（附论）
夫伤寒有五。其一为中湿。盖风湿之气。中人为病。发热。与 相类。故曰湿温。此因
汗出
烦。小便不利。大便反快。是谓中湿。若风湿相搏。则一身尽痛。日晡为剧。湿热相蒸。则
心动
大
细
歌云。其人湿气素来伤。暑气重伤病愈猖。多汗其人双胫冷。湿温当辨脉阴阳。
又云。湿温不可发汗。发汗则死。名曰重 。医杀之也。宜术附汤。白虎加苍术汤。又
问两
热相
小而
如
此名中湿也。风雨袭虚。山泽蒸气。人多中湿。湿流关节。须身体烦痛。其脉沉缓。为中湿。
脉细者。非也。主身尽痛。发热身黄。小便自利者。术附汤。若小便不利。大便反快者。当
利其小便。宜甘草附子汤。五苓散主之。
至真要大论云。治湿之法。不利小便。非其治也。金匮要略云。湿家。身烦痛。可与麻
黄汤
大
由
多
非
肢体痛。不可转侧。额上微汗。不欲去被。或身微肿。此名风湿也。脉浮。为风湿。是
风气与湿气相搏。肢体痛重。不可转侧。额上微汗。不欲去被。或身微肿。欲发汗。但
身润
桂
甘草附子汤。加防风。
方
麻黄杏仁薏苡仁甘草汤 治湿温。一身尽痛。发热，日晡所剧。此病伤于汗出当风。或
久伤
麻黄（去根节三两煎去沫） 杏仁（去皮尖双仁三十枚炒） 薏苡仁（一两） 甘草（炙
一两）
上
加术麻黄汤 治湿家身烦疼。发其汗为宜。慎不可以火攻之。
麻黄（去根节三两） 桂（去皮二两） 甘草（炙一两） 杏仁（去皮尖双仁七十枚） 白
术
（四两
防己黄 汤 治风湿。脉浮。身重。汗恶风者。并治风水。脉浮。身重。不出汗者
。
防己（四两） 黄 （五两） 甘草（炙二两） 白术（三两） 上 咀。每服五钱匕。
以水一
盏半
黄。
下如
杏仁汤 治风湿。身体疼痛。恶风。微肿。
杏仁（去皮尖双仁炒一十五枚） 桂（去皮） 麻黄（去根节先煮一两沸焙干） 芍药 天
门
冬（
时
候
温风丸 治湿温。身寒身凉。脉短。日逐有汗者。下虚。上攻头目昏痛者。
白附子 阳起石 滑石（各一两） 寒水石（四两烧） 上捣研为末。用糯粥饮和丸。
如梧
桐子
安息香丸 治湿温伤寒。四五日后。汗出。肢体冷。
安息香（一分） 五灵脂（二两半） 麻黄（去根节半两） 附子尖（七个） 巴豆（去
皮醋煮
半两）
性。生姜汤化下。
茵陈五苓散 治伤寒湿温热病感冒后。发为黄胆。小便赤。烦渴发热。不得安宁。
此盖汗下太早。服药不对证。因感湿热病。以致遍身发黄。予尝用茵陈五苓散治之。
甚妙。
上用生料五苓散一两。加入茵陈半两。车前子一钱。木通一钱半。柴胡一钱半。酒后得
证。
前服
白虎加苍术汤 治湿温多汗。
知母（六两） 甘草（二两炙） 石膏（一斤） 苍术（三两） 粳米（三两） 上锉
散。每服
五钱
胸项
余曰
加苍
贼邪
邪。
为正
最
于
每至暑月。两足汗 未尝干。每服此药二三盏。即便愈。
茯苓白术汤。治湿温。
茯苓 干姜 甘草 白术 桂（各一钱半） 上水二盏。煎至八分。去滓服。
麻黄加葛根汤 治太阳表病。风湿相搏。营卫俱病。一身尽疼。表气不和。当汗
而解之。风
杏仁（二十五个去皮尖） 麻黄 桂枝 葛根（各一两） 甘草（半两） 上锉细。每
服五
钱。或
知母干葛汤 治风湿。身体内热甚者。
知母（三钱） 干葛（八分） 石膏（六钱） 葳蕤（五钱） 甘草（炙） 黄芩 木
香升麻
生南
每服五
钱。
栝蒌根汤 治风湿加渴者。\x
栝蒌根（三分） 石膏（二两） 生葛根（一两半干者三钱） 人参 防风 甘草（炙
各半两）
上
（附论）
伤寒有五种。其中一种是中湿。这是由于风湿之气侵入人体而致病，出现发热症状，与湿温相似，所以称为湿温。这种情况是因为出汗后感到烦闷，小便不通利，大便反而通畅，这叫做中湿。如果风湿相互搏结，则全身都疼痛，在傍晚时分加重。湿热相互蒸腾，则导致心悸、脉象细小。歌诀说：此人湿气素来受伤，暑气重伤使得病情更加猖獗。多汗且双小腿发冷，湿温应当辨别脉象的阴阳。
又说：湿温不可使用发汗法治疗，若发汗会导致死亡，这种病名叫“重暍”（中暑重症）。这是医生误治致死。适宜使用术附汤、白虎加苍术汤。
又问：两热相合，脉小而……如同这样，名为中湿。风雨侵袭虚弱之人，山泽之间的蒸气弥漫，人容易感受湿邪。湿气流注关节，必须身体烦痛，其脉象沉缓，这是中湿。脉象细弱的，不是这种情况。主治全身疼痛、发热身黄、小便自利的情况，用术附汤。如果小便不利，大便反而通畅的，应当通利小便，适宜甘草附子汤，五苓散主治。
