Hierarchy of Patterns in the Clinical Application of Zhang Zhong Jing’s Formulas: An Empirical Approach

Zhang Zhong Jing’s Shang Han Lun (Treatise on Cold Damage) and Jin Gui Yao Lue (Essentials from the Golden Cabinet) include over 250 time‑tested herbal prescriptions that are characterised by their clear clinical focus and small number of ingredients. In the original texts the indications for these formulas are not explained in terms of abstract theories, but rather as objective descriptions of clinical patterns. This article provides a brief historical background of Zhang Zhong Jing’s work and discusses the significance of patterns in clinical practice according to the Shang Han Lun and Jin Gui Yao Lue. The author also introduces the concept of the hierarchical nature of patterns (disease pattern, formula pattern and single herb pattern) derived from these texts and the works of the 18th‑century Japanese physician Yoshimasu Todo. Selected case studies demonstrate how these patterns can be combined and cross‑referenced in clinic to arrive at a precisely targeted formula.