Dampness is one of the six pathogenic factors.
The invasion of dampness is ubiquitous, affecting countless individuals. The “Su Wen – Zhi Zhen Yao Da Lun” states: “All swellings due to dampness belong to the spleen.” The theory of transformation in the “Shang Han Lun” suggests that the Taiyin (Greater Yin) is inherently damp, and thus its manifestations are closely related to the spleen. From the “Nei Jing” to the “Shang Han Lun”, all discussions of damp diseases are intimately connected to the Taiyin spleen. This is a main pathway that must guide the differentiation of dampness syndromes.
1. Cold Dampness
According to the “Shang Han Lun” (section 273): “The disease of Taiyin manifests as abdominal fullness and vomiting, with little appetite, and the abdomen may ache at times. If purged, there will be hardness below the heart.” This section outlines the characteristics of cold dampness in the Taiyin spleen. Zhang Zhongjing identifies three features: 1) diarrhea; 2) abdominal fullness; 3) significant relief after bowel movements. By grasping these three characteristics, one can confidently treat according to the Taiyin spleen’s cold dampness theory.
A patient from Yinchuan, Mr. Yang, suffering from liver cirrhosis with ascites, presented with swelling in his legs and scrotum, and his condition was critical. He traveled to Beijing for treatment. His pulse was deep, his complexion dark, and his tongue was red with bloodstains on the edges. I asked: “Is your abdomen swollen? Is urination difficult?” He nodded affirmatively. I further inquired about his bowel movements: “How many times do you defecate daily?” He replied, “Three to four times, but they are not formed.” I said: “In Taiyin disease, abdominal fullness leads to significant relief after bowel movements, and it is said: ‘If there is relief without thirst, it belongs to Taiyin, due to cold in the organs.’ This indicates that the liver disease has affected the spleen, leading to cold dampness in the spleen, which cannot transform, causing stagnation in the central region. Observing the swelling in his legs and scrotum indicates that the issue is not limited to the spleen, but also involves kidney qi deficiency. The treatment was: 12g of Fu Zi (Aconite), 12g of Gan Jiang (Dried Ginger), 12g of Hong Ren Shen (Red Ginseng), 12g of Bai Zhu (White Atractylodes), and 10g of Zhi Gan Cao (Honey-fried Licorice). At that time, his daughter Baohua was present and remarked: “The patient’s tongue is red, and there are bloodstains on the edges, indicating a reflection of yin deficiency with heat. Now, using a large dose of Fu Zi in the Li Zhong Tang (Regulate the Middle Decoction), how does this not harm yin and move blood?” I replied: “This patient has ascites like a jar, with legs swollen like an elephant, and the scrotum accumulating water that does not dissipate, all due to the accumulation of water qi. Water is fluid. Now, if the fluid transforms into water, and water accumulates into disaster, it will inevitably lose its usual moistening properties, leading to signs of yin deficiency and heat. I use Fu Zi in Li Zhong Tang to warm the spleen and kidneys, dry and promote movement to overcome cold dampness. When the heavens clear and the clouds disperse, qi transformation will occur, and there will be no deficiency!” After taking the medicine for seven doses, his diarrhea reduced to two times, abdominal swelling decreased, and urine output increased. Continuing with warming herbs to transform qi and promote water movement, he turned from critical to stable and eventually recovered.
The “Su Wen – Zhi Zhen Yao Da Lun” states: “When dampness is abundant, it is due to the victory of earth, and cold water receives the pathogen, leading to kidney disease… This is what is meant by being affected by pathogens and developing disease.” I believe these two sentences explain the pathological mechanism of “kidney affliction” in the “Jin Kui Yao Lue” very appropriately. Zhongjing used the term “affliction” to indicate that the pathogen is damp, which has a sticky nature, originating from the spleen. The spleen governs earth, and the qi of earth is damp; earth can overcome water, and dampness can afflict the kidneys, thus pointing out the source of dampness. Based on clinical observations, the symptoms of “kidney affliction” primarily manifest as astringent and sticky discharges, with pain being secondary. In men, this often presents as dampness in the scrotum, resembling water stains; in women, it often presents as continuous vaginal discharge. Therefore, the text’s description of “as if sitting in water, resembling a water state” has a double meaning, not merely referring to the “cold in the waist and sitting in the water spring” syndrome.
