The pattern of cold dampness refers to a series of symptoms caused by the external invasion of cold-dampness pathogens or internal retention of water-dampness due to inherent spleen yang deficiency. It is often caused by exposure to rain and dew, sitting or lying on damp ground, or consuming raw and cold foods. Clinically, the symptoms vary depending on the location and severity of the cold-dampness, with differences in whether the symptoms are more external or internal.

The main clinical manifestations include: heaviness in the head and body, joint pain with limited flexion and extension, absence of sweating, mental fatigue, fear of cold, or facial and body swelling, especially below the waist, epigastric pain, loose stools, or diarrhea with more white than red discharge, difficulty urinating, a pale tongue with a white and moist coating, and a weak, soggy pulse.

The pattern of cold dampness is commonly seen in diseases such as "epigastric pain," "diarrhea," "cholera," "dysentery," and "bi syndrome."

This syndrome should be differentiated from the "pattern of dampness obstruction in the qi phase" and the "pattern of spleen deficiency with dampness encumbrance."

bubble_chart Differentiation and Treatment

The pattern of cold dampness can appear in various diseases, each with its own clinical characteristics, and the treatment methods are not entirely the same.

1. If the pattern of cold dampness is seen in epigastric pain, the clinical manifestations are characterized by stuffy pain in the stomach, poor appetite, sticky mouth, heaviness in the head and body, loose stools or diarrhea, a white and greasy tongue coating, and a soggy pulse. This is often caused by excessive consumption of raw and cold foods, trapping middle yang, and impaired spleen transportation. The treatment should focus on invigorating the spleen and resolving dampness, using Stomach Poria Decoction(Danxi Xinfa) with modifications.
2. If the pattern of cold dampness appears in diarrhea disease, the clinical manifestations typically include clear and watery diarrhea, abdominal pain with borborygmus, stuffiness in the stomach, poor appetite, or accompanied by an exterior cold pattern. This is caused by external contraction of cold-dampness invading the stomach and intestines, or excessive consumption of raw and cold foods leading to dysfunction of the spleen in transportation and internal excess of cold-dampness, resulting in impaired conduction. The treatment should focus on releasing the exterior and dissipating cold, using aromatic herbs to resolve dampness, with the formula Patchouli Qi-Righting Powder(Taiping Huimin Heji Jufang).
3. If the pattern of cold dampness is seen in cholera, the clinical manifestations include sudden vomiting and diarrhea, initially with loose stools, followed by clear and watery diarrhea, or rice-water-like stools, stuffiness in the chest and diaphragm, abdominal pain or no pain, cold limbs, a white and greasy tongue coating, and a weak and soggy pulse. This is caused by the stagnation of cold-dampness filthy turbidity in the middle energizer, yang qi being constrained, and the disruption of ascending and descending, leading to the mixing of clear and turbid. The treatment should focus on bitter-warm drying of dampness and aromatic herbs resolving dampness, using Patchouli Qi-Righting Powder(Taiping Huimin Heji Jufang) combined with Chunyang Healthy Qi Pill (from "Selected Chinese Medicinal Formulas") with modifications.
4. If the pattern of cold dampness is seen in dysentery, the clinical manifestations include white sticky mucus in the stool, or more white than red, abdominal pain, tenesmus, stuffiness in the chest and stomach, poor appetite, and heaviness in the head and body. This is called "cold-dampness dysentery" and is caused by unclean diet, excessive consumption of raw and cold foods, injury to spleen yang, internal retention of water-dampness, dampness transforming into cold, internal accumulation of cold-dampness, and obstruction of qi movement, leading to the accumulation of cold-dampness filthy turbidity in the intestines. The treatment should focus on warming and resolving cold and dampness, moving qi to stop dysentery, using Stomach Poria Decoction(Danxi Xinfa) with modifications.
5. If the pattern of cold dampness appears in Bi disease, the clinical manifestations include cold pain and heaviness in the lower back or limb joints, limited flexion and extension, difficulty in turning, gradual worsening, and aggravation in cold and rainy weather. This is caused by working in water, exposure to rain, living in damp environments, and the invasion of cold-dampness pathogens into the muscles, joints, and tendons, blocking the meridians. The formula used is Coix Seed Decoction(Leizheng Zhicai) with modifications.

