湿温者。先伤于湿。而后伤于暑也。其症胸满妄言。两胫逆冷。此因暑湿客于脾经。正气不行。郁而为火。
故令语言谵妄。湿热上壅。阳气不能下通于阴。故令足寒。仲景恐人认为寒症。误投发散。所以引入寒门。
其实非寒症也。夫湿温何以不可发汗。盖因湿邪在胸。已自有热。又遇暑气客之两热相侵。犹未混合。为一汗之。
则两邪混合。闭塞经络。不死何待耶。宜用柴胡清中汤。若脉来洪数。或上盛下虚者。加大黄以下之。难经云。
湿温之脉。阳濡而弱。阴小而急。濡弱见于阳部。湿气抟暑也。小急见于阴部。暑气抟湿
也。此言非不有理。但脉之变化不齐。不可执为一定耳。（此二句名言可佩）
柴胡清中汤
柴胡 黄芩 半夏 甘草 枳实 杏仁 石菖蒲 黄连 赤芍
暑湿侵脾。必有痰食留结。化痰化滞。亦不可少。
瘾疹者。遍身小颗。红白不一。有若痱子之状。或如黄豆样者。重者身发寒。脉来洪数。状类伤寒。宜用岑连败毒
散。
三四日不解。即为夹疹感寒。柴胡化滞汤。实为主剂。不过过用凉药。壅遏其毒。轻者。微寒微热。脉细微数。愈而复
发。此因湿中生热。热极生风。宜用疏风养荣汤。常服六味地黄丸。滋肾水以荣肝木。则虚风自息矣。又有身发疙瘩。
有如丹毒。痛痒不常。脓水淋沥者。宜用解热柴陈汤。
芩连败毒散
羌活 独活 柴胡 前胡 川芎 枳壳 桔梗 黄芩 连翘 甘草
疏风养荣汤
白芍 当归 生地 柴胡 防风 薄荷 麦冬 地骨皮 山栀
解热柴陈汤
柴胡 黄岑 半夏 甘草 陈皮 白茯 山栀 赤芍 苡仁 贝母
身热加荆防。（肤燥加蝉衣 云增）
Wen-heat (Warm-dampness) disease is caused by first being injured by dampness, and subsequently by summer-heat. Its symptoms include chest fullness and delirious speech, with coldness reversing up the lower legs. This is due to summer-dampness lodging in the Spleen meridian, causing the upright Qi to fail to circulate, becoming stagnant and transforming into fire. Hence, it causes delirious and confused speech. Damp-heat obstructs upward, preventing Yang Qi from descending to communicate with Yin, thus causing cold feet. Zhang Zhongjing feared that people might mistake this for a Cold syndrome and erroneously administer dispersing agents; therefore, he introduced it under the category of Cold syndromes (referring to the tendency to be misdiagnosed as cold). In reality, it is not a Cold syndrome.
Why should Wen-heat not be treated with sweating? Because the damp pathogen is in the chest, already harboring heat, and upon encountering summer-heat, two types of heat invade each other but have not yet fully merged. If one were to treat it with a single sweating method, the two pathogens would mix, blocking the meridians and collaterals. Who could expect survival? One should use Chaihu Qingzhong Tang (Bupleurum Decoction to Clear the Middle). If the pulse comes forth surging and rapid, or if there is excess above and deficiency below, add Rhubarb (Da Huang, 大黄) to purge downwards. The *Nan Jing* (Classic of Difficult Issues) states: "The pulse of Wen-heat is soggy and weak at the Yang position (Cun), and small and urgent at the Yin position (Chi)." Soggy and weak appearing at the Yang position indicates dampness combining with summer-heat; small and urgent appearing at the Yin position indicates summer-heat combining with dampness. This statement is not without merit, but pulse variations are inconsistent, so one cannot rigidly adhere to it as a fixed rule. (These two sentences are famous and commendable.)