A female patient, Liu, aged 37, presented with lower back pain and continuous foul-smelling vaginal discharge. Her pulse was deep and weak, and her tongue was large and tender. She was overweight, with weak qi and fatigue. I diagnosed this as cold dampness descending and obstructing the kidneys, belonging to the “kidney affliction” syndrome in the “Jin Kui Yao Lue”. The treatment was: 12g of Gan Jiang (Dried Ginger), 20g of Fu Ling (Poria), 16g of Bai Zhu (White Atractylodes), 6g of Zhi Gan Cao (Honey-fried Licorice), 10g of Chao Du Zhong (Stalk of Eucommia), and 10g of Xu Duan (Dipsacus). After taking this formula for seven doses, she recovered. The sticky nature of dampness is prone to corruption. Cold dampness stagnates, and the discharge has a foul odor; people often mistake it for heat, unaware that a little exposure to spleen yang can lead to recovery.
Next, I will discuss the issues of “cold dampness foot disease” and “heart affliction from foot disease”.
In the “Famous Doctors’ Experience Record” compiled by our school, there is an article summarizing Professor Song Xiaozhi’s clinical treatment of cold dampness foot disease, which has high practical value and should be promoted. In the treatment of heart failure with edema, Professor Song has unique insights and experiences, especially in differentiating and treating heart failure due to rheumatic heart disease. He employs methods to open the lungs and disperse the liver, warming and dispersing cold dampness, rather than merely focusing on reducing swelling and promoting urination. He introduced the “Ji Ming San” as the main formula, which bitterly descends and astringes, warming and dispersing cold dampness. For decades, he has treated many patients with rheumatic heart disease and heart failure using this method, achieving remarkable results, and has been praised by many doctors and patients as a unique treatment for edema. Professor Song believes that the special pathogenic mechanism of rheumatic heart disease and heart failure is that initially, the three evils of wind, cold, and dampness combine to cause disease, with cold dampness being the most severe. Cold dampness obstructs the liver meridian, flowing to the limbs and joints, leading to long-term obstruction of the meridians, cold dampness stagnation, and disharmony of qi and blood, resulting in edema. Since the liver is the mother of the heart, a long-standing illness of cold dampness can ascend to the heart and affect the lungs, leading to symptoms such as palpitations and shortness of breath. Treatment should focus on opening upward and guiding downward, warming the meridians, dispersing cold, and promoting the discharge of damp turbidity. Based on this mechanism, he selects Ji Ming San as the main formula.
Ji Ming San is a formula from the book “Classified Compilation of Zhu’s Medical Formulas” by Zhu Junfu from the Song Dynasty.
Originally a key formula for treating “damp foot disease” with swelling in both legs, it is based on the principle of “treating the affliction” with ingredients such as Bing Lang (Areca), Chen Pi (Tangerine Peel), Mu Guo (Papaya), Wu Zhu Yu (Evodia), Chai Hu (Bupleurum), Su Ye (Perilla Leaf), Jie Geng (Platycodon), and Sheng Jiang (Fresh Ginger) to promote qi and eliminate dampness. All the herbs in the formula are qi-dominant, as treating swelling must address water, and treating water must address qi; when qi moves, water disperses. Su Ye warms and disperses wind-cold, Jie Geng opens and promotes the upper jiao, Chen Pi opens the qi of the middle jiao, Wu Zhu Yu drains cold turbidity, and Bing Lang weighs down to reach the lower jiao, thus treating all three jiao simultaneously. Additionally, Mu Guo paired with Wu Zhu Yu can balance the upward counterflow of qi to prevent dampness from ascending. In summary, all the herbs primarily focus on qi, allowing the cold dampness to be resolved either through sweating or through bowel movements. It must be emphasized that this formula should be taken at the time of the rooster’s crow, cold, to allow yang to enter yin and to dispel the pathogen from yin. Modifications: If cold is severe, add Fu Zi; if heart yang is deficient, add Gui Zhi; if there is blood in the phlegm, add a small amount of Tao Ren (Peach Kernel); if edema is more severe, add Fu Ling and Ze Xie (Alisma); if women have menstrual irregularities, add Xiang Fu (Cyperus), Tao Ren, and Yi Mu Cao (Leonurus).
