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Writer's pictureRichard Lai

#45 Dampness in Traditional Chinese Medicine

Updated: Jul 22



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Welcome to another insightful blog post from Study Acupuncture with Me, where we strive to make complex Traditional Chinese Medicine (TCM) concepts digestible for students, practitioners, and curious minds.


In this episode, we dive deep into the concept of dampness—a critical, yet often misunderstood aspect of TCM. Dampness can manifest in various ways, impacting patients' overall health and well-being. In this comprehensive guide, we'll explore the nuances of dampness, how to diagnose it using the four pillars of examination, and delve into both external and internal dampness.


**What is Dampness in Traditional Chinese Medicine?**

Dampness, a key pathogenic factor in TCM, can significantly impact the body's qi and harmonious balance. It's one of several pathogenic influences, including wind, cold, dryness, and heat, that can invade the body, disrupting the flow of vital energy. Understanding dampness and its manifestations is essential for accurate diagnosis and effective treatment.


**Clinical Manifestations of Dampness**

When a patient presents with dampness, they may exhibit a range of symptoms, which can include:

  1. **Feeling of Heaviness:** Patients often describe a general feeling of heaviness, particularly in the limbs or the head.

  2. **Poor Appetite:** Digestive disturbances are common, leading to diminished interest in food.

  3. **Feeling of Fullness:** A persistent sensation of fullness, particularly in the abdomen, can be a hallmark sign.

  4. **Sticky Taste:** This peculiar symptom often accompanies dampness, where patients feel a sticky or greasy taste in their mouth.

  5. **Urinary Difficulty:** Issues with urination, such as difficulty or cloudy urine, are also indicators

  6. **Vaginal Discharge:** Abnormal vaginal discharge can be a symptom of dampness affecting the lower part of the body.

  7. **Sticky Tongue Coating:** A thick, sticky coating on the tongue is a key diagnostic sign.

  8. **Slippery or Soggy Pulse:** Pulse diagnosis reveals a unique, slippery pulse, confirming the presence of dampness.


**Characteristics of Dampness**

Understanding the nature of dampness helps explain why it causes the aforementioned clinical manifestations. There are three primary characteristics of dampness:

  1. **Heaviness:** Just as clothes feel heavy when soaked, dampness imbues a similar weighty sensation in the body.

  2. **Dirty:** Dampness tends to be turbid or unclean, leading to issues such as cloudy urine.

  3. **Sticky:** Its stickiness means it can linger and be challenging to eliminate, often resulting in chronic conditions.


**Diagnosing Dampness: The Four Pillars of Examination**

An accurate diagnosis in TCM relies on the Four Pillars of Examination: Looking (Inspection), Asking (Medical Inquiry), Palpating, and Listening and Smelling. Let's break down how each pillar contributes to diagnosing dampness.

  1. **Looking (Inspection):**

- **General Inspection:** Evaluate the patient's overall appearance, posture, and gait for signs of distress or heaviness.

- **Specific Observations:** Examine the skin, looking for edema, changes in color, and moisture.

- **Tongue Diagnosis:** A dampness-related tongue often presents with a sticky, slippery coating and may be swollen.

2. **Asking (Medical Inquiry):**

- Inquire about symptoms such as heaviness, digestive issues, and urinary problems.

- Ask detailed questions about the onset, duration, and nature of symptoms to gather comprehensive information.


3. **Palpating:**

- Check for edema and swelling in various parts of the body by pressing the skin and noting if it leaves an indent (pitting edema).

- Assess pulses in three dimensions to identify characteristics like slippery or soggy pulses.

4. **Listening and Smelling:**

- Evaluate the strength and quality of the patient's voice. A weak or strained voice can indicate underlying issues.

- Note any unusual smells, which can help identify the dampness.


**External vs. Internal Dampness**

Understanding whether dampness is external or internal informs the treatment approach. External dampness typically results from environmental exposure, while internal dampness often stems from an imbalance within the body.

