Evolution Of The Connotation Of The Theory Of Tcm, From The History Of The Dialectical Mode

The Treatment with Syndrome Differentiation, which is an important method in Traditional Chinese Medicine (TCM), comprises two types of models, Prescription Syndrome Differentiation (PSD) and Pathogenesis Differentiation (PD). Before the Jin and Yuan Dynasties, the PSD was applied in clinical practice. After the Jin and Yuan Dynasties, PD developed.PSD is an experiential differentiation model of prescription corresponding to syndrome. The primary approach of this model is differentiating the prescription syndrome. Accordingly, the medical treatment depends on whether a patient's symptom corresponds to the prescription syndrome. PD is an inferential differentiation model which consists of principle, method, prescription and medicine. The primary approach is differentiating the pathogenesis. In PD clinical practice, a physician uses TCM logic to comprehensively analyze a patient's symptoms and physical signs, deduce the pathogenesis of the disease, and then decide treatment and prescription.In PSD, a prescription is given depending on the syndrome, while in PD, a prescription is given depending on pathogenesis. However, pathogenesis is concluded by deducing and summarizing the syndrome. The pathogenesis and the syndrome are somewhat equal. A prescription based on pathogenesis is actually an indirect way of prescribing based on the syndrome. Therefore, the substance of PD is differentiation of the prescription syndrome, but only adding the mode of prescription corresponding to syndrome with the representative code of syndrome—pathogenesis. Hence, PD is formed on the basis of PSD. In TCM, the connotation of syndrome which consists of prescription syndrome and pathogenesis is the corresponding relationship between the prescription and the syndrome. Therefore, before the Jin and Yuan Dynasties, physicians named the syndrome according to the prescription and named the prescription according to the medicine; after the Jin and Yuan Dynasties, though present prescription scholars named the syndrome according to the pathogenesis, the efficient present prescriptions they founded were developed from classical prescriptions, but can not be separated from the essence of PSD.In PD, the mediator between the prescription and the syndrome is pathogenesis, so it is difficult to approve the converse theorem between the prescription and the syndrome. Hence, sometimes PD is not efficient in clinical practice, even though it is a reasonable theory. To resolve this problem, physicians who use PD should have some experience of differentiating the prescription syndrome. They need to remember a list of prescriptions corresponding to syndromes and prescribe based on the list after deducing the pathogenesis. Therefore, the experiential classical prescriptions are the presupposition and foundation of the Treatment with Syndrome Differentiation in TCM. In the process of Treatment with Syndrome Differentiation, correctly connecting prescription to syndrome and using effective experiential prescription are the key steps.