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1、病因：破坏人体自身及其与外界环境之间的相对平衡而引发疾病的原因。Etiology is defined as various kinds of factors that cause disharmony of relative balance and lead to disease.病机：各种致病因素作用于人体，所引起的疾病发生、发展与变化的机理。pathogenesis is meant the mechanism of the occurrence,development and outcome of disease.东汉时东汉时期期 张张仲景指出：仲景指出：“千般灾千般灾难难，不越三条，
2、不越三条”。Zhang ZhongJing of the Eastern Han Dynasty pointed out:despite numerous diseases,they would not exceed three categories.宋代宋代 陈陈无无择择提出三因学提出三因学说说，即：外因、内因、不内外因。更具体的，即：外因、内因、不内外因。更具体的说说，六淫自外侵犯人体属于外因；七情直接六淫自外侵犯人体属于外因；七情直接伤伤及内及内脏脏属于内因；其它如属于内因；其它如饮饮食食不不节节、过劳过劳，外，外伤伤、虫害等属于不内外因。、虫害等属于不内外因。Up to the Son
3、g Dynasty,Chen Wuze put forward the theory.“The theory of the three categories of etiologic”.i.e.exogenous pathogenic factors,endogenous pathogenic factors and non-endo-exogenous pathogenic factors.To be more specific,six pathogenic factors invading the body from the outside pertain to exogenous pat
4、hogenic factors;the seven emotions directly involving the internal organs are attributed to endogenous pathogenic factors;other pathogenic factors,such as improper diet,overwork,traumatic injury,insect and animal bites,etc.,are said to be non-endo-exogenous pathogenic factors.第一节 病因 ETIOLOGY外感致病因素：外
5、感致病因素：外感致病因素：外感致病因素：六淫六淫六淫六淫、疠气疠气疠气疠气内伤致病因素：内伤致病因素：内伤致病因素：内伤致病因素：七情七情七情七情、饮食饮食饮食饮食、劳逸劳逸劳逸劳逸可致病的病理产物：可致病的病理产物：可致病的病理产物：可致病的病理产物：痰饮痰饮痰饮痰饮、瘀血瘀血瘀血瘀血、结石、结石、结石、结石其他致病因素：外伤、烧烫伤、冻伤、虫兽伤其他致病因素：外伤、烧烫伤、冻伤、虫兽伤其他致病因素：外伤、烧烫伤、冻伤、虫兽伤其他致病因素：外伤、烧烫伤、冻伤、虫兽伤六六 淫淫 SIX EXCESSES（six exogenous pathogens）风、寒、暑、湿、燥、火本来是自然界的六种不
6、同的气候，称为“六气”。Under normal conditions,they are six climatic factors.TCM calls them the six qi.正常情况下，“六气”不致病。They are not harmful to human beings but rather are the essential conditions of the growth of all living things in nature.Thus,the six qi will not cause diseases normally.六六 淫淫 SIX EXCESSES（six
7、exogenous pathogens）只有在非正常情况下，“六气”才致病。这时才称为“六淫”。“淫”，太过或不及，所以“六淫”又称为“六邪”。是一切外感病的主要致病因素。when the six qi become too excessive or deficient,or when the bodys resistance is too weak to adapt itself to the abnormal changes,the six qi will be changed into the pathogenic factors to attack the human body and
8、 cause diseases.The six exogenous factors are a general term for wind,cold,summer-heat,damp,dryness and fire.However,They,as such,are known as“SIX EXCESSES”or“six exogenous pathogens”(liu yin).六淫致病的共同特点The pathogenic features of the exogenous pathogens外感性：六淫邪气多从肌表、口鼻而入，故称外感病。exogenous pathogensinvad
9、e the human body via the body surface or from the mouth and nose or through both concurrently.This is known asaffection resulting from six exogenous pathogens.六淫致病的共同特点The pathogenic features of the six exogenous pathogens季节性：有明显的季节性。The six exogenous pathogens have close relationships with the seas
10、onal changes and living environment.For example,diseases caused by wind-pathogen mostly occur in spring;summer-heat diseases usually appear in summer;damp diseases often happen in later summer,dry diseases arise most often in autumn and cold diseases are often seen in winter.六淫致病的共同特点The pathogenic
11、features of the six exogenous pathogens 地区性：与生活地区和环境密切相关。people who live in damp circumstances are susceptible to damp diseases,while the people living under a high temperature are liable to contract fire or dryness diseases.六淫致病的共同特点The pathogenic features of the six exogenous pathogens 相兼性：可单独侵袭人体
