Can’t See Clearly in the Morning? Doctor Zhu Danxi Treats Dampness Clouding the Clear Orifices

What the patient searches for: cannot see in the morning / eyes suddenly go blurry / blurred vision / heavy dampness / no energy at all

Medical terms: dampness clouding the clear orifices · cold-dampness trapping the spleen · spleen and stomach qi deficiency

Everyone knows about dampness — heaviness in the body, a foggy head, no appetite; it seems to be connected to everything. But would you ever imagine that dampness, once it becomes severe enough, could make a man go “blind” when he wakes up in the morning — pitch black in front of his eyes, unable to see a thing? That is not an exaggeration. It is a real case, treated with his own hands by Doctor Zhu Danxi, one of the greatest physicians of the Yuan dynasty.

💬 Note from Doctor Luo: The case we are looking at today is especially interesting because it teaches us a principle: when our “clear orifices” — the eyes, the ears, the nose — give trouble, one of the important underlying reasons is heavy dampness. You must remember this idea.

Who was the patient? A 35-year-old man in his prime, who fell ill in September

Doctor Luo Dalun says the patient in this case was a man of 35 — right in the prime of life, an age when the body should still be in good shape. He fell ill in September.

💬 Note from Doctor Luo: What is September? The weather is still hot, and the dampness is especially heavy — this is what the ancients called “long summer” (chang xia), that stretch joining the end of summer to the beginning of autumn: muggy, damp, and hot. Everyone knows how miserable that feels. So when illness strikes in this season, you must always think of dampness first.

One morning this strong young man ran into serious trouble: his eyes suddenly lost their light, and he could not see (忽目无光，视物不见) — as if his eyes could no longer take in light; everything went black before him.

💬 Note from Doctor Luo: Frightening, isn’t it? You wake up and cannot see — anyone would be terrified. And there was more: after a while he could just barely make out the shadow of a person or an object, but he “could not distinguish” them (竟不能辨) — he could see that someone was standing there, yet could not tell who it was, too blurry to recognize. That shows the dampness was clouding things severely. The problem was not that the eye itself was damaged — it was “pasted over,” as if fogged up.

How bad was it? Appetite cut in half, no strength at all

Apart from the eyes, he had two very typical symptoms: his appetite fell to half of what it used to be (饮食减平时之半) — he could not eat; and his spirit was utterly exhausted (神思极倦) — his mental energy was drained, the whole body felt lazy and weak. He went on like this for five days before Doctor Zhu Danxi was finally called in.

💬 Note from Doctor Luo: These two symptoms are crucial. Why does heavy dampness kill the appetite? Because dampness traps the spleen. The spleen belongs to Earth, and Earth is supposed to govern water (Earth controls Water). But when the water gets too big, it overwhelms the earth and drowns it — when dampness is too heavy, it traps the spleen and stomach, and a person naturally loses appetite, feels bloated, and tends toward loose stools. So one of the most important signs of heavy dampness is trouble in the spleen and stomach.

💬 Note from Doctor Luo: And why is the person so tired? Because the spleen governs thought, and the spleen governs the four limbs. When the spleen is trapped by dampness, even thinking feels exhausting, the limbs have no strength, and the whole day is spent weary and unwilling to move — it is not that he does not want to do things, it is that his spirit can no longer command his body.

Tracing the cause: one pulse reading, one question, and the truth comes out

Doctor Zhu Danxi took the pulse: slow and large (脉缓而大), about four beats per breath, unhurried. In his mind the judgment was already forming — this illness was tied to dampness.

💬 Note from Doctor Luo: How did Zhu Danxi reach his conclusion? A slow, large pulse, combined with the damp-heavy long-summer season, plus these symptoms — he already had his answer. Then he asked more carefully, and sure enough — the patient had slept on damp ground for half a month before falling ill. The cause was crystal clear: external dampness invading the body.

💬 Note from Doctor Luo: Pay attention: this is “sleeping on damp ground for half a month” — cold-dampness! Dampness is a yin pathogen and easily wounds yang qi. Even though it was September, in ancient times there was no air conditioning! In summer heat, people would lie right on the ground to sleep; the ground was damp, and after half a month of it, cold-dampness got in. Illness from sleeping on damp ground also tends to bring low-back pain — some people sleep on the floor in summer and wake up with their back hurting as if it were snapped in two. All of it is cold-dampness at work.