Ji Ming San is a renowned formula, specializing in treating damp foot disease and heart affliction from foot disease.
Although Professor Song has passed away, he left behind many invaluable medical experiences.
In my clinical practice, when treating water qi and leg swelling, I often achieve results with Wu Ling San (Five-Ingredient Powder with Poria) and Fang Ji Huang Qi Tang (Stephania and Astragalus Decoction), but sometimes it does not yield results. When patients urge for rapid swelling reduction, like a raging fire, it often leaves me at a loss. At such moments, I recall the “Ji Ming San” introduced by Professor Song, which astonishingly treats leg swelling and even kidney cysts, yielding remarkable results.
From the above, it can be seen that dampness in the middle jiao can descend to the kidneys and can also ascend to the heart from the lower jiao.
All substances have the characteristic of movement; “water inherently moistens downward,” yet there are also cases of upward counterflow. Both “kidney affliction” and “cold damp foot disease” belong to the category of cold dampness injuring qi, with qi stagnation and cold congealing, but they do not yet involve blood. Now I will introduce a syndrome and treatment of cold dampness injuring blood.
A male patient, Liu, aged 76, was showering at home when the water from the showerhead was scalding hot. He urgently called for cooler water, but it turned out to be ice-cold. Since then, red-purple spots appeared on his left leg, totaling three patches. The pain was quite severe. According to statistics: he had taken Long Dan Cao (Gentiana) decoction for cooling; he had taken Xiao Xu Ming Tang (Minor Resuscitation Decoction) for dispersing cold; he had also taken blood-activating detoxifying medicine, including Xian Fang Huo Ming Yin (Immortal’s Formula for Reviving Life). Despite taking many medicines, none were effective, and the pain worsened daily. His friend Zhao came to me for treatment. I found his pulse to be slow and weak, and his tongue coating was white, greasy, and moist. The painful areas still had three purple spots, which had not resolved for two months. The pain was felt in the muscles, with no relation to the tendons and bones, and it worsened with wind and cold. Based on the pulse, I diagnosed it as cold dampness injuring blood, rather than a heat pathogen. The prescription was: 10g of Cang Zhu (Atractylodes), 10g of Chen Pi (Tangerine Peel), 14g of Hou Po (Magnolia Bark), 10g of Zhi Qiao (Bitter Orange), 10g of Jie Geng (Platycodon), 3g of Ma Huang (Ephedra), 10g of Gui Zhi (Cinnamon Twig), 6g of Fu Zi (Aconite), 5g of Gan Jiang (Dried Ginger), 14g of Dang Gui (Angelica), 8g of Chuan Xiong (Szechuan Lovage), 10g of Chi Shao (Red Peony), 2 segments of green onion, and 3 slices of fresh ginger. After taking the second dose, the pain decreased; by the third dose, he broke into a sweat, and from then on, he recovered. This formula was modified from the “Wu Ji San” of the Song Dynasty, adept at treating various pains caused by cold dampness injuring blood, with remarkable efficacy.
Zhang Cuojing treated cold dampness with body pain using Ma Huang Tang (Ephedra Decoction) to disperse cold, adding Bai Zhu to eliminate dampness, and instructed that after taking the medicine, a “slight sweat” should be encouraged. The Ma Huang and Bai Zhu decoction can treat cold dampness throughout the body and also treat “edema” with excellent results. Regarding the treatment of edema with Ma Huang, it should be noted that there are two formulas: one is the local formula of Yue Bi Jia Zhu Tang (Yue Bi Decoction with Bai Zhu), and the other is Ma Huang and Bai Zhu Decoction.
