脉 沉细微缓。或涩或濡。皆为湿脉。浮濡为风湿。沉涩为寒湿。滑疾。身热。烦喘。胸满
。口燥。发黄。为湿热自甚。洪而动。湿热为痛。
症 内经云∶地之湿气。感则害人皮肉筋脉。又云∶诸湿肿满。皆属于脾土。按戴氏云∶东
南地下。多阴雨。地湿。凡受多从外入。多从下起。腿肿香港脚者多。治当汗散。久者宜疏利
。渗泄。西北地高。多食生冷。湿面乳酪鱼肉辛香炙爆之物。或饮酒后。寒气拂郁。湿热之
邪。不能发越。故作肿胀。甚则水气胀满。通身浮肿如泥。按之不起。此则自内出也。辩其
多少。通利二便而渗泄之。贾氏云湿为土气。火热能生湿土。故夏热而万物湿润。秋凉则万
物干燥。湿本不自生。因热拂郁而不能宣行。故停滞而生湿也。况脾脆弱之人。易于感冒。
岂必水不流而后为湿哉。人只知风寒之威严。不知暑湿之炎暄。感人于冥冥之中也。治湿之
法。宜理脾清热。利小便为上。故曰治湿不利小便。非知治也。
治 丹溪云∶六气之中。湿热为病。十居八九。湿有自外入者。谓阴雨地湿。皆自外入。宜
微汗散。经曰∶湿上甚而热。治以苦温。佐以甘辛。以防风、羌活、白术、苍术、茯苓、甘
草、微汗为动而已。不欲汗多。故不用麻黄桂枝等剂。湿在中下。宜淡渗利小便也。在下宜
升提。贾氏谓治湿用葶苈木香散。煎下神芎丸。下水湿。消肿胀利小便。理脾胃。无出乎此
。亦妙法也。
方 加味五苓散治诸湿身重。小便不利。
白术（二钱） 白茯苓（一钱五分） 猪苓（一钱） 肉桂（五分） 泽泻 苍术（各二钱） 羌活（
一钱五分）
上作一服。姜一片。枣一枚。煎服。
如湿在上。肩背疼。头重项强者。加防风、白芷（各一钱）、升麻（五分）、微汗之。
湿在中。腹胀脐突。小便不利。加木通、姜皮（各一钱五分）、湿在下。腰膝痛。足重不能移
。加薏芯仁（二钱）、木瓜、汉防己、黄柏（各一钱）。
湿热郁成黄胆。两服及遍身如金色者。加茵陈、石膏（各二钱）。
寒湿在下。腰重足痛。加酒防己、附子（各一钱）。
湿症汗多者。加黄 （一钱）、桂枝、当归（各七分）、麻黄根（一钱五分）、风寒湿三气合而为
痹。手足缓弱。肌体不仁。加防风防己当归、牛蒡子、威灵仙（各等分）。
诸痿因肺热所致。加人参、黄 、生地黄、麦门冬、防己、黄柏（各一钱）、五味子（十五
粒）、薏芯仁（一钱五分）。
风湿相抟。一身尽痛。手足痿痹。加防风、白芷（各一钱）、当归（一钱五分）、乌药、五加皮
（各一钱二分）、木香（五分）。
臂痛。加当归（一钱五分）、白芍药、防风、川芎、白芷（各一钱）、升麻（五分），去猪苓、泽
泻、桂。
香港脚。防己、当归、木瓜（各一钱五分）、黄柏、防风、白芷（各一钱）、槟榔、苏叶（各七
分），去猪苓、泽泻、忌补剂。并洗。
诸湿浮肿。并水气上多者。加防风、白芷（各一钱五分）、麻黄（一钱）、以汗之。下多者。加
茯苓皮、生姜皮、大腹皮、五加皮（各一钱）、木通（一钱五分）、以利之。
暑湿熏蒸。令人燥闷。自汗烦渴。加香薷（二钱）、黄连、扁豆、浓朴（各一钱），去羌活、名
薷苓汤。
麻木属气虚湿痰及死血。加人参、黄 、当归（各一钱二分）、白芍药、防风、白芷（各八
分）、柴胡、升麻（各五分）、黄柏、半夏（各一钱）。
四肢百节走痛。名痛风。在上。加川芎、白芷、酒芩、桔梗（各八分）、当归（一钱）、威灵
仙（一钱）、桂枝（七分），去猪苓、泽泻、在下。加当归（一钱五分）、牛膝、陈皮、桃仁、
木通、黄柏、防己（各一钱），去羌活，加川独活（七分）。
两手挛急。加半夏、当归、防风、天麻、白芷（各一钱），去猪苓、泽泻桂。
两脚挛急。加当归、杜仲、黄柏、木瓜、牛膝、薏苡仁（各一钱五分），去羌活。
走注疼痛。加当归、川芎、威灵仙（各一钱）、木香、枳壳（各七分）。
脚跟痛。加当归、白芍药、薏苡仁（各一钱五分）、知母、黄柏、牛膝（各一钱），去羌活，加独
活。
(Shangshi [Injury by Dampness], Swelling, Jaundice, Various Pains, Asthma and Cough)
Pulse: Deep (Chen), Fine (Xi), Minute (Wei), Slow (Huan), or Choppy (Se) and Soggy (Ru) are all pulses indicating Dampness. Floating and Soggy indicate Wind-Damp; Deep and Choppy indicate Cold-Damp. Slippery and Rapid, accompanied by fever, restlessness, asthma, chest fullness, dry mouth, and yellowing of the skin, indicate severe Heat-Damp. Surging (Hong) and pulsating indicate pain caused by Heat-Damp.
Symptoms: The *Neijing* states: "The dampness of the earth, when it affects humans, harms the skin, flesh, sinews, and vessels." It also states: "All swelling and fullness due to Dampness belong to the Spleen Earth." According to Dai Shi: In the southeast, where the land is low and there is much rain and dampness, Dampness usually enters from the exterior and rises from below, leading to many cases of leg swelling and Hongjiaojiao (Gouty Arthritis). Treatment should employ sweating to disperse; for