伤寒门，有身痛，有身重；中寒门，有身痛，无身重。可知身重皆是阳邪为患，非虚寒之
谓。按身重有风湿、有风温、有风寒、有火逆、有中 。如风湿相持，身体疼痛。不能转
侧，羌活胜湿汤重加防风。如风温身热，发汗犹灼热，身重多眠，防葛石膏汤。如风寒身重
者，即作伤寒施治。若无汗脉浮，恶寒发热，手足或冷，即是表邪，急宜汗之，羌活汤、败
毒散、羌活胜湿汤。若表邪已解，里有结热，恶热不恶寒，脉沉而数，口渴便赤，宜清里石
膏汤。邪在半表半里，宜和解，小柴胡汤。如火邪身重者，表汗未出，误用火；熏腰下重痹
者，宜解火邪。如中 发热，身重身痛，手足常冷，时时汗出，口渴齿燥，宜人参白虎汤。
太阳病，或已发热，或未发热，必恶寒，体重呕逆，脉阴阳俱紧者，名曰伤寒。
此条详注恶寒。
脉浮宜以汗解，用火灸之，邪无从出，因火而盛，病从腰以下必重而痹，名火逆也。脉
浮，宜发汗解肌者，失解表，误以火灸，两阳相熏灼，邪无从泄，腰以下必火闭无汗，故
必重痹，名曰火逆。
伤寒八九日，下之胸满烦惊，小便不利，谵语，一身尽甚重，不能转侧者，柴胡加龙骨牡蛎汤主之。
下后变症，仲景立小柴胡汤，加桂枝治身重；加大黄治谵语；又加龙骨牡蛎，敛神收摄，
制使大黄清里热而不下脱，制柴胡、桂枝散表邪而不外越，以下后危症，外越不脱，又所当慎。
伤寒脉浮缓，身不疼，但重，乍有轻时，无少阴证者，大青龙汤发之。
言但重、乍有轻时，的是太阳表邪攻注症。乍重者，寒伤营也；乍轻者，风伤卫也。言无
少阴症，以明太阳症也，故用大青龙汤。
阳明病，脉迟，虽汗出不恶寒者，其身必重。短气腹满而喘，有潮热者，此外欲解。可攻里
也；手足 然而汗出，此大便已硬也，大承气汤。若汗多，微发热恶寒，外未解也，其热不
潮，未可与承气汤。
此章详注潮热。泛视之，似乎身重之症，治宜攻里。细玩之，深言身重，宜发汗，未可攻里。
三阳合病，腹满身重，难以转侧，口不仁而面垢，谵语遗尿，发汗则谵语，下之则额上生
汗，手足逆冷，若自汗者，白虎汤主之。此条详注自汗。
羌活胜湿汤
羌活 防风 苍术 黄柏 泽泻 茯苓 广皮 甘草
身重风湿居多，此方用三味以祛风，又以泽泻，茯苓利小便去湿。风湿兼寒，去黄柏，加桂枝。
防风葛根石膏汤
防风 干葛 知母 石膏 甘草
阳明风湿身重。家秘用此方。
羌活败毒散 见恶寒。
石膏汤
石膏 白芍药 柴胡 升麻 黄芩 甘草 白术 茯苓 附子
此治阳虚寒湿之眩晕。
苓桂白术甘草汤
桂枝 茯苓 白术 甘草
此治上虚不能制水，水饮上冲眩晕之症。
天麻四君子汤 即四君子汤加天麻。
此治气虚眩晕者，有火加栀连；有痰，加半夏、广皮；有寒，加炮姜、肉桂。
天麻四物汤 即四物汤加天麻。
In the Shanghan (Cold Damage) category, there are symptoms of body pain and body heaviness; in the Zhonghan (Middle Cold) category, there are symptoms of body pain but no body heaviness. From this, it can be deduced that body heaviness is always caused by Yang pathogens, not by deficiency-cold. Regarding the etiology of body heaviness, there are Wind-Dampness, Wind-Warmth, Wind-Cold, Fire Reversal, and Middle Heat (the character is missing in the original text, inferred as "Heat" from the subsequent context). If Wind-Dampness is stagnant, causing body pain and inability to turn or shift position, Qianghuo Shengshi Tang (Notopterygium Decoction for Overcoming Dampness) should be used with an increased dose of Fangfeng (Saposhnikovia Root). If Wind-Warmth causes fever, and sweating still results in burning heat, accompanied by body heaviness and somnolence, Fangfeng Gegen Shigao Tang (Saposhnikovia, Pueraria, and Gypsum Decoction) should be used. If Wind-Cold causes body heaviness, it should be treated according to the methods for Shanghan. If there is no sweat, a floating pulse, aversion to cold and fever, and sometimes cold hands and feet, this indicates exterior pathogens, requiring urgent diaphoresis; Qianghuo Tang, Baidu San (Decoction to Defeat Pathogens), or Qianghuo Shengshi Tang may be used. If the exterior pathogens have been resolved, but there is accumulated heat inside, with aversion to heat rather than cold, a deep and rapid pulse, thirst, and dark urine, the interior heat should be cleared using Shigao Tang (Gypsum Decoction). For pathogens in the half-exterior, half-interior stage, harmonization is indicated, using Xiaochaihu Tang (Minor Bupleurum Decoction). If body heaviness is caused by Fire Pathogens, and the exterior syndrome was not resolved when fire therapy (such as moxibustion or fumigation) was mistakenly applied, causing heaviness and numbness below the waist, the Fire Pathogen should be resolved. If Middle Heat causes fever, body heaviness and pain, constant coldness of the hands and feet, frequent sweating, thirst, and dry teeth, Renshen Baihu Tang (Ginseng White Tiger Decoction) should be used.
