Fundamentals of pattern diagnosis/analysis
for classical Chinese medicine (CCM)
part 1

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Pattern analysis vs.
medical diagnosis
Chinese medicine
in crisis
The patterns of
The art, logic, &
mathematics of
pattern analysis
Taking back control
over our health

We are currently living in a time of extreme imbalances — worldwide turmoil, environmental destruction, an epidemic of complex chronic illnesses, and breakdown of trust in public institutions. Over a time-span of several millennia in East Asia, a systems science evolved for restoring balance which is applicable to

  • health and illness
  • psychology, human relations
  • military strategy, diplomacy
  • ecology, agriculture

and other complex systems.

Since 1990, we at RMHI have dedicated ourselves to distilling and sharing this wisdom. We've developed a clear, rigorous curriculum rooted in classical knowledge and integrated into the modern world. Those with a sincere desire and an open mind can learn tangible skills to heal themselves and others and to restore sanity to their lives.

The Rocky Mountain Herbal Institute strongly supports the growing worldwide movement to restore classical Chinese medicine to its ethical and philosophical roots, after being virtually extinguished throughout mainland China in the decades following the Communist Revolution of 1949.

I've served as Director of RMHI since its founding in 1990. In these lectures, I'll be examining facets of the pattern analysis system of classical Chinese medicine that are rarely discussed by most teachers of this subject.  

Fundamentals of pattern analysis
for classical Chinese medicine (CCM)

part 1:
Pattern analysis vs.
medical diagnosis

by Roger W. Wicke, Ph.D. (creator of  HerbalThink-TCM
and Director of Rocky Mountain Herbal Institute),

in collaboration with Curt Kruse, M.S.  &  C.S. Cheung, M.D.
rww   rww   rww

2021 Dec 01
(updated 2022 Dec 25)


by the





[[[Click on the link shown at right.
The window that pops up will be used to display links to diagrams, tables, or references throughout this lecture.]]]

    >> Create graphics/references window

I'm not a medical doctor, though I do have a PhD in biomedical engineering. As do the vast majority of herbalists in America and worldwide, I've practiced as a non-licensed herbalist for several decades. The information I'll be presenting in these lectures:

  • is educational and general in nature
  • should not be construed as medical advice
  • and — is not intended for the purpose of diagnosing, treating, curing, or preventing any disease


I (Roger Wicke) am not a medical doctor, though I do have a PhD in biomedical engineering — MIT, 1980. The information I will be presenting in these lectures

  • is educational and general in nature
  • should not be construed as medical advice
  • is not intended for the purpose of diagnosing, treating, curing, or preventing any disease

Individuals desiring help for specific health problems should seek advice from qualified professionals.

If you're curious to know why I use this disclaimer, see the referenced article on our website that explains how to use a simple disclaimer to preemptively rebut the legal accusation that you may be practicing medicine without a license. All alternative health educators and practitioners should know this information. This article systematically explains how to avoid the sin of "practicing medicine" without a license from both historical and legal perspectives and has long been one of the most popular articles on our website.

Throughout this lecture series, I'll be mentioning specific webpages, books, and other references. For a listing of all these references, see the provided link.

    >> Reference 0-alegal disclaimers

    >> ALL references for this lecture series

The word holism is widely misunderstood and misused, especially in the context of healthcare. It was originally coined to describe a philosophy of natural science that focuses on the overall behavior patterns of living organisms and other complex systems rather than on a detailed analysis of their physical structure. Though commendable, advocating the use of herbs, organically grown foods, exercise and other natural methods does not necessarily make one holistic.

In part 1, I'll explain the concept of holism and the frequently misleading consequences of asking "Which herbs and remedies should you take for medical disease X?" ·· If we ask vague questions, we should expect only vague answers. So, how might we frame our inquiries to target potential solutions more precisely? ·· Classical Chinese medicine (CCM), as originally practiced in China before the mid-20th century, was a truly holistic system of analysis in every technical sense. Within the CCM paradigm, remedies-for-medical-disease-X is, in many cases, a dangerously misleading perspective.

