Chronic reoccurrence belongs to the category of “deficiency labor”, “blood evidence”, “blood deficiency” and “deficiency loss” in Chinese medicine. The etiology of chronic reoccurrence in Chinese medicine is based on the effects of six external perversions, seven internal injuries, uncontrolled diet, excessive fatigue and drug toxicity, which injure the yin and yang of the internal organs, especially the liver, spleen, kidney and bone marrow, because the liver is the source of blood collection, the spleen is the source of Qi and blood biochemistry and blood control, and the kidney is the source of essence and marrow production. If they are out of balance, it will lead to clinical signs of “deficiency of blood in deficiency of labor”.
[Etiology and pathogenesis]
I. Etiology
1. Primary causes
(1) Insufficient endowment. Congenital is born with, endowed with parents, due to the parents are old and frail and sickly, older children or maternal pregnancy failure to regulate, or poisonous evil internal invasion, damage to the fetus, resulting in congenital weakness of the child. The essence is not full, the internal organs are weak, the vitality is not vigorous, the body is not healthy, and the deficiency of labor; or the loss of nourishment after birth, the weak constitution, or all diseases are not treated, the disease is not nourished for a long time, or the accumulation of labor and internal injury, the shape and the spirit are too depleted, gradually to the loss of vital energy, essence and blood deficiency, the decline of the internal organs function, and the lack of biochemistry of Qi and blood.
(2) External attack by the six lewdnesses. All the six evil spirits can cause this disease, but the wind-heat and damp-heat are more. Wind-heat attack on the lungs, delayed failure to treat, drying up the lung fluid, mother’s disease and the son, kidney essence loss; or heat evil internal trapped in the Ying and blood, evil heat torment, blood depletion and injury to the essence, resulting in this disease. Dampness and heat, trapped in the spleen and stomach, transport and transformation failure, water and grain do not transform, essence and blood do not fill; liver and gallbladder damp heat, dampness, sticky, lingering and difficult to heal, easy to block the qi, damage yang; heat does not go, long will hurt yin, liver and kidney homologation, son disease and mother, liver and kidney deficiency, or liver and kidney yin deficiency, or kidney yang deficiency, leading to this disease.
(3) External sensation is mostly due to cold and heat. Cold is the main astringent and stagnant, external cold, stagnant blood vessels, blood stasis. Heat is a yang evil, heat decoction fluid, making the blood sticky, stagnation does not work. Or the blood does not follow the meridian due to the heat evil forcing the blood to move, and the blood leaving the meridian is called stasis of blood. Stasis of blood due to internal injury is complicated by sorrow and worry, which results in stagnation of blood due to the stagnation of qi and the inability of qi to move blood, or the inability of qi to push blood vessels to run, which results in stagnation of blood, as said in Su Wen – Jing Yin Bu Bu Lun, “Cowardice is a disease.” The blood does not return to the meridian because the Qi does not take in the blood, or because of Yin deficiency and fire, and the blood that leaves the meridian becomes stagnant blood. Stasis of blood does not go away, by the new blood is not born, and the cost of the disease.
(4) Excessive strain. Excessive thinking, poor diet, damage to the spleen and stomach; excessive room labor; childbirth is not disciplined, the injury to sperm and blood; spleen deficiency of Qi and blood biochemical lack of sources, kidney essence deficiency, no main bone marrow blood, the disease is made.
(5) internal invasion of poisonous evil.” Not win the poison”, but to “thick medicine”, such as the application of chloramphenicol, antipyretic and analgesic drugs, anti-cancer drugs, or long-term exposure to radioactive, chemically harmful substances such as benzene, poisonous evil internal exposure, visceral damage, depletion of essence and blood caused by this disease.
2.Secondary causes
Long-term illness, deficiency of vital energy, deficiency of Qi and blood, low function of internal organs, deficiency and loss, accumulated loss into labor.
Second, the pathogenesis
1.Onset
The causes of this disease are many, or due to lack of endowment, kidney deficiency, kidney bone, marrow, essence, essence and blood of the same origin, kidney deficiency, the kidney does not store essence, essence does not turn blood, blood does not produce, and the symptoms of deficiency labor; or acquired loss of nourishment, diet, excessive room labor, accumulation of internal injuries, physical and mental overconsumption, gradually to the loss of vital energy, essence and blood deficiency, the decline in the function of the viscera, Qi and blood biochemical deficiencies and Qi and blood deficiency; external infection of six sexes, injury to the viscera, viscera The internal organs and organs are injured, and the organs and organs become dysfunctional, or the biochemistry of qi and blood is lost, or qi and blood are depleted and blood is injured, resulting in deficiency of qi and blood, and the disease develops.
