In addition to the six pathogenic factors, there is another category known as pestilential factors which is the source of epidemic disease. Its nature is similar to pathogenic heat and summer heat, but more pernicious and more fierce in pathogenicity; it is usually accompanied by pathogenic damp. Pestilential diseases are epidemical and dangerous, with rapid drastic changes as seen in small pox, plague, cholera, and most acute contagious diseases.
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