The six factors here refer to wind, cold, summer heat, humidity, dryness and fire. TCM calls them the “six evils” because they are the main causes of all diseases. It is the excess of these factors that causes the human organs to malfunction. Under normal conditions, they are just six manifestations of nature as a result of weather changes. As the seasons change, our human body functions adjudge themselves to adapt to those changes. When our body is not strong enough to defend itself from the intervention of these forces, we become ill. Thus these six factors are called the devils.

From this reasoning, we can see that diseases caused by the six factors are seasonal. In summer, we may become ill because of heat; in winter, we may become ill by feeling cold. Because the weather changes a lot, even during one season, our bodies are exposed to various factors that cause different symptoms. If a person is weak in nature, and likes cold drinks in hot summer, he may also suffer from cold disease.

Winter is a dry season and people are easy to get sick as a result of dryness with heat in warmer days or dryness with cold in cooler days.

Diseases caused by the six factors can be of single factor or multiple factors. In most cases, they are caused by multiple factors: wind, cold and humidity working together to cause joint pain or paralysis.

After the six evils enter the human body, they transform under certain conditions. Cold can be transformed into heat when it confronts with the inner defense; heat can also be transformed into dryness when it causes the body liquid to evaporate.

In diagnosis, we must look into different symptoms and how they have been affected by the six factors. We talk about them one by one.


Wind is the worst of all six evils, as it is around all four seasons. When our body is attacked, wind is generally the number one force. Other evils follow the wind in its attack and often causes colds, fever, flu or arthritis. Attack by wind is generally the starting point of a disease.

Wind is light and flows upwards. It normally attacks our skin and upper part of the body; clinical symptoms are headache, cold, measles, etc.

Wind moves about and makes quick shifts. Thus it often carries the symptom of pain up and down the muscle and joints. Thus a patient may have cramps of the limbs, pain in shoulders or joint pain.

1, Cold with wind

Symptoms: feeling cold, fever, no sweat, running nose, cough, little phlegm. Coating on the tongue looks white but wet. The pulse feels tight.

Pathology: Exterior parts of the body are under attack by cod wind; lung defense is not strong enough to confront the attack.

  1. Heat with wind

Symptoms: Fever, feeling a bit cold, little sweat or no sweat, headache, cough, sticky or yellow phlegm, running nose with sticky liquid, sore throat, thirsty. Thin coating of tongue, red at the edge. Pulse feels floating.

Pathology: Skin attacked by wind with heat; The lungs feels difficult to clear the waste gas.

3, Wind attacks the main and collateral channels

Symptoms: Pain moving about the joints; joints stretch with difficulty; pain in shoulders, deforming of mouth and eyes; cramps of limbs; teeth tightened. Thin and white coating of tongue; Pulse feeling floating and slippery.

Pathology: The wind evil enters the energy channels and blocks the flow of energy.


Cold is the main air of winter and the cause of many diseases in that season.

Cold is an evil force, a negative factor that can easily damage the positive energy flow. If it attacks the skin or exterior parts of the body, it cause typhoid fever. If it affects the interior organs, the problem will get more serious.

Cold confines and causes things stuck. When it enters the energy channels, it causes the muscles to cramp or veins to be stagnant. Thus the body parts shall have difficulty in stretching. Joint pain or paralysis is a result of that. Our blood flows in warm temperature. When attacked by cold, the blood condenses, thus causes a blockage. Pain is often the result of energy block.

1, Cold attacks the exterior

Symptoms: feeling cold, fever, no sweat, headache, pain in shoulder, muscle pain or joint pain, moving pain (relief when warm), difficulty in stretching. Thin and white coating of tongue, pulse feeling shallow but tight.

Pathology: Cold damages the exterior, lung respiration is confined.

2, Cold attacks the interior

Symptoms: feeling extremely cold and shivering, partly paralyzed, stomach pain. Face looks pale white; difficult to move about; feels fainted; breathing slows; air from mouth and nose becomes cold. White and smoothie coating of tongue; pulse weak.

Pathology: Cold evil prevails, and damages the positive energy flow.

Summer Heat

The air of summer is hot, as a result of heat from sunshine. Summer heat as an evil as it also make people ill. Summer heat is characteristic of high temperature easy to spread away. It causes an excess of the positive factors within the body and does harm to exterior and internal organs by sweating or drying up the body liquids.

The air of summer is easy to reach the heart and when attacked by summer heat, our heart is disturbed, causing symptoms like high fever, faintness, or unconsciousness.

Summer heat is usually mixed with humidity. On hot summer days, sunshine is strong, the earth is wet, air evaporating upwards. The transpiration of heat and humidity causes people sick.

1, Heat stroke

Symptoms: headache and dizziness, chest distress, feeling like vomiting, feeling hot and thirsty, short of breaths, weakness, red and dry skin, little sweat, short and small amount of urine in yellow, cramps, etc. Dry tongue, pulse weak.

Pathology: Summer heat attacks the heart; negative factor of energy flow is damaged.

