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