Part 2, "Chinese medicine in crisis", explores scholar-practitioner Heiner Fruehauf's commentaries on how, in the decades following the Chinese Communist Revolution of 1949, classical Chinese medicine was gradually and systematically replaced with a throughly Westernized, medicalized doppelgänger popularly known worldwide as "TCM". Similar strategies have been executed by Big Pharma all over the world to destroy indigenous natural healthcare traditions and professions, including many modern alternative and complementary practices. Fruehauf's commentaries reveal how Chinese medicine was so easily derailed from its holistic origins onto the reductionist schemes of scientific materialism under the guise of "improving" it, even though the philosophies of holism and scientific materialism are antithetical to each other.
    Throughout these lectures, I will often refer to classical Chinese medicine as CCM, instead of the more familiar moniker "TCM". Fruehauf's commentaries explain why an increasing number of people worldwide are making this important distinction.

Part 3, "The patterns of disharmony", is a general overview of the most basic clinical patterns of CCM and how we detect their presence in real people. Over a 30-year period, my colleagues and I have built the HerbalThink-TCM software collection to help our students learn this analysis system and its underlying logic. HerbalThink-TCM includes digital textbooks, databases, interactive games, video simulators, and artificial intelligence modules. In parts 3 and 4, I'll be demonstating these various software tools to help you understand the fundamentals of pattern analysis as well as some of the trickier issues involved in analyzing complex clinical cases that have become so common worldwide in recent decades.

Part 4, "The art, logic, and mathematics" [of pattern analysis], will give you an overview of the various components of AutoSage-TCM, our artificial intelligence system, and will end with presentation of two clinical cases as examples. Since 2017 at RMHI, this software has been an important part of our curriculum and provides students a powerful tool for examining the logic of complex pattern analysis.

And finally, in part 5: in an era of breakdown of trust in our public institutions, how can we as individuals regain control over our own health through online learning and networking with others worldwide who are studying the methods we teach at RMHI?


Lectures on CCM pattern analysis:

  1. Pattern analysis (systems theory, holistic analytics)
    vs. medical diagnosis (analytic reductionism,
    scientific materialism)
  2. Chinese medicine in crisis:
        Classical Chinese medicine (CCM)

        vs. "TCM" (the over-simplified version of
    traditional Chinese medicine promoted
    by the Chinese Communist Party).
  3. The patterns of disharmony:
        How are the basic patterns in CCM defined?
  4. The art, logic, and mathematics:
        How do we apply these pattern definitions to real people who may have complex combinations of patterns that do not exactly match any of the basic patterns defined in traditional textbooks?
        AutoSage-TCM, an expert system ("AI") for generating reliable, numerically quantifiable analyses of complex clinical cases.
  5. Taking back control over our health
        The Nuremberg Code, crimes against humanity;   solutions


Pattern analysis

(systems theory, holistic analytics)

vs. medical diagnosis
(analytic reductionism,
scientific materialism)


Much of modern science, including medicine, is focused around the notion that things in our world can ultimately be explained by analyzing the smallest components that constitute all matter — atoms, molecules, cells, and microbes, and the energy fields and exchanges that may occur between these constituents, like electricity and magnetism. This is the essence of the philosophy of scientific materialism.

Long ago, people relied more on their immediate sense perceptions to describe nature and to acquire experience and knowledge. Regularly recurring patterns observed in the weather, the land and seas, plants, animals, and other humans took precedence over obsession with their physical structure and anatomy. In the realm of health and illness, that meant acquiring an intimate understanding of symptoms and easily observed clinical signs like tongue, pulse, body appearance, and behavior.

An understanding of recurring patterns in nature is essential to holistic analysis and leads to an ability to accurately predict future events and behaviors and how these might be altered by specific actions. Since prehistoric times, such accuracy has been greatly valued, regardless of how achieved, because this often meant the difference between survival and destruction.


    >> Holistic — definition

By astute observation and intuition, early humans who became skilled at prediction were often designated as shamans in prehistoric cultures. The challenges of communicating the source and nature of their insights led some to accumulate power by shrouding their unique abilities in arcane rituals, which eventually evolved into many of the world's religions. (Lest we judge them too harshly or ridicule their methods, consider that our modern technocratic elites also employ authoritarianism, secrecy, and obscure technical jargon to mystify, confuse, and control the public.)

