1
Q
Etiology
Overview of CM History
What are the 2 basic causes of disease causing factors?
A
- the study of the causes of disease
CM - 2 basic categories of disease causing factors: YIN and YANG
- later doctors developed ideas further: 3 categories
- Shamanism (spirits, ancestors); Spring and Autumn (ideas about existence of natural laws and therefore natural causes of disease)
2
Q
What are the 4 categories of disease causing factors?
A
- Internal
- External
- Non-Internal/External
- aka “miscellaneous causes of disease” - Pathologically-generated etiological factors
3
Q
External Factors
A
- pathogens that invade the body from outside (from the environment)
4
Q
What are the 6 Exterior Pathogenic Factors?
Liu Qi:
Six Qi
Six Climatic Factors
Liu Yin:
Six Exogenous Factors
Six Exterior Pathogenic Factors
Six Evils
A
- Wind
- Cold
- Damp
- Dryness
- Fire (Warmth, Heat)
- Summer-Heat
5
Q
The Six Qi become the Six Evils/EPFs when
A
- when they are excessive or unseasonal, or the climate changes suddenly
6
Q
- EPFs can only invade when the _______ is weak
(in relation to the strength of the EPF)
A
- Zheng Qi (True Qi)
“if the Zheng Qi is present (and in good form) in the interior, evil cannot invade”
“that which evil invades must be deficient of qi”
7
Q
All EPFs, when affecting the body, invade through the
A
- skin, nose, or mouth
8
Q
Invasion by the Liu Yin quote
A
"”When [external] evils invade the body, they first reside in the skin and body-hair. If not expelled, they enter and reside in the minute vessels (sun mai). It not expelled, they can enter and reside in the main channels (jing mai) and connect internally with the five viscera.”
9
Q
Diseases due to the Six EPFs is closely related to
A
- seasonal changes in the weather and to living environment
EX:
- Heat diseases often occur in the summer
- Cold diseases often occur in the winter
- Damp diseases often caused by prolonged exposure to dampness
10
Q
Each of the Six EPFs may affect the body singly or in combination?
A
BOTH
EX:
- Wind-Cold
- Wind-Damp-Cold
- Damp-Heat
11
Q
The Six EPFs may, during the process of disease and under certain circumstances, transform…
A
- into each other!
EX:
- Cold may transform into Heat
- Heat may transform into Dryness
12
Q
WIND
Predominant Qi of…
Wind may easily invade the body after…
A
- of SPRING
- after sweating or while sleeping
13
Q
What is the primary EPF in causing disease?
A
WIND
- Cold, Damp, Dryness and Heat depend on Wind to invade the body
“Wind is the leading causative factor of the hundred diseases”
14
Q
WIND
Yin or Yang?
A
YANG
- is characterized by upward and outward movement
- easily invades yang portions of the body (head, face, surface/exterior, back)
- tends to cause the pores to open (sweat comes out; aversion to wind)
15
Q
Wind blows in…
A
Wind blows in gusts and is characterized by rapid changes
- abrupt onset
- rapid changes
- migratory symptoms (migratory joint pain, urticaria)
16
Q
Wind is characterized by
A
constant movement
- causes symptoms such as:
- tremor, spasm, convulsions
- dizziness, vertigo
- paralysis, deviation of mouth and eyes (Bell’s Palsy, stroke, etc)
17
Q
COLD
Predominant Qi of?
A
WINTER
(may occur in other seasons but usually not as strongly)
- thin clothing, exposure to cold after sweating, being caught in the rain, wading in water in winter, wearing damp clothes in cold weather, etc. – all may give rise to invasion of pathogenic cold
18
Q
Cold: Yin or Yang?
A
YIN
- Cold is a yin EPF and consumes yang-qi
19
Q
Cold causes
A
contraction and stagnation
- impairs opening and closing of pores
- spasmodic contraction of tendons
- impaired circulation of qi and blood
- PAIN, restricted movement, aversion to cold, etc.
20
Q
DAMP
- Predomninant Qi of
A
LATE-SUMMER
- Damp disease often occurs in late summer but is also frequently caused by damp living conditions, wearing damp clothes, frequent exposure to water, prolonged periods of rain, etc.
