张司农谓。暑邪之害甚于寒。因作暑症全书济世。窃以为湿邪之害。更有甚于
暑者。盖盛暑之时必兼湿。而湿盛之时不兼暑。暑邪止从外入。而湿邪兼乎内
外。暑邪为病。骤而易见。湿邪为病。缓而难知。凡处泽国水乡者。于湿症尤宜加
察焉。如外感之湿。着于肌表者。或从雨雾中而得。或从地气潮湿中而得。或上
受。或下受。或遍体均受。皆当以解肌法微汗之。兼风者。微微表散。兼寒者。佐以
温药。兼热者。佐以清药。此外受湿邪之治也。如内生之湿。留于脏腑者。乃从饮
食中得之。凡膏粱酒醴。甜腻浓味。及嗜茶汤瓜果之类。皆致内湿。治法不外上
开肺气。下通膀胱。中理脾阳为治。然阳体多成湿火。而阴体多患寒湿。又当察
其体质阴阳为治。用药之法。当以苦辛寒治湿热。苦辛温治寒湿。概以淡渗佐
之。甘酸腻浊之品。在所禁用。前太阴新法内。已陈湿邪之概。兹特参湿邪之兼
症。而以表里三焦分治焉。若夫湿邪变幻之态。为病非一。当以杂症各门求之
可也。
脾虚多中湿。一身尽痛为湿。有表有里。有湿热。有寒湿。有风湿。
湿痹 痹者。痹着不去也。论曰。太阳病。关节疼痛而烦。脉沉而细者。此名中湿。
亦曰湿痹。其候小便不利。大便反快。但当利其小便。此宜五苓散主之。发黄加茵陈。
风湿 病者一身尽疼。发热。日晡剧者。此名风湿。此病伤于汗出当风。或久伤取
冷所致也。可与麻黄杏仁薏苡甘草汤。又曰风湿脉浮。身重。汗出恶风者。防己黄 汤主之。
风湿相搏。一身尽疼痛。法当汗出而解。值天阴雨不止。医云。此可发汗。汗之。病不
愈者。何也。盖发其汗。汗大出者。但风气去。湿气在。故不愈也。若治风湿者。发其汗。
但微微似欲汗出者。风湿俱去也。
头中寒湿 湿家病。身疼发热。面黄而喘。头痛。鼻塞而烦。其脉大。自能饮食。腹中
和。无病。病在头中寒湿。故鼻塞。纳药鼻中则愈。用香瓜蒂一味为末。吹鼻中。黄水立下则愈。
湿家下之。额上汗出。微喘。小便利者死。若下利不止者。亦死。（以上述金匮）
表湿 关节疼痛。脉浮而濡。四肢痿弱。此湿邪在表也。小便利者。桂枝汤加川羌、
白术等。微汗之。小便不利者。五苓散加减。
中湿 若关节重痛。浮肿喘满。腹胀烦闷。昏不知人。脉沉而缓。或沉而细。此名中
湿。宜升阳除湿汤。或白术酒。
破伤湿 有破伤处。因澡浴。湿气从疮口入。其人昏迷沉重。状类中湿。名破伤湿。宜白术酒。
湿热 脉濡细而数。发热身痛。小水短涩。或身目俱黄。属湿热。宜五苓散。加生栀、
黄柏、茵陈、秦艽。
寒湿 脉沉迟而濡。身无热。但吐泻。口不渴。小水清利。身痛重着。或手足肿痛者。
为寒湿。宜分渗兼温中。胃苓汤加炮姜、木瓜。重者加附子。按论云。湿家。其人但
头汗出。背强。欲得被覆向火者。此寒湿也。又云。伤寒八九日。风湿相搏。身体疼痛。
不能自转侧。不呕不渴。脉浮虚而涩者。桂枝附子汤主之。亦风湿兼寒也。
风湿 脉浮身重。不能转侧。自汗。或额上多汗。此乃先伤于湿。又冒风所致。宜微
汗之。渍渍然似欲汗者。风湿俱去矣。大羌活汤。
湿痰 脉沉缓而滑。四肢流注。或项背强。恒见于肥白人。属湿痰。宜二陈、二术、桂枝、羌活等加减。
脾胃受湿。则沉困无力。怠惰好睡。须二术为君。上部湿。苍术最烈。下部湿。升麻提
之。外湿宜表散。内湿宜渗泄。湿盛身痛。羌活胜湿汤、平胃散之类。风湿相搏。一身尽痛。自汗者。防己
黄汤。湿盛身痛。小便不利。体重发渴者。五苓散加川羌一倍。煎服妙。（以上诸条参治法汇）
湿着肌表 如发热身痛。脘闷不渴。舌苔白腻。或汗出不解。此湿邪着于肌躯之
表也。宜解肌渗湿。如桂枝、秦艽、紫苏、二陈、浓朴、姜皮、茯苓皮之类。
湿留气分 凡发热身痛。汗出则解。继而复热。脉来濡缓。舌苔白腻。此湿邪阻于
气分。热自湿中来。徒用清热药不应。宜茯苓皮、大腹皮、滑石粉、黄芩、通草、半夏、猪
苓之类。以逐气分之湿。热自除矣。
太阴湿伏 凡身体沉重。不能转侧。四肢乍冷。目黄脘痞。自利。语言欲蹇者。此湿
