仲景云∶夏月中风湿,身重如山,不能转侧。宜除风胜湿去热之药治之。又云∶风
湿脉浮,身重,汗出恶风者,防己黄 汤主之。又云∶肾着之病∶其人身体重,腹中冷如
在水中,形如冰状,反侧不得;小便自行,饮食如故。病属下焦,身劳汗出,衣里冷湿,
久始得之,腰以下如带五千钱。甘姜苓术汤主之。
东垣云∶身重者,湿也。补中益气汤加去桂五苓散主之。
夜卧不能,谓之湿身重是也。小柴胡汤、黄 芍药汤主之。
(东垣)参术汤 治脾肾虚弱,元气不能充畅,四肢沉重,食后昏闷。
黄 (一钱) 人参 炙甘草 陈皮 青皮(各五分) 当归 酒黄柏 升麻 柴胡(各
三分) 神曲(七分)
上水二盏,灯心十根、枣一枚,煎八分,食前热服。
甘姜苓术汤 治肾冷湿,腰重不能起。
甘草 干姜(各五钱) 白术 茯苓(各一两)
上咀,以水五盏煎至三盏,作三服。
防己黄 汤 小柴胡汤 黄 芍药汤(并见伤寒门。)
(《局方》)五积散 治湿盛身重。(方见湿门。)
经云∶脾病者,身重,肉痿,取其经,太阴、阳明、少阴血者。
又云∶脾病者,身重,寝汗出,憎风,取其经,少阳、太阴血者。(盗汗也。)
《内经》云∶溺黄赤,安卧者,疸病。
《巢氏病源》云∶黄胆之病,此由酒食过度,脏腑不和,水谷相并,移于脾胃,复
为风湿所搏,瘀结不散,热气郁蒸,故食已如饥。令身体、面目、及爪甲、小便尽黄而欲
安卧。若身体多赤黑,多青皆见者,必寒热身疼而色微黄,齿垢黄,爪甲上黄,黄胆也。
渴而疸者,其病难治;疸而不渴,其病可治。发于阴部,其人必呕;发于阳部,其人
振寒而微热。
又云∶黄胆者,一身尽痛,发热,面色洞黄七八日;壮热,口里有血,当下之,法如肫
肝状,其人少腹内急;若其人眼睛涩痛,鼻骨痛,两膊及项强,腰背急,即其患黄,多大便
涩、但令得小便快,即不虑死。不用大便多,多则心腹胀,不食,此由寒湿在表,则热蓄于脾
胃,腠理不开,瘀热与宿谷相搏,烦郁不得消,则大、小便不得通,故身体、面目皆变黄
色。
张仲景说:夏季感受风湿之邪,身体沉重如压巨石,无法翻身转动。适宜使用祛风胜湿、清热的药物治疗。又说:风湿病脉象浮,身体沉重,出汗且怕风的,用防己黄芪汤主治。又说:肾着病,患者身体沉重,腹部寒冷如同坐在水中,形体僵硬如冰状,不能随意翻动;小便自遗,饮食正常。此病属下焦,因劳累出汗后,衣物内里冷湿,日久才得此病,腰部以下感觉像系着五千枚铜钱一样沉重。用甘姜苓术汤主治。
李东垣说:身体沉重,是湿邪所致。用补中益气汤合去桂枝的五苓散主治。
(李东垣)参术汤:治疗脾肾虚弱,元气不能充盛通畅,四肢沉重,饭后昏沉闷乱。
药物组成:黄芪(一钱)、人参、炙甘草、陈皮、青皮(各五分)、当归、酒黄柏、升麻、柴胡(各三分)、神曲(七分)。
煎服法:以上药材加水两盏,灯心草十根、大枣一枚,煎至八分,饭前热服。
甘姜苓术汤:治疗肾冷湿邪,腰部沉重无法起身。
药物组成:甘草、干姜(各五钱)、白术、茯苓(各一两)。
煎服法:以上药材切碎,加水五盏,煎至三盏,分三次服用。
防己黄芪汤、小柴胡汤、黄芩芍药汤(均见于《伤寒论》相关章节)。
(《太平惠民和剂局方》)五积散:治疗湿邪盛导致的身体沉重。(方剂见湿门章节。)
经文说:脾病患者,身体沉重,肌肉痿软,取足太阴、足阳明、足少阴经的血分穴位治疗。
又说:脾病患者,身体沉重,睡中出汗(盗汗),怕风,取足少阳、足太阴经的血分穴位治疗。
《诸病源候论》说:黄疸病,这是由于饮酒饮食过度,脏腑不和,水谷之气相并,移于脾胃,又为风湿所搏结,瘀滞不散,热气郁蒸,所以吃完饭后仍觉得饥饿。导致身体、面目及指甲、小便全部发黄而想安卧。如果身体多呈赤黑色,或多青色都出现的,必定有寒热交替、身体疼痛且面色微黄,牙齿垢黄,指甲上黄,这是黄疸。口渴而患疸病的,病情难治;患疸病但不口渴的,病情可治。病发于阴部的,患者必定呕吐;病发于阳部的,患者恶寒战栗且微热。
又说:黄疸病,全身疼痛,发热,面色深黄持续七八天;若高热,口中有血腥味,应当攻下,方法类似治疗肝实证的规律,患者小腹内部拘急;如果患者眼睛涩痛,鼻骨痛,两膊及颈部僵硬,腰背拘急,这就是患黄疸,大多大便干涩,只要能让小便通利畅快,就不必担心死亡。不需要让大便次数过多,过多则会导致心腹胀满,不能进食,这是因为寒湿在表,导致热邪蓄积于脾胃,腠理闭塞不开,瘀热与宿食相搏结,烦闷郁结不得消散,导致大小便都不通,所以身体、面目都变成黄色。
Zhang Zhongjing stated: In summer, contracting wind-dampness results in a body heavy as if weighed down by mountains, unable to turn or shift position. It is appropriate to treat with herbs that dispel wind, overcome dampness, and clear heat. He further stated: For wind-dampness presenting with a floating pulse, heaviness of the body, sweating, and aversion to wind, Fangji Huangqi Tang (Acanthopanacis Cortex and Astragali Decoction) is the primary treatment. He also stated: Regarding the disease of "Kidney Fixation" (Shen Zhuo), the patient experiences bodily heaviness, coldness in the abdomen as if sitting in water, stiffness resembling ice, and inability to change posture; urination occurs involuntarily, while appetite remains normal. This pathology belongs to the Lower Jiao (Lower Burner), arising from labor-induced sweating where cold and dampness penetrate the clothing lining, developing over time. The area below the waist feels as heavy as carrying five thousand coins. Gan Jiang Ling Zhu Tang (Ginger, Poria, and Atractylodes Decoction) is the primary treatment.