In ancient China, the art of divination by throwing oracle bones gradually evolved into a randomized tossing of short and long yarrow stalks to obtain a single hexagram, which in binary logic represents one out of 64 possible outcomes. Each of these 64 states of being can potentially transform into other states, depending on events and actions that might occur. Considerable commentary was devoted to how and under what conditions a given state may transition to other states. (In mathematics, this type of process is known as a 64-state Markov chain. In the diagram at right is shown a simple 3-state Markov chain.)

Over a period of several centuries, this system of divination was codified in a written text known as the The Book of Changes, or I Ching. Much more than merely a textbook on divination that deems humans as victims of fate, it yields insights into human psychology, behavior, social relations, strategy, and ethics.


    >> The hexagrams of the I Ching

    >> Reference 1-cI Ching


Example of a simple 3-state Markov chain,
showing the state-transition probabilities.
(The I Ching comprises a 64-state Markov chain.)

The I Ching is important to acknowledge here for several reasons:

  • It's one of the very first written records of a systematic codification of metaphysics in ancient China.
  • The principles described in the I Ching are fundamental to the subsequent evolution of the philosophical, religious, military, and medical traditions of East Asia.
  • Specific hexagrams have acquired cosmological significance and are closely related to other traditional names for the processes of change such as Yin and Yang and Wu Xing — the Five Phases of Fire, Earth, Air, Water, and Wood. (Similar notions are to be found within the ancient medical traditions of India, Mesopotamia, and Greece.)
  • The concepts of Yang and Yin embody the universal principal of duality: light vs. dark, activity vs. quiescence, heat-cold, light-heavy, expansion-contraction. These notions have become fundamental to science and mathematics: measurement scales for space and time, temperature, pressure, mass, motion, and energy. And in the domains of psychology and ethics, as exemplified by the Myers-Briggs Type Indicator: Extroversion vs Introversion, Sensing vs. Intuiting, Thinking vs. Feeling, and Judging vs. Perceiving.

I Ching — historical significance:

  • A systematic codification of metaphysics
  • Fundamental to philosophical, religious, military, and medical traditions of East Asia
  • Cosmology — Yin, Yang;   Wu Xing (the Five Phases of Fire, Earth, Air, Water, Wood)
  • Yang and Yin — the universal principal of duality:
    • light vs. dark
    • activity vs. quiescence
    • heat vs. cold
    • light vs. heavy
    • expansion vs. contraction
    >> measurement scales for space and time, temperature, pressure, mass, motion, and energy.
    >> Psychology and ethics, Myers-Briggs Type Indicator: Extroversion vs Introversion, Sensing vs. Intuiting, Thinking vs. Feeling, and Judging vs. Perceiving.

Each hexagram of the I Ching is comprised of two out of a possible set of eight trigrams.
In this chart, we can see how these trigrams are closely related to the concepts of Yin, Yang, and the Five Phases, which are essential to an understanding of classical Chinese medicine.

Four of the Five Phases are included in this set of eight.
    Trigram #0 is comprised exclusively of Yin lines and represents The Receptive principle, also known as the Earth phase or element.
    Trigram #7 is comprised exclusively of Yang lines and represents The Creative principle.
    The phases of Earth, Water, Fire, and Wood are highlighted in bold green.


    >> The trigrams

Psychotherapist Carl Gustav Jung devoted years of study to understanding the I Ching, and his 1921 textbook Psychological Types is a product of this study. His theory of psychological types was eventually incorporated by others into the Myers-Briggs Personality Type Indicator, still used by organizations worldwide to understand and quantify how individuals perceive, think, feel, interact with others, and make decisions.

I've intentionally designed these charts to reveal similarities between the Myers-Briggs Type Indicator and the I Ching. Instead of six dimensions or lines, as in the I-Ching hexagrams, the Myers-Briggs system is comprised of four dimensions, each dimension representing an independent aspect of personality. I've placed the dominant dimension, Extroversion vs. Introversion, at the bottom to be consistent with the I-Ching format of displaying the first line at the bottom.

Each dimension has a Yang and a Yin polarity. For example, within the first dimension, individuals can be classified either as extroverted, which is the Yang polarity, or as introverted, the Yin polarity. However, just as with measurement scales like temperature, it's really a continuous scale with people falling at both extremes and every point in between. Individuals can also change over time or in different social contexts, but in general, most people have some point on this scale which represents their most characteristic behavior. Instead of merely classifying individuals as either Extroverted or Introverted, the more sophisticated Myers-Briggs tests will result in a numerical value for each dimension.