21
Q
Damp is characterized by
A
heaviness and turbidity
- heavy body/head/joints, etc.
- turbid discharge (suppurative sores, weeping eczema, leukorrhea, turbid urine, sticky stool, stool with mucous)
22
Q
Damp is characterized by viscosity…
A
- “stickiness”, lingering and stagnation
- dampness is “sticky” and difficult to remove
- stagnates and causes further stagnation (Qi, Blood, food, stool, vessels, etc.)
- Sticky tongue coating, viscous stool that is difficult to pass
23
Q
Damp is a _____ pathogen
A
YIN pathogen, which impairs yang and obstructs qi circulation
- easily impairs Spleen-yang, but also yang anywhere in the body (Heart, vessels, etc.)
24
Q
Damp tends to (direction)?
A
- descend and easily resides in yin areas of the body
- tends to descend and accumulate in lower portion of the body
- has an affinity for (accumulates in) yin portions of the body
- but can also be found in upper and yang portions, too
25
DRYNESS
Predominant Qi of?
Cold, Warm??
AUTUMN
* Dryness can be cold OR warm (early-autumn tends to have warm-dry; late-autumn tends to have cold-dry)
26
Dryness is DRYING and consumes?
Body-Fluids
* dry-lips, nose, throat, skin, hair
* scant urine
* dry stool
27
Pathogenic dryness easily damages the?
**Lung**
* Lung is the delicate organ, likes to be moist and loathes dryness
* easily invades Lung via nose and mouth
28
HEAT (Fire, Warmth)
Predominant Qi of?
SUMMER
Degrees of Severity:
Fire: most severe
Heat: in middle
Warmth: less severe
\*All share same characteristics
29
Fire (Heat) is yin or yang?
What is it characterized by?
YANG
- characterized by burning and upward direction
* high fever, thirst, sweating, mouth and tongue ulcers, etc
* fire disturbing mind: restlessness, insomnia, mania, delirium, etc.
30
Fire often consumes?
- consumes/burns YIN/fluid
- forces yin fluid to surface of body and out as sweat
31
Fire stirs up ___ and disturbs \_\_\_\_
Fire stirs up **wind** and disturbs **blood**
* fire affects the Liver and deprives sinews and vessels of nourishment, stirring Liver-wind (high fever, convulsions, etc.)
* fire speeds up blood circulation; in severe cases blood may extravasate and/or blood and flesh may rot (rapid pulse; various types of bleeding; sores, carbuncles, furuncles, boils, ulcers, etc.)
32
SUMMER-HEAT
predominant Qi of
SUMMER
\*\*Only seen in its own season
Induced by:
* excessively high temperatures
* overexposure to sun
* working or staying too long in poorly ventilated spaces
33
Summer-Heat is characterized by
**extreme heat**, is a yang EPF which is transformed from fire
- high fever, restlessness, thirst, profuse sweating, surging pulse
34
Summer-Heat, which direction?
- upward direction, dispersion and consumption of body fluid
* often affects head and eyes
* may cause pores to stay open: sweating
* heat cooks fluids, sweating causes fluid loss
* Qi is dispersed and leaves body with sweat (often accompanied with Qi deficiency)
35
Summer heat frequently combines with?
dampness
* summer may be humid
* dizziness, heavy head, stuffy chest, nausea, poor appetite, etc.
36
INTERNAL FACTORS
Emotions -- 7 emotions
\*under normal conditions they are a normal, healthy response to environment
Become disease causing factors if--
- sudden and severe;
- chronic;
- body's ability to tolerate and self-regulate is impaired
\*\*emotions can cause illness and/or aggravate existing illness
37
What are the 7 emotions?
1. Joy
2. Anger
3. Worry (anxiety, distress)
4. Sorrow, grief, sadness
5. Pensiveness
6. Fear
7. Fright (shock)
38
Emotions drive from?
Emotions affect?
