Abstract：The endogenous "five pathogens" refers to the comprehensive pathological changes caused by abnormal physiological functions of the viscera and bowels，meridian and collateral，qi，blood，fluid，and humor. It is closely related to the pathogenesis and pathological changes of liver cancer. Therefore， explaining the Chinese medicine pathogenesis and treatment methods of liver cancer from the perspectives of internal wind，internal fire，internal cold， internal dryness，and internal dampness is of great significance. For liver cancer patients with impaired dispersing and draining function and internal stirring of liver wind，the treatment should focus on tranquilizing the liver，extinguishing wind，enriching yin and subduing yang. For those with internal blazing of stagnant fire and heat toxin accumulation，the treatment should focus on relieving depression， subduing fire， clearing heat， and resolving toxins. For those with internal cold and phlegm-stasis interlocking， the treatment should focus on warming the kidneys， benefiting yang， resolving phlegm，and dissipating stasis. For those with yin essence depletion and blood dryness with meridian stasis， the treatment should focus on nourishing yin， replenishing essence， moistening dryness， and resolving stasis. For those with spleen deficiency，debilitation of yang and internal accumulation of damp toxin，the treatment should focus on warming yang，strengthening the spleen，removing dampness，and expelling turbidity. In clinical practice，liver cancer may not be caused by a single pathogenesis. If it involves a combination of the "five pathogens ， " treatment should be based on the specific syndrome.