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There are individuals with accumulated dampness (Shi), which may be due to Spleen deficiency (Pi Xu) failing to transform and transport fluids, or because of a preference for rich, fatty foods, and the indulgence in tea and alcohol. Dampness accumulating generates heat; when there is no aversion to cold or fever, it is called Damp-Heat Disease (Shi Re Bing). If there is initial aversion to cold followed by fever, and sweating does not resolve the heat, it is called Damp-Warmth Syndrome (Shi Wen Zheng). Although categorized within the Shanghan (Cold Damage) school, one must not use Guizhi Tang (Cinnamon Twig Decoction) or Mahuang Tang (Ephedra Decoction), which treat Taiyang channel syndromes, for this condition—a fact known to all.

The pulse must be soggy (Ru), large, and rapid (Shu). The tongue coating must transition from white and greasy to yellow and greasy, or appear damp-grey. Although the mouth feels dry, the patient cannot drink much; or they hold water in the mouth without swallowing. This is because dampness is abundant in the middle jiao, preventing drinking, while heat surpasses dampness, causing the sensation of dryness. Dampness is the root of the disease, and heat is transformed from dampness. Therefore, treating Damp-Warmth requires aromatic herbs to dry dampness, bitter-cold herbs to drain heat, and bland-draining herbs to promote urination. This is an immutable principle, beyond doubt.

However, contemporary practitioners treat Damp-Warmth oppositely. Their formulas invariably use Dou Chi (Fermented Soybean) and Sheng Di Huang (Rehmannia Root), named Hei Gao Tang. They intend for Dou Chi to induce sweating and Sheng Di Huang to clear heat. Yet, they do not realize that current Dou Chi is processed with Ma Huang (Ephedra) rather than Sang Ye (Mulberry Leaf), thereby using heat to assist heat. Sheng Di Huang is sticky and cloying, obstructing phlegm-fluids, thereby using dampness to assist dampness. Unchecked assistance leads to more abundant dampness and fiercer heat. The patient frequently feels thirsty (due to fierce heat), the tongue coating becomes filthy and greasy, turning grey-black (due to extreme dampness; black corresponds to Water element), consciousness becomes clouded, and muttering occurs (all manifestations of fierce heat and abundant dampness).

The physician, unaware of the medication error, seeing coma and muttering, assumes rashes will erupt, and heavily prescribes Dou Chi and Dou Juan (also processed with Ma Huang) to induce sweating, disregarding the effort to assist heat. Seeing grey tongue and thirst, fearing fluid depletion, they heavily prescribe Sha Shen (Glehnia Root) and Shi Hu (Dendrobium Stem) to moisten, disregarding the effort to assist dampness. At this stage, coma deepens, tongue color turns grayer, phlegm-fluid surges upward, and life hangs in the balance, with no hope of survival. The physician is at a loss, unable to name the condition, calling it Lung Obstruction (Fei Bi), and uses Zi Xue Dan (Purple Snow Pill), Zhi Bao Dan (Precious Treasure Pill), Niu Huang Wan (Calculus Bovis Pill), Lian Zhu Fen (Pearl Powder), and Wu Xi Jiao (Black Rhinoceros Horn). One dose after another causes the damp-heat pathogen to enter the Pericardium (Xin Bao), leading to Jue (collapse) from which the patient never regains consciousness.

How could they know that dampness is Yin pathogen and turbid pathogen, whereas summerheat is Yang pathogen and clear pathogen? Clear-Yang pathogens have Qi but no substance, and can be expelled via opening and draining methods like Zi Xue Dan. Yin-Turbid pathogens have both Qi and substance; they must not be treated with opening and draining. Once opened and drained, the pathogen sinks into the Pericardium, and death follows instantly! Alas! In Damp-Warmth syndrome, the first error was using Dou Chi and Sheng Di Huang to assist heat and dampness; the second error was using Dou Juan and Shi Hu to assist heat and dampness; the final error was using Zi Xue and Zhi Bao to draw the pathogen into the heart, placing the patient in a fatal position. Who would know that Damp-Warmth is inherently not a fatal syndrome?

Damp-Warmth is not fatal, yet patients often die. Is this not due to medication errors? The disease is named "Damp"; thus, one should not use damp-assisting herbs to treat it. Even the most mediocre and foolish person would know this. The disease is named "Warm"; thus, one should not use warm-assisting herbs to treat it. Even the most mediocre and foolish person would know this. Yet, the patient does not know, the physician does not know, and even renowned physicians do not know. Is this not astonishing?

Moreover, dampness is a Yin pathogen. When Yin is excessive, Yang must decline. There is no case where declining Yang can be treated with Yin-nourishing methods. The more one nourishes Yin, the more abundant the dampness becomes. Treating dampness with Yin-nourishing herbs is like pouring brine onto the ground and hoping it dries. I am extremely foolish! So, how should Damp-Warmth be treated? Answer: Initially, before fire transformation, use Hou Po (Magnolia Bark), Bai Zhu (Atractylodes Macrocephala), Chen Pi (Tangerine Peel), and Ban Xia (Pinellia Tuber) to aromatically dry dampness. Subsequently, after fire transformation, use Lian Qiao (Forsythia Fruit), Huang Qin (Scutellaria Root), Zhi Zi (Gardenia Fruit), and Lian Qiao (Forsythia Fruit - *Note: Text says 'Qiao', usually refers to Lian Qiao or similar clearing herbs*) to bitterly drain heat. Finally, when dampness descends, use Fu Ling (Poria), Tong Cao (Tetrapanax Pith), Ze Xie (Alisma Rhizome), and Che Qian Zi (Plantago Seed) to blandly drain dampness. Throughout, one must not induce sweating. Patients with dampness naturally sweat; one must not induce further sweating. Throughout, one must not nourish Yin. Nourishing Yin is using water to meet water, which is useless and harmful.

Unfortunately, heretical theories penetrate deeply into people's bones. Foolish people lack autonomy and obey quack physicians, remaining oblivious to loyal advice. I am helpless!

Once, passing the gate of a wealthy man, I saw discarded medicinal dregs containing Jin Hu (Golden Dendrobium), which I ignored. Then I saw Huo Hu (Huo Dendrobium), then fresh Hu, and finally Tie Pi Feng Hu (Iron Skin Wind Dendrobium). I sighed, saying, "In this damp season, diseases are mostly Damp-Warmth. Continuing these prescriptions, the illness will surely become critical." Shortly after, the wealthy man indeed died. It seems Ginseng and Shi Hu were administered consecutively, fearing fluid depletion. However, those who heard of this did not consider it an error, as if preferring death by Yin-nourishing over living by drying dampness. Alas! The theory of Yin-nourishing strikes the human heart; even unto death, there is no repentance. How can I wield ten thousand long tongues, ascend the pulpit of Master Sheng, and make the stubborn stones nod together?