（附痹）
伤湿为病。发热恶寒。身重自汗。骨节疼痛。小便秘涩。大便多泄。腰脚痹冷。皆坐卧
卑湿。或冒雨露。或着湿衣所致。并除湿汤。
又前诸证。而腰痛特甚。不可转侧。如缠五六贯重。皆由湿气入肾经。肾属水。从其类
也。宜肾着汤。或渗湿汤煎服。
小便秘。大便溏者。尚书。雨淫腹疾者是也。五苓散。吞戊巳丸。戊巳属土。土能克水
因以得名。五苓乃湿家之要药。经云。治湿不利小便。非其治也。义盖取此。
伤湿而兼感风者。既有前项证。而又恶风。罔顾去衣被。或额上微汗。或身体微肿汗渍
衣湿
当风坐卧。多有此证。宜除湿汤。桂枝汤各半帖。和服。合微发汗。若大发其汗。则风去
湿在。已得汗而发热不去者。败毒散。加苍术一钱。防风半钱。
伤湿又兼感寒。有前诸证。但无汗。惨惨烦痛。宜五积散。和除湿汤各半帖微发汗已。
仍复热而渴者。除湿汤半帖。和五苓散半帖。
伤湿而兼感风寒者。汗出身重。恶风喘满。骨节烦疼。状如历节风。脐下连脚冷痹。
不能
屈伸。所谓风寒湿合成痹。宜防己黄 汤。五痹汤。详五痹。用药于风湿最宜。若因浴出。
未解裙衫。身上未干。忽尔熟睡。致及肾经。外肾肿痛。腰背挛曲。只以五苓散一帖。入真
坯少许。下青木香丸。如此三服。脏腑才过。肿消腰直。其痛自止。
(Note: Bi Syndrome)
Diseases caused by injury to dampness manifest as fever, aversion to cold, heaviness of the body, spontaneous sweating, pain in the bone joints, scanty and difficult urination, frequent diarrhea, and numbness with coldness in the waist and legs. These are all caused by sitting or lying in low-lying damp places for long periods, exposure to rain and dew, or wearing wet clothes. Chushi Tang (Dampness-Expelling Decoction) is applicable.
In cases where the aforementioned symptoms occur but lower back pain is particularly severe, making it impossible to turn or shift the side, feeling as if bound by ropes weighing five or six *guan* (a unit of weight), this is due to dampness invading the Kidney Meridian. The Kidney belongs to Water in the Five Elements, which resonates with its own kind (dampness). Shenzhuo Tang (Kidney-Abiding Decoction) is suitable, or Shen Shi Tang (Dampness-Seeping Decoction) may be decocted and taken.
For cases with scanty urination and loose stools, as described in the *Book of Documents* ("Excessive rain causes abdominal diseases"), Wuling San (Five-Ingredient Powder with Poria) is applicable, taken together with Wuji Wan (Wu-Ji Pill). Wu and Ji belong to Earth in the Five Elements; Earth controls Water, hence the name. Wuling San is a crucial medicine for treating dampness. The Classics state: "To treat dampness without promoting urination is not the correct method." The principle lies here.
When dampness injury is complicated by wind pathogen, in addition to the aforementioned symptoms, there is aversion to wind, disregard for removing clothing or bedding, slight sweating on the forehead, or slight swelling of the body with sweat soaking the clothes. Sitting or lying exposed to wind often leads to such conditions. Chushi Tang (Dampness-Expelling Decoction) and Guizhi Tang (Cinnamon Twig Decoction) should be used, half a dose of each, mixed and taken together to induce slight sweating. If profuse sweating is induced, the wind pathogen will leave but the dampness will remain. For those who have sweated but fever persists, Baidu San (Poison-Resolving Powder) is applicable, with added Cang Zhu (Atractylodis Rhizoma) 1 qian and Fang Feng (Saposhnikoviae Radix) 0.5 qian.
When dampness injury is complicated by cold pathogen, the aforementioned symptoms exist, but without sweating, accompanied by a miserable demeanor, restlessness, and painful sensation. Wuji San (Five-Accumulations Powder) is applicable, mixed with half a dose of Chushi Tang (Dampness-Expelling Decoction) to induce slight sweating. If fever and thirst persist after sweating, half a dose of Chushi Tang (Dampness-Expelling Decoction) mixed with half a dose of Wuling San (Five-Ingredient Powder with Poria) should be taken.
When dampness injury is complicated by both wind and cold pathogens, sweating occurs with body heaviness, aversion to wind, wheezing, and chest fullness, irritability and pain in the bone joints, resembling Li Jie Feng (Joint-Climbing Wind). Coldness and numbness extend from below the navel to the feet, preventing flexion and extension. This is what is referred to as Bi syndrome formed by the combination of wind, cold, and dampness. Fangji Huangqi Tang (Stephania and Astragalus Decoction) and Wubi Tang (Five-Bi Decoction) are applicable. (See details under Wubi). Medications are most suitable for wind-dampness. If, after bathing, one fails to remove wet garments, falls into a deep sleep while still damp, causing pathogenic invasion into the Kidney Meridian, resulting in swelling and pain of the external genitalia and contracture/curvature of the waist and back, simply taking one dose of Wuling San (Five-Ingredient Powder with Poria) with a small amount of Zhen Pi (true bark/shell - text specific term), followed by Qingmuxiang Wan (Green Woody Fragrance Pill), administered three times, will allow the internal organs to recover, reduce swelling, straighten the waist, and stop the pain naturally.