2.Position of the disease
The deficiency of qi and blood should be blamed on the spleen and kidney, the kidney is the origin of the first day, the spleen is the source of the second day; the kidney is the main reservoir of essence and marrow, the marrow is the sea of blood, the deficiency of kidney essence, the deficiency of kidney yang can not warm the five organs, because the heart deficiency can not master blood, the spleen deficiency can not unify blood, the liver deficiency can not collect blood, the lung deficiency outside the guard is not solid, so the deficiency is most closely related to the kidney. The spleen is the master of ascending and clearing the turbidity, the water and grain essence through the spleen ascending and clearing up through the heart changes and red is called blood, the spleen is involved, ascending and clearing can not and develop for blood deficiency; liver and kidney homologous source, the son disease and mother, liver and kidney deficiency, or liver and kidney yin deficiency, or kidney yang deficiency, and cause the disease, so the disease mainly involves the kidney, and the liver and spleen.
3.Pathology
The onset of the disease is slow and insidious, and it is prolonged for a long time, mainly due to deficiency, or mixed with deficiency and actuality, and the deficiency of the original and the symptoms of actuality. Or kidney yang deficiency, no marrow to nourish the bones, can not warm the body, biochemical disorders, essence and blood biochemical power, can not transpire gasification, and become deficient labor; or kidney yin deficiency, true yin deficiency, hyper yang no control, burning fluid, blood biochemical lack of source and appear deficiency blood deficiency, yin deficiency internal heat and other manifestations; or yin and yang loss, qi, blood, yin and yang deficiency, resulting in qi stagnation, blood deficiency, blood stasis, phlegm and fire interaction for the disease, injury is more, so that the kidney more weak The course of the disease is generally slow, but there are also cases of deficiency in the function of the external guard, feeling external evil, sudden changes in the condition, appearing to warmth, phlegm and fire, poisonous evil and other signs of real manifestations.
4.The disease situation
The disease generally starts slowly, due to the lack of innate endowment, excessive strain, poor diet, external sensation of six perversions, drugs or chemical poison damage, resulting in damage to the spleen and kidney, the kidney is the origin of the congenital, the main bone, the collection of essence, the production of marrow, the spleen is the source of the latter, ascending clear and secretive, transporting water and grain essence, damage to the spleen and kidney, resulting in the kidney does not collect essence, the spleen does not transport, essence and blood can not be transformed, the development of the disease. If the kidney is deficient, the water does not contain wood, the liver and kidney have the same disease, and the liver and kidney are deficient in yin; the kidney is deficient in yin for a long time, the yin loss and yang, and the kidney is deficient in both yin and yang; the kidney is deficient in yang, and the disease lasts for a long time, the spleen loses its warmth, and the spleen is deficient in yang, resulting in the spleen and kidney are deficient in yang; in severe cases, the true yin and yang are depleted, and the yin and yang can become critical and life-threatening; or the original is deficient, and then the warm evil is felt, and the evil is filled with internal and external toxins, and the ying and the qi and blood have the same disease, and the stagnation of heat is internalized. The heat and stagnation may be transmitted to the heart, or to the bone marrow, resulting in the death of the organ.
5.Transformation of disease mechanism
If the disease is caused by congenital deficiency of endowment and strain, kidney deficiency is the main cause, or by feeling external evil, depleting the essence and blood, which injures the kidney over time, resulting in kidney yin deficiency, yin loss and yang, and the disease lasts for a long time, resulting in kidney yin and yang deficiency and loss of warmth of the spleen, which can manifest as spleen and kidney deficiency. The pathogenesis of this disease mainly lies in the interrelationship between spleen and kidney disorders, yin and yang strengths and weaknesses, and positive deficiency and evil realities; yin loss and yang, general kidney yin deficiency, water does not contain wood, which affects the liver, liver and kidney yin deficiency, and over time, kidney yang is damaged, and the spleen loses warmth, resulting in spleen and kidney yang deficiency; qi and blood deficiency for a long time, qi and blood stagnation, can stay stagnant for stasis, stasis of blood obstructs the qi, qi stagnation and blood stasis interaction for the disease; due to the weakness of the right qi, the external guard is not solid, and can easily feel the six evil spirits. Due to the weakness of the vital energy and the lack of solidity of the external guard, it is easy to feel the evil toxins of the six sexes, which can easily enter the body, penetrate into the blood and bone marrow, and deplete the qi and blood, resulting in the mixed manifestations of deficiency and reality. The disease is generally characterized by Yin deficiency, followed by Yin and Yang deficiency of the kidney, Yang deficiency of the kidney, and Yang deficiency of the spleen and kidney.