By Andrew Sterman – Originally published in the Golden Flower Newsletter, Fall 2018 Issue.
Dampness is one of the six climatic factors taught in Chinese medicine, along with cold, heat (fire), wind, summer-heat, and dryness. For many today, modern heating and air-conditioning have eased the climatic influences—unrelenting cold or oppressively humid summer heat can be escaped by going indoors. And while climatic dampness can be an important issue for those living in basement apartments or with hidden mold, more and more what we see in our culture is dampness somehow arising from the inside. Dampness – often shadowing the obesity epidemic – is on the rise.
Dampness is a collection of signs and symptoms. It can be apparent or hidden:
- Water weight around the middle or thighs, or edema of the ankles or face.
- Swellings of any kind, including within the joints or in the sensory orifices.
- Dampness is a part of arterial plaque buildups, cataracts, glaucoma, blurry vision, sinus problems, hearing loss.
- Accumulations and conglomerations (jia and ju). These include not only fat deposits but masses, fibroids, cysts, endometriosis, prostatitis, tumor formation, even hernias.
- Signs and symptoms associated with spleen qi deficiency: thickening of the tongue coat, digestive stagnation, bloating, UTI, loose stool or alternating constipation with loose stool, cravings and appetite disturbances, brain fog, sluggishness, lethargy, difficulty sleeping with difficulty waking, worry with emotional impulsiveness, yeast or candida scenario, and if dampness progresses to phlegm, sinus problems, lung congestion, and lymphatic issues.
Each major innovation in the history of Chinese medicine contributes its own theory of the generation and progression of dampness. Two aspects are of special interest.
- First, internal dampness involves some degree of dietary problem that then weakens digestion further in a self-amplifying loop.
- Second, dampness is a heavy factor that tends to settle and sink from the middle jiao to the lower jiao. Once in the lower jiao, stagnation blocks descension of stomach and lung qi. Heat arises to move the stagnation. If this heat (combined with the natural fire of the stomach) can’t overcome the stagnation and clear through the bowels, it rises upward, carrying dampness with it. The way this plays out in different individuals controls the way dampness and its complications manifest for them.
In modern discussions, the mention of dampness is assumed to refer almost automatically to weakness of spleen qi. Sun Si Miao, the great master of the Sui and Tang Dynasties, felt that dampness (and its corollary tan/phlegm) was not caused directly by diet; rather it arose from stagnation due to sluggish elimination. Begin by assessing the bowels and restoring elimination in order to clear stagnation and permit the spleen-pancreas to gradually restore metabolism. Granted, modern clinicians, particularly in America, might point to the common diet today as vastly more likely to be at the root of dampness issues compared to earlier times, but Sun Si Miao reminds us to think for ourselves, without standard “this for that” thought patterns. Dampness may not be what it seems; it can be complicated.
In order to responsibly and effectively clear dampness we need to assess its causes and complications in the context of each individual’s health and lifestyle. The first differentiation to make is whether the dampness you are seeing is a natural response to a pathogenic process involving heat or if it is true pathological dampness based on spleen qi weakness combined with dietary excess. Clearing heat-related dampness prematurely can deprive the body of an important defense mechanism. While diet is involved in both scenarios, recommendations should differ to reflect sound strategy.
From a dietary perspective, dampness arises when digestion can’t keep up with what we are eating. Three broad mechanisms are at play: sticky foods, dietary irritants, and stagnation.
- Certain foods easily cause dampness directly, such as dairy, sugar, and glutinous grains (wheat, primarily). We can call these sticky foods.
- Other foods cause dampness as the body responds to irritation those foods cause in the alimentary canal. An irritant enters. The body says, “Oh no! This doesn’t belong in my gut, this is so spicy or mildly toxic that it could hurt my delicate tissues!” The body sends wei qi to move out the food that is being treated as a pathogenic factor. The wei qi lingers too long if the diet doesn’t change and the irritation becomes chronic. Concentrated wei qi, because it is yang, is hot. This heat and the original irritant combine into compounded heat, likely to damage tissues if allowed to persist.
