The Six Evils are also known as the Pernicious Influences. The evils are external in origin, but can penetrate deeply into the body. They are: Wind – Cold – Damp – Heat – Summer Heat – Dryness

Wind

(Associated with Liver, Wood, Spring, Yang evil)

Wind is involved with movement and activity, and brings other evil Qi in with it. It is the most important evil as it is the cause of the “100 diseases”.

Wind Disperses Qi upward and outward: Yang energy wants to rise and expand, so illnesses will manifest in upper and outer parts of the body in early stages, such as the head, sense organs and skin. Rashes are common, and itchy. They come and go quickly and spread quickly. Sweating is common, as wind causes opening of the pores, causing loss of Qi and fluids. This is most common in spring.

Rapid onset and rapid changes: Symptoms include acute illnesses with rapid progression such as fever, infectious diseases

Creates abnormal or sudden movement: Wind causes spasms, convulsions and twitches

Creates abnormal positions: Stroke or stiffness, such as a stiff neck with influenza symptoms

Wind Syndromes – External Wind

1.) Wind-Cold – Chills rather than fever, aversion to cold, occipital headache, stiff neck, runny nose, sneezing, any mucus will be clear and copious, body aches that move around. Slightly pale tongue with a thin white coat.

Type – Excess Type External Wind: Little to no sweat, Wei Qi is strong so the pores are held closed, a warm relieving surface treatment, such as Gua Sha, is used to induce the sweating out of evil and excess Wind and Cold. The pulse will be floating (superficial) and slow.

Type – Xu Type External Wind: Wei Qi is weak so there is sweating but it does not release the exterior. The aim with this type is to harmonize Ying and Wei Qi. Ying Qi will nourish Wei Qi to gently strengthen it, without tonifying the Evil Qi. The pulse will be floating, slow and deficient.

2.) Wind-Heat – There is fever more than chills, possible sore throat, a cough with thick yellow mucus, a thirst for cold drinks, a frontal (Yang Ming) headache; can be stronger, and pounding. There may be a redness or inflammation of the eyes, sinusitis or ear ache, with a red face. The tongue may be slightly red in early stage, yellow coat, thorns on lung area, and the pulse will be floating and rapid.

3.) Wind-Damp – There will be a sensitivity to wind, with strong body aches, fever and chills, with fever more pronounced in the afternoon. The body and head will feel heavy, and there may a runny nose, congestion, stuffiness, sinusitis, with copius phlegm. There also could be a sinus headache, foggy headedness and difficulty thinking. The tongue may be greasy with a thick coat, and swollen. The pulse will be slippery.

4.) Wind-Damp Bi Pain – Symptoms look like arthritis, with nerve pain, and numbness that is worse with cold and damp weather. The tongue will be swollen with a thick coat and the pulse slippery. Treatment includes opening the channels and mildly relieving the surface.

5.) Wind-Water – This condition is characterized by a disruption of Jin-Ye, presenting with sudden edema—often acute in onset and frequently occurring in the face—typically caused by factors such as allergic reactions, rashes, or acute nephritis, and is treated by relieving the surface and eliminating water; the pulse is slippery, and the tongue appears swollen with a greasy coating.

6) Wind-Rash – This has an acute onset, with symptoms that move around the body, appearing and disappearing suddenly; it is accompanied by a floating, rapid pulse and a red tongue with a yellow coating.

Wind Syndromes – Internal Wind

Internal wind is associated with the Liver and causes disorders involving shaking and abnormal body positions; unlike the acute nature of external wind, it is typically chronic and often combines with phlegm, as seen in deviations where wind displaces and phlegm anchors the body in an abnormal position.

Symptoms of Internal Wind include spasms, abnormal muscle contractions, convulsions, Parkinson’s disease, post-stroke sequelae, seizures (epilepsy), shaking triggered by anger, and migraines (often described as Wind blowing in the head), typically accompanied by a wiry, usually rapid pulse, and a tongue that may appear shaking or deviated.

