Causes of Illness - 6 Evils

The Six Evils or Six Pernicious

Influences in Chinese Medicine
The evils are external in origin, but can penetrate deeply into the body.

The Six Evils 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".

Disperses Qi upward and outward

Yang energy wants to rise and expand

Illnesses manifest in upper and outer parts of the body in early stage:
head, sense organs and skin
Rashes Common: itchy, come and go quickly, spread quickly
Sweating common: causes opening of pores (Qi and fluids lost)
Rapid onset and rapid changes

Acute illnesses with rapid progression such as fever, infectious diseases

Creates abnormal or sudden movement

spasms, convulsions, twitches

Creates abnormal positions

Stroke
Stiff neck with flu
Most common in spring

Wind Syndromes - External Wind

1.) Wind-Cold
 chills more than fever
aversion to cold
occipital headache
stiff neck
sneezing
mucous will be clear and copious
runny nose
body aches that move around
tongue: slightly pale, thin white coat
Excess Type External Wind

Little or no sweating
pulse: floating, slow, tight
Wei Qi is strong so pores are held closed
warm relieve surface treatment is used to sweat
out evil and excess Wind and Cold
Ma Huang Tang
Xu Type External Wind

Sweating
Pulse: floating, slow, Xu
Wei Qi is weak. There is sweating but it does not release the Exterior
Harmonize Ying and Wei Qi. Ying nourishes Wei to gently strengthen it,
without tonifying Evil Qi
Gui Zhi Tang
2.) Wind-Heat

fever more than chills

sore throat
cough with thick, yellow mucous
thirst for cold drinks
frontal headache; can be stronger, pounding (Yang Ming)
redness or inflammation of eyes
sinusitis
earache
red face
Pulse: Floating, rapid
Tongue: slightly red in early stage, yellow coat, thorns on lung area
3.) Wind-Damp

sensitivity to wind
fever and chills with fever more pronounced in the afternoon
strong body aches
body and head feel heavy
copious phlegm - runny nose, congestion, stuffiness, sinusitis
sinus headache
foggy headed, difficult thinking
Pulse: slippery
Tongue: swollen, likely to be a thick coat, could be greasy
4.) Wind-Damp Bi Pain
 Arthritis, nerve pain, and numbness that is worse with cold and damp
weather
Pulse: slippery
Tongue: swollen, thick coat
Treat by opening channels and mildly relieving surface
5.) Wind-Water

disruption of Jin-Ye
anything with sudden Edema
acute onset
frequently occurs in the face
Treat by relieving surface, eliminating water
causes include allergic reaction, rash, acute nephritis
Pulse: slippery
Tongue: swollen, greasy coat
6) Wind-Rash

acute onset
moves around to different parts of body
will appear and disappear
Pulse: floating, rapid
Tongue: red with yellow coat
Wind Syndromes - Internal Wind

Associated with the Liver, and causes diseases of shaking and abnormal
body positions.
It is usually chronic, where external wind is usually acute.
It combines easily with phlegm, as in Deviation (Wind blows it out of
position and the phlegm makes it stick in an abnormal position).
Symptoms of Internal Wind

spasms and abnormal muscle contractions

convulsions
Parkinson's
post-stroke sequelae
seizures(epilepsy)
shaking from anger
migraine (Wind blowing in head)
Pulse: wiry usually rapid
Tongue: shaking or deviated
Causes of Liver Wind

Excess fire affecting the Liver

Fire creates Wind

enters the Blood level
high fever (diseases such as meningitis)
poisons, toxins, radiation, drugs, alcohol
constitutional Liver Fire
Pulse: rapid, wiry, excess
 Tongue: red, yellow coat; shaking or stiff
Liver Yin Xu, Yang Kan - Long-standing Yin deficiency with Heat

long term use of drugs, alcohol

chronic Yin Xu fevers
Pulse: Wiry, rapid, thin
Tongue: red, no coat, shaking
Liver Blood Deficiency

1) Blood Xu makes Heat2) Blood not nourishing the "General"

