Six Pernicious Influences

In TCM, there are six pernicious (hurtful) influences that can cause disharmony within us. Long before the concepts of bacteria or viruses were understood, it is these six influences that the Chinese used to categorise the effects they observed when a patient was in a disharmonious state.

Wind, Heat, Cold, Dampness, Dryness and Summer Heat all bear their own signs but can often overlap and morph into each other depending on the stage of disharmony. For instance, a pernicious wind can change into Cold if balance is not restored to the body for some time. Wind heat and wind cold are also common combinations.


Each of the six pernicious influences bring their characteristics into the body. So for instance. when Cold affects us, we feel slower – our thoughts and actions begin to become heavier, almost as if we were freezing. We begin shivering to generate body heat, curling up and avoid cold things. A full list of characteristics of the six pernicious influences is given below.

Each of the six pernicious influences can occur in various degrees of severity. By their very nature, the six influences are external influences, in other words they come from the environment around us. There are varying degrees of ‘Cold’ just as there are varying degrees of Summer Heat or Dryness. Imagine a cold winter day and you nip outside to the shop  – when you come back, you may feel cold on a superficial level – your skin, face and hands may be freezing but otherwise you are fine. Spend a few hours outside and the cold penetrates the muscles and bone. Spend a few days outside and the coldness begins to seep into your organs or zang-fu. Treatment therefore will depend on how severe the influence has disrupted our harmony.

A good way of remembering the characteristics of each pernicious influence is to imagine yourself immersed in it. So surrounded by dampness, we begin to feel sluggish, mouldy, phlegm and sputum. In an extremely dry environment, we would be thirsty, have cracked lips, deep wrinkles, our urine would be scarce.

There will also be instances of two or more influences affecting us, particularly in the case of Wind. Wind-cold or Damp-Heat for example.


If you have ever suffered the effects of cold – that is cold that penetrated into the body – the characteristics will  be immediately familiar. Shivering (as our body attempts to heat up), slowness of actions and thoughts, curling up, pale complexion, avoidance of all cold things, lethargy and general sluggishness are all symptoms of cold.

Cold affects the Yang within us and if we can imagine ourselves suffering the effects of a bad case of freezing, we can begin to understand its effects on our bodies. As we get cold, our circulation becomes worse leading to stagnant blood, stiffness and pains in our joints. Our extremities may be numb. Food in our stomach and intestines will be unprocessed and this will show up in our stools. We will crave warmth such as fires, blankets and hot drinks.

Other symptoms of Cold are a slow pulse and pale tongue.


Wind is the most common cause of illness in Chinese medicine and readily combines with the other pernicious influences. The nature of wind – its shifting motion, appearing and disappearing without warning, the way it moves illness around the body, makes it difficult to pin down. It readily manifests itself in the upper body and head but symptoms can come and go. Shaking, shivering, twitches, spasms and convulsions are all tell-tale symptoms of wind and when it first begins to invade, those symptoms can be found on the external surfaces i.e. the skin or face. Naturally, the organ most at risk from wind is the lung and first symptoms may appear here also. As it seeps into the body, external wind can cause dizziness and seizures. Rashes caused by wind tend to come and go quickly.

Wind is considered Yang in nature. Its natural path is upward and outward, thus the linkage with the lung and head of the body. As it moves, so it opens the pores of the body and can thus cause sweating. It is most common in Spring time.


Heat, also known as Fire, is Yang in nature and causes fever, dry skin, inflammation, constipation and irritability. The face will appear red and sore, the throat will be dry. Yet the patient will be talkative and active – almost as if they are suffering the effects or running in the desert for a few hours – burnt up but slightly mad. Blisters or boils and a racing pulse are also common.

When heat combines with wind it is likely to be the common cold or flu. In this case we should expel the wind and heat. When heat begins to affect our organs we should look for ‘internal thirst’ such as constipation, burning or very dark urine and blisters related to where our meridians emerge on the body – this would help deduce which organ has been affected.


Think of one of those really damp days when everything is soaking. There isn’t a dry patch to stand on nor a piece of dry shelter to huddle under. This is dampness and it is hard to get anything done in it. Were you to stand in the rain for a day, you would be sodden, heavy and slow. Slumbering, you might work at a pace half your normal rate. As the next day dawns, it too is damp and drying out is difficult.

And so it is with dampness in traditional Chinese medicine. Our bodies become sluggish and heavy, our limbs tired and we being to suffer the effects of a damp environment if we do not treat it – phlegm, bloating, excess urine and mould are common symptoms. In damp conditions, water will accumulate in puddles and ponds and the same occurs in our bodies. Just as wind is Yang and floats upwards, dampness is Yin, heavy and sinks downwards. Dampness most commonly affects our lower half.

Just as it is difficult to dry clothes on a damp day, it can be difficult to balance out dampness embedded in the body. The spleen is the organ most susceptible to dampness and the evil is most common in late summer.


In Autumn, there is little moisture around. The ground drys out, plants begin to wither from the heat and lack of rain. So it is with Dryness, a yang pernicious influence. Dryness typically enters the body through the mouth and nose and its influence is felt in the head area, throat and lungs. Dry skin, parched lips, mouth, dry or slightly irritated throat, scant urine and bodily fluids are all symptoms of dryness. A dry cough may indicate it has reached the lungs. Dryness differs from Heat in that the the latter creates warmth and heat/redness, the former causes dehydration.


Summer Heat is similar to Heat but the latter is more concerned with a drying effect on bodily fluids. It is also often confused with Dryness. While Summer Heat and Dryness have similar symptoms and both are Yang in nature, Dryness is an Autumn illness and affects the lungs. Summer Heat is a summer illness that can occur in the humid and hot conditions and focuses on the heart.

Symptoms of Summer Heat are depletion of bodily fluids, exhaustion, dehydration, restlessness, blurred vision and fever. Care should be taken of the heart in cases of restlessness.

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