病者一身尽疼。发热。日晡所剧者。此名风湿。此病伤于汗出当风。或久伤取冷所致也。
一身尽疼发热者。湿也。日晡所剧者。风也。盖湿无来去。而风有休作。故疼痛发热。每至日
晡则剧也。成氏曰。若汗出当风而得之者。则先客湿而后感风。若久伤取冷所致者。则先感风而后客湿
。风与湿合。故曰此名风湿。
问曰、风湿相搏。一身尽疼痛。法当汗出而解。值天阴雨不止。医云可发汗。汗之病不愈者。何
也。答曰、发其汗。汗大出者。但风气去。湿气在。是故不愈也。若治风湿者。发其汗。但微微似
欲汗出者。风湿俱去也。风湿虽并为六淫之一。然风无形而湿有形。风气迅而湿气滞。值此雨淫湿
胜之时。自有风易却而湿难驱之势。而又发之速而驱之过。宜其风去而湿不与俱去也。故欲湿之去
者。但使阳气内蒸而不骤泄。肌肉关节之间充满流行。而湿邪自无地可容矣。此发其汗。但微微似欲
汗出之旨欤。
以上七条。亦从王叔和痉湿 篇中录出。非太阳原文也。
伤寒八九日。风湿相搏。身体疼烦。不能自转侧。不呕不渴。脉浮虚而涩者。桂枝附子汤主之
。若其人大便硬。小便自利者。去桂枝加白术汤主之。
伤寒至八九日之久。而身疼不除。至不能转侧。知不独寒淫为患。乃风与湿相合而成疾也。不
呕不渴。
里无热也。脉浮虚而涩。风湿外持。而卫阳不振也。故于桂枝汤去芍药之酸寒。加附子之辛温。
以振阳气而敌阴邪。若大便硬。小便自利。知其人在表之阳虽弱。而在里之气自治。则皮中之湿。
所当驱之于里。使从水道而出。不必更出之表。以危久弱之阳矣。故于前方去桂枝之辛散。加白术
之苦燥。合附子之大力健行者。于以并走皮中。而逐水气。此避虚就实之法也。
桂枝附子汤方
桂枝（四两去皮） 生姜（二两切） 大枣（十二枚擘） 甘草（二两炙） 附子（三枚炮去
皮破八片）
上五味。以水六升。煮取二升。去滓。分温三服。
风湿相搏。骨节烦疼掣痛。不得屈伸。近之则痛剧。汗出短气。小便不利。恶风不欲去衣。或
身微肿者。甘草附子汤主之。
此亦湿胜阳微之证。其治亦不出助阳驱湿。如上条之法也。盖风湿在表。本当从汗而解。而汗
出表虚者。不宜重发其汗。恶风不欲去衣。卫虚阳弱之征。故以桂枝、附子助阳气。白术、甘草崇
土气。云得微汗则解者。非正发汗也。阳胜而阴自解耳。
甘草附子汤方
甘草（二两炙） 附子（二枚炮去皮破） 白术（二两） 桂枝（四两去皮）
上四味。以水六升。煮取三升。去滓。温服一升。日三服。初服得微汗而解。能食汗出复烦者
。服五合。多者宜服六七合为妙。
患者全身疼痛，发热，且在傍晚时分（日晡）加重，这称为风湿。这种病是由于出汗时受风，或长期贪凉受寒所致。
全身疼痛且发热，是湿邪的表现；傍晚时分加重，是风邪的表现。因为湿邪没有明显的发作规律，而风邪有间歇性发作的特点，所以疼痛和发热往往在傍晚时分加剧。成无己说：如果是出汗时受风而得的病，则是先感受湿邪后感感风邪；如果是长期贪凉受寒所致的，则是先感受风邪后客居湿邪。风与湿相结合，所以称为风湿。
问：风湿相互搏结，导致全身剧烈疼痛，按照常规应当通过发汗来解除。如果正值阴雨连绵不止，医生说可以发汗，但发汗后病未痊愈，这是为什么？答：发汗时如果汗出过多，只有风邪被去除，而湿邪仍留在体内，所以病不能痊愈。治疗风湿病时，发汗应当只是微微似有汗出的样子，这样风湿才能一起被去除。风湿虽然同属六淫之一，但风无形而湿有形，风气迅疾而湿气黏滞。值此雨水淫溢、湿气偏胜的时候，自然有风邪容易驱散而湿邪难以祛除的趋势。如果再急于发汗且驱邪过度，就会导致风去而湿不去。所以想要去除湿邪，只需使阳气在内蒸腾而不骤然外泄，让肌肉关节之间充满并流行着阳气，那么湿邪就无处容身了。这就是“发汗只宜微微似欲汗出”的宗旨吧。
以上七条，也是从王叔和的《痉湿暍篇》中摘录出来的，并非《伤寒论》太阳病的原文。
患伤寒八九日，风湿相互搏结，身体疼痛烦扰，不能自行翻身转侧，不呕吐也不口渴，脉象浮虚而涩的，用桂枝附子汤主治。如果病人大便干硬，小便自利的，去掉桂枝加白术汤主治。
伤寒到了八九日这么久，身体疼痛仍未消除，甚至到了不能翻身的程度，知道不仅仅是寒邪为患，而是风与湿相结合而成的疾病。不呕吐不口渴，说明里没有热邪。脉象浮虚而涩，说明风湿在体表束缚，而卫阳之气不振。所以在桂枝汤中去掉芍药的酸寒之性，加入附子的辛温之性，以振奋阳气来抵御阴邪。如果大便干硬，小便通利，就知道这个人在体表的阳气虽然虚弱，但在里的正气还能自我调节，那么皮中的湿邪，应当引导到里，使其从小便排出，不必再强行从表发散，以免危及已经久弱了的阳气。所以在前方中去掉桂枝的辛散之性，加入白术的苦燥之性，配合附子的大力健行之功，共同作用于皮中，从而驱逐水气。这是避虚就实的方法。
桂枝附子汤方
桂枝（四两，去皮） 生姜（二两，切） 大枣（十二枚，掰开） 甘草（二两，炙） 附子（三枚，炮制，去皮，破成八片）
以上五味药，用水六升，煮取二升，去渣，分三次温服。
风湿相互搏结，骨节烦痛牵掣，不能屈伸，靠近则疼痛剧烈，出汗短气，小便不利，怕风不想脱衣，或者身体轻微浮肿的，用甘草附子汤主治。
这也是湿邪偏盛、阳气微弱的证候。其治疗也不超出助阳驱湿的范围，如同上一条所述的方法。风湿在体表，本应当通过发汗来解除，但如果已经出汗导致表虚，就不宜再次重发其汗。怕风不想脱衣，是卫气虚弱、阳气衰弱的征象。所以用桂枝、附子来辅助阳气，用白术、甘草来培补土气。所谓得到微汗就能解病，并不是正的发汗法，而是阳气胜则阴邪自解罢了。
甘草附子汤方
