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On the Four Major Causes in Traditional Chinese Medicine

Epidemic Toxin
A highly contagious pathogenic factor characterized by sudden onset, severe illness, similar symptoms, and strong transmissibility. Transmission occurs via air and contact, entering through the mouth and nose. Regardless of age, strength, or health, anyone exposed becomes ill. Epidemics are linked to abnormal natural climates—such as prolonged drought, extreme heat, humid miasma—and poor environmental and dietary hygiene, as well as social system differences.
Seven Emotions
Refers to seven emotional states: joy, anger, worry, thought, grief, fear, and shock—spiritual factors contributing to disease. Different emotional changes affect internal organs differently. The *Su Wen: Theory of Yin-Yang Correspondence* states: "Anger harms the liver," "Joy harms the heart," "Thought harms the spleen," "Grief harms the lung," "Fear harms the kidney." Abnormal emotional changes damage internal organs primarily by disrupting organ qi movement, causing imbalances in qi ascent and descent and disorder in blood and qi function. Though seven emotions can affect all five organs, clinical observation shows they most commonly impact the heart, liver, and spleen.
Diet and Labor/Rest
Diet and labor/rest are essential for human survival and health. However, moderation in diet and balanced labor/rest are necessary; otherwise, resistance decreases or organ function is impaired, leading to disease. Diet-related illnesses mainly stem from three areas: dietary irregularity, unclean food, and dietary bias. Since the spleen governs the transport and transformation of food essence, and the stomach receives and digests food, dietary damage first affects the spleen and stomach, then spreads to other organs or leads to secondary conditions.
Excessive physical labor depletes qi; excessive mental labor damages yin and blood; excessive sexual activity harms kidney essence. Conversely, excessive idleness, complete lack of work or physical exercise, can lead to poor blood and qi circulation, sluggish spleen function, and weakened resistance, predisposing to other diseases.
Phlegm and Blood Stasis
Both are pathological products resulting from organ dysfunction and can directly or indirectly affect certain organs and tissues, thus acting as causative factors.
1. Phlegm and Fluids: Both phlegm and fluids are pathological products arising from local disturbances in water metabolism. They are divided into tangible and intangible types. Tangible phlegm and fluids refer to visible, audible phlegm or fluids—thick and sticky is called phlegm; thin and clear is called fluid. Intangible phlegm and fluids refer to symptoms such as dizziness, nausea, vomiting, unconsciousness, without visible expectoration or tangible phlegm/fluid.
(1) Formation of Phlegm and Fluids: Resulting from impaired qi transformation in the lung, spleen, and kidney, or disrupted function of the triple energizer’s water passages, leading to impaired distribution and excretion of body fluids, causing fluid retention.
(2) Clinical Manifestations and Characteristics: Symptoms vary depending on the location of phlegm and fluids. For example, phlegm in the lung causes coughing, wheezing, and phlegm expectoration; phlegm obscuring the heart causes chest tightness, palpitations, mental confusion, mania; phlegm in the stomach causes nausea, vomiting, epigastric fullness; phlegm in meridians and bones causes goiter, nodules, numbness in limbs; phlegm blocking the throat causes a sensation of obstruction; phlegm and fluids rising to the head cause dizziness and fainting; fluid overflowing onto the skin causes edema; fluid in the thorax and flanks causes chest and flank distension, pain radiating to the chest with coughing; fluid in the diaphragm causes coughing and dyspnea preventing lying flat; fluid in the intestines causes intestinal rumbling, abdominal distension, and poor appetite.
2. Blood Stasis: Any condition where blood flow is impaired or blood that has left vessels fails to dissipate promptly can form blood stasis.
(1) Formation of Blood Stasis: Primarily due to qi deficiency, qi stagnation, or cold-blood conditions causing blood to stagnate and thicken, or due to trauma or other causes leading to internal bleeding that fails to dissipate or be expelled promptly.
(2) Characteristics of Blood Stasis Symptoms: Blood stasis symptoms are diverse, varying by location, but share common features: stabbing pain, cyanosis, masses, bleeding, rough skin, and fine, choppy pulse.

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