湿之为病。散见各门。此将湿之原委。逐一讲贯。治之。方不谬也。有自外而伤者。有自内而中者。从外而伤者。
即如冒雨而行。雾露而处。冷水灌汗。湿从上受也。若涉水履冰。当风洗足。坐卧湿地。湿从下受也。初起湿邪在经。
未郁为热。但觉骨中冷痛。或皮肉微肿。微微恶寒。其脉细缓而不洪数。可
知其为寒湿也。俱用人参败毒散加减。湿留日久。壅遏本身正气。即成湿热。脉多洪缓数大。向之细缓者。今则乌有矣。
但看上下部分。红肿酸痛。恶寒发热者。知其为湿热也。虽宜解表。但可用辛凉。不宜用辛温。如柴葛二
妙汤。上下俱可着用。如寒热已退。红肿不消。宜用加减柴苓汤。经云治湿不利小便。非其治也。可见治湿之法。又以
利小便为第二义矣。然而利小便之法。有湿则利湿。无湿则损津液。肿盛者可用。微肿而痿弱者。又当除
湿养荣。内经云。因于湿。首如裹。言湿邪初客。未郁为热。但觉蒙昧不清。如以物裹其首也。又云大筋软短。小筋驰
长。是言湿客日久。湿郁为热。热伤其血。则大筋为之软短。湿伤其筋。则小筋为之驰长。明此数语。方知治湿
之不可过于燥矣。此湿从外受者也。至于湿从内中者。又有上下之不同。如茶酒汤水。脾虚不能消散。积于上焦。即为
上焦之湿。其人头面发肿。或生瘾疹。是为湿中生热。治当凉散。不宜温散。亦用柴葛二妙汤。若其人小
便不利。在上之湿。难于下趋。又当用柴苓汤。利其小便。若脉来细缓无力。小便色白。不时淋滴而多汗。一切利水之
药。即不可施。其有身热足寒。时头热面赤。湿热上壅。阳气不能下通于阴。宜用柴胡汤加大黄下之。湿积于下。即为
下
焦之湿。合用柴苓汤利之矣。若其人恶寒发热。或两尺洪盛。余脉沉细。湿热下壅。阴气不能上通于阳。必用柴葛二妙
汤。散其标邪。方可利水。若脉来细缓。小便色白者宜用独活寄生汤。助阳以驱湿。亦不得不用之法也。
人参败毒散
羌活 独活 柴胡 前胡 川芎 枳壳 桔梗 人参 白茯 甘草
寒甚者。加桂枝。无人参。以白术代之
柴葛二妙汤
柴胡 黄芩 半夏 甘草 干葛 赤芍 苍术 黄柏
湿热之脉。洪数者多。亦有湿邪壅滞。脉沉细缓者。但问身热内烦。即以此方散之。在上者去黄柏。加连翘。
加减柴苓汤
柴胡 黄芩 半夏 甘草 赤茯 泽泻 赤芍 枳壳 苡仁 木瓜
除湿养荣汤
当归 川芎 白芍 熟地 牛膝 杜仲 木瓜 苡仁 续断 黄芩 石斛 五茄皮
加味柴胡汤
柴胡 黄岑 甘草 花粉 白芍 麦冬 山栀 大黄
独活寄生汤
当归 川芎 白芍 熟地 人参 茯苓 甘草 杜仲 牛膝 续断 秦艽 防风 独活 细辛 肉桂 桑寄生
（按此方重在助阳以驱湿小溲清白脉来尺微寸缓是其的剂若湿热未尽者尤宜三复庶免抱薪救焚之虞）
湿邪致病，散见于各科疾病之中。此处将湿邪的起因和演变过程逐一讲解透彻，治疗时才不会出错。湿邪有从外部侵袭的，也有从内部产生的。从外部侵袭的，就像冒雨行走，处于雾露之中，冷水浇灌汗水，这是湿邪从上焦受入；如果涉水踩冰，对着风洗脚，坐卧在潮湿的地方，这是湿邪从下焦受入。初起时湿邪在经络，尚未郁结化为热邪，只感觉骨头中冷痛，或者皮肉轻微肿胀，微微怕冷，其脉象细缓而不洪大急促，可以知道这是寒湿证。都用人参败毒散加减治疗。湿邪停留日久，壅遏阻碍人体正气，就会形成湿热证。脉象多表现为洪大、缓和、数急或盛大，原先细缓的脉象现在就没有了。只看身体上下部分红肿酸痛，怕冷发热的，就知道是湿热证。虽然适宜解表，但可用辛凉药物，不宜用辛温药物。如柴葛二妙汤，上部和下部都可以使用。如果寒热症状已经消退，红肿不消，适宜用加减柴苓汤。《内经》说治疗湿邪如果不通利小便，就不是正确的治法。可见治疗湿邪的方法，又以通利小便为第二要义。然而通利小便的方法，有湿邪则利湿邪，没有湿邪则会损伤津液。水肿严重的可以使用（利湿法），轻微肿胀且身体痿弱无力的，又应当除湿并滋养营血。《内经》说：“因于湿，首如裹”，意思是湿邪刚客居体内，尚未郁结化为热邪，只感觉头脑昏沉不清，好像有东西包裹着头部一样。又说“大筋软短，小筋驰长”，这是说湿邪客居日久，湿郁结化为热邪，热邪损伤血液，导致大筋变得软弱而缩短；湿邪损伤筋脉，导致小筋变得松弛而伸长。明白这几句话，才知道治疗湿邪不可过于使用燥烈药物。这是湿邪从外部受入的情况。至于湿邪从内部产生的，又有上部和下部的不同。比如茶、酒、汤、水等，脾虚不能运化消散，积聚在上焦，就形成上焦之湿。这类病人头面部浮肿，或者生出瘾疹（皮肤红斑丘疹），这是湿中生热，治疗应当用清凉发散的方法，不宜用温散发散。也使用柴葛二妙汤。如果其人小便不利，上部的湿邪难以向下排泄，又当用柴苓汤，通利小便。如果脉象细缓无力，小便颜色清白，不时淋漓滴沥且多汗，一切利水药物，就不可施用。那些身体发热、足部寒冷，时常头部发热、面色红润的，是湿热上壅，阳气不能下行通达于阴分，适宜用柴胡汤加大黄攻下。湿邪积聚在下部，就形成下焦之湿，合用柴苓汤通利小便即可。如果其人怕冷发热，或者两尺脉洪盛，其余脉象沉细，是湿热下壅，阴气不能上行通达于阳分，必须用柴葛二妙汤，疏散其表邪，才可以通利小便。如果脉象细缓，小便颜色清白的，适宜用独活寄生汤，扶助阳气以驱除湿邪，这也是不得不用的方法。
人参败毒散
羌活、独活、柴胡、前胡、川芎、枳壳、桔梗、人参、白茯苓、甘草
寒邪严重的，加桂枝。无人参时，用白术代替。
柴葛二妙汤
柴胡、黄芩、半夏、甘草、干葛、赤芍、苍术、黄柏
湿热证的脉象，洪数者居多。也有湿邪壅滞，脉象沉细缓的。只要询问是否有身热内烦，就用此方发散。病位在上部的，去掉黄柏，加连翘。
加减柴苓汤
柴胡、黄芩、半夏、甘草、赤茯苓、泽泻、赤芍、枳壳、苡仁、木瓜
除湿养荣汤
当归、川芎、白芍、熟地黄、牛膝、杜仲、木瓜、苡仁、续断、黄芩、石斛、五茄皮
独活寄生汤
当归、川芎、白芍、熟地黄、人参、茯苓、甘草、杜仲、牛膝、续断、秦艽、防风、独活、细辛、肉桂、桑寄生
（按：此方重在扶助阳气以驱除湿邪。小溲清白、脉来尺微寸缓是其对症之剂。若湿热未尽者，尤其应该反复斟酌，以免犯抱薪救焚的错误。）
