Qiological Community

Dry / Damp Signs and Symptoms . .

Would people be so kind as to share lists of signs and symptoms, substantial and insubstantial of . . .

Dampness Inside
Dampness Outside
Dryness Inside
Dryness Outside

so we can generate a really comprehensive catalog
to help with assessing the whole Stomach - Lung - Spleen - Large Intestine domains?

Thanks in advance.

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Oh boy, I would love such a list too. The problem is defining interior and exterior. Toby’s teacher would never do it. Toby has some general guidelines from his experience but admits that they are only guidelines and that there have been exceptions.

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Ha! Figured it would be difficult

ok, so how about a list of just signs and symptoms of


followed by some ‘loose’ guidelines for interior and exterior?

In my short time practicing Saam (just 3 weeks – but like a man possessed – I’m even treating my in-laws on my days off), I have already experienced a lot of contradictory S/S in these 2pairs/4 channels. I’m starting to get the sense, that the “Excess” S/Ss are really due to both being Deficient. A few other posts seemed to suggest this.

So I’ve decided to just start w/ which one seems to have the grossest S/S and supplementing its pair and then toggle if the px’s results dictate/allow.

Any thoughts?

I have definitely supplemented both LU and ST on the same patient (at different times of course) and saw beneficial results. As Kristin said the inside vs outside is not clearly defined in this system. What about a patient that has moist skin on the legs and arms, sweaty feet, but really dry dorsal aspect of their hand. Dry or damp outside? I think you need to look at the entire presentation in front of you and make a decision based on their MC and intuition as so many people do not fit into an algorithm.
A simple example: An overweight person with dry mouth perhaps supplement ST whereas a thin person with dry mouth supplement LU.


I had a kind of scary thing happen that I thought I’d share to hopefully benefit others. I have a 48 year old obese woman who’s skin is not overly dry or moist. She is not overly resourced…single, school teacher, she gets by but no Mercedes. She has been working really hard over the summer on a renovation of her house that she needs to get done by winter. She also took in a foster kid in the midst of this project. She came in today, dragging, saying she was just tapped out with months of working on this project and this difficult kid (she is a teacher but has none of her own).I started with + kid with the idea of gathering her resources. She didn’t settle, she said she felt zippy so I took those needles out and thought I’d work with her constitution which I took to be Sp xs. So I put in LI+. within a couple of minutes, she said she felt like she couldn’t breathe. Like she couldn’t inhale fully. A few years ago, she was living in China and got very ill with something that resulted in the weight gain and it had significant respiratory component. LI+ treatment made her feel like that mystery health situation in China. I pulled those needles out and I would love to tell you that I immediately put in SP+, but in my panic I put in ST+. The situation quickly resolved, fortunately, and she actually felt quite good by the end. So, I’m not totally sure what I learned except that clinic is hard and this whole wet dry thing is really hard. I guess I learned that she is not SPxs, but LUxs.


Wow - great and real clinic story - thanks Amy!

Thinking on your feet, good work. @amyjenner
So, I’m not totally sure what I learned except that clinic is hard and this whole wet dry thing is really hard. I guess I learned that she is not SPxs, but LUxs.

I have an interesting case of someone today with dry/ damp interior exterior factors. He injured his wrist at work with a drill. His wrist got over rotated. He’s average build. Skin is neither dry or moist. I saw him 3 days ago and the pain and lack of motion was really around the Lu/LI channels. I decided to do LU+ because when testing things he got the best mobility from pressure on Lu9/SP3.
3 days later and the swelling and pain went down significantly and he has more motion BUT his throat and mouth got very dry and her had noticeable inhibited urination. Now on palpation SI5 and ST41 got the most mobility and he seemed to really settle with ST+. So it seems to me his dry throat and mouth in this case are almost exterior signs. Before his injury I imagine I wouldn’t be constitutionally thinking of either LU or ST for him.
Interior/exterior damp/dry seems to be not so definitive.

