Modern individuals often suffer from damp-heat, cold-damp, and damp-obstruction syndromes, and the prevalence of dampness is a common concern. In fact, discussions on dampness can be traced back to the Huangdi Neijing and Nanjing. The term “damp syndrome” can be traced back to the Jinkui Yaolue where it discusses dampness-related diseases. The earliest mention of damp syndrome appears in the Jingyue Quanshu, and there are dedicated writings such as Xue Xue’s On Damp-Heat Diseases. Damp syndromes are not exclusive to the southern regions; northern areas also experience dampness. Diagnosis often differentiates between internal and external patterns and the three burners. Below are twelve commonly used diagnostic and treatment methods for internal medicine, which can be referred to as a comprehensive guide for treating various damp syndromes such as damp-heat, cold-damp, and damp-obstruction.
1. Spleen Qi Deficiency with Damp Obstruction
Symptoms: Abdominal fullness and distension, worse after eating, heavy head and dizziness, pale yellow complexion, fatigue, lethargy, lack of desire to move, bland taste, poor appetite, loose stools, pale and swollen tongue with teeth marks, thin white greasy coating, weak and thin pulse.
Treatment Principle: Tonify Qi, strengthen the spleen, transform turbidity, and eliminate dampness.
Prescription: 12g Tai Zi Shen (Pseudostellaria), 12g Fu Ling (Poria), 10g Cang Zhu (Atractylodes), 9g Ban Xia (Pinellia), 9g Chen Pi (Aged Tangerine Peel), 4g Sha Ren (Amomum), 10g Bian Dou (Lima Bean), 6g Huo Xiang (Agastache), 10g Pei Lan (Eupatorium), 3 slices of Sheng Jiang (Fresh Ginger).
Modifications: For Qi deficiency with sinking sensation and heavy abdomen, remove Bian Dou, Huo Xiang, and Pei Lan, and add 15g Huang Qi (Astragalus), 9g Chao Zhi Shi (Stir-fried Bitter Orange), and 6g Sheng Ma (Cimicifuga). For severe dizziness, indicating failure of clear Yang to rise, add 6g He Ye (Lotus Leaf) and 10g Ge Gen (Kudzu Root). For food stagnation, add 30g Jiao San Xian (Three Immortals) and 9g Xiang Yuan Pi (Citron Peel).
2. Dampness Accumulation in the Stomach
Symptoms: Stomach fullness and discomfort, bloating after meals, nausea and vomiting, poor appetite, hiccups, pale red tongue, thin white greasy coating, slippery or soft pulse.
Treatment Principle: Aromatic transformation of turbidity, harmonize the stomach, and descend rebellious Qi.
Prescription: 10g Jiang Ban Xia (Ginger Pinellia), 10g Pi Pa Ye (Loquat Leaf), 12g Huo Xiang (Agastache), 6g Su Geng (Perilla Stem), 6g Bai Dou Kou (White Cardamom), 10g Chen Pi (Aged Tangerine Peel), 10g Fu Ling (Poria), 6g Xing Ren (Apricot Kernel), 3g Sheng Jiang (Fresh Ginger).
Modifications: For thick white greasy coating, add 6g Cao Guo (Tsaoko Fruit); for thin yellow greasy coating, add 12g Zhu Ru (Bamboo Shavings) and 15g Lu Gen (Reed Rhizome); for thick yellow greasy coating with bitter sticky mouth, remove Su Geng, and add 6g Huang Qin (Scutellaria) and 3g Huang Lian (Coptis). For bitter vomiting and noisy stomach, add 3g Wu Yu (Evodia) and 6g Huang Lian (Coptis). For severe hiccups and vomiting, add 12g Dao Dou (Sword Bean) and 10g Xuan Fu Hua (Inula Flower).
3. Damp Obstruction of the Spleen
Symptoms: Abdominal fullness and distension, general fatigue, heavy limbs, poor appetite, aversion to greasy foods, sticky mouth, white phlegm, sticky stools or diarrhea, pale red tongue, white greasy coating, slippery pulse.
