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THE TRADITIONAL CHINESEMEDICINE

CONCEPT OF DAMPNESSE. F. BLOCK IV

June 2007

Updated February 2011

Updated June 2015

INTRODUCTION

The subject of etiology is study of the origins of disease, the causative

factors, in the body. Pathogenesis is the study of the actual processes

within the body whereby disease occurs, develops and changes. One of

the most central concepts of Traditional Chinese Medicine (TCM) is that

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of the intimate connection between the body of man and the

environment within which man lives, works and plays. The physiology of

the cells, tissues, zang-fu organs and meridian system of the body is in

dynamic internal equilibrium and constantly adjusts to the vagaries of

the external environment. If the body is not able to cope with changes inthe environment, if the body is not able to adjust to changing external

conditions, internal equilibrium will be lost and disease will be the result.

Thus, according to the constitution of any particular individual, the

presence of disease is due to a lack of adaptability by the physiology of

the individual to the conditions of the environment.(1)

The above paragraph assumes that one is healthy, eating nourishing

foodstuffs, drinking clean water and getting the proper amount of

exercise. In addition to being able to alter the physiology of the body tochanging environmental conditions, a healthy body needs nutritious

foodstuffs and clean water in order to maintain the integrity of the body.Our ancestors did not have or use herbicides and pesticides that are of

manmade origin. All of their food was what we call today as "organic".

Also, while they may have needed to drink fermented beverages in order

to ingest liquids that were not contaminated with pathogenic








microorganisms, these beverages were not contaminated with injurious

manmade organic compounds that seem to be ubiquitous in today's

drinking water. The reason that the condition of Dampness seems to be

rampant in industrialized societies is due in part to the burden of un-

natural substances in our food and water that needs to be eliminatedfrom our bodies after ingestion/consumption. Dampness is a condition

that is partly hormonally based. The body reaction to chronic stress is to

produce more cortisol which can then result in the accumulation of fat

tissue. Another source of weight gain is the eating of much of the

manufactured foodstuffs in a developed country. The use of white flour,

refined sugar, hydrogenated oils and soybean products in themanufacture of foodstuffs is a quite serious problematical health issue in

itself. Also, the ingestion of xenoestrogens

(https://womeninbalance.org/2012/10/26/xenoestrogens-what-are-they-

how-to-avoid-them/) that are found in our foodstuffs severly complicates

the problem. Xenoestrogens are a sub-category of endocrine disruptorcompounds that specifically have estrogen-like effects in the body.These compounds are found in multiple aspects of contemporary life.

Please read the above link to discover these sources and how to avoid

them. See the link on osteoarthritis for more information.





http://oa.htm/




TCM etiology lists many factors that are the cause of disease. Theseinclude the six exogenous factors, the seven emotions, the lack of

physical exercise, an improper diet, traumatic injury, bites of insects and

animals, stagnant blood and phlegm fluid. The causative factors will

affect the body in a specific manner or ways. These aberrations are thesigns and symptoms that are used in order to analyze clinical

manifestations. The clinical manifestations provide the basis for theetiology of disease produced by each causative factor.

There is a saying in TCM - "The earth element creates dampness andthe metal element stores it." In CM, The organs associated with the earth

element are the Stomach and Spleen. The organs associated with the

metal element are the Lungs and Large Intestine. When dampness is

created by impaired digestion, caused by chronic improper nutrition, it

likes to end up in the Lungs and Large Intestine. When dampness

moves into the Lungs, the usual symptom is phlegm coming up whilecoughing (especially after eating something that is inherently difficult to

digest such as a milk shake, other cold dairy products, or greasy foods).

When the dampness is stored in the Large Intestine, we find mucus-








lined stools, loose stools, sticky stools that are difficult to clean up after,

or diarrhea with undigested bits of food in it. Even intestinal rumblings

are due to dampness in the intestines. These are all forms of internal

dampness. Internal dampness is directly due to the impaired

transformative and transportive function of the Spleen system that thenresults in some form of pathogenesis within the body, zang-fu organs

and meridians.