A female patient, Gao, aged 37, suffered from edema for eight years, which had never resolved, and it worsened whenever she was exposed to wind and cold. She had been diagnosed by Western medicine as “myxedema” and had received various treatments without effect. The patient presented with facial swelling. She also experienced chills, fullness in the chest, heaviness and soreness in the limbs, difficulty urinating, and constipation. Her tongue coating was white and slippery, and her pulse was floating and wiry. Based on the above pulse and symptoms, I diagnosed it as cold dampness obstructing the exterior, with the three jiao not functioning properly, and the lung’s regulating function not being effective. The treatment was: 9g of Ma Huang (Ephedra), 6g of Gui Zhi (Cinnamon Twig), 10g of Xing Ren (Apricot Kernel), 3g of Zhi Gan Cao (Honey-fried Licorice), and 10g of Cang Zhu (Atractylodes). After each dose, she would break into a slight sweat; after three doses, the swelling subsided, and urination improved, with all other symptoms resolving as well. The Ma Huang and Bai Zhu decoction is a renowned formula for treating body pain caused by dampness. “Body pain” refers to severe pain, indicating a cold dampness syndrome. Now using it to treat edema, Zhongjing had not mentioned this before. If it is said that “upper swelling is suitable for sweating,” then using it to “open the ghost gate” to reduce swelling is also acceptable. Moreover, Ma Huang opens the lung of the Taiyin to promote the qi of the three jiao, while Bai Zhu moves the qi of the Taiyin spleen to transform the dampness of the entire body, making it suitable for treating “two Taiyin damp diseases”; how can it be resolved solely by sweating? Thus, I conclude with a verse:
Cold dampness causes body pain and unrest, borrowing treatment for swelling is not biased; slight sweating is good, four herbs of Bai Zhu and three of Ma Huang must be carefully considered.
2. Wind Dampness and Damp Heat
Wind dampness causes pain throughout the body, particularly with fever, and is more severe in the afternoon, which is its characteristic.
Zhang Zhongjing treated wind dampness with Ma Huang Xing Ren Yi Yi Gan Cao Tang (Ephedra, Apricot Kernel, Job’s Tears, and Licorice Decoction). The formula is: Ma Huang (Ephedra) without branches, half a tael soaked, one tael of licorice, roasted, half a tael of Job’s Tears, and ten apricot kernels, peeled and roasted. Grind to a powder, take four qian (a traditional weight unit), with half a cup of water, boil to 80% remaining, strain, and take warm with slight sweating. This formula treats wind dampness, and the dosage should be light, not heavy. “Light can remove the solid,” and a mild flavor can transform the turbid. The dosage in the “Wai Tai Mi Yao” is four taels of Ma Huang, which is difficult to follow.
Wu Jutong’s “San Ren Tang” developed from Ma Huang Xing Ren Yi Yi Gan Cao Tang. His differentiation of damp-warm patterns created the theory of the three jiao. “The three jiao are the officials of decision and drainage, and the waterway emerges from them.” Therefore, Wu’s theory of the three jiao closely ties to the transformation rules of damp diseases, while also subtly indicating the treatment principles for damp-warm diseases. San Ren Tang promotes the upper jiao lung qi, allowing the water dampness to flow downward, preventing it from hiding; Bai Dou Kou (White Cardamom) has a spicy aroma that awakens the stagnant qi; Yi Yi Ren (Job’s Tears) promotes dampness and breaks stagnation, clearing damp heat to relieve the lower jiao’s obstruction. Although the herbs have distinctions in the three jiao, they are interconnected and have synergistic effects. Opening the upper jiao aids the qi of the middle jiao; rotating the qi of the middle jiao also has the function of guiding upward and downward; opening the lower jiao allows dampness to have an exit, thus eliminating concerns of damp heat entanglement. Once the three jiao are unblocked, the damp heat and turbid filth will be transformed, and the qi will flow smoothly.
