Tonics Always Make You Feel “Hot” and Your Tongue Coating Is Thick and Greasy? Doctor Luo Dalun on Constitution Recognition, Part 2: Phlegm-Dampness, Constrained Liver Qi, and Blood Deficiency

What people search for: tonics always make me feel hot / thick greasy tongue coating / phlegm-dampness constitution / pointed tongue liver qi constraint / blood deficiency symptoms / what constitution am I Constitutions covered in this part: phlegm-dampness (tan shi) · constrained liver qi with liver fire (gan qi bu shu / gan huo wang) · blood deficiency (xue xu)

Opening: Be a little kinder to yourself — keep the green hills, and you will never run out of firewood

Dear friends, good morning, everyone. Last time we talked about how, at a time like this, everyone has figured it out — you read the news every day, and what strikes you is how people keep leaving us, how things keep going wrong. The internet was well developed before too, but it was never like this. So at a moment like this you have to see clearly what matters most: your body matters most. We have to take care of our bodies.

💬 Note from Doctor Luo: This isn’t just my advice to everyone — I hold myself to the same standard. This past New Year I sat down and thought carefully: what matters? First protect and adjust my own body, then keep spreading knowledge to everyone. You cannot run yourself into the ground — say “I’ll sacrifice myself and spread all the knowledge,” and end up with your own health ruined; then you can’t teach anyone anything. So these days I follow my own health regimen: moxibustion every day, standing meditation (zhan zhuang), medicinal food, soups — the health pot bubbles away all day long and I drink from it daily. In the past I wasn’t kind to myself: I lectured and traveled every day. Now I’ve started being good to myself. So, everyone, let us together calm the spirit and settle the mind (an shen ding zhi).

The changes in heaven and earth at this time are enormous, so this is the moment to hold steady, protect your body and slow the pace. Keep the green hills, and you will never run out of firewood — once your body is healthy, you can do whatever you need to do, slowly, with plenty of energy to spare. If you rush and crash, it will be too late. So what matters most in protecting yourself? First, you must understand your own constitution. If you don’t understand your constitution and just apply every method you come across blindly, you might as well not use them at all.

Does your constitution change? — Look at it dynamically

People always say, “I feel like I match every single one.” Is that possible? Your constitution is basically stable and unchanging, but your state does change: what you’ve been eating lately, living in a cold damp environment — after a while things may shift. So you have to look at this dynamically.

💬 Note from Doctor Luo: For example, if I have yang deficiency, I take Jin Gui Shen Qi Wan (Kidney Qi Pill from the Golden Cabinet) and start with moxibustion to warm the yang. After warming the yang for a while, I look at my tongue and it has turned red — that means something has changed, I’m no longer yang deficient. At that point I correct course: is there a hint of yin deficiency? Add a little yin-nourishing medicine, and gradually dial the yang-warming methods back — not too hard — and slowly things come back into balance. So you see, it’s all adjustment. That includes me — I adjust too. I look at my own tongue: how am I lately? I adjust according to what I see. So what do you do about it? First, if there’s a Chinese medicine practitioner nearby, it’s best to have them check on you regularly. Second, learn the knowledge yourself — wouldn’t it be wonderful to read your own tongue and adjust any time?

Yang deficiency and yin deficiency: the two states you must learn to recognize first

Last time we talked about learning to recognize yang deficiency and yin deficiency — can you recall them clearly? Yang deficiency and yin deficiency are the two most important states to recognize. Yang deficiency is easy to spot; quite a lot of yin deficiency goes unnoticed — these days I see a great many people with yin deficiency.

💬 Note from Doctor Luo: There was an old practitioner who once said: “In all my years of practice, I have never seen a truly yin-deficient patient.” I think that’s going a bit far. I see many people with yin deficiency now, and the moment you nourish yin, their bodies improve at once. So yin deficiency and yang deficiency are two states the body actually exists in — you must learn to recognize them first.

Insufficient body fluid: dryness everywhere, cramps, twitching muscles

Besides yin and yang deficiency, earlier we covered insufficient body fluid (jin ye bu zu). When body fluid is insufficient, it’s the liver’s fluid that runs low — liver fluid can no longer moisten and nourish the channels and sinews, so you get twitching and cramping: muscles jump, the heart “skips” a beat when it beats (that’s also a kind of empty spin), the eyelid twitches and hops, the facial muscles twitch; and there’s dry mouth and throat, and so on.