In Chinese Medicine, dampness is considered to be the cause of manyillnesses such as high cholesterol, cancer, metabolic disorders, chronic

fatigue syndrome, fibromyalgia, allergies and environmental illness.

DISCUSSION

For the sake of this discussion, only the symptoms of the aberrations of

water metabolism will be considered. There are two general categories of

Dampness: external and internal. Internal dampness is most commonand will easily combine with Heat or Cold to cause Damp-Heat or Damp-Cold. Dampness can be thought of as the condition of "high humidity"

inside the body. Symptoms can include a feeling of heaviness, swelling

(edema) or water retention, distended abdomen, any type of phlegm








discharge, nodular masses (lymph nodes), loose bowels and turbidity of

fluids. Individuals with a Dampness condition often have sluggish energy

and easily gain weight. The pulse is commonly described as slippery;

the tongue is often puffy with teeth mark indentations on the sides, very

moist looking and with a greasy looking tongue coating.

Exposure to damp weather, wearing wet clothes and a humid

environment can cause External Dampness to invade. External

dampness is a condition of prolonged high humidity that usually occursin late summer. When exterior Dampness invades the body it tends to do

so from the lower extremities first. Damp then works its way up the legsand settles into the lower jiao (lower abdomen) and then from there it

spreads throughout the body. Patients often complain of dizziness, a

heavy sensation in the head (as if wrapped in a towel), heaviness of thebody and soreness, pain and heaviness of the joints. In both cases,

external and internal, there may be turbid discharges from the body(such as suppurating sores, weeping eczema, profuse purulent

leukorrhea with a foul odor, dark & turbid urine and stools containing

mucus and perhaps even blood).(2) Summer heat with dampness

causes dizziness, heaviness in the head, a stifling sensation in the








chest, nausea, poor appetite, loose stools, general lassitude, fever,

restlessness and thirst.

A collection of dampness and heat may lead to such problems as

inflammation, allergies (especially food allergies), high blood sugar,

weight gain, and urinary tract infections. Symptoms can include

heaviness, a sensation of fullness in the chest, a smelly and sluggish

bowel, abdominal pain, leukorrhea, eczema, and deep yellow colored

urine. The pulse is often slippery and fast; the tongue is commonly red with a yellow, thick greasy coating; the nails are often red; the hands are

often puffy and red with a mottled appearance with swollen, red cuticles.Especially in women, the ankles and feet may also be swollen.

Classicaly, Dampness describes a condition of viscosity and stagnation.

Patients usually have a thick, greasy looking, sticky tongue coating and

perhaps a viscous stool that is difficult to void and/or in some manner anobstructed urination. Diseases due to Dampness tend to be prolonged

and intractable. Damp is a yin pathogen that impairs yang and easilycauses qi stagnation. Signs and symptoms include a sensation of

fullness in the chest, epigastric distention, difficult & scanty urination








and hesitant & viscous stools. Pathogenic Damp impairs Spleen yang

that leads to distention and fullness in the epigastrium and abdomen,

poor appetite, loose stools and generalized edema. All conditions of

Dampness will yield to treatment only after an appropriate long term

concerted and persevering regimen.

What is the difference between Damp, Phlegm Fluids and Water? All

three of these concepts refer to the products of the disturbance of water

metabolism in the human body, which after being produced will causefurther pathologic changes, and thus also are regarded as pathogenic

factors in TCM. They are often used interchangeably, but they reallyhave some differences and should, therefore, be used differently.