1. **External Dampness:**

- **Causes:** Arises from environmental factors like prolonged exposure to rain, living in a damp climate, or sitting on wet surfaces.

- **Manifestations:** Swelling, joint pain, and heaviness, often appearing suddenly after environmental exposure.

- **Areas Affected:** Can invade the internal organs, channels, or Wei Qi Level.

2. **Internal Dampness:**

- **Causes:** Often related to deficiencies in organs responsible for fluid metabolism, mainly the spleen, lungs, and kidneys.

- **Manifestations:** Chronic symptoms such as persistent edema, digestive issues, and fluid-filled blisters.

- **Organ Influence:** Each organ plays a distinct role—spleen governs transformation and transport, lungs regulate water passages, and kidneys govern water metabolism.


**Case Study: Diagnosing Dampness**

Let's illustrate how these principles apply with an example. A patient arrives complaining of heavy legs, difficulty with socks, and swollen feet. Using the Four Pillars:

1. **Inspection:** Observing the patient's gait reveals difficulty walking. The patient's legs exhibit pitting edema.

2. **Inquiry:** Questions reveal the swelling started gradually and worsened over weeks.

3. **Palpation:** Pressing the skin leaves a persistent indent—indicative of pitting edema.

4. **Tongue and Pulse Diagnosis:** The tongue has a sticky coating and the pulse feels slippery.

Combining these findings, we identify dampness as the primary issue. Further diagnosis might explore whether the dampness is external or internal, considering factors such as the patient's environment and their organ function.


**Treatment and Management**

Effective treatment of dampness in TCM involves:

1. **Lifestyle Adjustments:** Encourage patients to avoid damp environments, improve diet, and engage in exercises that promote fluid movement.

2. **Herbal Remedies:** Utilizing dampness-resolving herbs such as Fu Ling (Poria) or Yi Yi Ren (Coix Seed) for their diuretic and spleen-tonifying properties.

3. **Acupuncture Points:** Focusing on points like SP9 (Yinlingquan) to resolve dampness and promote fluid metabolism.

4. **Adjunct Therapies:** Integrating techniques like moxibustion to enhance treatment outcomes.


**Conclusion**

Understanding dampness in Traditional Chinese Medicine is a critical skill for any practitioner. It requires a thorough and nuanced approach to diagnosis, integrating the Four Pillars of Examination and recognizing the symptoms and characteristics unique to dampness. Whether external or internal, managing dampness effectively can significantly improve patient outcomes.


We hope this comprehensive guide has deepened your understanding and provided valuable insights into diagnosing and treating dampness.


For a more detailed study, download our free study guide at [www.studyacuwithme.com/dampness]


Stay tuned for more episodes and blog posts, and don't forget to share this post with anyone who might find it valuable. Happy studying, and may your journey in TCM be enlightening and rewarding.


**Keywords:** Traditional Chinese Medicine, dampness, diagnosing dampness, TCM, four pillars of examination, acupuncture, spleen deficiency, internal dampness, external dampness, pitting edema, tongue diagnosis, herbal remedies, acupuncture points, moxibustion.


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Transcript of Episode
 

Dr. Richard Lai DPT LAc [00:00:00]:

Hey, everyone. Doctor Richard Lai here with study acupuncture with me. Now today's episode is on dampness. So we're gonna go into all that and more after we hear a quick word from our sponsor. Alright. And we're back. So today's episode is on dampness, and this comes from a request on Spotify where a listener named Shanti responded to my q and a, and Shanti said, please talk about dampness and all of its facets. Also discuss how to diagnose.


Dr. Richard Lai DPT LAc [00:00:29]:

I'm a student, and I struggle with diagnosis during clinic. So, Shanti, you've come to the right place because my whole mission with study acupuncture with me is to help people exactly like you. And that's because I was there too. I was once you. And I know exactly what it's like to feel really overwhelmed in clinic where you're driving to clinic or you're driving to class and you're feeling really nervous because you don't even fully understand the material and the teacher's already going on to another topic. You're still confused about last week's topic, and now you're in clinic and there's a real live patient in front of you, and you're supposed to figure out what the pattern is and what the treatment approach is and what the treatment principle and what the point prescription is. And then you look at your clinical instructors and your other students, and some of them, they're just spewing out like beautiful poetic diagnoses. And you're just like, if you're like me, I'm just like, where did you pull that from? Like, how did you even get to that diagnosis? So believe me when I say I've been there too.


