Online Submissions: http://www.journaltcm.com J Tradit Chin Med 2013 February 15; 33(1): 137-140 [email protected] ISSN 0255-2922 © 2013 JTCM. All rights reserved.

THEORETICAL STUDY Logical thinking in pattern differentiation of Traditional Chinese

Jing Zhou, Jiankun Zhu, Meijuan Chen, Miao Jiang, Zongming Zhang, Zhen Zhan, Xu Zhang aa

Jing Zhou, Basic Medical College, Nanjing University of Chi- may lack rigorousness, continuity, systematic induc- nese Medicine Nanjing 210046, China; Gansu Province Cen- tion and deduction, but its logical thinking still can ters for Disease Control and Prevention, Lanzhou 730000, attain its goal following a process with rigorous, China regulated and scientific formal logic. Jiankun Zhu, Gansu traditional Chinese medicine colleges, Lanzhou 730000, China Meijuan Chen, Miao Jiang, Zongming Zhang, Zhen © 2013 JTCM. All rights reserved. Zhan, Xu Zhang, Basic Medical College, Nanjing University of Chinese Medicine Nanjing 210046, China Key words: Logic; Traditional Chinese Medicine; Supported by the National Science & Pillar Progr- Pattern differentiation; Syllogism am in the 11th Five year Plan of China (2006BAI11B0801) and the Priority Academic ProgramDevelopment (PAPD) of Jiang- su Higher Education Institutions INTRODUCTION Correspondence to: Prof. Xu Zhang, International Educa- tion College, Nanjing University of Chinese Medicine, Nan- The knowledge of medical science including Western jing 210029, China. [email protected] Medicine and traditional such as Traditional Telephone: +86-13952098828 Chinese Medicine (TCM) and Tibetan medicine, is Accepted: September 16, 2012 the accumulation of practical experience of human be- ings. Exploitation of state-of-the-art molecular biology, , , mathematics, statistics, logic etc, better facilitates the test of the efficacy of the medi- Abstract cines. And the knowledge of evidence-based medicine, OBJECTIVE: To discuss the application of logic to grey system theory, mathematical model and logic have pattern differentiation for treatment in Traditional become the vital tool for the research into TCM. It is Chinese Medicine (TCM). worth mentioning that logic topped the list of the disci- plines in the UNESCO nomenclature for fields of sci- METHODS: Comparing logic reasoning of syllo- ence and technology.1 In China, however, it has long gism with the logical thinking of TCM pattern differ- been considered as a sub-subject of or entiation for treatment. mathematics, which is a big difference from the classifi- cation of disciplines.2 The gap was due to the deliberate RESULTS: TCM logical thinking depends on symbol- separation of social science and natural science.3 The ic and intuitive judgment with abstractive reason- of logic can be divided into traditional logic ing integrated into the process. Although it lacks phase and modern logic phase. The former includes tra- quantitative measurement, it pays great attention ditional deduction logic and traditional induction log- to the comprehensive analysis of a disease's cause ic. The latter includes modern deduction logic and and its development patterns to get insight into modern induction logic, which also is called the mathe- the essence of illness. matical logical or symbolic logic. This article discusses TCM logical thinking for its pattern differentiation CONCLUSION: TCM diagnosis reasoning method and the application of logic in TCM practice.

JTCM | www. journaltcm. com 137 February 15, 2013 | volume 33 | Issue 1 | Zhou J et al. / Theoretical Study

