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ObjectiveTo explore multiple relationships in traditional Chinese medicine (TCM) knowledge by comparing binary and multiple relationships during knowledge organization.MethodsCharacteristics of binary and multiple semantic relationships as well as their associations are described. A method to classify multiple relationships based on the involvement of time is proposed and theoretically validated using examples from the ancient TCM classic Important Formulas Worth a Thousand Gold Pieces. The classification includes parallel multiple relationships, restricted multiple relationships, multiple relationships that involve time, and multiple relationships that involve time restriction. Next, construction of multiple semantic relationships for TCM concepts in each classification using Protégé, an ontology editing tool is described.ResultsProtégé is superior to a binary relationship and less than ideal with multiple relationships during the constitution of concept relationships.ConclusionWhen applied in TCM, the semantic relationships constructed by Protégé are superior than those constructed by correlation and/or attribute relationships, but less ideal than those constructed by the human cognitive process

Expression model for multiple relationships in the ontology of traditional Chinese medicine knowledge