邪伏于太阴。以致脾阳不运而然也。宜健脾兼分利。茅术、浓朴、茯苓皮、草蔻、菖蒲、
广皮、木瓜、泽泻之类。如口内生白疳。而仍不渴者。此湿滞于中。气蒸于上也。治
在气分。茅术、米仁、猪苓、泽泻、广皮、桔梗、寒水石之类。如痞结胸满。饮食不进。舌
黄微渴。此湿热伤脾也。宜泻心法。半夏、茯苓、川连、浓朴、茅术、通草。
湿热内结 如寒热腹满。小便不利。此湿热内结也。宜走湿清热。茅术、赤小豆、
茵陈、茯苓皮、浓朴、黄柏、泽泻之类。
酒湿伤胃 脘中食阻。痛而呕吐。或目色金黄。此酒湿伤胃所致。宜以苦辛寒为
治。半夏、枳实、姜汁、黄连、豆豉、茵陈之类。
湿兼痧秽 秽湿从口鼻吸入。则膜原先受。分布营卫。先呕逆。次寒热。头胀身痛。
小便不通。舌苔白腻。渴不多饮。当以芳香淡渗兼施。俾秽湿浊邪可以分消。宜广
皮、藿梗、郁金、茅术、米仁、茯苓皮、猪苓、大腹皮、石菖蒲、通草。
湿热兼秽 暑湿兼秽气。都从口鼻触入。必由膜原以走中道。踞募原。则寒热交
作。走中道。则不食不饥。口渴舌黄。胸痞腹胀。治宜清热开郁。兼芳香逐秽。栀豉汤。
加藿香、川郁金、白蔻、枳实、制连、蒌皮、桔梗之类。若小水不利。加赤小豆、赤茯苓之
类。腹胀甚。加浓朴、大腹皮。
湿热为痹 外受湿热之邪。内进甜腻之物。则湿聚热蒸。蕴于经络。寒战热炽。骨
骱烦疼。舌苔灰腻。面目痿黄。此湿热入于经络为痹也。湿家忌汗。宜苦味辛通为
治。防己、杏仁、滑石、半夏、米仁、连翘、山栀、野赤豆皮、路路通之类。更有暑湿风邪
混杂。阻于气分。气不主宣。右肢若废。头胀胸痞。法当通阳驱邪。
杏仁（三钱） 生米仁（三钱） 桂枝（五分） 浓朴（一钱） 半夏（一钱五分） 汉防己
（一钱五分） 白蒺藜（二钱） 片姜黄（一钱）
三焦湿郁 发热后。神识渐昏。小腹硬满。大便不下。此暑湿气蒸。弥漫三焦。乃诸
窍阻塞之兆。气分结邪。忌用滋腻。须桂苓甘露饮法。茯苓、猪苓、滑石、寒水石、晚蚕
砂、皂荚子去皮。（以上参叶案）
Zhang Sinong stated that the harm of Summerheat pathogen is more severe than that of Cold, and therefore wrote the *Complete Book of Summerheat Syndromes* to benefit the world. I, however, believe that the harm of Dampness pathogen is even more severe than that of Summerheat. This is because during the peak of Summerheat, it must be accompanied by Dampness, whereas when Dampness is prevalent, it does not necessarily accompany Summerheat. The Summerheat pathogen enters only from the exterior, while the Dampness pathogen affects both interior and exterior. Diseases caused by Summerheat appear suddenly and are easily visible; diseases caused by Dampness develop slowly and are difficult to detect. Those living in marshy or water-rich regions should pay particular attention to Dampness syndromes.