Causes of Liver Wind

Excess fire affecting the Liver: Fire can generate Wind when it enters the Blood level, often seen in conditions with high fever such as meningitis, and may be triggered by toxins, poisons, radiation, drugs, alcohol, or constitutional Liver Fire; this pattern presents with a rapid, wiry, excess pulse and a red tongue with a yellow coating that may appear shaking or stiff.

Liver Yin Xu, (Yang Kan) – Long-standing yin deficiency with heat, can be caused by long-term use of drugs or alcohol and may result in chronic Yin Deficiency fevers, characterized by a wiry, rapid, thin pulse and a red tongue with no coating that may appear shaking.

Liver Blood Deficiency: Blood Deficiency generates heat and fails to nourish the “General” (Liver). Symptoms such as numbness of the limbs often arise, accompanied by a thready or hollow pulse and a pale tongue with a white or yellow coating.

Liver wind mixing with Phlegm: Wind blows it into an abnormal position and phlegm makes it stick. It affects Liver (Wind) and Heart (Phlegm misting). There is rigidity especially of limbs, neck, tongue, and stiffness in tongue (May affect the Speech)

Neurological conditions: This pattern is associated with brain disorders such as Alzheimer’s disease, senility, stroke, and brain tumors.

Fire and Phlegm occurring together: This pattern, often seen in long-term alcohol and drug use, presents with more sweating than internal wind alone, rapidly changing emotions, and a red face, accompanied by a rapid, slippery, full pulse and a red tongue, particularly at the tip, which may be skewed to one side.

Cold

Cold, is associated with the Kidney, winter, the water element, and is considered a Yin evil, It therefore damages the Yang, impairing the body’s ability to maintain temperature, weakening and slowing life activities, and creating a pervasive feeling of cold, its symptoms are relieved by warmth; it causes Qi and Blood to contract and congeal, leading to stagnation, pain, and stiffness, particularly affecting the low back, knees, and joints, as well as the Stomach, Intestines, and Liver, and is characterized by thin, watery, pale, and cold discharges such as urine, stools, and blood.

Syndromes of Cold

Wind Cold – This is characterized by chills more than fever, an aversion to cold, occipital headache, stiff neck, clear copious phlegm, runny nose, sneezing, and mild body aches. Excess type has little to no sweating, Floating, tight, slow pulse, tongue is slightly pale with a thin white coat. Deficiency type has sweating, with a floating, slow, weak pulse, and the tongue is the same, slightly page with a thin white coat.

Cold attacking the Spleen and Stomach – This pattern resembles Spleen Qi Deficiency but is caused by external factors such as living in a damp environment or consuming cold foods; it presents with diarrhea, loose or watery stools, bloating, poor digestion, nausea, vomiting, and abdominal pain that worsens with cold, along with loss of appetite, fatigue, a slow pulse, and a pale tongue, and may also involve the accumulation of Phlegm and Dampness leading to dizziness.

Cold Evil damaging both Spleen and Kidney Yang – This can be acute, as seen in hypothermia, or chronic, as in long-term exposure to a cold climate damaging the Spleen and Kidneys; it includes symptoms from the previous syndrome, such as watery stools, undigested food in the stools, or bird-like stools, along with an aversion to cold, a pervasive cold sensation throughout the body, profuse urination or oedema, strong fatigue, a pale face, possibly green or purple lips, and dark discoloration under the eyes—especially if Kidney Yang is affected—with a slow, weak pulse and a pale tongue marked by a white coating and tooth marks.

