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Etiology and Pathogenesis Pathogen Wind Yin/Yang Season Yang Spring Etiology/ pathogenesis Ext: penetrates skin due

to s eating or hile sleeping !nt: "# pattern $% heat &% yang rising '% (lood deficiency Summer Ext: com(ines ith ind+ in*ades through nose and mouth !nt: emotions+ improper diet+ yin deficiency "ate Ext: damp li*ing and summer orking conditions+ damp hot climate+ damp clothing !nt: improper diet+ SP dysfunction 5utumn Ext: in*ades through nose and mouth+ external dry climate !nt: S6 or 0D yin deficiency+ S6 yin damage due to irregular eating Winter Ext: com(ines ith ind+ in*ades through skin !nt: yang deficiency Summer Excessi*e heat+ .only% o*erexposure to sun+ lack of *entilation 6 Pathogenic Factors Direction/ quality Damages/ consumes Manifestations )p ard and Wei qi+ (lood+ yin Ext: rapid onset, changes+ headache+ snee-e+ cough+ runny nose+ itchy out ard/ rapid onset and painful throat+ facial s elling and paralysis+ a*ersion to ind+ and changes/ seating+ migratory pain and symptoms+ mo*ing . ind% /i mo*ing !nt: di--iness+ *ertigo+ tinnitus+ con*ulsions+ tremor+ spasm+ de*iation+ paralysis 2ire (urns up ard+ /ody fluids+ yin+ Excess: fe*er+ ref face and eyes+ dry mouth+ (itter taste+ restless+ thirst+ rises to head+ (lood+ qi+ shen s eat+ oral ulcers+ s ollen painful gums+ headache+ insomnia+ mania+ damages (lood agitation+ delirium+ coma+ constipation+ dark scanty urine+ (leeding *essels+ affects Def: night s eats+ 1 center heat+ malar flush+ dry mouth+ tidal fe*er+ red mind+ dries fluids peeled tongue Do n ard/ hea*y+ Yang qi+ SP+ Di--y+ hea*y head and (ody+ sensation head rapped in cloth+ sore tur(id+ *iscous+ circulation of qi painful hea*y 4oints+ tur(id discharges from skin and orifices+ chest and stagnating epigastric distension and fullness+ poor appetite+ loose or sticky stools+ edema+ leukorrhea+ cloudy urine+ mucus in stools+ sticky tongue coating+ dysuria+ fixed .damp% /i Drying and /ody fluids+ (lood+ Dry nose+ mouth+ and throat+ thirst+ dry skin and (ody hair+ constipation+ ithering yin .esp, ") yin% scanty urine+ dry cough ith scanty (loody sputum Special characteristics 0ing of pathogenic factors+ com(ines ith 1 others and phlegm/ easily in*ades upper and exterior+ and impairs opening and closing of pores 2ire+ heat+ and mild heat *ary in intensity/ forces yin fluids to exterior/ stirs internal ind/ speeds (lood circulation and causes (leeding Prolonged disease course+ difficult to eliminate

2ire 3eat Mild heat Dampness

Yang

Yin

Dryness

Yang

7old

Yin

7ontracting and stagnating

Yang qi

Summer heat

Yang

)p ard/ dispersing+ Yin+ (ody fluid+ qi consumes fluid

Ext: a*ersion to cold+ snee-e+ cough+ runny nose+ slight fe*er+ occipital ache+ no s eat+ no thirst+ pain+ restricted mo*ement+ spasm+ painful .cold% /i !nt: cold lim(s+ cold a(dominal pain+ cold diarrhea+ desire for arm drinks+ no thirst+ pale face+ profuse clear urine Extreme heat: high fe*er+ restless+ thirst+ profuse s eat+ surging pulse+ dry mouth and tongue+ di--y+ (lurred *ision+ qi deficiency signs+ collapse+ coma With damp: fe*er+ restless+ thirst+ di--y+ hea*y head+ stuffy chest+ nausea+ poor appetite+ loose stools+ lassitude

/locks opening and closing of pores/ restricts circulation of qi and (lood and mo*ement of lim(s Exterior pathogen+ ne*er interior/ only in summer/ com(ines ith damp/ causes pores to open

Emotion 5nger ;oy Pensi*eness .melancholy% Worry <rief 2ear 2right .shock%

5ffects the qi 5scends Slo s do n Stagnates Stagnates/ depletes Dissol*es Descends/ depletes Scatters/ depletes

7 Emotions 8ang9fu affected Precipitated (y Manifestations "#+ SP+ S6 :esentment+ frustration+ hatred+ (itterness 3eadache+ tinnitus+ di--iness+ red face+ thirst+ red tongue+ (itter taste+ hypochondriac pain+ irrita(ility+ (elching+ sighing+ irregular menstruation 36 Excessi*e excitement Mental confusion+ palpitations+ insomnia+ dream9distur(ed sleep+ a(normal laughing and crying+ mania SP Excessi*e mental ork 2atigue+ poor appetite+ loose stools+ phlegm signs ")+ SP+ 36 2inances+ family+ ork 2atigue+ poor appetite+ loose stools+ shortness of (reath+ stiff neck and shoulders ")+ SP+ 36 "oss+ death Shortness of (reath+ fatigue+ depression+ crying+ (lood deficiency and amenorrhea in omen 0D !nsecurity+ chronic anxiety 2lushing up+ night s eating+ palpitations+ dry mouth and throat+ enuresis in children 36+ 0D Shock of any kind Palpitations+ (reathlessness+ insomnia+ mo*ing pulse+ night s eating+ dry mouth+ di--iness+ tinnitus

Others Secondary factors: phlegm9fluid and stagnant (lood !mproper diet =*erexertion+ stress+ and lack of exercise 6rauma+ parasites+ and poisons !ncorrect treatment Weak constitution

3 aspects of pathogenesis 7onflict (et een antipathogenic qi and pathogenic factors !m(alance (et een yin and yang 5(normal ascending and descending of qi