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Revised Spring 07  修订版 春 07

I．Etiology（病因）  病因

What is Etiology？  什么是病因学？

－the cause of a disease．
疾病的原因
－Pathogenic factors：  致病因素
－Exterior abnormalities in climate／infections of epidemic disease
气候/流行病感染的外部异常
－Interior：a）emotional conditions
- 内部：a）情绪状况
b）improper diet  b）不合理的饮食
c）overstrain  过度紧张
d）injuries，trauma  d）损伤，创伤
e）wounds and bites by insects and beasts
昆虫和野兽的伤口和咬伤
The pathogenesis of one disease：
一种疾病的发病机制：

Cause ⟷→ ⟷→ longleftrightarrow rarr\longleftrightarrow \rightarrow effect（cause） ⟷ ⟷ longleftrightarrow\longleftrightarrow effect
原因 ⟷→ ⟷→ longleftrightarrow rarr\longleftrightarrow \rightarrow 影响（原因） ⟷ ⟷ longleftrightarrow\longleftrightarrow 影响

Ex：wind－cold → → rarr\rightarrow lung → → rarr\rightarrow exterior symptoms（cough，chills，no sweat，headache，thin white tongue，floating－tight pulse） → → rarr\rightarrow if the exterior pathogenic factors are not dispelled properly， these EPF stays intemally → → rarr\rightarrow transform to Heat（intemal） → → rarr\rightarrow fever，constipation，thirst，red tongue，rapid pulse．
风冷 → → rarr\rightarrow 肺 → → rarr\rightarrow 外部症状（咳嗽，恶寒，无汗，头痛，薄白舌，浮紧脉） → → rarr\rightarrow 如果外部致病因素未得到适当清除，这些致病因素会留在体内 → → rarr\rightarrow 转化为热（体内） → → rarr\rightarrow 发热，便秘，口渴，舌红，脉数
Also，phlegm，blood stasis，dampness（internal），and heat（internal） → → rarr\rightarrow these are the pathogenic products of the internal organs disorder，but they can be the cause of the other diseases．
此外，痰、血瘀、湿（内湿）和热（内热） → → rarr\rightarrow 这些是内脏器官失调的病理产物，但它们也可能是其他疾病的原因
Ex：the internal dampness → → rarr\rightarrow Spleen Qi deficiency
内部湿气 → → rarr\rightarrow 脾气虚弱

II．Pathogenesis  II. 病因学

What is Pathogenesis（病机）？
什么是病机？
－describes the mechanism of the initiation，development and change of a disease．
描述了疾病的起始、发展和变化机制
From the observation of the clinical practice：
从临床实践观察：
Qi strong or deficiency depends on → → rarr\rightarrow
气强或气虚取决于 → → rarr\rightarrow
a）body condition → → rarr\rightarrow mental state，living environment，nutrition，and excecise．
a）体况 → → rarr\rightarrow 心理状态、生活环境、营养和锻炼
b）Congenital condition → → rarr\rightarrow born with，inherited from parents
b）先天性状况，出生时就有，由父母遗传而来
＊in TCM，to determine the cause of disease not only looking at the external factor，it will according to the clinical signs，analyse the disease symptoms，to determine the cause，and provide the treatment．
在中医中，确定病因不仅要看外部因素，还会根据临床体征，分析疾病症状，以确定病因，并提供治疗方案
＂determination of pathogenic factors based on the differentiation of symptoms and signs＂
基于症状和体征的致病因素确定

Etiology  病因

Exterior Pathogenic Factors:
外部致病因素：

A. Six Exterior Pathogenic Factors
六淫
Wind - cold -summer heat - damp - dry - fire (heat) → → rarr\rightarrow also called " 6 natural factors"
风 - 寒 - 夏热 - 湿 - 干 - 火（热） → → rarr\rightarrow 也称为“六自然因素”
The 6 exterior pathogenic factors → → rarr\rightarrow cause exterior conditions.
六种外感致病因素导致外邪。
How do they cause disease?
他们是如何引起疾病的？
  • When the resistance of the human body declines, the 6 natural factors may become pathogenic factors. (Western - the immune system decline → → rarr\rightarrow the human body is susceptible to pathogens such as bacteria, virus)
    当人体电阻下降时，6 种自然因素可能成为致病因素。（西方——免疫系统下降 → → rarr\rightarrow 人体易受细菌、病毒等病原体侵害）
In General, the 6 pathogenic factors have the following characteristics in causing diseases:
一般来说，6 种致病因素在引起疾病时具有以下特点：
  1. Usually related to seasonal conditions and living environments.
    通常与季节性条件和居住环境有关。
  2. Attack the human body either separately or simultaneously with or more in combination.
    攻击人体，可以单独或同时，或更多结合进行。
  3. In the course of causing diseases, may not only influence each other, but also may transform into each other under certain conditions.
    在导致疾病的过程中，不仅可能相互影响，而且在某些条件下还可能相互转化。
  4. They cause disease usually by entering the body through the skin or the mouth and nose.
    他们通常通过皮肤或口腔和鼻腔进入人体而引起疾病。

