TCM- External Causes of Disease (Test 5)

Six Qi:

1. Wind
2. Cold
3. Summer-Heat
4. Dampness
5. Dryness
6. Fire

Climate as a Cause of Disease:
The weather becomes a cause of disease only when the equilibrium between the body and the environment breaks down, either because the weather is excessive or unseasonable (for instance too cold in summertime or too hot in wintertime), or because the body is weak in relation to the climatic factor.

Each of the 6 climatic factors is associated with a certain season during which it is more prevalent and a relationship to a particular Yin Organ:

Climatic Factor	Season	Organ
Wind	Spring	Liver
Cold	Winter	Kidney
Summer-Heat	Summer	Heart
Dampness	Late Summer	Spleen
Dryness	Autumn	Lungs
Fire	Summer	Heart

Wind versus Bacteria and Viruses:

• Western medicine sees infectious disease as being caused by bacteria and viruses
• Chinese medicine sees them as being causes by exterior climatic factors

Climatic Factors as Patterns of Disharmony:

• Climatic factors denote patterns of disharmony and etiological factors.

Artificial Climates as Causes of Disease:

• Air-conditioning
• Refrigerated storerooms
• Hot Kitchens
• Steel Plants

Pathology and Clinical Manifestations of Exterior Pathogenic Factors:
Each of the climatic factors causes certain clinical manifestations that are typical of that particular climate. As a practitioner of Chinese medicine you will be able to infer the cause of the disease from the particular manifestations:

• Exterior Wind causes symptoms and signs to arise suddenly and change rapidly
• Cold contracts and causes pain and watery discharges
• Dampness invades the body gradually and causes turbid, sticky discharges
• Dryness dries the Body Fluids
• Heat and Fire give rise to sensations of heat, thirst and mental restlessness

Pathology and Clinical Manifestations

• Exterior pathogenic factors enter the body via the skin or via the nose and mouth
• Exterior pathogenic factors invade the space between skin and muscles first
• If no expelled, an exterior pathogenic factor may penetrate into the Interior and cause an interior pattern

Symptoms and Signs of Exterior Pathogenic Factors Patterns:
The following is a brief description of the clinical manifestations arising from the invasion of each of the exterior pathogenic factors
Wind:

• Invading the space between the skin and muscles and the Lung's Defensive Qi portion:
• Aversion to cold
• Fever
• Sore throat
• Sneezing
• Runny nose
• Occipital stiffness
• Floating pulse
• Invading the muscles and channels
• Stiffness
• Rigidity
• Contraction of the muscles with sudden onset
• Invading the joints:
• Pain that moves from joint to joint, especially in the upper portion of the body (Wind painful Obstruction Syndrome)

Cold:
Cold contracts and causes pain and watery discharges

• Invading the muscles and sinews:
• Stiffness
• Contraction of muscles
• Pain
• Chilliness
• Invading the Joints:
• Severe pain in a joint (Cold Painful Obstruction Syndrome)
• Invading the Stomach, Intestines, or Uterus
• Sudden epigastric pain with vomiting
• Sudden abdominal pain with diarrhea
• Acute dysmenorrhea

Summer-Heat
Heat and Fire give rise to sensations of heat, thirst and mental restlessness

• Aversion to heat
• Fever
• Sweating
• Headache
• Dark urine
• Thirst
• Floating-Rapid Pulse

Dampness:
Dampness invades the body gradually and causes turbid, sticky discharges

• Invading muscles and sinews:
• A feeling of heaviness of the limbs
• Dull ache of the muscles
• Invading the joints:
• pain
• heaviness and swelling of the joints
• Especially of the lower part of the body (Damp painful Obstructive Syndrome)
• Acute urinary discomfort
• Acute vaginal discharge
• Acute skin diseases with vesicles or papules
• Acute digestive upsets

Aversion to Cold and Fever:
When the symptom of aversion to cold occurs simultaneously with the objective sign of the body feeling hot (or having an actual fever), this indicates an acute invasion of external Wind and it denotes that the pathogenic factor is still on the Exterior.

Four degrees of aversion to cold:

• Aversion to Wind:
• The patient has goose pimples, dislikes going out in the wind and wants to stay indoors
• Fear of Cold:
• Patient feels quite cold, wants to be indoors and near sources of heat and wants to cover up
• Aversion to Cold:
• Patient feels very cold, wants to stay indoors and cover up in bed; this, however, does not relieve the cold feeling
• Shivers
• Patient feels extremely cold shivers and wants to cover up under several blankets in bed; this however, does not relieve the cold feeling.