甘草（二两，炙） 附子（二枚，炮制，去皮，破开） 白术（二两） 桂枝（四两，去皮）
以上四味药，用水六升，煮取三升，去渣，温服一升，每日三次。初次服药得到微汗即可解病。如果能进食但出汗后又感到烦闷的，服用五合（约现代100毫升左右）。病情重的宜服用六七合为妙。
The patient suffers from pain throughout the entire body, fever, and exacerbation in the late afternoon (Ribu). This condition is named Wind-Dampness (Fengshi). This disease is caused by exposure to wind while sweating, or by long-term indulgence in cold.
Pain throughout the body accompanied by fever indicates Dampness (Shi). Exacerbation in the late afternoon indicates Wind (Feng). Since Dampness lacks a specific pattern of onset and remission, whereas Wind has periods of activity and rest, the pain and fever tend to worsen in the late afternoon. Cheng Wuji stated: If contracted through exposure to wind while sweating, Dampness enters first and Wind follows; if caused by long-term exposure to cold, Wind enters first and Dampness subsequently lodges. The combination of Wind and Dampness is thus termed Wind-Dampness.
Question: When Wind and Dampness contend with each other, causing severe pain throughout the body, the standard treatment is to induce sweating for resolution. However, if it is continuously rainy and cloudy, and the physician prescribes inducing sweating, yet the illness does not resolve after sweating, why is this? Answer: If sweating is induced excessively, only the Wind pathogen is expelled, while the Dampness remains within. Therefore, the illness does not resolve. In treating Wind-Dampness, inducing sweat should result only in a slight, continuous perspiration, allowing both Wind and Dampness to be expelled together. Although Wind and Dampness are both among the Six Evils (Liuyin), Wind is formless while Dampness is tangible; Wind moves swiftly while Dampness lingers. During times of excessive rain and prevailing Dampness, there is naturally a tendency where Wind is easily dispelled but Dampness is difficult to drive out. If one induces sweating too rapidly and aggressively, the Wind may leave without taking the Dampness along. Thus, to eliminate Dampness, one must allow Yang Qi to steam internally without sudden leakage, filling and circulating freely between muscles and joints, leaving no room for the Dampness pathogen. This is the principle behind "inducing only slight perspiration."
