Cold-Damp invading the Spleen

Understanding Cold-Damp invading the Spleen

The Spleen transforms food and moves fluids, and it is said to prefer dryness. Cold and Dampness together slow that work to a stop, so food and fluid sit in the middle rather than being processed.

The upper abdomen feels full and cold, the body feels heavy, and the stools are loose or watery. There is usually no thirst, and if there is, warm drinks are wanted.

The tongue is the clearest sign: pale and swollen with teeth marks, a thick white greasy coat and a wet surface. The pulse is deep, slow and often slippery.

It comes from cold and raw food, greasy food, cold damp environments, or on top of an existing Spleen Yang weakness.

Treatment warms the middle and dries Cold-Damp, with moxibustion and warm food as core measures.

Signs and symptoms

Key signs

• Bloating and fullness in the upper abdomen
• A heavy feeling in the body and limbs
• Loose or watery stools
• Thick white greasy tongue coating

Also seen

• A cold feeling in the abdomen
• No thirst, or a wish only for warm drinks
• Nausea or a poor appetite
• A muzzy head
• Tiredness after eating
• Frequent pale urine

Variations

• Borborygmus (gurgling in the abdomen)
• Undigested food in the stool
• Aching in the limbs

Timing

• Symptoms build after cold or raw meals and are worse in cold damp weather.
• They improve with warmth and with a light warm diet.

Practitioner notes

• The tongue is pale and swollen with teeth marks, a thick white greasy coat and an excessively wet surface.
• The pulse is deep, slow and often slippery. A rapid pulse would suggest Heat has been added.
• The distinction from Damp-Heat is colour and thirst: here the coat is white and there is no thirst for cold drinks.
• The distinction from Spleen Yang deficiency is the presence of an active Cold-Damp obstruction on top of the weakness.

Causes

Common causes

• Too much cold and raw food
• Too much greasy, fatty or sweet food
• Exposure to damp and cold environments
• Pre-existing Spleen Yang weakness

How it develops

• It can arise acutely after cold damp exposure or a run of cold food.
• If it persists, it deepens the underlying Spleen Yang deficiency.

Diagnosis

Diagnosis rests on the pale, wet, thickly coated tongue with a cold, full middle.

Tongue

• Body: Pale and swollen with teeth marks.
• Coating: Thick white greasy, and excessively wet.
• Note: A yellow coat would indicate Damp-Heat.

Pulse

Deep, Slow, Slippery

Deep slow slippery fits interior cold dampness.

Observation

• Pale, slightly puffy face
• Warm clothing
• A heavy bearing

Listening

• A quiet voice
• Abdominal gurgling

Palpation

• Abdomen: Cool and full, improved by warmth and gentle pressure.
• Channels: REN-9 and ST-25 may be sensitive; the abdomen feels cool to the touch.

Questions that separate it from look-alikes

• Are the stools loose or watery?
• Is there thirst, and for warm or cold drinks?
• How much cold, raw and greasy food?
• Is the abdomen cold, and does warmth help?

Treatment

Principles

• Warm the middle
• Dry Cold-Damp
• Move Qi so the middle is not congested
• Avoid cold and greasy food

Herbs

Formulas

• Ping Wei San - The reference formula for Dampness obstructing the Spleen, drying and moving.
• Wei Ling Tang - For Cold-Damp with fluid retention and loose stools.
• Huo Xiang Zheng Qi San - For Cold-Damp with nausea, fullness and a heavy head.
• Shi Pi Yin - For Cold-Damp with swelling and fatigue from Spleen Yang weakness.
• Li Zhong Wan - For the cold middle with diarrhoea, warming and strengthening.
• Ling Gui Zhu Gan Tang - For fluid retention with dizziness and palpitations from Spleen Yang weakness.

Acupoints

• REN-9 (Shuifen) - Regulates fluids, used for Dampness with oedema or loose stools.
• ST-25 (Tianshu) - Regulates the intestines and is used for diarrhoea.
• SP-6 (Sanyinjiao) - Drains Dampness and supports the Spleen.
• BL-20 (Pishu) - The Spleen back-shu point, supporting the Spleen underneath.

Personalising the plan

• If coldness dominates, warming herbs and moxibustion are increased.
• If Dampness dominates, drying and draining herbs are increased.
• If nausea dominates, aromatic herbs are increased.
• If the Spleen Yang deficiency is deep, warming tonics are added.

Self-care

Diet

• Warm cooked food; ginger, cinnamon and small amounts of pepper
• Avoid all cold, raw and iced food and drink
• Reduce dairy, sugar and greasy food
• Small frequent warm meals

Lifestyle

• Apply warmth to the abdomen; moxibustion is traditionally used
• Keep warm and dry
• Gentle walking after meals
• Avoid damp living spaces

Qigong and movement

• Gentle warming practice emphasising the abdomen.

How it differs from look-alikes

Patterns that can be mistaken for cold-damp invading the spleen, and the contrast that separates them.

Where it appears

Skin conditions in which this pattern is commonly seen.

Safety and when to get help

For anything severe, sudden or spreading quickly, read when a skin problem needs urgent care.

This page describes a TCM pattern, not a diagnosis, and a pattern can accompany more than one skin condition. Get urgent medical help for a rash with fever, confusion or feeling very unwell; skin that is blistering, peeling or spreading quickly; swelling of the face, lips or throat, or difficulty breathing; or a lesion with increasing pain, warmth, red streaks or pus. For anything persistent, severe or changing, have it assessed by a clinician before treating it yourself.

Read the skin condition pages for the red flags that belong to a specific presentation.

Urgent-sign guidance is based on standard sources: NHS anaphylaxis, NHS cellulitis, NHS Stevens-Johnson syndrome, NHS melanoma.

Evidence note

No controlled trial of this treatment in skin conditions was identified for this entry. What is described here rests on the classical and later materia medica record and on traditional clinical use, not on controlled trial evidence, and it is not a prediction of benefit. Where skin-specific research does exist it is linked above.

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