12、致病，也可以合并导致疾病。The six exogenous pathogens may singly invade the body by a single pathogen and simultaneously invade the body by more than two pathogen.For example,common cold results frequently from pathogenic wind and cold。六淫致病的共同特点The pathogenic features of the six exogenous pathogens 转化性：六淫之间可以互相转
13、化。例如，体内寒邪可化热，暑湿可以化火化燥伤阴。The six exogenous pathogens may be transformed into each other.Example:pathogenic cold in the body may be transformed into heat and prolonged summer-heat dampness may bring about dryness and fire to impair yin.六淫的性质和致病特点风：风为阳邪，其性开泄；风善行而数变；风为百病之长。寒：寒为阴邪，易伤阳气；寒性凝滞；寒性收引暑：暑为阳邪，其性
14、炎热；属性升散，耗气伤津；暑多挟湿。湿：湿为阴邪，易阻碍气机，损伤阳气；湿性重浊；湿性粘滞；湿性下趋，易袭阴位。燥：燥性干涩，易伤津液；燥易伤肺。火（热）：火为阳邪，其性炎上；火（热）易伤津耗气；火（热）易生风动血；火（热）易致肿疡。六淫的性质和致病特点风：风为阳邪，其性开泄；风善行而数变；风为百病之长。Wind is a yang pathogen,and is characterized by dispersing.Wind is characterized by constant movement and rapid changeWind is the first and foremos
15、t factor in cause disease.六淫的性质和致病特点寒：寒为阴邪，易伤阳气；寒性凝滞；寒性收引Cold is a yin pathogen,and apt to damage yang-qi.Cold is characterized by stagnation,condensation and obstruction.Cold is characterized by contraction,traction,constriction.六淫的性质和致病特点暑：暑为阳邪，其性炎热；属性升散，耗气伤津；暑多挟湿 Summer-heat is a yang pathogen,ch
16、aracterized by burning heat.Summer-heat is characterized by rising and dispersion,and apt to consume qi and body fluid.Summer-heat often combines with dampness.六淫的性质和致病特点湿：湿为阴邪，易阻碍气机，损伤阳气；湿性重浊；湿性粘滞；湿性下趋，易袭阴位。Dampness is a yin pathogen,apt to damage yang-qi and block qi movement.Dampness in the natur
17、e is heavy,turbid and sticky.Dampness tends to descend and incidentally to invade the yin position.六淫的性质和致病特点燥：燥性干涩，易伤津液；燥易伤肺.Dryness is dry in nature,incidentally to consume fluid.Dryness is prone to impair the lung.六淫的性质和致病特点火（热）：火为阳邪，其性炎上；火（热）易伤津耗气；火（热）易生风动血；火（热）易致肿疡.Fire（heat）is a yang pathogen,
18、and in the nature of flaring upward.Fire（heat）easily injures fluid and consume qi.Fire（heat）tend to stir up wind and cause bleeding.Fire（heat）is likely to cause pyogenic infection.疠 气(epidemic qi)是一类具有强烈传染性的病邪，又称疫气、毒气、时气、杂气、异气、戾气、乖疠之气等。epidemic qi is an external pathogen which possesses intensive in
19、fectivity.致病特点：传染性强，易于流行；发病急骤，病情危重；一气一病，症状相似。Feature:1.strong contagiosity and being epidemic 影影影影响响响响疫疫疫疫疠疠疠疠发发发发生生生生与与与与流流流流行行行行的的的的因因因因素素素素：气气气气候候候候、环环环环境境境境、饮饮饮饮食食食食、预预预预防措施、社会等因素。防措施、社会等因素。防措施、社会等因素。防措施、社会等因素。疠 气(epidemic qi)2.发病急骤，病情危重；Rapid onset and being dangerous 3.一气一病，症状相似。One epidemic q
20、i causing one kind of disease影响疫疠发生与流行的因素：气候、环境、饮食、预防措施、社会等因素。七 情(seven emotions )即喜、怒、忧、思、悲、恐、惊七种情志变化，是机体的精神状态。是人体对客观事物和现象所作出的不同情志反映。正常情况下不会使人发病。The seven emotions refer to the human mental activities,including joy,anger,worry,thought,grief,fear and terror.They are the different responses to the en
21、vironmental stimuli in the human body in general circumstances,they belong to the normal physiological activities and will not cause diseases.七 情(seven emotions)只有突然、强烈或持久的情志刺激，超过了人体自身生理活动的调节范围于耐受能力，使人体气机逆乱，脏腑阴阳气血失调，才会导致疾病的发生。When sudden,strong,long or prolonged emotional stimuli go beyond the bodys
22、 adaptability and endurance,the emotional stimuli will become pathogenic factors,which cause dysfunction of qi,blood and the zang-fu organs and imbalance of yin and yang,hence leading to diseases.由于七情致病是直接影响有关内脏的阴阳气血而发病，病自内生，又称“内伤七情”。This is known as internal injury caused by the seven emotions“,or