The diagnostic highlight: dampness clouding the clear orifices

Why would heavy dampness make a man lose his sight? Zhu Danxi’s answer comes in four characters: shi meng qing qiao — dampness clouds the clear orifices.

💬 Note from Doctor Luo: Under normal conditions, turbid damp qi should move downward. When the spleen and stomach qi is sufficient, the body can “ascend the clear and descend the turbid” — clear qi rises, turbid qi is expelled below. When the spleen and stomach turn deficient, this ascending/descending function weakens, and when the dampness is also very heavy, it is like fog covering the sky: it steams upward and blankets the head. Our eyes, nose, and ears are all “clear orifices.” So people with heavy dampness may have ear problems and tinnitus, or a stuffy, humming nose, or — as here — trouble with the eyes.

💬 Note from Doctor Luo: The Huangdi Neijing (Yellow Emperor’s Inner Classic) has a line: “When the nine orifices are impaired, it is born of the stomach and intestines” (九窍不利，皆肠胃之所生) — the two eyes, the two nostrils, the two ears, plus the throat: when these “orifices” give trouble, the cause is often linked to insufficiency of spleen-stomach qi and excessive dampness. You should understand this idea.

Breaking down the prescription: Bai zhu as sovereign, Huang qi and Chen pi as ministers, Fu zi to warm yang

The formula Doctor Zhu Danxi wrote out follows a clear line of thinking: bai zhu (Atractylodes) as the sovereign herb to strengthen the spleen and dispel dampness; huang qi (astragalus) and chen pi (aged tangerine peel) as ministers — huang qi works with bai zhu to tonify qi, while chen pi moves and regulates the qi so the tonics do not stagnate, and it also helps transform dampness; and then fu zi (aconite) to warm and supplement yang qi and scatter the cold-dampness.

💬 Note from Doctor Luo: Bai zhu is the number-one herb for strengthening the spleen and dispelling dampness — Zhang Zhongjing’s Shen Zhu Tang (Kidney-Attachment Decoction) for cold-damp low-back pain uses bai zhu as its core. This patient’s spleen was deficient, and spleen deficiency always brings qi deficiency, so huang qi was added to tonify qi; the dampness also had to be transformed, so chen pi was there to regulate qi and resolve dampness. The most brilliant touch is fu zi — this man had been struck by cold-dampness, so yang qi absolutely had to be lifted; fu zi warms yang and hits the disease mechanism exactly.

And the result? More than ten doses, and he was at peace (十余帖而安). After a dozen or so doses the patient recovered, and his eyes could see again.

💬 Note from Doctor Luo: The eyes getting better is only the surface. What really happened is that the dampness was driven out and the clear orifices opened up again. That is the way Chinese medicine treats disease — it does not stare at the eye and treat the eye; it resolves the dampness at the root.

Note from the commentator: Zhu Danxi’s “three moves” for dispelling dampness

Doctor Luo Dalun says this case is a perfect chance to explain Zhu Danxi’s whole approach to dampness — when he treated dampness, his most common combination was Er Chen Tang (Two Aged Decoction) plus qiang huo (Notopterygium) and cang zhu (black Atractylodes).

💬 Note from Doctor Luo: Er Chen Tang (fu ling/Poria, chen pi/aged tangerine peel, ban xia/Pinellia, gan cao/licorice) is the ancestral formula for transforming phlegm, and since phlegm and dampness are really one thing, transforming phlegm is dispelling dampness. Add qiang huo to lift yang upward and release the exterior through sweating, scattering the dampness above out through the surface; add cang zhu to dry dampness and percolate it downward. Zhu Danxi prized cang zhu especially — it lifts yang above, percolates dampness below, and in the middle can also be pushed out by sweating. This was his signature way of regulating dampness.

💬 Note from Doctor Luo: There is another layer of principle: external dampness must be “released from the exterior” — dampness that came in from outside should be scattered outward; internal dampness must be “percolated blandly” — using bland herbs like fu ling (Poria), yi mi (coix seed), and chi xiao dou (red adzuki beans) to draw it downward. But no matter how you dispel dampness, supporting upright qi is essential — when the spleen and stomach qi is strong and upright qi is sufficient, the dampness can truly be eliminated. Dampness-dispelling herbs combined with upright-qi-supporting herbs work best together.