The pattern of cold dampness is more common in the elderly and those with weak constitutions, as the spleen and kidney yang qi are often deficient in the elderly, leading to failure in promoting water transformation, making them more susceptible to the pattern of cold dampness. Common symptoms include listlessness, dull complexion, cold limbs, heaviness and lack of strength, and even swelling in the lower limbs, stuffiness in the stomach, loose stools, diarrhea, and a white and greasy tongue coating. In women, the pattern of cold dampness mainly manifests as clear and thin leukorrhea, dysmenorrhea, and cold uterus infertility, which should be carefully differentiated and treated.

Cold and dampness are both yin pathogens. Cold is congealing and stagnant, easily damaging yang qi. Dampness is heavy and turbid, easily obstructing qi movement. Both can suppress qi and congeal blood, leading to the pattern of qi stagnation and blood stasis. If the pattern of cold dampness is accompanied by the pattern of qi stagnation and blood stasis, it often indicates severe injury to yang qi, and it is difficult to dispel cold and overcome dampness without warming yang and transforming qi.

bubble_chart Differentiation of Similar Patterns

1. Pattern of dampness obstruction in qi phase and pattern of cold dampness: Both syndromes belong to the category of dampness disease. In terms of disease cause, the pattern of cold dampness is mostly caused by working in water, getting caught in the rain, living in damp and low places, leading to the invasion of cold-dampness, or by improper diet, excessive consumption of raw and cold foods, injuring the spleen and stomach, causing dampness to transform into cold. On the other hand, the pattern of dampness obstruction in qi phase is mostly caused by excessive consumption of raw, cold, sweet, and fatty foods, and rarely by wind-dampness or dew. In terms of symptoms, the pattern of cold dampness can be divided into external and internal types. The external type often presents with heaviness of the head, body pain, joint stiffness, and swelling of the limbs; the internal type often presents with stomach pain, loose stools, or diarrhea with more white than red. The pattern of dampness obstruction in qi phase varies depending on the location of dampness obstruction, with distinctions between dampness obstruction in the triple energizer, upper energizer, middle energizer, and lower energizer. Dampness obstruction in the upper energizer causes head distension and stomach discomfort, lack of hunger and appetite; dampness obstruction in the middle energizer causes abdominal distension and fullness, and heaviness of the limbs; dampness obstruction in the lower energizer causes foot edema and difficulty in urination. It can be seen that the pattern of cold dampness involves both dampness and cold, while the pattern of dampness obstruction in qi phase involves only dampness obstruction without cold symptoms.
2. Pattern of spleen deficiency with dampness encumbrance and pattern of cold dampness: Both the pattern of spleen deficiency with dampness encumbrance and the pattern of cold dampness are related to spleen deficiency and dampness turbidity. Their disease causes can both be due to indulging in cold drinks or getting caught in the rain, and their symptoms can both include loose stools, limb edema, heaviness of the head and body, and a white greasy tongue coating. However, the pattern of spleen deficiency with dampness encumbrance is limited to the spleen and stomach, while the pattern of cold dampness, in addition to being closely related to the spleen and stomach, also involves the muscles and joints of the limbs, often accompanied by joint stiffness or pain. This is how the two can be distinguished.

bubble_chart Documentation

1. Zhengzhi Huibu‧dampness pattern: "dampness injury combined with cold is called cold-dampness. Due to prior exposure to dampness and subsequent injury from raw and cold [factors], the symptoms include head sweating, body pain, generalized stiffness, inability to turn over, severe pain upon touch, generalized absence of sweating, and difficulty in urination. The symptoms are similar to wind-dampness, but with the addition of diarrhea. It is appropriate to treat with eliminating dampness decoction."
2. Zhengyin Maizhi-Cold-Dampness Lumbago: "The symptoms of cold-dampness lumbago include headache, body pain, absence of sweating, stiffness, and lumbago, with inability to turn over. These are the symptoms of cold-dampness lumbago. The causes of cold-dampness lumbago may be due to years of cold-dampness, when pudendal coldness prevails, and people suffer from heavy body and lumbago. This is due to the influence of the year's climate. Or, it may be due to exposure to cold and rain, where pudendal coldness and dampness cause pain. This is due to common cold contracted by the individual."
3. Zhengyin Maizhi‧cold-dampness body swelling: "The symptoms of cold-dampness body swelling include heavy body, body pain, cold feet, chest fullness, and generalized swelling. These are the symptoms of cold-dampness swelling. The causes of cold-dampness swelling may be due to seasonal overcast and rainy weather, cold climate, or living in damp and cold environments, where pudendal coldness invades the skin. Or, it may be due to exposure to water after sweating, where cold water causes injury, leading to the formation of cold-dampness swelling."