Chapter 6 Cause of Disease

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Chapter 6 Cause of Disease
Lecturer QU Hongyan
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Brief introduction

• The cause of disease, refers to the
  factors that damage the relative equilibrium and
  result in disease.
• The etiology, an important component
  of the theoretical system of traditional Chinese
  medicine, studies the concept of various
  pathogenic factors, their formation, nature,
  pathogenic characteristics and the clinical
  manifestations of the disease caused by them.

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Methods to seek the cause of disease
A characteristic of etiology in TCM
seeking the cause by syndrome differentiation
TCM studies the cause of a disease, by
understanding objective conditions that may
become pathogenic factors according to the
manifestations of the disease and through
analysis of symptoms and signs of disease to
infer its cause
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Exogenous pathogenic factors

• Exogenous pathogenic factors---refer to the
  pathogenic factors which originate from the
  nature and invade the body from the body surface,
  or through the mouth and nose, causing exogenous
  disease.

Six excesses
Pestilential qi
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• Six excesses

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Basic concept

• Six qi a collective term for six normal climate
  changes in nature including wind, cold,
  summer-heat, dampness, dryness and heat (fire).
• Six excesses a collective term for six exogenous
  pathogens including pathogenic wind, pathogenic
  cold, pathogenic summer-heat, pathogenic
  dampness, pathogenic dryness and pathogenic heat
  (fire).

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• Under the following conditions, six qi will turn
  into six excesses
• six qi changes sharply, which goes beyond the
  normal adaptive ability
• body resistance becomes weak due to deficiency
  of healthy qi.

Six excesses
Fall ill
Climatic changes (six qi)
Healthy qi
Six qi
Healthy
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Common pathogenic characteristics of six excesses

• 1.Exogenousnessthe six excesses usually invade
  the body through the body surface, the mouth and
  nose.
• 2.Seasonality diseases caused by the six
  excesses are often characteristic of distinct
  seasonality.

In spring there are more wind diseases dryness
disease more in autumn
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Common pathogenic characteristics of six excesses

• 3.Regionality Diseases caused by the six
  excesses are often connected with the
  environments and regions where people live and
  work.
• 4.Combination each of the six excesses can
  cause disease either alone or in combination with
  another.

e.g. wind-heat cold wind-cold-dampness
arthralgia
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Common pathogenic characteristics of six excesses

• 5.Transformability Under certain conditions, the
  natures of diseases caused by six excesses can
  transform into one another.

• e.g. Wind-cold syndrome of exterior may turn
  into interior heat syndrome.

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Wind pathogen

• All exogenous pathogenic factors characteristic
  of lightness, rising, and opening-dispersing and
  migrating are called wind pathogen.

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Natures and characteristics

• Wind pertains to yang and is characteristic of
  lightness, rising and opening-dispersing and
  tends to attack yang location
• Characteristic of wind being mobile and rapid
  changeable
• Characteristic of wind being mobile
• Wind being primary pathogen

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Cold pathogen

• All exogenous pathogenic factors characteristic
  of cold, coagulation and contraction are called
  cold pathogen.
• Cold is prevalent in winter so there are more
  diseases caused by cold in this season. Diseases
  caused by cold can also be seen in other seasons.

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Natures and characteristics

• Cold pertains to yin and is apt to attack yang qi
• Cold having property of coagulation and
  stagnation
• Cold having property of contraction

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Dampness pathogen

• All exogenous pathogenic factors
  characteristic of heavy turbidity, stickiness and
  stagnation and downward are called dampness
  pathogen.
• Dampness is the dominant qi in late-summer or in
  the intersection of summer and autumn, it is the
  dampest in the year because there is steaming
  damp-heat and vaporizing water.
• In addition, diseases caused by dampness can also
  result from swimming and drenching, living in wet
  and damp places and working in the water.

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Natures and characteristics

• Dampness is a yin pathogen and apt to hamper qi
  movement and damage yang qi
• Characteristic of dampness being heavy and turbid
• Characteristic of dampness being sticky and
  stagnant
• Characteristic of dampness being descending and
  apt to attack yin locations

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Summer-heat pathogen

• During the time from summer solstice to
  autumn begins, the exogenous pathogenic factors
  characteristic of scorching-hot, ascending and
  dispersive, mixed with dampness are called
  pathogenic summer-heat.
• Summer-heat is the dominant qi in summer and
  transformed from fire-heat qi. It is only seen in
  summer, which is characterized by an apparent
  seasonality. So summer-heat is a pure exogenous
  evil and attacks the body usually not from the
  interior, but the exterior.

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Natures and characteristics

• Summer-heat pertains to yang and is
  characteristic of scorching-hot
• Characteristic of summer-heat being ascending and
  dispersive, impairment of fluids and exhaustion
  of qi
• Summer-heat being likely to be mixed with dampness

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Dryness pathogen

• All exogenous pathogenic factors
  characteristic of dryness and astringency are
  called dryness pathogen.
• Dryness, the dominant qi in autumn marked by
  depurating, descending, astringency and dryness,
  can be seen in four seasons of the year.

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Natures and characteristics

• Characteristic of dryness being dry and puckery
  and apt to impair fluids
• Dryness likely to injure lung

The lung is a tender viscus. It is externally
connected with skin and hair, opens into the nose
and aversion to dryness
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Fire (heat) pathogen

• All exogenous pathogenic factors
  characteristic of torridity and flaming up are
  called fire (heat) pathogen.
• Fire (heat) blooms in summer but is not so
  seasonal as summer-heat and it is no affected by
  seasons and climates. therefore fire diseases are
  seen in four seasons.