Dr. Richard Lai DPT LAc [00:01:22]:

And so that's why I make this content so that listeners like you can get a quick win because you need education that's easy to digest and easy to understand. Because between juggling work, juggling family, juggling school, maybe you're just too busy to really dive into some of the textbooks. First thing you need to understand about diagnosing patients in the clinic is that So the first thing you need to understand about diagnosing patients in the clinic is that your patients can present very differently almost every time they come into the clinic, and that's because they're people, and people can change. And things that they go through can change from a day to day basis. Now as people, we fall into our daily routines. We fall into our daily habits. We fall into our work habits. We fall into also our daily living activity habits.


Dr. Richard Lai DPT LAc [00:02:12]:

And those daily activity living habits can actually default us into being exposed to similar pathologies from day to day. For example, if we work a very high stress job or we work a very laborious job where we have to lift heavy things, where we have to crawl under things, we have to fix things while lying on our back and our hands are above our head. These things can expose us to similar types of injuries over time. Now, as an acupuncturist, we have to figure out what's going on with our patient. Like what's the actual root cause? Is it an internal pathology? Is it an external pathology? Is it because they're constantly stressed about work that they're not sleeping well? Or is it because of pain because of their day to day labor that they have to get on their hands and knees and they need to lift heavy things that's causing them pain and that's why they can't sleep. So as an acupuncturist, when we look at our patients, we can look at them through 4 pillars. Now these are called the 4 pillars of examination, which number 1 is looking, number 2 is asking, number 3 is palpating, and then number 4 is listening and smelling. Now to be honest, a lot of time for me is spent on 1, 2, and 3, which is looking, asking, and palpating.


Dr. Richard Lai DPT LAc [00:03:21]:

And number 4 is sort of more passive data that comes in as I'm evaluating the patient. Now with these 4 pillars too, it's not like you're just going from 1 pillar to the next and to the next. You're looking at your patient, you're evaluating them, and you're taking the information from all the 4 pillars at the same time. So let me give you an example. So if you look at all the subtopics under each of these pillars, you're going to see how we could bounce around from pillar to pillar. And, honestly, even we may not even get to all of them during our evaluation because we already get the data that we need to complete our diagnosis. Alright. So let's give a clinical example.


Dr. Richard Lai DPT LAc [00:03:55]:

So let's say you have a patient that comes into your treatment room and you're saying, hi there. How are you? And they say, they're good because they're a nice person. And we all know they're in your clinic because they're feeling terrible. So they're lying to you and they're saying, yes, I'm wonderful. So at this point, as your patient's entering into your treatment room, you should already be taking in data because your patient's coming into your treatment room for treatment. So you should be looking to see how are they coming in. Are they hobbling in? Are they limping? Are they slow? Are they guarding a certain part of their body? Right from the get go, you can get information about the patient's presentation. Now at the same time, you can be asking the patient, oh, wow.


Dr. Richard Lai DPT LAc [00:04:31]:

I see you're having some trouble moving your legs. Okay. How long has that been happening? When did it start? And so now the patient's starting to talk about their legs and how they are legs feel heavy. And they say that they've had a harder time getting their socks on And even they're having a harder time getting their feet onto their bed at night because their feet just feel so heavy. So at this point, you help your patient onto the treatment table and you can start to inspect other parts of their body. So when you look at their feet, you're looking for what? You're looking for changes in skin color. Maybe you're looking for changes in musculature. Is there atrophy involved? What's the color of their skin? What's the temperature of their skin? Is it hot to the touch? Is it cold? You can even assess the skin for moisture, like is the skin dry or is the skin wet? And when you look at the muscles, when you palpate them, you can see if there's atrophy or maybe there's swelling.


