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**Initial Stage of Injury by Dampness**

In the initial stage of injury by dampness, there is absence of sweating, aversion to cold, fever, headache, heaviness of the body, and pain/discomfort in the limbs and joints. The tongue coating is white, and the pulse is slow. This indicates that Yang-dampness (Wet-Warmth) is injuring the exterior. It is appropriate to use herbs such as Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Bohe (Menthae Haplocalycis Herba), Dalili (Arctii Fructus), Xingren (Armeniacae Semen Amarum), Houpo (Magnoliae Officinalis Cortex), Doujuan (Sojae Semen Praeparatum), Tongcao (Tetrapanacis Medulla), Chiling (Poria Cocos with Red Sandalwood), and Yiren (Coicis Semen). These are used to dispel wind and promote diuresis to resolve dampness.

This passage discusses Yang-dampness injuring the exterior. Yang-dampness refers to Wet-Warmth disease. Whenever people sit or lie on wet ground, or wear clothes soaked with sweat, it can generate this condition. The heavy, turbid, and miasmic qi obstructs Wei-yang (Defensive Yang), resulting in aversion to cold and absence of sweating; it blocks the Cou-li (pores and interstices), resulting in fever and bodily heaviness. Furthermore, the Yangming channel corresponds to the Stomach, which is the Earth element of the Middle Jiao. It governs the muscles and the four limbs. When dampness invades, the Qi of the channels becomes stagnant, leading to laxity of the joints, headache, and body pain. At this time, the pulse is slow and large, all caused by the steaming effect of damp-heat. One must understand that dampness is the remainder of Earth; without Wind, it cannot be overcome. Therefore, Qianghuo, Fangfeng, Bohe, and Dalili are used to assist Wind herbs to move to the exterior; Xingren and Houpo use their bitter-warm nature to regulate the Spleen; Doujuan, Yiren, Chiling, and Tongcao use their bland-leaching nature to promote diuresis and resolve dampness. This perfectly aligns with the principle in the *Neijing* (Inner Canon): "When dampness prevails internally, treat it with bitter-warm methods, assisted by bland-leaching methods."

**Dampness Transforming into Heat**

If a patient with injury by dampness sweats profusely, has no forehead/headache, but experiences stiffness/impairment in the limbs and joints, feels thirsty but does not desire to drink, has a feverish body, and a large pulse, this indicates that dampness is gradually transforming into heat. It is appropriate to use herbs such as Xingren (Armeniacae Semen Amarum), Houpo (Magnoliae Officinalis Cortex), Lianqiao (Forsythiae Fructus), Huangqin (Scutellariae Radix), Doujuan (Sojae Semen Praeparatum), Huashi (Talcum), Tongcao (Tetrapanacis Medulla), Lugeng (Phragmitis Rhizoma), Xianheye (Nelumbinis Folium), and Pipaye (Eriobotryae Folium). These are used to promote diuresis to resolve dampness and clear heat.

The previous paragraph described absence of sweating and headache due to dampness invading the exterior where Wei-yang resides. Zhang Zhongjing stated: "Patients with dampness should avoid sweating; inducing sweat may lead to spasms (Jing syndrome) because it injins Yin." Thus, he left instructions for future generations, warning against excessive ascending and dispersing methods that might damage Yin fluids. In this current paragraph, since the patient is sweating and has no headache, it indicates that the exterior pathogen has been released, but the dampness has not yet transformed. Therefore, the limbs and joints still hurt. As dampness transforms from heat, fluids do not ascend, causing thirst; heat is trapped by dampness, causing the Qi to be unclear, hence the lack of desire to drink. The pulse gradually becoming large indicates that the fire-like momentum is intensifying like a prairie fire. One must use the bitter-warm nature of Xingren and Houpo to regulate the Spleen; the bitter-cold nature of Lianqiao and Huangqin to clear heat; and simultaneously employ the sweet-bland leaching nature of Doujuan, Huashi, Tongcao, and Lugeng to resolve dampness, along with the acrid-cool nature of Heye and Pipaye to clear the Qi. This ensures that dampness resolves and heat clears, Yin fluids are not injured, thereby avoiding the danger of heat sinking inward leading to coma and delirium.