TCM Clinical Answers

Question 1

What is TCM pattern differentiation (bian zheng)?

Accepted Answer

Pattern differentiation is the process of organising a patient's full presentation — symptoms, tongue, pulse, emotional state, history — into a single TCM pattern such as Liver Qi Stagnation with Spleen Qi Deficiency. Unlike a Western disease label, the pattern describes the functional mechanism causing the complaint, which is what determines point selection and herbal strategy. Two patients with the same Western diagnosis frequently carry different patterns and therefore receive different treatments.

Question 2

What does tongue diagnosis tell a practitioner?

Accepted Answer

The tongue body reflects the state of Qi, Blood and the Zang-Fu organs, while the coating reflects the state of the Stomach and Spleen and the presence of pathogenic factors. A pale, swollen body with a wet coating suggests Yang or Qi deficiency with Dampness; a red body with little coating suggests Yin deficiency with Heat. Because the tongue changes slowly, it is considered a reliable indicator of the underlying, chronic condition rather than of transient states.

Question 3

What do the six pulse positions indicate?

Accepted Answer

Each wrist carries three positions — cun, guan and chi — read at superficial and deep levels, giving six organ pairs per hand: Lung/Large Intestine, Spleen/Stomach and Kidney Yang on the right, Heart/Small Intestine, Liver/Gallbladder and Kidney Yin on the left. The quality at each position (wiry, slippery, thin, weak, rapid) localises the imbalance, while the overall pulse describes the general state of Qi and Blood.

Question 4

How does a TCM pattern relate to a Western diagnosis?

Accepted Answer

They answer different questions. A Western diagnosis names the disease entity; a TCM pattern names the functional disharmony producing the presentation. Insomnia may be Heart Blood deficiency, Liver Fire rising, or Heart–Kidney disharmony, and each requires a different protocol. Good clinical practice holds both frames at once: the Western diagnosis governs red flags and referral, the TCM pattern governs treatment.

Question 5

How does Tung's acupuncture differ from traditional TCM point selection?

Accepted Answer

Tung's Acupuncture (Tung Ching-Chang lineage) uses its own point map — numbered points across 12 zones — rather than the classical 361 channel points, and selects them by correspondence and immediate palpated response rather than by channel theory alone. Points are typically needled distally, contralateral to the complaint, with far fewer needles per treatment, and effect is assessed by asking the patient to move the affected area during the session.

Question 6

What is the Korean Sa-Am four-needle technique?

Accepted Answer

Sa-Am acupuncture treats a deficient or excess organ through the Five Element cycle using exactly four needles: two that tonify or reduce the affected channel and two that act on its mother or controlling channel. Because the prescriptions are derived from the generating and controlling relationships rather than from symptomatic point choice, the same pattern always yields the same four points, which makes the style highly reproducible.

Question 7

What is Richard Tan's Balance Method?

Accepted Answer

The Balance Method selects channels rather than individual points, pairing the affected channel with a balancing channel through six defined systems (such as the Chinese clock opposite or the same-name channel on the opposite limb) and then needling distal points on that channel, away from the pain. Treatment is contralateral and distal, so the painful area stays free to move and response can be tested immediately.

Question 8

Which Chinese herbs require caution with anticoagulants?

Accepted Answer

Blood-invigorating herbs carry the greatest theoretical bleeding risk alongside warfarin, DOACs or antiplatelet therapy — notably Dan Shen (Salvia), Chuan Xiong (Ligusticum), Hong Hua (Carthamus), Tao Ren (Persica) and San Qi (Panax notoginseng). Dan Shen additionally raises warfarin plasma levels, and Dang Gui contains coumarins. These combinations are not absolute contraindications, but they require prescriber awareness and INR monitoring rather than being managed silently.

Question 9

How is a classical formula modified for an individual patient?

Accepted Answer

The base formula is chosen for the core pattern, then adjusted by addition and subtraction: herbs are added to address the chief complaint or a secondary pattern, removed when their thermal nature or action conflicts with the presentation, and dosages shifted to change the formula's emphasis. This is why two patients receiving Xiao Yao San may receive materially different prescriptions — the classical formula is a starting architecture, not a fixed product.

Question 10

Which acupuncture techniques are contraindicated by medication or device?

Accepted Answer

Electro-acupuncture is avoided across the trunk in patients with a pacemaker or implanted cardiac device; bloodletting and wet cupping are avoided with anticoagulants, thrombocytopenia or bleeding disorders; strong moxibustion and cupping are avoided over areas of impaired sensation, neuropathy or fragile skin, and on the lower abdomen and lumbosacral region during pregnancy.

Question 11

Can software generate a TCM diagnosis?

Accepted Answer

Software can generate a pattern differentiation and a proposed protocol from structured intake data, and do so consistently across the classical frameworks — but it cannot palpate, observe or take clinical responsibility. The appropriate framing is decision support: the platform produces a differential with its reasoning and safety flags exposed, and the licensed practitioner confirms, adjusts or rejects it.

Question 12

What should TCM clinical software include for licensed practitioners?

Accepted Answer

At minimum: pattern differentiation with primary and secondary patterns and visible reasoning; point selection with rationale, depth, angle and needling technique; classical herbal formulas with per-herb dosages and herb–drug interaction checking; TCM-native patient records that carry tongue, pulse and pattern history across sessions; explicit contraindication flags; and exportable reports. Generic practice-management software captures appointments but not the clinical reasoning.

Question 13

Is TCM Clinical Pro suitable for pregnancy and pediatric cases?

Accepted Answer

Yes. Dedicated modules cover women's health (cycle, pregnancy stage, menopausal status) and pediatrics (birth history, developmental milestones, feeding), and the platform adjusts accordingly — forbidden points and contraindicated techniques are excluded in pregnancy, and pediatric cases receive age-appropriate dosing, shallower needling and shorter retention, including non-insertive options.

TCM clinical answers

Diagnosis fundamentals