The “Six Evil” in Traditional Chinese Medicine

One thing you’ll notice as an expat is that your local Hong Kong colleagues will not always automatically reach for paracetamol when they have a headache. A lot of times, they will try to avoid western medicine, and try to take some Traditional Chinese Medicine instead, which they believe has fewer side effects, and addresses the cause of the problem instead of just covering up the pain. Many of our more seasoned expat readers tell us that, stay long enough in Hong Kong, and you too will become more holistic in how you look at your health and wellbeing. For those of you who are new to Hong Kong, here are some terms related to body ailments that you may hear your local friends talking about, especially as the weather changes.

Traditional Chinese Medicine （TCM） emphasises balance, both within the human body, and in how our bodies interact with our external environment. It is a different medical system to the well-being of humankind compared to Western medicine. 

In common conception, people pay attention to how TCM practitioners apply Chinese herbal medicines to their patients. With more research being done and academic seminars being held, a lot of it’s thinking and approaches are adopted and form what is called complementary and alternative medicine.   

It is a complex, interconnected system that involves concepts such as of Yin and Yang (陰陽) from Tai Chi (太極), the Five Elements (五行) and Qi (氣). 

Qi (氣) – the vital energy that runs through all of nature – circulates both within our bodies and in our surroundings. During different seasons of the year, our bodies will try to adjust the Qi within, to adapt and interact with external seasonal elements and achieve a balance. 

There are six conditions within the human body, and when these are unbalanced, we may feel unwell or become ill. When this happens, these conditions are known as the Six Evils (六邪): Wind, Cold, Damp, Heat, Summer Heat and Dryness （風、寒、熱、暑、濕、燥）.

Wind Evil (風邪)

Belonging to the Wood (木) Element, this “evil” is especially prevalent during spring. 

Instead of staying in one part of the body, it travels around and surfaces as different symptoms. The Wind Evil might cause headaches, dizziness or skin conditions. It is regarded as the most elusive Evil, as Wind is always in constant movement and mutation. 

Aside from its mobility, it often combines with other evils to cause variations of sickness around the human body. Mostly we regard it as just catching a common cold in the West, yet in Traditional Chinese Medicine theory, Wind illnesses are more complex, varying according to the season and weather. 

For instance, in winter, Wind often combines with the Cold Evil, causing people to catch a wind-cold (風寒 ). Wind-Cold is characterized by chills, stiffness (especially in your neck), headaches, sneezing and possibly cold feet. 

During spring, when the weather gets warm, it can combine with the Heat Evil and become a wind-heat cold (風熱). Wind-Heat is characterized by a slight fever, headache, sore throat and chills. It is similar to Wind-Cold but instead presents with excess body heat. 

Both of these involve symptoms such as coughing, sneezing and runny noses, but will require different approaches to restore balance inside the body.

Cold Evil (寒邪)

Belonging to the Water (水) Element, this “evil” is especially prevalent during winter. 

It is the cause of symptoms such as headaches, pale skin, diarrhoea and muscle pain. The Cold Evil is characterized by its stagnation. Unlike Wind Evil, it stays in one body part and even blocks the flow of blood and Qi. 

If there is a sufficient amount of Yang Qi (陽氣) inside the body, blood flows smoothly to keep the body warm. However, if the body is exposed to sudden colds (for instance if you stay in damp clothing after being in the rain), it might lead to the body losing its Yang Qi. As a result, the balance between Yin and Yang is disrupted, giving way to the Cold Evil. 

Aside from the weather, Traditional Chinese Medicine also encourages us to pay attention to the nature of our food. Food that is uncooked or served cold, such as sushi or soft drinks, might also reduce the Yang Qi of the body. Conversely, food like ginger is highly recommended to increase Yang Qi. 

Summer-Heat Evil (暑邪)

Belonging to the Fire (火) Element, this “evil” is especially prevalent during summer. 

Symptoms of the Summer-Heat Evil are excess body heat, excessive sweating, dehydration, constipation and heart palpitations. The heat of the sun and high temperatures are considered leading causes.

According to Traditional Chinese Medicine theory, excessive sweating opens up pores and might lead to leaking of internal Qi along with the sweat. Due to the lack of Qi in the body, fatigue and a decrease in vitality are likely. The lack of Qi also causes imbalance within the body, inviting other evils to enter. First to enter is often the Wind Evil, followed by the Cold Evil or the Dryness Evil, causing various compound illnesses.

Therefore, it is vital to stay hydrated when under the hot sun. 

Dryness Evil (燥邪)

Belonging to the Metal (金) Element, this “evil” is especially prevalent during autumn. 

According to Traditional Chinese Medicine theory, the lungs are the organ that takes charge of regulating the Qi within our body. Excessive dryness damages the lungs and symptoms include heavy coughing, shortness of breath, constant thirst, dry and wrinkled skin, dry nose and even dry stools. 

Staying hydrated and eating soothing fruits such as pears to protect our lungs and throat are effective ways to protect ourselves from the Dryness Evil.

Damp Evil (濕邪)

Belonging to the Earth (土) Element, this “evil” is especially prevalent during late summer. 

Excessive dampness in the body induces symptoms such as dizziness, heavy limbs and sticky stools. These symptoms can be induced by sudden exposure to fog or mists, immersion in water and exposure to rain, or living in climates that are high in humidity. 

The Damp Evil is characterized by its stickiness and stagnation. Just like the Cold Evil, it also interrupts our blood flow and the movement of Qi within our body. Yet, the Damp Evil tends to stay in joints and lower parts of the body. In many cases, it combines with other evils, making it the most difficult evil among the six to get rid of. 

Spicy food is thought to reduce the amount of dampness within the body. Hence many in China who live in humid climates like to reach for spicy food when they are feeling sluggish.

Heat Evil (熱邪)

This “evil” belongs to the Fire (火) Element. The word heat (熱) is synonymous with the word Fire (火) in Traditional Chinese Medicine theory, but there is a slight difference between them. 

Heat mostly describes external conditions such as the Summer-Heat (暑), and it is usually at milder levels. However, Fire is internal and is the extreme form of Heat. Furthermore, when any of the other five evils become too extreme, they often mutate into the Fire Evil (五志化火/ 火邪). 

Symptoms of the Heat Evil include thirstiness, sweating and facial redness. The Heat Evil tends to stay in the upper parts of the body including the head. 

When the other evils become too extreme, or a person is having mental health issues such as depression or anxiety, then it will be described as Fire Evil. Symptoms of the Fire Evil include high blood pressure, stress, insomnia and shortness of temper. These problems tend to occur when the Fire Evil resides in the liver or the heart. 

Therefore, it is essential to maintain a stable state of mind and avoid being exposed to stress for long durations.