《本草》云∶苍术治湿，上下部皆可用。二陈汤中加酒芩、羌活、苍术，散风行湿。脾
胃受湿，沉困无力，怠惰好卧。去痰须用白术。上部湿，苍术功烈；下部湿，宜升麻提之。
外湿宜表散，内湿宜淡渗。若燥湿，以羌活胜湿汤、平胃散之类；若风湿相搏，一身尽痛，
以黄 防己汤；若湿胜气实者，以神佑丸、舟车丸服之；气虚者，桑皮、茯苓、人参、葶苈
、木香之类。凡肥人沉困怠惰，是湿热，宜苍术、茯苓、滑石；凡肥白之人，沉困怠惰，是
气虚，宜二术、人参、半夏、草果、浓朴、芍药；凡黑瘦而沉困怠惰者，是热，宜白术、黄
芩；凡饮食不节，脾胃受伤，不能递送，宜枳术丸。去上焦湿及热，须用黄芩，泻肺火故也
。又如肺有湿，亦宜黄芩；如肺有虚热，宜天门冬、麦门冬、知母，用黄芩多则损脾。去中
焦湿与痛热，用黄连，泻心火故也。如中焦有实热，亦宜黄连。若脾胃虚弱，不能运转而郁
闷，宜黄芩、白术、干葛；若中焦湿热积久而痛，乃热势甚盛，宜黄连用姜汁炒。去下焦湿
肿及痛，并膀胱有火邪者，必须酒洗防己、黄柏、知母、草龙胆。又云∶凡下焦有湿，草龙
胆、防己为君，甘草、黄柏为佐，如下焦肿及痛者，是湿热，宜酒防己、草龙胆、黄芩、苍
术。若肥人气虚之人，肿痛，宜二术、南星、滑石、茯苓；黑瘦之人，下焦肿痛，宜当归桃
仁、红花、牛膝、槟榔、黄柏。
戴云∶湿有自外入者，有自内出者，必审其方土之致病源。东南地下，多阴雨，地湿，
凡受必从外入，多自下起，以重腿香港脚者多，治当汗散，久者宜疏通渗泄；西北地高，人多
食生冷、湿面、 酪，或饮酒后寒气怫郁，湿不能越，以致腹皮胀痛，甚则水鼓胀满，或通
身浮肿，按之如泥不起，此皆自内而出也。辨其元气多少，而通利其二便，责其根在内也。
此方土内外，亦互相有之，但多少不同，须对症施治，不可执一。
附方
二陈汤 见中风类。
羌活胜湿汤
羌活 独活（各一钱） 本 防风 甘草（炙） 川芎（各五分） 蔓荆子（三分）
上 咀。作一服，水二盏，煎至一盏。去渣，大温服，空心。如身重，腰沉沉然，加
酒洗防己五分，轻者附子五分，重者川乌五分。
平胃散 见厥类。
防己黄 汤 治风温脉浮，身重汗出恶风或痛。
防己（一两） 甘草（炙,半两） 白术（七钱半）黄 （一两一钱）
上 咀。每服一两，入姜枣煎。喘者，加麻黄；胃气不利，加芍药；气上冲，加桂枝；
下有寒，加细辛。
三花神佑丸 治一切水湿肿病，大腹实胀，喘满。
轻粉（一钱） 大黄（一两,为末） 牵牛（二两） 芫花（醋拌炒） 甘遂 大戟（各半两）
上为末，滴水丸小豆大。初服五丸，每服加五丸，温水下，无时，日三。
舟车丸
大黄（二两） 甘遂 大戟 芫花 青皮 陈皮（各一两） 牵牛（头末，四两） 木香（半两）
上为末，水丸如梧子大。每服六七十丸，白汤下。随证加减。
枳术丸 见内伤类。
升阳除温汤 见泄泻类。
《本草》记载：苍术能治疗湿邪，上部和下部的湿证都可以使用。在二陈汤中加入酒炒黄芩、羌活、苍术，可以疏散风邪、祛除湿气。脾胃受湿邪侵袭，会出现身体沉重困倦、无力、懒于活动且喜欢躺卧的症状。若要祛除痰饮，必须使用白术。上部湿邪，苍术功效猛烈；下部湿邪，宜用升麻提升阳气。外感湿邪适宜用发汗解表的方法散除，内伤湿邪适宜用淡味渗利小便的方法排出。如果是燥湿，可用羌活胜湿汤、平胃散之类的方剂；如果是风湿相搏结，导致全身疼痛，可用防己黄芪汤；如果是湿邪盛而正气不虚者，可服用神佑丸、舟车丸；如果是正气虚弱者，可用桑白皮、茯苓、人参、葶苈子、木香之类的药物。凡是体型肥胖的人出现身体沉重困倦、懒动，这是湿热证，适宜用苍术、茯苓、滑石；凡是肤色白胖的人出现身体沉重困倦、懒动，这是气虚证，适宜用苍术、白术、人参、半夏、草果、厚朴、芍药；凡是肤色黑瘦的人出现身体沉重困倦、懒动，这是热证，适宜用白术、黄芩；凡是饮食不节制，损伤脾胃，导致运化传导失常，适宜用枳术丸。要去除上焦的湿邪和热邪，必须使用黄芩，因为黄芩能清泻肺火。又如肺中有湿邪，也适宜用黄芩；如果肺中有虚热，适宜用天门冬、麦门冬、知母，如果使用黄芩过多则会损伤脾胃。要去除中焦的湿邪与郁热疼痛，使用黄连，因为黄连能清泻心火。如果中焦有实热，也适宜用黄连。如果脾胃虚弱，不能正常运化而导致郁闷不适，适宜用黄芩、白术、干葛根；如果中焦湿热积聚日久导致疼痛，说明热势非常旺盛，适宜用黄连并用姜汁炒制。要去除下焦的湿肿及疼痛，以及膀胱有火邪的情况，必须使用酒洗过的防己、黄柏、知母、龙胆草。又记载：凡是下焦有湿邪，以龙胆草、防己为君药，甘草、黄柏为佐药；如下焦出现肿胀及疼痛，属于湿热证，适宜用酒洗防己、龙胆草、黄芩、苍术。如果是体质肥胖但气虚的人出现肿痛，适宜用苍术、白术、天南星、滑石、茯苓；如果是黑瘦的人下焦出现肿痛，适宜用当归、桃仁、红花、牛膝、槟榔、黄柏。
戴元礼说：湿邪有从外部侵入的，也有从内部产生的，必须审察当地地理环境致病的原因。东南地区地势低洼，多阴雨天气，地气潮湿，凡受湿邪多从外部侵入，多从下肢开始，患重腿和脚气病的人较多，治疗应当用发汗散邪的方法，病程久者适宜用疏通渗泄的方法；西北地区地势高，人们多吃生冷食物、湿面、奶酪，或者饮酒后寒气郁结，湿气不能发散，导致腹部皮肤胀痛，甚至出现水鼓胀满，或全身浮肿，按压后凹陷不起，这些都属于从内部产生的湿邪。辨别患者元气多少，从而通利大小便，追究病根在于内脏。这种因地域不同导致的内外湿邪，往往互相夹杂，只是比例不同，必须对症施治，不可拘泥于一种方法。
附方：
二陈汤 见中风类。
羌活胜湿汤