Dampness is created to soothe. Damage can occur within the digestive system or—since one role of digestion is to transport, heat and dampness can also spread anywhere. More specificity to understand where this can progress is provided by zang–fu and channel theory.
Foods that commonly raise fire either directly or through the
irritation—>heat—>dampness progression include spicy foods, onions, garlic, coffee, alcohol, sometimes nightshades, and more.
- And, as mentioned above, the body will naturally focus yang qi in the lower jiao to respond to stagnation in the intestines, if present. If this extra yang qi is not successful in moving the stagnation (if, for example, the individual’s diet continues unchanged), that Heat can itself become an irritant and cause a Damp response. Digestive fire can then become rebellious and travel upward—impacting the heart—leading to psychological irritation, sleep problems, and so forth. The whole body becomes involved and the question then is where to begin to unwind this situation. It can be a challenging process, particularly as the individual may crave their dietary ‘treats’ more than ever.
Around this point in the discussion an objection is raised: “This is all too complicated! Digestion doesn’t ‘fall behind’, people just eat too much! It’s just too many calories, too many sweets, too much food, not enough discipline! Be more honest, ‘dampness’ is just fat, and if you eat less—fewer calories, that is—you’ll lose weight. There, it’s simple!” But the calorie model misses so much that it is only as useful as one leg of a four leg chair. Only with the other legs does it hold up. The other ‘legs’ are the ways certain foods tend to cause dampness more than others, either through their tendency to be thickening and sticky (sugar, gluten, dairy), their tendency to irritate the gut (hot peppers, garlic, onions, nightshades, alcohol), or damage done to digestion by eating even good foods in poor combinations. Poorly combined foods tend to cause food stagnation or chronic constipation, leading to the stagnation-heat-dampness-ascending mechanism described above.
Looking more deeply, four more mechanisms must be considered.
First, dampness can arise not only from excess but also from deficiency. This dampness can be stubborn and resistant to weight-loss dieting even with perfect discipline. Since hormones require fats for their production, it is very common that a person with hormone deficiency (or imbalances) will gather dampness in an attempt to replenish what is deficient. Failing to replenish hormones (healthy yin), the body will weigh itself down with whatever yin substance it can gather. There can be accompanying sugar or dairy cravings. Rather than satisfy the underlying deficiency, excess weight easily develops (spleen qi is often already compromised and lower jiao stagnation often already occurring, with secondary dampness scenarios intertwined with the hormonal cause.) This is pathology based on a correct response going awry. The dietary approach is not to ‘diet’ to lose weight or directly clear dampness, rather:
- provide the best quality fats possible (in place of fried foods and poor snacks, have olive oil and butter, whole yogurt, eggs, avocado, nuts and seeds, etc.)
- eliminate sugar, gluten and dairy (with the possible exception of full-fat yogurt or kefir in modest amounts).
- simplify meal combinations to allow stagnation to clear (along with accompanying inflammation).
- add more directional foods such as warming spices (e.g., rosemary, oregano, tarragon, ginger, turmeric, cinnamon, nutmeg, clove, cumin, cardamom, mustard seed),
- vegetables that direct qi (e.g., asparagus, kale, bok choy, dandelion greens, radicchio, parsley, cilantro, etc.),
add aromatic foods to cut through existing dampness (e.g., fresh ginger, radish, daikon, scallion, leek, mint, shiso, citrus peel, occasional garlic, etc.)
Second, if wei qi becomes habituated to responding to certain foods or conditions, such as is the case with allergies, even a small amount of that food (or pollen) can create significant dampness.
Third, since kidney yang qi underlies spleen yang qi and all digestion, any lifestyle stress to kidney qi will slow digestion and deepen the dampness scenario already underway. It’s common in the clinic to see individuals who are not fundamentally improving despite eating well, taking herbs, and having good treatment. Lifestyle stress on kidney yang qi must be considered. In such cases, food choices should:
- support kidney yang (include black beans, adzuki beans, sesame seeds, shellfish, seaweeds).
- avoid building more dampness (abstain from sugar, dairy, gluten, using the general advice above).