Numbness of limbs common

Pulse: thready or hollow
Tongue: pale with white or yellow coat
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

brain disorders
Alzheimer's, senility
Stroke
brain tumors
Fire and Phlegm occurring together

more sweating than with internal wind alone

rapidly changing emotions
commonly occurs with long term alcohol and drug use
red face
Pulse: Rapid, slippery, full
Tongue: red, particularly at tip, may be skewed to one side
Cold
(Associated with Kidney, Winter, Water element, Yin evil)
Damages the Yang
Impairs ability to maintain body temp
Weakens and slows life activities
Feeling of cold
Symptoms better with warmth
causes Qi and Blood to contract and congeal which creates stagnation,
pain, stiffness
Easily effects the low back and knees, joints
Easily effects the Stomach, Intestines, Liver
Thin, watery, pale, cold discharges urine, stools, blood etc.
Syndromes of Cold
Wind Cold
chills more than fever
aversion to cold
occipital headache
stiff neck
clear copious phlegm
runny nose
sneezing
mild body aches Excess type
little or no sweating
Pulse: Floating, slow, tight
Tongue: slightly pale, thin white coat
Deficiency type

sweating
Pulse: Floating, slow, Xu
Tongue: slightly pale, thin white coat
Cold attacking the Spleen and Stomach

Looks like spleen Qi Xu but the cause is external (Examples are living by
the ocean or eating cold foods). Phlegm and Dampness can also collect
and cause dizziness.

diarrhea
loose stools
watery stools
bloating
poor digestion
nausea
vomiting
stomach or abdominal pain that is worse with cold
loss of appetite
fatigue
Pulse: slow
Tongue: pale
Cold evil damaging both spleen and Kidney Yang

Can be acute, as in hypothermia, or chronic, as in a cold climate

damaging spleen and kidneys.Symptoms as in previous syndrome with:

watery stools
undigested food in stools
bird stools
aversion to cold
feeling of cold in entire body
profuse urination or edema
strong fatigue
pale face
possibly green or purple lips
Purple or black under eyes if the Kidney Yang is damaged
 Pulse: slow, weak
Tongue: pale, white coat, tooth marks
Cold contracting the Qi and Blood

Cold slows circulation, contracts, congeals, stagnates

Liver Qi Stagnation

abdominal bloating
depression, irritability
Pulse: wiry
Tongue: light purple
Blood stagnation

pain that is sharp, stabbing, needle-like, constant

purple lips, complexion etc.
Pulse: choppy
Tongue: deep purple, possibly purple spots
Wind cold damp Bi pain

arthritis (more commonly Osteoarthritis) with cold, stiff, contracted

joints
sensitivity to cold is strongest symptom
can be nerve or muscle involvement
symptoms better with warm weather, heat therapy, saunas
Cold contracting the liver meridian

pain on inside of legs, genital area along liver meridian

severe menstrual pain
endometriosis
hernia
muscular problems i.e. groin pull
testicular problems
sperm production
may be infertility
will exhibit signs of liver blood stagnation
Pulse: choppy
Tongue: pale and purple
Damp
(Associated with spleen, late summer, Earth element, Yin evil)
Dampness is heavy, tenacious, difficult to treat, and lasts a long time. It
tends to move downwards in the body.

Sticky, greasy, oily, dirty, bad smell

"looks like water or mud, "looks and smells dirty

greasy hair and face
greasy skin: acne, pus, oozing wound
mucous or discharge anywhere in body
 bad body odor, bad breath, smelly perspiration
bad smelling diarrhea with mucous (if mixed with heat, there can be
cloudy urine)
thick or bad smelling vaginal discharge as in STD
copious nasal discharge
edema or swelling
arthritis with swollen joints
fluid coming out of anywhere
candida, fungus, yeast
Damages the Yang of body

worse in cold, damp weather

Spleen works to transform Damp; Kidney supports Spleen
Creates stagnation

Stagnate fluids will also stagnate Qi and Blood

Syndromes of Damp

Wind-DampAcute condition, but has the slowest onset of all winds. It is

affected by damp and cold weather. Symptoms can reflect a respiratory
infection with copious phlegm or a gastrointestinal flu.

strong generalized body aches

heavy feeling in head and body
foggy headed, unclear thinking, band headache
copious phlegm, can be runny or thick
sneezing
afternoon fever
nausea, vomiting
diarrhea, possibly with mucous
Pulse: slippery, slowing down pulse
Tongue: swollen with thick, greasy coat
Wind-Damp Bi pain

swelling of joints
edema
Pulse: slippery
Tongue: swollen with thick, greasy coat
Damp poison in skin

discharge: pus, carbuncles, boils, acne, oozing

infection after wound
warts, fungus, yeast
Damp heat

Infection or inflammation that can affect many places, such as the Liver,
Gallbladder, Urinary Bladder, Intestines, Sinuses, etc.

