Author: Chen Chuxiong, Sun Yat-sen Memorial Hospital, Sun Yat-sen University
Wind, cold, summer heat, dampness, dryness, and fire are considered the six major pathogenic factors in Traditional Chinese Medicine (TCM), with dampness being one of them. An old saying goes: “It is easy to eliminate a thousand colds, but hard to get rid of dampness. Dampness is sticky and turbid, like oil in flour.” This indicates that once the body is afflicted by dampness, it is often difficult to regulate, and the condition can be prolonged.So, where does dampness come from? Firstly, it can enter from the outside, commonly due to humid climates, exposure to rain, or living in damp environments. Secondly, it can arise from within, often due to irregular eating habits. If one frequently consumes greasy, rich, or cold foods, combined with a pre-existing spleen deficiency, the body’s ability to transform and transport fluids is impaired, leading to the formation of dampness.
Dampness combined with heat is called damp-heat, with cold it is called cold-damp, with summer heat it is summer-damp, and with wind it is wind-damp. If there is dampness in the body and it is not eliminated, various diseases can arise. Many conditions are related to dampness and phlegm, such as fatty liver, hypertension, hyperlipidemia, kidney diseases, and even malignant tumors.If the body is simply burdened with dampness, dietary adjustments are usually sufficient. Common damp-eliminating dietary recipes include Tudou Fuling Qianshi Chixiaodou Qu Shi Tang (Tuckahoe, Job’s Tears, and Red Bean Damp-Removing Soup), Mian Yincheng Chixiaodou Jiyu Qu Shi Tang (Cottonweed, Red Bean, and Carp Damp-Removing Soup), Wuzhi Maotao Zisheng Qu Shi Tang (Five-Finger Peach Nourishing Damp-Removing Soup), Shuanghong Chenpi Shui Ya Tang (Double Red Tangerine Peel Water Duck Soup), and Wuhua Qu Shi Cha (Five Flower Damp-Removing Tea), among others.If dampness has persisted for a long time or is combined with other pathogenic factors, it can lead to various diseases. In such cases, it is often necessary to use Chinese herbal medicine for regulation, and it is recommended to seek guidance from a TCM physician for differential diagnosis and targeted treatment for optimal results.Below, the pharmacist will introduce common types of dampness and corresponding TCM formulas for your reference.
Summer Dampness Accumulation
Summer dampness accumulation is common in the summer and autumn seasons. When summer dampness obstructs the body, internal heat cannot be released, leading to damp-heat stagnation, often presenting with symptoms such as fever, heaviness in the head and body, chest fullness, irritability, poor appetite, bitter mouth, dry throat, constipation or diarrhea, dark yellow urine, and a red tongue with yellow coating.
Treatment for summer dampness accumulation should focus on clearing summer heat, transforming dampness, and detoxifying. Common TCM formulas include: Ganlu Xiaodu Wan (Sweet Dew Disinfecting Pill), Qingre Qu Shi Granules (Clear Heat and Eliminate Damp Granules), Shu Shi Ganmao Granules (Summer Damp Cold Granules), and Huo Xiang Zheng Qi Shui (Agastache Correct Qi Water). The Ganlu Xiaodu Wan not only has the effect of aromatic transformation but also clears heat and detoxifies; the Qingre Qu Shi Granules eliminate damp-heat while benefiting qi and generating fluids; the Shu Shi Ganmao Granules excel in aromatic transformation and clearing summer heat; Huo Xiang Zheng Qi Shui not only releases the exterior and transforms dampness but also regulates qi and harmonizes the middle, suitable for both exterior wind-cold and internal damp stagnation or summer heat dampness colds, or gastrointestinal colds.
Dampness Obstructing the Spleen and Stomach
The spleen prefers dryness and dislikes dampness, and it can easily be obstructed by dampness, leading to spleen deficiency, known as “dampness obstructing the spleen earth.” The spleen’s ability to transform and transport fluids declines, causing a vicious cycle of water and damp stagnation. Symptoms may include fatigue, heaviness in the limbs, poor appetite, abdominal distension, loose stools, short and scanty urination, a sticky mouth, and a tongue with a thick, scalloped coating.
For those with dampness obstructing the spleen and stomach, it is essential to tonify qi and strengthen the spleen while also transforming dampness. Shenling Baizhu Wan (Ginseng, Poria, and Atractylodes Pill) is a TCM formula for treating spleen deficiency with excess dampness. It is based on the formula of Si Jun Zi Wan (Four Gentlemen Pill) with the addition of yam, lotus seed, Job’s tears, white hyacinth bean, sand ginger, and platycodon. It not only strengthens the spleen and benefits qi but also promotes urination and reduces swelling. It is primarily used for treating spleen deficiency with excess dampness, fatigue, poor appetite, and loose stools.
