成 身重之由有风湿有风寒有风湿俱见有火逆有易病有三阳合病虽所得不一然悉属三阳非若身疼兼有三阴里寒也坏病有矣寒则无之识者鉴焉
太阳 伤寒脉浮缓身不疼但重乍有轻时无少阴证者大青龙汤发之（详太阳病）发汗已身犹灼热名曰风温脉浮汗出身
重多眠鼻息鼾（详风温宜活人葳蕤汤）风温脉浮身重汗出恶风者宜防己黄 汤
防己（一两） 甘草（半两） 白术（七钱半） 黄 （去芦一两一钱）上 咀每服五钱生姜四片大枣一枚水一盏
半煎至八分温服良久再服服后当如虫行皮中从腰下如冰后坐被上又以一被绕腰以下温令微汗瘥喘者加麻黄半两胃中不
和者加芍药三分气上冲者加桂三分下有沉寒者加细辛三分脉浮宜以汗解用火炙之邪无从出因火而盛病从腰以下必重而
痹名火逆也脉浮数者法当汗出而愈若下之身重心悸者不可发汗当自汗出以解所以然者尺中脉微此里虚须表里实津液自
和便自汗出愈伤寒八九日下之胸满烦惊小便不利谵语一身尽重不可转侧者柴胡加龙骨牡蛎汤主之（方见惊张 病有身重
不能转侧下后血虚津液不荣于外也身疼不能转侧者风湿相搏于经而里无邪也经曰伤寒八九日风湿相搏身疼体烦而不能
自转侧不呕不渴脉浮虚而涩者以桂枝附子汤主之此以柴胡加龙骨牡蛎汤主之以上二证言不能转侧颇相似论疼与重俱不
相侔各从本法为宜也
阳明 病脉迟汗出不恶寒身重短三腹满而喘或潮热或不潮热承气汤证（详腹满）阳明病脉浮紧口苦咽燥腹满而喘发
热汗出不恶寒身重忌汗忌烧针忌下（详自汗注云此证宜和解之）
三阳合病 腹满身重难以转侧口不仁而面垢谵语遗尿发汗则谵语下之则额上生汗手足逆冷若自汗出者白虎汤主之
（成 腹满身重难以转侧口不仁谵语者阳明也针经曰少阳病甚则面微尘此面垢者少阳也遗尿者太阳也三者以阳明证多
故出阳明篇中三阳合病为表里有邪若发汗攻表则燥热益甚必愈谵语若下之攻里表热乘虚内陷必额上汗出手足逆冷其自
汗出者三阳经热甚也内经曰热则腠理开荣卫通汗大泄与白虎汤以解内外之热）
少阴 病腹痛小便不利四肢沉重疼痛下利者真武汤
中 发热恶寒身重而痛手逆递冷小有劳身即热小便已洒洒然毛耸其脉弦细芤迟口开前板齿燥此为太阳中 忌汗
下温针（宜白虎加人参汤详暑病）
阴阳易 身重少气少腹里急或引阴中热上胸冲眼花者此为阴阳易宜烧 汤（方论见阴阳易）
成无己注：身体沉重的原因，有风湿、有风寒、有风湿并见、有火逆误治，以及“中暍”（中暑），共有这三种情况。虽然病因各不相同，但都归属于三阳经病证，不像身痛兼有三阴经里寒的情况那样。坏病（变证）中有身重，但寒证中没有。明眼人应当仔细鉴别。
太阳病篇：
伤寒脉象浮缓，身体不疼痛只是沉重，偶尔有减轻的时候，且没有少阴病证候的，用大青龙汤发汗治疗。（详见太阳病章节）
发汗后身体仍然灼热，称为风温。脉象浮，出汗，身体沉重，嗜睡，鼻息鼾声。（详见风温，宜用《活人书》葳蕤汤）
风温脉象浮，身体沉重，出汗，恶风的，宜用防己黄芪汤。
防己（一两）、甘草（半两）、白术（七钱半）、黄芪（去芦头，一两一钱）。以上药物捣碎成粗末，每次服用五钱，加生姜四片、大枣一枚，水一盏半，煎至八分，温服。服后过一会儿，感觉像虫子在皮肤中爬行，腰部以下如冰般寒冷，然后坐在被子上，再用一条被子围绕腰部以下，使其微微出汗而痊愈。若有喘症，加麻黄半两；胃中不和者，加芍药三分；气上冲者，加桂枝三分；下有沉寒者，加细辛三分。
脉象浮，应当用发汗法解表，若用火灸法，邪气无从排出，反而因火而炽盛，病势从腰部以下必然沉重而麻痹，这称为火逆。
脉象浮数者，依法应当通过出汗而痊愈。如果误用下法，导致身体沉重、心悸的，不可再发汗，应当等待其自汗出而解。之所以这样，是因为尺中脉微，这是里虚的表现，需要使表里之气充实，津液自然调和，便会自汗出而痊愈。
伤寒八九日，误用下法，出现胸满、烦惊、小便不利、谵语、全身沉重不能转侧的，用柴胡加龙骨牡蛎汤主治。（方剂见惊悸张仲景病篇）
有的病案记载身体沉重不能转侧，是下法后血虚、津液不能濡养于外所致；身体疼痛不能转侧的，是风湿相搏于经络而里没有邪气。经文说：伤寒八九日，风湿相搏，身体疼痛、烦躁而不能自行转侧，不呕不渴，脉象浮虚而涩的，用桂枝附子汤主治。此处用柴胡加龙骨牡蛎汤主治。以上两种证候关于不能转侧颇为相似，但论述疼痛与沉重截然不同，各依本法治为宜。
阳明病篇：
病脉迟，出汗，不恶寒，身体沉重，呼吸短促，腹部胀满而喘，或有潮热，或无潮热，属承气汤证。（详见腹满章节）
阳明病脉象浮紧，口苦咽干，腹部胀满而喘，发热，出汗，不恶寒，身体沉重，忌用发汗、忌用烧针、忌用下法。（详见自汗注云：此证宜和解之法）
三阳合病篇：
腹部胀满，身体沉重难以转侧，口舌麻木不知味而面部污垢，谵语，遗尿。发汗则谵语加重；误下则额上出汗，手足逆冷。若自汗出的，用白虎汤主治。
（成无己注：腹部胀满、身体沉重难以转侧、口舌麻木、谵语，这是阳明病。《针经》说：少阳病严重时面色如蒙尘，这就是面垢，属于少阳病。遗尿属于太阳病。三者中以阳明证居多，故列在阳明篇中。三阳合病为表里有邪，若发汗攻表，则燥热更甚，必致谵语加重；若下之攻里，表热乘虚内陷，必致额上出汗、手足逆冷。其自汗出者，是三阳经热盛所致。《内经》说：热则腠理开，营卫通，汗大泄。给予白虎汤以解内外之热。）
少阴病篇：
病腹痛，小便不利，四肢沉重疼痛，下利的，用真武汤。
