[ENG]Part 5: The Principle of Change in the I Ching — Transformation and the Flow of Pathology

  CALee Acupuncture

🔄 Part 5: The Principle of Change in the I Ching — Transformation and the Flow of Pathology

How the dynamics of changing trigrams mirror the progression and diagnosis of disease in Oriental medicine

As mentioned in the introduction to this series, this final post will explore one of the I Ching’s most essential concepts—transformation (變易)—and how this dynamic principle resonates with the way Oriental medicine understands disease progression, diagnosis, and prognosis. We'll also examine examples from classical texts that integrated I Ching thought into medical reasoning.

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🌪 1. Changing Trigrams and the Flow of Symptoms

The I Ching discusses three forms of change: immutability (不易), simple transformation (簡易), and dynamic transformation (變易). Among these, dynamic change refers to constant transformation over time—a concept that closely aligns with the way symptoms appear and evolve in the human body.

In Oriental medicine, the pathological flow of disease typically follows a four-stage model:

1. Latent phase – Before imbalance occurs; a state of stillness (similar to a stable hexagram)

2. Onset – An emerging imbalance (symbolized by a changing line or “moving yao” in the trigram)

3. Progression – The transformation of the current hexagram into another, indicating spread or worsening

4. Resolution – Either restoration of harmony or development of chronic imbalance

This mirrors the way hexagrams evolve in the I Ching. Interpreting changes in the hexagram provides a framework to understand how diseases unfold and where they are likely headed.

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🧩 2. Diagnosis and Prognosis through the Original and Transformed Trigrams

In the I Ching, the original hexagram (本卦) represents the present situation, while the transformed hexagram (之卦) reveals where things are headed. The key mechanism is the moving line (動爻)—a symbol of change. In Oriental medicine, this concept can be mapped as follows:

• “Disease hexagram” (病卦): The current symptomatic pattern or root cause

• “Prognostic hexagram” (用卦): The direction the condition is likely to take, and the outcome after treatment

For example, a patient with stagnated Liver qi may be represented by a base trigram of ☳ (Zhen – Thunder – Liver). If the moving line transforms part of this into ☵ (Kan – Water – Kidney), it may suggest an interaction between Liver and Kidney channels, indicating a path of internal progression and giving insight into treatment priority.

This method allows for a holistic diagnosis, incorporating not only the physical state but also the emotional and constitutional aspects of the patient—captured through symbolic transformation.

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📜 3. Classical Applications of the I Ching in Medical Literature

The integration of the I Ching into medical reasoning has deep historical roots. Several classical texts illustrate this:

• Huangdi Neijing (Yellow Emperor's Classic of Internal Medicine): Uses "correspondence between Heaven and Man (天人相應)" to align trigrams with organ systems

• Donguibogam (Treasured Mirror of Eastern Medicine): Reflects a constitutional approach that harmonizes with trigram-based thinking

• Zhouyi Canyi (I Ching Supplement for Medicine): A lesser-known text applying hexagram transformation to diagnostics and prognosis

These examples demonstrate that the I Ching has long served as more than a philosophical text—it has been used as a practical tool for pattern identification, disease interpretation, and therapeutic decision-making.

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🌱 In Closing

Throughout this five-part series, we have explored how the I Ching and Oriental medicine share a common foundation in the principles of nature, balance, and transformation. From yin-yang and the Five Phases, to the trigrams and meridians, and finally to the flowing dynamics of symptom change—we find a consistent philosophical thread.

Thank you for walking this quiet path with me.
May these insights find their way into your practice, your reflections, and your understanding of the living connection between Heaven and Humanity.

Shall we keep walking? 🌿