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Natures and characteristics

• Fire (heat) is a yang pathogen which
  characteristic being flaring up
• Fire (heat) being likely to disturb heart-mind
• Fire (heat) being likely to consume body fluids
  and exhaust qi
• Fire (heat) being likely to cause convulsion and
  bleeding
• Fire (heat) being likely to cause sores and
  abscesses

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Pestilential qi

• Concept
• It is an exogenous pathogenic factor which is
  strongly infective, and it can cause diseases
  through air, food, bites by insects and animals,
  dermal contact, etc.
• Pathogenic characteristics of pestilential qi
• Strong infective and epidemic
• Acute onset and severe condition
• Diseases vary with pestilential qi but symptoms
  are similar

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Internal injury pathogenic factors

• Internal injury cause of disease are those
  generated internally, which can directly lead to
  disorders of qi and blood as well as impairment
  of visecra.

Internal injury due to seven emotions
Improper diet
Overstrain and overease
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Internal injury due to seven emotions
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Basic concept

• Seven emotions refer to seven emotional
  activities including joy, anger, worry, anxiety,
  sadness, fear and fright.
• Internal injury due to seven emotions when the
  emotional stimulations are too abrupt, violent,
  and prolonged and beyond ones adaptability or
  when there is diminished adaptability due to
  imbalanced yin-yang, qi and blood of viscera, can
  they turn into pathogenic factors.

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Fall ill
Internal Injury due To seven emotions
Emotional stimulus
Healthy qi
Be healthy
Seven emotions
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• Relationship between seven emotions and
  visceral essential qi

?? liver heart spleen lung kidney
?? anger joy anxiety sadness fear
store
transform
essence
generate
Qi
impair
hurt
injure
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Pathogenic characteristics

• Impairing the viscera
• Affecting the visceral qi movement
• Tending to cause emotional diseases
• Affecting the sequelae of diseases

Rage leading to qi ascending, excessive joy
leading to qi loose Fear leading to qi
sinking Fright leading to qi turbulance.
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Irregularity of diet
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Improper diet

Food preference
Unhygienic diet
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Improper diet
Anorexia, lusterless Complexion,
palpitations Short breath, general lassitude
Conscious control of eating
Obstinate Psychological diseases
Gastric and abdominal fullness and
distention eruction, acid regurgitation anorexia,
vomiting and diarrhea
Overeating impairs the spleen and stomach
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Unhygienic diet

• This refers to eating unclean food, such as
  taking food gone bad, polluted by pestilent
  evils, parasites or mistaken intake of poisonous
  food.

Gastric and abdominal pain, nausea and vomiting,
diarrhea with borborygmus, or dysentery
Take in the food that has gone bad
Take in the food contaminated by epidemic toxin
Infectious diseases
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Diet predilection

• This refers to the phenomenon that diseases can
  start due to the liking of foods with certain
  taste or specially eating certain foods,
  including predilection for cold or hot food, or
  predilection for one of the five tastes or
  predilection for alcohol.

Predilection for alcohol
Predilection for cold or heat
Predilection for the five tastes
Predilection for one type of food
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Predilection for cold or heat
Excessive intake of cold food
Impair the yang qi of spleen and stomach
Cold-dampness is produced internally
Abdominal pain diarrhea
Partiality to spicy-hot food
Impair the stomach yin
Thirst, halitosis, abdominal distention pain,
constipation etc
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Predilection for the five tastes

• Long term of preferring food with a
  certain taste can cause the preponderance of its
  corresponding viscera, thus causing disharmony
  among viscera.

e.g.
acid bitter sweet pungent salt
liver heart spleen lung kidney
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Predilection for one type of food

• It refers to a long period of special taking of
  some foods or not taking some foods or lack of
  certain food.

Obesity, vertigo stroke, consumptive thirst and
so on
Long time of excessive ingesting rich food
Production of Phlegm and transformation of heat
Long time for lacking of some nutrients
Night blindness goiter and tumor
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Imbalance between work and rest
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Imbalance between work and rest

• It refers to long time of overstrain or
  indulgence in easy life.

Normal work can help build the body and improve
health Proper rest can remove fatigue and help
recover strength
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overexcertion
overstrain
Mental overstrains
Sexual overstrains
Overease/ indulgence in easy life
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Overexertion

• It refers to prolonged engagement of
  physical labor or exercise, beyond a normal limit.

Reluctant to speak fatigue and tiredness sweating,
dyspnea etc
Consumption of qi
Impair the functions of viscera and
cause asthenia of visceral qi
Injure muscles, tendons and bones
Impairment of the body
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Mental overstrains
It refers to long time of attention or
pensiveness.
Heart throb, amnesia, insomnia dreaminess, poor
appetite, abdominal distention and diarrhea,
etc.
Impair the heart and the spleen and consume
qi and blood
mental overstrains
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Sexual overstrains
It refers to excessive sexual activities,
masturbation, or early pregnancy or giving many
births.
Consume essence In the kidney
sexual overstrains
Aching and weakness in the waistand knees,
vertigo, tinnitus, dispiritedness, or
spermatorrhea prospermia, and impotence in men
and dysmenorrhea leukorrhea or sterility in women
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Indulgence in easy life
Reduced appetite, abdominal distention, limb
heaviness, muscular flaccidity, oppression in
chest and shortness of breath
Qi stagnation of the spleen and stomach
Absence of physical work sports
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Pathological products

• Phlegm-fluid retention
• Stagnant blood
• calculus