💬 Note from Doctor Luo: People with insufficient body fluid can replenish it — with something like e jiao (donkey-hide gelatin), you can drink a little; use shi hu (dendrobium), which replenishes body fluid; sour-sweet yin-nourishing drinks like suan mei tang (sour plum soup) or wu mei tang (smoked plum soup) are also fine — sour and sweet together generate yin (suan gan hua yin). What should people with insufficient body fluid watch out for? Don’t be injured by dryness pathogen (zao xie): for example, the fierce Sanya sun — go out at noon and get baked, and the sweat pouring out of you does you great harm; or steaming sauna until you sweat profusely — that also harms you badly. Avoid heavy sweating and harsh sun exposure; intensely hot environments easily injure yin and body fluid. Yin and body fluid are usually linked — they belong to the same material category. When body fluid is depleted, it hasn’t yet reached the point of blazing deficiency fire; once deficiency fire blazes, we call it yin deficiency — it has risen to a higher level.

Tonics always make you feel “hot”? — First check whether phlegm-dampness is heavy

Friends always tell me: “Every time I take a tonic I feel hot, every time I take a tonic I feel hot.” Some of this, I think, is yin deficiency; and another part is heavy phlegm-dampness.

💬 Note from Doctor Luo: How do you recognize heavy phlegm-dampness? Look at the tongue coating: thick, greasy, sticky and slimy, spread across the whole tongue, filling the entire surface — one look when the tongue comes out and you know. You absolutely must learn to read the tongue coating. Besides the coating, what other symptoms do phlegm-damp people have? Their minds are easily foggy — like wearing a big hat or a big towel wrapped around the head, heavy and drowsy. When dampness sits heavy up top, the ears and eyes aren’t clear, there may be slight tinnitus; everything looks blurry; thinking isn’t crisp — in a word, utter weariness. When phlegm-dampness moves, sometimes the belly sloshes with water sounds; the belly easily grows big and soft like cotton; the skin easily turns greasy, and the hair is oily too; stools are easily sticky and unsatisfying, smearing the toilet bowl. These are all signs of heavy phlegm-dampness. I mainly rely on the tongue — nothing is clearer than the tongue. Everyone must learn to read the tongue: stick it out and it’s thick, greasy, sticky and slimy — that’s heavy phlegm-dampness.

Where does phlegm-dampness come from? — No exercise plus eating too richly, and it splits into cold-damp and damp-heat

Where does heavy phlegm-dampness come from? First, no exercise — qi deficiency cannot push the body’s fluids along, so the fluid stays put. Second, eating too richly, too many rich, fatty, sweet foods — they’re all nutrients, but you eat too much, and what the body can’t transform and move out stays inside and combines with water to form phlegm-dampness.

💬 Note from Doctor Luo: Strictly speaking, phlegm-dampness divides into cold-damp (han shi) and damp-heat (shi re). Cold-damp belongs to the yang-deficiency side — its phlegm-dampness is all watery fluid, cold water sitting inside the body. Damp-heat is the obese, eats-too-well kind, with a bit of fire: the tongue coating is yellow, the face is oily and slightly flushed and shiny. With today’s climate, plus everyone’s love of spicy hotpot, damp-heat is quite common. Neither type suits jumping straight into tonics — this calls for strengthening the spleen and resolving dampness, transforming phlegm and draining dampness.

What formulas resolve dampness? — Foot-soaking with Wen Dan Tang, San Ren Tang, Lian Pu Yin

What do you do about damp-heat? I once talked about foot-soaking with Wen Dan Tang (Warm Gallbladder Decoction) — for soaking the feet to clear damp-heat you drop the ginger and jujube, just the Wen Dan Tang. There are many other ways to resolve phlegm-dampness: San Ren Tang (Three Kernels Decoction) clears dampness — Chinese medicine has plenty of formulas.

