In TCM, “signs and symptoms,” “syndrome,” and “disease” have different meanings but are closely connected.
“Signs and symptoms” means physical or mental changes which often reflect the condition of organs and indicate disease or disorder. CWM considers signs and symptoms only as subjective evidence of a disease and may not be trusted, but TCM’s use of this concept is much broader and subtle, such as: lack of thirst, bitter taste, aversion to speaking, dull eyes, yellow tongue, aversion to cold, chest stuffiness, sweating, or loose stools. Symptoms are also sought in examination of the urine, pulse, complexion, smell, sound, and meridians. Observation of demeanors, mental state, emotions, preferences, and disharmony is also performed. Each symptom or sign acquires meaning only in conjunction with certain environmental conditions.
A “Syndrome” is a coming-together of related symptoms at a certain disease stage, and summarizes the characteristics of the disease course.
Differentiation of syndromes analyzes and recognizes the underlying disharmony using data from the Four Diagnostic Methods to identify the Zheng (the dynamic function state in System Science) of the disease. As with pattern identification, the whole picture of disharmony or circulating stagnation is pieced together by considering all signs and symptoms. For instance, the common cold is classified as a Wind-Cold or a Wind-Heat Syndrome. Actually, the two patterns of Zheng come from different pathologic causes.
The Wind-Cold is cold averse, fevered without sweat, and manifests with sneezing, general pain, headache, a clear nasal discharge, a floating tense pulse, and a thin white tongue coating. The Wind-Heat is mildly wind or cold averse, fevered with sweat, and manifests with headache, a turbid nasal discharge, dry mouth and thirst, a sore red throat, cough, yellow sticky phlegm, a floating pulse, and a thin yellow tongue coating.
“A disease may have several syndromes”; and the same syndrome may develop into different diseases, or a syndrome can be seen in several diseases. Clinically, differentiation of syndromes and differentiation of diseases should be combined to have an accurate diagnosis.