【纲】仲景曰。病者一身尽疼。发热。日晡所剧者。此名风湿。此病伤于汗出当风。或久伤寒冷
所致也。
【目】刘完素曰。身尽疼者。湿也。发热日晡所剧者。风也。若汗出当风而得之者。则先有湿
而后感风。若久伤寒冷得之者。则先伤风而后中湿。可与麻杏薏甘汤。
陶华曰。风湿必脉浮。先伤湿而后伤风也。其症肢体肿痛。不能转侧。额上微汗。恶寒不欲去
衣。大便难。小便利。热至日晡而剧。治法。但微解肌。宜羌活冲和汤。咽渴小便不利。五苓散。
外不热。内不渴。小便利。术附汤。缓弱昏迷。腹满身重。自汗失音。大便不禁。白通汤去甘草加
白术。身肿痛微喘恶风。杏仁汤。热而烦渴。小柴胡加花粉。中湿小便不利。一身尽痛。身黄。大
便快。茵陈五苓散。大小便俱利。无黄者。术附汤。身痛鼻塞。小建中汤加黄芩。
【纲】仲景曰。伤寒八九日。风湿相搏。身体疼烦。不能自转侧。不呕不渴。脉浮虚而涩者。
桂枝附子汤主之。
【目】虞抟曰。以散表中风湿。若大便硬。小便自利。桂枝去桂加白术汤。此条。妙在脉浮虚
而涩。脉若沉实滑大数者。非也。
【纲】仲景曰。风湿相搏。骨节烦疼。掣痛。不得屈伸。近之则痛剧。汗出短气。小便不利。
恶风。不欲去衣。或身微肿者。甘草附子汤主之。
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。答曰。发其汗。汗大出者。但风气去。湿气在。是故不愈也。若治风湿者。发其汗。但微微似
欲汗出者。风湿俱去也。
【目】张兼善曰。风在外而湿在内。风湿相搏也。汗大出者。其气暴。暴则外之风邪去而里之
湿邪不出。故风则去而
湿则在也。
【纲】仲景曰。湿家其人但头汗出。背强。欲得被覆。向火。若下之早。则哕。胸满小便不利。
舌上如苔者。以丹田有热。胸中有寒。渴欲得水而不能饮。则口燥烦也。
【目】张元素曰。湿胜者则多汗。伤寒者必无汗。故寒湿相搏。虽有汗而不能周于一身。但头
汗出也。
[General Principle] Zhang Zhongjing stated: When a patient suffers from pain throughout the entire body, fever, and exacerbation during the Shen hour (approximately 3-5 PM), this condition is named Wind-Dampness. This disease arises from sweating while exposed to wind, or from long-term exposure to cold.
[Commentary] Liu Wansu stated: Pain throughout the body indicates Dampness; fever that worsens during the Shen hour indicates Wind. If contracted through sweating while exposed to wind, there was pre-existing Dampness followed by Wind invasion. If contracted through long-term exposure to cold, Wind was injured first, followed by Dampness. Ma Xing Yi Gan Tang (Apricot Kernel, Ephedra, Coix Seed, and Licorice Decoction) may be administered.
Tao Hua stated: In Wind-Dampness, the pulse must be Floating. This indicates injury to Dampness first, then Wind. Symptoms include swelling and pain in the limbs, inability to turn over, slight sweating on the forehead, aversion to cold with reluctance to remove clothing, difficult defecation, free urination, and worsening heat during the Shen hour. The treatment method should only slightly release the muscle layer; Qiang Huo Chong He Tang (Notopterygium Decoction for Harmonization) is appropriate. If accompanied by throat thirst and difficult urination, Wu Ling San (Five-Ingredient Powder with Poria) is used. If there is no external heat, internal thirst, and free urination, Shu Fu Tang (Atractylodes and Aconite Decoction) is used. For symptoms of lethargy, coma, abdominal fullness, heaviness of the body, spontaneous sweating, aphonia, and incontinence of stool, Bai Tong Tang (White Conjunction Decoction) with Gancao (Licorice Root) removed and Baizhu (Atractylodes Macrocephala Rhizome) added is indicated. For body swelling/pain, slight wheezing, and aversion to wind, Xing Ren Tang (Apricot Kernel Decoction) is used. For heat with irritability and thirst, Xiao Chai Hu Tang (Minor Bupleurum Decoction) with Huang Jing Hua (Polygonatum Flower/Trichosanthes Root) is used. For Dampness injury causing difficult urination, whole-body pain, jaundice, and smooth defecation, Yin Chen Wu Ling San (Artemisia Capillaris Five-Ingredient Powder with Poria) is used. If both urination and defecation are free and there is no jaundice, Shu Fu Tang (Atractylodes and Aconite Decoction) is used. For body pain with nasal congestion, Xiao Jian Zhong Tang (Minor Construct the Middle Decoction) with Huang Qin (Scutellaria Root) added is used.
[General Principle] Zhang Zhongjing stated: After eight or nine days of Cold Damage, when Wind and Dampness intermingle, causing severe body pain and inability to turn over independently, without vomiting or thirst, and with a Floating, Deficient, and Choppy pulse, Gui Zhi Fu Zi Tang (Cinnamon Twig and Aconite Decoction) is the primary treatment.
[Commentary] Yu Tun stated: This disperses Wind and Dampness from the exterior. If the stool is hard and urination is free, Gui Zhi Qu Gui Jia Bai Zhu Tang (Cinnamon Twig Decoction with Cinnamon Removed and Atractylodes Added) should be used. The subtlety of this clause lies in the Floating, Deficient, and Choppy pulse. If the pulse is Deep, Excess, Slippery, Large, or Rapid, it does not fit this pattern.
[General Principle] Zhang Zhongjing stated: When Wind and Dampness intermingle, causing vexing pain in the bones and joints, pulling pain, inability to flex or extend, and intensified pain upon touch, accompanied by sweating, shortness of breath, difficult urination, aversion to wind, reluctance to remove clothing, or slight bodily edema, Gan Cao Fu Zi Tang (Licorice and Aconite Decoction) is the primary treatment.
When Wind and Dampness intermingle, causing pain throughout the body, the law dictates resolution through sweating. If it encounters continuous rainy weather, and the physician says sweating can induce relief, but the disease persists after sweating, why is this? The answer is: If sweating causes profuse perspiration, only the Wind pathogen leaves, while Dampness remains; therefore, the disease does not resolve. When treating Wind-Dampness, inducing sweat should result only in a slight, continuous moisture on the skin; only then will both Wind and Dampness depart together.
[Commentary] Zhang Jianshan stated: Wind is on the exterior and Dampness is on the interior; this is the intermingling of Wind and Dampness. Profuse sweating implies violent Qi; violence causes the external Wind pathogen to leave while the internal Dampness pathogen fails to exit. Thus, Wind departs while Dampness remains.
[General Principle] Zhang Zhongjing stated: Patients suffering from Dampness diseases may exhibit sweating only on the head, stiffness in the back, and a desire to cover themselves with blankets or sit near fire. If purgatives are applied too early, hiccups, chest fullness, and difficult urination will occur. The tongue may appear coated due to Heat in the Lower Dan Tian and Cold in the Chest. The patient may feel thirsty and desire water but be unable to drink, resulting in dry mouth and vexation.
[Commentary] Zhang Yuanyu stated: When Dampness prevails, there is much sweating; in Cold Damage, there is necessarily no sweating. Therefore, when Cold and Dampness intermingle, although there is sweating, it cannot circulate throughout the body, resulting in sweating only on the head.