Daniel: August 28, 2019, 7:06pm
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.
KristinWisgirda: August 28, 2019, 7:57pm
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.
Daniel: August 28, 2019, 8:09pm
Ha! Figured it would be difficult
ok, so how about a list of just signs and symptoms of
Dampness
Dryness
followed by some ‘loose’ guidelines for interior and exterior?
ronhubbs: August 28, 2019, 8:13pm
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 the18/01/2024, 11:00Dry / Damp Signs and Symptoms . . – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/dry-damp-signs-and-symptoms/553/print2/10
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?
George_Mandler: August 28, 2019, 11:30pm
ronhubbs:
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.
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.
amyjenner: August 28, 2019, 11:40pm
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.
3 Likes18/01/2024, 11:00Dry / Damp Signs and Symptoms . . – Sa’am Clinical Questions – Qiological Community
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Daniel: August 29, 2019, 12:14am
Wow – great and real clinic story – thanks Amy!
Jeffrey: August 29, 2019, 4:41pm
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.
[/quote]
Shanlarson: August 29, 2019, 5:53pm
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.
Daniel: August 30, 2019, 12:23am
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”
mariamorris: August 30, 2019, 3:51am
18/01/2024, 11:00Dry / Damp Signs and Symptoms . . – Sa’am Clinical Questions – Qiological Community
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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!
Daniel: August 30, 2019, 3:58am
whoa!! thats a remarkable story. thanks so much for sharing. It really demonstrates how dynamic this all is –
including our interventions!
KristinWisgirda: September 3, 2019, 8:09pm
amyjenner:
She didn’t settle, she said she felt zippy
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!
kellykd: December 4, 2019, 4:27am
18/01/2024, 11:00Dry / Damp Signs and Symptoms . . – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/dry-damp-signs-and-symptoms/553/print5/10
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.
KristinWisgirda: December 4, 2019, 3:59pm
kellykd:
I just knew I needed to supplement LI.18/01/2024, 11:00Dry / Damp Signs and Symptoms . . – Sa’am Clinical Questions – Qiological Community
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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.
kellykd: December 4, 2019, 5:35pm
KristinWisgirda:
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.
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!
thanks!
KristinWisgirda: December 4, 2019, 6:10pm
Looking forward to more of your posts.
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.
kellykd: December 4, 2019, 7:48pm
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.18/01/2024, 11:00Dry / Damp Signs and Symptoms . . – Sa’am Clinical Questions – Qiological Community
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I’m pretty obsessed with Sa’am!
mariayung: December 31, 2020, 12:30am
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.
George_Mandler: December 31, 2020, 2:44pm
mariayung:
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.
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.
mariayung:
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 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.18/01/2024, 11:00Dry / Damp Signs and Symptoms . . – Sa’am Clinical Questions – Qiological Community
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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”.
mariayung:
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.
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.
mariayung:
I was wondering if hemorrhoids could be considered exterior dampness too? I had one patient whose
hemorrhoids got worse after ST+.
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.
mariayung:
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.
Yes. Clinic is so interesting. It keep us on our toes.
KristinWisgirda: December 31, 2020, 4:32pm
mariayung:
It seems just because they are obese, we can’t assume there is interior dampness.
Totally true.
mariayung:
This damp/dry inner/outer thing seemed so obvious initially but I have learned is extremely complex and not18/01/2024, 11:00Dry / Damp Signs and Symptoms . . – Sa’am Clinical Questions – Qiological Community
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easy to ferret out.
Even when the patient has gross damp/dry signs, it is always helpful to look at other aspect of the patient’s picture.
While you can emphasize interior/exterior damp/dry with the Lung/St dynamic, there is so much more going on
with this channel pair: up/down and ability to draw in and hold resources.
mariayung:
I was wondering if hemorrhoids could be considered exterior dampness too? I had one patient whose
hemorrhoids got worse after ST+.
What does this response tell you about the patient and his/her hemorrhoids? Hemorrhoids are a local stagnation of
blood but also a prolapse of the vessels. In my limited experience, Lung+ has been the most helpful treatment so
far for hemorrhoids. These patients were clearly Stomach excess.
As George mentioned, it can be worthwhile to write up your challenging cases to present here using this
format:Case Study Format
We can give you more nuanced feedback when you use the format. It is a tool to help all of us see your patient
more clearly.
All of us are interested in your cases!
Daniel: January 8, 2021, 4:34pm
Just had a patient in clinic – he has dry eyes . . . . but he is so much the Pillsbury Dough Boy . . . very overweight,
excessive Spleen flesh, sweaty and sticky skin . . . I gave him a LI+ treatment – and he said during the session and
after, his eyes felt much moister!!! (I can only postulate that freeing up the overall moisture dynamics in his body,
their ‘correct functioning’ [i.e. moisture/dampness where it should be and not where it should not be] – in other
words – rectification – is what the treatment enabled – regardless of the seeming paradox that a drying out treatment
(LI+) moistened his dry eyes.
George_Mandler: January 9, 2021, 12:03pm
Daniel:
I gave him a LI+ treatment – and he said during the session and after, his eyes felt much moister!!! (
Awesome share. I often remind myself not to get fixated on a symptom when the overall presentation tells us to do
the opposite. Especially in a case such as this when his Sa’am archetype is so so clear except for this symptom of
dry eyes. I have a few experiences where treating the overall physiology has surprisingly corrected a symptom that
would go against the channel characteristics I just supplemented.18/01/2024, 11:00Dry / Damp Signs and Symptoms . . – Sa’am Clinical Questions – Qiological Community
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Thinking it through I most notice this in the damp/dry physical cases. ST/LU. LI/SP.
One of the most common symptoms I have seen improve by following the morphology/physiology is better sleep.
Daniel: January 14, 2021, 9:34pm
George_Mandler:
One of the most common symptoms I have seen improve by following the morphology/physiology is better
sleep
YES!! I have SO MANY cases like that – in particular – when I correctly rectify the whole damp-dry scenario via
the Sp-LI and Lu-ST axes . . . sleep almost always improves quite dramatically. So much so that when insomnia is
the main complaint, I just really really focus on the prevalent patterns rather than ‘going to’ our sleep related
preferences . . .