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Cold-dampness injury presents with a white tongue coating and cold limbs, pain in the wrists, desire to vomit, and a wiry yet thin pulse. This indicates that cold-dampness is injuring the Spleen (Spleen). It is appropriate to use Lizhong Tang (Cinnamon Twig and Dried Ginger Decoction), removing Atractylodis Rhizoma (Baizhu), and adding Pinelliae Tuber (Banxia), Alpiniae Oxyphyllae Fructus (Yizhi), Evodiae Fructus (Wuyu), and Aconiti Lateralis Radix Praeparata (Fuzi), etc., to support Yang Qi and drain dampness.
(1) "Limbs": The original text reads "wrists," which is inappropriate; it is corrected to "limbs" based on the annotation's meaning.
The preceding paragraph discusses internal deficiency of Spleen Yang with external invasion of dampness; this paragraph discusses insufficiency of Spleen Yang with internal stagnation of dampness.
Therefore, there are no symptoms of aversion to cold, fever, or body ache, but only wrist pain, cold limbs, white tongue coating, and a moderate pulse. If one does not use acrid-warm herbs to strengthen the Spleen and transport fluids, how can the dampness be resolved? Thus, Lizhong Tang is used to move Middle Jiao Yang Qi. Removing Atractylodis Rhizoma (Baizhu) avoids potential stagnation; adding Pinelliae Tuber (Banxia) and Alpiniae Oxyphyllae Fructus (Yizhi) unblocks Yang Qi; Evodiae Fructus (Wuyu) drains turbidity. If the cold is severe, Aconiti Lateralis Radix Praeparata (Fuzi) is added for warming.

Damp-heat injury presents with fever, slight aversion to cold, yellow tongue coating, red urine, thirst, anorexia, fatigue, large pulse, profuse sweating, and floating Qi. This indicates that Yang-dampness is injuring the Stomach (Stomach). It is appropriate to use fresh Eupatorii Herba (Peilan), fresh Agastaches Herba (Huoxiang), fresh Dendrobii Caulis (Shihu), fresh Nelumbinis Folium (Heye), Liuyi San (Six-to-One Powder), Phragmitis Rhizoma (Lugen), and Lophatheri Herba (Zhuye), etc., to regulate dampness and clear heat.
The previous case involved Yin-dampness injuring the Spleen, appropriately treated with warming and dispersing methods. This case involves Yang-dampness injuring the Stomach, likely caused by excessive consumption of fried and roasted foods, indulgence in alcohol and sexual activity, leading to Yin deficiency and Stomach heat. During the season of summer-dampness, internal and external heat steams together. Therefore, there is no headache or body ache externally, nor vomiting, nausea, or chest fullness internally. Only fever is seen, slightly resembling aversion to cold. Until yellow tongue coating, red urine, thirst, and anorexia appear, the condition becomes fierce like a prairie fire. Coupled with fatigue, large pulse, profuse sweating, and floating Qi, these are all signs of Yin deficiency and Yang hyperactivity. Therefore, Peilan, Heye, Huoxiang, and Shihu are used in their fresh forms, taking advantage of their light aroma and mild potency to dispel heat pathogens. Fearing the heat may remain trapped, Liuyi San, Phragmitis Rhizoma (Lugen), and Lophatheri Herba (Zhuye) are added to clear and promote urination. This method neither damages healthy Qi nor fails to eliminate pathogenic factors; abandoning this approach for cloying and greasy herbs would likely exacerbate the condition.

Dampness injury presents with limb fatigue, lethargy, anorexia, greasy tongue coating, loose stools, and a weak, powerless pulse. This indicates Qi deficiency complicated by dampness. It is appropriate to use Dongyuan Qingshu Yiqi Tang (Dongyuan's Clear Summerheat and Boost Qi Decoction) to ascend clear Yang and descend turbid Yin.
Generally, individuals with chronic deficiency of Middle Qi are prone to dampness accumulation. In summer, when atmospheric Qi opens and dissipates, the body cannot sustain itself, suddenly presenting with limb fatigue, lethargy, and anorexia. The Classic states: "Injury by dampness results in heaviness of the body and inability to lift." It also states: "When the Spleen is diseased, the complexion becomes dull, and there is lethargy." Furthermore, greasy tongue coating, loose stools, and a weak, powerless pulse are all symptoms of Spleen decline and abundant dampness. Therefore, Ginseng Radix et Rhizoma (Renshen), Astragali Radix (Huangqi), Atractylodis Macrocephalae Rhizoma (Baizhu), and Glycyrrhizae Radix et Rhizoma (Gancao) tonify the Middle Jiao; Puerariae Lobatae Radix (Gegen) and Cimicifugae Rhizoma (Shengma) ascend clear Yang; Poria (Fuling) and Alismatis Rhizoma (Zexie) descend turbid Yin; Massae Fermentatae Medicinalis (Shenqu) and Hordeum Germinatum (Maiya) soothe Spleen Qi; Ophiopogonis Tuber (Maidong) clears Heart Fire; Schisandrae Fructus (Wuweizi) astringes Lung Qi. Together, they provide ascending, descending, soothing, and tonifying effects, focusing on strengthening Earth (Spleen/Stomach), while also clearing heat and preserving fluids. This demonstrates the exquisite art of formula modification by Master Dongyuan, which is hardly conceivable by common practitioners.