Li Dongyuan stated: Bodily heaviness is caused by dampness. Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting the Qi) combined with Wuling San (Five-Ingredient Powder with Poria), minus Guizhi (Cinnamon Twig), is the primary treatment.
Inability to rest peacefully during sleep is termed "heaviness of the body due to dampness." Xiaochaihu Tang (Minor Bupleurum Decoction) or Huangqin Shaoyao Tang (Scutellaria and Peony Decoction) are the primary treatments.
(Cangshu Tang by Li Dongyuan): Treats spleen and kidney deficiency, where Yuan Qi (Original Qi) fails to circulate freely, causing heaviness in the four limbs and mental fogginess after eating.
Ingredients: Huangqi (Astragali Radix, 1 qian), Renshen (Ginseng Radix), Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Qingpi (Citri Reticulatae Pericarpium Viride) (each 0.5 qian), Danggui (Angelicae Sinensis Radix), Jiu Huangbai (Phellodendri Cortex processed with wine), Shengma ( Cimicifugae Rhizoma), Chaihu (Bupleuri Radix) (each 0.3 qian), Shenqu (Massa Medicata Fermentata, 0.7 qian).
Preparation: Add two cups of water, ten roots of Dengxincao (Junci Medulla), and one Jujube (Ziziphi Jujubae Fructus). Decoct until reduced to 0.8 cup. Take hot before meals.
Gan Jiang Ling Zhu Tang (Ginger, Poria, and Atractylodes Decoction): Treats cold-dampness affecting the kidneys, causing heaviness in the lower back preventing rising.
Ingredients: Gancao (Glycyrrhizae Radix et Rhizoma), Ganjiang (Zingiberis Rhizoma) (each 5 qian), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria) (each 1 liang).
Preparation: Coarsely crush the ingredients. Add five cups of water, decoct until reduced to three cups. Divide into three doses.
Fangji Huangqi Tang (Stephaniae Tetrandrae and Astragali Decoction), Xiaochaihu Tang (Minor Bupleurum Decoction), Huangqin Shaoyao Tang (Scutellaria and Peony Decoction) (see Chapter on Cold Damage).
(Wuji San from *Taiping Huimin Heji Jufang*): Treats bodily heaviness due to excessive dampness. (Formula see Chapter on Dampness.)
The Classics state: In Spleen diseases, presenting with bodily heaviness and muscle flaccidity (Rou Wei), treat by selecting blood points from the Taiyin, Yangming, and Shaoyin meridians.
It also states: In Spleen diseases, presenting with bodily heaviness, night sweats (Dao Han), and aversion to wind, treat by selecting blood points from the Shaoyang and Taiyin meridians.
The *Neijing* (Inner Canon) states: Yellowish-red urine accompanied by a desire to lie still indicates Dan Disease (Jaundice).
The *Chaos Bing Yuan* (Source Book of Diseases and Syndromes) states: Jaundice arises from excessive consumption of alcohol and food, leading to disharmony of the Zang-Fu organs. Water and grain qi merge and transfer to the Spleen and Stomach, where they are constrained by wind-dampness. Stasis accumulates without dispersing, and heat qi stagnates and steams, causing hunger even after eating. This leads to yellowing of the body, face, nails, and urine, along with a desire to lie still. If the body shows red-black or blue-green hues, accompanied by alternating chills and fever, body pain, slightly yellow complexion, yellow dental plaque, and yellow nails, it is Jaundice. Jaundice with thirst is difficult to treat; jaundice without thirst is curable. If the pathogen originates in the Yin aspect, vomiting will occur; if in the Yang aspect, there will be shivering chills and slight fever.
It also states: Jaundice presents with generalized body pain, fever, and a deep yellow facial complexion persisting for seven to eight days. If high fever is present with a bloody taste in the mouth, purgation is indicated, following methods similar to those for Liver excess syndromes, with urgency in the lower abdomen. If the eyes are dry and painful, nasal bone pain, stiffness in both arms and neck, and tension in the lower back occur, this confirms Jaundice. Bowel movements are often constipated; however, if urination becomes smooth and profuse, death can be avoided. There is no need to induce frequent bowel movements, as this may cause abdominal distension and anorexia. This occurs because cold-dampness remains at the exterior, trapping heat within the Spleen and Stomach. When the Couli (pores) fail to open, stasis-heat combats retained food, causing vexation and郁结 (stagnation) that cannot dissipate, blocking both large and small bowel movements. Consequently, the body and face turn yellow.