In Taiyang Disease (Disease of the Solar Channel), whether fever has already appeared or not, there must be aversion to cold, body weight/heaviness, vomiting, and a tight pulse at all three positions (Cun, Guan, Chi); this is named Shanghan (Cold Damage).
This clause details the symptom of aversion to cold.
A floating pulse should be resolved by inducing sweating. If moxibustion is used, the pathogen has no outlet, becomes exacerbated by the fire, and the condition will definitely result in heaviness and numbness from the waist down; this is called Huoni (Fire Reversal). A floating pulse should be treated by inducing sweating and releasing the muscle layer. If the exterior release is missed and moxibustion is mistakenly applied, the two Yangs (external Yang pathogen and fire pathogen) scorch each other, the pathogen has no way to exit, and the area below the waist will certainly suffer from fire-induced closure without sweat, resulting in definite heaviness and numbness; this is called Huoni (Fire Reversal).
After eight or nine days of Shanghan, if purgation is mistakenly applied, leading to chest fullness, irritability and fright, difficulty in urination, delirium, extreme heaviness of the whole body, and inability to turn or shift position, Chaihu Jia Longgu Muli Tang (Bupleurum Decoction with Dragon Bone and Oyster Shell) is the primary treatment.
For complications after purgation, Zhang Zhongjing established Xiaochaihu Tang, adding Guizhi (Cinnamon Twig) to treat body heaviness; adding Dahuang (Rhubarb) to treat delirium; and adding Longgu (Dragon Bone) and Muli (Oyster Shell) to calm the spirit and consolidate essence. This controls Dahuang so it clears interior heat without causing excessive diarrhea, and controls Chaihu and Guizhi so they disperse exterior pathogens without causing them to scatter outward excessively. For critical conditions after purgation, preventing the loss of Zheng Qi (Upright Qi) through outward scattering requires caution.
In Shanghan, if the pulse is floating and slow, the body does not hurt but is heavy, occasionally feeling lighter, and there are no Shaoyin (Lesser Yin) signs, Daqinglong Tang (Major Green Dragon Decoction) should be used to induce sweating.
The statement that the body is merely heavy and occasionally lighter indicates that these are indeed symptoms of Taiyang exterior pathogen invasion. Sudden heaviness is due to Cold injuring the Ying (Nutrient) level; sudden lightness is due to Wind injuring the Wei (Defensive) level. The mention of "no Shaoyin signs" clarifies that this is a Taiyang syndrome, hence Daqinglong Tang is used.
