“Dampness enters the body as oil pours into the flour”: exploring discursive construction of eliminating dampness in Chinese social media

3.1 Data collection

This study collected data from RedNote, an Instagram-like social platform where users share insights about life. Since “narratives can be seen as constructions” (Allsop and Mulcahy 1998: 819) and identities emerge as people story their individual experiences (Monrouxe 2010), the experience-sharing posts on dampness-elimination are vital in revealing netizens’ discursive construction of identity. Specifically, we first collected posts by searching for keywords. Posts that contained both singular and/or compound terms were included in our dataset, such as “dampness” (湿气, shiqi), “dampness + etiology” (湿气+病因, shiqi + bingyin), “dampness + TCM” (湿气+中医, shiqi + zhongyi) and “dampness + elimination” (湿气+祛除, shiqi + quchu). This systematic approach yielded a comprehensive dataset of posts from January 2023 to January 2024. The posts were characterized by an average length of 383 Chinese characters, ensuring a concise yet informative content representation. Then, selected posts were evaluated based on their format, with a preference for those combining textual and pictorial elements, thereby excluding video-based content. This criterion was established to maintain consistency and focus on the textual analysis of the data. A meticulous review was also conducted to exclude posts with redundant content and advertisement posts. Also, posts issued by doctors (identified by tag or register information) were excluded from this study as we aim to investigate how individuals share their personal experiences at the grassroots level. This data-cleaning process was essential to ensure the uniqueness and integrity of the data. In the end, 192 experience-sharing posts in the format of the main post and 67 post-comment interactions (main posts with comments directly replied to by the authors of the posts) were collected as valid data in our study, comprising a total of 160,669 Chinese characters.

For ethical considerations, since all the posts are publicly available online, datasets taken from RedNote represent a typical example of a public environment without obtaining online users’ informed consent (Elm 2009; Sugiura et al. 2017). Besides, in this study, usernames were systematically removed from the dataset to ensure privacy, and the personal information (age, gender, occupation) of the selected posts was also anonymized. Posts were presented by a sequence number and the date of their publication during the coding process.

3.2 Data analysis

All the selected posts were coded and analyzed by using NVivo (version 11), a qualitative data analysis computer software package. Given the framework of grounded theory (Corbin and Strauss 1990), we first read through all selected posts and coded their themes without making any assumptions (open coding) as we hold that “identifying, analyzing and reporting patterns (themes) within data” helps us to generate identity types in the following procedures (Braun and Clarke 2006: 79). Also, we took a constructivist perspective on defining identity: identities are not sets of characteristics that can be ascribed to individuals or manifestations of individual essences, but emerge through semiotic processes in which people construct images of themselves and others (originally in De Fina et al. 2006; quoted from De Fina 2015: 351).

Additionally, we grouped the selected posts around certain themes for the axial coding, with the additional support of Latent Dirichlet Allocation Topic Modelling, a language model to generate or extract topics and themes (Hou and Li 2023). Given our open coding and the quantitative results of LDA, e.g. the Perplexity Ratio, the Intertopic Distance Map, and the Top-30 Most Salient Terms, selected posts primarily fell into three categories: “What” dampness is, the reasons “why” the netizens eliminated dampness, and “how” the netizens eliminated dampness in certain ways.

For the final coding, we also referred to Matthiessen’s (2013) eight primary types of social-semiotic processes in contexts of health and healthcare as the theoretical framework: processes of “expounding” the general knowledge of the world, “reporting” on particular phenomena, “recreating” aspects of (human) life, “sharing” personal experiences and values, “doing” some social process, “recommending” some course of action, “enabling” some course of action, and “exploring” public views, values, and ideas. These social-semiotic processes are closely related to our study, e.g. investigating how netizens share their experiences, and importantly, this model of patient-centered care views persons as “meaning-makers” or “meaners” from a socio-semiotic perspective: “the recognition that patients are not only organisms but also persons and meaners takes us back to the combination of field and tenor” (Matthiessen 2013: 460). By drawing on Halliday’s concept of register (Halliday and Matthiessen 2004), Matthiessen’s model theorizes patients and doctors as “meaners” within the context of institutions and interactions rather than coding snapshots of verbal behaviours in a vacuum (Karimi 2024). This dynamic and interactive perspective is especially vital in our investigation of how netizens construct their identities in experience-sharing posts.