If it is exogenous Dampness lodging on the muscle layer (Muscle Layer), whether contracted from rain and fog, from damp ground air, received from above, from below, or uniformly throughout the body, one should employ the method of resolving the muscle layer to induce slight sweating. If accompanied by Wind, use mild dispersing methods; if accompanied by Cold, assist with warm herbs; if accompanied by Heat, assist with clearing herbs. This is the treatment for exogenous Dampness pathogen.
If it is endogenous Dampness remaining in the Zang-Fu organs, it usually arises from diet. Rich foods, sweet wines, sugary and greasy flavors, as well as habits of drinking tea and eating fruits, all lead to internal Dampness. The treatment methods do not exceed opening Lung Qi in the upper Jiao, unblocking the Bladder in the lower Jiao, and regulating Spleen Yang in the middle Jiao. However, constitutions with excess Yang tend to form Damp-Heat Fire, while constitutions with excess Yin tend to suffer from Cold-Dampness. One must treat according to the patient's Yin-Yang constitution. The principle of medication is to use Bitter-Pungent-Cold herbs for Damp-Heat, and Bitter-Pungent-Warm herbs for Cold-Dampness, generally assisted by bland leaching agents. Sweet, sour, greasy, and turbid substances are strictly prohibited. In the previous section on New Methods for Taiyin, the general overview of Dampness pathogen was already presented. Here, we specifically discuss the complicated syndromes of Dampness pathogen and treat them according to Exterior/Interior and the Three Jiaos. As for the变幻 (changing) nature of Dampness pathogen, which causes various diseases, one should seek treatments in the respective categories of miscellaneous diseases.
Spleen deficiency often leads to contracting Dampness. Whole-body pain is a sign of Dampness. There are distinctions between Exterior and Interior, Damp-Heat, Cold-Dampness, and Wind-Dampness.
Damp Bi (Obstruction): "Bi" refers to obstruction and stagnation that does not disperse. The medical theory states: In Taiyang disease, joint pain accompanied by irritability, with a deep and fine pulse, is named Zhong Shi (Striking Dampness), also called Damp Bi. Its symptoms include difficulty in urination and loose stools. The treatment should focus on promoting urination. This syndrome is suitable for Wuling San (Five-Ingredient Powder with Poria). If jaundice appears, add Yinchen (Artemisiae Scopariae Herba).
Wind-Dampness: When a patient suffers from whole-body pain, fever, which worsens at Shen hour (3-5 PM), this is named Wind-Dampness. This condition results from sweating followed by exposure to wind, or prolonged exposure to cold and dampness. Mahuang Xingren Yiyi Ren Gancao Tang (Ephedra, Apricot Seed, Coix Seed, and Licorice Decoction) can be used. It is also stated that for Wind-Dampness with a floating pulse, heavy body, sweating, and aversion to wind, Fangji Huangqi Tang (Stephania and Astragalus Decoction) is indicated.
Wind-Dampness Combining: Whole-body severe pain should theoretically resolve through sweating. If it coincides with continuous rainy weather, and the physician advises sweating but the disease does not improve, why? Because excessive sweating removes only the Wind, leaving the Dampness behind, hence no improvement. To treat Wind-Dampness, sweating should be induced so that there is merely a slight, continuous perspiration; then both Wind and Dampness will be expelled.