[Recommended] Mr. Liu Duzhou’s “Discussion on Dampness Syndromes”
Wu’s genius developed Zhongjing’s studies, establishing an immortal achievement in the medical field. However, he also had a fear of Ma Huang. Due to his hesitation in using Ma Huang, he overlooked Zhongjing’s great phenomenon of “cloud dragon’s three appearances”.
What is “cloud dragon’s three appearances”? The ancients referred to Ma Huang as “green dragon”. The dragon is a divine creature, bringing clouds and rain, unpredictable. One is for treating cold wheezing with Xiao Biao Long Tang (Minor Dragon Decoction), the second is for treating heat wheezing with Ma Huang Xing Ren Shi Gan Cao Tang (Ephedra, Apricot Kernel, Gypsum, and Licorice Decoction), and the third is for treating damp wheezing with Ma Huang Xing Ren Yi Yi Gan Cao Tang.
Some may ask: Ma Huang Xing Ren Yi Yi Gan Cao Tang is only mentioned by Zhongjing for treating wind dampness, fever, and body pain, but not for wheezing.
I hear this and smile, saying: This formula contains both Ma Huang and Xing Ren, and the only difference from Ma Huang Xing Ren Shi Gan Cao Tang is the addition of Shi Gan (Gypsum); it can treat heat wheezing, and it is unreasonable to disallow this formula from treating damp wheezing. To treat wheezing, Ma Huang must be used, but there are certain limits and orderly methods. Zhongjing depicted the divine dragon soaring through the clouds with a stroke of genius, writing the great phenomenon of “cloud dragon’s three appearances,” which can be said to be “rarely seen”. However, I am surprised that both domestically and internationally, reports on using Ma Huang to treat damp cough and wheezing are extremely rare, and it can be said to be a niche topic in today’s warm disease studies.
Next, I will discuss the issue of damp warmth causing wheezing. According to the TCM theory of “the interaction of human and natural qi”, due to changes in the climate and the improvement of living standards, people’s constitution is developing towards a “damp-heat type”. Therefore, across the world, whether from external pathogens or internal injuries, dampness transforms into heat, easily combining. Damp heat entangles like oil in flour, difficult to separate; over time, it divides into damp diseases according to the three jiao: in the upper jiao, there is damp cough and wheezing; in the middle jiao, there is jaundice; in the lower jiao, there are kidney and liver diseases. If damp heat causes wheezing, treating it with wind, cold, fire, or heat will not only be ineffective but will worsen the condition. Based on clinical observations, this disease presents with copious and sticky phlegm, which may be white or yellow, fullness in the chest, bloating, fatigue, throat discomfort, and low-grade fever in the afternoon. Urine is yellow, and stools are sticky and unsatisfactory, with a floating and slippery pulse and a white greasy tongue coating. The key points for differentiation are: cough and wheezing with chest fullness, white greasy tongue coating, and floating slippery pulse.
In treating this disease, I have used many formulas, but they have all been ineffective. Finally, I selected the “Gan Lu Xiao Du Dan” from the “Wen Re Jing Wei”.
This formula, also known as “Pu Ji Jie Du Dan”, was originally for treating damp warmth and warm epidemic diseases. The ingredients of this formula include: Chao Pu (Acorus), Bei Mu (Fritillaria), She Gan (Belamcanda), Huo Xiang (Agastache), Yin Chen (Virgate Wormwood), Huang Qin (Scutellaria), Bai Dou Kou (White Cardamom), Lian Qiao (Forsythia), Hua Shi (Talc), Mu Tong (Akebia), Bo He (Mint). When I used this formula, I always added Zi Wan (Aster), Xing Ren (Apricot Kernel), and Yi Yi Ren (Job’s Tears), removing Mu Tong and replacing it with Tong Cao (Rice Paper Plant). This formula uses aromatic herbs like Chao Pu and Huo Xiang to transform damp turbidity; She Gan and Bei Mu clear phlegm heat to benefit the lung and throat; Yin Chen and Huang Qin are bitter and cold, clearing damp heat; Lian Qiao and Bo He are spicy and cool, able to disperse heat from dampness; the three ren (Apricot, Job’s Tears, and Cardamom) benefit the three jiao’s damp heat and regulate the upward and downward qi; Hua Shi and Tong Cao are cold and penetrating, effectively clearing damp heat and sticky pathogens; Zi Wan stops cough and calms wheezing, having the function of lifting the lid.