TCM LOGICAL THINKING AND ITS nation of intuitive reasoning and logical reasoning pos- sesses some advantages despite the fact that it has some RELATION WITH FORMAL LOGIC deficiency, which could lead to misdiagnosis and the Characteristics of TCM logical thinking ambiguity of illness information may lead to subjective TCM theory developed under specific circumstance, judgment for diagnosis as well.5 which made it to make use of black-box theory and sys- The human subconscious activities also follow certain tematic and holistic methods. Most of them belong to logical rules, which is subconscious logic. The subcon- information system theory and cybernetics.4 Several scious logic follows four basic , namely of simi- characteristics of TCM logical thinking are as follows: larity, law of freedom, law of vagueness and law of coin- 1) obtaining pathologic information without wound; cidence.7 As to TCM, the so-called logical thinking of 2) diagnosis based on information outside human TCM is not completely equivalent to dialectical logic. body; 3) deduction of holistic conditions based on part Although TCM diagnosis reasoning method may lack of the conditions; 4) integration with abstractive think- rigorousness, continuity, systematic induction and de- ingt.5 duction, TCM logical thinking still can attain its goal Four examinations of inspecting, listening and smell- by following a process with rigorous, regulated and sci- ing, inquiring, pulse taking and palpating, are em- entific formal logic. ployed by TCM to collect pathologic information as ev- idences to judge the state of an illness without using so- phisticated instruments and chemical examination. INFLUENCE OF LOGIC CONCEPT ON Pulse taking is not merely the pulsation of the arteries. TCM LOGICAL THINKING It is closely related to the five Zang-organs and six Fu-organs, and the changes of Qi, boold, Yin and Basic logical characteristics of concept Yang. It provides the biologic information of human A concept has two basic logical characteristics: connota- body and reveals motion information of human body's tion and extension. Connotation refers to the character- matters and their changing patterns. istic or the essence of the object a concept defines; the extension refers to all things mentioned by the con- Relation between the basis of TCM logical thinking cept. According to its nature, the relations between and formal logic concepts can be divided into compatibility relation and Formal logic is a abstract study of propositions and de- incompatibility relation. The former can further be ductive reasoning. It strictly follows the logical rules subdivided into: identical relation, contained relation, such as law of identity, law of contradiction, and law of containing relation and overlapping relation. The latter excluded middle etc. Its progression follows a straight- can be subdivided into: contradictory relation and op- line or stair-way, which can be decomposed into the posed relation. From the perspective of the relation be- course of a series of continual analogy, induction and tween extension, the relations between the subject term deduction.6 TCM logical thinking depends on symbol- (hereinafter referred to as S) and the predicate term ic and intuitive judgment with abstractive reasoning in- (hereinafter referred to as P) can be classified into five tegrated into the process. It is a qualitative method relations (Table 1). used to grasp the pattern of an illness. Although it lacks quantitative measurement , it pays great attention Unified understanding of a concept from different to the comprehensive analysis of a disease's cause and angles of thinking its development patterns to get insight into the essence Professor Shine Zhu explained the possible pattern of of illness. unification of TCM and Western Medicine vividly8 TCM logic thinking for diagnosis is a reasoning pro- with the expression of A+B+ab+C (Figure 1), which on- cess that is based on clinical data available. The combi- ly explained respective contribution of A, B, C, ab to Table 1 Relations between S and P Identical Contained Containing Overlapping Totally different

Judgment

SAP Truth Truth Falsity Falsity Falsity SEP Falsity Falsity Falsity Falsity Truth SIP Truth Truth Truth Truth Falsity SOP Falsity Falsity Truth Truth Truth Notes: In this chart, O expressed accommodating relations between S and P, the gray expresses S. A means full title affirmation judgment (SAP: S always is P, shorted as A), B means full title denial judgment (S always is no P), I means stating affirmation judgment (S is P sometimes), O means stating denial judgment (S is no P sometimes).

JTCM | www. journaltcm. com 138 February 15, 2013 | volume 33 | Issue 1 | Zhou J et al. / Theoretical Study the formation of a universal theory system, but did not due to aristolochic acid and its metabolite--aristolo-lac- mention their logical relations. For instance, A stands tam. They are the basis for the plant's toxicity to kid- for the content derived from TCM theory, Ying-Yang, ney.10 Obviously, two kinds of trifoliate akebia are dif- and meridian and collateral theory etc, which contrib- ferent and imprecise definition creates a confusion, ute to the new theory system; B stands for the content which causes the unexpected problem. derived from Western Medicine theory; ab stands for the The essential element for thinking is concept.11 There- content of the overlap of TCM and Western Medicine; C fore, no matter using the method of integrating TCM stands for the contents derived from any other kinds of with Western Medicine or using TCM alone to diag- medicines except forTCM and Western Medicine. nose and treat illnesses, the concept related to the pro- cess must definitely reveal the distinguished characteris- tics of the defined object to ensure that no deviation and divergence shall exist in the way of thinking.