Dampness and Turbidity Obstructing
Dampness is a yin pathogen that can invade the body and stagnate in the organs and meridians, easily obstructing the flow of qi, leading to abnormal rising and falling of qi. The chest and flanks are the pathways for qi movement; dampness obstructs the chest, causing qi stagnation and chest tightness.
Therefore, many damp-eliminating agents often include qi-regulating ingredients to promote qi movement and damp transformation. Common TCM formulas include Muxiang Shunqi Wan (Aromatic Cardamom Qi-Regulating Pill), which consists of Mu Xiang (Aromatic Cardamom), Sha Ren (Amomum), Vinegar Fried Cyperus, Areca Nut, Licorice, Chen Pi (Dried Tangerine Peel), Hou Po (Magnolia Bark), Zhi Ke (Bitter Orange), Cang Zhu (Atractylodes), Qing Pi (Green Tangerine Peel), and Ginger. It has the effects of regulating qi, transforming dampness, and strengthening the spleen and stomach. It is used for damp turbidity obstructing qi, chest tightness, abdominal distension, nausea, and poor appetite. Xiangsha Weiling Wan (Aromatic Cardamom and Poria Pill) consists of Mu Xiang, Sha Ren, Cang Zhu, Hou Po, Bai Zhu, Chen Pi, Fu Ling, Zexie, Pigweed, Cinnamon, and Licorice, which has the effects of regulating qi and stomach, eliminating dampness, and promoting spleen function. If dampness is heavy, taking it can help eliminate dampness and strengthen the spleen and stomach. Other formulas like Xiangsha Pingwei Granules also have the effects of drying dampness, promoting spleen function, and regulating qi and stomach.
Damp-Heat Accumulation
Dampness is a heavy, turbid pathogen that can easily affect the flow of qi. When combined with heat, damp-heat obstructs the body, making it difficult to clear heat due to damp obstruction, and dampness can further injure yang qi due to heat steaming. Clinical manifestations include persistent heat, heaviness, fatigue, lethargy, chest tightness, nausea, poor appetite, abdominal distension, loose stools, or jaundice, irritability, bitterness in the mouth, dry mouth, oral ulcers, difficulty urinating or yellowish urine, and a yellow greasy tongue coating. Damp-heat is mainly divided into spleen-stomach damp-heat and liver-gallbladder damp-heat.
Spleen-stomach damp-heat often presents with more dampness than heat, primarily showing symptoms such as abdominal distension, nausea, aversion to food, heaviness in the limbs, poor appetite, and loose stools. Common TCM formulas for spleen-stomach damp-heat include Zhi Shi Xiao Pi Wan (Bitter Orange Pill), which consists of Zhi Shi (Bitter Orange), Bai Zhu (Atractylodes), Ban Xia (Pinellia), Huang Lian (Coptis), Dang Shen (Codonopsis), Licorice, Fu Ling, Hou Po, Mai Ya (Barley Sprout), and Gan Jiang (Dried Ginger). It has the effects of transforming damp-heat and relieving fullness, used for damp-heat accumulation causing chest and abdominal distension and pain. Other formulas like Zhong Man Fen Xiao Wan also have the effects of tonifying the spleen, regulating qi, and clearing heat and eliminating dampness.