I think the whole damp / dry - inner / outer thing is tremendously complex and takes a lot to really see the whole dynamic with some patients. I know cases where I am certain the skin is dry in areas because there is dampness under the skin that is blocking the skin from receiving moisture (so you would think Inner damp, outer dry), BUT the inner damp is a pathological congealed damp that is the body’s overcompensating distorted attempt to hold on to dampness because the interior is more fundamentally dry!! (a Jeffrey Yuen principle) . . in which case it might ultimately be better to supplement healthy moisture generation on the interior (supplement Lungs in Sa’Am) even though superficially it may appear the patient has inner dampness, outer dryness!! “Clinic is hard”


To follow on that Jeffrey Yuen principle…
I had some warts start to appear about 2 years ago on dorsal side of my right thumb (LU meridian). It started with just 2 small blemishes on the middle joint but in the last year, since moving to an extremely dry climate, they spread to the whole dorsal right thumb and one appeared on the middle joint of dorsal left thumb.
I see myself as damp inside, dry outside, and thought that the warts were coming from the inner dampness.
When in the Tuscon class with Toby, he mentioned this Jeffrey Yuen principle of holding onto dampness because the interior is dry.
I’ve experimented and supplemented almost every channel on myself (except SJ and GB).
The last time I supplemented LI (due to gum and tooth pain) some more warts came up on my right thumb the very next day!
I then supplemented SP about a week later and to my great surprise some warts started to peel off. I gave another SP treatment and warts continued to peel away.
The internal damp symptoms started to increase though, so I then I supplemented ST and the warts continue to peel, while internal damp symptoms are gone.
The location of the warts is so clearly LU, but I hadn’t noticed any change in the warts when I had previously supplemented it’s balancing channel of ST… it took supplementing SP first.
This makes me wonder if the internal damp signs are from an inability of the Spleen to absorb due to underlying dryness in digestive system.
Experimenting and learning with SA’AM is so fun!


whoa!! thats a remarkable story. thanks so much for sharing. It really demonstrates how dynamic this all is - including our interventions!

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If the zippy feeling was the result of treatment aggravation, then SI+ would have been the ideal next step.
BUT- your treatment gave your such valuable clinical information!


I am a little late to this conversation about dry/damp signs but I had to reply. I have given much thought to this topic for years and using the lens of Sa’am is interesting and refreshing. and ah, the Sp LI and Lu St conundrum.

I remember Toby saying that inside and outside are relative.

Thinking about throat and mouth - or say, sinuses - could go either way, but I think it is more outside part of the exterior cuz its not that deep, really. Or is it a symptom of a deeper, more interior problem?

I have been trying to be non complicated about looking at dry and damp.
Dry inside: (inside) thirsty, skinny
Dry outside: dry skin, dry hair (maybe inside)
could be either/not sure: possibly dry mucus or phlegm, dry lips or mouth

Damp inside: overweight or puffy
Damp outside: sweaty, oily, greasy hair, runny nose, pimples and cysts, lumps and bumps
could be either/not sure: phlegm in Lungs, tearing (“dry eye”) - or is this due to dryness

then there are things like dry skin in winter - who in Vermont doesn’t have dry skin in the winter? so I ask how it is in the summer - and touch it.

So I have been playing with this dry damp and i have a case for you from last week.

CASE female 52
This patient had been coming to me for high blood pressure, just once a month, and I wasn’t having particularly satisfying results. She is quite active and is vegetarian. She is quite heavy, about 5’5" 200 pounds and gains weight easily. It was clear that her blood pressure was worse when she gained more weight. Her skin was not dry, but not moist or oily, she is sweaty in the summer.

2 months ago she was diagnosed with A fib. I had not yet done Sa’am with her but I just knew I needed to supplement LI. She was scheduled for cardiac version in a few days! I was able to get her in 24 hours before the procedure and did LI+. She reported feeling well that afternoon. I told her to make sure they check her heart before the procedure. They did. She did not have A fib and they cancelled the procedure. Yay!

note: My husband also experience high blood pressure when he gained 40 pounds of “pregnancy weight” 11 years ago. So he lost a bunch of weight and his blood pressure went back to normal. He gained all of his weight in his upper half of his body. Damp affecting the heart.