Treatment Principle: Aromatic awaken the spleen, dry dampness, and move Qi.
Prescription: 10g Pei Lan (Eupatorium), 12g Huo Xiang (Agastache), 9g Cang Zhu (Atractylodes), 3g Sha Ren (Amomum), 9g Hou Po (Magnolia Bark), 6g Bai Zhi (Angelica Dahurica), 9g Da Fu Pi (Areca Peel), 9g Chen Pi (Aged Tangerine Peel), 12g Fu Ling (Poria), 6g Ze Xie (Alisma), 12g Liu Yi San (Six One Powder), 6g Jie Geng (Platycodon).
Modifications: For dizziness and unclear vision, add 6g Man Jing Zi (Vitex); for clear and thin leukorrhea, add 9g Chao Jing Jie Sui (Stir-fried Schizonepeta) and 20g Chao Yi Yi Ren (Stir-fried Coix). For severe heaviness in limbs, add 6g Fang Feng (Siler) and 6g Fang Ji (Stephania).
4. Damp-Heat Accumulation
Symptoms: Chest discomfort, abdominal fullness, heavy limbs, dry mouth with bitter taste, sticky stools or constipation, yellow turbid urine, afternoon fever, irritability, pale red or red tongue, yellow greasy coating, slippery or rapid pulse.
Treatment Principle: Clear heat, eliminate dampness, regulate the middle, and move Qi.
Prescription: 6g Huang Lian (Coptis), 3g Zhi Zi (Gardenia), 6g Dou Chi (Fermented Soybeans), 10g Hou Po (Magnolia Bark), 10g Huo Geng (Perilla Stem), 9g Ban Xia (Pinellia), 12g Yin Chen (Virgate Wormwood), 6g Bai Dou Kou (White Cardamom), 10g Xing Ren (Apricot Kernel), 15g Hua Shi (Talc), 6g Tong Cao (Rice Paper).
Modifications: If dampness is heavier than heat, remove Zhi Zi, reduce Huang Lian to 3g, and add 10g Cao Guo (Tsaoko Fruit); if heat is heavier than dampness, add 9g Huang Qin (Scutellaria) and 6g Lian Qiao (Forsythia). For sticky stools, add 12g Bai Jiang Cao (Patrinia) and 10g Zhi Shi (Bitter Orange); for constipation, add 6g Bing Lang (Areca) and 1.5g Sheng Da Huang (Fresh Rhubarb).
5. Cold-Damp Obstruction
Symptoms: Abdominal fullness, dull pain that worsens with cold, alleviated by warmth, clear watery diarrhea, poor appetite, bland taste, heavy body, sore limbs, pale tongue with white slippery coating, deep and slow pulse.
Treatment Principle: Warm the middle, disperse cold, dry dampness, and move Qi.
Prescription: 9g Hou Po (Magnolia Bark), 6g Gan Jiang (Dried Ginger), 6g Cao Guo (Tsaoko Fruit), 12g Cang Zhu (Atractylodes), 9g Chen Pi (Aged Tangerine Peel), 12g Fu Ling (Poria), 6g Ze Xie (Alisma), 6g Guang Mu Xiang (Aromatic Wood).
Modifications: If there is concurrent invasion of cold-damp, with cold body and sore limbs, add 9g Su Ye (Perilla Leaf); if there is liver channel deficiency cold with chest and flank discomfort, pain radiating to the lower abdomen, or menstrual pain, remove Sha Ren and Ze Xie, and add 9g Wu Yao (Lindera) and 10g Cu Yuan Hu (Vinegar-processed Cyperus) and 12g Dang Gui (Angelica Sinensis).
6. Diffuse Dampness, Affecting Both Middle and Upper
Symptoms: Chest fullness and discomfort, abdominal fullness, heavy head, aversion to food, sticky mouth, lack of thirst, pale red tongue, white greasy coating, slippery or soft pulse.