Pathogenic dampness manifests as diseases scattered across various categories. Here, the origins and mechanisms of dampness are explained in detail so that treatment will not be erroneous. Dampness may invade from the exterior or originate from within. Invasion from the exterior occurs, for instance, when walking in rain, dwelling in mist and dew, or having cold water poured over sweat; this is dampness entering from above. Wading through water, stepping on ice, washing feet in the wind, or sitting and lying on damp ground results in dampness entering from below. In the initial stage, pathogenic dampness resides in the meridians and has not yet stagnated to transform into heat. The patient merely feels cold pain in the bones or slight swelling of the skin and flesh, with mild aversion to cold. The pulse is fine and slow (Xì Huǎn) rather than surging and rapid (Hóng Shù), indicating a pattern of Cold-Dampness (Hán Shī). All such cases should be treated with modifications of Renshen Baidu San (Ginseng Detoxification Powder). If dampness remains for a long time, it obstructs the body's righteous qi and transforms into Damp-Heat (Shī Rè). The pulse becomes surging, slow, rapid, or large, whereas the previous fine and slow pulse disappears. Observing redness, swelling, soreness, and pain in the upper or lower parts of the body, accompanied by aversion to cold and fever, indicates Damp-Heat. Although releasing the exterior is appropriate, acrid-cool herbs should be used rather than acrid-warm ones. For example, Chaige Ermiao Tang (Bupleurum and Pueraria Two Marvels Decoction) can be applied to both upper and lower regions. If chills and fever have subsided but redness and swelling persist, Jiachai Ling Tang (Modified Bupleurum and Poria Decoction) is indicated. The *Neijing* states, "In treating dampness, if diuresis is not employed, it is not the correct method." Thus, promoting urination is the second most important principle in treating dampness. However, methods of diuresis must be chosen carefully: if dampness exists, promote dampness; if no dampness exists, diuretics will damage body fluids. Diuretics may be used for severe edema, but for mild swelling accompanied by flaccidity and weakness, one should eliminate dampness and nourish Ying (Nutritive Qi). The *Neijing* says, "Due to dampness, the head feels as if wrapped," meaning that when dampness initially invades and has not yet transformed into heat, the