I. The Macroscopic Nature of Traditional Chinese Diagnostic Differentiation

I. The Macroscopic Nature of Traditional Chinese Diagnostic Differentiation

Diagnostic differentiation and treatment is a hallmark of the traditional Chinese medical system and represents the very essence of Chinese medicine as a whole. The foundation of diagnostic differentiation lies in the four diagnostic methods—inspection, auscultation and olfaction, inquiry, and palpation—and the method itself relies on logical reasoning. In the process of diagnostic differentiation, physicians fully utilize their sensory abilities and the analytical capacity of the cerebral cortex. Looking back at the history of traditional Chinese medical scholarship, we can easily trace the origins of this tendency.

The development of traditional Chinese medical scholarship can be traced back to Bian Que in the 4th century BC and extends to modern medical scholars such as Xiao Longyou and Pu Fuzhou. Throughout history, their practical experience and academic ideas have always been grounded in agriculture and handicrafts. Traditional Chinese medical scholars never had access to the sophisticated tools provided by large-scale industry for medical research, so the traditional achievements in the field of traditional Chinese medicine could only emerge from macroscopic observation and judgment of the external manifestations of disease. Consequently, tongue color, pulse condition, patients' subjective symptoms, and certain external physical signs became the primary basis for diagnosing illness. For example, the four diagnostic methods, eight diagnostic categories, qi-blood-phlegm-fire, five movements and six energies—these were all summarized by predecessors and formed a distinctive system of traditional Chinese diagnostic differentiation. This system has indeed played a tremendous role in humanity's understanding and treatment of disease and continues to do so today. However, since human senses can only observe the external manifestations of disease, the essence of the principle "treat the disease by seeking its root" is actually logical reasoning to identify the underlying cause, while direct insight into the internal changes of the disease remains elusive. Over the centuries, medical scholars have accumulated many vivid methods of reasoning, such as analogy and similarity, and the principle of like attracting like, in an attempt to form an accurate mental image of the true nature of disease. Although these mental images lack a foundation in experimental research, they originate from clinical practice and are underpinned by practical experience, thus providing universal guidance for clinical practice in traditional Chinese medicine.