JUDGMENT IN PROPOSITION VS TCM LOGICAL THINKING Categorical terms of proposition There are mainly four types. They are as follows: a)A-type--universal and affirmative symbolized with SAP; b)E-type--universal and negative symbolized with SEP; c)I-type--particular and affirmative symbolized withSIP; d)O-type--particular and negative, symbolized with SOP. Judgment of truth or fallacy in proposition and Figure 1 Zhu Shine's new theory of the unification of TCM and Western Medicine TCM logical thinking TCM: Traditional Chinese Medicine. A stands for the content For SAP, take the syndrome for Radix Bupleuri as an ex- derived from TCM theory; B stands for the content derived ample, if the symptoms of felling fullness and discom- from Western Medicine theory; ab stands for the content of fort in chest and hypochondrium, and alternating chill the overlap of TCM and Western Medicine; C stands for the and fever accompanied by vomiting, or by being reluc- contents derived from any other kinds of medicines except tant to speak and eat, or by reversal cold of limbs, then for TCM and Western Medicine. the syndrome for Radix Bupleuri is true. And the judg- From the perspective of contained relation, containing ment of a syndrome for Radix Bupleuri is fallacious if relation and overlapping relation, we explain the influ- any of the accompanied symptoms appear while the ence on TCM logical thinking of the connotation and symptoms of felling fullness and discomfort in chest extension of a concept. A is the modern knowledge of and hypochondrium, and alternating chill and fever do TCM; B is the modern knowledge of Western Medi- not always appear. Then in the latter sense, the syn- cine; ab is the consensus on the knowledge on which drome is not the chief complain for the medication us- both TCM and Western Medicine agree, underpinned ing Radix Bupleuri. Therefore , in the process of TCM by modern molecular biology, mathematics, chemistry pattern differentiation for treatment, all type of propo- and genetics, and so forth. Then what is C, Zedong sitions should be explicitly defined so as to ensure that Mao once defined "Integrating the knowledge of TCM it is able to be performed correctly. with western medical and pharmaceutical knowledge to create a new unified system of medicine and phar- maceuticals", thus C stands for a new medical and DEDUCTION OF SYLLOGISM AND pharmaceutical system.9 It is obvious that different per- TCM LOGICAL THINKING spective can leads to different ways of thinking, but the consensus on knowledge of an object may be reached General rules for syllogism and its basic structure by various ways of thinking from different perspectives. 1) General rules A syllogism is a deduction that consists of three parts: A definition should reveal the characteristics of its two premises and a conclusion. The general rules for defining object syllogism are summarized as follows: Take Gentian Liver-Draining decoction as an example, a. A valid syllogism must consist of three unambiguous trifoliate akebia is one of the herbs in the formula. Tri- terms. foliate akebia mainly originated from lardizabalaceae, b. The middle term must be universal and unqualified ranunculaceae and aristolochiaceae. No toxicity was re- in at least one premise. ported through all the time for the herb belonging to c. The middle term must be distributed in the two lardizabalaceae. However, for several decades, trifoliate premises and the middle term may not show up in the akebia available on the market from aristolochiaceae proposition, which demands that the middle term have been reported for its toxicity to human's kidney must serve as the subject of one premise and the predi-

JTCM | www. journaltcm. com 139 February 15, 2013 | volume 33 | Issue 1 | Zhou J et al. / Theoretical Study cate of the other. tion of the two kinds of medicines. The diagnosis and d. The middle term is required to be distributed in the treatment is a process of constant combination of em- two premises and the middle term may not appear in pirical thinking and theoretical thinking, and is a pro- the proposition. cess of constant evolution of thinking and deci- e. At least one premise must be affirmative. sion-making as well.12 2) A syllogism may be classified as one of the four In sum, pattern differentiation for treatment is the pri- figures mary method which typically epitomizes TCM charac- The differing positions of the major, minor, and mid- teristics and advantages in diagnosis and treatment of dle terms gives rise to another classification of syllo- diseases. Only can its scientific value be achieved as gisms known as the figure. Given that in each case the long as the process of patter differentiation for treat- conclusion is S-P, there exist four figures (Table 2): ment is standardized. However, pattern differentiation Table 2 Figures of syllogism for treatment tends to be more individualized, which contradicts to the need of standardized process. It is a Syllogism Figure 1 Figure 2 Figure 3 Figure 4 hard problem to integrate TCM with contemporary Major premise M-P P-M M-P P-M medicine.13 Further study is required to address the Minor premise S-M M-S M-S - problem. Conclusion S-P S-P S-P S-P Notes: Figure 1, if M is P, then S is M, then S is P. REFERENCES Syllogism and TCM logical thinking 1 Unesco/Ns/Rou/257 rev.1. 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