patient feels mental cloudiness, as if the head were wrapped in something. It also states, "The large tendons become soft and short, the small tendons become lax and long." This implies that when dampness lingers, it stagnates and transforms into heat; heat damages blood, causing the large tendons to become soft and shortened, while dampness damages the tendons, causing the small tendons to become lax and elongated. Understanding these statements reveals that treating dampness should not rely excessively on drying agents. This describes dampness invading from the exterior.
Regarding dampness originating from within, there are differences between the upper and lower jiao. For example, tea, wine, soups, and waters that the spleen fails to transport and transform due to deficiency accumulate in the Upper Jiao, forming Upper Jiao Dampness. Patients present with swelling of the head and face or develop maculopapular rashes (Yin Zhen). This represents heat arising from dampness; treatment requires cooling and dispersing rather than warming and dispersing. Chaige Ermiao Tang is also used. If the patient experiences difficulty in urination, making it hard for upper dampness to descend, Chai Ling Tang (Bupleurum and Poria Decoction) should be used to promote urination. If the pulse is fine, slow, and forceless, urine is clear, and there is frequent dribbling urination with profuse sweating, all diuretic drugs are contraindicated. In cases where the body is hot but the feet are cold, with intermittent heat in the head and flushed face, this indicates Damp-Heat congesting upward, preventing Yang Qi from descending to communicate with Yin. Chai Hu Tang (Bupleurum Decoction) with added Da Huang (Rhubarb) should be used to purge downward. Accumulation of dampness in the lower part forms Lower Jiao Dampness, which can be treated with Chai Ling Tang to promote urination. If the patient has aversion to cold and fever, or if the radial pulses at both chi positions are surging and full while other pulses are deep and fine, this indicates Damp-Heat congesting downward, preventing Yin Qi from ascending to communicate with Yang. One must use Chaige Ermiao Tang to disperse the superficial pathogens before promoting urination. If the pulse is fine and slow and the urine is clear, Du Huo Ji Sheng Tang (Angelica Pubescens Decoction for Sustaining Life) is indicated to assist Yang Qi in driving out dampness; this is an indispensable method.