On the road of dispelling dampness, the master who walked farthest in Chinese medicine is Zhang Zhongjing.

💬 Note from Doctor Luo: Zhang Zhongjing is the founding ancestor of dampness treatment — Ling Gui Zhu Gan Tang (Poria, Cinnamon, Atractylodes, Licorice Decoction) and Wu Ling San (Five-Pepper Powder) are all famous dampness formulas. Later physicians kept enriching his thinking. Zhu Danxi excelled at miscellaneous diseases, and if dampness cannot be removed, there is no point talking about treating miscellaneous diseases — so he was especially skilled at transforming phlegm and dispelling dampness. That is how Chinese medicine developed, generation after generation.

Extended story one: Why is dampness heavier today than in the past?

Doctor Luo Dalun reminds us that dampness divides into external dampness and internal dampness — external dampness comes from the environment; internal dampness is created when one’s own upright qi is insufficient and the spleen and stomach cannot transform and transport, leaving fluids trapped in the body. And today, both kinds are worse than before.

💬 Note from Doctor Luo: The external cause is smog. In the old days morning fog would burn off once the sun came up; today pollutants combine with water vapor into smog, with solid, turbid particles clinging overhead, and the sun cannot disperse them — so even in daytime the sky stays hazy, and ambient dampness is increasing overall. The internal cause? People move too little, sitting in air-conditioned offices all day, unlike the past when people walked, worked, and sweated freely. Qi and blood do not circulate well, and upright qi is insufficient. Add rich, fatty food injuring the spleen and stomach: spleen earth can no longer govern water, and the dampness inside the body naturally turns heavy.

Extended story two: A railway soldier who slept on damp ground — and a hair dryer

Doctor Luo Dalun also told a moving story — an elder in his own family had been a railway soldier in his youth, opening roads through mountains and bridging rivers to build the rail lines. In some places there was simply no proper condition; the ground was soaking wet, and they would spread something down and sleep on it. Today the railways run and everyone rides comfortably, but those soldiers carried the cost — this elder was tormented in his later years by rheumatic-type disease.

💬 Note from Doctor Luo: Geological survey crews are the same — sleeping outdoors in places with heavy dampness, and these problems come easily. Why does one person sleep on damp ground and nothing happens, while another falls ill? The key is whether upright qi is sufficient. So here is a tip for travel: if you find the hotel bedding is damp, use the room’s hair dryer — stuff the nozzle between the blankets, blow hot air in, and after a while the whole duvet puffs up, hot and dry inside, and the dampness is blown away. It is an essential traveler’s trick.

Life wisdom: never sleep where the dampness is heavy

The life lesson this case teaches, and which Doctor Luo Dalun keeps hammering home: do your best to avoid staying in places with especially heavy dampness — above all while sleeping.

💬 Note from Doctor Luo: Why be especially careful when sleeping? Because while you sleep, your upright qi operates at a low, resting level, and dampness enters the body most easily at that time. Heavy dampness in the daytime may not affect you; but a damp sleeping environment genuinely injures you. This patient slept on damp ground for half a month and only then ran into such a big problem.

💬 Note from Doctor Luo: Guard against it even when awake: exercise until you sweat, your clothes are soaked — or it is hot and muggy outside and you step into an air-conditioned room with your pores still open — dampness slips right in. So my advice: keep a dry change of clothes in the car and change immediately after exercise; keep a dry towel to tuck between your damp clothes and your skin; and if possible carry a hair dryer and dry yourself off anywhere you plug it in. In regions with heavy home dampness, a dehumidifier helps too. Don’t let external dampness harm you — there are not many of us with truly sufficient upright qi these days.

💬 Note from Doctor Luo: To sum up today’s case: when your eyes suddenly cannot see clearly, the problem is not necessarily in the eyes — it may be dampness clouding the clear orifices; and the root of dampness is very often in the spleen and stomach. Strengthen the spleen and dispel dampness, support upright qi and expel evil — that is the wisdom Doctor Zhu Danxi left us.

Compiled from Doctor Luo Dalun’s explanation of a case by Doctor Zhu Danxi, from Zhu Danxi’s case records (朱丹溪医案).

📋 Case Details