Cold Contracting the Qi and Blood – Cold slows circulation, contracts, congeals, stagnates. There are 4 types of this: Type – Liver Qi Stagnation has symptoms possibly including abdominal bloating, depression and irritability, the pulse is wiry and the tongue is light purple. Type – Blood Stagnation is shown by constant stabbing, sharp, needle like pain, with a possible purple complexion and/or lips, with a choppy pulse and purple spots on the tongue, or purple tongue body. Type – Wind cold damp Bi pain appears like arthritis (most commonly osteoarthritis), with cold, stiff, contracted joints, sensitivity to cold, with nerve or muscle involvement. Symptoms improve with warmth, including saunas, warm baths, heat therapy or warm weather. Type – Cold Contracting the Liver Meridian involves pain along the Liver meridian, particularly on the inner legs and genital area, and may present with severe menstrual pain, endometriosis, hernia, muscular issues such as groin pulls, testicular problems, impaired sperm production, and potential infertility, all accompanied by signs of Liver Blood stagnation, a choppy pulse, and a pale, purple tongue.

Damp

This Yin Evil is associated with spleen, late summer and is of the Earth element. Dampness is heavy, tenacious, difficult to treat, and lasts a long time. It tends to move downwards in the body

Damp is characterized by sticky, greasy, oily, and foul-smelling qualities, often described as looking like dirty water or mud, with symptoms such as greasy hair and skin, acne with pus, oozing wounds, and mucous or discharge anywhere in the body. It includes bad body odour, halitosis, smelly perspiration, and foul-smelling diarrhea with mucous; when combined with heat, cloudy urine may also occur. Other signs include thick, malodorous vaginal discharge (as seen in STDs), copious nasal discharge, edema or swelling, swollen joints from arthritis, and fluid discharge from various areas, including conditions like candida, fungal infections, or yeast overgrowth. This Dampness pattern damages the Yang of the body, is aggravated in cold, damp weather, and creates stagnation by impeding the transformation function of the Spleen, supported by the Kidney, and ultimately leading to stagnation of fluids, which in turn obstructs the flow of Qi and Blood.

Syndromes of Damp

Wind-Damp is an acute condition, though it has the slowest onset among the wind-related patterns, and is often influenced by cold and damp weather. It may present as a respiratory infection with copious phlegm or resemble a gastrointestinal flu. Symptoms include strong, generalised body aches, a heavy sensation in the head and body, foggy thinking or a band-like headache, sneezing, and copious phlegm that may be runny or thick. Digestive symptoms can include nausea, vomiting, and diarrhoea—sometimes with mucous. There may also be an afternoon fever. The pulse is typically slippery and slow, and the tongue appears swollen with a thick, greasy coating.

Wind-Damp Bi pain is characterised by swelling of the joints, and odema, with a slippery pulse and a swollen tongue with a thick greasy coat.

Damp-Poison in Skin appears as discharges, including pus, carbuncles, boils, acne and oozing. It can occur as infection after a wound, warts, fungus or yeast infections.

Damp Heat is an Infection or inflammation that can affect many places, such as the Liver, Gallbladder, Urinary Bladder, Intestines, Sinuses, etc. In western diagnosis it can sometimes be identified as any disease that ends in “itis”, for instance Bronchitis, Hepatitis, Vaginitis, Prostatitis or Colitis. The pulse is slippery or rapid (check which quality is the more prominent), the tongue is red, thick or swollen, with a thick yellow coat. Again check which is the more prominent.

Internal dampness arising in the body generally comes from Spleen deficiency, with damp as the main factor and the deficiency the secondary factor. It often compromises immunity due to congestion of lymphatic system, autoimmune conditions in particular. If severe, it becomes Phlegm. A long term chronic situation is often due to damp, cold, raw foods. Symptoms may be associated with a wide variety of diseases: Chronic Fatigue, Fibromyalgia, Candida, Lymphoma, and include bloating, nausea, vomiting, diarrhoea and dizziness, with a low appetite and heaviness of the head and body.

Heat

Heat is associated with the Heart, summertime and the Fire element, it is a Yang Evil.

Heat damages Yin by drying fluids, leading easily to Yin Xu; it rises, often affecting the face, eyes, and nose with redness, (the redder, the hotter), can generate Wind when it affects the Liver, speeds up bodily processes causing agitation, restlessness, or even bleeding as Blood moves too fast to stay within the vessels, and frequently impacts the skin with red, itchy, painful rashes.