Cold-Dampness in the Head: Patients with Dampness disease may experience body pain, fever, yellowish complexion, asthma, headache, nasal congestion, and irritability, with a large pulse. They can eat normally, and the abdomen is peaceful without pathology. The disease lies in Cold-Dampness in the head, causing nasal congestion. Inserting medicine into the nose cures it. Use Xiang Gua Di (Melon Seed) alone, powdered, and insufflated into the nose. Yellow discharge appearing immediately indicates cure.
Downward purging in Dampness patients: Sweating on the forehead, slight asthma, and free urination indicate death. If diarrhea persists uncontrollably, it also indicates death. (Above quoted from *Jin Gui Yao Lue*)
Exterior Dampness: Joint pain, floating and soft pulse, flaccidity and weakness of limbs indicate Dampness in the Exterior. With free urination, Guizhi Tang (Cinnamon Twig Decoction) plus Chuan Qianghuo (Notopterygii Rhizoma et Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma) is used to induce slight sweating. With impaired urination, Wuling San (Five-Ingredient Powder with Poria) is modified.
Zhong Shi (Striking Dampness): If joints are heavy and painful, edema, asthma, chest fullness, abdominal distension, irritability, coma, and unconsciousness occur, with a deep-slow or deep-fine pulse, this is named Zhong Shi. Shengyang Chushi Tang (Ascending Yang and Expelling Dampness Decoction) or Baizhu Wine is suitable.
Traumatic Dampness: At the site of a wound, bathing allows Dampness to enter through the sore. The patient becomes comatose and heavy, resembling Zhong Shi, named Traumatic Dampness. Baizhu Wine is suitable.
Damp-Heat: A soft, fine, and rapid pulse, fever, body pain, short and scanty urine, or yellowing of body and eyes belong to Damp-Heat. Wuling San (Five-Ingredient Powder with Poria) plus Sheng Zhizi (Gardeniae Fructus), Huangbai (Phellodendri Cortex), Yinchen (Artemisiae Scopariae Herba), and Qinjiao (Gentianae Macrophyllae Radix) is indicated.
Cold-Dampness: A deep, slow, and soft pulse, absence of fever, only vomiting and diarrhea, no thirst, clear and abundant urine, heavy body pain, or swelling and pain in hands and feet indicate Cold-Dampness. Treatment involves separating and leaching combined with warming the middle. Weiling Tang (Stomach Regulating Decoction) plus Pa Jiang (Prepared Ginger) and Mugua (Chaenomelis Fructus) is used. For severe cases, Fuzi (Aconiti Lateralis Radix Praeparata) is added. According to the discussion, Dampness patients who only sweat on the head, have a stiff back, and desire covering themselves near fire suffer from Cold-Dampness. Also, after eight or nine days of Cold Damage, Wind-Dampness combines, causing body pain, inability to turn independently, no vomiting or thirst, and a floating, deficient, and choppy pulse. Guizhi Fuzi Tang (Cinnamon Twig and Prepared Aconite Decoction) is indicated. This is also Wind-Dampness combined with Cold.
Wind-Dampness: Floating pulse, heavy body, inability to turn, spontaneous sweating, or excessive sweating on the forehead result from initial Dampness injury followed by Wind exposure. Mild sweating is required; a slight, continuous perspiration expels both Wind and Dampness. Da Qianghuo Tang (Great Notopterygium Decoction) is used.
Damp-Phlegm: A deep-slow and slippery pulse, wandering pain in limbs, or stiffness in neck and back, commonly seen in obese individuals, belongs to Damp-Phlegm. Er Chen Tang (Two-Aged Decoction) combined with Er Zhu (two types of Atractylodes), Guizhi (Cinnamon Twig), and Qianghuo (Notopterygii Rhizoma et Radix) is modified.