A boy named Zhao, aged 6, was first diagnosed on June 20, 1993. He had allergic asthma, which was triggered by odors, leading to sneezing, followed by coughing, and then wheezing. Recently, his condition worsened, and he could not lie flat due to severe wheezing. Western medicine examination revealed wheezing sounds in both lungs, accompanied by fine rales. White blood cells and eosinophils were elevated. His temperature was 37.9°C. He was diagnosed with allergic asthma combined with pneumonia. Treatment with antibiotics, chlorpheniramine, and theophylline was ineffective. Based on his fullness in the chest, copious phlegm, and white thick tongue coating, I diagnosed it as warm heat obstructing the lung, accumulating phlegm, and dampness obstructing the lung qi, leading to cough and wheezing. The urgent treatment was to use aromatic herbs to transform turbidity, clear heat, benefit dampness, and promote lung function. The prescription was: 12g of Zhe Bei Mu (Zhejiang Fritillaria), 10g of Chao Pu (Acorus), 10g of She Gan (Belamcanda), 10g of Bai Dou Kou (White Cardamom), 10g of Yin Chen (Virgate Wormwood), 12g of Hua Shi (Talc), 8g of Huo Xiang (Agastache), 10g of Xing Ren (Apricot Kernel), 12g of Yi Yi Ren (Job’s Tears), 6g of Huang Qin (Scutellaria), 8g of Zhi Zi (Gardenia), 10g of Tong Cao (Rice Paper Plant), 10g of Jie Geng (Platycodon), 12g of Hou Po (Magnolia Bark), 10g of Qian Hu (Peucedanum), and 10g of Zi Wan (Aster). After taking this formula for seven doses, his cough and wheezing significantly improved, allowing him to lie flat at night, and after taking another seven doses, his cough stopped and wheezing resolved. The wheezing sounds in both lungs and fine rales completely disappeared, and his blood count returned to normal.
The lung is located in the upper jiao, serving as the official of regulation, responsible for managing the body’s qi. The lung is sensitive to fire and is most averse to phlegm and dampness, which obstruct its descending qi. In this case, the wheezing and body heat were not prominent, with chest fullness, poor appetite, short and red urine, and a white greasy tongue coating, reflecting dampness obstructing the lung qi. The selected treatment was a combination of Gan Lu Xiao Du Dan and San Ren Tang, using aromatic herbs to transform dampness, clear heat, and promote lung function, effectively treating damp wheezing.
Once, I treated a patient named Xu, aged 48, whose symptoms included severe wheezing with light coughing, copious phlegm that was difficult to expel, and he could not lie flat due to wheezing. His pulse was floating and slippery, and his tongue coating was white and greasy. I had a clear understanding and immediately diagnosed it as damp wheezing. I used Gan Lu Xiao Du Dan for treatment, but to my disappointment, the patient showed no improvement after taking the medicine. What should I do next? I recalled that Zhongjing prioritized Ma Huang for treating wheezing, such as Qing Long (Green Dragon) and Ma Gao (Ephedra Paste), but none mentioned treating “damp wheezing.” Moreover, the dampness pathogen is also a concern with Ma Huang, leaving me in a dilemma. Therefore, I searched the “Jin Kui Yao Lue” and found that in the section on dampness, it states: “The patient experiences pain throughout the body, fever, and is more severe in the afternoon, known as wind dampness. It can be treated with Ma Huang Xing Ren Yi Yi Gan Cao Tang.” Ma Huang without branches, half a tael soaked; one tael of licorice, roasted; half a tael of Job’s Tears; and ten apricot kernels, peeled and roasted.
In treating wind dampness on the surface, I realized the treatment plan for damp warmth causing wheezing.
