of patterns]]). The concrete pattern identified should account for ''all'' the symptoms a person has.<ref name="Flaws 1996">Flaws, B. & Finney, D. (1996): [https://books.google.com/books?id=iJT3mz20yHoC&q=tcm+pattern&pg=PA1 "A handbook of TCM patterns & their treatments"] {{Webarchive|url=https://web.archive.org/web/20170320165212/https://books.google.com/books?id=iJT3mz20yHoC&pg=PA1&dq=tcm+pattern&hl=zh-CN#v=onepage&q=tcm%20pattern&f=false |date=20 March 2017}} Blue Poppy Press. 6th Printing 2007. {{ISBN|978-0-936185-70-5}}</ref>

====Six Excesses====
The Six Excesses ({{zh|labels=no|c=六淫|p=liù yín}},<ref name="Wiseman 1996" /> sometimes also translated as "Pathogenic Factors",<ref name="1U3dN">{{cite book|url=https://books.google.com/books?id=WbThUt45ZXgC&q=tcm+six&pg=PA159|title=Foundations for integrative musculoskeletal medicine: an east-west approach|author=Marcus & Kuchera|publisher=North Atlantic Books|year=2004|access-date=22 March 2011|isbn=978-1-55643-540-9|archive-date=31 January 2021|archive-url=https://web.archive.org/web/20210131201452/https://books.google.com/books?id=WbThUt45ZXgC&q=tcm+six&pg=PA159|url-status=live}} p. 159</ref> or "Six Pernicious Influences";<ref name="Ross 1984" /> with the alternative term of {{zh|c=六邪|labels=no|p=liù xié}}, – "Six Evils" or "Six Devils")<ref name="Ross 1984" /> are allegorical terms used to describe disharmony patterns displaying certain typical symptoms.<ref name="Ergil 2009" /> These symptoms resemble the effects of six climatic factors.<ref name="Ross 1984" /> In the allegory, these symptoms can occur because one or more of those climatic factors (called {{zh|c=六气|labels=no|p=liù qì}}, "the six qi")<ref name="Deng 1999" /> were able to invade the body surface and to proceed to the interior.<ref name="Ergil 2009" /> This is sometimes used to draw causal relationships (i.e., prior exposure to wind/cold/etc. is identified as the cause of a disease),<ref name="Deng 1999" /> while other authors explicitly deny a direct cause-effect relationship between weather conditions and disease,<ref name="Ergil 2009" /><ref name="Ross 1984" /> pointing out that the Six Excesses are primarily descriptions of a certain combination of symptoms<ref name="Ergil 2009" /> translated into a pattern of disharmony.<ref name="Ross 1984" /> It is undisputed, though, that the Six Excesses can manifest inside the body without an external cause.<ref name="Ergil 2009" /><ref name="Wiseman 1996" /> In this case, they might be denoted "internal", e.g., "internal wind"<ref name="Wiseman 1996" /> or "internal fire (or heat)".<ref name="Wiseman 1996" />

The Six Excesses and their characteristic clinical signs are:
# Wind ({{zh|c=风|labels=no|p=fēng}}): rapid onset of symptoms, wandering location of symptoms, itching, nasal congestion, "floating" pulse;<ref name="Deng 1999" /> tremor, paralysis, convulsion.<ref name="Ergil 2009" />
# Cold ({{zh|c=寒|labels=no|p=hán}}): cold sensations, aversion to cold, relief of symptoms by warmth, watery/clear excreta, severe pain, abdominal pain, contracture/hypertonicity of muscles, (slimy) white tongue fur, "deep"/"hidden" or "string-like" pulse,<ref name="jvz68">{{harvp|Wiseman|Ellis|1996|pp=80, 142}}</ref> or slow pulse.<ref name="Ross 1984" />
# [[Shanghuo|Fire/Heat]] ({{zh|c=火|labels=no|p=huǒ}}): aversion to heat, high fever, thirst, concentrated urine, red face, red tongue, yellow tongue fur, rapid pulse.<ref name="Ergil 2009" /> (Fire and heat are basically seen to be the same)<ref name="Wiseman 1996" />
# Dampness ({{zh|c=湿|labels=no|p=shī}}): sensation of heaviness, sensation of fullness, symptoms of Spleen dysfunction, greasy tongue fur, "slippery" pulse.<ref name="Ross 1984" />
# Dryness ({{zh|c=燥|labels=no|p=zào}}): dry cough, dry mouth, dry throat, dry lips, nosebleeds, dry skin, dry stools.<ref name="Ergil 2009" />
# Summerheat ({{zh|c=暑|labels=no|p=shǔ}}): either heat or mixed damp-heat symptoms.<ref name="Wiseman 1996" />
Six-Excesses-patterns can consist of only one or a combination of Excesses (e.g., wind-cold, wind-damp-heat).<ref name="Deng 1999" /> They can also transform from one into another.<ref name="Deng 1999" />

