TCM: Pathogenic Factors & Disease Causes

• The six pathogenic factors combine with Eight Principles and Zang fu assessment to create a diagnosis.
• The best assessments include diagnosis, etiology, and progression.
• SP Qi deficiency from over-consumption of cold damp foods weakens the Spleen Yang, leading to Damp accumulation; progression into Yang deficiency injuring the Kidney Yang is likely if untreated.
• Pathogenic factors characterize signs and symptoms, revealing underlying disharmony patterns; some may be causative, others secondary, referred to as root and branch in TCM.

Causes of Disease

• Disease can be caused by external or internal factors
• External factors are pathogens that attack from the outside
• Internal factors stem from stress/emotions, damaging organ systems and impairing their function
• Organ impairment results from diet, toxins, medication, overwork, emotional factors, or external pathogens penetrating and damaging organ systems

Six Pathogenic Factors

• Wind, Cold, Heat, Dampness, Dryness, Summer Heat

Wind

• Characterized by conditions that arise and change rapidly such as skin reactions, allergies, acute infections, headaches, fevers
• Can be interior/exterior, caused by hot/cold, or deficiency/excess
• Indicated in conditions like itching, rashes, swelling, hives, and other skin reactions - often trapped between Interior and Exterior.
• Manifests as uncoordinated movements, tremors, tics, fasciculation
• Affects the joints, indicating joint pain (Bi syndromes)
• Internal Wind often begins in the Liver and its causes are Heat, Deficiency, and obstruction.
• In external patterns, considered the vehicle for acute invasions and first invades the Lungs

Wind Cold Entering the Lungs

• Characterized by a rapid onset of symptoms, aversion to cold/wind/heat, chills/fever, sneezing, cough with white phlegm, runny nose with white mucus, body stiffness and aches, floating pulses, and a thin white coat covering the whole tongue body

Wind Heat Entering the Lungs

• Characterized by a rapid onset of symptoms, aversion to cold/wind/heat, chills/fever, sneezing, cough with yellow phlegm, runny nose with yellow mucus, itchy and/or sore throat, swollen tonsils with red back of throat, floating and rapid pulses, and a thin yellow coat covering the whole tongue body
• External Wind characterizes acute colds and flus while Internal Wind is more serious, caused by Blood deficiency or Empty Heat
• Serious Internal Wind results from damage to multiple Zang fu organs like the Liver, Heart, Kidneys, and Lung.
• Conditions such as stroke and paralysis are considered internal wind

Cold

• Cold contracts and congeals, creating stasis or stagnation and affects Yang
• Results in sleepiness, slowness, severe localized pain improved by heat, a white tongue coating and clear body discharges
• Can cause a slow pulse, cravings for warmth, aversion to cold, pale complexion, lack of thirst, loose stool, and clear/profuse urine

Excess Cold (Full Cold)

• Involves an acute onset triggered by external factors
• Characterized by pale complexion, chills, cold limbs, cold abdomen, diarrhea, and copious urination
• Causes intense cramping or stabbing pain thats improved by warmth, made worse by cold, and worse with pressure
• Associated with a thick white tongue that may show blueness in body and a full, tight, slow pulse

Deficient Cold (Empty Cold)

• Chronic (and usually internal).
• Experiencing dull pain improved by warmth and made worse by cold, which is better with pressure
• Characterized by a thin white, pale tongue body that may show some blueness and a weak, deep, slow pulse

Heat

• Yang in nature that blazes upwards and dries - damages Blood and Yin
• May cause bleeding & exhibit a potential to generate Wind when severe while affecting the mind (Shen)
• Results in high fever, desires cold climate, aversion to heat, redness in the skin, face, eyes, and complexion
• Can include thirst, constipation or foul smelling diarrhea, foul smelling discharges, and scanty dark yellow urine

Heat Symptoms

• Restlessness, irritability, bleeding, rapid pulse & respiration, a yellow tongue coating and body discharges

• Excess Heat (Full Heat)*

  • Exhibits a constant feeling of heat, intense thirst, constant dry mouth, intense agitation

• Deficient Heat (Empty Heat)*

  • Feeling of heat in the afternoon or at night
  • Evening and night thirst with sipping
  • Night dry mouth
  • Mild restlessness and agitation

• The body is more red, with a full, rapid pulse, intense agitation, while the deficient body has papules and a thin yellow coat

Dampness

• Accumulation of Yin or Fluids characterized by heaviness and slowness
• Arises from Qi and Yang deficiency, lack of physical activity, damp living environments and ingestion of Damp substances like dairy, sugar, alcohol, and soy
• Is sticky and difficult to move and clear, representing an Excess or Stagnation

Symptoms of Dampness

• Characterized by edema, feelings of swelling, oozing lesions, and fungal infections in the skin, causing joint pain, stiffness, swollen joints, and heavy limbs in the meridians
• The abdomen exhibits bloating, distension, nausea, poor appetite, and loose stools
• The pelvis causes difficult or cloudy urination and a feeling of heaviness

Types of Dampness

• Cold-Damp: Feelings of cold, heaviness in the head and body, joint stiffness and pain, swelling and edema in the abdomen and lower body
• Damp-Heat: Painful or burning urination, foul smelling discharge, red and eruptive skin lesions, thirst with no desire to drink, hypochondriac pain
• Wind-Damp: Chills and fever, joint aches
• Water-Damp: Pitting edema, ascites, difficult urination
• Dampness is unmetabolized liquid that’s sticky and does occur when Fluid isn’t absorbed or transformed, escaping the vessels to infiltrate tissues and organs.
• Phlegm is a progression of Dampness forming when elements of Fluid come out of solution; is Dampness taken form.

Dryness

• Can be brought on by internal heat from drying, a lack of fluid intake, from dry/hot weather, and is a form of Yin deficiency with no heat signs
• Can be caused through cold congealing fluids as well; all symptoms exhibit are DRY

Summer Heat

• This factor usually refers to heat stroke

Stagnation and Stasis

• Stagnation and Stasis are outcomes from other pathogenic factors disturbing the vital substance, rather than independent pathogenic factors
• Stagnation occurs with absent proper flow but the Liver is involved if there’s stagnation/stasis.
• Stasis is stagnation taken form, objectively confirmed by diagnostics (ex Dampness/Phlegm)
• Characterized by distending pain that fluctuates while stasis is characterized by fixed and sharp pain.