(If you are curious, this author is of type INTJ.)


    >> The Myers-Briggs Type Indicator

    >> Reference 1-fMyers-Briggs

The I Ching, the Myers-Briggs Type Indicator, and the pattern analysis system of classical Chinese medicine are all examples of what are known in mathematics as vector spaces.

Beginning students of Chinese medicine are taught the Eight Principal Patterns, which comprise a 3-dimensional vector space for holistically describing states of illness.

AutoSage-TCM, the artificial intelligence system that we've created for classical Chinese medicine, transforms a confusing jumble of over 600 symptoms and clinical signs like tongue and pulse characteristics into an expanded vector space of 10 abstract variables.

Similarly, the creators of the Myers-Briggs system have transformed a complex tangle of subjective observations about human psychology into a 4-dimensional vector space, which in turn, opens up many possibilities for clinical and experimental research and the application of statistical methods to the data.

An example of a simple 3-dimensional vector space is the Cartesian coordinate system, which is one of several coordinate systems commonly used to specify location in space.

Vector spaces compared.
SystemPurpose# of
I Chingmetaphysics6
Myers-Briggs Type
Simple model for
CCM pattern analysis
(The Eight Principal Patterns)
health and illness3
Expanded model for
CCM pattern analysis
health and illness10
Cartesian coordinateslocation within small, localized spaces (laboratory coordinates)3
Spherical coordinateslocation in space
(astrophysics, geophysics, geography, mapping)

In Cartesian coordinates, a set of three numbers, X, Y, and Z, uniquely locates any point within this space.

Vector spaces have many useful features, which is why they are considered essential tools in almost every field of science, mathematics, and even many of the so-called "soft" sciences like psychology and operations research.

One useful property of vector spaces is that they allow us to transform subjective judgments like similar, different, and very different into numbers and statistics. For example, the patterns of disharmony in Chinese medicine span a wide range of illness conditions. Some of those conditions are similar to each other and require similar treatment methods and herbal formulas. On the other hand, even if two patterns share a few symptoms like nausea and vomiting, but otherwise have very different qualities according to CCM pattern classification, we could actually risk making a serious error if we tried to give a remedy or treatment that's contraindicated.

If we assign each pattern to a specific location within an appropriately constructed vector space, we can then calculate its distance from any other pattern, which is a measure of how similar or different the two patterns are.


(from Wikipedia)

The distance (squared), d1,2 ,
between any two points, P1 and P2 ,
is determined by the following equation:
d1,22 = (x1-x2)2 + (y1-y2)2 + (z1-z2)2

During the early 20th century, the word holistic was coined to describe methods for analyzing the behavior of complex systems. As systems exceed a certain level of complexity, it becomes increasingly difficult to predict their behavior based solely on a detailed analysis of their components. With the development of electronic computers, mathematical and computational methods were developed to allow scientists to quantify and predict the behavior of such systems, giving rise to a discipline called operations research.

In the top diagram here, we have a simple system of three components: when the first component generates event A, it immediately triggers event B in the second component, which in turn immediately triggers an event C. In such a system, event A is said to be the cause of this sequence. Machines like automobiles may be comprised of hundreds or even thousands of individual components linked in similar chains of causality. But if they are designed for ease of use, such actions as rotating the steering wheel, shifting gears in the transmission, or depressing the accelerator pedal will cause predictable, reliable responses by people who may understand very little about their inner workings.

Though we often think of complex systems as those that have lots of component parts, we also need to consider the complexity of interactions between components. The bottom diagram illustrates a three-component system for which each component interacts mutually and continuously with each of the other components — for example, via positive and negative feedback loops. What is the cause here? There is no simple answer to that question. (Is the cause perhaps the entity who created and activated the system — not shown in the diagram?) Such is the nature of living systems like plants and animals. Living systems are generally so complex and sophisticated that they can continually adjust their own behavior, adapt to changes in their environment, and sometimes even to repair themselves when damaged. However, when non-holistically minded persons interfere in an attempt to "improve" or "fix" them, they often bungle things badly. For example, how many of us are familiar with the effects of pharmaceutical drugs prescribed for a single desired effect, but which often result in dozens of side effects, for which even more drugs are prescribed? And how many of us have pursued herbs-for-disease-X, only to try dozens of remedies without relief before finally stumbling onto something that helps?


