bubble_chart Concept

The pattern of dampness and heat in the spleen and stomach refers to the symptoms and signs formed by the accumulation of dampness-heat in the spleen and stomach, and the dysfunction of the spleen in transportation and the stomach in descending. This syndrome can be caused by improper diet, excessive consumption of rich and greasy food leading to the formation of dampness-heat that accumulates in the spleen and stomach, or by exposure to dampness-heat that obstructs the middle energizer.

The main clinical manifestations include: stuffiness and fullness in the epigastric and abdominal regions, nausea and vomiting, anorexia, heavy and tired limbs, loose and foul-smelling stools, scanty and dark urine, yellowing of the face or skin, fever with sweating that does not relieve the heat, red tongue texture, yellow and greasy tongue coating, and a soggy and rapid pulse.

The pattern of dampness and heat in the spleen and stomach is commonly seen in diseases such as "diarrhea," "dysentery," "dampness obstruction," "jaundice," "edema," and "tympanites."

This syndrome should be differentiated from the "pattern of cold-dampness disturbing the spleen," the "pattern of dampness-heat in the liver and gallbladder," and the "pattern of stomach fire (heat)."

bubble_chart Differentiation and Treatment

1. This syndrome is seen in dampness obstruction, Jingui Yaolue Xindian‧痙濕暍病 says: "Those with dampness stroke must first have internal dampness before being affected by external dampness. Therefore, these individuals usually have deficient earth virtue and dampness moves within, leading to slow qi movement and dampness soaking externally, combining external and internal pathogens." This results from dysfunction of the spleen and stomach, failure in transportation and transformation, dampness generated internally, invasion of external dampness, and the combination of internal and external dampness transforming into heat, leading to dampness obstruction. Symptoms include a bitter and sticky taste in the mouth, and a soggy and rapid pulse. Treatment should focus on clearing heat and resolving dampness, using Coptis and Magnolia Bark Decoction(Huoluan Lun) or Sweet Dew Detoxicating Pill(Wenre Jingwei).
2. This syndrome is seen in jaundice, Shengji Zonglu.jaundice section says: "Mostly due to excessive alcohol and food, water and grains accumulate in the spleen and stomach, and are further affected by wind-dampness, leading to heat qi depression and steaming, thus causing jaundice." Symptoms include yellowing of the eyes and body, heaviness of the head, fatigue, nausea and vomiting, chest and gastric stuffiness, greasy tongue coating, and a soggy and rapid pulse. Treatment should focus on clearing heat and resolving dampness, transforming turbidity, using Virgate Wormwood Decoction(Shanghan Lun) and Sweet Dew Detoxicating Pill(Wenre Jingwei).
3. This syndrome is seen in edema, caused by internal invasion of water dampness, dampness accumulating internally, spleen being oppressed by dampness, dampness transforming into heat, dampness-heat steaming together, and bladder's inability to transform, leading to edema. Symptoms include generalized edema, chest and abdominal stuffiness, scanty and dark urine, dry stool, yellow tongue coating, and a deep and rapid pulse. Treatment should focus on draining dampness and heat, using Eight-Ingredient Rectification Powder with modifications(Hejiju Fang).
4. This syndrome is seen in tympanites, caused by the combination of dampness-heat in the spleen and stomach, and the accumulation of turbid water. It is accompanied by symptoms such as feverishness, bitter taste in the mouth, thirst without desire to drink, scanty and dark urine, constipation, or yellowing of the face and skin, yellow and greasy or gray-black tongue coating, and a wiry and rapid pulse. Treatment should focus on clearing and draining damp-heat, expelling water by purgation, using Middle Fullness Separatively Eliminating Pill(Lanshi Micang) with modifications.

The spleen is averse to dampness, and late summer is dominated by dampness, with the summer season often being damp. Therefore, this symptom and sign are often seen in the hot and damp summer season, or in people who live in damp environments for a long time, with inherent spleen deficiency and irregular diet, often triggered by dampness.