chronic cases, draining and leaching methods are appropriate. In the northwest, where the land is high, people often consume raw/cold foods, wet noodles, dairy, fish/meat, and spicy, aromatic, roasted, or fried items. After drinking alcohol, cold qi may become stagnant, preventing Heat-Damp from venting, thus causing swelling. Severe cases involve water qi accumulation, with whole-body edema resembling mud that does not rise upon pressure. This originates from within. One must distinguish the degree and treat by promoting urination and defecation to drain Dampness. Jia Shi stated that Dampness is the qi of Earth; Fire/Heat generates Wet Earth, hence summer heat brings moisture to all things, while autumn coolness brings dryness. Dampness does not generate itself but arises from stagnation due to Heat obstructing free flow. Moreover, those with weak Spleens easily contract pathogens; one need not wait for water stagnation to define Dampness. People only recognize the severity of Wind-Cold, unaware of how silently Summerheat-Damp affects them. The method for treating Dampness involves regulating the Spleen and clearing Heat, with promoting urination as the superior approach. Thus, it is said: "Treating Dampness without promoting urination shows ignorance of treatment principles."
Treatment Methods: Danxi stated: Among the Six Qi, diseases caused by Heat-Damp account for eight or nine out of ten. Dampness can enter from the exterior, such as from rainy weather or ground dampness, requiring mild sweating to disperse. The Classics state: "For Dampness affecting the upper body with Heat, treat with Bitter-Warm herbs, assisted by Sweet-Acrid ones." Use Fangfeng (Saposhnikoviae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Cangzhu (Atractylodis Rhizoma), Fuling (Poria), and Gancao (Glycyrrhizae Radix et Rhizoma) to induce mild sweating. Sweating should not be excessive, so Mahuang (Ephedrae Herba) and Guizhi (Cinnamomi Ramulus) formulas are avoided. For Dampness in the Middle and Lower Jiao, bland diuretics are used to promote urination. For lower Jiao involvement, lifting methods are appropriate. Jia Shi suggested using Tingli Muxiang San (Descurainiae Semen et Lepidii Semen et Aucklandiae Decoction) taken with Shenxiong Wan (Diviner's Xiongan Pill) to drain water-damp, reduce swelling, promote urination, and regulate the Spleen and Stomach—a brilliant method.
Formulas: Jiawei Wuling San (Modified Five-Ingredient Powder with Poria) treats various Dampness conditions causing heaviness and difficult urination.