羌活、独活（各一钱） 藁本、防风、甘草（炙）、川芎（各五分） 蔓荆子（三分）
以上药材切碎。作为一服剂量，用水两盏，煎煮至一盏。去渣，趁大温热服，空腹服用。如果身体沉重，腰部感觉沉沉然，加酒洗防己五分，症状轻者加附子五分，症状重者加川乌五分。
平胃散 见厥类。
防己黄芪汤 治疗风温脉浮，身体沉重、出汗、恶风或疼痛。
防己（一两） 甘草（炙，半两） 白术（七钱半） 黄芪（一两一钱）
以上药材切碎。每次服用一两，加入生姜、大枣煎煮。气喘者，加麻黄；胃气不利者，加芍药；气上冲者，加桂枝；下部有寒者，加细辛。
三花神佑丸 治疗一切水湿肿胀疾病，大腹实胀，喘满。
轻粉（一钱） 大黄（一两，研末） 牵牛子（二两） 芫花（醋拌炒） 甘遂、大戟（各半两）
以上研为细末，滴水泛丸如小豆大。初次服用五丸，每次增加五丸，温水送服，不限时间，每日三次。
舟车丸
大黄（二两） 甘遂、大戟、芫花、青皮、陈皮（各一两） 牵牛子（头末，四两） 木香（半两）
以上研为细末，用水泛丸如梧桐子大。每次服用六七十丸，白开水送服。根据症状加减。
枳术丸 见内伤类。
升阳除温汤 见泄泻类。
According to the *Bencao* (Materia Medica): Cangzhu (Rhizoma Atractylodis) treats dampness and can be used for both upper and lower body dampness. In Erchen Tang (Two-Aged Decoction), adding Jiuhuangqin (Scutellariae Radix fried with wine), Qianghuo (Notopterygii Rhizoma et Radix), and Cangzhu disperses wind and eliminates dampness. When Spleen and Stomach are affected by dampness, symptoms include heaviness, lethargy, weakness, lassitude, and a preference for lying down. To eliminate phlegm, Baizhu (Atractylodis Macrocephalae Rhizoma) must be used. For upper body dampness, Cangzhu has potent effects; for lower body dampness, Shengma (Cimicifugae Rhizoma) should be used to raise yang. External dampness is best treated by diaphoresis (sweating method); internal dampness is best treated by bland diuresis (promoting urination). If drying dampness is required, formulas such as Qianghuo Shengshi Tang (Notopterygium Decoction to Overcome Dampness) or Pingwei San (Stomach-Pacifying Powder) may be used; if wind-dampness intertwines causing whole-body pain, Fangji Huangqi Tang (Stephania and Astragalus Decoction) is indicated; if dampness is excessive while qi is substantial, Shenyao Wan (Divine Protection Pill) or Zhouche Wan (Boat Cart Pill) may be taken; if qi is deficient, drugs such as Sangpiao (Morus Folium), Fuling (Poria), Renshen (Ginseng Radix et Rhizoma), Tingli (Semen Lepidii seu Descurainiae), and Muxiang (Aucklandiae Radix) are suitable. Generally, obese individuals presenting with heaviness, lethargy, and lassitude suffer from damp-heat, and should use Cangzhu, Fuling, and Huashi (Talcum). Individuals who are pale and fat, presenting with heaviness, lethargy, and lassitude, suffer from qi deficiency, and should use Ershu (both Cangzhu and