中暍（中暑）篇：
发热，恶寒，身体沉重而疼痛，手足厥冷，稍作劳作即发热，小便结束后洒淅然恶寒毛耸，脉象弦细芤迟，张口前板齿干燥。此为太阳中暍，忌用发汗、下法及温针。（宜用白虎加人参汤，详见暑病章节）
Cheng Wuji's Commentary: The causes of heaviness of the body include wind-dampness, wind-cold, simultaneous presence of wind and dampness, fire-ni (adverse reaction to fire therapy), and Zhong-Yue (heatstroke). There are three main categories. Although the etiologies differ, all belong to the Three Yang meridians, unlike body pain accompanied by interior cold of the Three Yin meridians. Bianzheng (complicated diseases) may present with heaviness, but cold syndromes do not. Those who understand should distinguish them carefully.
Taiyang Chapter:
In Shanghan (cold damage), if the pulse is floating and slow, the body is not painful but heavy, occasionally alleviating, and there are no Shaoyin syndrome signs, Da Qing Long Tang (Great Blue Green Dragon Decoction) should be used to induce sweating. (See Taiyang Syndrome chapter)
After inducing sweating, if the body remains burning hot, it is called Feng Wen (Wind-Warmth). The pulse is floating, there is sweating, heaviness of the body, somnolence, and snoring in nasal breathing. (See Wind-Warmth; Yi Ren Huang Qi Tang from *The Man Who Lives* is suitable)
If Feng Wen presents with a floating pulse, heaviness of the body, sweating, and aversion to wind, Fang Ji Huang Qi Tang (Stephania and Astragalus Decoction) is appropriate.
Fang Ji (1 liang), Gan Cao (0.5 liang), Bai Zhu (0.75 liang), Huang Qi (deprived of roots, 1.1 qian). The above herbs are coarsely crushed. Take 5 qian per dose, add 4 slices of Sheng Jiang (Fresh Ginger), 1 Da Zao (Jujube), and 1.5 cups of water. Decoct until 0.8 cup remains. Take warm. After some time, a sensation like insects crawling on the skin will occur. From the waist down, it feels like ice. Then sit under blankets, wrap another blanket around the waist downwards, and induce slight sweating for recovery. If panting occurs, add Ma Huang (Ephedrae Herba) 0.5 liang; if stomach disharmony exists, add Shao Yao (Paeoniae Radix Alba) 0.3 fen; if qi rushes upward, add Gui Zhi (Cinnamomi Ramulus) 0.3 fen; if deep cold exists below, add Xi Xin (Asari Radix) 0.3 fen.