As the saying goes, “the heart has a connection with the mind,” I couldn’t help but exclaim: “To treat damp wheezing, there is no other than Ma Huang Xing Ren Yi Yi Gan Cao Tang!” The brilliance of the Ma Huang Xing Ren Yi Yi Gan Cao Tang formula lies in the fact that it only uses half a tael of Ma Huang, not more, and is soaked, which serves to lightly disperse the upper jiao, first opening the lung qi and inducing slight sweating, which is the method for treating dampness. Accompanied by Xing Ren and Yi Yi Ren to benefit lung qi and guide dampness, allowing it to exit through the three jiao. If the lung does not disperse, the three jiao will not function properly; if the three jiao do not function, the lung qi will also not disperse. Thus, the interplay of opening and descending, dispersing and benefiting, is remarkable in its lightness and clarity. Upon deep reflection, I find the profound meaning boundless; although the formula is ancient, its treatment remains fresh. The great phenomenon of “cloud dragon’s three appearances” is clearly established, adding fresh air to the study of damp warmth. Who says there is no development within inheritance? Thus, I resolutely added 2g of Ma Huang to the Gan Lu Xiao Du Dan, first boiling it to remove the foam. Xu’s grandmother changed to this formula, and after three doses, his wheezing improved, and he felt better, quickly recovering. Since then, not only hundreds of patients have benefited from this method, but due to space limitations, I cannot elaborate further.
I believe that the greatest flaw in the study of “warm diseases” lies in its “damp warmth theory”; damp warmth is the most complex, and the treatment methods are the most challenging. The essence of differentiation and treatment is vividly expressed, demonstrating great effort. To simplify and generalize, one should first reveal the characteristics of damp warmth as a disease, which includes four distinct points:
1. Dampness is a sticky pathogen that can obstruct the movement of qi;
2. Dampness causes fever, with body heat not rising, more severe in the afternoon;
3. Damp heat harms the body, causing heaviness and soreness, leading to lethargy;
4. The pulse is floating and slippery, with a white greasy tongue coating.
In verse:
Damp warmth with a white coating and a floating slippery pulse, chest fullness and abdominal bloating with no desire to eat; fever not rising, body heavy and sore, the four major characteristics for differentiation.
Although the treatment of damp warmth varies in the upper, middle, and lower jiao, the representative formulas include: San Ren Tang, Gan Lu Xiao Du Dan, and Huo Xiang Zheng Qi San, which are renowned formulas for treating damp warmth. Grasping this core allows one to charge into battle and achieve remarkable success.
Even when the damp warmth disease is condensed to this extent, it cannot be said to be completely resolved. There is also a famous formula called “Jia Jian Mu Fang Yi Tang” that can treat “damp heat obstruction” with remarkable efficacy, which must be mentioned. Jia Jian Mu Fang Yi Tang originates from Wu Jutong’s “Wen Bing Tiao Bian”. He stated: “For summer dampness obstruction, Jia Jian Mu Fang Yi Tang is the main treatment.” Summer is a heat pathogen, and “summer damp obstruction” is synonymous with “damp heat obstruction.” Jia Jian Mu Fang Yi Tang is a renowned formula for treating damp heat obstruction.
Since the “Su Wen – Bi Lun” pointed out that “wind, cold, and dampness are mixed, combining to form obstruction. If wind prevails, it is moving obstruction; if cold prevails, it is painful obstruction; if dampness prevails, it is sticky obstruction.” Later generations of physicians have followed this principle, emphasizing the importance of wind, cold, and dampness in treating obstruction syndromes.
The concept of “damp heat obstruction” emerged in later generations, developed by Qing Dynasty physicians. This syndrome arises from the external invasion of heat pathogens combined with dampness; or from a constitution with excess yang, easily transforming into heat upon exposure to external pathogens; or due to long-standing wind, cold, and dampness obstruction, which stagnates yang qi and transforms into heat; or due to excessive use of warm and hot medicines during treatment, all of which can lead to the occurrence of “damp heat obstruction”.