This article introduces Dampness, one of the six pathogenic factors which Chinese medicine believes to be the cause disease. Chinese medicine explains there are six main factors which can cause disease by attacking the body individually or in combination. They are Wind, Cold, Fire, Heat, Dryness and Dampness. Here I shall introduce the basic understanding of dampness, look at how dampness attacks the body and what are the clinical manifestations.

 

“TCM believes that man is an organic unity, with the Five Zang organs as its core, realised by the connecting effect of meridians. There exists the dynamic balance maintained by the contradictive movements among the Zang Fu organs and between man and nature so that the human body can conduct its normal physiological functions. When this dynamic balance is disturbed due to various kinds of factors and the human body fails to adjust this disturbance to be normal, disease occurs as the result.” (Ouyang & Gu 1996, p134)

 

Dampness is one of the factors mentioned above, it attacks and disturbs the normal balance of the body. It can attack the body in many different ways, causing various kinds of diseases and symptoms. It can attack the body from outside (exogenous) as one of the six climatic evils, caused by unseasonable damp weather, long periods of wet weather or damp living or working conditions. It can also attack the body from the inside, caused by the failure of the spleen to transform and transport of fluids within the body (endogenous), resulting in the accumulation of dampness. 

 

These two types of attack can also lead into one another, with attack by exogenous dampness leading to dysfunction of the spleen, while the inability of the spleen to transform & transport body fluids will make it easier for exogenous dampness to invade the body. Diet can also lead to the manifestation of dampness within the body. By consuming foods with a damp nature or foods that damage the function of the spleen & stomach, accumulation of dampness will occur.

 

Dampness is a Yin pathogen. It is exuberant in the late summer or early autumn and directly attacks the spleen and stomach. It possesses the ability to disturb other organs such as the large intestine and bladder and can encroach the meridians, limbs and even the skin.

 

Dampness can combine with any of the other five pathogenic factors to invade the body. It is also capable of transforming, once inside the body, into another of the pathogenic evils, if treatment is not received promptly or correctly. As it mainly attacks the spleen, most symptoms associated to dampness are linked to the function spleen and will manifest in the lower body i.e.; liquid stools, turbid urine, leukorrhagia, oppressive feeling in chest and hypochondriac region, oedema, ascites and heaviness of the limbs.

Dampness is the prevalent climatic evil in long summer, which refers to the period between late summer and early autumn. Yang heat descends to vaporize the moisture in the earth spreading dampness into the air leading to mists and fogs. This is the period when the body is most at risk from exogenous attack by dampness. Spending prolonged periods near water, in damp conditions, or being caught in the rain and staying in wet cloths are all ways of exposing the body to exogenous dampness. 

 

If the patient’s genuine qi is not strong enough or their ability to resist disease is weak then they the dampness will enter the body. However, if they are in good health, only when these conditions are met in their extremes will they be affected.

Endogenous dampness refers to the accumulation of phlegm or dampness inside the body, due to the disturbed function of the spleen. If in a deficient state, the spleen transforming and transporting functions are impaired leading to the accumulation of phlegm-turbidity within the body. This deficient state can occur due to prolonged illness, internal injury or indulgence in raw, cold, greasy and fatty foods which weaken the spleen yang and impair the spleen qi. 

 

The kidney can also play a part in damp-turbidity infestation. The spleens transformation and transportation function depends on the warming function of the kidney yang. If the kidney yang is unable to warm the spleen, its duty of moving the body fluid from the stomach after ingestion will be disturbed. The water metabolism will be affected and lead to a retention of fluid - Dampness. 

 

When exogenous Dampness attacks the body it will affect the normal functioning of the spleen and lead to a failure of the transforming and transporting functions, which will in turn cause endogenous dampness syndrome. On the other hand if the spleen yang is deficient and the transformation of fluid is impaired, attacking dampness from the outside cannot be dispersed leading to susceptibility to exogenous Dampness.

 

When dampness is discussed in Chinese medicine it is normally noted as having four main distinctive characteristics.

 

 

Dampness is strongly related to heaviness and turbidity and these show in some of the symptoms that pathogenic attack by dampness causes. Heaviness is a sensation experienced in the limbs and head as though they are supporting a heavy loads. 

 

Dampness will lay in the meridians obstructing them and impairing the dispersal of yang qi around the body leading to numbness, lack of sensitivity of skin and sluggish sensation and movement of the limbs.

 

Turbidity mainly refers to the turbid and dirty things that will be secreted from the body due to the invasion of Dampness. Such symptoms range from dirty appearance of the face and secretions from the eyes to turbid urine, leucorrhoea and liquid stools.

 

This character can be seen in two ways. The symptoms of damp are usually slimy and greasy, for instance greasy tongue fur, mucus in stools, difficult urination and sticky secretions and discharges. The other is damp diseases often have a long course, are hard to treat and tend to attack repeatedly i.e.: eczema and arthralgia.

 

As Dampness is a yin pathogen is will mainly attack and exhibit symptoms in the yin aspect of the body, which is the lower body cavity and the lower limbs. This is can be seen with symptoms such as oedema manifesting mainly in the lower extremities, diseases of the lower body such as stranguria with turbid urine, leucorrhoea and diarrhoea, all of which result from a downward movement of dampness. The Su Wen notes: “When Dampness attacks the human body, it attacks the lower part of the body first”.

 

When exopathic dampness attacks the body many symptoms can be exhibited, the combination of these will mainly depend on what the dampness invades the body in conjunction with. Generally dampness attack will lead to the onset of the following symptoms:

 

·        Fever with aversion to cold is due to the dampness; caused by the attack of the body surfaces and obstructing the yang qi. 