Selected examples were chosen from our dataset for further discursive analysis regarding the Relevance Ratio of certain topics generated from LDA. In order to ensure the reliability of the translated examples, we adopted free translation from Chinese into English to provide a clearer and more complete understanding of dampness-related posts by reproducing the general meaning of the original Chinese text without closely following its original linguistic form or textual organization (Feng 2010). In presenting the data, each post was transcribed sentence by sentence, keeping the original Chinese punctuations, emoticons, and macro-images to preserve the posts’ authenticity. Given the presence of TCM terminology in posts related to dampness, we referred to the authoritative TCM English Standardized Corpus available on the Xinglinyuan TCM Database website (http://ylk.sstp.cn) that offers a reliable parallel text corpus in Chinese and English (Wei and Mao 2023).

4.1 Meaners as symptom identifiers in experience-sharing

The first type of experience-sharing shows how netizens identify “what dampness is” and “what the symptoms of dampness are”, during which they construct their identity as symptom identifiers. In a broad sense, identifying dampness and its symptoms embodies the feature of “expounding”, a socio-semiotic process of creating and disseminating general medical knowledge (Matthiessen 2013), as shown in Example (1):

The discourse of “expounding” is used to create and disseminate general medical knowledge through explaining and categorizing (Matthiessen 2013). Clearly in Example (1), the netizen first explained “what dampness is” through definition (01) and quotation (02). The reference to the classical TCM work Su Wen, the impersonal authority, also enforced the medical authorization of the definition (van Leeuwen 2008). Moreover, the netizen categorized dampness into exterior dampness and interior dampness, further disseminating the general knowledge of TCM dampness.

What is interesting in Example (1) is how the netizen categorized dampness, which fully demonstrates the medical philosophy of TCM. The first way of categorizing dampness is to refer to the holistic cycle of nature – body – organ. In this experience-based sharing post, the human body is in the middle position of this three-dimensional cycle, and it interacts with nature extensively, i.e. the dampness of the human body is caused by climate factors, such as evil Qi from the outside (04), humid climate (05), long summer (06) and dampness-returning period (07), and regional factors or environmental factors, e.g. dampness in the dwelling (05) and living in the south region (07). Importantly, the terms “exterior” and “interior” are locative words and the transferring of these locative words to the categorization of dampness further demonstrates the close interrelatedness between nature and the human body – “integrity between human and cosmos” (Lu et al. 2004: 1854). In a broad sense, Qi is fundamentally part of the universe and the body, and thus, from an ideological perspective of TCM, eliminating dampness is a way for human beings to adjust to the law of nature. Moreover, TCM deems the human body as a miniature nature or universe, and the component parts and the whole body are physically interconnected (Dong and Zhang 2001). From this point of view, when the human body is infected with dampness, one of the exogenous pathogenic factors or the Six Excessive Atmospheric Influences, infections occur in specific body parts or organs, leading to diseases such as rheumatism and arthritis (08). In other words, local pathological changes and the whole body are mutually influenced.

Also, the human body itself functions as an organic whole or entity, not only embedded in the body-organ interaction (whole-local) but also in the interaction with daily activities and habits. The detailed listing of the daily habits in line 11 has revealed that some unnoticeable habits or preferences may lead to a pathological condition of “dampness” in the long run, implicitly demonstrating the importance of Yangsheng practice (nurturing and nourishing life) from the TCM philosophy (Sun 2015). In this sense, maintaining one’s health requires managing the interaction with nature (spatial level) as well as with accumulated habits (temporal level). Through the exemplification of the exterior and interior factors,^[2] the netizen not only made a relatively clear categorization of exterior and interior dampness but also presented how the human body has interacted with nature and daily habits.

