Part 4 of 6 in the "What Malaysians mean by heavy dampness" series. The list of the other five is at the foot of this part.

Part 2 listed the habits the theory counts; part 3 said who should ask first. This part goes one step in: in the theory's model, how dampness comes from a glass of iced coffee or an air-con vent.

The answer first. The model has only two lines. The "spleen" in the theory turns what is eaten into what the body can use, and moves the surplus water out; when the second line slows, water stays. The standard's phrase for that is "internal retention of water dampness", and it is where the theory's dampness comes from.

The definitions below are from the WHO's 2022 international standard terminologies on traditional Chinese medicine, called "the standard" from here on. Only definition sentences are quoted, never a symptom list, and none of it is about any particular reader.

The short version

• The standard describes "the spleen governs transportation and transformation" as the spleen's functions in transporting and transforming water, food and fluids: it digests water and food, absorbs and distributes nutrients and regulates water metabolism.
• The standard's "the source of phlegm generation" entry completes the second half: failure to transport and transform water fluids may cause internal retention of water dampness and generate phlegm.
• The standard defines pathogenic dampness as a pathogenic factor that obstructs the flow of qi, characterised by heaviness, turbidity, stickiness and downward flowing.
• The standard also carries "the spleen dislikes dampness": the spleen is intolerant of dampness; as an earth organ, it is intolerant of and affected by dampness.
• The standard defines internal dampness as the opposite of external dampness: a pathological state of retained water, dampness, phlegm and turbidity due to dysfunctions of the zang-fu organs and disordered water metabolism.

A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.

First, the things that cannot wait

⚠️ A safety note: TCM and Western medicine complement each other; it is not a choice between them. For severe abdominal pain, chest tightness or breathlessness, or fever with a stiff neck, call 999 now, or go to the nearest hospital emergency department.

Persistent high fever, blood in the stool, or unexplained weight loss means seeing a doctor first — the reason behind each is in part 6.

A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.

I. The theory's model of fluids: the spleen governs transportation and transformation

The standard describes the spleen governs transportation and transformation (脾主运化) as a collective term for the spleen's functions in transporting and transforming water, food and fluids: the spleen digests water and food, absorbs and distributes nutrients and regulates water metabolism.

In other words, in this model the "spleen" runs two lines at once: turning what is eaten into what can be used, and moving surplus water out. The "transformation" in part 1 means these two lines.

The standard completes the second half under the source of phlegm generation (生痰之源): the spleen governs transportation and transformation of water and food, and its failure to transport and transform water fluids may cause internal retention of water dampness and generate phlegm. "Internal retention of water dampness" is where the theory's dampness comes from.

So in the theory's account dampness is not only something brought in from outside; it can also be what stays behind when that second line slows. That is why the habits in part 2 are counted at all — they land on this line. Which habit lands on which link is set out one by one in part 5.

II. Why "dampness" and not something else

The standard defines pathogenic dampness (湿邪) as a pathogenic factor that obstructs the flow of qi, characterised by heaviness, turbidity, stickiness and downward flowing. The three words part 1 uses for dampness, heavy, turbid and sticky, come from this entry.

The standard has a further entry, the spleen dislikes dampness (脾恶湿): the spleen is intolerant of dampness; as an earth organ, it is intolerant of and affected by dampness. So in the theory dampness and the spleen are a pair: more dampness affects transformation; slower transformation lets water dampness linger more easily.

Internal dampness (内湿) is defined in the standard as the opposite of external dampness: a pathological state of retained water, dampness, phlegm and turbidity due to dysfunctions of the zang-fu organs and disordered water metabolism.

Part 1's "external factor" corresponds to external dampness in the standard's terms; the "internal factors" of diet and daily rhythm act on where internal dampness comes from, transformation. A damp room is still external dampness; it simply reaches you at home.

This section describes how a set of terms relate to each other, not a diagnosis. The standard gives definitions, not judgements about anyone; who falls under what is not something the standard says, and not something this part says either.

The words in this part

All four are entry headings in the WHO's 2022 standard terminologies on traditional Chinese medicine. Only their definition sentences are quoted here.

• The spleen governs transportation and transformation (脾主运化) — the standard: a collective term for the spleen's functions in transporting and transforming water, food and fluids; the spleen digests water and food, absorbs and distributes nutrients and regulates water metabolism.
• The source of phlegm generation (生痰之源) — the standard: the spleen governs transportation and transformation of water and food, and its failure to transport and transform water fluids may cause internal retention of water dampness and generate phlegm.
• The spleen dislikes dampness (脾恶湿) — the standard: the spleen is intolerant of dampness; as an earth organ, it is intolerant of and affected by dampness.
• Internal dampness (内湿) — the standard: the opposite of external dampness, a pathological state of retained water, dampness, phlegm and turbidity due to dysfunctions of the zang-fu organs and disordered water metabolism.

