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Ancient texts state: All diseases stem from the Six Evils.
The Six Evils refer to the six types of external pathogenic factors: Wind, Cold, Heat, Dampness, Dryness, and Fire (Heat).
These Six Evils are also known as the “Six Excesses”. In the “San Yin Ji Yi Bing Zheng Fang Lun, Volume Two”, it is mentioned: “The Six Excesses are Cold, Heat, Dryness, Dampness, Wind, and Fire.” It further states: “The Six Excesses are the regular atmospheric conditions; when they invade, they first enter the meridians and then affect the organs, becoming external causes of disease.”
Under normal circumstances, Wind, Cold, Heat, Dampness, Dryness, and Fire (Heat) are the six natural climatic changes of the universe.
However, when climatic changes are abnormal, such as experiencing cold in spring when it should be warm, or heat in autumn when it should be cool; or when changes occur too rapidly, such as sudden cold or heat, the human body cannot adapt and becomes ill, thus these six qi become pathogenic factors, known as the “Six Evils”.
On the other hand, even normal climatic changes can lead to disease if the body’s righteous qi is insufficient and adaptability is low, as stated in the “Huangdi Neijing”: “Where the evils gather, the qi must be deficient.”
The Six Evils hold an important position in TCM etiology and pathogenesis. Today, we will first understand the nature and pathogenic characteristics of each of the Six Evils.
01
Wind Evil
Any external evil characterized by lightness, movement, and non-stationarity is classified as Wind Evil, which often invades the body through the skin and muscles, leading to external wind diseases.
● Characteristics
1. Wind Evil is a Yang Evil, characterized by its dispersing nature, often invading the body’s head, face, throat, skin, and lower back, which are Yang areas.
2. Wind Evil moves quickly and changes frequently, indicating that its pathogenic effects are characterized by shifting locations, unpredictability, and rapid onset.
3. Wind is the leader of all diseases; Wind Evil often precedes other external evils and is most likely to combine with them to harm the body.
02
Cold Evil
Any external evil characterized by coldness, stagnation, and contraction is termed Cold Evil. In daily life, sudden drops in temperature, exposure to rain, sweating in the wind, and overly cool air conditioning can all lead to the invasion of Cold Evil.
● Characteristics
1. Cold is a Yin Evil that can harm Yang Qi; when the body is affected by Cold Evil, Yang Qi is damaged, leading to a lack of warmth, and obvious cold symptoms may appear throughout the body or in specific areas.
2. Cold Evil causes stagnation, obstructing the flow of qi and blood, resulting in “no flow leads to pain”; the nature of the pain often manifests as cold pain, which decreases with warmth and worsens with cold.
3. Cold has a contracting nature, thus when Cold Evil invades the skin, it can cause blockage of the pores, leading to symptoms such as fever, chills, and lack of sweating; when it invades the meridians and joints, symptoms may include difficulty in limb movement and muscle and joint stiffness and pain.
03
Wet Evil
Any external evil that causes disease characterized by heaviness, stickiness, and a tendency to descend is termed Wet Evil. In daily life, this often occurs due to climate or living in damp environments, exposure to rain, or working in water, leading to the invasion of Wet Evil.
● Characteristics
1. Wet is a Yin Evil that easily obstructs the Spleen Yang, leading to dysfunction in transformation and transportation, resulting in internal water and dampness accumulation.
2. Wet is heavy and turbid, often leading to symptoms characterized by a feeling of heaviness in the limbs, such as heaviness in the head, body heaviness, and heaviness in the limbs.
3. Wet is sticky, which includes two aspects: one is that symptoms are often sticky and uncomfortable, such as sticky stools; the other is that after the invasion of Wet Evil, it often becomes chronic and difficult to resolve.
4. Wet is similar to water, thus Wet Evil tends to descend, easily affecting the lower parts of the body, with common symptoms including lower limb edema, diarrhea, and women’s leukorrhea.
04
Dry Evil
Any external evil that causes disease characterized by dryness and astringency is termed Dry Evil. Dry Evil often invades the body through the mouth and nose, leading to external dry diseases.
● Characteristics
1. Dryness is characterized by astringency, which can consume the body’s fluids, leading to symptoms such as dry mouth, dry lips, dry nasal passages, dry skin, and dry stools.
2. Dry Evil often enters through the mouth and nose, and the lungs open to the nose, serving as the gateway for respiration and connecting with the natural world, making the lungs particularly vulnerable to Dry Evil.
05
Fire (Heat) Evil
Fire Evil is an external evil characterized by ascending, inflammatory, and vaporizing properties.
● Characteristics
1. Fire has an upward tendency; when the fire heat evil invades the body, its effects are often manifested in the upper body, especially in the head and face.
2. The nature of fire heat is restless; the center of the five organs is connected to fire energy, thus fire heat evil entering the nutritive blood easily affects the spirit.
3. When Fire Evil invades the body, it can easily consume and scorch Yin fluids, forcing sweat to leak out; clinical manifestations often include fever, accompanied by profuse sweating, thirst, dry throat, and dark yellow urine.
4. Fire heat evil invading the body can also easily lead to internal wind movement and chaotic blood flow.
06
Summer Heat Evil
Summer Heat Evil is a part of Fire Heat Evil; it typically refers to the external fire heat evil experienced in nature from the summer solstice to the beginning of autumn, characterized by heat, ascending, and dampness.
● Characteristics
1. Summer heat is the qi of the peak summer heat, thus it is a Yang Evil, characterized by its heat; therefore, Summer Heat Evil often manifests as a display of Yang heat symptoms.
2. Summer heat is a Yang Evil, its nature is to ascend; when it affects the head, it can cause dizziness and blurred vision; when Summer Heat Evil disturbs the spirit, it can lead to irritability and restlessness.
3. Summer Heat Evil often combines with Wet Evil to invade the body, with Summer Heat being the primary factor and Wet Evil being secondary.
It is worth noting that the Six Excesses can coexist; they can invade the body individually or simultaneously, and during the disease process, they can influence and transform into one another, requiring careful consideration during clinical differentiation.
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