The pattern of dampness and heat in the spleen and stomach, if not treated properly, can easily evolve into other symptoms and signs. For example, if dampness-heat of the spleen and stomach invades the large intestine, it can lead to intestinal dampness-heat pattern, manifested as abdominal pain, dysentery with pus and blood, tenesmus, and burning sensation in the anus.

bubble_chart Differentiation of Similar Patterns

1. pattern of cold-dampness disturbing spleen and pattern of dampness and heat in the spleen and stomach: both symptoms and signs can be caused by dampness obstructing the spleen and stomach, or improper diet, dysfunction of the spleen in transportation, and obstruction of qi movement. Both can present with symptoms such as epigastric and abdominal distension, anorexia, nausea, abdominal pain, and loose stools. Although the clinical manifestations are similar, the nature of the diseases is entirely different. This syndrome belongs to dampness-heat invading internally, or dampness injuring the body and transforming into heat over time. The pattern of cold-dampness disturbing spleen involves dampness transforming into cold, or inherent deficiency-cold of the spleen and stomach, exacerbated by excessive consumption of raw and cold foods. Therefore, the dampness in this syndrome must be accompanied by heat signs, such as loose stools with difficulty in defecation, scanty and dark urine, dampness-heat of the spleen and stomach causing steaming and stagnation, leading to yellowing of the face and skin, a red tongue with yellow and greasy coating, and a soft and rapid pulse. The pattern of cold-dampness disturbing spleen must be accompanied by cold signs, such as watery diarrhea, due to cold-dampness stagnating in the Jingmai, obstructing qi movement, often causing edema due to dampness overflowing the skin. The spleen, constrained by cold-dampness, leads to insufficient generation and transformation, resulting in poor nourishment of qi and blood, causing a pale yellow complexion, which is classified as yin jaundice and must be differentiated from yang jaundice caused by dampness-heat of the spleen and stomach. The pattern of cold-dampness disturbing spleen may present with a bland taste in the mouth and lack of thirst, while the pattern of dampness and heat in the spleen and stomach presents with body heat and dry mouth, which also aids in differentiation.
2. pattern of dampness-heat in liver and gallbladder and pattern of dampness and heat in the spleen and stomach: both syndromes belong to the pattern of dampness and heat, often caused by exposure to dampness-heat pathogens or excessive consumption of rich and sweet foods generating dampness-heat. However, the pattern of dampness and heat in the spleen and stomach affects the spleen and stomach, belonging to middle energizer dampness-heat, while the pattern of dampness-heat in liver and gallbladder affects the liver and gallbladder, with different locations of disease, making clinical differentiation straightforward. The pattern of dampness and heat in the spleen and stomach presents with epigastric and abdominal stuffiness, nausea, anorexia, heavy limbs, loose stools with difficulty in defecation, scanty and dark urine, a red tongue with yellow and greasy coating, and a soft and rapid pulse. The pattern of dampness-heat in liver and gallbladder presents with abdominal distension and fullness, nausea, anorexia, but mainly involves dysfunction of liver and gallbladder qi, causing hypochondriac distending pain, bitter taste in the mouth, yellowing of the body and eyes, alternating chills and fever, scrotal eczema or testicular swelling and heat pain. In women, it may present with vulvar pruritus, yellow and foul-smelling leukorrhea, a yellow and greasy tongue coating, and a wiry and rapid pulse.
3. pattern of stomach heat and pattern of dampness and heat in the spleen and stomach: the pattern of stomach heat is caused by pathogenic heat invading the stomach or excessive consumption of spicy and hot foods, while the pattern of dampness and heat in the spleen and stomach involves the binding of dampness and heat, with a certain relationship to seasonal factors. The pattern of stomach heat, due to heat stagnation in the stomach, presents with burning epigastric pain, rapid digestion with increased hunger, foul mouth odor, dry mouth, thirst, and preference for cold drinks. It may also cause hematemesis and gingival hemorrhage due to stomach heat scorching the blood vessels, with a red tongue and yellow coating, and a slippery and rapid pulse. The pattern of dampness and heat in the spleen and stomach presents with epigastric and abdominal distension and fullness, nausea, vomiting, and a heavy body. The clinical manifestations of the two are different and easy to distinguish.

bubble_chart Documentation

1. Wenbing Tiaobian. The chapter on the middle energizer states: "The invasion of dampness into the middle energizer can be due to cold-dampness, damp-heat, external factors, internal accumulation of water and grains, or a combination of internal and external factors. The damage it causes can affect spleen yang, spleen yin, stomach yang, stomach yin, or both the spleen and stomach."