The above seven clauses are excerpted from Wang Shuhe's *Jing Shi Han Zhuo Bing Lun* (Treatise on Spasm, Dampness, and Heatstroke) and are not original text from the Taiyang chapter of the *Shanghan Lun*.
After eight or nine days of Cold Damage (Shanghan), Wind and Dampness contend, causing bodily pain and vexation, inability to turn oneself over, absence of vomiting or thirst, and a floating, deficient, and choppy pulse. Guizhi Fuzi Tang (Cinnamon Twig and Aconite Decoction) is the primary formula. If the patient has hard stool and spontaneous urination, remove Cinnamon Twig and add Atractylodes Macrocephala Rhizome (Baizhu) as the primary formula.
Having suffered from Cold Damage for eight or nine days, with persistent bodily pain progressing to an inability to turn over, it is known that this is not solely due to Cold Evil, but rather a disease formed by the combination of Wind and Dampness. Absence of vomiting and thirst indicates no heat in the interior. A floating, deficient, and choppy pulse indicates that Wind-Dampness is binding the exterior while Defensive Yang (Weiyang) is not vigorous. Therefore, in Guizhi Tang (Cinnamon Twig Decoction), remove the sour-cold Paeonia Root (Shaoyao) and add the pungent-warm Prepared Aconite Root (Fuzi) to invigorate Yang Qi and combat Yin pathogens. If stool is hard and urination is free, it indicates that although Exterior Yang is weak, the Qi within the interior can regulate itself. The Dampness in the skin should then be directed inward to exit via the urinary pathway, rather than being forced out through the exterior, which would endanger the already weakened Yang. Thus, in the previous formula, remove the pungent-dispersing Cinnamon Twig (Guizhi) and add the bitter-drying Atractylodes Macrocephala Rhizome (Baizhu), combined with the powerful moving action of Aconite Root (Fuzi), to act jointly on the skin and expel water qi. This is the method of avoiding deficiency and targeting strength.
**Guizhi Fuzi Tang Formula**
Cinnamon Twig (Guizhi, 4 liang, peeled)
Fresh Ginger (Shengjiang, 2 liang, sliced)
Jujube (Dazao, 12 pieces, broken open)
Prepared Licorice Root (Gancao, 2 liang, honey-fried)
Prepared Aconite Root (Fuzi, 3 pieces, processed, peeled, broken into 8 slices)
Take these five herbs, add six sheng of water, boil to obtain two sheng, remove the dregs, and divide into three warm doses.
When Wind and Dampness contend, causing severe joint pain with pulling sensations, inability to flex or extend, intensified pain upon touch, sweating, shortness of breath, difficulty in urination, aversion to wind with reluctance to remove clothing, or slight edema of the body, Gancao Fuzi Tang (Licorice and Aconite Decoction) is the primary formula.
This is also a syndrome of prevailing Dampness and weak Yang. Its treatment does not depart from assisting Yang and driving out Dampness, following the method described in the previous clause. Wind-Dampness residing in the exterior should normally be resolved through sweating. However, if sweating has already occurred leading to exterior deficiency, heavy induction of sweat is inappropriate. Aversion to wind and reluctance to remove clothing are signs of deficient Wei Qi and weak Yang. Therefore, Cinnamon Twig (Guizhi) and Aconite Root (Fuzi) are used to assist Yang Qi, while Atractylodes Macrocephala Rhizome (Baizhu) and Licorice Root (Gancao) are used to fortify Earth Qi. The statement that "slight sweating leads to resolution" does not refer to proper diaphoresis, but rather that when Yang prevails, Yin pathogens resolve spontaneously.
**Gancao Fuzi Tang Formula**
Prepared Licorice Root (Gancao, 2 liang, honey-fried)
Prepared Aconite Root (Fuzi, 2 pieces, processed, peeled, broken)
Atractylodes Macrocephala Rhizome (Baizhu, 2 liang)
Cinnamon Twig (Guizhi, 4 liang, peeled)
Take these four herbs, add six sheng of water, boil to obtain three sheng, remove the dregs, and take one sheng warm, three times daily. Resolution occurs with slight sweating after the initial dose. If the patient can eat but becomes vexated again after sweating, take five he (approx. 100 ml). For more severe cases, taking six or seven he is optimal.