Sa’am is fun. Clinic is a puzzle.

Cases are fun where the the treatment isn’t a textbook match for the symptom, but works because it is a spot-on match for the person. The grossest thing in the room should always be considered. Thanks for sharing the case.

Your post on damp/dry sounds more like musing and sorting it out for yourself than direct questions. If I am wrong and you want to talk about a certain aspect, just say.

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Yes, a bit of musing about the dry/damp thing - plus responding to Daniel’s original question. Seems like some signs are more clearly damp/dry inside/outside while others are relative or just not clearly in/out.

I have been really getting into Saam since August, but just really getting into the forum now. I have some many things I want to discuss… so you’ll be seeming me on here more!


Looking forward to more of your posts. :slight_smile:

You case reminds me of the way Sharon Weizenbaum talks about the Heart. It can’t have pathology by itself because it is the emperor but it can be effected by any kind of pathology in the body. She describes it as a baby being held by the rest of the body. It will cry if it is being squeezed, if it isn’t fed, if it is too hot/cold or in your case if it is drowning in or pressed upon by dampness.
Many of my afib/arrthymia patients are dry and blood stasis types. It is good to be reminded that damp can be a problem too.

Funny you said that, Kristin. I had been thinking about exactly that - what Sharon said about holding the baby too tightly vs too loosely. I even started typing it into the post last night but didn’t want to ramble on too much. It is exactly how I imagined her and my husband’s heart - like a baby being held too tightly.

I have some odds and ends questions that I will be posting when I can steal a few minutes - plus a couple cases that I totally screwed up and other awesome cases with some insights that I want to share, too.

I’m pretty obsessed with Sa’am!

I have a patient who is obese and has scaly dry skin all over. She is not thirsty and runs hot. I thought automatically that it is a case of inner damp and outer dry so I did ST+. It seemed to have helped so I did it again. But this time, it flared up her gout badly. So it seems like she has dampness that is blocking the moisture to her skin so could this be a case of false exterior dryness?

I have another patient who has bad eczema. Again she is obese and very dry in patches, around her eyes, on her arms. I did ST+, it seemed to have made the skin worse. Then, next time, I did LU+, but it didn’t do too much. I was hesitant to do SP+ because the patient seems so damp but she has no sweet tooth, stubborn and is never bored which are hallmarks of LI+. She responded well to the SP+ treatment.

I was wondering if hemorrhoids could be considered exterior dampness too? I had one patient whose hemorrhoids got worse after ST+.

It seems just because they are obese, we can’t assume there is interior dampness. This damp/dry inner/outer thing seemed so obvious initially but I have learned is extremely complex and not easy to ferret out.

What did it help? Was gout her MC? Did she have other signs of Lung excess besides the dry skin?
You don’t want to jump to a diagnosis based on just a couple of cardinal signs - she is also hot with dry skin and the second time it flared her gout. Maybe she needs some cold water for a treatment.
Even if the first treatment is awesome I don’t always go for it a second time as I re-evaluate - no problem stays solved in a complex dynamic system. Take all the channels into consideration.

I have seen cases where it would appear there is dampness internally but it is more that water is being held underneath the skin. Maybe she is obese but actually internally dry - it is possible. I look at stool consistency, tongue, thirst, flesh palpation, divine intervention.
The internal/external does need to be evaluated on a case by case - it is the adage “you cannot judge a book by its cover”.

If SP+ worked well does that mean the patches improved?. Do you see where she needed warm moist soil? If you want help with the case write it all out in Kristin’s case review format.

You are going in the wrong direction with this. First any symptom can be every channel… Any channel can treat every symptom. Some more equal than others.
Just because you had a negative reaction to a treatment do not assume that it means the symptom is the opposite archetypical sign. It sound more likely that you supplemented Stomach and that it was the incorrect treatment for the patient.

Yes. Clinic is so interesting. It keep us on our toes.