Treatment Principle: Disseminate lung Qi, regulate Qi, strengthen the spleen, and eliminate dampness.
Prescription: 12g Huo Xiang (Agastache), 12g Xing Ren (Apricot Kernel), 9g Dou Chi (Fermented Soybeans), 12g Pei Lan (Eupatorium), 6g Bai Dou Kou (White Cardamom), 9g Ban Xia (Pinellia), 9g Hou Po (Magnolia Bark), 12g Fu Ling (Poria), 6g Zhu Ye (Bamboo Leaf), 10g Pi Pa Ye (Loquat Leaf).
Modifications: For severe chest fullness and discomfort, remove Dou Chi and Zhu Ye, and add 9g Zhi Shi (Bitter Orange) and 9g Xiang Yuan Pi (Citron Peel). If lung Qi is rebellious with cough and phlegm, remove Dou Chi, Pei Lan, and Zhu Ye, and add 10g Qian Hu (Peucedanum) and 10g Chen Pi (Aged Tangerine Peel). If stomach Qi is rebellious with vomiting, add 10g Xuan Fu Hua (Inula Flower) and 6g Sheng Jiang (Fresh Ginger). If dampness transforms into heat, add 6-9g Huang Qin (Scutellaria).
7. Damp Obstruction, Liver and Spleen Disharmony
Symptoms: Flank fullness, abdominal distension, dull pain, pain worsens with diarrhea, pain alleviates after defecation, fatigue, poor appetite, nausea, pale tongue with white greasy coating, weak and wiry pulse.
Treatment Principle: Soothe the liver, relieve urgency, dry dampness, and move the spleen.
Prescription: 12g Chai Hu (Bupleurum), 10g Zhi Ke (Bitter Orange), 9g Qing Chen Pi (Green Aged Tangerine Peel), 10g Cang Zhu (Atractylodes), 10g Yi Yi Ren (Coix), 6g Fang Feng (Siler), 12g Bai Shao (White Peony), 6g Gan Cao (Licorice).
Modifications: For spleen Qi deficiency, add 12g Tai Zi Shen (Pseudostellaria) and 12g Fu Ling (Poria). For middle Yang deficiency with cold symptoms, add 3g Gan Jiang (Dried Ginger) and 6g Cao Guo (Tsaoko Fruit). If there is noisy stomach with sour vomiting, bitter water vomiting, red tongue edges, and dry sticky mouth, it indicates damp-heat accumulation, liver and stomach disharmony, and should be treated with Huang Lian Wen Dan Decoction with modifications.
8. Damp Obstruction of Liver and Gallbladder, Causing Jaundice
Symptoms: Chest and flank fullness, pain and distension in the ribs, yellowing of the skin and eyes, abdominal fullness, dry mouth with bitter taste, nausea and vomiting, poor appetite, heavy limbs, yellow turbid urine, irregular stools, pale tongue with thin yellow greasy coating, deep wiry slippery pulse.
Treatment Principle: Soothe the liver, benefit the gallbladder, clear heat, and eliminate dampness.
Prescription: 12g Chai Hu (Bupleurum), 15g Yin Chen (Virgate Wormwood), 15g Zhi Ke (Bitter Orange), 12g Chi Shao (Red Peony), 10g Chuan Po (Perilla), 6g Chuan Lian Zi (Melia), 9g Yu Jin (Curcuma), 12g Fu Ling (Poria), 6g Ze Xie (Alisma), 6g Cang Zhu (Atractylodes), 6g Gan Cao (Licorice).
Modifications: If dampness transforms into heat, with heat heavier than dampness, remove Chuan Po, Cang Zhu, and Chuan Lian Zi, and add 10g Huang Qin (Scutellaria), 6g Long Dan Cao (Gentiana), and 12g Che Qian Zi (Plantago). If there is significant flank pain, remove Ze Xie, and add 9g Yuan Hu (Cyperus). If there is cold-damp descending, with lower abdominal tightness and testicular heaviness, remove Yin Chen and Ze Xie, and add 6g Gan Jiang (Dried Ginger), 10g Wu Yao (Lindera), and 12g Salted Fennel to warm the liver, disperse cold, and move Qi.
