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We often say that “humans have seven emotions and six desires,” where the “six desires” mainly refer to the physiological needs and desires inherent in humans. In Traditional Chinese Medicine (TCM), we also frequently encounter the term “Six Evils” (六淫, liu yin). However, it is important to note that “Six Evils” is different from “six desires.” The “Six Evils” typically refer to external pathogenic factors, especially common in exogenous diseases. So, what exactly are the “Six Evils” and what are their characteristics?The so-called “Six Evils” mainly refer to the six types of external pathogenic factors: Wind (风, feng), Cold (寒, han), Heat (暑, shu), Dampness (湿, shi), Dryness (燥, zao), and Fire (火, huo). Due to the changing seasons, the external Yin and Yang also undergo changes. Under normal circumstances, climate changes follow certain patterns. However, during periods of extreme climate anomalies, when the six Qi (气, qi) are either excessive or insufficient, and our body cannot adapt, it can lead to the onset of diseases. Thus, the “Six Qi” become significant pathogenic factors.
The concept of “Six Evils” first appeared in the work “San Yin Ji Yi Bing Zheng Fang Lun” (三因极一病证方论) by the Song Dynasty physician Chen Wuze (陈无择). The term “Evil” (淫, yin) implies excess and infiltration, so “Six Evils” can be understood as the six Qi being excessive and surpassing our body’s capacity, leading to illness.Many people often equate the six Qi with the Six Evils, but in fact, there is a distinction. If a disease is caused by normal natural climate, it is referred to as six Qi; if it is a key pathogenic factor, it is termed Six Evils. For example, common exogenous pathogenic factors in TCM, such as Wind Evil (风邪, feng xie), Heat Evil (热邪, re xie), Damp Evil (湿邪, shi xie), and Dry Evil (燥邪, zao xie), all belong to the category of Six Evils. The Six Evils are the primary pathogenic factors in exogenous diseases, and each “Evil” has its own treatment differences.1. Wind Evil (风邪, feng xie)Wind is known as the leader of all diseases. In TCM, diseases induced by Wind Evil are among the most numerous. This is mainly because Wind Evil is a Yang Evil, which easily invades the human body. Once Wind Evil enters the body, it often causes the pores to open, resulting in symptoms such as sweating and aversion to wind. In terms of the location of invasion, Wind Evil primarily attacks Yang areas, such as the head, where Yang Qi is most concentrated.Another reason why Wind Evil is a common pathogenic factor is its ability to change rapidly and unpredictably. Once it enters the human body, it often moves throughout the body, commonly leading to joint pain and bi syndrome (痹症, bi zheng). Moreover, Wind Evil can invade the body with just a slight breeze, making it a difficult condition to guard against.2. Cold Evil (寒邪, han xie)Cold Evil is also very common in clinical practice. The most obvious characteristic of Cold Evil is its “coldness,” which can easily deplete the body’s Yang Qi. Cold Evil causes stagnation; as TCM says, “where there is no flow, there is pain.” Most of the pain is related to the invasion of Cold Evil, as it can cause Qi and blood stagnation, leading to blockages and pain, commonly referred to as “painful bi” (痛痹, tong bi).When Cold Evil invades the body, it causes the Qi mechanism to contract, and the pores to close, making it difficult for the internal Cold Evil to be released through the skin, resulting in aggravated symptoms. The most obvious symptoms include no sweating, fever, and aversion to cold. When Cold Evil directly invades the meridians, it can lead to stiffness in the meridians, causing Qi and blood obstruction, resulting in joint pain and difficulty in movement.3. Heat Evil (暑邪, shu xie)Heat Evil is the most common pathogenic factor in summer. Depending on the severity of the disease, it can be classified as Heat Injury (伤暑, shang shu) or Heat Stroke (中暑, zhong shu). Most people are familiar with Heat Stroke, which occurs because Heat Evil is a Yang Evil with hot characteristics that can easily injure fluids and disturb the spirit. Additionally, Heat Evil has a characteristic of being “mixed with Dampness” (夹湿, jia shi), as summer is not only hot but also rainy, which increases humidity in the air. Therefore, Heat Evil often enters the body along with Dampness, harming the organs and causing disease.
4. Damp Evil (湿邪, shi xie)When discussing Damp Evil, many people first think of dampness. Excessive internal dampness can lead to symptoms such as heaviness in the head and body, and fatigue. This is mainly because Damp Evil is a Yin Evil, characterized by heaviness and stickiness, and it tends to invade the lower body, making it most common in the lower jiao (下焦, xia jiao). Its sticky nature manifests clinically in two ways: first, sticky symptoms, such as when Damp Evil lingers in the large intestine, leading to sticky and unsatisfactory stools; second, a prolonged course of illness that is prone to recurrence.5. Dry Evil (燥邪, zao xie)Dry Evil is dry and can easily harm the lungs, making it most common in autumn. This is mainly due to the drying nature of the autumn air, and the lungs, which are delicate organs, are most susceptible to Dry Evil.6. Fire Evil (火邪, huo xie)Fire Evil, also known as Heat Evil, is a Yang Evil that easily depletes Qi and injures fluids. Fire has an upward tendency and can easily invade the upper part of the body, leading to symptoms such as disturbance of the spirit, sore throat, and a flushed complexion. Fire Evil can easily cause blood movement, leading to bleeding, vomiting blood, and nosebleeds.
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