"itis" Diseases
 Bronchitis
Hepatitis
Vaginitis
Prostatitis
Colitis
Pulse: slippery, rapid (which quality is greater?)
Tongue: red, thick yellow coat, swollen (how thick, how swollen, how
red?)
Internal dampness arising in the body

Dampness arising from Spleen Xu: Dampness is the main factor, the Xu is
secondary. 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, Etc.

bloating
nausea
vomiting
diarrhea
heaviness of head and body
dizziness
low appetite
Heat
(Associated with the Heart, summertime, Fire element, Yang Evil)
Damages Yin

dries fluids, easily leads to Yin Xu

Heat rises

diseases most common on face, eyes, and nose

Causes redness

the more red, the more heat

Easily produces wind

when heat affects the Liver

Speeds things up

agitation, restlessness
can be bleeding: Blood moves so fast it leaves the vessels
Easily affects the skin

red, itchy, painful rashes

Syndromes of Heat
Wind-Heat

fever more than chills

sore throat
frontal headache (yang Ming channels)
big thirst
sinus infection
red eyes, conjunctivitis
cough with yellow, green or brown phlegm
Tongue: red and raised dots in lung area (thorns)
Pulse: rapid, floating
Damp Heat

Upper Jiao - Affects face and chest

Middle Jiao - Affects Spleen and Liver
Lower Jiao - Intestines, bladder, genitals, etc.
Excess Fire

Strong heat that reaches deep in to organs. It can have an external or

internal origin.

Symptoms

big thirst
redness
restlessness
symptoms are loud and forceful (cough, diarrhea etc.)
Syndromes of Fire

Lung fire

can be loud, forceful cough with blood (fire has burnt off protection of
mucous membranes so capillaries have burst)
mucous is yellow, green , brown
red, painful rash
Stomach fire

burning ulcer, heartburn)

Stomach channel problems: toothache (infection), frontal headache
strong pain or burning on channel
Heart fire

strong anxiety
restlessness
insomnia
mania
Liver fire

anger
shingles in costal region
 burning pain in genital area as from STD's
Large Intestine fire

dysentery
toothache (channel pain) -> Kidney fire
long term alcohol or drug abuse
bone infection
meningitis (affects Marrow)
Deficient Fire

Yin Xu, Yang Kan, Heat is deep in the body: Ying level. Pattern of mixed Xu
and excess. Treatment must include quelling fire as well as nourishing yin

smoldering heat especially at night

low grade rashes
severe restlessness
slight bleeding
Tongue: scarlet
Pulse: thready, rapid
Summer Heat
(Associated with the Heart, Fire Element, Summer, Yang Evil)

Syndromes of Summer Heat

Summer heat

high fever
restlessness
thirst with strong desire to drink
can go up and affect the head
dizziness
blurred vision
headache
constipation
scant yellow urine
coma
Yin collapse
profuse sweating
Tongue: dry, red
Pulse: surging (flooding - strong, big waves)
Summer Heat combined with Dampness

A person with a Damp constitution experiencing Summer Heat, or a

person who eats Damp foods in summer (ice cream, cold soda).

Dampness turns into phlegm because of heat

nausea
vomiting
 loose stools or diarrhea
poor appetite and fatigue
phlegm can rise to head
dizziness
heavy head
foggy thinking
suffocating feeling in chest
tightness in chest
sweating, but not as much as Summer Heat without Dampness
Dryness
(Associated with the Lung, Autumn, Metal Element, Yang evil)

Exterior in origin (not yin Xu, not internal)

Easily damages body fluids

Dry skin
Dry hair
Dry eyes
Dry lips
Dry throat or low grade sore throat
Dry stools
Scant urine
Thirst
Easily damages lungs

Could be from dry climate or smoking

Dry cough and dry phlegm (thick, sticky, hard to expel)
Syndromes of Dryness

Warm Dryness

Symptoms

Fever
Headache
Thirst
Dry Mouth
Dry Nasal Passages
Dry cough with Dry Phlegm
Tongue: red with thin or no coat
Pulse: rapid
Treatment

acute: treat as wind-heat

chronic: tonify yin
Cool dryness (Example: Dried out from air conditioning)

Symptoms
 Dry phlegm (thick, doesn't move)
Sensitive to cold
Chills
Mild fever
Headache
Dry cough
Dry mouth
Dry nasal passages with stuffiness
Tongue: thin, white
Pulse: tight, slow
Treatment

Acute: Treat as wind-cold