The second way of categorizing dampness in the experience-sharing post is to refer to hot and cold, a critical differentiation of syndromes in TCM. TCM terms are based on the law of nature, i.e. syndrome differentiation in TCM is based on eight principal syndromes: Yin and Yang (阴阳), interior and exterior (内外, neiwai), cold and hot (冷热, lengre) and deficiency and excessiveness (虚实, xushi) (Dong and Zhang 2001; Wei and Mao 2023). Accordingly, as shown in Example (2), the netizen categorized dampness into damp-heat (hot) and damp-cold based on the resemblance to the law of nature and explained these two categories by comparing syndromes in specific body parts.

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12	湿热: 头发、皮肤油腻、爱长痘、舌苔黄腻、口干口气重、易急躁发火、小便黄、大便粘、白带多色黄、怕热爱出汗。 [ Damp-heat (hot): Oil hair, greasy and acne-prone skin, yellow and greasy tongue coating, dry mouth, heavy breath, irritably hot-tempered, yellow urine, sticky stool, multi-colored yellow vaginal discharge, fear of heat, and easy to sweat.]
13	湿寒: 头发皮肤油腻、易浮肿、舌苔白腻有齿痕、口黏发甜、易消沉没精神、小便清长、大便粘马桶、白带多清稀、怕冷手脚冰凉。 [ Damp-cold: Greasy hair and skin, easy to puffy, white and greasy tongue coating with tooth marks, sticky and sweet saliva, easy to be depressed, long urine, sticky stool, thin vaginal discharge, fear of cold, and cold hands and feet.]

Similarly, Example (3) further demonstrated the cycle of body–organ by categorizing dampness regarding specific body parts, namely, skin, muscles, bones, viscera, and the whole body. In this sense, dampness damages a specific body part, and simultaneously evades the whole body through an outer-inner sequence as shown in the categorization of dampness (from Level 1 to Level 5). Also, unlike the medical jargon used in Example (1) (quotation from classical TCM works in 02) and Example (2) (syndrome differentiation in 12 and 13), the netizen in Example (3) mainly employed plain language to describe symptoms, as well as used emoticons to enforce the urgency of eliminating dampness. Importantly, the netizen highlighted the correlation between dampness-elimination and weight-losing (20), and his/her prominence of the so-called “dampness-fat” escalated the negative consequence of dampness from health-maintaining to body management or daily life.

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14	湿气等级&五脏六腑位置。对照看看你是否早已湿进骨骼或是湿进脏腑, 又或者早已湿遍全身。 [Level of dampness and location of organs: Check to see if you’ve already got dampness in your bones , or in your viscera , or over your body .]
15	等级一：湿气在“皮肤”。特征: 多容易长痘、皮肤痒、长湿疹；皮肤头发非常容易出油。 [Level 1: Dampness in the “skin”. Characteristics: prone to acne, itchy skin, eczema, or greasy hair and skin.]
16	等级二：湿气在“肌肉”。特征：腰酸、乏力、提不起精神，感觉总是睡不醒，尤其是晨起就像是脑袋裹了一层什么。 [Level 2: Dampness in the “muscles”. Characteristics: backache, fatigue, lethargy, feeling like the head is wrapped in something in the morning.]
17	等级三：湿气在“骨骼”。特征：常有肩周炎、肩痛、颈椎痛, 关节容易风湿, 变天关节就痛。 [Level 3: Dampness in the “bones”. Characteristics: frozen shoulder, shoulder pain, cervical spine pain, prone to rheumatism, joint pains when weather changes.]
18	等级四：湿气在“脏腑”。特征: 便秘 、容易胖 、肚子大等等。湿气入肺, 容易出现咳嗽痰多等; 湿气入肾容易腰酸疼痛冒汗 ; 湿气入脾, 影响脾的运化, 大便粘马桶。 [Level 4: Dampness in the “viscera”. Characteristics: constipation , easy to gain weight , large belly, etc. When dampness enters the lungs, it causes coughing and phlegm; When dampness enters the kidneys, it leads to backache, aches, and sweating ; When dampness enters the spleen, it affects the movement of the spleen and causes the stool to stick to the toilet.]
19	等级五：湿气在全身。特征：容易出现各种结节，甚至各种瘤⋯⋯ [Level 5: Dampness over the whole body. Characteristics: prone to different kinds of nodules, and even various types of tumors…]
20	(看看你是几级湿气⋯⋯, 其实很多人减脂困难，湿气是个很大的阻力, “湿胖”也是东方特色的肥胖。) [(Look at which level of dampness you are…In fact, many people have difficulty in losing fat because of dampness, and “dampness-fat” is also an obesity with Oriental characteristics.)]