When Spleen and Stomach are affected by Dampness, there is heaviness, fatigue, weakness, lethargy, and sleepiness. Cangzhu (Atractylodis Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma) should be the chief herbs. For upper Jiao Dampness, Cangzhu is most potent; for lower Jiao Dampness, Shengma (Cimicifugae Rhizoma) lifts it. Exterior Dampness should be dispersed via the exterior; Internal Dampness should be leached. For Dampness-induced body pain, Qianghuo Shengshi Tang (Notopterygium Decoction for Overcoming Dampness) or Pingwei San (Regulate the Stomach Powder) are used. For Wind-Dampness combining with whole-body pain and sweating, Fangji Huangqi Tang (Stephania and Astragalus Decoction) is used. For Dampness-induced body pain, impaired urination, heavy body, and thirst, Wuling San (Five-Ingredient Powder with Poria) with double the dose of Chuan Qianghuo (Notopterygii Rhizoma et Radix) is effective. (These items reference *Zhi Fa Hui*)
Dampness Lodging on Muscle Layer: Fever, body pain, epigastric stuffiness without thirst, white greasy tongue coating, or unresolved sweating despite diaphoresis indicates Dampness lodging on the exterior of the muscle layer. Resolve the muscle layer and leach Dampness using Guizhi (Cinnamon Twig), Qinjiao (Gentianae Macrophyllae Radix), Zisu (Perillae Folium), Er Chen Tang (Two-Aged Decoction), Houpo (Magnoliae Officinalis Cortex), Jiangpi (Zingiberis Pericarpium), and Fuling Pi (Poria Cum Woody Host).
Dampness Remaining in Qi Level: Fever and body pain that resolve with sweating but recur later, with a soft-slow pulse and white greasy tongue coating, indicate Dampness obstructing the Qi level. Heat originates from Dampness; clearing heat alone is ineffective. Use Fuling Pi (Poria Cum Woody Host), Fupi (Arecae Pericarpium), Huashi (Talcum), Huangqin (Scutellariae Radix), Tongcao (Tetrapanacis Medulla), Banxia (Pinelliae Rhizoma), and Zhuling (Polyporus) to eliminate Dampness in the Qi level, thereby removing the Heat.
Taiyin Dampness Latency: Heavy body, inability to turn, intermittent cold limbs, yellow eyes, epigastric fullness, spontaneous diarrhea, and slurred speech indicate Dampness latent in Taiyin, causing failure of Spleen Yang to transport. Strengthen Spleen and promote separation/drainage using Maoyu (Atractylodis Rhizoma), Houpo (Magnoliae Officinalis Cortex), Fuling Pi (Poria Cum Woody Host), Cao Kou (Amomi Fructus Rotundus), Changpu (Acori Tatarinowii Rhizoma), Guangpi (Citri Reticulatae Pericarpium), Mugua (Chaenomelis Fructus), and Zexie (Alismatis Rhizoma). If white patches appear in the mouth without thirst, Dampness stagnates in the middle, steaming upwards. Treat the Qi level with Maoyu (Atractylodis Rhizoma), Yiyiren (Coicis Semen), Zhuling (Polyporus), Zexie (Alismatis Rhizoma), Guangpi (Citri Reticulatae Pericarpium), Jiegeng (Platycodonis Radix), and Hanshuishi (Halloysit Rubrum). If chest fullness and blockage occur with loss of appetite, yellow tongue coating, and slight thirst, Damp-Heat injures the Spleen. Use Xiexin Method (Drain Heart Method) with Banxia (Pinelliae Rhizoma), Fuling (Poria), Chuanlian (Coptidis Rhizoma), Houpo (Magnoliae Officinalis Cortex), Maoyu (Atractylodis Rhizoma), and Tongcao (Tetrapanacis Medulla).
Damp-Heat Internal Knotting: Alternating chills and fever, abdominal fullness, and impaired urination indicate Damp-Heat internal knotting. Promote Dampness movement and clear Heat using Maoyu (Atractylodis Rhizoma), Chixiaodou (Phaseoli Semen Rubrum), Yinchen (Artemisiae Scopariae Herba), Fuling Pi (Poria Cum Woody Host), Houpo (Magnoliae Officinalis Cortex), Huangbai (Phellodendri Cortex), and Zexie (Alismatis Rhizoma).
Wine-Dampness Injuring Stomach: Food stagnation in the epigastrium, pain with vomiting, or golden-yellow eye color indicates Wine-Dampness injuring the Stomach. Treat with Bitter-Pungent-Cold methods using Banxia (Pinelliae Rhizoma), Zhishi (Aurantii Fructus Immaturus), Jiangzhi (Zingiberis Juice), Huanglian (Coptidis Rhizoma), Douchi (Sojae Semen Preparatum), and Yinchen (Artemisiae Scopariae Herba).