The TCM "spleen" is not the anatomical organ, as part 1 sets out: it names a set of functions, not that organ.

Frequently asked

I often feel heavy in the body. Does that mean I have heavy dampness? Heaviness is one of TCM theory's three descriptors of dampness (heavy, turbid, sticky), so the theory counts it as one clue, but never concludes on it alone; lack of sleep, stress and an unbalanced diet feel the same. The practitioner reads it together with diet, daily rhythm and the tongue. With persistent high fever, blood in the stool or unexplained weight loss, see a doctor first.

What is the difference between internal and external dampness? What the standard defines is internal dampness: the opposite of external dampness, a pathological state of retained water, dampness, phlegm and turbidity due to dysfunctions of the zang-fu organs and disordered water metabolism. Read against that definition, external dampness is the environment side and internal dampness is the transformation side. A damp room counts as external dampness; it simply reaches you at home, while diet and daily rhythm act on where internal dampness comes from.

Which comes first, the dampness or the spleen? The standard sets no order. It gives two definitions that lock into each other: "the spleen dislikes dampness" says the spleen is intolerant of and affected by dampness, and "the source of phlegm generation" says that failure to transport and transform water fluids may cause internal retention of water dampness. Read together, that is the "pair" the theory speaks of — and on which side comes first, the standard makes no judgement.

Do not: apply this part's words to yourself. The standard gives definitions, not a checklist to match yourself against; what your own situation is belongs in a consultation, which part 6 covers.

The other five parts

• Part 1: Why do Malaysians always say "dampness is heavy"? What dampness is in TCM theory, and what the humidity figures say
• Part 2: Which daily habits count — iced drinks, air-con and long sitting, and what the theory links to dampness
• Part 3: Dampness teas and 薏米 water: who should ask before drinking
• Part 5: Iced, greasy, late, seated: which link each one loads, and how the theory reads a working day
• Part 6: When to see a doctor first — each sign, and what it can mean

👉 If you are not sure what this account would mean in your own case, you are welcome to book an online consultation with HansMed, where a practitioner registered under the T&CM Act 2016 can assess it with you.

Sit with a licensed TCM practitioner from wherever you are.

HansMed Modern TCM

Sources

• World Health Organization, WHO international standard terminologies on traditional Chinese medicine (2022) — https://www.who.int/publications/i/item/9789240042322

本文是「马来西亚人说的「湿气重」」系列的第 4 篇，共 6 篇。另外五篇的清单在文末。

第 2 篇列了理论算进去的习惯，第 3 篇说了谁要先问。这一篇往里走一步：在理论的模型里，「湿」是怎么从一杯冰饮、一个出风口来的。

先给答案。 模型只有两条线。理论里的「脾」一边把吃进去的变成身体能用的，一边把多余的水送走；第二条线慢了，水就留下来——这四个字在标准里叫「水湿内停」，就是理论里「湿」的来处。

下面的定义引自世界卫生组织 2022 年的中医术语标准，下文简称「标准」。引的是定义句，不是任何症状清单，也不在说任何一位读者。

一分钟看完

• 标准对「脾主运化」的说明是：脾运化水、食物与水液的功能；脾消化水谷，吸收并输布营养，并调节水液代谢。
• 标准的「生痰之源」条目把后半句说完：脾运化水液的功能失常，可致水湿内停，并生痰。
• 标准对「湿邪」的定义是：一种阻碍气运行的致病因素，特点是重、浊、黏、趋下。
• 标准另有「脾恶湿」：脾不耐受湿；作为土脏，脾不耐湿并受湿影响。
• 标准对「内湿」的定义是：与外湿相对，因脏腑功能失调、水液代谢紊乱而致水、湿、痰、浊停留的病理状态。

小提醒：本段仅为一般知识说明。相关情况请以西医的诊断与治疗为主，并在需要时及时就医。

先说不能等的几件事

⚠️ 安全提醒：中医与西医是互相补位的关系，不是二选一。若出现剧烈腹痛、胸闷或呼吸困难，或发烧伴颈部僵硬，请立刻拨打 999，或前往最近的医院急诊部。

持续高烧、大便带血，或无法解释的体重下降，请先看医生——每一项的理由，见第 6 篇。

小提醒：本段仅为一般知识说明。相关情况请以西医的诊断与治疗为主，并在需要时及时就医。

一、理论的水液模型：脾主运化

标准对「脾主运化」的说明是：统称脾运化水、食物与水液的功能；脾消化水谷，吸收并输布营养，并调节水液代谢。

换句话说，在这个模型里，「脾」同时管两条线：把吃进去的变成能用的，把多余的水送走。第 1 篇说的「运化」，指的就是这两条线。

标准在「生痰之源」这一条把后半句说完整了：脾运化水谷；脾运化水液的功能失常，可致水湿内停，并生痰。「水湿内停」四个字，就是理论里「湿」的来处。

所以在理论的说法里，「湿」不是一样从外面带进来的东西而已，也可以是第二条线变慢之后留下来的。第 2 篇那些习惯为什么被算进去，原因就在这里——它们落在这条线上。哪一个习惯落在哪一环，第 5 篇一项一项对。