Renshen Baidu San (Ginseng Detoxification Powder)
Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix), Chai Hu (Bupleuri Radix), Qian Hu (Peucedani Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Zhi Ke (Aurantii Fructus), Jie Geng (Platycodonis Radix), Ren Shen (Ginseng Radix), Bai Fu Ling (Poria), Gan Cao (Glycyrrhizae Radix et Rhizoma).
For severe cold, add Gui Zhi (Cinnamomi Ramulus). If Ren Shen is unavailable, substitute with Bai Zhu (Atractylodis Macrocephalae Rhizoma).
Chaige Ermiao Tang (Bupleurum and Pueraria Two Marvels Decoction)
Chai Hu (Bupleuri Radix), Huang Qin (Scutellariae Radix), Ban Xia (Pinelliae Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), Gan Ge (Puerariae Lobatae Radix), Chi Shao (Paeoniae Radix Rubra), Cang Zhu (Atractylodis Rhizoma), Huang Bo (Phellodendri Cortex).
Damp-Heat patterns often present with surging and rapid pulses, though dampness stagnation may present with deep, fine, and slow pulses. If the patient reports internal restlessness with fever, this formula is used to disperse the pathogen. For patterns located in the upper jiao, remove Huang Bo and add Lian Qiao (Forsythiae Fructus).
Jiachai Ling Tang (Modified Bupleurum and Poria Decoction)
Chai Hu (Bupleuri Radix), Huang Qin (Scutellariae Radix), Ban Xia (Pinelliae Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), Chi Fu Ling (Poria cum Rubro), Ze Xie (Alismatis Rhizoma), Chi Shao (Paeoniae Radix Rubra), Zhi Ke (Aurantii Fructus), Yi Yi Ren (Coicis Semen), Mu Gua (Chaenomelis Fructus).
Chushi Yangrong Tang (Dampness-Eliminating and Nutritive-Qi-Nourishing Decoction)
Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Bai Shao (Paeoniae Radix Alba), Shu Di Huang (Rehmanniae Radix Preparata), Niu Xi (Achyranthis Bidentatae Radix), Du Zhong (Eucommiae Cortex), Mu Gua (Chaenomelis Fructus), Yi Yi Ren (Coicis Semen), Xu Duan (Dipsaci Radix), Huang Qin (Scutellariae Radix), Shi Hu (Dendrobii Caulis), Wu Jia Pi (Acanthopanacis Cortex).
Jiawei Chai Hu Tang (Modified Bupleurum Decoction)
Chai Hu (Bupleuri Radix), Huang Qin (Scutellariae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), Hua Fen (Trichosanthis Radix), Bai Shao (Paeoniae Radix Alba), Mai Dong (Ophiopogonis Radix), Shan Zhi (Gardeniae Fructus), Da Huang (Rhei Radix et Rhizoma).
Du Huo Ji Sheng Tang (Angelica Pubescens Decoction for Sustaining Life)
Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Bai Shao (Paeoniae Radix Alba), Shu Di Huang (Rehmanniae Radix Preparata), Ren Shen (Ginseng Radix), Fu Ling (Poria), Gan Cao (Glycyrrhizae Radix et Rhizoma), Du Zhong (Eucommiae Cortex), Niu Xi (Achyranthis Bidentatae Radix), Xu Duan (Dipsaci Radix), Qin Jiao (Gentianae Macrophyllae Radix), Fang Feng (Saposhnikoviae Radix), Du Huo (Angelicae Pubescentis Radix), Xi Xin (Asari Radix et Rhizoma), Rou Gui (Cinnamomi Cortex), Sang Ji Sheng (Taxilli Caulis et Folium).
(Note: This formula focuses on assisting Yang Qi to expel dampness. Clear urine and a pulse that is faint at the chi position and slow at the cun position indicate its precise indication. If Damp-Heat is not fully resolved, careful consideration is required to avoid the error of adding fuel to the fire.)