《至真要大论》说：治疗湿邪的方法，如果不通利小便，就不是正确的治疗方法。《金匮要略》说：患湿病的人，身体烦痛，可以用麻黄汤……肢体疼痛，不能翻身转侧，额头微微出汗，不想去掉被子，或者身体轻微浮肿，这叫风湿。脉浮，为风湿。这是风气与湿气相互搏结，肢体疼痛沉重，不能翻身转侧，额头微微出汗，不想去掉被子，或者身体轻微浮肿。想要发汗，但……桂枝、甘草附子汤，加防风。
方剂：
麻黄杏仁薏苡仁甘草汤：治疗湿温，全身疼痛，发热，傍晚时分加重。此病因出汗时当风受邪，或久伤……
麻黄（去根节三两，煎煮去沫）、杏仁（去皮尖，双仁三十枚，炒）、薏苡仁（一两）、甘草（炙一两）。
上药……
加术麻黄汤：治疗湿家身体烦疼，发汗为宜。千万不可以火攻法治疗。
麻黄（去根节三两）、桂枝（去皮二两）、甘草（炙一两）、杏仁（去皮尖，双仁七十枚）、白术（四两）。
防己黄芪汤：治疗风湿，脉浮，身体沉重，汗出恶风者。并治疗风水，脉浮，身体沉重，不出汗者。
防己（四两）、黄芪（五两）、甘草（炙二两）、白术（三两）。上药切碎，每服五钱匕，用水一盏半……
黄芪……下如……
杏仁汤：治疗风湿，身体疼痛，恶风，微肿。
杏仁（去皮尖，双仁炒一十五枚）、桂枝（去皮）、麻黄（去根节先煮一两沸，焙干）、芍药、天门冬……时候……
温风丸：治疗湿温，身体寒冷发凉，脉短，每日都有汗出，下虚，上攻头目昏痛者。
白附子、阳起石、滑石（各一两）、寒水石（四两，烧过）。上药捣研为末，用糯米粥饮和丸，如梧桐子大。
安息香丸：治疗湿温伤寒，四五日后，汗出，肢体冷。
安息香（一分）、五灵脂（二两半）、麻黄（去根节半两）、附子尖（七个）、巴豆（去皮醋煮半两）。性味……生姜汤化下。
茵陈五苓散：治疗伤寒湿温热病感冒后，发为黄疸，小便赤色，烦渴发热，不得安宁。这是因为汗下太早，服药不对证，因感受湿热病，以致遍身发黄。我曾使用茵陈五苓散治疗，非常奇妙。
上用生料五苓散一两，加入茵陈半两，车前子一钱，木通一钱半，柴胡一钱半，酒后得证……前服……
白虎加苍术汤：治疗湿温多汗。
知母（六两）、甘草（二两，炙）、石膏（一斤）、苍术（三两）、粳米（三两）。上药锉散，每服……五钱……胸项……
余曰：加苍……贼邪……邪……为正……最……于……
每到暑月，两足出汗未尝干燥。每服此药二三盏，即便痊愈。
茯苓白术汤：治疗湿温。
茯苓、干姜、甘草、白术、桂枝（各一钱半）。上药水二盏，煎至八分，去滓服。
麻黄加葛根汤：治疗太阳表病，风湿相搏，营卫俱病，全身疼痛，表气不和，应当通过发汗来解表。
杏仁（二十五个，去皮尖）、麻黄、桂枝、葛根（各一两）、甘草（半两）。上药锉细，每服五钱……或……
知母干葛汤：治疗风湿，身体内热甚者。
知母（三钱）、干葛（八分）、石膏（六钱）、葳蕤（五钱）、甘草（炙）、黄芩、木香、升麻、生南……每服五钱。
栝蒌根汤：治疗风湿兼口渴者。
栝蒌根（三分）、石膏（二两）、生葛根（一两，干者三钱）、人参、防风、甘草（炙，各半两）。上药……
(Attached Discussion)
Cold damage (Shanghan) comprises five types. One of them is "Zhong Shi" (Struck by Dampness). This occurs when Wind-Damp pathogenic factors invade the human body causing disease, presenting with fever, which resembles Wen Wen (Damp-Heat), hence it is called Wen Wen. This condition arises from sweating followed by irritability, dysuria (difficult urination), and loose stools; this is termed Zhong Shi. If Wind and Dampness struggle against each other, the whole body aches severely, worsening in the late afternoon. When Damp-Heat steams and steeps internally, it causes palpitations and a fine pulse. The verse states: "The person has been injured by dampness since childhood; severe heat-stroke makes the illness rampant. Profuse sweating and cold calves indicate Wen Wen; one must distinguish its Yin and Yang pulses."