In Yangming Disease, if the pulse is slow, although there is sweating and no aversion to cold, the body must be heavy. If there is shortness of breath, abdominal fullness, and wheezing, and if there is tidal fever, it indicates that the exterior is about to resolve and the interior can be attacked; if the hands and feet are continuously sweating, it indicates that the stool has hardened, and Dachengqi Tang (Major Order the Qi Decoction) should be used. If there is profuse sweating, slight fever and aversion to cold, indicating the exterior is not yet resolved, and the fever is not tidal, Chengqi Tang should not be administered.
This chapter details tidal fever. Superficially, it might seem that body heaviness should be treated by attacking the interior. However, upon careful study, the deeper meaning is that body heaviness should be treated by inducing sweating, and attacking the interior is inappropriate.
In San Yang He Bing (Combined Disease of the Three Yang), there is abdominal fullness, body heaviness, difficulty in turning or shifting position, insensitivity of the mouth/face, facial dirtiness, delirium, and urinary incontinence. If sweating is induced, delirium worsens; if purgation is used, sweating appears only on the forehead and the hands and feet become cold. If there is spontaneous sweating, Baihu Tang (White Tiger Decoction) is the primary treatment. This clause details the symptom of spontaneous sweating.
Qianghuo Shengshi Tang (Notopterygium Decoction for Overcoming Dampness)
Ingredients: Qianghuo (Notopterygium Rhizome), Fangfeng (Saposhnikovia Root), Cangzhu (Atractylodes Rhizome), Huangbai (Phellodendron Bark), Zexie (Alisma Rhizome), Fuling (Poria), Guangpi (Tangerine Peel), Gancao (Licorice Root).
Body heaviness is mostly due to Wind-Dampness. This formula uses three herbs (Qianghuo, Fangfeng, Cangzhu) to dispel wind, and Zexie and Fuling to promote urination to remove dampness. If Wind-Dampness is combined with Cold, remove Huangbai and add Guizhi (Cinnamon Twig).
Fangfeng Gegen Shigao Tang (Saposhnikovia, Pueraria, and Gypsum Decoction)
Ingredients: Fangfeng (Saposhnikovia Root), Gan Ge (Pueraria Root), Zhimu (Anemarrhena Rhizome), Shigao (Gypsum Fibrosum), Gancao (Licorice Root).
Used for body heaviness caused by Yangming Wind-Dampness. This is a secret formula used by the author's family.
Qianghuo Baidu San (Notopterygium Decoction to Defeat Pathogens) See entry for "Aversion to Cold".
Shigao Tang (Gypsum Decoction)
Ingredients: Shigao (Gypsum Fibrosum), Baishao Yao (White Peony Root), Chaihu (Bupleurum Root), Shengma (Cimicifuga Rhizome), Huangqin (Scutellaria Root), Gancao (Licorice Root), Baizhu (Atractylodes Macrocephala Rhizome), Fuling (Poria), Fuzi (Aconite Lateral Root).
This treats vertigo caused by Yang deficiency and Cold-Dampness.
Linggui Zhugan Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction)
Ingredients: Guizhi (Cinnamon Twig), Fuling (Poria), Baizhu (Atractylodes Macrocephala Rhizome), Gancao (Licorice Root).
This treats vertigo caused by upper Jiao (Triple Burner) deficiency failing to control water, leading to Water-Fluid rushing upward.
Tianma Sijunzi Tang (Gastrodia and Four Gentlemen Decoction)
This is Sijunzi Tang (Four Gentlemen Decoction) plus Tianma (Gastrodia Rhizome).
This treats vertigo caused by Qi deficiency. If there is Fire, add Zhizi (Gardenia Fruit) and Lianhua (Lotus Stamen) or Lianzi (Lotus Seed); if there is Phlegm, add Banxia (Pinellia Tuber) and Guangpi (Tangerine Peel); if there is Cold, add Paojiang (Prepared Ginger) and Rougui (Cinnamon Bark).
Tianma Siwu Tang (Gastrodia and Four Substances Decoction)
This is Siwu Tang (Four Substances Decoction) plus Tianma (Gastrodia Rhizome).