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The "Three Causes" refer to internal causes, external causes, and non-internal/external causes. This theory originates from ancient times. Its meaning contains aspects that have not been fully expounded.

Internal causes arise primarily from the Seven Emotions (joy, anger, worry, thought, sadness, fear, fright), which become constrained within the body. They are further compounded by a diet rich in rich flavors and fatty foods (Gao Liang), which steam and damage the Zang-Fu organs. Additionally, excessive sexual activity leads to physical exhaustion and depletion of Yuan Qi (Original Qi). These factors primarily affect the Five Zang Organs, causing diseases to originate internally. Such conditions occur mostly among wealthy individuals and those who are obese, accounting for eight or nine out of ten cases. The clinical manifestations include sores that are hard, with deep and firm roots; irregular bowel movements and urination; reduced appetite; an appearance of softness on the exterior but hardness on the interior; flat depressions without pus; a pattern of excess at the exterior and deficiency at the interior; and difficulty in expelling toxins. Patients presenting these symptoms suffer from internal injury-type disorders, hence termed "internal causes."

External causes arise primarily from the Six Excesses (Wind, Cold, Summerheat, Dampness, Dryness, Fire). In individuals with weak constitutions, sleeping outdoors in summer and autumn, cooling off in the wind, or sitting/sleeping on damp ground allows Wind-Cold-Dampness pathogens to invade the meridians. Another scenario involves contracting pathogens after sexual intercourse, where Cold-Toxins penetrate deeply into the bone marrow due to deficiency, coagulating with Qi and Blood, resulting in particularly severe conditions. Alternatively, incomplete dispersion of externally contracted Wind-Cold may lead to swelling and pain. These factors primarily affect muscles, blood vessels, and sinews/bones. Diseases originating from external invasion occur mostly among those who fail to regulate their lifestyle, leading a precarious and laborious life, also accounting for eight or nine out of ten cases. Clinical manifestations often include alternating chills and fever, pain in bones and sinews, difficulty walking, flow of Damp-Phlegm and toxic pathogens, various paralysis syndromes caused by Wind, deviation of the mouth and eyes, hemiplegia, Wind-Dampness, Wind-Warmth, and epidemic toxic diseases. Patients presenting these symptoms suffer from exogenous diseases, hence termed "external causes."

There is also the category of non-internal/external causes. If there are no internal disturbances from the Seven Emotions and no external injuries from the Six Excesses, where do the diseases come from? These illnesses result from irregular eating and drinking, overwork, frequent mood swings, improper dietary temperature regulation, and reckless physical exertion. This leads to disharmony of the Zang-Fu organs, disruption of Ying-Qi and Wei-Qi (Nutritive and Defensive Qi), injury to the Spleen and Stomach, and stagnation of the meridians. Consequently, patients present with no characteristic signs of the Six Meridians (Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, Jueyin) externally, nor any obstruction of urination or defecation internally. These diseases typically arise between the fascia, muscle layers, and skin, such as Scrofula (Luoli), Phlegm Nodules (Tanzhu), Qi Distension (Qipi), and Goiter/Tumors (Yingliu). The treatment method does not require releasing the exterior (Biao) or purging the interior (Li); rather, it should focus on nourishing Qi and Blood, regulating the meridians, strengthening the Spleen and harmonizing the Middle Jiao, moving Phlegm, and resolving depression. This approach is considered the most appropriate. Thus, the principles of the Three Causes are thoroughly explained.