New Interpretation of the Five Organs Pathogenesis in the"Nineteen Pathogenesis Guidelines"

WANG Ranran; DENG Jiashuai; HE Juan

Abstract：The renowned"nineteen pathogenesis guidelines"constitutes the core theoretical framework of pathogenesis in traditional Chinese medicine(TCM),originating from the Plain Questions:Great Treatise on the Essentials of Supreme Truth.Its interpretation must be situated within the theoretical system of five movements and six Qi.The fundamental concepts of"wind,cold,summer-heat,dampness,dryness,and fire"originally refer to distinct Qi transformation states within Yunqi theory,representing pathogenic mechanisms rather than external pathogenic factors.Taking the hepatic pathogenesis"All wind-type manifestations with tremors and dizziness pertain to the liver"as an example:"All wind"denotes all Yunqi phenomena related to Jueyin Qi or wood movement;"pertain to"carries the meaning of"association"or"involvement",indicating secondary effects on the liver.Thus,the principle"Examine pathogenesis meticulously without neglecting Qi dynamics"implies that treatment for tremor-dominant disorders should primarily address the original Yunqi pathogenic mechanisms,supplemented with liver-regulating components.In clinical practice,when encountering wind-transformation manifestations(e.g.,muscle twitching,vertigo)caused by celestial-terrestrial interactions,Yunqi formulas such as Lingzhu decoction,Fuhe decoction,or Shengming decoction from Chen Wuze's Three-Yin Si Tian prescriptions can be employed as foundational therapies,augmented with liver-nourishing and sinew-relaxing herbs like Chaenomeles Fruit(Mu Gua),Spatholobus Stem(Ji Xue Teng),and Japanese Climbing Fern Stem(Shen Jin Cao),rather than being confined to conventional liver heat or liver deficiency patterns.Only by returning to the original theoretical essence can we achieve fundamental interpretation and proper clinical application of these doctrines.