4.2 Meaners as advice givers in dampness-elimination

The second type of experience-sharing demonstrates how netizens provide specific advice on dampness elimination. Normally, doctors advise patients in medical consultation through the socio-semiotic process of “recommending” (Matthiessen 2013). As shown in our dataset, there are three ways of recommending: (1) Netizens shared their personal experience in hospital selection, medical treatments, what they have drunk or eaten, or what they have done to eliminate dampness; (2) Doctors provided professional advice based on the netizen’s picture of his/her tongue, and popularized the knowledge on dampness elimination through posts or videos; (3) Advertisements. Our study pays particular attention to the first way of “recommending” not only because it has the largest portion in our dataset, but also because we aim to reveal how netizens negotiate their identities between medical experts and peer-like experienced patients at the same time, a research focus that has not been fully investigated in previous studies.

Based on the Top-30 Most Salient Terms generated by LDA, netizens’ strategies of recommending fall into two categories. First, netizens highlighted the importance of “strengthening the spleen (健脾, jianpi/about 110 times)”, “Yangsheng” (养生/“nurturing and nourishing life”/about 130 times), and “benefiting Qi and nourishing blood” (补气血, buqixue/about 40 times). Moreover, frequent words, such as “tremella fungus” (银耳, yin’er/about 20 times), “rhizome” (芡实, qianshi/about 50 times), “poria cocos” (茯苓, fuling/about 70 times), “lotus seed” (莲子, lianzi/about 30 times), “red dates” (红枣, hongzao/about 40 times), “barley” (薏米, yimi/about 60 times), “wolfberry” (枸杞, gouqi/about 35 times), are also prominent in netizens’ advice on eliminating dampness, as shown in Example (4):

