Aug 2, 20213 min read

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"