====Typical examples of patterns====
For each of the functional entities (qi, xuĕ, zàng-fǔ, meridians etc.), typical disharmony patterns are recognized; for example: qi vacuity and qi stagnation in the case of qi;<ref name="Wiseman 1996" /> blood vacuity, blood stasis, and blood heat in the case of xuĕ;<ref name="Wiseman 1996" /> Spleen qi vacuity, Spleen yang vacuity, Spleen qi vacuity with down-bearing qi, Spleen qi vacuity with lack of blood containment, cold-damp invasion of the Spleen, damp-heat invasion of Spleen and Stomach in case of the Spleen zàng;<ref name="Ergil 2009" /> wind/cold/damp invasion in the case of the meridians.<ref name="Flaws 1996" />

TCM gives detailed prescriptions of these patterns regarding their typical symptoms, mostly including characteristic tongue and/or pulse findings.<ref name="Wiseman 1996" /><ref name="Flaws 1996" /> For example:
* "Upflaming Liver fire" ({{zh|c=肝火上炎|labels=no|p=gānhuǒ shàng yán}}): Headache, red face, reddened eyes, dry mouth, nosebleeds, constipation, dry or hard stools, profuse menstruation, sudden [[tinnitus]] or deafness, vomiting of sour or bitter fluids, expectoration of blood, [[irascibility]], impatience; red tongue with dry yellow fur; slippery and string-like pulse.<ref name="Wiseman 1996" />

====Eight principles of diagnosis====
The process of determining which actual pattern is on hand is called {{lang|zh|辩证}} ({{zh|labels=no|p=biàn zhèng}}, usually translated as "pattern diagnosis",<ref name="Ergil 2009" /> "pattern identification"<ref name="Wiseman 1996" /> or "pattern discrimination"<ref name="Flaws 1990" />). Generally, the first and most important step in pattern diagnosis is an evaluation of the present signs and symptoms on the basis of the "Eight Principles" ({{zh|c=八纲 |labels=no|p=bā gāng}}).<ref name="Ergil 2009" /><ref name="Wiseman 1996" /> These eight principles refer to four pairs of fundamental qualities of a disease: exterior/interior, heat/cold, vacuity/repletion, and yin/yang.<ref name="Wiseman 1996" /> Out of these, heat/cold and vacuity/repletion have the biggest clinical importance.<ref name="Wiseman 1996" /> The yin/yang quality, on the other side, has the smallest importance and is somewhat seen aside from the other three pairs, since it merely presents a general and vague conclusion regarding what other qualities are found.<ref name="Wiseman 1996" /> In detail, the Eight Principles refer to the following:
* ''Yin and yang'' are universal aspects all things can be classified under, this includes diseases in general as well as the Eight Principles' first three couples.<ref name="Wiseman 1996" /> For example, cold is identified to be a yin aspect, while heat is attributed to yang.<ref name="Wiseman 1996" /> Since descriptions of patterns in terms of yin and yang lack complexity and clinical practicality, though, patterns are usually not labeled this way anymore.<ref name="Wiseman 1996" /> Exceptions are vacuity-cold and repletion-heat patterns, who are sometimes referred to as "yin patterns" and "yang patterns" respectively.<ref name="Wiseman 1996" />
* ''Exterior'' ({{zh|c=表|labels=no|p=biǎo}}) refers to a disease manifesting in the superficial layers of the body – skin, hair, flesh, and meridians.<ref name="Wiseman 1996" /> It is characterized by aversion to cold and/or wind, headache, muscle ache, mild fever, a "floating" pulse, and a normal tongue appearance.<ref name="Wiseman 1996" />
* ''Interior'' ({{zh|c=里|labels=no|p=lǐ}}) refers to disease manifestation in the zàng-fǔ, or (in a wider sense) to any disease that can not be counted as exterior.<ref name="Deng 1999" /> There are no generalized characteristic symptoms of interior patterns, since they'll be determined by the affected zàng or fǔ entity.<ref name="Wiseman 1996" />
* ''Cold'' ({{zh|c=寒|labels=no|p=hán}}) is generally characterized by aversion to cold, absence of thirst, and a white tongue fur.<ref name="Wiseman 1996" /> More detailed characterization depends on whether cold is coupled with vacuity or repletion.<ref name="Wiseman 1996" />
* ''Heat'' ({{zh|c=热|labels=no|p=rè}}) is characterized by an absence of aversion to cold, a red and painful throat, a dry tongue fur and a rapid and floating pulse if it falls together with an exterior pattern.<ref name="Wiseman 1996" /> In all other cases, symptoms depend on whether heat is coupled with vacuity or repletion.<ref name="Wiseman 1996" />
* ''Deficiency'' ({{zh|c=虚|labels=no|p=xū}}), can be further differentiated into deficiency of [[#Qi|qi]], xuě, [[#Yin and yang|yin and yang]], with all their respective characteristic symptoms.<ref name="Wiseman 1996" /> Yin deficiency can also cause "empty-heat".<ref name="Kaptchuck 2000" />
* ''Excess'' ({{zh|c=实|labels=no|p=shí}}) generally refers to any disease that cannot be identified as a deficient pattern, and usually indicates the presence of one of the Six Excesses,<ref name="Deng 1999" /> or a pattern of stagnation (of qi, xuě, etc.).<ref name="hM4aY">Tierra & Tierra 1998, p. 108</ref> In a concurrent exterior pattern, excess is characterized by the absence of sweating.<ref name="Wiseman 1996" />

