Differential Diagnosis: This is the fine tuning, using different methodologies to determine the pattern: For example, most frequently used is the "eight principles" method of differential diagnosis. With this method, we ask the following questions: Is a particular organ which the physician finds out of balance vacuitous or replete? Is the condition an exterior or interior pattern? Is there a hot or cold pathogen? Is it a Yin or Yang pathogen? This is just one of ten different methods of differential diagnosis used in Chinese medicine, and often, they are combined together.
Pattern Identification: In Chinese medicine, a pattern is not the same as a disease. For although a patient's disease is considered when determining a treatment plan, in Chinese medicine, the pattern determines the treatment, rather than the disease. The pattern first considers the internal "terrain" of the patient and the relationship of his organs to each other. The entire person is considered: his symptoms, his constitution, his mind and his body. By verifying the patterns involved, the physician is able to identify which organs and channel systems are out of balance, as he determines a treatment plan.
Repletion and Vacuity: The practitioner of Chinese medicine is very much like a sculptor, gently molding the patient into a healthy and balanced form. There will be parts that need to be chipped away, and there will be parts which need to be filled in. As such, the use of the terms excess or deficiency are less accurate than replete or vacuitous. An excess or deficient state implies a greater sense of permanence and one which needs to constantly supported. For example, if one has a calcium deficiency, they will need to take supplemental calcium to prevent serious illness such as osteoporosis. On the other hand, if that same person has a yin, blood or jing (essence) vacuity, the foods, herbs and acupuncture they receive will fill in and balance the patient, eliminating the vacuity, and the danger of illness. Repletion, therefore, indicates a condition or pathogen which is excessively full, whereas Vacuity indicates a state which is empty or hollow. I would add, that some of my patients have described a sense of "filling in the spaces" after either treatments or taking medicinal herbs.
Qi: (pronounced like chee): Qi has been characterized as energy or vital force, but it is much more than that. It is an indefinable term used in Chinese medical literature to connote that spark of life and connectivity which we receive from Ha-Shem, which drives our various levels of being and which leaves us when we pass away. Our state of health is relative the degree of our qi's cultivation and its unimpeded flow. Internally we cultivate our qi through nourishing ourselves physically as well as non-physically. Though this term does not have an equivalent Traditional Jewish sources, it is consistent with the spirit of Torah. As the author of "Likutei Amarim" says in "Igeres Hakodesh" chapter 31, "...Illness and health depend upon the quality and circulation of the vitality flowing from the heart and enveloping all the organs ....And if the circulation of the spirit of life (ruach hachayim) is as it should be, then a person is healthy...." In classic Chinese medical literature, we are told that "Qi is the commander of blood and blood is the mother of qi." Qi is indeed the life force, that moves and energizes the blood, and which reciprocally receives its nourishment from the blood. As blood traverses the vessels, so too, qi traverses the channels. When our circulation is impeded, our qi is stagnated.
Wu Xing: It is important to understand that ancient Chinese did not appear to be concerned with the origin of the universe. Rather they were astute observers of phenomena, and recognized specific patterns of movement and mutation, of birth, growth, deterioration, death and rebirth. This they called Wu Xing or five phases. The five phases of wood, fire, earth, metal and water, and also represent different inherent qualities, including emotions, flavors, sounds and states of natural phenomena. The Wu Xing model also provides an important framework clinically in determining relationships among the internal organs, their health and balance. Among the Yin organs, for example, liver corresponds to wood, heart corresponds to fire, spleen corresponds to earth, lung corresponds to metal and kidney corresponds to water. There are also correspondences to the yang organs, as well as to sensory organs, tissues and bodily fluids. From a Torah perspective the theory of Wu Xing would seem to correspond to the second process of creation: First, Ha-Shem created a primeval substance as a building material from which all else would be made. This our sages called "Chomer Hiyuli". This first process was called yesh mi'ayin ( ex-nihilo), and everything in the universe was formed from this original material, yesh miyesh, with an inherent vitality and transformational ability.
Yin and Yang: Before actually discussing the meaning and medical applications, it is important to clarify that Yin and Yang are merely descriptions of the relative nature of all phenomena as observed and noted by ancient Chinese scholars, and are in no way reflect a duality or division of Divine power or authority. Rather, there is One unique, eternal, all-powerful, and indivisible Creator, Master and Life source, Ha-Shem. The concept of Yin and Yang is, therefore, an important conceptual method for categorizing and analyzing all of creation, and is not inconsistent with the fundamental Torah beliefs. Furthermore, what the ancient Chinese observed as the intrinsic qualitative polarity within all phenomena, which they called Yin and Yang, is not incongruent with the fundamental tenet of the Jewish mystical tradition of elevating and clarifying the physical world. In Jewish contexts, this polarity is often reflected as male and female aspects, and symbolizes active and passive or physical and energetic qualities. When they are brought together in harmonious balance, they represent a rectification of the universe. Lehavdil, Yin and Yang, should also be viewed as cosmological modifiers of phenomena, with some creations being qualitatively more Yin and others more yang. (In fact, when the Chinese refer to something or someone as being "Yin" or "Yang", they are only referring to its dominant aspect, while not negating the presence, to a lesser degree, of its other aspect). An element of their observation, was that there exists a dynamic tension between these two forces which is constantly changing and transforming the state of being. Yin represents the material, structural, passive and cooling aspect of phenomena, whereas Yang represents the energetic, functional, active and warming aspect. All things contain different ratios of both Yin and Yang, and though opposites, as mentioned above, they are also interdependent and inter-transformational.
This observation of the relativism of Yin and Yang also is an essential principle of Chinese medicine. For when either Yin or Yang are out of balance, a process of disharmony is detected, which we call "dis-ease" .This imbalance can manifest in such clinical conditions as "repletion" (excess) or "vacuity" (insufficiency) of either Yin or Yang. Furthermore, repletion and vacuity can exist simultaneously, in different organs or channels. Organs, too, have been classified as either Yin or Yang, and it is the physician's mission to listen carefully, determine what is out of balance and together with the patient, work to harmonize and heal.