What Are The Six Evils ?
The six climatic evils are:
※ Wind ※ Cold ※ Summer ※ Heat ※ Dampness ※ Dryness ※ Fire
They have the following pathogenic features:
The pathogenic features of the six TCM evils.
- They are related to the seasons or working environment
For example, generally there are wind diseases in spring, summer-heat diseases in summer, damp diseases in late summer and early autumn, dry diseases in autumn, and cold diseases in winter. In addition, people who live for a long time in a damp environment tend to be easily attacked by the damp evil, and those who work long in an environment of high temperature tend to be easily attacked by the dry-heat evil or fire evil.
- All evils can work alone or in combination of two more in attacking the body
Such syndromes like the common cold of wind-cold type, damp-heat diarrhoea, and wind-cold-damp blockage are examples of medical problems caused by a combination of evils.
- In the course of causing disease, any one of the six evils can influence the others and can also transform into another kind of evil under certain conditions.
For example, the cold evil that enters the body’s interior can be transformed into the heat evil, and the long-persisting summer-heat with dampness can be transformed into dryness evil.
- The six climatic evils enter the body and cause disease mostly through the spaces located between skin and muscle, or the openings like nose and mouth. For this reason they are also termed the “six exogenous or outside evils”.
The Six Evils do not affect every person in the same way. Indeed, exceptionally healthy persons are not adversely affected by any of them. An “evil-excess” will attack the body only when and where it is weak and only when the protective-qi is deficient somewhere along the surface of the body. One of the purposes of preventive medicine is to keep the body resistant to such outside attacks.
Diseases of the six evils are most likely to occur under abnormal weather conditions, when the body is prepared for the dominant season and suddenly faces an opposite force. Sudden cold spells in mid-summer, for example often causes epidemics of influenza. Similarly, people who travel or move from a cold, dry place to a warm, damp climate are more vulnerable to invasion by local meteorological excesses than natives of the region.
Plague was a major problem during ancient time; therefore TCM learnt about epidemic diseases earlier and pestilential evils are blamed for it. The pestilential evil is a kind of pathogenic factor with intense infectivity. Attacks of pestilential evils are usually related to unusual climates such as droughts, floods, extreme heat as well as pollution. Epidemics occur suddenly with severe symptoms and are highly contagious.
Belongs to the element wood and dominates in spring. It is considered the leading evil. In the spring, the body is unaccustomed to the warm temperatures and the pores dilate easily, making it easier for evil-wind excess to enter the body. Suwen (The Book of Plain Questions) says, ” The wind evil can hide in the skin. It causes cold symptoms and sweating when the subcutaneous tissue is loosened, it causes heat symptoms but no sweating when the subcutaneous (means beneath the skin) space is closed.” Symptoms of “wind-injury” are coughing, stuffy or runny nose, headache, dizziness, and sneezing. Wind often combines with heat, “wind-heat”, or cold “wind-cold” depending on the weather, and such winds induce symptoms of both excesses. There is also an “inner-wind” unrelated to weather, which originates in the heart, liver, or kidneys due to energy imbalances. Symptoms of “inner-wind injury” are fainting, weakness, nervous spasms, blurry vision, and stiffness in the muscles and joints.
Characteristics of the Wind Evil:
- The wind is the leading evil of all diseases.
- The wind evil possesses a penetrating ability.
- Wind is characterized by constant movement, moveable and changeable.
- Upward and outgoing dispersion is a yang pathogenic factor.
- Wind, especially pathogenic wind occurs in gusts and is characterized by rapid change, giving rise to abrupt onset, migrating pain and fluctuating symptoms. For example, flare-ups of rheumatic joint pain and skin rashes are associated with wind evils.
Cold is associated with the element water and dominates in winter. Belonging to water, cold is a “yin-evil” which usually injures the body’s yang qi. If cold enters the exterior surface of the body, it produces symptoms of fever, aversion to cold, headache and body pains. If it reaches the meridians, it produces muscle cramps and pains in the bones and joints. If it enters as far as the internal organs, cold-excess causes diarrhoea, vomiting abdominal pains, and intestinal noises. “Inner-cold”, again not related to weather, is usually caused by a deficiency of yang-energy, in the stomach and spleen, inducing the internal cold symptoms of nausea, diarrhoea, coldness in the limbs and a pallid complexion. Excessive consumption of cold foods (“cold” in the sense of energy, not temperature) can also induce inner-cold. Some examples of cold foods are green tea, eggplant, tomato, celery, and barley.
Characteristics of the Cold Evil:
- Being a yin-evil, cold tends to impair yang-qi.
- It is the nature of cold to congeal and stagnate.
- It is the nature of cold to contract and shrink.
Summer-heat belongs to the element of fire and is predominant during the summer season. Major symptoms of summer heat are excess body heat, profuse sweating, parched mouth and throat, constipation, and heart palpitations. When summer-heat combines with dampness, it produces abdominal pains, vomiting, and intestinal spasms.
Characteristics of the Summer Heat Evil:
- Summer-heat belongs to the yang evils; it is hot in nature.
- The summer-heat evil is characterized by ascension and dispersal; it can consume qi (vital energy) and impair body fluid.
- The summer-heat evil often mingles with pathogenic dampness.
Dampness is associated with the element earth and is most active in late summer. Ailments of excessive dampness can be induced by sudden exposure to fog or mists, immersion in water or exposure to rain, and living in excessively damp locations of climates. The symptoms – lethargy, aching joints, and heaviness in the chest – are characteristically heavy and sluggish in nature and tend to block the flow of energy throughout the body. “Inner-dampness” is caused by excess cold consumption of liquor, tea, cold melons, and sweet, greasy foods. These impede spleen functions and cause symptoms of abdominal swelling, vomiting, and diarrhoea.
Characteristics of the Damp Evil:
- The damp evil is related to heaviness and turbidness.
- The damp evil belongs to the yin evil, and it tends to disturb the functional activities of qi (vital energy) and injure the yang-qi.
- Dampness is characterized by stickiness and stagnation.
- Dampness tends to descend and attack the yin sites of the body.
Dryness belongs to the element Metal and dominates in autumn. Two types are distinguished “cold-dryness” and “hot-dryness”, depending on other conditions. Excessive dryness easily injures the lungs, causing symptoms of heavy coughing, blood in the sputum, dry nose and throat, and pains in the chest. Dryness evil is also harmful to the body’s fluid balance. “Inner-dryness” is caused by excessive loss of fluids due to too much sweating, vomiting, bleeding, and diarrhoea. Use of herbal medicines, which induce sweating, vomiting, or purging of the bowels, can also induce inner-dryness. Characteristic symptoms are dry, wrinkled, or withered skin, dry hair and scalp, dry mouth and cracked lips, dry stomach and hard, dry stools.
Characteristics of the Dry Evil:
- Dryness has a drying and puckering nature, and tends to impair the body.
- Dryness tends to impair the lungs.
When any of the five evils become too extreme, they often transform to become fire-evil. The symptoms are usually more intense forms of those associated with the original evil, plus symptoms of extreme heat. “Inner-fire” can also be caused by excessive emotional activity or by over-indulgence in food, drink, and sex. Violent anger, for example, often causes a sensation of heat rising from the upper abdomen, where liver-fire is raging. Too much strong food and drink causes fire to collect in the stomach; while deep grief or passion will often cause it to rise to the lungs.
Characteristics of the Fire Evil:
- Pathogenic fire-heat is one of the yang evils and it flames upwards in the body.
- Fire is likely to consume qi (vital energy) and impair the body fluid.
- Fire may produce wind and stir up the blood.
- Fire is likely to cause sores and ulcers.