- avoid raw foods, cold food and drinks (the cold in drinks, smoothies and salads can stimulate dampness and phlegm as well as slow digestion).
- include easy to digest meals that are also hydrating (soups, stews, wet breakfasts).
- include animal foods in moderate amounts for the yang qi boost they provide (salmon, beef, pork, and/or chicken). Vegetarians are strongly advised to increase warming spices to simulate the yang qi contribution of animal food.
The Fourth mechanism (and for some the most important) is the role dampness can play to establish psychological protection. As with dampness for latency or attempted hormonal replacement, it is important not to deprive the individual of what is perceived as essential to feel secure, in other words, do not attempt strong damp clearing protocols without nourishing yin and self-confidence first. When a person feels more secure at the somatic and emotional levels, the body can become ready to let go of pathological dampness.
Clearly there are important variations in the dampness scenario for different individuals. Nonetheless, a trend emerges. Improving overall health is needed, including diet, stress levels, sleep status, social connections, and external environmental factors. Management of pathogens needs to be considered, as dampness may be functioning to secure latency. Hormonal status needs to be considered, as dampness is often pathogenic yin gathered as an attempt to restore healthy yin. Psychological considerations are always important.
At the same time, from a dietary perspective some general guidelines are sensible for nearly everyone with dampness: avoid foods that easily add to dampness (sugar, dairy, gluten), avoid stimulants and irritants that easily add to dampness through irritation or adrenal depletion (excess coffee or alcohol, hot peppers, onions, garlic, nightshades, as well as erratic mealtimes,eating while under stress, while standing or walking, for emotional sedation before sleep, and so forth). While removing problem foods, consistently add foods that help build healthy yin and hydrate while draining existing dampness through diuresis. Also add foods for specific issues (for example, whole grains, oils, and root vegetables to clear stagnation in the intestines).
Here are some recipes to choose from or model after.
Wet Breakfasts are very important—they provide hydration, nourish yin, and send a clear signal that sufficient fluids are consistently arriving. If used regularly, this gives the body a chance to let go of stagnant fluids and pathological yin, particularly important for dampness responding to heat or changes in the hormonal complement. I recommend rice congee, millet porridge, grits or polenta, and porridges made from oats, quinoa, amaranth, buckwheat and so forth. Fine tuning is possible—rice congee for heat and hydration, millet porridge for heat, hydration, and hormonal depletion, or corn grits or polenta for hydration and adrenal exhaustion—but most people would greatly benefit from any consistent wet breakfasts for the way they nourish yin while draining dampness. My instructions for congee and porridges can be read here: (“Congee and the Importance of Wet, Cooked Breakfasts,” (originally published in the Golden Flower Chinese Herbs Newsletter, Autumn, 2015).
In Chinese medicine, the sixth taste, bland, is used to drain dampness. Bland or very mild-flavored foods establish a special communication between spleen-pancreas and kidney energetics, a relationship described in the legendary Tang Ye Jing, an early text that heavily influenced the Shang Han Lun. A cook should keep a mental list of culturally available bland foods. Within that list, specific foods can be selected for their other affinities to help aim the therapeutic function at any of the burners or to a specific organ system. If choices are limited, vegetables or envoy spices can make these connections.
For example, zucchini is a bland food with stomach and spleen-pancreas affinity. Mung bean sprouts are bland with liver affinity. Mushrooms are bland with kidney connection. Celery rises up before cooling, descending, and draining. Its directionality, mineral taste and diuretic quality make it particularly useful for draining dampness that has been pushed upward (it was later given a bladder affinity).
Dampness eventually stresses the heart, and phlegm can accumulate in the lungs. The chest will clear if digestion and kidney-adrenal functions improve, but to help the lungs more directly, add aromatic spices such as ginger, scallions, cinnamon, nutmeg, cumin, coriander, caraway, cardamom, grain of paradise, fennel seed, mint, parsley, or citrus peel. Most of these spices aid all three burners, properly avoiding treating any organ on its own.
