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Nineteen pathomechanisms

病机十九条 〔病機十九條〕bìng jī shí jiǔ tiáo

From Plain Questions (素问 sù wèn, zhì zhēn yào dà lùn, Chapter 74). Nineteen laws statements ascribing symptoms to evils, viscera, or body parts. Many of these are still considered highly valid today. Note that nine of the 19 are conditions ascribed to fire and heat, one to wind, one to dampness, and the rest to viscera and body parts.

The Nineteen Pathomechanisms

Wind and Cold

  • All fulminant rigidity is ascribed to wind 诸暴强直，皆属于风 zhū bào jiàng zhí, jiē shǔ yú fēng
  • All disease with watery humors that are clear, pure, and cold is ascribed to cold 诸病水液澄澈清冷, 皆属于寒 zhū bìng shuǐ yè chéng chè qīng lěng, jiē shǔ yú hán

Fire

  • All excessive agitation and mania is ascribed to fire 诸燥狂越，皆属于火 zhū zào kuáng yuè, jiē shǔ yú huǒ
  • All diseases with aching pain and swelling of the instep, and fright are ascribed to fire 诸病跗肿， 疼酸惊骇，皆属于火 zhū bìng fù zhǒng, téng suān jīng hài, jiē shǔ yú huǒ
  • All heat with visual distortion and tugging is ascribed to fire 诸热瞀瘛，皆属于火 zhū rè mào chì, jiē shǔ yú huǒ
  • All counterflow upsurging is ascribed to fire 诸逆冲上， 皆属于火 zhū nì chōng shàng, jiē shǔ yú huǒ
  • All clenching, shuddering, and chattering [of the jaws] with the seeming loss of the spirit's presence is ascribed to fire 诸禁鼓栗，如丧神守，皆属于火 zhū jìn gǔ lì, rú sāng shén shǒu, jiē shǔ yú huǒ

Heat

  • All diseases with [abdominal] sounds, where tapping makes a drum-like sound, are ascribed to heat 诸病有声，鼓之如鼓，皆属于热 zhū bìng yǒu shēng, gǔ zhī rú gǔ, jiē shǔ yú rè
  • All major abdominal distension is ascribed to heat 诸腹胀大，皆属于热 zhū fù zhàng dà, jiē shǔ yú rè
  • All sour retching and vomiting, and fulminant downpour with lower-body distress are ascribed to heat 诸呕吐酸，暴注下迫, 皆属于热 zhū ǒu tù suān, bào zhù xià pò, jiē shǔ yú rè
  • All cramp, arched-back rigidity, and turbid watery humors are ascribed to heat 诸转反戾，水液浑浊，皆属于热 zhū zhuǎn fǎn lì, shuǐ yè hún zhuó, jiē shǔ yú rè

Dampness

  • All tetany and stiffness of the neck is ascribed to dampness 诸痉项强，皆属于湿 zhū jìng xiàng jiàng, jiē shǔ yú shī

Upper and Lower Body

  • All wilting, panting, and retching are ascribed to the upper body 诸痿喘呕，皆属于上 zhū wěi chuǎn ǒu, jiē shǔ yú shàng
  • All reversal with constipation or diarrhea is ascribed to the lower body 诸厥固泄，皆属于下 zhū jué gù xiè, jiē shǔ yú xià

The Viscera

  • All painful and itching sores are ascribed to the heart 诸痛痒疮，皆属于心 zhū tòng yǎng chuāng, jiē shǔ yú xīn
  • All qì huffing and depression is ascribed to the lung 诸气膹郁，皆属于肺 zhū qì fèn yù, jiē shǔ yú fèi
  • All dampness with swelling and fullness is ascribed to the spleen 诸湿肿满，皆属于脾 zhū shī zhǒng mǎn, jiē shǔ yú pí
  • All wind with shaking and dizzy vision is ascribed to the liver 诸风掉眩，皆属于肝 zhū fēng diào xuàn, jiē shǔ yú gān
  • All cold with contraction and tension is ascribed to the kidney 诸寒收引，皆属于肾 zhū hán shōu yǐn, jiē shǔ yú shèn

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