Syndromes of Heat

Wind-Heat presents with fever predominating over chills, sore throat, frontal headache (indicating Yang Ming channel involvement), pronounced thirst, sinus infection, red eyes or conjunctivitis, and a cough producing yellow, green, or brown phlegm, accompanied by a red tongue with raised dots (thorns) in the Lung area and a rapid, floating pulse, indicates a pattern of external Wind-Heat invasion.

Damp-Heat affects the Upper Jiao in the face and chest, the Middle Jiao in Spleen and Liver, and the Lower Jiao in the intestines, the bladder, the gentials and other organs in that area.

Excess-Fire is a strong heat, whether of external or internal origin, which penetrates deeply into the organs and presents with intense symptoms such as pronounced thirst, marked redness, restlessness, and loud, forceful manifestations like explosive cough or diarrhoea.

Syndromes of Fire

Lung Fire presents with a loud, forceful cough that may include blood, due to fire burning away the protective mucous membranes and causing capillary rupture, along with thick yellow, green, or brown mucus, and a red, painful rash.

Stomach Fire manifests as burning sensations such as ulcers or heartburn, and may affect the Stomach channel, leading to symptoms like toothache from infection, intense frontal headaches, or burning pain along the channel.

Heart Fire is characterised by intense anxiety, restlessness, insomnia, and in severe cases, manic behaviour.

Liver-Fire can result in, or from anger, and can cause shingles in the costal region, and burning pain in the genital area, or STDs.

Large Intestine Fire may present with dysentery, toothache along the channel (sometimes linked to Kidney Fire), and can arise from long-term alcohol or drug abuse, potentially leading to deeper complications such as bone infections or even meningitis, as the fire can penetrate to affect the Marrow.

Deficient Fire, a pattern of Yin deficiency with false Yang excess where Heat lies deep in the body at the Ying level, presents with smouldering heat especially at night, low-grade rashes, severe restlessness, slight bleeding, a scarlet tongue, and a thready, rapid pulse; treatment must both quell the fire and nourish Yin.

Summer Heat

Summer Heat is associated with the Heart, is a fire element, associated with the season of summer, and is a Yang Evil

Syndromes of Summer Heat

Summer Heat is an intense pathogenic factor that presents with high fever, restlessness, intense thirst with a strong desire to drink, and may rise to disturb the head, causing dizziness, blurred vision, and headache; it can also lead to constipation, scant yellow urine, profuse sweating, and in severe cases, coma or Yin collapse, with a dry, red tongue and a surging, flooding pulse.

Summer Heat with Dampness occurs when a person with a Damp constitution, or one who consumes Damp-producing foods like ice cream and cold drinks during summer, is exposed to Summer Heat; this leads to Damp turning into Phlegm, causing symptoms such as nausea, vomiting, loose stools or diarrhoea, poor appetite, fatigue, dizziness, a heavy head, foggy thinking, a suffocating or tight feeling in the chest, and reduced sweating compared to pure Summer Heat.

Dryness

Dryness, is associated with the Lung, Autumn, and the Metal element, is an exterior pathogenic factor (not caused by Yin deficiency or internal factors) that easily damages body fluids, leading to symptoms such as dry skin, hair, eyes, lips, throat (or a low-grade sore throat), dry stools, scant urine, and thirst; it also commonly affects the lungs, especially in dry climates or from smoking, causing a dry cough with thick, sticky, hard-to-expel phlegm.

Warm Dryness presents with symptoms such as fever, headache, thirst, dry mouth, dry nasal passages, and a dry cough with dry phlegm, accompanied by a red tongue with a thin or absent coat and a rapid pulse; treatment for acute cases involves addressing it as Wind-Heat, while chronic cases require Yin tonification.

Cool Dryness, often caused by exposure to air conditioning, presents with symptoms like thick, stagnant phlegm, sensitivity to cold, chills, mild fever, headache, dry cough, dry mouth, and dry nasal passages with stuffiness, along with a thin, white tongue and a tight, slow pulse; acute cases should be treated as Wind-Cold.