Chapter 8 Pathomechanism Pathomechanism refers to the mechanism of the onset, development and transformation of a disease, also called pathology. The study of pathomechanism is a theory investigating on the mechanism and law of the onset, development and transformation of a disease, which are of great significance for the diagnosis, prevention and treatment of the disease. The main contents of pathomechanism in Chinese medicine include the mechanism of disease attack (pathogenesis, see chapter 7), the mechanism of pathological changes (focusing on the basic pathomechanism, the mechanism of the five pathogens produced by five zang-organs, and 2ang-fu organs’ pathomechanism, which is omitted in this chapter) and the mechanism of the progress and transmission of disease. Plain Questions: Discussion on the Most Important and Abstruse Theary (Six Wen: Zhi Zhen Yao Da Lin, RA-BABAIC): “Analyze pathogenesis with no violation of the natural lav. cautiously grasp pathogenesis by recognizing what each syraptom or sign is attributed to." Section 1 Basic Pathomech- anism The basic pathomechanism indicates the basic pathological reactions to invasion of the 286 pathogens, being general rules of the pathological changes and the basis for the pathomechanism of various diseases and syndromes. It mainly includes the following aspects: Superiority or inferiority of the Vital or the Evil It implies the rise and fall of the vital and the evil in the conflictive struggle of resistance and invasion. The result of the struggle influences both the attack and the development of the disease. In the course of a disease, the superiority or inferiority of the vital or the evil contributes to the changes of excess and deficiency of syndromes and the prognosis of the disease @ The Relation between Superiority or Inferiority of either the Vital or the Evil and Change of either Deficiency or Excess (Fig. 8-1a, Fig. 8-1b) (1) Pathomechanism of excess and deficiency Excess and deficiency are a pair of opposite concepts in pathomechanism. a. The pathomechanism of excess Excess refers to the excess of evil qi, which is a pathological status with excess evil as the principal aspect of the contradiction. Right after the attack of the evil, the right qi is still not declined and can fight against the evil: the sharp conflict between them produces a series of