Liver-gallbladder damp-heat often presents with more heat than dampness, primarily showing symptoms such as rib pain, fever, bitterness in the mouth, dry mouth, constipation, and short yellow urine. The treatment principle for liver-gallbladder damp-heat is to eliminate dampness and clear heat. For those with more dampness, Yin Chen Wu Ling San (Virgate Wormwood and Five Poria Powder) is used; for those with more heat symptoms, Long Dan Cao Pian (Gentian Liver-Draining Pills) is used. Long Dan Cao Pian is a classic TCM formula for clearing the liver and gallbladder and eliminating damp-heat, primarily used for dizziness, red eyes, tinnitus, ear swelling and pain, rib pain, bitterness in the mouth, painful urination, and damp-heat leucorrhea.Damp-heat diarrhea is often treated with Ge Gen Qin Lian Pian (Pueraria and Coptis Tablets) or Xiang Lian Wan (Fragrant Lian Pills); damp-heat downward flow is often treated with Si Miao Wan, which consists of Cang Zhu, Niuxi (Achyranthes), Huang Bai (Phellodendron), and Yi Yi Ren (Job’s Tears), having the effects of clearing heat and eliminating dampness, and is used for damp-heat downward flow, numbness in the legs, and soreness in the muscles and bones. Wu Lin Wan has the effects of clearing heat, draining fire, and promoting urination, primarily suitable for damp-heat downward flow causing urinary symptoms. Compound Jin Qian Cao Granules have the effects of clearing heat, eliminating dampness, promoting diuresis, and relieving pain, mainly used for urinary stones and urinary tract infections due to damp-heat downward flow. Lotus Leaf Lipid-Adjusting Tea has the effects of eliminating dampness, reducing turbidity, and promoting bowel movements, mainly used for damp-heat accumulation leading to hyperlipidemia. Angelica and Sophora Flavescens Pills have the effects of cooling blood and eliminating dampness, mainly used for acne and eczema caused by blood dryness and damp-heat. Gynecology Qianjin Pills have the effects of clearing heat, eliminating dampness, and tonifying qi and blood, mainly used for pelvic inflammatory disease and endometritis due to damp-heat accumulation.
Cold-Damp Obstruction
As dampness is a yin pathogen, excessive yin can harm yang, making dampness pathogenic and easily injuring yang qi. Cold-damp obstruction often presents with symptoms such as cold limbs, fatigue, abdominal distension, heaviness throughout the body, poor appetite, bland taste, and a pale tongue with a white, slippery coating, and a slow, deep pulse. Treatment should focus on warming the middle, dispersing cold, drying dampness, and promoting qi. Fuzi Lizhong Wan (Aconite and Ginseng Pill) is a TCM formula that warms the middle, disperses cold, strengthens the stomach, and eliminates dampness, primarily used for vomiting and diarrhea due to spleen and stomach deficiency-cold, chest fullness, abdominal pain, and indigestion.
Phlegm-Damp Accumulation
The spleen governs the transformation of water and dampness, the lungs are the upper source of water, and the kidneys are the lower source of water. If the ability of these three organs to regulate water and fluids is impaired, it can lead to the accumulation of water and dampness, forming phlegm. “The spleen is the source of phlegm,” but one must not forget that “liver wood overcomes spleen earth,” and the liver is the true culprit. Therefore, in treating phlegm-damp accumulation, in addition to exercising and focusing on dietary adjustments, it is more important to nourish the liver and spleen.
The classic TCM formula for phlegm-damp syndrome is Erchen Wan (Two Aged Pills), which consists of Chen Pi (Dried Tangerine Peel), Ban Xia (Pinellia), Fu Ling (Poria), and Licorice. It has the effects of eliminating dampness, transforming phlegm, regulating qi, and harmonizing the stomach, primarily used for cough with phlegm, chest tightness, and nausea. Additionally, Wen Dan Tang (Warm Gallbladder Decoction) is also an ancient formula for transforming phlegm and eliminating dampness, but it should be used under the guidance of a physician for differential diagnosis.
Water Retention in the Bladder
When the bladder’s qi transformation is impaired, water and fluids can accumulate, leading to difficulty urinating. Treatment should focus on promoting yang, transforming qi, and eliminating dampness. Wuling San (Five Poria Powder) is one of the top ten classic TCM formulas, consisting of Zhu Ling (Polyporus), Fu Ling (Poria), Bai Zhu (Atractylodes), Zexie (Alisma), and Gui Zhi (Cinnamon Twig). It has the effects of promoting urination, eliminating dampness, and warming yang, primarily used for bladder water retention syndrome, with symptoms such as difficulty urinating, shortness of breath, cough, and edema, as well as urinary retention, ascites, and hydrocephalus due to internal dampness accumulation. Of course, Wuling San is a prescription medicine and should be used under the guidance of a physician; do not self-medicate.
In summary, dampness is a widespread pathogenic factor that can lead to numerous diseases. Its sticky nature often results in a slow onset and lingering conditions that are difficult to eliminate, making it challenging for Western medicine to treat, while TCM regulation has its advantages. The key is to clearly differentiate during the improvement process.
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This article was first published by: Yixian Pharmacy V
Reviewed by: Qiu Kaifeng, Sun Yat-sen Memorial Hospital, Sun Yat-sen University
Second Review by: Wu Junyan, Sun Yat-sen Memorial Hospital, Sun Yat-sen University
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