Baizhu), Renshen, Banxia (Pinelliae Rhizoma), Caoguo (Tsaoko Fructus), Houpo (Magnoliae Officinalis Cortex), and Shaoyao (Paeoniae Radix). Individuals who are dark-skinned and thin, presenting with heaviness, lethargy, and lassitude, suffer from heat, and should use Baizhu and Huangqin (Scutellariae Radix). If irregular diet injures the Spleen and Stomach, impairing transport and transformation, Zhizhu Wan (Immature Bitter Orange and Atractylodes Pill) is appropriate. To remove dampness and heat from the Upper Jiao, Huangqin must be used because it clears Lung fire. Similarly, if there is dampness in the Lung, Huangqin is also suitable; however, if there is deficiency-heat in the Lung, Tianmendong (Asparagi Radix), Maidong (Ophiopogonis Radix), and Zhimu (Anemarrhenae Rhizoma) are suitable; excessive use of Huangqin damages the Spleen. To remove dampness and painful heat from the Middle Jiao, Huanglian (Coptidis Rhizoma) is used because it clears Heart fire. If there is excess heat in the Middle Jiao, Huanglian is also suitable. If Spleen and Stomach are weak and fail to transform, leading to oppression and discomfort, Huangqin, Baizhu, and Gengegen (Puerariae Lobatae Radix) are suitable. If damp-heat accumulates in the Middle Jiao over time causing pain, indicating intense heat, Huanglian fried with ginger juice is suitable. To remove damp-swelling and pain from the Lower Jiao, and when Bladder has pathogenic fire, Jiuhuanfangji (Stephania Root washed with wine), Huangbai (Phellodendri Cortex), Zhimu, and Caolongdan (Gentianae Radix) are essential. It is also stated: whenever there is dampness in the Lower Jiao, Caolongdan and Fangji are the sovereign drugs, with Gancao (Licorice Root) and Huangbai as ministering drugs; if swelling and pain occur in the Lower Jiao, indicating damp-heat, Jiuhuanfangji, Caolongdan, Huangqin, and Cangzhu are suitable. For obese individuals with qi deficiency presenting with swelling and pain, Ershu, Nanting (Arisaematis Rhizoma), Huashi, and Fuling are suitable; for dark-skinned, thin individuals with Lower Jiao swelling and pain, Danggui (Angelicae Sinensis Radix), Taoren (Persicae Semen), Honghua (Carthami Flos), Niuxi (Achyranthis Bidentatae Radix), Binglang (Arecae Semen), and Huangbai are suitable.