Baizhu (Atractylodis Macrocephalae Rhizoma) (2 qian), Baifuling (Poria cum Mycelium) (1.5 qian), Zhuling (Polyporus), Rougui (Cinnamomi Cortex) (0.5 qian), Zexie (Alismatis Rhizoma), Cangzhu (Atractylodis Rhizoma) (each 2 qian), Qianghuo (Notopterygii Rhizoma et Radix) (1.5 qian).
Take as one dose. Add one slice of Shengjiang (Zingiberis Rhizoma Recens) and one date. Decoct and take orally.
If Dampness is in the Upper Jiao, causing shoulder/back pain, heavy head, and stiff neck, add Fangfeng (Saposhnikoviae Radix) and Baizhi (Angelicae Dahuricae Radix) (each 1 qian), Shengma (Cimicifugae Rhizoma) (0.5 qian) to induce mild sweating.
If Dampness is in the Middle Jiao, causing abdominal distension, protruding umbilicus, and difficult urination, add Mutong (Akebiae Caulis) and Jiangpi (Zingiberis Pericarpium) (each 1.5 qian).
If Dampness is in the Lower Jiao, causing waist/knee pain and heavy legs unable to move, add Yiyiren (Coicis Semen) (2 qian), Mugua (Chaenomelis Fructus), Hanfangji (Stephaniae Tetrandrae Rhizoma), and Huangbo (Phellodendri Cortex) (each 1 qian).
If Heat-Damp stagnates into Jaundice, turning the body golden after two doses, add Yinchen (Artemisiae Scopariae Herba) and Shigao (Gypsum Fibrosum) (each 2 qian).
If Cold-Damp is in the Lower Jiao, causing heavy waist and painful feet, add Jiu Fangji (Stephaniae Tetrandrae Rhizoma prepared with wine) and Fuzi (Aconiti Lateralis Radix Praeparata) (each 1 qian).
If Dampness symptoms present with excessive sweating, add Huangqi (Astragali Radix) (1 qian), Guizhi (Cinnamomi Ramulus), Danggui (Angelicae Sinensis Radix) (each 0.7 qian), and Mahuanggen (Ephedrae Radix et Rhizoma) (1.5 qian).
If Wind, Cold, and Damp combine to form Bi Syndrome, causing weak limbs and insensible skin, add Fangfeng (Saposhnikoviae Radix), Fangji (Stephaniae Tetrandrae Rhizoma), Danggui (Angelicae Sinensis Radix), Niubangzi (Arctii Fructus), and Weilingxian (Clematidis Radix et Rhizoma) (equal parts).
For Wei Syndrome caused by Lung Heat, add Renshen (Ginseng Radix), Huangqi (Astragali Radix), Shengdihuang (Rehmanniae Radix), Maidong (Ophiopogonis Radix), Fangji (Stephaniae Tetrandrae Rhizoma), Huangbo (Phellodendri Cortex) (each 1 qian), Wuweizi (Schisandrae Chinensis Fructus) (15 grains), and Yiyiren (Coicis Semen) (1.5 qian).
If Wind and Damp contend, causing whole-body pain and flaccid paralysis of limbs, add Fangfeng (Saposhnikoviae Radix), Baizhi (Angelicae Dahuricae Radix) (each 1 qian), Danggui (Angelicae Sinensis Radix) (1.5 qian), Wuyao (Linderae Radix), and Wujiaopi (Acanthopanacis Cortex) (each 1.2 qian), Muxiang (Aucklandiae Radix) (0.5 qian).
For arm pain, add Danggui (Angelicae Sinensis Radix) (1.5 qian), Baishao (Paeoniae Radix Alba), Fangfeng (Saposhnikoviae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baizhi (Angelicae Dahuricae Radix) (each 1 qian), Shengma (Cimicifugae Rhizoma) (0.5 qian). Remove Zhuling (Polyporus), Zexie (Alismatis Rhizoma), and Gui (Cinnamomi Ramulus/Cortex).
For Hongjiaojiao (Gouty Arthritis), use Fangji (Stephaniae Tetrandrae Rhizoma), Danggui (Angelicae Sinensis Radix), Mugua (Chaenomelis Fructus) (each 1.5 qian), Huangbo (Phellodendri Cortex), Fangfeng (Saposhnikoviae Radix), Baizhi (Angelicae Dahuricae Radix) (each 1 qian), Binglang (Arecae Semen), and Ziye (Perillae Folium) (each 0.7 qian). Remove Zhuling (Polyporus), Zexie (Alismatis Rhizoma). Avoid tonics. Combine with external washing.