As with herbs, relatively few foods have a direct heart affinity. In the later version of five element associations, bitter greens such as radicchio are used to relieve damp burdening the heart via the small intestine. If the Tang Ye theory interests you (as it does me) and you prefer to stay within its model, have a mild red food such as adzuki beans in a soup with kidney and spleen-pancreas ingredients such as seaweed, mushroom, and zucchini (or various white, cooking gourds from Chinatown markets). This soup builds resources while draining dampness, satisfying the need to do both, as described above. To be effective, be sure to repeat therapeutic meals often (have them as a side dish twice daily for a week, to start) and to eliminate factors that cause dampness, irritation or inflammation.
Despite the technical term, ‘bland’ dishes can be delicious. The test of a master home cook is the ability to make tasty dishes that truly support health, including dishes of gentle taste that can function for clearing dampness. A template recipe can be made as follows:
- Cook 1-2 cups lentils (brown, black, red, green or ivory) or adzuki beans, set aside.
- Cook 1 cup wild rice and/or white rice, brown rice, millet or buckwheat.
(Cooking the grain and lentils can be done in advance. )
- Heat a large pan, add 2 Tablespoons grapeseed or other vegetable oil.
- Add 1 Tablespoon slivered fresh ginger
3 coarsely chopped scallions
1/2 cup julienned carrots
1/2 cup sliced celery
3/4 cup sliced mushrooms (basic cap mushrooms, enoki, maitake, shiitake,
- When vegetables have barely softened, about 4-5 minutes, add ½ cup rinsed
mung bean sprouts, then add ½ cup cooked wild rice and 1/2 cup cooked lentils
- 1/2 cup water to circulate steam into the dish
Pinch sea salt or splash of tamari
1/2 teaspoon toasted sesame oil just before serving
A simple soup can be made of the same ingredients (or energetically similar substitutions) by adding 4 cups of water or mushroom-kombu stock. Avoid the temptation to add garlic, onion, chicken or beef stock, or spicy seasonings. I have resisted my own temptation to include classic bland dishes such as loofah with black mushroom; if you find the above recipe maddeningly bland, you might examine your diet for attachment to overly dramatic flavors that may not be supporting your best health.
A whole food bowl is another important template meal that is adaptable for specifics along the guidelines of your strategy. Include a grain, beans, green vegetable, root vegetable, sea vegetable, squash (gourd), a sauce, and, since some people don’t digest beans well, appropriate spices and herbs. A small portion of fish or meat can be added and single elements omitted as needed. A Whole Food Bowl is hearty eating, helpful to satisfy deficiencies while restoring good digestion and clearing stagnation of the lower jiao.
Cook 1 cup rice. Use white rice to emphasize hydration, brown rice to focus on clearing stagnation. (We should all shed our biases against white rice, brown rice, or grains overall, and learn to use each of them for their specific benefits). Other options, each with specific qualities, are black rice, red rice, millet, buckwheat, and any other non-glutinous grain, alone or in combination (for example, 2/3 cup millet with 1/3 cup buckwheat, or 3/4 white rice with 1/4 precooked wild rice).
Cook 1 cup black lentils (or other lentil, black beans, adzuki beans, etc.) Pre-cooked canned beans are less special but perfectly acceptable.
Trim, wash, and steam 1 or 2 bunches of kale (depending on bunch size). When steamed, drain excess water and dress with olive oil and sea salt (or wait for tahini sauce). Substitute cabbage, bok choy, asparagus, depending on what is in season and what is needed energetically. Keep greens warm in the cooking pot.
Soak 1 cup arame seaweed in hot water (easily available in large markets or health-food stores). Once soaked, pull the arame out of the water with tongs, add to a warm pan, season with a splash or two tamari, mirin, and/or toasted sesame oil.
Steam or roast chunks of carrot and squash. Squash can be summer variety (zucchini, patty-pan, delicata, etc.) or winter type (butternut, acorn, kuri, kabocha, etc.) The skin of these cooking pumpkins can be eaten (if organic) or the ‘flesh’ can be scooped out. Eating the skin seems unconventional but it is excellent food for the lower small intestine once the microbiota is in good working order. Steam daikon radish as an option, or parsnip, rutabaga, parsley root, etc.