Dr. Richard Lai DPT LAc [00:05:21]:

Now, all these different presentations, they correspond to different things. So let's say for example, when you inspect the legs, you notice that the legs are swollen. When you press your finger into it, the skin, it makes an indent and it takes some time for that skin to return to normal. You also notice that when you touch the skin, it's slightly weeping, like it's slightly wet. So then you bring that data and you start to ask questions. How long have you had this swelling? How long have you had that weeping? Does your primary doctor know about the swelling? Are you taking any medications for the swelling? And when you're evaluating your patient and you're finding some of these symptoms and they just make you feel like a flag is raised, then you should always recommend that other disciplines see them. So you can refer them back to their primary care or you can refer them to a specialist. However you see clinically fit.


Dr. Richard Lai DPT LAc [00:06:06]:

Alright. So back to the evaluation. Patient's on your table. You're asking them questions. You're inspecting their skin. You're inspecting the different parts of their body. So you're palpating their skin. You're palpating their pulse.


Dr. Richard Lai DPT LAc [00:06:17]:

You're palpating their channels. You're assessing the swelling. You're also at the same time, you're listening to their voice. How strong is their voice? How weak is their voice? And you're even taking in any smells that could correspond to a potential diagnosis. So that's what I mean by you're jumping from pillar to pillar, and that's the 4 pillars in a nutshell. Now like I said before, it's not like you're doing it 1 at a time, but you're weaving into and out of the different pillars just like how a detective looks for clues. So you're like a detective looking for clues to what the diagnosis could be. So now with the 4 pillars, the first pillar is looking.


Dr. Richard Lai DPT LAc [00:06:51]:

Now looking is also called inspection. So in this pillar, you're inspecting the patient. You're looking at their presentation, and some text will say that you're inspecting their form and their bearing. Now form and bearing is basically their posture and their ability to move. Now it goes further than that though because you're assessing their spirit. You're assessing their presentation in so many different parts of their body. You're assessing their complexion and their face. You're assessing their head.


Dr. Richard Lai DPT LAc [00:07:15]:

You're assessing their eyes, their nose, their mouth, their ears. You're assessing their arms and their legs. You're assessing their skin. You're looking at their tongue. You're looking at the tongue for tongue body color, tongue body shape, tongue coat, moisture. You're also looking at the channels, especially the ones that go over the area that the patient's complaining about. And so you're pulling in data from all of these areas and you're trying to see if there's any recurring themes, anything that keeps poking its head up and saying, Hey, it's me. I'm the problem.


Dr. Richard Lai DPT LAc [00:07:44]:

It's me. So in our patient before in the clinical example, we inspected their legs, we saw swelling. We even saw moisture and we saw pitting edema. So now we take this data, the swelling, the moisture, the pitting edema. We combine this with the fact that they told us that they feel heavy. Their legs have felt heavy. So already we have swelling. We have edema.


Dr. Richard Lai DPT LAc [00:08:05]:

We have heaviness. So then what's the pathology that we're thinking? We're thinking dampness. Right? Dampness could be the pathology here. So then we can use the other pillars to help us rule in the diagnosis. So we can look at the tongue and we can look at the pulse. So if it's a dampness type tongue or a dampness type pulse, what kind of tongue might we expect to find? And what kind of pulse might we expect to find? So in terms of the tongue, we look at the tongue in 4 different ways. Now number 1, we look at the tongue body color. Number 2, we look at the tongue body shape.


Dr. Richard Lai DPT LAc [00:08:35]:

And number 3 and 4, we look at the tongue coat and the moisture of the tongue overall. So in terms of the tongue body color, we look to see if the tongue is normal. Meaning, is it a pale red? Or is there some sort of color that's pathological? Like, for example, is it redder than that pale red? Or maybe is the tongue purple? Or is it blue? Or is it crimson? Now all of these can mean something different. Like for example, a purple tongue will always mean blood stasis and a red tongue will generally mean heat or fire. Next, we can look at the tongue body shape. So the tongue body shape is the overall shape of the tongue. Is it long? Is it thin? Is it short? Or is it swollen? And all these can mean different pathologies too. Next we can look at the tongue coating.


