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The Fourth Stagnation: Damp Stagnation, Part 1

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Whether you've had April showers or are experiencing May ones, rain is a great metaphor for Dampness in the body. Just as rain collects and congests traffic (Qi or Blood stagnation) it can also flood and eventually swamp an area (Damp Stagnation). Damp Stagnation can be likened to standing swamp that breeds bacteria.

In TCM, when Dampness collects over time, Heat develops and dries Fluids. The Dampness then congeals to form Phlegm. Phlegm is a more serious condition that can cause such conditions as cough, wheezing, nausea, vomiting, loss of appetite, GERD, scrofula, goiter, arthritis and lymphadenitis, or it can lead to major diseases like cancer, stroke, atherosclerosis, plaque in the arteries, coma, lockjaw, contracted limbs, cerebral vascular accident, and seizures. While Phlegm is a secondary pathogen, it is considered "the mother of 100 diseases" by the Yuan dynasty physician, Wang Gui. In Ayurvedic medicine, it is called kapha, or the mucus humour.

In general, Fluid (Damp) Stagnation is often associated with Qi Deficiency or low energy. It is accompanied by a general appearance of edema or tissue swelling, especially seen on the abdomen, face, enlarged glands, nodules and/or any other puffy, swollen areas of the body. The tongue reflects generalized edema by appearing enlarged, swollen, scalloped on the sides, and very moist. The pulse feels "slippery," gliding or "rolling," whichever description aptly describes its manifestation.

Phlegm has the following characteristics:

  1. Yin in nature, and as such, can injure Yang Qi
  2. Heavy in nature: feels like a weight or oppression/heaviness in limbs, head, chest, or whole body
  3. Gives rise to lumps and masses: these are soft, movable nodules and not usually painful; swollen joints, goiter, scrofula, cysts
  4. Sticky and obstructive: it can appear as such in the stools, throat, nausea, vomit, or in the channels (numbness); if there’s phlegm in the throat, this is enough to determine the existence of phlegm (especially if this occurs in the morning or after meals and if the tongue is swollen)
  5. Moves and changes: phlegm often moves with Liver Yang or Liver Wind, causing such issues as strokes, or hypertension
  6. Interacts with Blood Stasis (mainly in the elderly); when the two interact, it causes major diseases and death. As well, Phlegm aggravates and harbors Blood stasis (both together create dark nails, a dark complexion, purple lips, and a purple and swollen tongue)
  7. Damages the Spleen and especially, the Stomach
  8. Easily mixes with other pathogenic factors
  9. Is the origin of other diseases: when symptoms don’t fit, think of Phlegm as Phlegm conditions are complicated and a strange group of symptoms


Pulse: Slippery and/or wiry

Tongue body: Swollen – where the tongue is swollen indicates the location of Phlegm

Tongue coat: Sticky

Combinations of body and coat:

  • swollen body, sticky coat: phlegm
  • swollen body, sticky coat without root and partially peeled: Phlegm and Stomach Yin Deficiency
  • swollen body, sticky coat, deep cracks: Phlegm and Yin deficiency
  • swollen body, sticky coat, deep crack in heart area: Phlegm misting the Shen
  • swollen body, no coat, slightly purple: phlegm and Blood stasis
  • swollen body, no coat: Phlegm and Yin Deficiency
  • swollen body, dry, yellow inside stomach crack: Phlegm Fire in Stomach
  • swollen body and red: Phlegm Heat

Frankly, if you’ve got to spit out mucus from your throat first thing in the morning or after eating meals, you’ve got phlegm.

Dampness vs. Phlegm



Can be external

Is only internal

Not obstructive


Slimy and/or sticky


Doesn’t move

Moves and changes

Diseases not so serious

Causes serious diseases

From Spleen impairment

From Spleen, Kidney and Lung impairment

Usually affects lower body

Usually affects middle and upper body

Doesn’t affect the mind

Affects the mind

Combines with Heat or Cold

Combines with Heat, Cold, Fire, Blood, Wind, Dryness

Mostly affects the Spleen, Gall Bladder, Urinary Bladder, Large Intestine, Small Intestine Mostly affects the Lungs Heart, Kidneys, Stomach

Affects the Spleen

Affects the Stomach


Moves with (or blocks) Qi and Blood

Sticky, heavy, dirty, flows downward

Sticky only

Only assumes one form: watery

Can be Phlegm, Phlegm Fluids

Use "drain Dampness" herbs

Use "resolve Phlegm" herbs


Phlegm always affects the Spleen but it accumulates in the Lungs. However, because it moves and changes, it can be found anywhere in the body, such as:

Phlegm in the Lungs: cough, wheezing, stifling sensation in the chest, pain in the ribs

Damp Phlegm Obstructing the Lungs: chronic cough coming in bouts, profuse white sputum which is easy to expectorate, white-pasty complexion, stuffiness of the chest, feeling "clogged up," shortness of breath, dislike of lying down, slippery or weak-floating and fine pulse and thick-sticky white tongue coating.