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21	前15天：先健脾 [The first 15 days: strengthening the spleen] 去湿有顺序 [The steps for eliminating dampness] 后15天：再去湿 [The second 15 days: eliminating dampness]
22	祛 湿, 先健脾, 顺序可别弄错了! [To get rid of dampness, strengthen the spleen first, don’t get the order wrong!]
23	想要有/效去 湿, 那就要先健脾胃。俗话说：健脾去 湿不分家, 脾主运化水湿，脾虚则水湿停滞, 脾虚的人, 一定湿气缠身‼只有脾胃好了吸收好，顺序对了，这样才能事半功倍。 [If you want to effectively remove dampness, you must first strengthen the spleen and stomach. As the saying goes: strengthening the spleen and eliminating dampness are close related. The spleen is mainly used to dissolve water and dampness, and if the spleen is deficient, water and dampness cannot be resolved. People with a deficient spleen must have dampness‼ Only when the spleen and stomach function well and the order is correct, can we get twice the result with half the effort.]
24	第1个步骤：前15天先健脾胃。 [Step 1: Strengthen the spleen and stomach for the first 15 days.]
25	1. 四神(汤)茶包 [1. Sishen (soup) tea bag] 食材：五指毛桃+陈皮+茯苓+芡实+莲子+山药。 [ Ingredients: five-fingered peach + tangerine peel + poria cocos + gourd + lotus seed + yam.] 6味都是健脾养胃的食材, 日常来上一包胃暖暖的很舒服, 调养脾胃真滴不错 [The 6 flavors are all ingredients for strengthening the spleen and stomach, and it is very comfortable and warm to have a pack of this tea every day. It is really effective for regulating the spleen and stomach] 2. 四神汤包 [2. Sishen soup bag] 食材：茯苓+芡实+莲子+山药 [ Ingredients: Poria cocos + gourd + lotus seed + yam] 四神汤包, 可经常炖汤来喝, 随便加什么肉类味道都好喝, 食欲不好 消化不良的可以多喝，老少皆宜 [Sishen soup bag, you can often stew this soup bag to drink, whatever meat you add tastes good, and those with poor appetite and indigestion can drink more, suitable for all ages]
26	第2个步骤：后15天再去湿气 [Step 2: After 15 days, eliminate dampness]
27	1. 薏米茶(湿热) [1. barley tea (damp-heat)] 食材：赤小豆+薏米+芡实+陈皮+栀子+红豆+甘草+苦荞+大麦 [ Ingredients: red adzuki beans + barley + gourd + tangerine peel + gardenia + red beans + licorice + tartary buckwheat + barley] 经常熬夜, 湿气重, 老是觉得睡不够, 浑身没力气, 脚步沉重, 犯懒不想动, 脸出油快, 粉刺痘痘反复, 大便粘的人, 适合喝这个茶哦∼ [People who often stay up late, get damp, always feel that they can’t sleep enough, have no strength all over their bodies, have stompy steps, don’t want to move, have a fast oily face, have repeated acne and have sticky stools, are suitable for drinking this tea la∼] 2. 陈皮茯苓茶(寒湿) [2. Tangerine peel and poria tea (damp-cold)] 食材：陈皮+茯苓+甘草+人参+炒白扁豆 [ Ingredients: tangerine peel + poria cocos + licorice + ginseng + fried white lentils] 寒湿, 手脚冰凉, 体寒怕冷, 易困乏没有精气神多多喝这个茶。 [Cold and damp, cold hands and feet, cold body, fear of cold, easy to be sleepy, no energy, drink more of this tea.]
28	看看自己属于湿热还是寒湿, 再选择食养祛 湿 [ Check which type of dampness you have, heat or cold, and then choose food to dispel dampness.]

As shown in the above Example (4), the netizen first emphasized the “correct” order of eliminating dampness, i.e. strengthening the spleen and stomach (24) before eliminating dampness (26). Importantly, in this advice-giving post, he/she established his/her medical authority by referring to “custom” (van Leeuwen 2008), e.g. “as the saying goes” (23). Then, the netizen offered specific suggestions on each step and gave different advice based on the syndrome differentiation of damp-heat and damp-cold (27). The specific advice on dietary therapy for damp-heat and damp-cold embodied the medical philosophy of TCM: medicine and food are homologous (药食同源, yaoshitongyuan). In other words, TCM advocates seeking suitable treatment through ordinary food, and in most cases, dietary therapy is more effective than herbal medicine (食补胜于药补, shibu shengyu yaobu). In TCM, herbs or foods have four properties, namely, cold, hot, warm, and cool (Dong and Zhang 2001). Specifically, hot foods such as pepper, chili, and garlic have heating and warming effects on the body; while cold ones, such as tomatoes and bananas, cool the body or the internal heat, and have a calming effect on the spirit; warm and cool foods have a milder effect on the body (Matos et al. 2021). Compared to herbal medicine, dietary therapy has fewer side effects and patients have easier access to ordinary food, both of which will achieve a long-term efficacy in the long run. Through the legitimation of “custom” (23) and the demonstration of professional medical knowledge (24–27), the netizen implicitly constructed and reinforced his/her medical expertise.

What is also interesting in this post is that the netizen tried to balance establishing medical authority and constructing a partnership. The netizen summarized the textual information into one picture (21), facilitating the users of RedNote to grasp as much information as possible in social media. Also, he/she used emoticons and macro-images throughout the whole post to shorten the distance between other users of RedNote. With the medical expertise established and a friendly partnership built at the same time in Example (4), users of RedNote are more likely to be convinced and thus accept the netizen’s advice.

