When you first learn about patterns of Heat during your study of Chinese medicine, it seems that what is being described is inflammation. (I will be capitalizing the word Heat when referring to the Chinese medical pattern in order to distinguish it from one of the pathognomonic signs of inflammation, which is a sensation of local warmth.)Depending on who first taught you about Heat patterns, you may have heard that this is a correct correlation or you may have heard what I consider to be a more accurate statement. Which is that inflammation can present even when the diagnosis does not indicate the presence of heat. For example, Damp Bi. However, I believe that this is only a true statement in the context of acute inflammation. I’ve come to believe that chronic, low grade inflammation always involves an element of Heat. 

There has been widely accepted hypothesis in Chinese medicine for about 500 years that the primary cause of chronic illness originates in poor dietary choices that overwhelm the digestive system, which results in accumulation of brewing dampness and phlegm that transforms to chronic low-grade heat. This is not a universally accepted pathomechanism, but it is widely accepted by modern practitioners focused primarily on herbal medicine. This pathomechanism is conceptually very similar to the modern concept of inflammaging.  Inflammaging is a leading hypothesis for what is essentially a single pathomechanism for all of the adverse health consequences of aging and chronic disease.


  • According to geroscience, inflammation is one of the seven evolutionarily conserved mechanistic pillars of ageing that are shared by age-related diseases, including metabolic diseases.
  • Inflammaging is the long-term result of the chronic physiological stimulation of the innate immune system, which can become damaging during ageing — a period of life largely unpredicted by evolution.
  • Inflammaging is the by-product of the degeneracy of a few receptors that can sense a variety of non-self, self and quasi-self damage signals (or ‘garbage’) and activate the innate immune system.
  • Inflammaging and metaflammation largely share the same molecular mechanisms, in which metaflammation can be conceptualized as a specific situation of chronic inflammation caused by nutrient excess.
  • The gut microbiota has a central role in metaflammation and inflammaging, as it can release inflammatory products and contribute to the circadian rhythms and crosstalk with other organs and systems.