Dampness is both a physiological and a pathologic concept in TCM. As a

TCM physiological concept it refers to the water received by the Stomachand digested and absorbed by the Spleen, so it is also sometimes called

Water Damp. The Stomach likes dampness but the Spleen abhorsdampness. As a TCM pathologic concept, it refers to the retained water

caused by disturbances of the Spleen, so it is mainly used in the case of

water retention due to diseases of the Spleen system. Phlegm fluid

retention is a general term for all congealed water metabolism in the







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human body. This is mainly an indication of retained water that is not

directly related to altered Spleen function. For example, we may ascribe

the cause of diarrhea to the downward flow of excess dampness from

the Stomach/Spleen (Middle Jiao or upper abdomen), or the cause of

edema to the outward flow of dampness as a result of a disturbance inthe Spleen system. But we usually say the causative factor of scrofula

(nodules as thickened, rubbery feeling lymph nodes) is the accumulation

of Phlegm Fluids, because this is a disease mainly secondary to

stagnation of Liver Qi (which further disturbs water metabolism) instead

of being secondary to Spleen disorders. As for Water, it is mainly used to

describe the fluid that accumulates in a cavity of the body, such aspleural effusion, ascites or edema that is easily rectified with the return of

normal Spleen functionality.

Phlegm also affects the brain. One of the major causes of brain phlegm

is the consumption of all kinds of dairy products. The condition of brainphlegm is commonly known as brain fog. It is the opinion of the author

that brain phlegm leads to the conditions known as Alzheimer's disease

and Prion disease. It is also the opinion of the author that no-one after

the age of 4 years should eat any dairy products except for very well







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aged cheeses and naturally fermented kefir & yogurt.

Worry, pensiveness and mental overwork often negatively affect thetransporting and transforming function of the Spleen and contribute to

deranged water metabolism as internal dampness. Organs of the body

other than the Spleen also contribute to the action of water metabolism.

The lungs (Upper Jiao or chest cavity) produce arginine-vasopressin that

acts on the kidney nephron to alter water balance in the body. Grief and

melancholy stifle Lung qi that disrupts the production of arginine-vasopressin. The mineral corticoids of the adrenal glands (part of the

TCM Kidneys in the Lower Jiao) also regulate water balance in the bodyvia the kidney nephron. The liver (Lower Jiao) produces angiotensinogen

that assists in water balance via the angiotensin-renin-aldosterone

system. The kidney (Lower Jiao) produces rennin that assists in theregulation of water balance in the above-mentioned system.

Disharmonies between the organ systems of the Lungs, Kidneys andLiver with the Spleen system all cause some form of disrupted water

metabolism. The degree of aberration, the length of time of disruption

and the systems involved determine the symptoms and progression of

pathogenesis within the body. According to TCM, the San Jiao meridian







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is the pathway for the movement of all fluids within the body.(3) Thus

any obstruction in the channels and meridians will ultimately affect water

metabolism adversely in some manner. The role of diet in contracting

internal Dampness and that of food therapy in combating internal

Dampness is well known. Foods that impair digestion, yield foodstagnation and in general interfere with the Spleen in some manner

contributing to the development of internal Dampness due to the

impairment of water metabolism within the body. When one overeats, a

condition of food stagnation ensues and the digestive system will not

function properly. This gives rise to such clinical manifestations as foul

belching, sour regurgitation, distention, bloating, pain in the epigastrium& abdomen, loss of appetite, vomiting and diarrhea. Overindulgence in

cold or raw foods can easily impair Spleen yang and leads to the

development of interior damp-cold.(4) The resulting symptoms are

diarrhea and abdominal pain. Likewise, the overindulgence of alcoholic

beverages or greasy, sweet and spicy foods may lead to damp-heat,phlegm and stagnation of qi & blood. Symptoms resulting are thesensation of fullness or stifling fullness in the chest with profuse sputum,

dizziness and vertigo, bleeding hemorrhoids and yang type sores (red,

weepy, itchy).