二、为什么是「湿」，不是别的

标准对「湿邪」的定义是：一种阻碍气运行的致病因素，特点是重、浊、黏、趋下。第 1 篇用来形容湿的「重、浊、黏」三个字，出处就是这一条。

标准另有一条「脾恶湿」：脾不耐受湿；作为土脏，脾不耐湿并受湿影响。所以在理论里，湿与脾是一对：湿多了，运化受影响；运化慢了，水湿又更容易停留。

「内湿」在标准里的定义是：与外湿相对，因脏腑功能失调、水液代谢紊乱而致水、湿、痰、浊停留的病理状态。

第 1 篇说的「外因」，术语上对应的是外湿；饮食、作息这类「内因」影响的，是内湿的来处——运化。房间潮湿仍属外湿，只是它进门的途径在家里。

这一节说的是一套术语之间的关系，不是诊断。标准给的是定义，不是对任何人的判断；谁属于什么，标准不说，这篇也不说。

这篇出现的几个词

四个都是世界卫生组织 2022 年中医术语标准里的条目名称。本篇只引它们的定义句。

• 脾主运化（the spleen governs transportation and transformation）——标准的说明：统称脾运化水、食物与水液的功能；脾消化水谷，吸收并输布营养，并调节水液代谢。
• 生痰之源（the source of phlegm generation）——标准的说明：脾运化水谷；脾运化水液的功能失常，可致水湿内停，并生痰。
• 脾恶湿（the spleen dislikes dampness）——标准的说明：脾不耐受湿；作为土脏，脾不耐湿并受湿影响。
• 内湿（internal dampness）——标准的定义：与外湿相对，因脏腑功能失调、水液代谢紊乱而致水、湿、痰、浊停留的病理状态。

中医的「脾」不是解剖学上的脾脏，这一点第 1 篇说过：它指的是一组功能，不是那个器官。

常见问题

我常觉得身体困重，是不是就是湿气重？ 「困重」是中医理论对湿的三个描述之一（重、浊、黏），所以理论会把它列为线索之一，但不会单凭它下结论；睡眠不足、压力、营养不均衡都会有同样的感受。医师会连同饮食、作息、舌象一起看。伴随持续高烧、大便带血或体重无故下降，先看医生。

「内湿」和「外湿」有什么分别？ 标准定义的是「内湿」：与外湿相对，因脏腑功能失调、水液代谢紊乱而致水、湿、痰、浊停留的病理状态。按这个定义去读，外湿指的是环境那一边，内湿指的是运化这一边。房间潮湿算外湿，只是它进门的途径在家里；饮食、作息影响的是内湿的来处。

湿和脾，是哪个先？ 标准没有排先后，它给了两条互相咬住的定义：「脾恶湿」说脾不耐受湿、并受湿影响；「生痰之源」说脾运化水液的功能失常可致水湿内停。两条放在一起读，就是理论说的「一对」——哪一边先，标准不作判断。

不要这样做： 不要把这一篇的词套到自己身上。标准给的是定义，不是对号入座的清单；您本人属于什么情况，第 6 篇说那是问诊里的事。

这个系列的另外五篇

• 第 1 篇：为什么大马人常说「湿气重」？—「湿」在中医理论里是什么，气象局的湿度数字怎么说
• 第 2 篇：哪些日常习惯算——冰饮、冷气、久坐，理论把什么联系到「湿」
• 第 3 篇：祛湿茶、薏米水：谁要先问再喝
• 第 5 篇：冰、油、晚、坐：各自加载哪一环，理论怎么读一个工作日
• 第 6 篇：什么时候先看医生——每一项信号，以及它可能意味着什么

👉 如果您不确定「这套说法放在我身上是什么情况」，欢迎透过汉方中医的线上问诊，由依 2016 年 T&CM 法令注册的医师为您评估。

无论身在何处，与持证中医师对坐。

汉方现代中医

资料来源

• 世界卫生组织，《WHO international standard terminologies on traditional Chinese medicine》（2022）— https://www.who.int/publications/i/item/9789240042322