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What is it? Damp or phlegm?

Updated: Dec 31, 2021


Oh, damp and phlegm I have spent a long time trying to work you out!


This is my attempt to show you how I am learning about them, because out of all the hard things about Chinese medicine this is probably, for me, one of the hardest.


They can come from a similar source, a deficiency of the Spleen's function of transportation and transformation but there are many differences in how they can manifest.


I hope you find this useful, but if you have any questions or comments please do not hesitate to contact me.


Love from Andrea


 

What is damp?

Damp is a yin pathogen that can be created in one of two ways:

  • Internally it can be created by the dysfunction of the Spleen's function of transformation and transportation.

  • Externally it can be created by the environment in which we live or work in i.e. a damp house or working in wet conditions

Its properties are heavy, dirty and sticky. Like mud on your welly boots. It also predominantly affects the lower half of the body, however, don't hold on to that too tightly as there are signs and symptoms which affect the top of the body!


So signs and symptoms you might see are:

  • the feeling of bodily heaviness

  • lack of appetite

  • feeling of congestion in / around chest

  • difficulty passing urine

  • sticky taste in the mouth

  • dirty or sticky discharges e.g. vaginal discharge. Depending on if there is cold or heat will depend on the colour.

  • muzzy head

  • the pulse will be slippery

  • the tongue will be swollen and a sticky tongue coat

 

What is phlegm?

Phlegm, similarly to damp, is a yin pathogen, which can only be created internally. Whilst it can be created by the dysfunction of the Spleen, it also crucially can be created by:

  • Lung qi not diffusing and descending

  • Kidneys fail to transform and excrete fluids

There are two types of phlegm, substantial and insubstantial and are described below.

  • Substantial - can be seen, such as sputum

  • Insubstantial

    • under the skin: lumps under the skin

    • in the channels: numbness

    • misting the heart: mental illness from depression to schizophrenia

    • in gall bladder or kidneys: gall bladder or kidney stones

    • joints: bone deformities such as rheumatoid arthritis

Whilst some of the signs and symptoms can be similar e.g.

  • muzzy head

  • feeling of heaviness

  • slippery pulse

  • swollen tongue

you will see below that there are key critical differences from damp.


Phlegm can create a wide and diverse set of symptoms including:

  • chest oppression

  • Nausea

  • Dizziness

  • Lack of Shen in the eyes

  • Dark eye sockets

  • Sallow complexion

  • Swollen body, puffy face, obesity

  • Greasy skin

  • Sweaty external genitalia, axilla or palms/soles

  • Enlarged fingers and toes

  • Thick thumbs

 

So, what are the differences?

Below I have added two illustrations of seeing the differences.


 

How does it manifest in the body?

I have broken down the areas of the body and how damp or phlegm may show up.


For me, crucial differences have been:

  • Phlegm there will be dizziness as well as a muzzy head (but dizziness can also be blood deficiency, liver yang rising, spleen qi deficiency or liver wind)

  • Phlegm can have mental-emotional signs and symptoms

  • The skin with damp will be more about spots or any oozing lesion

  • I found upper body symptoms hard to get a true distinction

  • The lower body is where the differences really arise with a lot of signs and symptoms for damp, as opposed to phlegm so questioning could really help here


 

Treatment principles

These are taken from the excellent Steven Clavey book called Fluid Physiology and Pathology, which has gone a long way to help me with understanding damp and phlegm.


I was taught in school that acupuncture (versus herbs) can only really look at moving damp or phlegm out either via urination or sweating, which is why food therapy is key when combined with acupuncture. However Clavey does also talk about damp-cold where you can use moxa to transform and dry damp.


Damp


Phlegm

"In strange diseases treat phlegm. This refers to complicated clinical patterns with symptoms and signs that not seem to fit into any pattern. In complicated syndromes treat phlegm. In acute serious conditions treat phlegm. If you see phlegm, treat phlegm"


 

How can I help myself?

Acupuncture: these points are specifically indicated for damp and or phlegm, however other points are:


Main points for phlegm

  • Ren-9

  • Ren-5

  • SP-9

  • ST-40

  • BL-22

  • PC-5

Main points for damp

  • SP-3

  • SP-9

  • SP-6

  • BL-20


Food: because damp and phlegm are tricky to eliminate, food therapy is an absolutely key part of helping yourself.



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