Besides treating disease through ordinary food in Example (4), TCM also emphasizes the importance of daily activities, as shown in Example (5):

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29	中医养生|湿气 都是吃出来的! [ Traditional Chinese medicine health preservation | Dampness comes from diet!] 我们的脾胃乃是后天之本, 现在各种压力、美食出现的情况下, 大家经常吃香喝辣、吃个12分饱，那么久而久之中焦不通, 脾胃就会堵住, 湿气就会源源不断 [ Our spleen and stomach are the foundation of life after birth. Now, with all kinds of pressure and delicacy, we often eat oily and spicy food and get a full stomach. So, day by day, the middle energizer (the spleen and stomach) becomes blocked, leading to continuous dampness.]
30	下面有些小tips, 帮助你去湿气、还原本来美貌 [ Here are some tips to help you get rid of dampness and restore your original beauty.]
31	1. 泡脚 [1. Soak your feet] 睡前1–2小时, 用热水泡脚, 可以疏通经络, 促进血液循环有效去除湿气。 [1–2 hours before going to bed, soak your feet in hot water, which can dredge the meridians, promote blood circulation and effectively eliminate dampness.]
32	2. 晒太阳 [2. Sunbathe] 每天晒15分钟以上的太阳, 可以提升代谢, 增强体质, 增脾阳, 提升去除湿气的能力。 [Basking in the sun for more than 15 minutes a day can improve metabolism, enhance physical fitness, increase spleen Yang-Qi, and improve the ability to eliminate dampness.]
33	3. 走路/做八段锦 [3. Walking/doing Baduanjin exercise] 走路和做八段锦都可以增加身体的代谢能力, 激活身体深层的阳气, 疏通经络, 活血消肿, 也是消除湿气的好办法。 [Walking and doing Baduanjin exercise can increase the body’s metabolic capacity, activate the deep Yang energy of the body, dredge the meridians, invigorate blood, reduce swelling, and is also a good way to eliminate dampness.]
34	4. 饮食调理 [4. Diet] 根据身体情况吃红豆、薏仁、冬瓜、羊肉、姜汤等食物, 可以对湿气有较大帮助。同时, 应少吃生冷油腻的食物。 [Eating foods such as red beans, barley, wax gourd, mutton, and ginger soup according to your physical condition can greatly help get rid of dampness. At the same time, you should eat less raw, cold, and greasy food.]
35	□ 5. 精油按摩 [□ 5. Oil massage] 可以使用含有陈皮、当归等精油的油方对脾胃进行按摩, 增强脾胃功能, 每次饭后一小时左右进行按摩即可。 [You can use oil recipes containing essential oils such as tangerine peel and angelica to massage the spleen and stomach to enhance their function and massage them about an hour after each meal.]
36	6. 艾灸 [6. Moxibustion] 通过艾灸, 刺激相应穴位和特定部位来拔除湿气, 同时可以温通经络，驱寒除湿。 [Through moxibustion, the corresponding acupuncture points and specific parts are stimulated to eliminate dampness, and at the same time, the meridians can be warmed and dispelled from cold and dampness.]

Similar to Example (4), the netizen in Example (5) also used emoticons and macro-images throughout the whole post to build a friendly partnership, with prominence of daily activities in eliminating dampness (31, 32, 33, 35, 36). Importantly, TCM advocates a holistic, interconnected, dynamic treatment, e.g. having topical treatment on feet, spleen and stomach, and relevant acupuncture points (31, 35, 36), and activating the energy of the whole body through sunbathing, exercise, and diet (32, 33, 34). Moreover, in this advice post, the netizen offered detailed reasons why each tip helped eliminate dampness, e.g. dredging the meridians, promoting blood circulation (31, 36), improving metabolism (32), activating the deep Yang energy of the body (33), enhancing the function of spleen and stomach (35), etc. The prominence of these underlying reasons with TCM jargon or terms increased the credibility of the netizen’s advice-sharing, helping him/her to establish medical expertise to some extent.