Dampness

Damp is the only one of the five that can arrive from outside as well as build up inside. Externally it is one of the 六淫 liù yín, the six climatic excesses — wind, cold, summerheat, damp, dryness and fire — the classical list of what weather does to a body. Internally it accumulates when the spleen falls behind in moving fluid on.

Its character is described in four characters that predict almost everything a reader will report: 重浊黏滞, heavy, turbid, sticky, lingering. Heaviness in the head and limbs. Turbidity in secretions and in thinking. Stickiness in the mouth and in the stool. And lingering — damp is the slowest of the patterns to shift, and a report that pretends otherwise is not worth reading.

When damp thickens further the tradition calls it 痰 tán, phlegm, and means considerably more than the stuff in a tissue: lumps, cysts, fogginess, and a certain stuck quality of thought. The couplet every student learns is 脾为生痰之源，肺为贮痰之器 — the spleen is the source that makes phlegm, the lung is the vessel that stores it.

The nineteen clauses of chapter 74 are the closest thing the canon has to a decision table, and this is the clause every damp reading is built on. It also explains why the suggestions in a report for damp are aimed at the digestion rather than at the fluid.

Our clinic sits in the region of the 梅雨 méi yǔ, the plum rains — five or six weeks of humidity every June when Hangzhou and Shanghai are wringing wet. Half the people who came through the door in that season came in describing this list, and they described it in the same order.

• A head that feels wrapped or bandaged — the classical phrase is 头重如裹, the head heavy as if wrapped.
• Limbs heavy, and thinking foggy, particularly on grey wet days and before rain arrives.
• A sticky or sweetish mouth, with no thirst even though the mouth is not dry.
• A small meal producing fullness and bloating; appetite that comes and goes.
• Stools loose, sticky, hard to finish, and hard to flush.
• Puffiness in the fingers, ankles or eyelids in the morning; a heaviness that settles around the middle.
• A coating on the tongue that returns within an hour of brushing it off.

People often say this pattern makes them feel stupid, and are relieved to find it is on a list. In the classical description, foggy thinking is not a metaphor for being unwell — it is one of the defining signs.

If the other four patterns are read mostly from the body of the tongue, this one is read from the coating. It is the single most useful photograph we receive.

A yellow greasy coating is read as 湿热 shī rè, damp heat, which is a different pattern again — hotter, more urgent, more often involving the skin and the lower body. A report will say which of the two it sees, because the food suggestions differ.

This is the pattern where behaviour outweighs everything else, and where the two things that matter most are what time you eat and how much you move.

What tends to make it heavier

• Dairy, sugar, fried food and refined flour, which the tradition groups together as damp-forming.
• Cold raw food and iced drinks, which are read as slowing the very function that would move the fluid on.
• Eating late at night, and eating past comfortable fullness.
• Beer in particular, and alcohol generally.
• Sitting all day, humid weather, damp housing, and exercising in wet cold.

What tends to ease it

• Moving daily until you are warm and slightly breathing — the oldest suggestion for damp there is, and still the best.
• Plain cooked food, less of it, and finishing dinner three hours before bed.
• Warm and dry rather than cold and wet: soups over smoothies, roasted over raw.
• Airing and drying the rooms you sleep in.
• Patience. Damp is described as lingering for a reason, and change here is counted in months.

The damp list is the most practical one on the site, because three of its members are ordinary kitchen ingredients sold in every Chinese grocery and are cooked exactly like a grain or a spice.

• 薏苡仁 yì yǐ rén, job’s tears — cooked like barley, in soup or congee, and the single most named food for this pattern.
• 茯苓 fú líng, poria — a bland white fungus, powdered into congee or simmered in soup.
• 赤小豆 chì xiǎo dòu, adzuki bean, cooked with the job’s tears.
• 陈皮 chén pí, aged tangerine peel, a strip dropped into a stew or infused in hot water after a heavy meal.
• 白扁豆 bái biǎn dòu, hyacinth bean, and 山药 Chinese yam, for the digestive side of it.
• Less: milk, cheese, cold sweet drinks, and anything deep fried.

Job’s tears and poria appear in the same household soup across most of southern China, which is a fair summary of how seriously the region takes its own weather. Full list on the food as medicine page.

The point paired with damp is 足三里 Zúsānlǐ, Stomach 36 — again, because in this tradition damp is a digestive problem before it is a fluid problem. Its classical partner for damp specifically is 阴陵泉 Yīnlíngquán, Spleen 9, on the inside of the shin below the knee, which a practitioner will often use alongside it.

For self-applied pressure, Zusanli is the one we write about, because it is easy to find on your own leg and hard to get wrong. Thirty to sixty seconds, both legs, and ideally a walk afterwards. How to find it, and the rules for pressing — including not pressing a leg that is swollen, hot or painful.

Damp almost never stands alone. It is the thing that settles on top of something else, which is why a reading that names it usually names what is underneath as well.

• Under it, nearly always, is qi deficiency of the spleen — the fluid is not being moved because there is not enough capacity to move it.
• With cold it becomes 寒湿 cold damp, which is yang deficiency plus heaviness: puffy, cold, loose, and worse all winter.
• With heat it becomes 湿热 damp heat: yellow greasy coating, a bitter mouth, heaviness with urgency, and often skin involvement.
• It sits least easily with yin deficiency and blood deficiency, and when a reading names damp alongside either, the food suggestions have to be written with real care.

This is the clearest case for a written reading rather than a list from a search result: the same food that is right for one of two named patterns can be wrong for the other, and someone has to decide the order.

Oedema is a physical finding with a real differential, and a Chinese-medicine reading of dampness is not the way to sort through it. Come back to the pattern afterwards; it will still describe the fog and the heaviness accurately, and by then it will be safe to work with.