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There is dampness from the Heaven (upper body/environment), such as rain, dew, fog, and mist. Dampness originating from Heaven is based on Qi; therefore, it first affects the Ying and Wei (Nutritive and Defensive Qi) at the exterior. There is dampness from the Earth (lower body/environment), such as mud and water. Dampness originating from Earth is based on Form; therefore, it first damages the muscles, sinews, bones, and blood vessels. There is dampness from diet, such as alcohol, milk, and cheese. The Stomach is the Sea of Water and Grain; thus, it injures the Spleen and Stomach. There is dampness from sweat, referring to sweat-soaked clothes that are not changed promptly. There is dampness transformed by the Taiyin Spleen Earth, which does not enter from the exterior. When Yang is excessive, Fire prevails, transforming into Damp-Heat; when Yin is excessive, Water prevails, transforming into Cold-Damp. The manifestations include fever with aversion to cold, heaviness of the body, spontaneous sweating, pain in the sinews and bones, scanty and difficult urination, loose stools, lower back pain preventing turning or side-bending, edema of the dorsum of the foot where depression remains after pressure.

The Classic states: "Due to dampness, the head feels wrapped." Dampness steams upward, causing heaviness of the head. It also states: "Dampness injures the sinews," causing the large sinews to shorten and the small sinews to relax and lengthen. Shortening leads to spasms/contracture; relaxation and lengthening lead to flaccidity. It also states: "Excess dampness causes loose diarrhea," hence loose stools. Loose stools cause urinary obstruction. It also states: "Dampness enters from below," hence edema of the feet. It also states: "All dampness-related swelling and fullness belong to Spleen Earth," hence abdominal distension and flesh soft like mud. When dampness enters the Kidney, and since the Kidney governs Water, water flows toward dampness, following its kind, hence pain in the lower back and Kidneys.

Treatment principles: For conditions located above, slight diaphoresis (sweating) should be induced using Qianghuo Shengshi Tang (Notopterygium Decoction for Overcoming Dampness). For conditions located below, promoting urination should be used using Wuling San (Five-Ingredient Poria Pill). The Spleen is the most Yin organ among the Five Zang organs; its nature dislikes dampness. Now, dampness resides internally within the Spleen, so it cannot rot and cook food and drink, leading to a failure to separate the clear from the turbid. Water enters the intestines, and deficiency fails to control it, resulting in loose diarrhea. The method should be to eliminate dampness and promote urination.

Li Dongyuan said: "In treating dampness, if one does not promote urination, it is not the correct treatment." He also said: "For those located below, guide and exhaust them." The words of the Sages, though recorded in texts, have未尽 meanings that can be sought through intuitive understanding. When dampness overflows and moves from the exterior to the interior, if one uses bland and leaching agents to remove it, this is lowering again and lowering, further benefiting Yin and doubly exhausting Yang, causing Yang to be further depleted and Spirit to become short. This means Yin is excessively strong while Yang is excessively weak, which inadvertently assists the pathogen. Therefore, using ascending wind herbs will cure the disease. Prescription: Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Chaihu (Bupleuri Radix), Shengma (Cimicifugae Rhizoma) each 1 qian, Fangfeng Gen (Saposhnikoviae Radix) half qian, Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma) half qian. Decoct in water and take hot. The general principle states: "When dampness overflows, assist with wind to calm it." It also says: "Lift those that sink," allowing Yang Qi to ascend and recover. It also says: "Remove the guest," which is straightening what is curved due to pathology. The methods of the Sages can be analogized; knowing one allows knowing hundreds.

There is a condition called Hong Kong Foot (Jiaoxi / Beriberi), resembling Shanghan (Cold Damage), with fever and aversion to cold, necessarily accompanied by swelling and pain in the calves. All are treated from the perspective of dampness. The *Qianjin Fang* distinguishes between Yin and Yang types. Yin-type Hong Kong Foot presents with swelling in the calves but no redness; Yang-type Hong Kong Foot presents with swelling and redness.

For yellowing caused by Damp-Heat, treatment should focus on "Stagnation" (Yu). Any Damp-Heat pathogen, if not stagnant, will not cause yellowing. Yinchen Wuling San (Artemisiae Scopariae and Five-Ingredient Poria Decoction) is strictly prohibited. Those who use Yinchen and Wuling San rarely survive (one in ten lives). Instead, Xiaoyao San (Free and Easy Wanderer Powder) should be used. See the chapter on "Yu" for the formula.

Generally, Shanghan involves aversion to cold; Shangfeng (Wind Injury) involves aversion to wind; Shangshi (Dampness Injury) involves aversion to rain. If dampness injury is combined with aversion to cold, absence of sweat, and joint pain, Zhang Zhongjing provides Gancao Fuzi Tang (Licorice and Aconite Decoction).

Gancao Fuzi Tang:
Zhi Gancao (Prepared Licorice Root) 1 qian, Fuzi (Processed Aconite Lateral Root) 1.5 qian, Baizhu (Atractylodis Macrocephalae Rhizoma) 2 qian, Guizhi (Cinnamon Twig) 4 qian. Decoct in water, take in one dose.

Jinkui Fangji Tang: Treats excess dampness with heavy body and mild Yang. Wind-stroke causes sweating and aversion to wind, so Huangqi (Astragali Radix) and Zhi Gancao are used to solidify the exterior, while Fangji (Stephaniae Tetrandrae Radix) and Baizhu overcome dampness.
Fangji 3 qian, Zhi Gancao (Prepared Licorice Root) 1.5 qian, Baizhu 2 qian, Huangqi 3.5 qian. Add Shengjiang (Fresh Ginger) and Dazao (Jujube). Decoct in water, take in one dose.

Qianghuo Shengshi Tang: Universally treats dampness conditions.
Qianghuo, Duhuo, Gaoben (Ligustici Rhizoma et Radix), Fangfeng, Gancao, Chuanxiong (each 1 qian), Manjingzi (Viticis Semen) 0.3 qian.
If there is body heaviness, lower back pain feeling heavy, indicating cold in the meridians, add Jiu Fangji (Wine-processed Stephaniae Tetrandrae Radix) 0.5 qian and Fuzi 0.5 qian.

A friend serving as an official in the capital fell ill with leg pain and fever, unable to walk. Others believed it was a leg abscess (Tong) and invited me to examine him. He was supported out to see me. I said, "It is not an abscess." I prescribed Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with added Qianghuo and Fangfeng, 1 qian each. After one dose, the illness disappeared. The next day, he came to thank me riding a horse.

One day, I suffered from swelling of one testicle (Yinwan) the size of a duck egg, with fever. Treating it as a Damp-Heat pattern was ineffective. Upon careful reflection, a few days prior I returned from Dinghai by boat; there was a wet cloth and sail under my seat. I only realized this upon disembarking. Inferring from this, I concluded that Cold-Damp had invaded the Kidney Testicles. I then used Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) with added Chaihu, Wuzhuyu (Evodiae Fructus), Rougui (Cinnamon Bark) each 1 qian, and Duhuo 0.5 qian. After one dose, the fever subsided; after two doses, the swelling disappeared. Later, patients with unilateral hernia/scrotal swelling found this formula highly effective.