23、seven emotions damager.七 情(seven emotions)七情与脏腑气血的关系：五志分属五脏；“血有余则怒，不足则恐”。Relations of the seven emotions to qi-blood and viscera七 情(seven emotions)七情致病特点：v直接伤及内脏：怒伤肝；喜伤心；悲伤肺；恐伤肾；思伤脾。vThe seven emotions directly affect the corresponding zang-fu organs to bring on diseases because a certain zang-fu or
24、gan is closely related to a certain emotional activity.Anger impairs the liver;excessive joy impairs the heart;grief or worry impairs the lung,thought impairs the spleen,and terror or fear impairs the kidney2626七 情(seven emotions)v影响脏腑气机：怒则气上；喜则气缓；悲（忧）则气消；恐则气下；惊则气乱；思则气结。The abnormal emotions mainly
25、influence qi activity of the internal organs,so as to cause the dysfunction in ascending and descending of qi.Anger causes the qi(to the liver)to ascend,joy makes the qi(of the heart)sluggish;grief makes the qi(of the lung)consumed;fear induces the qi(of the kidney)to dissipate;terror causes the dis
26、order of the qi(of the kidney);and thought brings about the depression of the qi(of the spleen)2727七 情(seven emotions)v影响病情变化Emotional upset may aggravate the patients condition or rapidly deteriorate it.2828饮 食improper dietimproper diet饮食不节：过饥、过饱、食无定时。饮食不节：过饥、过饱、食无定时。饮食不节：过饥、过饱、食无定时。饮食不节：过饥、过饱、食无定时
27、。Immoderate diet饮食不洁：导致胃肠炎、寄生虫病、中毒等。饮食不洁：导致胃肠炎、寄生虫病、中毒等。饮食不洁：导致胃肠炎、寄生虫病、中毒等。饮食不洁：导致胃肠炎、寄生虫病、中毒等。Insanitary diet饮食偏嗜：饮食无味偏嗜；饮食的寒热偏嗜。饮食偏嗜：饮食无味偏嗜；饮食的寒热偏嗜。饮食偏嗜：饮食无味偏嗜；饮食的寒热偏嗜。饮食偏嗜：饮食无味偏嗜；饮食的寒热偏嗜。Particular diet劳 逸过劳：劳力过度、劳神过度、过劳：劳力过度、劳神过度、房劳过度。房劳过度。过逸：过度安逸。过逸：过度安逸。maladjustment of work and leisure malad
28、justment of work and leisure病理产物pathogens from pathological products痰饮 phlegm retention瘀血 blood stasis结石 calculus3131痰 饮phlegm retention痰饮：痰和饮都是机体水液代谢障碍所形成的病理产物。稠浊者为痰，清稀者为饮。The pathological product of water metabolism disorder.phlegm is thick and turbid,stagnant fluid is thin and clear.。痰 饮phlegm re
29、tention痰饮的形成：多由外感六淫、或饮食、劳逸、七情内伤等使肺、脾、肾、三焦等脏腑气化功能失常，水液代谢障碍，以致水津停滞而成。Formation of phlegm retention:because of water metabolism disturbances due to dysfunctions of the lung,spleen,kidney and tri-jiao in qi transformation.。痰 饮phlegm retention致病特点：阻滞气机；影响水液代谢；易于蒙蔽神明；致病广泛，变化多端；“百病多由痰作祟”Feature:blocking ci
30、rculation of qi and blood Influencing the metabolism of water Being prone to disturb spirit Causing various and changeable disease。瘀 血blood stasis瘀血是指体内有血液停滞。包括离经之血积存体内；或血液运行不畅，阻滞于血脉、经络及脏腑内的血液，均称为瘀血。blood stasis refers to stagnated blood held within the body.It includes extravagated blood and sluggi
31、sh or stagnated blood.They are the pathological outcome in the progression of a disease.瘀 血blood stasis瘀血的形成：气虚、气滞、血寒、血热等原因，使血液运行不畅而凝滞；还有外伤、气虚统摄失职或邪热迫血妄行，使血离经脉，积存于体内而形成瘀血。Formation of blood stasis:Circulatory retardation caused by various factors including qi deficiency，qi stagnation，blood-cold and
32、blood-heat.Extravasated blood held in body caused by various traumas,a deficient qi to control blood,and wild flow of blood due to heat in it.瘀血致病特点 feature of blood stasis易于阻滞气机 Tending to block qi movement 影响血脉运行Influence the blood circulation 影响新血生成Influence the generation of fresh blood 病位固定，病证繁
33、多Fixed location of disease with varied patterns瘀血病证特点 clinical characteristic of the disease caused by blood stasisv疼痛(pain)：刺痛、痛处固定不移、拒按、多夜间疼痛加甚。v肿块(masses)：固定不移。v出血(hemorrhage)：多紫暗色，或夹有血块。v肌肤爪甲失荣(cyanosis)：面色黎黑或紫暗，肌肤甲错，口唇青紫，皮下紫斑、青筋暴露。v瘀血舌象(dark-purplish tongue proper)：舌色紫暗、或有瘀斑、瘀点，舌下脉络青紫、粗张、迂曲。v瘀血脉象(retarded or regularly/irregularly intermitent pulse)：细涩、沉弦或结代。