9. Dampness Obstruction, Spleen and Kidney Yang Deficiency
Symptoms: Abdominal fullness and discomfort, intermittent sharp pain, alleviated by warmth, poor appetite, slow digestion, pale complexion, fatigue, heavy limbs, cold body, loose stools, sore lower back, pale swollen tongue with teeth marks, white slippery coating, deep slow pulse.
Treatment Principle: Tonify the spleen and kidneys, warm Yang, and transform dampness.
Prescription: 9g Fu Zi (Aconite), 6g Pao Jiang (Roasted Ginger), 12g Bai Zhu (White Atractylodes), 12g Fu Ling (Poria), 10g Dang Shen (Codonopsis), 6g Hou Po (Magnolia Bark), 6g Guang Mu Xiang (Aromatic Wood), 4g Zhi Gan Cao (Honey-fried Licorice).
Modifications: If there are frequent loose stools, clear and watery, add 12g Zhu Ling (Polyporus) and 10g Ze Xie (Alisma) to enhance diuresis and dampness elimination. If there is significant lower back pain, add 15g Sang Ji Sheng (Mulberry Stem) and 12g Shan Yao (Chinese Yam).
10. Damp-Heat Obstruction of the Intestines
Symptoms: Diarrhea with red and white pus and blood, burning sensation in the anus, abdominal pain and distension, urgency with a feeling of heaviness, fever, irritability, short and red urine, yellow greasy coating, slippery and rapid pulse.
Treatment Principle: Clear heat, dry dampness, regulate Qi, and invigorate blood.
Prescription: 9g Huang Lian (Coptis), 10g Huang Qin (Scutellaria), 3g Da Huang (Rhubarb), 12g Chi Shao (Red Peony), 12g Bai Shao (White Peony), 9g Guang Mu Xiang (Aromatic Wood), 6g Bing Lang (Areca), 12g Ge Gen (Kudzu Root), 6g Gan Cao (Licorice).
Modifications: If dampness is predominant, with more pus than blood, and mild fever, abdominal fullness, and nausea, remove Da Huang and add 12g Huo Xiang (Agastache) and 6g Cang Zhu (Atractylodes). If heat toxicity is severe, with more blood than pus, bright red blood, high fever, and dry tongue, add 12g Bai Tou Weng (Pulsatilla), 15g Bai Jiang Cao (Patrinia), 15g Yin Hua (Honeysuckle), and replace Chi Shao with Dan Pi (Moutan). If there is food stagnation with sour belching, vomiting, and mixed pus and blood, add 12g Zhi Shi (Bitter Orange), 9g Chao Lai Fu Zi (Stir-fried Radish Seed), and 15g Gu Ma (Barley). If diarrhea is red and white, with abdominal pain and cold intolerance, urgency with heaviness, poor appetite, pale tongue with white greasy coating, and slippery pulse, it indicates cold-dampness obstructing the intestines. Treatment should warm the middle, disperse cold, move Qi, and dry dampness, using Wei Ling Tang with Dang Gui, Pao Jiang, and Guang Mu Xiang.
11. Damp Obstruction of the Uterus, Affecting the Dai Mai
Symptoms: Excessive leukorrhea, either clear and thin like mucus or yellow and turbid with a foul smell. Heaviness and soreness in the lower back and knees, distension in the lower abdomen, fatigue, greasy tongue coating, slow and slippery pulse.
Treatment Method: For white leukorrhea, tonify the spleen, dry dampness, and stop leukorrhea; for yellow leukorrhea, clear heat, dry dampness, and stop leukorrhea.