Dr. Richard Lai DPT LAc [00:09:17]:

Like what color is the coating? How thick is the coating? Is it white? Is it yellow? Is it thick? Is it thin? Or maybe is there no tongue coating at all? Again, all of these can mean different pathologies. And then lastly, we can look at the moisture of the tongue. Is it dry? Is it wet? Is it sticky? Is it slippery? All these different presentations also mean different pathologies. So now the question is, what does a dampness type tongue look like? And with a dampness type tongue, it's generally found in the moisture of the tongue and the biggest indicator is if the tongue is sticky or slippery. If the tongue is sticky or slippery, it could mean that the patient is presented with dampness or phlegm. And then with the pulse, we have 28 different kinds of pulses and when we assess the pulse, we're using our fingers to inspect the pulse and we're assessing the pulse in 3 dimensions. So when we put our finger on the pulse, we can do a lot of different things. We can lift, which means we're lifting the fingers to see what the level of the pulse is in.


Dr. Richard Lai DPT LAc [00:10:13]:

Is it superficial? Is it deep? Or is it somewhere in between? This is the z axis that you see in the picture. And then we can also press down. So when we press down, we see how strong the pulse is against our fingers and we can see how deep the pulse goes. Another thing we can do with the pulse is we can search. So when we search there's no movement involved at all. We just rest our fingers and we see what the rate of the pulse is. Is the pulse fast or is the pulse slow? And then we can also push. Now pushing is just moving our fingers side to side.


Dr. Richard Lai DPT LAc [00:10:47]:

Now this lets you see the overall shape of the pulse. Is the pulse slippery? Is it thin? Is it tight like a rope? And the last thing we can do with the pulse is we can roll. So rolling is just moving your fingers up and down or proximal and distal. Now this is so you can see the length of the pulse. So is the pulse long? Is it short? Or is the pulse moving? Now in terms of a dampness type pulse, a dampness type pulse generally presents as 2 different pulses. It could either be soggy or it could be slippery. Now we assessed our patient, we inspected, we palpated, we asked questions, and we also listened and smelled. Now we take all that data together, and we interpret our findings to get a diagnosis.


Dr. Richard Lai DPT LAc [00:11:28]:

Okay. So I hope that was helpful as an eagle eye view of what an evaluation looks like because easily an actual lecture on evaluation and the 4 pillars and all the different details and different presentations in your evaluation, like color changes in the face, the eyes, the ears, all of that can actually take a couple classes worth of time, but this was just an eagle eye view of an evaluation. Alright. So for the remainder of this episode, we're gonna talk about these things. First, we're gonna talk about the general clinical manifestations that your patient will feel if there's dampness. Then we're gonna talk about the characteristics of dampness. And there, you're going to understand why dampness causes the clinical manifestations that it does. And then we're going to talk about where dampness can go in the body.


Dr. Richard Lai DPT LAc [00:12:10]:

And then we're going to end the episode by pulling back and looking at dampness in an eagle eye view in the 2 ways that it can happen in the body. And that's in terms of an external dampness and an internal dampness. Alright. So first of all, what is dampness? Dampness is a pathogenic factor. Now we have different pathogenic factors that can invade our body. So we have things like wind. We have cold. We have dampness.


Dr. Richard Lai DPT LAc [00:12:31]:

We have dryness. We have summer heat. We have fire. Right? These all can invade the body. Now with these, they can be either exterior or interior, and I'm referring to the 8 principles there. For example, with wind. Wind can come from an exterior origin where it's invading the body, but wind can also be generated internally, which, remember, I have a video on. If you haven't seen it before, I will link it in the description below.