Chaihu Qingzhong Tang (Bupleurum Decoction to Clear the Middle)
Bupleurum Root (Chaihu, 柴胡), Scutellaria Root (Huangqin, 黄芩), Pinellia Tuber (Banxia, 半夏), Licorice Root (Gancao, 甘草), Immature Bitter Orange (Zhishi, 枳实), Apricot Seed (Xingren, 杏仁), Acorus Rhizome (Shichangpu, 石菖蒲), Coptis Rhizome (Huanglian, 黄连), Red Peony Root (Chishao, 赤芍).
When summer-dampness invades the Spleen, phlegm and food stagnation inevitably remain and knot together. Resolving phlegm and moving stagnation are indispensable.
Urticaria (Yinzhen) presents as small bumps all over the body, varying in red and white colors, resembling prickly heat or soybeans. In severe cases, the body feels cold, the pulse is surging and rapid, and the condition resembles Taiyang disease (Cold damage). One should use Qinlian Baidu San (Scutellaria and Coptis Detoxifying Powder).
If unresolved after three or four days, it becomes a case of urticaria complicated by cold invasion; Chaihu Huazhi Tang (Bupleurum Decoction to Resolve Stagnation) is the principal formula. However, excessive use of cooling medicines may block and suppress the toxin. In mild cases, there is slight chills and fever, the pulse is fine, subtle, and rapid, and the condition recurs after recovery. This is because heat generates within dampness, and extreme heat generates wind. One should use Shufeng Yangying Tang (Dispel Wind and Nourish Ying Decoction). Regularly服用 Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) to nourish Kidney Water to enrich Liver Wood, so that empty wind will naturally subside. There are also cases where bumps appear on the body like erysipelas, with intermittent pain and itching, and dripping pus and water. One should use Jiere Chaichen Tang (Clear Heat and Unblock Bupleurum and Tangerine Peel Decoction).
Qinlian Baidu San (Scutellaria and Coptis Detoxifying Powder)
Notopterygium Rhizome (Qianghuo, 羌活), Angelica Pubescens Root (Duhuo, 独活), Bupleurum Root (Chaihu, 柴胡), Peucedanum Root (Qianhu, 前胡), Ligusticum Chuanxiong Rhizome (Chuanxiong, 川芎), Bitter Orange (Zhiqiao, 枳壳), Platycodon Root (Jiegeng, 桔梗), Scutellaria Root (Huangqin, 黄芩), Forsythia Fruit (Lianqiao, 连翘), Licorice Root (Gancao, 甘草).
Shufeng Yangying Tang (Dispel Wind and Nourish Ying Decoction)
White Peony Root (Baishao, 白芍), Chinese Angelica Root (Danggui, 当归), Prepared Rehmannia Root (Shengdi, 生地), Bupleurum Root (Chaihu, 柴胡), Saposhnikovia Root (Fangfeng, 防风), Mint (Bohe, 薄荷), Ophiopogon Tuber (Maidong, 麦冬), Cortex Lycii (Digupi, 地骨皮), Gardenia Fruit (Shanzhi, 山栀).
Jiere Chaichen Tang (Clear Heat and Unblock Bupleurum and Tangerine Peel Decoction)
Bupleurum Root (Chaihu, 柴胡), Scutellaria Root (Huangqin, 黄芩), Pinellia Tuber (Banxia, 半夏), Licorice Root (Gancao, 甘草), Aged Tangerine Peel (Chenpi, 陈皮), Poria (Baifu, 白茯), Gardenia Fruit (Shanzhi, 山栀), Red Peony Root (Chishao, 赤芍), Coix Seed (Yiren, 苡仁), Fritillaria Bulb (Beimu, 贝母).
For body heat, add Schizonepeta Spike (Jingjie) and Saposhnikovia Root (Fangfeng). (For dry skin, add Bombyx Batryticatus [Chanyi, 蝉衣], note by Yun Zeng).