Prescription for White Leukorrhea: 12g Cang Bai Zhu (White Atractylodes), 12g Chen Pi (Aged Tangerine Peel), 15g Yi Yi Ren (Coix), 12g Che Qian Zi (Plantago), 15g Shan Yao (Chinese Yam), 9g Chao Jing Jie Sui (Stir-fried Schizonepeta), 20g Sheng Long Mu (Fresh Dragon Bone, separately packaged and cooked first), 12g Chai Hu (Bupleurum), 15g Fu Ling (Poria), 9g Ze Xie (Alisma), 6g Gan Cao (Licorice).
Modifications: If there is dizziness or heaviness in the head, remove Ze Xie and add 6g Chuan Xiong (Chuanxiong) and 6g Tian Ma (Gastrodia). If there is significant lower abdominal pain, especially with cold symptoms, remove Che Qian Zi and add 6g Pao Jiang (Roasted Ginger) and 10g Wu Yao (Lindera). If there is a pale complexion, shortness of breath, and fatigue, with a pale swollen tongue, add 12g Tai Zi Shen (Pseudostellaria) and replace Gan Cao with honey-fried licorice.
Prescription for Yellow Leukorrhea: 10g Huang Bai (Phellodendron), 15g Qian Shi (Euryale), 15g Che Qian Zi (Plantago), 12g Chun Gen Pi (Mulberry Root Bark), 15g Yi Yi Ren (Coix), 9g Ze Xie (Alisma), 10g Chuan Lian Zi (Melia), 18g Shan Yao (Chinese Yam).
Modifications: If leukorrhea is red, add 15g Ji Guo Hua (Chrysanthemum) and 12g Dan Pi (Moutan) to clear heat and cool the blood. If there is itching or eczema in the external genitalia, or ulcers, use a self-formulated external wash: 30g Ku Shen (Sophora), 30g Ma Bian Cao (Verbena), 20g Che Qian Cao (Plantago), 15g Huang Bai (Phellodendron), 15g She Chuang Zi (Cnidium), and 10g Bai Fan (Alum). Boil for 20 minutes, first fumigate, then wash, 2-3 times a day.
12. Damp Accumulation in the Bladder
Symptoms: Fullness in the lower abdomen, frequent urination, painful urination with a burning sensation, sticky mouth with a bitter taste, lack of thirst, yellow greasy coating, slippery and rapid pulse.
Treatment Principle: Clear heat, eliminate dampness, and promote urination.
Prescription: 12g Qu Mai (Dianthus), 12g Bian Xu (Polygonum), 10g Mu Tong (Akebia), 15g Hua Shi (Talc), 15g Che Qian Zi (Plantago), 9g Zhu Ye (Bamboo Leaf), 9g Zhi Zi (Gardenia), 6g Gan Cao (Licorice).
Modifications: If there is blood in the urine, indicating heat injuring the blood vessels, add 15g Xiao Ji (Cirsium) and 12g Pu Huang (Typha), and 15g Sheng Di (Rehmannia). If the urine is yellow and turbid, resembling rice wash water, add 12g Bei Mu (Fritillaria) and 9g Huang Bai (Phellodendron). If urination suddenly stops, with painful urination or stones, indicating damp-heat accumulation, causing stones to form and block the urethra, add 15g Hai Jin Sha (Lygodium), 20g Jin Qian Cao (Lysimachia), and 3g Ji Nei Jin (Chicken Gizzard Membrane) (divided into two doses). If symptoms improve but residual dampness remains, do not solely focus on clearing, to avoid damaging Yin and depleting fluids; use Qing Xin Lian Zi Drink with modifications to support the body and eliminate residual dampness. In clinical practice, dampness is a common pathogenic factor, and if accompanied by Yin deficiency, treatment can be more challenging, requiring careful differentiation.
Warm Reminder
The formulas and herbs mentioned in this article are intended to provide a more intuitive understanding of the issues and to offer references for colleagues and patients, allowing you to better appreciate the charm of Traditional Chinese Medicine. This does not mean recommending the use of the above herbal formulas, nor does it encourage self-purchase and consumption.