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DIAGNOSIS OF DAMPNESS CONDITIONS

An excellent, clear and concise description of the diagnosis of Damp

conditions may be found in the text by G. Maciocia.(12)

External Dampness Condition Categories are:

1. Simple invasion of Dampness in the Zang-Fua. Urinary Bladder - difficulty and pain on urination, scanty but

frequent urination, cloudy urine, a feeling of heaviness in the

lower abdomen, tongue with a thick & sticky coating on the root,pulse slippery. If associated with Heat - a burning on urination,

dark urine, thirst with no desire to drink, yellow tongue coating,

slightly rapid pulseb. Stomach - acute onset of vomiting, watery diarrhea without

smell, epigastric pain, a feeling of stuffiness in the epigastrium,cold limbs, no appetite, a thick sticky & white tongue coating, a

slippery or soggy pulse

c. Intestines - acute onset of watery diarrhea without smell,abdominal pain, a feeling of heaviness, thick sticky & white






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tongue coating, slippery pulse

d. Uterus - acute onset of painful periods, excessive vaginal

discharge, thick sticky & white tongue coating, slippery pulse

e. Gall Bladder - acute onset of hypochondrial pain, a feeling of

heaviness, a bitter taste in the mouth, a sticky yellow coating onone the side of the tongue, slippery pulse

2. Invasion of acute, external dampness in the channels/meridians

manifesting as pain, swelling and heaviness of the joints

3. Invasion of external Damp-Heat at the defensive (wei) qi level

manifesting with fever: external Damp-Heat, external Summer-Heat

with Dampness

Internal Dampness Condition Categories are:

1. Chronic

a. Internal dampness in the Zang-Fu(1. Stomach & Spleen - epigastric pain and fullness, poor

digestion, a feeling of fullness, a sticky taste in the mouthand a poor appetite

(2. Urinary Bladder - difficult and painful urination and cloudy






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urination

(3. Intestines - loose stools with mucus, abdominal pain and

fullness

(4. Uterus - infertility or excessive vaginal discharge

(5. Gall Bladder - hypochondrial pain & fullness(6. Liver - hypochondrial fullness, distension and pain,

jaundice

(7. Kidneys - cloudy urine, difficult urination

b. Dampness in the channels/meridians manifesting as pain,

swelling and heaviness of the joints

c. Dampness in the skin manifesting mainly as eczema, puffinessand oozing lesions

2. Acute - Damp-Heat at the qi level with fever that is worse in the

afternoon, body that is hot to the touch, aversion to cold, swollen

glands, headache, a feeling of heaviness, a feeling of oppression in

the epigastrium, a sticky taste in the mouth and thirst with no desireto drink, sticky white tongue coating and soggy pulse

Treatments - Acupuncture

i






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Points:

1. St36 - strengthens the Spleen and disperses Damp-Heat and Wind-Damp in the whole body

2. St40 - resolves Damp and Phlegm in the whole body

3. St44 - cools Heat in the Stomach and removes obstruction from the

Intestines - for conditions of Damp-Heat diarrhea and dysentery

4. LI4 - dispels Damp-Heat from the Stomach and Intestines

5. LI11 - cools Heat and alleviates Dampness; for Damp-Heat dysenteryor skin conditions (e.g. eczema)

6. Sp3 - best with Dampness in the channels7. Sp9 - disperses Dampness but is used more for Damp-Heat than

Damp-Cold, more for Damp-Heat diarrhea, dysentery, vaginal

discharge or urinary disorders8. Ren9- resolves Dampness in the middle jiao

9. Ren12 - regulates Stomach Qi and disperses Dampness in themiddle jiao

10. UB20 - used more for Damp-Cold to reinforce Spleen yang

11. Pc6 - pacifies the Stomach and resolves Dampness in the middle jiao

T t t H b l F l







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Treatments - Herbal Formulae

The Formulas and Strategies text (13) lists formulae the treat conditions

of Dampness that are categorized into 5 sections.

