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*Author:* Lu Tingzhen (Zixian) of Chongming
*Revised by:* Qiu Shixin (Yunchu) of Shaoxing

Dampness is a pathogenic factor characterized by heaviness and turbidity, and its injury to the human body is the most widespread. Examining the *Nan Jing* (Classic of Difficult Issues) and the *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet), there are names for Shang Shi (Injury by Dampness), Zhong Shi (Strike by Dampness), Feng Shi (Wind-Dampness), and Shi Wen (Damp-Heat Febrile Disease). Generally, "Shang" refers to injuring the exterior; the exterior refers to the exterior of the Yangming channel, namely the muscles and limbs. "Zhong" refers to striking the interior; the interior refers to the interior of the Taiyin channel, namely the Yin of the Spleen and the Earth of Dampness (the Spleen belongs to Earth and governs the transformation of water-dampness). Therefore, when injured at the exterior, the joints and limbs must ache; when struck in the interior, the epigastrium and abdomen must feel stuffy. When dampness combats with wind, the whole body suffers from pain; when dampness combines with heat, there is vexation, heat, and steaming sensation, which are more severe in summer and autumn.

Generally, the Jiangnan region has low terrain and humid climate. Along the rivers and seas, fog, dew, wind, and tide are more severe than in other places, making it easy to become infected. Therefore, physicians do not focus on treating Shang Han (Cold Damage), but specialize in Shi Wen (Damp-Heat Febrile Disease). However, compared to Shang Han, it is even more trivial and complicated, and harder to treat. It is said that one who can cure diseases in the great Jiangnan region has mastered more than half of medicine. Moreover, these symptoms occur not only in summer and autumn but throughout all four seasons. When dampness is abundant, there may be slight fever, aversion to cold, body pain, white tongue coating, chest stuffiness, and dark urine as reliable signs. If dampness is slight, there is still no external pain or internal vexation, only feeling fatigue and drowsiness, with a slow and weak pulse and syndrome, exactly like Xu Sun (Deficiency Consumption).

In this condition, if mistakenly treated with tonification, dampness will quickly transform into heat and the disease will worsen; if mistakenly treated with resolution/digestion, dampness will remain while healthy qi is damaged, making it even more unbearable. One must distinguish between Yang Dampness and Yin Dampness. In Yang Dampness, stomach heat is often abundant, constituting Shi Re (Damp-Heat); in Yin Dampness, Spleen Yang must be deficient, constituting Shi Han (Damp-Cold). Furthermore, one must examine whether it is an internal or external injury. In internal injury, the Spleen Earth must be deficient; as stated in the *Nei Jing* (Inner Canon), "low and narrow earth" (referring to deficient Spleen Earth) easily accumulates dampness, leading to fullness in the chest and abdomen and stagnation of Qi mechanism. In external injury, Yang Qi must be deficient; as Liu Hejian (Liu Wansu) stated, a "deficient exterior constitution" easily attracts dampness, leading to heaviness in the limbs and pain in the joints. For internal injury, regulating the Spleen is primary; for external injury, promoting Qi movement is prioritized. For Yang Dampness, the main treatment is Bitter-Pungent (Ku Xin); for Yin Dampness, the main treatment is Bitter-Warm (Ku Wen). Both should be assisted by Dan Shen (Light Percolation/Draining Dampness). If one can clarify Yin and Yang, distinguish internal and external, and adapt flexibly during clinical practice with divine understanding, then one truly deserves to be called the master of life among physicians.