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PATHOMECHANISM
Parasite
◦ Taking in the food contaminated by parasitic
ovum or contacting with polluted water, or
earth may allow the parasite to enter the body,
lodging in the viscera of the body to cause
various diseases.
Traumatic Injuries:
refers to traumatic wounds, burns and scalds,
frostbite, struck by lightning, drowning, and
injuries by insect or animal.
Patho-mechanism is the mechanism of onset,
development and change of a disease
The onset, development and change of disease
are associated with the strength and physique
of the patient and the nature of the pathogenic
factors.
Patho-mechanism includes three aspects:
The Onset of a Disease Concerns Vital Qi and
Pathogenic Qi.
Vital qi refers to functional activities (including the
functions of the viscera, meridians, qi and blood)
and the resistance and recovery capacity of the
body.
Pathogenic qi refers to various pathogens causing
disease, and it is known as the “pathogen”.
The onset and change is a reflection of the struggle
between the vital and pathogens in a certain
condition.
A deficiency of vital qi is the inner basis of
pathogenesis.
When vital qi is vigorous, the pathogenic qi
cannot invade the body and disease will not
occur.
The invasion of pathogenic qi is the important
condition of disease.
No disease occurs as the vital can defeat the
pathogen.
Disease occurs as the pathogen defeats the
vital.
1. Relation between the constitution and the vital qi.
• the constitution of an individual depends upon
the innate endowment, dietary nutrition and
physical training.
• lack of food and or malnutrition will decrease the
formation of qi and blood and in turn lead to a
weak physique.
• eating and drinking too much will damage
the spleen and stomach
• over-ease and a lack of exercise will
harm the circulation of qi and blood,
reduce the functions of the spleen and
stomach and ultimately result in a weak
physique.
2. Relation of psychological state to vital qi:
• a relaxed mind and happy feeling contribute
to a smooth movement of qi, harmony of qi
and blood, and cooperative functions of the
viscera, thus, the vital qi will be vigorous.
• when one pays attention to mental
hygiene, keeps an easy mind, and has no
strong desires, then the genuine qi
will be harmonious.
• briefly, deficiency of vital qi is the internal
basis of the onset of a disease.
1. Immediate attack
• a disease immediately occurs after contraction
of a pathogen.
2. Slow attack
• it is closely associated to nature of the
pathogen and the constitutional factor of the
patient
• eg, the dampness pathogen is characterized
by stagnation and viscosity and most of
exogenous diseases caused by it slowly
occur, with a long course
2. Slow attack
• for some old patients whose vital-qi has
already gotten deficient, if they are affected
by exogenous pathogens, the disease often
slowly occurs
• in endogenous disease, pensiveness, great
sorrow, indulgence in sexual life, addiction to
alcohol, and preference for eating fat food with
thick flavors may cause pathological changes
that progressively develop day by day, and
result in obvious clinical symptoms and sign
after a long period.
3. Latent attack
• indicates that after a pathogen invades the
body, it hides in a part of the body, after a
period of time or under the action of a certain
inducing factors, a disease occurs.
• ancient physicians believe that due to the little
impact of the invading pathogen and the vital
qi is deficient, the disease would not
immediately appear;
• the pathogen takes advantage of the deficient
vital qi to hide in the body and to cause
disease later.
4. Secondary attack
• A new disorder occurring based on the primary
disease is called secondary attack.
• Secondary disease must take primary disease as its
prerequisite.
• E.g. a prolonged indigestion with insufficiency of
the spleen and stomach of intestinal parasitosis
in children can produce malnutrition with
accumulation.
5. Relapse
• refers to attack once more or repeatedly
of the primary disease
• is a special type of attack and a reflection
of struggle between the vital and the
pathogen under a certain conditions.
5. Relapse
5.1 The characters of relapse:
• It is the representation of the basic
pathological changes and major
pathological features of the primary
disease
• Relapse of disease mostly is of severer
conditions than the original and the
more times of relapse, the more
complicated the condition
• Relapse of disease mostly has a
certain inducing factors.
5. Relapse
5.2 The factors of relapse
• Relapse due to improperdiet
• Relapse due to overstrain
• Relapse due to abuse of medicine
• Relapse by new affection
• Relapse by other factors ie environmental or
emotional disturbance
• Spontaneous relapse due to insufficient vital qi
and
• existence of the residual pathogen.
1. Superiority or Inferiority of the Vital or the
Pathogen
• Superiority of the vital with decline of
the pathogen
• Superiority of the pathogen with deficiency
of the vital
2. Imbalance of Yin-yang
• superiority of yin or yang
• inferiority of yin or yang
• involvement of yang by yin
deficiency
• involvement of yin by yang
deficiency
• exuberant yin blocks yang
• exuberant yang blocks yin
3. Disorders of Qi and Blood
• Qi deficiency
• Disturbance of qi dynamic
• Deficiency of blood
• Disorder of blood flow
• Blood stasis
• Acceleration of blood flow
• Bleeding
• Qi stagnancy with blood stasis
• Failure of qi to control blood
• Qi deficiency with blood stasis
• Deficiency of both qi and blood
• Qi exhaustion following blood
• Failure of qi-blood to nourish meridian
4. Disorders of Metabolism of Body Fluid
• Water retention with qi stagnancy
• Qi exhaustion following fluid
• Fluid exhaustion with blood dryness
• Fluid shortage with blood stasis
5. Five Endogenous Pathogens
5.1 Production of wind from liver yang
• Is a pathological state resulting from
failure of water to nourish wood with yin
deficiency and yang hyperactivity, which is
mostly caused by emotional injuries and
mental overstrain that consume yin of the
liver and kidney, and thus lead to
undersupply of nourishment for the
tendon and vessels.
5. Five Endogenous Pathogens
5.1 Production of wind from liver yang
• Its clinical manifestations are numbness of
the limbs, tremor, vertigo with a tendency
to fall down, or wry mouth with distorted
eyes, or in a severe case, sudden coma
and unconsciousness.
5.2 Production of cold internally
• It is a pathological state deficiency-cold is
produced internally or yin-cold spreads all
over the body, which is caused by decline of
yang-qi with hypofunction of warming and qi
transforming.
• The development of endogenous clod is
mostly associated with yang qi decline of the
spleen and kidney
• Deficiency of yang qi leads to internal
production of deficiency-cold
5.3 Internal generation of turbid-dampness
• It is a pathological state of internal generation
and accumulation of water, dampness, phlegm
and stagnant fluid, which is caused by
disturbance of distribution and excretion of
body fluid.
• The key of patho-mechanism of the
endogenous dampness lies in disorder of the
spleen in transformation and transportation
5.4 Generation of dryness from fluid
consumption
• The development of endogenous dryness is
mostly due to consumption of yin-fluid in a
prolonged illness, or shortage of yin-fluid
resulting from heavy sweating, serious
vomiting, or diarrhea, or massive loss of blood
and essence, consumption of fluid by
exuberant heat in the process of some
exogenous febrile diseases.
5.5 Generation of fire-heat internally
• It is caused by exuberance of yang, or
yin deficiency with yang hyperactivity,
or transformation of fire from
emotional disturbance.
1. Prevention before a disease occurs
a. Increasing Resistance against Disease
• Taking good care of body
• Cultivating mental health
• Having a proper diet
• Medicinal prevention