1. Formulae that Promote Urination and Leach out Dampnessa. wu ling san (5 Ingredient Powder with Poria) - exterior

pathogenic influences that disrupt the functions of the UrinaryBladder

b. zhu ling tang (Polyporus decoction) - injury from Cold entering

the Yangming or Shaoyin where it transforms into Heat

c. wu pi san (5 Peel Powder) - skin edema due to invasion of

wind disrupting the function of the Lungs to move qi downwards

d. fang ji huang qi tang (Stephania & Astragalus Decoction) -Wind-Dampness or Wind edema due to invasion of Wind &

Damp

2. Formulae that Transform Damp Turbiditya. ping wei san (Calm the Stomach Powder) - Damp-Cold

stagnating in the Spleen and Stomach

b. huo xiang zheng qi san (Agastache Powder to Rectify Qi) -externally contracted Wind-Cold causing qi stagnation

3 F l th t Cl D H t







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3. Formulae that Clear Damp-Heat

a. san ren tang (3 Nut Decoction) - early-stage damp warm-

febrile disease or summerheat warm-febrile disease where

Dampness predominates and the pathogenic influences are

lodged in the wei and qi levelsb. gan lu xiao du dan (Sweet Dew Special Pill to Eliminate Toxin)

- early-stage of a damp warm-febrile disease or seasonal

epidemic disorder

c. lian po yin (Coptis and Magnolia Bark) - sudden turmoil

disorder due to an aggregation of Damp-Heat in the body

d. yin chen hao tang (Artemisia Yinchenhao Decoction) - yang-type or "fresh tangerine" color jaundice due to Dampness and

Heat interior accumulation

e. zhong man fen xiao wan (Separate and Reduce Fullness in

the Middle Pill) - drum-like abdominal distention due to Heat

f. ba zheng san (8 Herb Powder for Rectification) - hot or bloodypainful urinary dysfunction due to clumping of Damp-Heat in thelower jiao

g. shao yao tang (Peony Decoction) - Damp-Heat lodged in the

Intestines causing Qi and Blood stagnation

h er miao san (2 Marvel Powder) Damp Heat in the lower jiao








h. er miao san (2 Marvel Powder) - Damp-Heat in the lower jiao

4. Formulae that Warm and Transform Water and Dampness

a. zhen wu tang (True Warrior Decoction) - Kidney yang

deficiency or Kidney and Spleen yang deficiency with retention of

pathogenic waterb. shi pi yin (Bolster the Spleen decoction) - yin type edema due

to Spleen and Kidney yang deficiency

c. bei xie fen qing yin (Dioscorea Hypoglauca Decoction to

Separate the Clear) - cloudy painful urinary dysfunction due to

Cold from deficiency in the lower jiao

d. ji ming san (Powder to take at Cock's Crow) - "damp" leg qicaused by Damp-Cold obstructing the smooth flow of Qi and

Blood in the legs

5. Formulae that Dispel Wind-Dampness

a. qiang huo sheng shi tang (Notopterygium Decoction to

Overcome Dampness) - Wind-Dampness in the superficialaspects of the bodyb. juan bi tang (Remove Painful Obstruction Decoction) - joint

pain due to local obstruction by Wind-Cold-Damp

c. gui zhi shao yao zhi mu tang (Cinnamon Twig, Peony and

Anemarrhena Decoction) recurrent Wind Cold Damp localized








Anemarrhena Decoction) - recurrent Wind-Cold-Damp localized

painful obstruction causing Heat

d. xaun bi tang (Disband Painful Obstruction Decoction) - painful

obstruction due to containment of Damp-Heat in the channels

e. du huo ji sheng tang (Angelica Pubescens and SangjishengDecoction) - painful obstruction with Liver and Kidney deficiency

Treatments - Food Therapy

Many of the foods that one finds in the typical grocery store have

been manufactured such that they are inimical to your health,one estimate being at least 85%. Any food that causes any kind

of adverse affect on the Spleen system (in TCM) will eventuallyresult in Dampness in the organs and meridians, depending

upon the particular genetic constitution of the patient.

One may find the result of decades of dampness in the body bysearching the skin and finding the following lesions: white or dark

colored patchy and rough raised splotches around the eyes due

to cholesterol deposits, skin tags due to toxic damp-heat in the

skin and seborrheic keratoses due to chronic damp-heat in the

skin








skin.