Dampness Combined with Filth: Filthy Dampness inhaled through nose and mouth first affects the Membrane Source (Mo Yuan), distributing through Ying and Wei. Symptoms include initial nausea/vomiting, alternating chills and fever, head distension, body pain, urinary obstruction, and white greasy tongue coating with thirst but little desire to drink. Apply aromatic and bland-leaching methods to dissipate filthy Dampness and turbid pathogens. Use Guangpi (Citri Reticulatae Pericarpium), Huogeng (Agastaches Herba), Yujin (Curcumae Radix), Maoyu (Atractylodis Rhizoma), Yiyiren (Coicis Semen), Fuling Pi (Poria Cum Woody Host), Zhuling (Polyporus), Fupi (Arecae Pericarpium), Shichangpu (Acori Tatarinowii Rhizoma), and Tongcao (Tetrapanacis Medulla).
Damp-Heat Combined with Filth: Summer-Dampness combined with filth enters through nose and mouth, traveling via the Membrane Source to the Middle Path. Occupying the Mo Yuan causes alternating chills and fever; entering the Middle Path causes anorexia, thirst, yellow tongue, chest stuffiness, and abdominal distension. Treat with clearing Heat, opening depression, and aromatic expulsion of filth. Zhichi Tang (Gardenia and Fermented Soybean Decoction) plus Huoxiang (Pogostemonis Herba), Chuan Yujin (Curcumae Radix), Baokou (Cardamomi Fructus), Zhishi (Aurantii Fructus Immaturus), Zhilian (Prepared Coptidis Rhizoma), Loupi (Benincasae Exocarpium), and Jiegeng (Platycodonis Radix) is used. If urination is impaired, add Chixiaodou (Phaseoli Semen Rubrum) and Chifuling (Poria cum Wood). For severe abdominal distension, add Houpo (Magnoliae Officinalis Cortex) and Fupi (Arecae Pericarpium).
Damp-Heat Bi Obstruction: Exogenous Damp-Heat combined with internal intake of sweet/greasy foods causes Dampness accumulation and Heat steaming, accumulating in collaterals. Symptoms include chills, intense fever, bone/joint pain, gray greasy tongue coating, and sallow complexion. This is Damp-Heat entering collaterals causing Bi obstruction. Dampness patients should avoid sweating. Treat with Bitter-Pungent unblocking methods using Fangji (Stephaniae Tetrandrae Radix), Xingren (Armeniacae Semen Amarum), Huashi (Talcum), Banxia (Pinelliae Rhizoma), Yiyiren (Coicis Semen), Lianqiao (Forsythiae Fructus), Shanzhi (Gardeniae Fructus), Ye Chidoupi (Wild Phaseoli Semen Rubris Cuticle), and Lulutong (Liquidambaris Fructus). If Summer-Dampness-Wind pathogens mix, obstructing the Qi level, preventing Qi circulation, causing right limb paralysis, head distension, and chest stuffiness, the method is to unblock Yang and drive out pathogens.
Prescription: Xingren (3 qian), Sheng Yiyiren (3 qian), Guizhi (0.5 qian), Houpo (1 qian), Banxia (1.5 qian), Han Fangji (1.5 qian), Bai Jili (2 qian), Pian Jianghuang (1 qian).
Three Jiaos Dampness Depression: After fever, mental confusion gradually sets in, lower abdomen becomes hard and full, and defecation stops. This indicates Summer-Dampness steaming and filling the Three Jiaos, signaling obstruction of orifices. Pathogenic knots in the Qi level contraindicate cloying/nourishing herbs. Use the method of Guiling Ganlu Yin (Cassia Seed and Poria Decoction). Ingredients: Fuling (Poria), Zhuling (Polyporus), Huashi (Talcum), Hanshuishi (Halloysit Rubrum), Wancansha (Bombyx Batryticatus), and Zaopiaozi (Gleditsiae Sinensis Spina - peeled). (Referencing Ye Tianshi's medical cases)