Dr. Richard Lai DPT LAc [00:12:55]:

It's a good episode on internal wind and how liver wind works. Alright. So now let's talk about the clinical manifestations that your patient can present with if there's dampness present. So here I have a list of all the different presentations of dampness. Now these are just in general. So if there's dampness present, your patient could complain of a feeling of heaviness, a poor appetite, a feeling of fullness, sticky taste, urinary difficulty, vaginal discharge, sticky tongue coating, and slippery or soggy pulse. And the reason they can feel this is because of the characteristics of dampness, which there are 3 basic characteristics of dampness. Number 1: dampness is heavy in the body.


Dr. Richard Lai DPT LAc [00:13:35]:

Imagine like when you get stuck in the rain and all your clothes are wet and you feel heavy because all your clothes are weighing you down. Now that's the same effect that dampness has on your body. Now depending on where the dampness has invaded, that dampness will also present as different manifestations. Like, for example, if it invades the abdomen, your patient might say my stomach feels really full. Or if the dampness has invaded like their legs, they might say their legs feel full. Or if the dampness invaded their head, they might say that their head feels like it weighs a £1, 000 or they might say they feel really tired and sleepy, or they just feel fuzzy in the head. And that's because of the dampness invading and causing that feeling of tiredness or feeling weighed down or just feeling fuzzy overall. Now the next characteristic of dampness is that it's dirty.


Dr. Richard Lai DPT LAc [00:14:20]:

So dampness is dirty in the body. So for example, when you're asking your 10 questions, you're asking things like, how is your urine? What's the color of your urine? Is it pale yellow? Is your urine cloudy? Is your urine dark amber? And if they say yes, my urine has been cloudy, then that's a sign of dampness because dampness is dirty. Now dampness is also characteristic number 3, is sticky, and that's why we have things like a sticky tongue coating. That's why our patient may complain of a sticky taste in their mouth, and that's also why the pulse can be slippery. Now another thing about dampness is that because it's sticky, it tends to stick around longer. So that means it can become chronic more easily because of that stickiness. Alright. So now let's talk about the different areas that dampness can invade our body.


Dr. Richard Lai DPT LAc [00:15:05]:

So in general, regardless of external or internal dampness, dampness can invade the internal organs, it can invade the channels, and it can invade the skin. Now depending on the organ, the patient may present differently. Now I do have a study guide that details exactly how the patient may present depending on the organ. So if you want a copy of that study guide, please go to www.studyacu with me.com/dampness. You can download it there for free. Alright. So now this slide is a general eagle eye view of dampness. So as you can see, we have dampness at the top and that dampness can be split off into external dampness and internal dampness.


Dr. Richard Lai DPT LAc [00:15:44]:

Now external dampness is easier to grasp, so let's start talking about that 1 first. Now, external dampness. External dampness just invades the body and it happens because of the climate. Like for example, someone was out in the rain for a long time, or or maybe they live in an area that's really damp, or maybe they were in the pool for too long, or maybe they were out. And for some reason they had to sit on wet things. Like maybe they had to sit in the wet grass or they had to sit on wet towels or something wet on the floor. These are all opportunities for external dampness to to invade the body. So then the question becomes, where does it invade? Now external dampness can invade 3 areas.


Dr. Richard Lai DPT LAc [00:16:24]:

So it can invade the internal organs. It can invade our channels and it can invade the wei qi level. Now the Wei Chi level, if you look back on your notes on the 4 levels theory, you're gonna see these 2 things here on the slide, the damp heat and the dampness with summer heat, are 2 patterns in the Wei qi level of the 4 levels theory. Alright. So now let's pull back again. So dampness can be external or it can be internal. External dampness can invade the internal organs, it can invade the channels, or it can invade the Wei Chi level. The weiqi level has those 2 patterns there, but the 2 patterns that have to do with dampness are damp heat and summer heat.


Dr. Richard Lai DPT LAc [00:17:02]:

Now both of these patterns are in the 4 levels theory. Alright. So now dampness can also invade the internal organs. Now depending on the organ, the patient may present with different manifestations. And again, you can get that study guide if you go to www.studyacu with me.com/dampness. Alright. Now in terms of channels, external dampness can also invade our channels. And when it invades the channels, this is known as E Syndrome or Painful Obstruction Syndrome.