Dai Yuanli said: Dampness comes either from external invasion or internal generation; one must examine the geographical source of the disease. In the Southeast, where land is low and rainy, ground dampness prevails; dampness usually enters from outside, starting from below, often manifesting as heavy legs and Hongjiaojiao (foot ailment/gout); treatment should employ sweating and dispersing methods, and for chronic cases, unblocking and draining methods. In the Northwest, where land is high, people often consume raw/cold foods, wet noodles, and dairy products, or after drinking alcohol, cold qi becomes stagnant, preventing dampness from dissipating, leading to abdominal distension and pain, severe water drumming (ascites), or generalized edema that pits upon pressure; these all arise from within. One must assess the amount of Yuanqi (primordial qi) and promote the free flow of urine and stool, addressing the root cause internally. These internal and external dampness factors due to geography often coexist but in varying proportions; treatment must be symptomatic and flexible, not rigidly adhering to a single method.
Attached Formulas:
Erchen Tang See Stroke Category.
Qianghuo Shengshi Tang (Notopterygium Decoction to Overcome Dampness)
Qianghuo (1 qian), Duhuo (1 qian) Gaoben (Ligustici Wallichii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Gancao (Honey-fried, 0.5 qian), Chuanxiong (0.5 qian) Manjingzi (Vittariae Spora, 0.3 qian)
Decoct these ingredients. Take as one dose, with two cups of water, decoct to one cup. Strain and take warm on an empty stomach. If body weight is heavy and the waist feels heavy, add Jiuhuanfangji (0.5 qian); for mild cases, add Fuzi (Aconiti Lateralis Radix Praeparata, 0.5 qian); for severe cases, add Chuanwu (Aconiti Radix, 0.5 qian).
Pingwei San (Stomach-Pacifying Powder) See Jue Category.
Fangji Huangqi Tang (Stephania and Astragalus Decoction) Treats Wind-Warmth with floating pulse, heaviness, sweating, aversion to wind, or pain.
Fangji (1 liang) Gancao (Honey-fried, 0.5 liang) Baizhu (0.75 liang) Huangqi (Astragali Radix, 1.1 liang)
Decoct these ingredients. Take 1 liang per dose, with ginger and jujube. For asthma, add Mahuang (Ephedrae Herba); for poor Stomach qi movement, add Shaoyao; for upward rushing qi, add Guizhi (Cinnamomi Ramulus); for cold below, add Xixin (Asari Radix et Rhizoma).
Sanhua Shenyao Wan (Three-Flower Divine Protection Pill) Treats all water-dampness swelling diseases, abdominal fullness and distension, asthma, and oppression.
Qingfen (Calomelas, 1 qian) Dahuang (Rhei Radix et Rhizoma, 1 liang, powdered) Qianniu (Semen Pharbitidis, 2 liang) Yuanhua (Genkwa Flos, stir-fried with vinegar) Gansui (Kansui Radix) Daji (Euphorbiae Pekinensis Radix, each 0.5 liang)
Grind into powder, mix with drops of water to make pills the size of small beans. Start with five pills, increasing by five pills per dose, taken with warm water at any time, three times daily.
Zhouche Wan (Boat Cart Pill)
Dahuang (2 liang) Gansui, Daji, Yuanhua, Qingpi (Citri Reticulatae Pericarpium Viride), Chenpi (Citri Reticulatae Pericarpium, each 1 liang) Qianniu (Head powder, 4 liang) Muxiang (1 liang)
Grind into powder, make water pills the size of Chinese quince seeds. Take 60-70 pills per dose, with plain boiled water. Adjust according to symptoms.
Zhizhu Wan (Immature Bitter Orange and Atractylodes Pill) See Internal Injury Category.
Shengyang Chuwen Tang (Ascending Yang and Removing Warmth Decoction) See Diarrhea Category.