For general Dampness edema with significant upward rushing of water qi, add Fangfeng (Saposhnikoviae Radix), Baizhi (Angelicae Dahuricae Radix) (each 1.5 qian), Mahuang (Ephedrae Herba) (1 qian) to induce sweating. If downward accumulation predominates, add Fulingpi (Poria Peridium), Jiangpi (Zingiberis Pericarpium), Dafupi (Arecae Pericarpium), Wujiaopi (Acanthopanacis Cortex) (each 1 qian), Mutong (Akebiae Caulis) (1.5 qian) to promote urination.
For Summerheat-Damp steaming causing irritability, spontaneous sweating, restlessness, and thirst, add Xiangru (Moslae Herba) (2 qian), Huanglian (Coptidis Rhizoma), Bidou (Dolichoris Semen), Houpo (Magnoliae Officinalis Cortex) (each 1 qian). Remove Qianghuo (Notopterygii Rhizoma et Radix). Name this formula Ru Ling Tang (Xiangru and Poria Decoction).
For numbness attributed to Qi deficiency, Damp-Phlegm, and static blood, add Renshen (Ginseng Radix), Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix) (each 1.2 qian), Baishao (Paeoniae Radix Alba), Fangfeng (Saposhnikoviae Radix), Baizhi (Angelicae Dahuricae Radix) (each 0.8 qian), Chaihu (Bupleuri Radix), Shengma (Cimicifugae Rhizoma) (each 0.5 qian), Huangbo (Phellodendri Cortex), Banxia (Pinelliae Rhizoma) (each 1 qian).
For wandering pain in all joints, known as Tongfeng (Gout), if located above, add Chuanxiong (Ligustici Chuanxiong Rhizoma), Baizhi (Angelicae Dahuricae Radix), Jiu Huangqin (Scutellariae Radix prepared with wine), Jiegeng (Platycodonis Radix) (each 0.8 qian), Danggui (Angelicae Sinensis Radix) (1 qian), Weilingxian (Clematidis Radix et Rhizoma) (1 qian), Guizhi (Cinnamomi Ramulus) (0.7 qian). Remove Zhuling (Polyporus), Zexie (Alismatis Rhizoma). If located below, add Danggui (Angelicae Sinensis Radix) (1.5 qian), Niuxi (Achyranthis Bidentatae Radix), Chenpi (Citri Reticulatae Pericarpium), Taoren (Persicae Semen), Mutong (Akebiae Caulis), Huangbo (Phellodendri Cortex), Fangji (Stephaniae Tetrandrae Rhizoma) (each 1 qian). Remove Qianghuo (Notopterygii Rhizoma et Radix), add Du Huo (Angelicae Pubescentis Radix) (0.7 qian).
For spasms and cramping of both hands, add Banxia (Pinelliae Rhizoma), Danggui (Angelicae Sinensis Radix), Fangfeng (Saposhnikoviae Radix), Tianma (Gastrodiae Rhizoma), Baizhi (Angelicae Dahuricae Radix) (each 1 qian). Remove Zhuling (Polyporus), Zexie (Alismatis Rhizoma), Gui (Cinnamomi Ramulus/Cortex).
For spasms and cramping of both feet, add Danggui (Angelicae Sinensis Radix), Duzhong (Eucommiae Cortex), Huangbo (Phellodendri Cortex), Mugua (Chaenomelis Fructus), Niuxi (Achyranthis Bidentatae Radix), Yiyiren (Coicis Semen) (each 1.5 qian). Remove Qianghuo (Notopterygii Rhizoma et Radix).
For wandering pain, add Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Weilingxian (Clematidis Radix et Rhizoma) (each 1 qian), Muxiang (Aucklandiae Radix), Zhike (Aurantii Fructus Immaturus) (each 0.7 qian).
For heel pain, add Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Yiyiren (Coicis Semen) (each 1.5 qian), Zhimu (Anemarrhenae Rhizoma), Huangbo (Phellodendri Cortex), Niuxi (Achyranthis Bidentatae Radix) (each 1 qian). Remove Qianghuo (Notopterygii Rhizoma et Radix), add Duhuo (Angelicae Pubescentis Radix).