Are You Hot and Damp?

Traditional Chinese Medicine Damp-Heat Patterns: Two Modern Case Studies

In ancient China, diseases involving heat and/or dampness were often due to wen bing (warm diseases), what we might today call infectious diseases. As such, although sometimes serious or widespread, they typically had a beginning and end. Today, dampness and heat pathogens may develop as a result of lifestyle choices and the conditions can become chronic.

In the mid 18th century, the Chinese physician Xue Xue authored “Systematic Differentiation of Damp-Heat,” in which he set forth the knotty characteristics that occur when the pathogens dampness and heat combine (i.e., “damp-heat”). In modern times it is not at all unusual for patients to present to my office with damp-heat patterns. Their symptoms can range from mild to severe, as the following two case studies demonstrate.
  1. Recently, a patient I had been treating for low back pain mentioned that he had been waking with swelling and severe itching of the genital region for the past week. The symptoms would tend to diminish as the day progressed but they would return by the next morning when he awoke. He considered any changes to new detergents, soaps, or clothing that might be the cause. He sought help from his primary care physician who found nothing particularly unusual. His doctor told the patient to simply watch the condition and return if it worsened.

    The gentleman very shortly thereafter inquired with me about his situation.I explained to the patient that he was suffering from a very mild form of a traditional Chinese medicine (TCM) pattern called damp-heat. I instructed the patient to keep his sleeping area cool and to wear light clothing at night. The patient was also instructed to minimize spicy warming foods and to reduce or limit alcohol intake for a while. I discussed with the patient the use of a TCM formula with rather cold and downward draining properties that we could use. However, I suggested that he initially try the aforementioned simple steps first so as to avoid additional expense to him and also to avoid the use of a helpful but rather strong TCM herbal formula. I asked the patient to keep me informed of progress or lack thereof.

    Happily, this case was easily resolved. Within a few days the patient contacted me to say that he may have stumbled on a solution. He and his spouse were finding their upstairs bedroom overly warm so that he decided to sleep one night in a cooler downstairs bedroom. He awoke the next morning with much diminished symptoms. Now, this gentleman had an otherwise sub-clinical damp-heat pattern such that he had a propensity to exhibit symptoms under certain conditions. Fortunately, the modification he stumbled upon was uncomplicated, safe, and effective, the kind of outcome we like.

  2. A more severe situation is represented by a woman who presented to my office several years ago. Her primary health concern was debilitating lower leg edema. She also suffered from type 2 diabetes, elevated cholesterol, and a history of various infections. The leg condition was uncomfortable for her, even limiting her ability to be active.The patient was considerably overweight and her tongue was red with a greasy yellow coating. She emitted a foul odor. When I asked to examine her lower legs, she exhibited red, weepy hot and painful looking sores below the knees as well as obvious edema.

    It was the sores that were causing the strange and unpleasant odor. The woman had been seen by her doctor and given a steroid cream, but this had not improved her condition. Acupuncture was employed, but the main focus of treatment was use of an ancient / classical formula to purges excess heat or fire from the liver and gallbladder, and clears and drains heat-damp from the lower part of the body. Her sores resolved nicely within two weeks, after which we continued to work on the underlying causes that had contributed to her painful lower legs.

Way back in 1707 C.E., Xue Xue noted that “dampness will become severe when it mixes with heat [because it congeals dampness, making it more tenacious].1 Dampness blocks qi, causing it to stagnate. In turn, qi stagnation can transform into heat, further exacerbating existing heat. Heat is formless; dampness has form. Guohui Liu says that “Their combination is like a mixture of wheat flour and oil; once mixed, they are very difficult to treat separately.” 2

When responded to in an unhealthy manner, the stressors of modern living cause qi to become constrained and to stagnate so that energy and nourishment (blood) fail to circulate. This causes dampness to accumulate and combine with heat. This situation can be exacerbated even further by our highly processed, sugar-laden diets and our intensive life-styles.

1. Song Zhao-Qi (Song You -Fu, c. 1878), Differentiation of the Diseases in the Sough of China (Nan bing bie jian). Shanghai: Shanghai Health Publishing House, 1958, Chapter 2:10.
2. Guohui Liu, Warm Diseases: A Clinical Guide. Seattle: Eastland Press, 2001, pp. 57-58.

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