 

·        Sweating without reduction in the fever and a fever worsens in the afternoon is due to the dampness hindering the heat from escaping from the body. 

 

·        Heaviness of the head is caused by the dampness wrapping the head due to its heavy nature.

 

·        Uncomfortable feeling in the chest is due to dampness affecting the ascending and descending of qi, this will also cause epigastric distension and scanty urine. 

 

·        When the functional activity of the spleen is impaired by dampness poor appetite, nausea, and loose stool will follow. 

 

·        Dampness impeding and obstructing the blood circulation leads to numbness, ulceration, and pain. Pain experienced due to dampness will be in a fixed location. 

 

·        Turbid urine and leucorrhoea are due to the moving of dampness to the lower jiao.

 

·        Oedema is the spreading of fluid over the skin and muscles as a result of dysfunction of the spleens transporting and transforming function. 

 

·        The spleen is responsible for nourishing the limbs but as the dampness encroaches the body heaviness of the limbs is experienced.

 

·        The spleen opens into the tongue. When dampness attacks there will be a slimy taste in the mouth with a slippery and greasy tongue coating combined with a soft pulse. 

 

Dampness can combine with any of the other exopathogenic evils and the resulting symptoms may vary:

 

·        Dampness-Injury is when dampness attacks unaccompanied, exhibiting symptoms of fever, aversion to cold, sweating without declining of the fever and aggravated in the afternoon. Heavy head and body, chest distress, poor appetite, nausea, thin and white tongue coating, soft and moderate pulse.

 

·        Wind-Damp will result from the combined attack of the body by wind and dampness with symptoms of sweating, aversion to wind, shortness of breath, painful joints and dysurea.

 

·        Cold-Damp will result from the joint attack of cold and dampness, with symptoms of chilly sensations even in summer, painful joints, and heavy sensations below the waist.

 

·        Damp-Heat is the result of the dampness and heat attacking the body, manifesting in fever, pain and swollen limbs, fever in isolated parts of the body, distension and fullness in the abdomen, and scanty and dark urine.

 

·        Damp-Warm is the result of dampness and warmth attacking the body, manifesting in symptoms similar to damp-heat but of a lesser degree, fever which is not very high but aggravated in the afternoon, espigastric distension, poor appetite, lassitude and loose stools.

 

·        Damp-Arthralgia is arthritis that is accompanied by heaviness of the limbs with pain, numbness, swelling and ulceration.

 

Endogenous Dampness manifestations in the body differ depending on the organ they are affecting and what other endopathogen they attack in conjunction with.

 

·        Spleen encumbered by Cold-Damp caused by a poor diet of mainly cold, uncooked food that damages the functional activity of the spleen and stomach. This leads to indigestion of food and retention of cold and damp evils in the middle jiao. It can also be due to the attack of exogenous cold and damp damaging the spleen. It will manifest as dark dusty yellow complexion, chills, no thirst, nausea, poor appetite, abdominal distension, heavy sensation in head, tiredness, loose stools, scanty urine and leucorrhoea. The tongue will be pale with white greasy or white slippery coating and a soggy pulse.

 

·        Damp-Heat in the Spleen and Stomach is again caused by a poor diet but this time by the excessive intake of rich food or alcohol which produces dampness and heat in the middle jiao. It could also be caused by the attack of exogenous damp-heat. It manifests in the following ways: fever, sweating, nausea, vomiting, poor appetite, abdominal distension, heaviness of the body, loose stool with difficulty to excrete and yellow urine. The tongue will be red with a yellow greasy coating and the pulse will be rapid and soggy or rapid and slippery.

 

·        Damp-Heat in the Gallbladder is the accumulation of damp-heat in the Liver and Gallbladder due to over indulgence in rich/fatty foods, inward invading of exogenous damp-heat, or splenic dysfunction leading to accumulation of dampness. It will manifest as alternating chills and fever, bitter taste in mouth, distending pain in hypochondrium, poor appetite, nausea and vomiting, abdominal distension, constipation or un-smooth defecation, loose stool, dark scanty urine. The tongue will be red with and yellow greasy fur, and a taut and rapid pulse.

 

·        Damp-Heat in Urinary Bladder is due to the accumulation of damp-heat evils in the bladder produced by an improper diet which flow down into urinary bladder causing: yellow urine, urgency feeling urination and a burning of urethra during urination. Also fever, lumbago, urine mixed with blood or even bladder stones. The tongue will be red with yellow greasy coating thicker at the back and the pulse rapid.

 

 

Dampness is a pathogenic factor that is capable of attacking the body both from the external environment and also from within. It will mainly attack the spleen and disrupt its function. Four characteristics control how dampness will invade the body, in what way it will cause disharmony and in which areas of the body it will manifest. Depending on which organs are under attack from the dampness and which exogenous factor in attacks with can greatly alter the symptoms experienced. 

 

Dampness is a major factor that attacks the body. It is experienced often in clinical practice especially in the U.K. with dietary preferences of cold and raw foods and also a love of rich dishes. The climate in the U.K. is fairly wet with long periods of rain. If the population are not conscious of their health and do not take the right precautions when these conditions manifest, it will be easy for them to be affected. Dampness, especially endogenous dampness, once in the body is very hard for physicians to release. It can stay within the body over long periods and if left untreated, gradually the patient’s health will suffer, most likely leading to digestive and genito-urinary system problems. Its treatment must be swift and carried out by a competent practitioner as differentiation of syndrome is very important if the treatment is to be effective.

 

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