Dr. Richard Lai DPT LAc [00:17:31]:

Now what kind of painful obstruction syndrome? It depends on the manifestations. That's how you know what kind of painful obstruction syndrome. Now in terms of damp painful obstruction syndrome, your patient is going to complain of heaviness in the joints, maybe swelling in the joints, or even achiness. Sometimes the dampness can combine with other pathogenic factors, so they might complain of a mixture of things. Like for example, if the joint is swollen, it's heavy feeling, it's aching, and it's also hot and red, that could mean that dampness has also combined with heat. So it's a damp heat painful obstruction syndrome. Alright. So now let's talk about internal dampness.


Dr. Richard Lai DPT LAc [00:18:09]:

So now why might internal dampness happen in the body? Now to understand this, we have to bring it back to the general theory of body fluids. Now we have 3 general organs that have a major effect on the body fluids in our body. Number 1, the first organ is spleen. Spleen, we know controls or governs TNT. It governs transformation and transportation. What does it transform and transport? It transforms and transports food essence, chi, and body fluids. Now, if there's a weakness in the spleen organ, so that means the ability for the spleen to transform and transport body fluids is going to be impaired. So what's going to happen is that the body fluids are going to accumulate because it's not being transformed and it's not being transported.


Dr. Richard Lai DPT LAc [00:18:54]:

And what's going to happen if the body fluids accumulate? It's going to form into dampness in the body. Now this can affect also the lung then because the lung is supposed to regulate the water passages. And because the lung receives fluids from the spleen and what it does with the fluids is that it diffuses those fluids into the space between the skin and the muscles. What's going to happen since it's not diffusing, it's going to accumulate and that can also cause dampness. And then with the kidneys, the kidneys govern water and the kidneys are actually a source of energy for the spleen to transform body fluids because they provide heat that the spleen needs to transform body fluids. Now, also the kidneys assist the other organs in terms of the separation of the body fluids. So basically what I'm saying is that a kink in any part of the system here can cause fluid to accumulate and turn into dampness. So you as an acupuncturist or an acupuncture student, you are basically a mechanic.


Dr. Richard Lai DPT LAc [00:19:50]:

And when you're evaluating your patient, you're evaluating their body, you're checking under the hood. So you're looking at all the different parts of the car and you're figuring out, is it an external cause or is it an internal cause? Maybe the spleen is deficient, maybe the lung is deficient, or maybe the kidney, or maybe all 3 are deficient. And with internal dampness, it can either be chronic or it can be acute. If it's acute, it presents as either an acute flare up of chronic internal dampness that they have already. Meaning they have dampness, they've had it for a long time, and it just flares up every once in a while. Or it can present as the damp heat pattern in the chi level of the 4 levels theory. Now if it's chronic, then that chronic dampness can affect either the organs, the channels, or it can be retained in the skin. Now depending on the organ, the manifestations in the patient may present differently.


Dr. Richard Lai DPT LAc [00:20:42]:

Again, I have all those manifestations in a study guide which you can get for free at www.studyacu with me.com/dampness. If there's chronic dampness in the channels, then this presents as painful obstruction syndrome, which with dampness, the patient's gonna complain of those 3 things. They're gonna complain of swelling, heaviness, and aching of the joints. And then if there's dampness in the skin, then this can present as edema. It can present as oozing or weeping of the skin, or it can present as fluid filled blisters. Alright, and that brings us to the end of this episode. If you found value out of this episode, I hope that you interact with this episode. You can interact by commenting below, by answering the Q and A, maybe when you comment say hello, and suggest another topic that you'd like to see on this channel.


Dr. Richard Lai DPT LAc [00:21:32]:

And of course if you found value out of this episode, someone else might also find value. So please share this episode with a friend, text it to them, email it to them, share it on your Instagram stories, just help me spread the message out there. And until next time, God bless and happy studying.


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