WIND  风

  • Yang pathogen  杨病原体
  • Spring  春季
  • “Wind is leading hundred diseases”
    风是百病之源
  • attacks the body in combination with the other EPF
    攻击身体，与其他 EPF 结合
  • invading the upper part of the body
    侵犯身体上部
  1. Yang pathogen, Apt to Attack and invade the Upper Part of the body
    杨病原体，易攻击和侵入身体上部
  2. Apt to Migrate and Change
    易于迁移和变更
    a) migration → → rarr\rightarrow no fixed time and/or place - wandering
    a) 迁移 → → rarr\rightarrow 没有固定时间和/或地点 - 流浪
    b) Change → → rarr\rightarrow the onset of a disease is sudden and the disease is liable to change rapidly.
    b) 疾病的发作是突然的，且疾病容易迅速变化。
  3. Leading Pathogen, and Being Apt to Cause Disease in Combination with Other Pathogenic Factors
    主要病原体，并易于与其他病原因素结合引起疾病
    Wind - cold  风 - 冷
    Wind-heat  风热
    Wind - dampness  风 - 潮湿
    Wind - dryness  风 - 干燥
    Wind - water  风 - 水
  4. Apt to Move  易于移动
Move → → rarr\rightarrow abnormal movements or rigidity occur in the body and limbs.
身体和四肢出现异常运动或僵硬。

COLD  寒冷

  • Yin pathogen  隐病原体
  • Winter  冬季
  • Impair Yang Qi  损伤阳气
Coagulative & obstructive in nature → → rarr\rightarrow cause constriction
凝固性与阻塞性，导致收缩
  1. Yin pathogen, tending to impair Yang Qi
    阴性病原体，易损阳气
  2. Coagulative and obstructive in nature
    凝固性和阻塞性
  3. Causing constriction  导致狭窄
Cold → → rarr\rightarrow causes meridians and collaterals, and tendons to contract.
冷 → → rarr\rightarrow 导致经络和筋腱收缩。
SUMMER - HEAT  夏日 - 炎热
  • Yang pathogen  杨病原体
  • Summer  夏日
  • Scorching in nature  炽热，本质上
  • Tends to rise and disperse
    倾向于上升和扩散
  • Apt to impair body fluid and to exhaust Qi
    易损体液，耗气
  • Usually accompanied by dampness
    通常伴有潮湿
  1. Yang pathogen, scorching in nature
    杨病原体，性质炎热
  2. Tending to rise and disperse, and being apt to impair body fluid and exhaust Qi
    易致升散，耗伤津液，耗气
  3. Usually accompanied by dampness
    通常伴有潮湿

DAMPNESS  潮湿

  • Yin pathogen  隐病原体
  • Late Summer  晚夏
  • Obstruct the functional activities of Qi and impairs Spleen Yang
    阻碍气机功能活动，损伤脾阳
  • Heavy and turbid in nature
    性质上浓重且浑浊
  • Viscous and lingering in nature
    粘稠而持久
  • Tends to go downward
    倾向于向下
  • Apt to attack the lower part of the body
    易攻击身体下部
  1. Yin pathogen, tending to obstruct the functional activities of Q i Q i Qi\mathbf{Q i} and impair Spleen Yang
    阴性病原体，倾向于阻碍 Q i Q i Qi\mathbf{Q i} 的功能活动并损害脾阳
  2. Heavy and turbid in nature
    性质上浓重且浑浊
Heavy → → rarr\rightarrow feeling heavy of the body and head.
身体和头部沉重。
Turbidity → → rarr\rightarrow refers to the excretion and secretion → → rarr\rightarrow eye secretions, mucus stools with pus and blood, turbid urine, yellow and white leukorrhea, stick sputum, turbid nasal discharge.
混浊度 → → rarr\rightarrow 指眼部分泌物的排泄和分泌，脓血便，混浊尿液，黄白带，粘痰，混浊鼻涕。
3. Viscous and lingering
3. 黏稠且持久
4. Tending to go downward, and being apt to attack the lower part of the body
4. 倾向于向下，并倾向于攻击身体下部

DRYNESS  干燥

  • Fall season  秋季
  • Tends to impair body fluid
    易损害体液
  • Attack the lung  攻击肺部
Warm-dryness → → rarr\rightarrow early fall or late summer
温暖干燥 → → rarr\rightarrow 初秋或晚夏
Cold - dryness → → rarr\rightarrow late fall
寒冷 - 干燥 → → rarr\rightarrow 深秋