A simple chain of causality.

A complex network of mutual,
continuous interactions.

(What is the "cause" here??)

Whenever we fixate on the question "What herbs and remedies should I use for medical disease X?" we are ignoring the complexity of our bodies. Yet this blindspot is common throughout standard medical practice. It's difficult to take a holistic approach when a typical appointment allots 10 minutes or less for listening to the patient's story.

Socially engineered by education, the media, and peer pressure, this narrow-mindedness has also become a habit among the public. Too many of us accept medical doctors' authority without question, even when our bodies are protesting with severe side effects.

However, there is one major medical specialty that routinely applies holistic analysis to each and every patient — at least when it is acting ethically. And that one example reveals how challenging it can be to do holistic analysis and treatment well. (In part 5, I discuss the ongoing systemic collapse of ethics within the medical-industrial complex and rampant violations of the Nuremberg Code.)


    >> Holistic — definition

Consider the primary goal of emergency medicine: to keep patients alive who have life-threatening conditions by simultaneously juggling blood pressure, heart rate and contractility, respiration and blood oxygenation, blood pH, electrolytes, and glucose levels, body temperature, hydration and fluid balance, parasympathetic vs. sympathetic activity levels, and other core systems parameters.

This is a perfect example of the holistic paradigm at work. But why should we wait until the patient is near death to apply these and similar ideas??

Although emergency medicine relies on instrumentation to measure most of these parameters, similar information is available to us if we know how to correctly interpret symptoms, tongue, and pulse data.

In all my years teaching both health professionals and non-professionals, including housewives, retirees, and young people just out of high school, I've noticed that emergency medicine physicians seem to grasp the fundamentals of Chinese medicine almost immediately, because they routinely apply similar principles in their own profession.


Emergency medicine:   an example of holistic medicine applied to life-threatening conditions. The goal: to simultaneously juggle

  • blood pressure
  • heart rate, rhythm, and contractility
  • respiration and blood oxygenation
  • blood pH, electrolytes, and glucose levels
  • body temperature
  • hydration, fluid balance
  • parasympathetic vs. sympathetic activity levels

and other core systems parameters in an effort to keep the patient alive.

But why wait until the patient
is in extremis to apply these principles??

Holistic cognitive abilities are routinely praised (the mind-body-spirit mantra) by many who neither understand nor practice holism themselves. That is the situation in virtually every licensed or unlicensed health profession today, even the plethora of so-called "complementary-alternative" professions. Many senior naturopaths, herbalists, and nutritionists lament that younger generations of practitioners have largely capitulated to the philosophy of scientific materialism that now dominates most professional schools.

This is not a new phenomenon, either. Classical Chinese medical scholars have long observed that while the stated ideals of CCM are high, very few practitioners rise to those heights, and they explained in some detail why this happens. (See references.)

The Collected Medical Theses of Jin Shou Shan describe the 5 levels that CCM doctors could aspire to attain. The lowest level, the prescription herbalist, chooses remedies by applying the least effort of thought possible in spite of having memorized lots of concepts and formulas, which in modern terms equates to remedy-for-medical-disease-X. According to a traditional saying, these people are "standing outside the gate of Chinese herbal wisdom." In contrast, level-3 herbalists are able to apply pattern analysis correctly in most cases, even those of moderate complexity.

By applying the Pareto Distribution 80/20 principle widely cited by economists to each successive level, I estimate that Level-5 herbalists currently constitute fewer than 0.2% of the Chinese medicine profession worldwide; this estimate is consistent with my own observations of the profession over a 35-year period. However, could this tiny fraction be vastly increased by radical reform of the educational system for herbalists? I am no believer in the infallibility/inflexibility of the Pareto 80/20 "rule" — could even a modest shift to 60/40 increase the percentage of Level-5 herbalists by an order of magnitude? This is what I hope to demonstrate to you in the remaining lectures of this series.