Phlegm Heat in the Lungs: barking cough, profuse yellow or green or dark sputum which is foul-smelling, shortness of breath, asthma, stuffiness of the chest, slippery, rapid, full pulse and red tongue body with a thick-sticky yellow coating

Phlegm in the Stomach: nausea, vomiting, loss of appetite, epigastric distention

Phlegm in the Channels: scrofula, goiter, lymphadenitis

Turbid Phlegm blocking the Heart orifices: wind stroke, coma, lockjaw, contracted limbs, CVA, seizures

Upper Warmer Symptoms: edema in top part of body such as face and hands, congestion in the head and/or chest

Middle Warmer Symptoms: sound of abdominal fluid, damp abdomen, ascites, edema in the middle part of the body

Lower Warmer Symptoms: Edema in lower part of body, such as the legs and ankles, pitting

Is Damp Stagnation Hot or Cold?

Dampness and Phlegm always appear with either Heat or Cold. If with Heat, there’ll be other signs of Heat along with a yellow tongue coat and yellowish excretions and secretions; if with Cold, there’ll be other signs of Cold along with a white tongue coat and clear to white excretions and secretions.

Causes for Damp Stagnation

Dampness and Phlegm are always pathologies of the Qi mechanism. While it is primarily caused by deficient Spleen Qi or Yang failing to transform and transport Body Fluids, it may also be created by deficient Kidneys unable to control the Fluids and/or Liver Qi Stagnation failing to facilitate the transportation and transformation functions of the Spleen. As well, it may be caused by the invasion of pathogenic influences such as External Wind-Cold that interferes with the Lung’s function of dispersing and descending. Here are several other factors that can cause Damp stagnation and Phlegm to develop:

Pathogenic Influences: Phlegm easily combines with other pathogens to create many conditions such as:

  • Wind-Phlegm
  • Dry-Phlegm
  • Phlegm-Fire
  • Phlegm with Qi Stagnation
  • stone Phlegm (chronic swelling of the glands or nodules on the vocal chords)
  • food Phlegm
  • shock Phlegm
  • wine Phlegm
  • Phlegm obstructing the Heart
  • Lung Deficiency with Phlegm
  • Phlegm-Fire in the Lungs
  • turbid Phlegm in the Lungs
  • Phlegm obstructing the Lung Qi
  • Phlegm-Fluids in the Lungs
  • Spleen Qi Deficiency with Phlegm
  • Phlegm obstructing the middle burner
  • Phlegm-Fire in the center
  • Phlegm-Fluids in the center
  • Liver-Wind harboring Phlegm
  • Phlegm-Heat in the Liver channel
  • Liver Qi Stagnation and Phlegm
  • Liver Blood Deficiency and Phlegm
  • Kidney Yang Deficiency with Phlegm
  • Kidney Yin Deficiency with Phlegm

Emotions: Any emotional excess can eventually lead to Damp Stagnation and Phlegm

Diet: High consumption of cold foods and/or drinks; raw foods; dampening foods like fried and fatty foods, dairy, sugar, tofu, soy milk, alcohol, and flour products

Lifestyle Habits: Irregular eating habits, overwork, inactivity, excessive or long-term use of many pharmaceuticals such as antibiotics and antidepressants

In Part II we will discuss treatments and therapies for Damp Stagnation. However, if you feel stagnant just by reading all of this, guess what I’m going to suggest that you do? That’s right! Immediately get up and MOVE! Movement is one of the great keys to circulating everything in the body. It can be exercise, but if you do what you love at the same time, it also smoothes emotions and nourishes you, preventing further stagnation. 

1 comment

  • Comment Link Jasmine Orenstein Friday, 28 October 2016 23:37 posted by Jasmine Orenstein

    I have found that it is best to spit out mucus rather than swallow it. When digested t will pollute the intestines and cause uncleanliness at the bottom where it comes out as an abnormal waste product. Even worse, if it should emerge from the anus in a fully digested or partially digested form it can gain access to the vagina all too easily and then thebacteria in it can then go on to create sepsis. I have known several women who died in this manner; from phlegm poisoning which resulted in a septic condition.

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