I have trouble with classify a client with excess or deficency pattern. To me they are just a maze, because a lot of people i treat seems to have both sign and symptoms. So how do you classify them to treat them right.
It is often difficult to separate out a clear diagnosis when patients present with conflicting signs and symptoms. If you read my article on general TCM diagnoses you will see they are listed as excess patterns, deficiency patterns, and mixed patterns. This is because there is often a mix and nothing stands out strongly. The real key to creating a diagnosis in Chinese Medicine is to take into account many different signs and symptoms, the tongue, pulse, medical history, palpation, results of previous treatments, etc. The more information you put into the equation the more patterns you will see and the clearer your diagnosis will become - in general you are looking for a preponderance of signs within some of the more general categories such as excess, deficiency, etc. When you treat there are patterns to follow such as clearing excess first, then building deficiencies, etc. but these have to do with your individual style and training to some degree. As you grow more familiar with all the patterns and get more clinical experience it will be easier to take all of these things into account and see patterns within seemingly unrelated issues. Using one or two aspects of TCM diagnostics, however, is a good a way to feel very uncomfortable with your conclusions - i.e. people who overly rely on the pulse, for example, without taking into account all of the other factors.