From Metaphor to Mechanism: How LLMs Decode Traditional Chinese Medicine Symbolic Language for Modern Clinical Relevance

Abstract: Metaphorical expressions are abundant in Traditional Chinese Medicine (TCM), conveying complex disease mechanisms and holistic health concepts through culturally rich and often abstract terminology. Bridging these metaphors to anatomically driven Western medical (WM) concepts poses significant challenges for both automated language processing and real-world clinical practice. To address this gap, we propose a novel multi-agent and chain-of-thought (CoT) framework designed to interpret TCM metaphors accurately and map them to WM pathophysiology. Specifically, our approach combines domain-specialized agents (TCM Expert, WM Expert) with a Coordinator Agent, leveraging stepwise chain-of-thought prompts to ensure transparent reasoning and conflict resolution. We detail a methodology for building a metaphor-rich TCM dataset, discuss strategies for effectively integrating multi-agent collaboration and CoT reasoning, and articulate the theoretical underpinnings that guide metaphor interpretation across distinct medical paradigms. We present a comprehensive system design and highlight both the potential benefits and limitations of our approach, while leaving placeholders for future experimental validation. Our work aims to support clinical decision-making, cross-system educational initiatives, and integrated healthcare research, ultimately offering a robust scaffold for reconciling TCM's symbolic language with the mechanistic focus of Western medicine.