Abstract: The Song, Jin, and Yuan dynasties marked a period of transformation in traditional Chinese medicine for visceral syndrome differentiation, with the emergence of numerous new ideas and theories. Zhang Yuansu was a key figure in the transition from Han and Tang to Jin and Yuan medicine. His Medication Patterns for Treating Deficiency-Excess and Cold-Heat of Five Viscera embodies his thinking on visceral syndrome differentiation. This work breaks away from the pre-Song classification of visceral syndrome differentiation based on deficiency and excess, focusing on the specific physiological and pathological patterns of the five zang organs and proposing corresponding treatments for their specific syndromes. Medication Patterns propose the diagnosis and treatment of reproductive system diseases based on the Mingmen, assuming that the Mingmen undertakes some of the functions of the kidneys. This enriched the connotations of visceral syndrome differentiation and provided an important theoretical basis for identifying certain complex pathogenesis. The visceral syndrome differentiation concept in the Medication Patterns has promoted subsequent research on visceral syndrome differentiation, exemplified by works such as Li Dongyuan's "Treatise on the Spleen and Stomach", Zhu Danxi's "Treatise on the Xianghuo" and the "Mingmen Theory". In-depth exploration of the inherent differentiation logic and theoretical framework of the Medication Patterns is of great significance to current research on differentiation standards and norms.