💬 Note from Doctor Luo: There’s also Lian Pu Yin (Coptis and Magnolia Bark Beverage) — it resolves dampness with a little heat-clearing added, dissolving that damp-heat. Overall, to clear dampness you need to transform phlegm and resolve dampness, and then you must strengthen the spleen and resolve dampness — strengthening the spleen is absolutely key. But people always ask me: what over-the-counter Chinese patent medicine can I take for heavy dampness? I’ll tell you honestly: there really isn’t one. This is a problem on the part of our national regulators — there should be many such formulas, but almost no dampness-resolving formulas have ever been approved. There are so many ancient formulas, yet almost none for resolving dampness got approved. So you have to find your own way: get some wu zhi mao tao (five-finger fig root), some corn, some chi xiao dou (adzuki beans), some fu ling (poria), and stew yourself a soup to drink; to open up the spleen and stomach add a little huo xiang (patchouli) and the like. Later I’ll prepare a formula for everyone, maybe a paste formula (gao fang).

The key to resolving dampness: drain the water first, then strengthen the spleen

Remember: resolve the dampness, and then you must strengthen the spleen. The spleen belongs to Earth, and Earth transforms dampness. To resolve dampness in the end, you first have to drain the water a little, and then eat spleen-strengthening things — like Liu Jun Zi (Six Gentlemen), Ba Zhen Gao (Eight-Treasure Cake), Ba Zhen Fen (Eight-Treasure Powder) — these strengthen the spleen. Only when the spleen and stomach are strong can dampness really be cleared in the end; only when kidney qi is strong can water pathogen truly be removed.

💬 Note from Doctor Luo: Jin Gui Shen Qi Wan (Kidney Qi Pill from the Golden Cabinet), for example, actually transforms water and warms yang to store water — this “reservoir” idea is an important way of thinking. Also, watch out: stop giving yourself more stimulation. Gulping down cold drinks — really slamming them; loving to play in water and splashing around hard whenever you go somewhere — be careful, don’t make your dampness worse. Eat with moderation and don’t let phlegm-dampness build up. Whenever your tongue coating is thick and greasy, don’t touch tonics yet — first dissolve and drain it outward.

Do it yourself: tip the dampness out

Today the approach I’m giving you: soak your feet with Wen Dan Tang to drain a little; or take wu zhi mao tao (five-finger fig root) with a slice of chen pi (aged tangerine peel), some stir-fried yi mi (coix seed), and a little chi xiao dou (adzuki beans), boil it into a drink and tip the dampness out; if there’s heat, add a few slices of zhu ye (bamboo leaf) to clear the damp-heat outward.

💬 Note from Doctor Luo: This is what recognizing it means — clear the water first, and only then tonify. Otherwise no tonic will work, none of it will be right. Friends with thick greasy tongue coating: don’t rush to take ren shen (ginseng) or huang qi (astragalus) — dissolve that dampness first, and then we’ll talk.

Constrained liver qi: a pointed tongue, and a quick temper

Besides all that, there are people with constrained liver qi and vigorous liver fire (gan qi bu shu / gan huo wang) — you need to know how to adjust for them. People with constrained liver qi have a tongue that is pointed and sharp at the tip, and red — this often coexists with liver-yin deficiency; many yin-deficient people have insufficient liver yin, and they overlap with the liver-fire group.

💬 Note from Doctor Luo: People with constrained liver qi have big tempers. Stick out your tongue and the tip is sharp and pointed, banana-shaped. Are you liver-qi constrained? You know yourself — is your temper big? Do you flare up easily? Quite a lot of my fans are exactly like this — very hot-tempered, flaring up easily. If you’re this kind of liver-fire person, then don’t take any tonics; and hold off on moxibustion too — moxibustion on liver-channel points with fire this big just adds more fire. You’d do better with cupping or scraping (gua sha), letting it move outward. Skip the ginseng honey slices for now.

What to do about vigorous liver fire? — Flower teas with chen pi, finish with Xiao Yao Wan

How do liver-fire people adjust? Get some flowers — chrysanthemum, rose, jasmine — steep them with a little chen pi (aged tangerine peel) and drink, to regulate the qi. For the severe cases, take Chai Hu Shu Gan Wan (Bupleurum Soothe-the-Liver Pill) and the like; generally Jia Wei Xiao Yao Wan (Augmented Free and Easy Powder) is enough — taking it around midday every day is fine.

💬 Note from Doctor Luo: First soothe the liver qi, then adjust yourself and relax. Look at the world out there — fighting everywhere, chaos, so many displaced people. We live in such a peaceful country; we’re still fairly blessed. Think about it: what is there to worry about? Let go of some things, see things through, and pair it with a cup of rose tea. Once the liver qi is soothed, then I can tonify — do you all understand? Soften the liver first, then nourish.