If the pulse is floating, sweating should be used to release the exterior. If moxibustion/fire therapy is applied, the pathogen cannot exit, and the condition worsens due to fire. The disease will manifest as heaviness and numbness from the waist down, termed Huo Ni (Fire Adversity).
If the pulse is floating and rapid, recovery should naturally come through sweating. If purgation is mistakenly used, resulting in body heaviness and palpitations, sweating should not be induced again. Recovery should await spontaneous sweating. This is because the chi position pulse is faint, indicating interior deficiency. The interior and exterior must be strengthened, fluids harmonized, leading to spontaneous sweating and recovery.
After eight or nine days of Shanghan, if purgation is mistakenly used, presenting with chest fullness, irritability and fright, dysuria, delirium, and whole-body heaviness making turning difficult, Chai Hu Jia Long Gu Mu Li Tang (Bupleurum Plus Dragon Bone and Oyster Shell Decoction) is the primary treatment. (Formula seen in Palpitations Zhang Zhongjing Disease Chapter)
Some case records describe heaviness preventing turning, caused by blood deficiency and fluid failure to nourish the exterior after purgation; pain preventing turning is due to wind-dampness battling in the meridians without interior pathogens. The classic states: After eight or nine days of Shanghan, wind-dampness battles, causing body pain, restlessness, inability to turn independently, no vomiting, no thirst, and a floating, deficient, and choppy pulse. Gui Zhi Fu Zi Tang (Cinnamon Twig and Aconite Decoction) is used. Here, Chai Hu Jia Long Gu Mu Li Tang is used. These two syndromes regarding inability to turn are similar, but the discussion of pain versus heaviness differs significantly; each should be treated according to its own method.
Yangming Chapter:
Disease with a slow pulse, sweating, aversion to cold absent, body heaviness, shortness of breath, abdominal fullness and wheezing, with or without tidal fever, belongs to Cheng Qi Tang (Order the Qi Decoction) syndrome. (See Abdominal Fullness chapter)
Yangming disease with a floating-tight pulse, bitter taste in mouth, dry throat, abdominal fullness and wheezing, fever, sweating, aversion to cold absent, and body heaviness. Sweating, burning needles, and purgation are contraindicated. (See Spontaneous Sweating note: This syndrome is suitable for harmonizing methods)
Three Yang Combined Disease Chapter:
Abdominal fullness, body heaviness making turning difficult, oral insensitivity with facial greasiness, delirium, and urinary incontinence. Inducing sweating worsens delirium; purgation causes sweating on the forehead and cold extremities. If spontaneous sweating occurs, Bai Hu Tang (White Tiger Decoction) is the primary treatment.
(Cheng Wuji's Commentary: Abdominal fullness, body heaviness making turning difficult, oral insensitivity, and delirium indicate Yangming disease. *Zhen Jing* states: When Shaoyang disease is severe, the face appears dusty; this facial greasiness indicates Shaoyang disease. Urinary incontinence indicates Taiyang disease. Since Yangming symptoms predominate among the three, it is listed in the Yangming chapter. Three Yang combined disease involves exterior and interior pathogens. If sweating attacks the exterior, dry-heat intensifies, worsening delirium. If purgation attacks the interior, exterior heat sinks inward due to deficiency, causing forehead sweating and cold extremities. Spontaneous sweating indicates excessive heat in the Three Yang meridians. *Nei Jing* states: Heat opens pores, Ying and Wei flow freely, causing profuse sweating. Administer Bai Hu Tang to resolve interior and exterior heat.)
Shaoyin Chapter:
Disease with abdominal pain, dysuria, heaviness and pain in four limbs, and diarrhea is treated with Zhen Wu Tang (True Warrior Decoction).
Zhong-Yue (Heatstroke) Chapter:
Fever, aversion to cold, body heaviness and pain, cold extremities, fever upon slight exertion, chills and piloerection after urination, pulse that is string-tiny, hollow, and slow, dry front teeth when opening the mouth. This is Taiyang Zhong-Yue. Sweating, purgation, and warm needles are contraindicated. (Yi Ren Jia Ren Shen Tang plus Ginseng is suitable; see Heatstroke chapter)
Yin Yang Yi Chapter:
Body heaviness, shortness of breath, urgency and tension in the lower abdomen, or pulling heat sensation from the yin region rising to the chest, dizziness, indicates Yin Yang Yi (Exchange of Yin and Yang). Shao Kun San (Burnt Undergarment Powder) is suitable. (Formula theory seen in Yin Yang Yi chapter)