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The Three Causes of Disease (sān yīn 三因) External six exongenous factors/evils/excesses wind rapid onset convulsion/tremors wandering pain / itching dizziness upper body and exterior invasion (yang nature) aversion to wind leads other pathogens in to body season: spring cold aversion to cold / desire for warmth cold extremities cold and pain in lower abdomen (yin nature) stomach, uterus and L.I. easily invaded channels can also have cold invasions cold, thin, clear excretions tendency to develop qi stagnation pains contracture / tautness of limbs season: winter summerheat summerheat-heat sunstroke high fever thirst irritated absence of sweating after exhausting fluids surging pulse rise and disperse summerheat-damp fluctuation fever fatigue limbs loss of appetite oppression in the chest nausea and vomitting abnormal urine reddish urine soggy pulse thick slimy fur season: summer dampness persistent / chronic clammy fatigue aching and lack of flexability spleen disfunction poor apetite indigestion oppression in the chest nausea sloppy stool and short voidings thick slimy fur and soggy moderate puse swelling and other damp accumulations and obstructions stools with mucus, turbid urine, oozing soars, eczema season: late summer yin nature that obstructs and impairs yang qi dryness dry nostrils / nosebleeds, invasion of longue dry mouth cracked lips tickle dry sore throath dry cough rough skin and shriveled body hair reduced urine yang nature season: Autumn, warm dry and start of seasons, cold dry at end fire signs of heat high fever aversion to heat / desire for cool red eyes, face, tongue, sores and urine rapid pulse, yellow tongue coat thick, sticky or bloody excretions foul smelling acute diarrhea with burning sensations fluid damage hemorrhages or maculopapular eruptions, carbuncles shen disturbance yang nature principals Environment induces six factors can invade alone or together can transform in to each invade through skin, mouth, and/or nose evil/pestilence Qi secondary causes phlegm (Tan) thick turbid fluids from external or internal pathogens plus disfunction of lung, spleen, kidney, and San Jiao as a result disturbance of fluid metabolism + Qi stagnation clear fluids = Yin types concrete Tan Yin visible, palpabale and audible phlegm and fluid formless Tan Yin symptomatic phlegm retention dizziness, chest tightness, bi-polar psychosis subcutaneous nodules/scrofula greesy fur and slipper pulse Phlegm (Tan) lung cough w/ dyspnea and expectoration heart palpitation and chest oppression heart orifices misted coma and dementia middle jiao epigastric fullness, vomiting, nausea Jing Luo numbness of limbs, problems flexing, hemiplegia Fluid (Yin) intestines noise hypochondrium pain with caugh and spitting limbs pain, edema chest shortness of breath, insomnia, edema, cough with dyspnea stagnant/static blood inernal causes Qi deficiency blood cold blood heat reduces volume by exhausting yin external causes injury or other cause of bruising that fails to disperse symptoms pain worse with pressure dark bleeding or bruises purple tongue or spots on tongue dry scaly skin wiry and uneven pulse, knotted pulse, or intermittent pulse Internal seven affects joy heart excessive Qi slows heart Qi (palpitations, insomnia, etc.) anger liver upward flow of liver Qi liver Qi stagnation - Sighing greef lung (+ spleen) worry/anxiety spleen stagnation of spleen-qi melancholy/sorrow lung consumes Qi fear kidney sinking of kidney-qi, blocks upper jiao terror/fright kidney/Qi and Heart-Spirit interrupts/scatters flow of qi six external excesses have internal parallels wind caused by liver external fire tends to promote liver wind Neutral dietary irregularities taxation fatigue damage tendons exhausts Qi sexual overstrain parasites injury over rest stagnation of Qi mental stress exhausts heart blood impairs spleen Qi

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