2, Summer heat

Symptoms: fever, skin feeling hot, little sweat, or feeling hotter in the afternoon, thirsty, bad appetite, weakness. Reddish tongue, pulse weak.

Pathology: Summer heat does harm to body liquids.

3, Summer humidity

Symptoms: Body feels minor hot, aversion to wind, little sweat, chest distress, floating abdomen, feeling like vomiting, mouth feeling bitter or mild, limbs feeling sour and tired, stool thin or water-like. Sticky coating of tongue, pulse feeling slippery.

Pathology: Summer heat with humidity; skin and muscle confined.


Air with humidity is the main character of the time of late summer and early autumn. We are easy to get sick because of humidity by wet weather, rain, smog, or working long hours in water.

Humidity is a evil factor as it is sticky and not easy to get rid of. Diseases caused by humidity usually last long and hard to cure.

Humidity is heavy, going downwards. When it attacks our body, it blocks our energy flow. At the top, we feel weight in the head; in the middle, we feel chest distressed and bad appetite; at the lower part, we feel weak with our hands and feet. The evil of humidity does harm to our positive factors, causing imbalance in evaporation. Our face will look dirty, stool sticky with uneasiness, urine not clear, virginal discharge sticky, coating of tongue dirty, feet smelling bad.

As humidity is easy to go with wind, it confines our external defense, thus causing pain or heaviness of limbs. When it attacks our skin, it causes various skin diseases.

1, Humidity confines the external defense

Symptoms: body feeling a bit hot, aversion to cold, some sweat and sticky, headache with weight, sore and pain in limbs. Possible chest distressed, uneasiness of abdomen, sticky mouth, water-like stool, pale face. White coating of tongue, pulse slippery.

Pathology: Humidity attacks the skin; exterior defense collapses.

2, Humidity affects the main and collateral channels

Symptoms: sore and pain in joints, moving pain, or swollen knee-joint, difficulty in stretching, swelling in feet. White coating of tongue, pulse slow.

3, Humidity spread all over

Symptoms: Scabies, herpes,wet smell in feet, scratchiness, yellow water running, urine not clear, smelly virginal discharge. Yellow sticky coating of tongue, pulse slippery.

Pathology: Evil of humidity spread all over the body skin


Autumn air is dry, with lower humidity. The infection may be warm or cool in nature. In early autumn, some summer heat still remains and dryness is coupled with heat; in deep autumn, cold air is coming, so dryness is coupled with cold. Symptoms are different under different weather conditions.

1, Dryness with heat

Symptoms: headache, fever, slightly aversion to wind and cold, cough with little phlegm, or coughing with blood, thirsty, dry tongue, sore throat, upset, dry stool. Red tongue with thin coating, pulse weak.

Pathology: Evil of dryness attacks the lungs; body liquids damaged.

2, Dryness with cold

Symptoms: headache, nasal congestion, aversion to cold, fever, no sweat, dry tongue and lip, thin phlegm. Dry tongue with thin coating, Pulse shallow and floating.

Pathology: Cold dryness confines the exterior, affecting respiration of lungs.


Fire-infected diseases are caused directly by excess of warmth or heat. Fire is stronger than warmth and heat, but with the same qualities. Wind, cold, summer heat, humidity and dryness can all be transformed into “fire”.

Fire is evil of the positive factor. When it attacks, disease comes quick. It develops or changes fast, thus the condition of disease is often quite serious. Heat and concrete symptoms are apparent. A patient feels high fever with reddish face, thirsty, fretful, and sleep difficulty.

Fire burns the liver and is easy to cause liquid damage there. When liver wind is motivated, it is hot and moving about. Symptoms like high temperature, cramps, and pain in shoulders can be seen.

Fire burns the blood channels and is easy to cause bleeding.

When fire attacks the heart, it causes mental problems, and mania.

Other symptoms include rough breaths, bad smell in mouth, constipation, or red spots,difficulty with vision, yellow tongue with thorns. The Pulse feels fast and slippery.

These are the six external factors of wind, cold, heat, humidity, dryness and fire.

As a matter of fact, these six factors can also start from inside.

Inner wind relates to the liver and it’s called “liver wind is activated from within the liver.” The result is an excess of positive factors in the liver.

Inner cold relates directly to the kidney as it is the result of deficiency of the kidney’s yang (positive) factors.

Inner heat or fire relates to the heart and stomach. When the heart has a excess of heat, it is the result of depression (or seven emotions of joy, anger, worry, sorrow, sadness, hatred); uneasiness of mind and sleep problems are common. Heat in the stomach is often the result of eating too much fats or not-clean food.

Inner humidity relates closely to the spleen. It’s also the result of foods and drinks.

Inner dryness relates to body liquids; lack of nourishment by liquids brings about problems to mainly the liver, kidney, lungs and the stomach.

Thus diagnosis shall take into consideration of evil attacks from both interior and exterior factors.

Talk to you next time.


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