After the fundamental nature of a disease in terms of the Eight Principles is determined, the investigation focuses on more specific aspects.<ref name="Wiseman 1996" /> By evaluating the present signs and symptoms against the background of typical disharmony patterns of the various entities, evidence is collected whether or how specific entities are affected.<ref name="Wiseman 1996" /> This evaluation can be done
# in respect of the meridians ({{zh|c=经络辩证|labels=no|p=jīngluò biàn zhèng}})<ref name="Flaws 1990" />
# in respect of qi ({{zh|c=气血辩证, |labels=no|p=qì xuè biàn zhèng}})<ref name="Flaws 1990" />
# in respect of xuè ({{zh|c=气血辩证|labels=no|p=qì xuè biàn zhèng}})<ref name="Flaws 1990" />
# in respect of the body fluids ({{zh|c=津液辩证|labels=no|p= jīnyè biàn zhèng}})<ref name="Flaws 1990" />
# in respect of the zàng-fǔ ({{zh|c=脏腑辩证|labels=no|p= zàngfǔ biàn zhèng}})<ref name="Flaws 1990" /> – very similar to this, though less specific, is disharmony pattern description in terms of the Five Elements [{{zh|c=五行辩证|labels=no|p=wǔ xíng biàn zhèng}}]<ref name="Flaws 1996" />)

There are also three special pattern diagnosis systems used in case of febrile and infectious diseases only ("Six Channel system" or "six division pattern" &#91;{{zh|c=六经辩证|labels=no|p=liù jīng biàn zhèng}}&#93;; "Wei Qi Ying Xue system" or "four division pattern" [{{zh|c=卫气营血辩证|labels=no|p=weì qì yíng xuè biàn zhèng}}]; "San Jiao system" or "three burners pattern" &#91;{{zh|c=三焦辩证|labels=no|p=sānjiaō biàn zhèng}}&#93;).<ref name="Flaws 1996" /><ref name="Clavey 1995" />

====Considerations of disease causes====
Although TCM and its concept of disease do not strongly differentiate between cause and effect,<ref name="Ross 1984">Ross, Jeremy (1984) [https://books.google.com/books?id=t23zKB1FSVYC&q=Chinese+medicine+is+completely+different%3B+it+emphasizes+function.+Little&pg=PA6 "Zang Fu, the organ systems of traditional Chinese medicine"]{{Dead link|date=February 2024 |bot=InternetArchiveBot |fix-attempted=yes }} Elsevier. First edition 1984. {{ISBN|978-0-443-03482-4}}</ref> pattern discrimination can include considerations regarding the disease cause; this is called {{lang|zh|病因辩证}} ({{zh|labels=no|p=bìngyīn biàn zhèng}}, "disease-cause pattern discrimination").<ref name="Flaws 1990" />

There are three fundamental categories of disease causes ({{zh|c=三因|labels=no|p=sān yīn}}) recognized:<ref name="Wiseman 1996" />
# external causes: these include the Six Excesses and "Pestilential Qi".<ref name="Wiseman 1996" />
# internal causes: the "Seven Affects" ({{zh|c=七情|labels=no|p=qī qíng}},<ref name="Wiseman 1996" /> sometimes also translated as "Seven Emotions"<ref name="Ross 1984" />) – joy, anger, brooding, sorrow, fear, fright and grief.<ref name="Ross 1984" /> These are believed to be able to cause damage to the functions of the zàng-fú, especially of the Liver.<ref name="Wiseman 1996" />
# non-external-non-internal causes: dietary irregularities (especially: too much raw, cold, spicy, fatty or sweet food; voracious eating; too much alcohol),<ref name="Wiseman 1996" /> fatigue, sexual intemperance, trauma, and parasites ({{zh|c=虫|labels=no|p=chóng}}).<ref name="Wiseman 1996" />