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The disease is caused by emotional distress, improper sexual activity, dietary habits, and overexertion, leading to internal damage factors such as static blood, phlegm-fluid retention, etc., which directly harm the qi and blood, resulting in illness of the zang-fu organs. Therefore, its fundamental transmission and change forms include the transmission and change of qi and blood, and transmission among zang-fu organs. The process of transmission and change is often slow and accumulative. The details are described as follows:

1. The transmission and change of qi and blood generally start with qi in the early stages of the disease, damaging and depleting qi. In prolonged illness, it enters the collaterals and blood, damaging and depleting blood. In terms of qi, it may manifest as disorders in qi movement, either excess or deficiency, leading to qi stagnation, qi counterflow, or qi deficiency, qi sinking, and even forming masses, lumps, or hernias. In terms of blood, it may manifest as obstruction and injury of blood collaterals, or depletion and deficiency of nutrient-blood, leading to blood stasis, blood knots, or blood deficiency, blood loss, and even static blood retention, coagulation and stasis in the collaterals, forming masses or tumors. Diseases related to qi are superficial, while those related to blood are deeper. Qi disease does not necessarily involve blood disease, but blood disease always involves qi disease. Generally, it progresses from qi to blood, but there are cases where both qi and blood are affected simultaneously. Disorders in qi are mostly related to the disturbance of qi movement, while disorders in blood involve substantial damage. This is the general outline, and more details can be found in the chapter "Mechanism of Disease in Qi and Blood" in this book.
2. Transmission among zang-fu organs involves the five zang-organs and the zang-fu organs, which are physiologically interconnected and mutually supportive, and pathologically influence and transmit to each other, such as liver Bingchuan affecting the spleen, lung disease affecting the kidney, etc., often culminating in the disease moving from the fu organs to the zang organs and "ultimately affecting the kidney." The forms of transmission and change include "mutual transfer" and "generation and restriction."

The so-called "mutual transfer" refers to the transmission and change form where pathological changes in zang-fu organs transfer to each other, including the transfer of zang evils to zang organs and fu evils to fu organs. Suwen-Qijue Lun has extensively discussed the transfer of cold from the kidney to the liver, spleen to liver, liver to heart, heart to lung, lung to kidney, spleen to liver, liver to heart, heart to lung, lung to kidney, kidney to spleen, as well as the transfer of heat from the uterus to the bladder, bladder to small intestine, small intestine to large intestine, large intestine to stomach, stomach to gallbladder, gallbladder to brain, etc., among the five zang and six fu-organs. Clinically common conditions such as heart heat transferring to the small intestine and liver heat transferring to the gallbladder also belong to this form of transmission and change. Its characteristic is that it does not entirely follow the generation and restriction relationships among zang-fu organs.

As for "generation and restriction" transmission and change, it refers to the rules and forms of pathological changes in zang-fu organs transmitting according to their Five Phases attributes and generation and restriction relationships, which is also the main mode of transmission among zang-fu organs. The so-called "generation" refers to the mutual promotion in physiology and mutual compensation and benefit in pathology among zang-fu organs; the so-called "restriction" refers to the mutual restraint in physiology and mutual harm and aggravation in pathology among zang-fu organs. Pathological generation and restriction are essentially reflections of physiological generation and restriction in the disease process. Therefore, zang-fu organs that have generation and restriction relationships in physiology will have and produce generation and restriction transmission and change relationships in pathology. Suwen-Yuji Zhencang Lun states: "The five zang-organs are interconnected, and their transmission follows a certain order. When the five zang-organs are diseased, they each transmit to their element being restricted... Transmitting through the five zang-organs leads to death, following the order of sequential transmission of the element being restricted," referring to this form of transmission and change. In summary, this transmission and change involves two basic modes: one is where the pathological changes mainly follow the "restriction" relationship, transmitting from one zang-fu organ to another, often resulting in worsening or deterioration of the condition; the other is where the pathological changes follow the "generation" relationship, receiving mutual support and benefit among the generating zang-fu organs, thereby limiting the pathological changes and alleviating the condition. The former is "transmitting to the element being restricted," while the latter is "transmitting to the child" and "transmitting to the mother," collectively known as "mother-child transmission," which is the principle and mechanism described in Suwen-Yuji Zhencang Lun as "the five zang-organs receive qi from what they generate, transmit to what they restrict, contain qi from what they generate, and die from what they do not restrict."

In summary, in the form of transmission among zang-fu organs, the inherent generating and restricting relationships between the initially affected zang-fu organs and the subsequently affected zang-fu organs have a crucial impact on the evolution and outcome of diseases. As stated in Suwen-Cangqi Fashi Lun, "When pathogenic qi from heaven invades the body, it follows the principle of overcoming and adding, reaching the organs it generates and healing, reaching the element that is unrestricted and worsening, reaching the organs it generates and maintaining, and returning to its own position and rising." This also illustrates this relationship and pattern from another perspective. For more details, see the chapter on zang-fu organs mechanism of disease in this book.