The author has found that the daily drinking of a decoction (tea)made from dried flowers (seed pods) of the Roselle (Hibiscus

sabdariffa) and Ju Hua (Chrysanthemum flower) is very effective

in drying up these type of lesions. One must make the tea very

concentrated for it to be effective. Results may not become

visible for as long as a year and longer due to the number of

years the condition has been building. If the tea is too weak,there is no affect. If the tea is too strong it may cause

constipation. Each person will need to determine their effectivedose for themselves through trial and error.

If your intention is also to loose weight, brew your favorite Oolong

tea (or other tea type) with the Roselle. Sweeten your tea

sparingly with Maple syrup, raw sugar, honey or Agave syrup.Make the tea as bitter as you can stand in order to get the

polyphenols that are beneficial(http://en.wikipedia.org/wiki/Polyphenol_antioxidant).

Studies have shown that drinking Hibiscus tea can effectively








Studies have shown that drinking Hibiscus tea can effectively

lower high blood pressure and reduce high cholesterol levels in

many individuals! Read an article about it in the February 1, 2009

issue of Internal Medicine News. Hibiscus and Hibiscus Mint tea

are caffeine free. Hibiscus tea is also rich in Vitamin C; has aunique, delicious taste; has a smooth, pleasant fragrance; has a

distinctive, vibrant, natural color (fushia to purple); is great served

hot or cold; has long been known in the deep South of the USA

to act as a natural body refrigerant. This is particularly useful

during the time of summer heat.

CONCLUSIONS

In dealing with the many problems of Dampness, the organs

involved in the metabolism of water need particular attention. The

Lungs, the Spleen and the Kidneys are all intimately involved in

various ways with the issue of water metabolism in the body.Dampness and its combinations with Wind, Cold and Heat cause

some form of obstruction of Qi and Blood or blockage of thechannels in some manner, if not directly impairing the function of

the Lungs the Spleen and the Kidneys Treatment of Damp and








the Lungs, the Spleen and the Kidneys. Treatment of Damp and

its combinations involves removing the obstructions and

dissipating the pathological products as well as returning the

normal functionality of the Zang-Fu organs. Both the use of

acupuncture and Chinese herbal medicine is very effective forresolving the pathological conditions of Dampness. Treatment is

as always dependent upon the skill of the practitioner in

determining the diagnosis from the signs and symptoms of the

patient. Choice in use of points and herbal formulae and their

modifications comes with observation, experience and practice.

The patient needs to be aware that there is no quick fix for thetreatment of Dampness conditions. Depending upon how many

years the condition has been developing and been evident, it

may take a few years to correct. All will be to no avail if the

patient does not make serious lifestyle changes to the better.

Perseverance furthers!

REFERENCES

1. Cheng, X. N., Chief Editor, 1987, "Chinese Acupuncture andMoxibustion", Foreign Languages Press, Beijing, pg 254

2 Ibid pgs 256-257








2. Ibid, pgs 256 257

3. Akopyan, A., 2003, "Dampness and the Circle of Wellness",

http://www.acupuncture.com/newsletters/m_dec03/main2.htm

4. Ibid, pg 260

5. Bensky, D., Gamble, A., 1993, "Chinese Herbal MedicineMateria Medica, Revised Edition", Eastland Press, Seattle, pg

134

6. Ibid, pg 386

7. Ibid, pg 145

8. Ibid, pg 390

9. Treharne, A., "Food Therapy for Diarrhoea",http://www.rchm.co.uk/articles/food_therapy.html

10. Chia. M., 2006, "Guidelines for Eating", http://www.universal-

tao.com/article/guidelines.html

11. Dharmananda, S., 1997, "The Use of Aromatic Agents for

Regulating Qi, Vitalizing Blood and Relieving Pain",http://www.itmonline.org/arts/aromatic.htm

12. Maciocia, G., 2004, "Diagnosis in Chinese Medicine: A

Comprehensive Guide", Churchill Livingstone, pgs 948-950

13. Bensky, D., Barolet, R., 1990, "Chinese Herbal Medicine:

Formulas and Strategies" Eastland Press Seattle pgs 173-








Formulas and Strategies , Eastland Press, Seattle, pgs 173

212

Oriental Medicine Section





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