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Yang Ruhou stated: Body heat with sweating, yellow and slippery tongue coating, irritability, thirst, and dark urine, with a surging (Hong) and rapid (Shu) pulse, indicates Damp-Heat. Headache, aversion to cold, heaviness and pain in the body, sweating, chest fullness, lack of appetite, yellow or white tongue coating, thirst without desire to drink, a string-taut (Xian), fine (Xi), and soggy (Ru) pulse, pale yellow complexion, afternoon fever resembling Yin deficiency, and a condition that is difficult to resolve quickly, indicate Wet-Warmth Disease (Shi Wen). Generalized stiffness and pain, inability to turn over, severe pain upon touch, sweating only on the head, a slow (Huan) pulse approaching sluggishness (Chi), and clear white urine indicate Cold-Dampness. Generally, at the end of summer and beginning of autumn, Damp Earth governs the Qi, residual Summer-Heat remains fierce, and new Coolness is added. At this time, the three pathogens of Summer-Heat, Dampness, and Cold are most mixed. Some contract Damp-Heat, some contract Wet-Warmth, and some contract Cold-Dampness. Cold-Dampness can be resolved with warming methods; Damp-Heat can be cleared and unblocked. Only Wet-Warmth, being neither cold nor hot, is the most difficult to treat. Its nature is sticky and tenacious, hence the disease is hard to resolve quickly. Physicians of the world do not recognize it as Wet-Warmth. Seeing headache, aversion to cold, body heaviness, and pain, they mistake it for Cold Damage (Shang Han) and apply diaphoresis (sweating method). Consequently, the Dampness responds to acrid-warm exterior-releasing herbs, steaming and rising upward, clouding the orifices inside and outside, leading to coma, deafness, closed eyes, and reluctance to speak. Seeing chest fullness and lack of appetite, they mistake it for food stagnation and apply purgation. Consequently, Spleen Yang sinks, and Damp Pathogen collapses inward, leading to incessant diarrhea. Seeing afternoon fever, they mistake it for Yin deficiency and apply soft/moistening Yin-nourishing drugs. Since Dampness is a sticky, obstructive Yin pathogen, adding soft/moistening Yin drugs creates an impeded and unresolved state. Generally, compared to other Warm Diseases, Wet-Warmth has a slower course but is actually more severe. Lesions in the Upper Jiao are fewest, with mild manifestation; lesions in the Middle Jiao are the most numerous.

Zhu Danxi said: Among the Six Qi, diseases caused by Damp-Heat account for eight or nine out of ten cases.

Zhu Nanyang said: Wet-Warmth is similar to Summer-Heat Stroke, differing in that the body is cool and there is no thirst.

Cai Zongyu said: Cold body with spontaneous sweating and heavy limbs constitutes Wet-Warmth.

He further stated: In Yin syndromes, if the calves are cold, the arms are also cold. In Wet-Warmth, if the calves are cold, the arms are not cold. This is not "Jue from below ascending" or Yang-deficiency Cold Jue.

Lei Shaoyi said: Discussions on Wet-Warmth are diverse, leaving later learners with few established rules to follow. Some say Warm Disease re-infected by Dampness is named Wet-Warmth; based on this, the disease occurs in Spring. Some say chronic injury by Dampness followed by Summer-Heat stroke, where Summer-Heat and Dampness contend, is named Wet-Warmth; based on this, the disease occurs in Summer. Some say early Changxia (late summer) to early autumn, where Heat generates within Dampness, i.e., the Damp-predominant form of Summer-Heat disease, is named Wet-Warmth; based on this, the disease occurs at the end of summer and beginning of autumn. Carefully evaluating these three theories, the theory that Wet-Warmth occurs at the end of summer and beginning of autumn aligns well with the *Neijing*’s teaching of "Autumn injury by Dampness" and corresponds with the seasonal Qi, specifically the period from Great Heat to White Dew when Damp Earth governs. Therefore, one should adopt the end of summer and beginning of autumn as the boundary. The previous statement that Warm Disease re-infected by Dampness implies that since Warm Disease is in Spring, it should be called "Warm Disease with Dampness"; the statement about chronic Damp injury followed by Summer-Heat implies that since Summer-Heat disease is in Summer, it should be called "Summer-Heat with Dampness." Neither should be named Wet-Warmth. Investigating the etiology, the cause lies in Damp Pathogen occupying the Qi Level, fermenting into Warmth, yet not yet transforming into Heat. It differs from Cold-Dampness, which can be cured with acrid-dispersing methods, and Damp-Heat, which is resolved with clearing and draining methods. The pulse of this disease has no fixed form; it may be surging, slow, hidden, or fine. Thus, it is difficult to diagnose solely based on a fixed pulse pattern. Symptoms begin with aversion to cold, progressing to fever without aversion to cold, sweating, chest stuffiness, white or yellow tongue coating, and thirst without desire to drink. One should use Clearing, Diffusing, and Warming Transformation Method, removing Lian Qiao (Forsythia Fruit) and adding Hou Po (Magnolia Bark) and Dou Juan (Fermented Soybean). If there is headache, no sweating, aversion to cold, and body heaviness, indicating pathogen in the Exterior, one should use Diffusing and Dispersing Exterior-Damp Method, adding Ge Gen (Kudzu Root), Qiang Huo (Notopterygium Rhizome), and Shen Qu (Medicated Leaven). If there is thirst and spontaneous diarrhea, indicating Damp flowing to the Lower Jiao, remove Ban Xia (Pinellia Tuber) from the base formula and add Sheng Yi Ren (Coix Seed) and Ze Xie (Alisma Rhizome). If there is cold calves and abdominal fullness, indicating Damp Pathogen suppressing and obstructing Yang Qi, use Diffusing Yang and Revealing Hidden Method, removing Cao Guo (Tsaoko Cardamom) and Shu Qi (Periploca Root Bark), and adding Chen Pi (Citrus Peel) and Fu Pi (Mandarin Orange Peel). If there are alternating chills and fever resembling Malaria, with a white and slippery tongue coating, indicating pathogen restraining the Mo Yuan (Membrane Source), use Diffusing and Revealing Mo Yuan Method. If treatment is delayed, leading to coma and delirious speech, or laughing or spasms, indicating pathogen forcing into the Pericardium and disturbing the Ying (Nutritive) Level, use Removing Heat and Opening Orifices Method, adding Ling Yang Jiao (Antelope Horn), Gou Teng (Uncaria Ramulus), Xuan Shen (Scrophularia Root), and Sheng Di Huang (Rehmannia Root). If there is grasping at empty air and tracing lines, with yellow prickly tongue coating turning black, and constipation, this indicates Damp-Heat transforming into Dryness, closing and binding the Stomach Fu Organ. Use Moistening Purging and Saving Fluids Method, replacing Shu Jun (Prepared Rhubarb) with Sheng Jun (Raw Rhubarb), and adding Zhi Ke (Aurantium Fruit), so that the purgative action is effective. If the tongue coating does not become prickly or scorched-yellow, this method must not be used indiscriminately. Wet-Warmth disease has the most variable manifestations, which are hard to exhaustively describe; one must apply flexible methods during clinical practice.