What do blood-deficient people look like? — Black spots before the eyes when you stand up from a squat

What if I’m blood deficient — I sleep badly, feel dizzy and see spots, tired all day, poor memory, black spots before my eyes when I squat down and stand up, cold hands and feet in winter — that’s blood deficiency (xue xu).

💬 Note from Doctor Luo: For blood deficiency take Yu Ling Gao (Jade Spirit Syrup) — but if you have liver fire, soothe the liver fire first, and only after it’s soothed take the Yu Ling Gao. To tonify qi, huang qi (astragalus) and gou qi (goji berry) steeped in water, with a slice of ginseng honey — sure, that works; but if there’s liver fire, soothe the liver fire before tonifying. If your spleen qi is weak, eat shan yao (Chinese yam) — again, soothe the liver first, then the yam powder. For all these nourishing things, you must first adjust constrained liver qi and water-dampness, and then tonify — if these two are still in there, they easily cause trouble and make you feel hot halfway through. So do you all see: every way of adjusting in Chinese medicine — including the external methods — has its conditions. Whether you choose cupping, scraping or moxibustion is also conditional; some suit you better than others. First know your constitution and learn to recognize it, then slowly work with it and feel your way along.

Closing: sharpening the axe does not delay the cutting of wood

Once you know your constitution, conditioning becomes very easy and the thinking is clear. If you simply refuse to learn about it, you’ll eat things at random — and if you take the opposite of what you need, you make things worse instead of better. So if there’s a Chinese medicine practitioner nearby, make friends with them and let them help you sort out what constitution you are; learn a little tongue diagnosis yourself, learn this method, and tick off your own checklist. Actually, just search online for “what constitution are you” — there are self-test tables; count how many items match you.

💬 Note from Doctor Luo: This is what they mean by sharpening the axe does not delay the cutting of wood. Spend a little effort now to get your constitution clear — you don’t need to learn everything. I’m yin deficient — I just learn about yin deficiency. Once you’ve mastered those few, you won’t be afraid when things shift along the way; you just adjust back according to the changes. Guided by constitution theory, then use all the methods to adjust yourself precisely — this is a real luxury. Other medicines — Western medicine understands none of this; it doesn’t know the body can be in two states, cold or hot, and it hasn’t studied these things in relative terms. This is a treasure our ancestors left us. Dear friends, let’s stop here for today. I hope you all take good care of yourselves, and we’ll meet again next time!

What to take away

1. Your constitution is basically stable, but your state changes — look at it dynamically and adjust as your tongue and symptoms change.
2. If tonics always make you feel “hot,” suspect two things: yin deficiency, or heavy phlegm-dampness.
3. Heavy phlegm-dampness: thick greasy tongue coating spread across the whole tongue, foggy head, drowsiness, sloshing belly, oily skin, sticky stools. Clear the dampness first — foot-soak with Wen Dan Tang, or drink wu zhi mao tao, chen pi, yi mi and chi xiao dou water.
4. Resolving dampness must include strengthening the spleen — drain the water, then Liu Jun Zi, Ba Zhen Gao and the like; only a strong spleen truly removes dampness.
5. Whenever the tongue coating is thick and greasy, stop the tonics first — dissolve the dampness before you nourish.
6. Constrained liver qi / liver fire: pointed banana-shaped tongue, big temper — don’t moxibustion, prefer cupping or scraping; drink flower teas with chen pi; Jia Wei Xiao Yao Wan midday is usually enough.
7. Blood deficiency: poor sleep, dizziness, black spots on standing, cold hands and feet — Yu Ling Gao, huang qi and gou qi tea, ginseng honey slices.
8. The golden rule: soothe the liver and clear dampness before you tonify — every conditioning method is conditional. Recognize your constitution first: sharpening the axe does not delay the cutting of wood.

Compiled from Doctor Luo Dalun’s lecture series on traditional Chinese medicine. Constitution recognition, Part 2: if tonics always make you feel hot, first check whether phlegm-dampness is heavy — a thick greasy coating means resolve dampness first, and resolving dampness requires strengthening the spleen; with constrained liver qi, soothe the liver before tonifying; with blood deficiency, clear the obstacles before tonifying blood. Every conditioning method has its conditions — recognize your constitution first, and sharpening the axe does not delay the cutting of wood.