Serve with a tahini sauce or a dressing of your choice. Tahini sauce is often made simply with 1/2 cup tahini, juice of 1/2 lemon, 3-6 tablespoons water, pinch of salt and chopped parsley to taste, but I often like to add a few flavor notes to improve digestion. Tahini is crushed sesame seeds, and as such has a kidney affinity, but it can be challenging to digest on its own in much the same way that nut butters are more difficult to digest than most people presume. Try tahini sauce with 1/2 cup tahini, 1-2 tablespoon tamari, 1 teaspoon mirin, 1 teaspoon rice vinegar, 1 tablespoon toasted sesame oil, and 4-6 tablespoons warm water. Add parsley, oregano, cumin, and other digestive herbs if desired. Mix, serve at the table for each diner to add to their food bowl as they like.
If a more ‘kitchen-herbal’ approach is desired, very simple diuretic teas can be easily made at home.
To make corn silk ‘tea’, boil a full handful of corn silk (fresh, or dried as the herb yu mi xu) in 4 cups fresh water, then strain, allow to cool. Sip gradually through the day slightly warm or at room temperature. This decoction helps rid dampness and edema, and is especially good for urinary tract infections or other urinary difficulties, including passing kidney stones. At my local farmers market some customers gather the corn silk that others have discarded. If you know corn silk tea as a traditional Chinese
kitchen remedy for clearing dampness you can understand the looks on their faces, “People are leaving the best part!”
Roasted barley tea is just as simple. Purchase roasted barley in an Asian market or make your own by dry roasting unhulled barley kernels for 10-12 minutes in a heavy pan before removing them to cool and store. To make the tea, place 2 ounces (60 grams) of the roasted whole barley whole kernels directly into a pot with 3-4 cups boiling water (do not use hulled or pearled barley). Boil for 10 minutes, strain, cool. Sip when it is only slightly warm or at room temperature. This decoction clears heat, dampness, and the climatic factor of summer-heat—the idea is that internal dampness is preventing normally effective sweating during periods of hot humidity.
These kitchen remedy ‘teas’ are appealing and useful, but it’s essential to remember that dampness arises for various reasons and can progress in complex ways. Successful adjustment of diet is not based on an “eat this for that” approach, and certainly not a blanket pronouncement that “everyone should avoid those foods and rely on these foods.” At the foundation of Chinese medicine is a radical individuality. While certain factors may be common, there are always surprises with individuals; each patient deserves to be treated as if we are seeing their symptoms for the first time. Chinese medicine – including dietary recommendations – requires a full individual diagnosis based solidly in pulse and tongue readings, followed by an appropriate strategy aimed at enacting fundamental change at an acceptable pace.
Dampness is often accompanied by a feeling of being overwhelmed – whether consciously or not. When dampness is prevalent a person can feel, as they say, ‘swamped’ by life. Dietary change not only helps clear somatic issues, it provides people with something tangible they can do for themselves to regain sovereignty in their lives. That’s particularly important for people working to overcome problems of dampness. Diet is the key to success, either along with other treatments or, if skillfully applied, as a complete medicine on its own.
Andrew Sterman is author of Welcoming Food: Diet as Medicine for Home Cooks and Other Healers (Classical Wellness Press, New York, available Spring 2019). Based in New York City, Andrew works with clients in the areas of dietary therapy, medical qigong and meditation, and writes a popular column for the Golden Flower Chinese Herbs newsletter. Andrew first entered Chinese medicine through qigong and taiji in 1988. He began studying the healing potential of food at the same time by enrolling at the Natural Gourmet Cookery School. Seeking to deepen his understanding of food energetics, Andrew began formal study of Chinese herbal medicine, diagnostics, medical theory, and dietary therapy with Master Jeffrey Yuen in 2001. Andrew’s parallel career as a professional musician enables him to travel extensively and learn from chefs of many cultures, further inspiring him to discover unique ways to incorporate food and healing into daily cooking routines. At home, Andrew cooks for his wife, author and acupuncturist Ann Cecil-Sterman, and their two children. Visit Andrew Sterman Food on the web.