The 5 levels of attainment of CCM herbalists
— Jin Shou Shan.
Lowest: prescription herbalists May have memorized some classical formulas, though with little understanding of CCM theory and assessment methods. Equivalent to the modern-day habit of remedy-X-for-disease-Y.
2: mediocre bian-zheng (pattern diagnosis) herbalists Know how to use herbs, have studied some CCM theory, pathophysiology, clinical reasoning and interpretation of symptom-sign complexes, herbal materia medica and classical formulas. However, they cannot apply the theory well, so their effectiveness is limited when confronted by complex health problems characterized by multiple symptom-sign complexes.
3: successful bian-zheng herbalists Have usually been trained by old masters and have studied and practiced CCM extensively. They are capable of accurate and comprehensive differential pattern assessment and are skilled in managing clinical cases. However, their abilities are standard for the profession, and they are unable to resolve difficult cases with which other herbalists also have difficulty. They are good herbalists, but not exceptional.
4: the difficult problem solvers Capable of independently analyzing and solving difficult problems, regardless of the roots of the problems, regardless of danger, and can solve almost all problems like untangling knots. Often use simple formulas with ordinary ingredients, but in a confident manner, certain of their properties and effects.
5: the intractable problem solvers Very rare. Can solve even the most intractable problems quickly and with confidence. Differential assessment skills refined and exact, precisely tailoring formulas to individual needs, using neither more nor less than necessary to achieve desired results. (My addendum: can also readily integrate non-herbal methods — environmental medicine — when necessary.)

Pareto Distribution applied to the 5 levels of Jin Shou Shan.
LevelEstimated % of profession
(re:Pareto 80/20)
— 60/40?

    >> Reference 1-lideal goals for CCM education

In 1956, Benjamin Bloom and his colleagues published "a framework for categorizing educational goals: Taxonomy of Educational Objectives. Bloom’s Taxonomy has been applied by generations of K-12 teachers and college instructors in their design of curricula." The elements of teaching high-level competence have never been a secret, as millions of home-schooling families have discovered to their delight.

Since the 1970's, the American educational system has been the target of relentless, severe dumbing-down at all levels from kindergarten to college. Public school teacher John Taylor Gatto became so disgusted by this evil scheme that he vowed to wage war by publishing books (e.g.: The Underground History of American Education) and articles to educate parents as to why, in his opinion, the system was so broken that it should be allowed to collapse and alternatives prepared to replace it.

Public education systems designed to intentionally dumb-down the masses can be traced at least back to India in the times of the ancient Hindus. Their rigid caste system was buttressed by stratified education that enforced rote memorization on the lower castes and swiftly punished independent thinking and any questioning of teachers. Such educational systems were the rule throughout Asia for thousands of years. East Asian countries began adopting some of the best aspects of European and American models of education only within modern times in order to facilitate economic development, while Americans were systematically demolishing their own educational systems.

In the remaining lectures, I will describe the various obstacles currently impairing the CCM/TCM profession worldwide — and a detailed overview of how each of these obstacles can be overcome. With the aid of interactive software, challenging games, video simulators, and artificial intelligence tools, RMHI's Level-1 graduates, at the moment of graduation, routinely achieve the abilities of successful bian-zheng herbalists — level 3 in Jin Shou Shan's hierarchy and the "Applying" stage in Bloom's classification. RMHI Level-2 students master the stages of Analyzing and Evaluating by working on their own clinical cases.

Since 1990, while many educators were bemoaning the woeful state of American education, we at RMHI were busy creating new software tools, educational strategies, and an entirely private organization disconnected from the mainstream in order to experiment and implement all stages of Bloom's Taxonomy.

Bloom's Taxonomy of Learning Domains.
(a systematic roadmap to designing effective educational curricula for any field)
Level of learning, competenceDescription
RememberRecall or retrieve previous learned information.
UnderstandComprehend meaning; translating, interpolating, interpreting instructions and problems. State a problem in one's own words.
ApplyUse concepts in new situations; unprompted use of an abstraction. Apply what was learned in the classroom into novel real-life situations.
AnalyzeSeparate material or concepts into component parts so that its organizational structure may be understood. Distinguish between facts and inferences.
EvaluateMake judgments about the value of ideas or materials.
CreateBuild a structure or pattern from diverse elements. Put parts together to form a whole, to create new meanings or structures.

    >> Reference 1-mBloom's Taxonomy, John Taylor Gatto


go to Part 2
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