- Qi, Blood, and the organs
- Qi, Blood and the organs
39
All emotions first affect the
Emotions directly affect the
- Heart and *Shen*
- organs (all organs can be affected, mostly viscera)
40
CHART
Emotion Affect on Qi Organ Affected
Anger Slows, slackens Heart
Joy Ascends Liver
Worry Knots Lung
Sadness Depletes, dissolves Lung (Heart)
Pensiveness Knots Spleen
Fear Descends Kidney
Shock/Fright Scatters (deranges) Heart/Kidney
41
MISCELLANEOUS FACTORS (5)
1. Improper Diet
2. Overstrain, stress
3. Lack of physical exercise
4. Traumatic injury and insect or animal bites
5. Incorrect medical treatment
42
Improper Diet
A. Overeating and malnutrition
- "overeating damages the stomach and intestines"
B. Overindulgence in particular foods
- one type of food
- wrong types of foods
- cold or raw foods and drinks
- alcohol, sweet, greasy, rich
C. Intake of unclean food
- spoiled food
- parasites
43
Overstrain and Stress
A. Excessive physical labor (consumes Qi)
B. Excessive mental work (consumes Heart-Blood and damages Spleen Qi)
C. Excessive sexual activity (consumes and damages Kidney essence)
44
Lack of Physical Exercise
- causes impairment of Qi and Blood circulation and weakness of the body
\*\*Spleen governs the 4 limbs
- insufficient activity negatively affects Spleen transformation and transportation (causes deficiency of Qi and Blood)
"Long-term laying down damages Qi"
45
Tramatic injury and insect or animal bites
- traumatic injuries tend to cause blood stagnation (external pathogens can invade)
- insect or animal bites (may result in toxcosis)
46
Incorrect Medical Treatment
- obviously incorrect
- seemingly correct but not correct
- not perfect, but fairly close to correct
- also includes lack of treatment
47
Pathologically-Generated Etiological Factors
- pathological substances that are generated within the body through various pathogenic processes
A. Pathological water, dampness, phlegm, and rheum
B. Blood stasis
48
Pathological water, dampness, phlegm, and rheum
Varying levels
Yin or Yang?
- Generated when body's water-metabolism functions are impaired (normal fluids stagnate and become pathological fluids) -- become etiological factors
**Phlegm** (thickest); **Rheum** (thinner); **Water** (thinner than rheum); **Dampness** (pathological fluids that are dispersed in the tissues)
\*Dampness gathers and forms water-- water accumulates and forms rheum-- Rheum congeals and forms phlegm.
**YIN pathogens**, derived from fluids
49
Pathological water, dampness, phlegm and rheum
Formations
* EPFs
* Seven Emotions
* Improper Diet
* Overwork and Inactivity
* Impaired Organ Function
* Lung, Spleen, Kidney, Liver, TB, UB
50
Characteristics of water, dampness, phlegm, and rheum
CHARACTERISTICS
* **A.** Obstruct Qi-mechanism and impair circulation of Qi and Blood
* **B.** Cause a wide range of illness and pathologican dampness
* **C.** Resulting illnesses tend to be stubborn and "sticky", and disease-course tends to be long
* **D.** Easily disturb the *shen* (shen enters and exists the heart through an orifice, phlegm and pathogenic facots can obstruct the orifice
* **E.** Very often will be accompanied by slippery and greasy tongue coating
51
BLOOD STASIS
- Blood that has accumulated and stagnated and can no longer circulate normally
* no longer functioning as healthy blood
* includes:
* extravasated blood
* Blood stagnating in vessels and organs
\* can stop in vessels, leave vessels (dead Blood) -- turbid yin pathology
- A product of various pathogenic processes, blood stasis becomes an etiological factor in its own right
52
Blood Stasis
Production
* EPFs
* 7 emotions
* Improper Diet
* Overwork, Inactivity
* Trauma
* Dysfunction of Qi and Blood
* 1. Qi deficiency causing Blood-stasis
* 2. Qi-stasis causing Blood-stasis
* 3. Blood-cold causing Blood-stasis
* 4. Blood-heat causing Blood-stasis
53
Blood Stasis
CHARACTERISTICS
1. **PAIN** - fixed; sharp, stabbing; worse with palpation/pressure; worse at night
2. **MASSES** - fixed, immobile; purple, blue-green (if near surface of body)
3. **BLEEDING** - dark, purple blood; clots
4. **PURPLE COLOR** - complexion; nail beds; lips; etc.
5. **PURPLE, DARK TONGUE BODY** - often with "stasis macules"; often with purple, distended sublingual veins
Livingston Year 1
flashcards
Decks in class (11)
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