It is further stated: Wen Wen should not be treated with diaphoresis (sweating methods); inducing sweat leads to death. This condition is named "Chong Yue" (Severe Heat Stroke). It is caused by medical error killing the patient. Suitable formulas include Shu Fu Tang (Atractylodes and Aconite Decoction) and Bai Hu Jia Cang Zhu Tang (White Tiger plus Cang Zhu Decoction).
Another inquiry: When two heat pathogens combine, and the pulse is small... resembling this, it is named Zhong Shi. Wind and rain attack the deficient, mountain and marsh vapors rise, and people easily contract dampness. Dampness flows into the joints, necessitating bodily irritability and pain, with a deep and slow pulse, indicating Zhong Shi. A fine pulse indicates otherwise. For cases of whole-body pain, fever, yellowing of the skin, and spontaneous urination, Shu Fu Tang is indicated. If there is dysuria but loose stools, one should promote urination; Gan Cao Fu Zi Tang (Licorice and Aconite Decoction) is suitable, or Wu Ling San (Five-Ingredient Powder with Poria).
The *Zhi Zhen Yao Da Lun* states: The method for treating dampness is to promote urination; without promoting urination, it is not the correct treatment. The *Jin Gui Yao Lue* states: For patients with dampness suffering from bodily irritability and pain, Ma Huang Tang (Ephedra Decoction) may be used... for limb pain, inability to turn over, slight sweating on the forehead, aversion to removing blankets, or slight edema, this is Feng Shi (Wind-Damp). A floating pulse indicates Wind-Damp. This is where Wind Qi struggles with Dampness Qi, causing heavy limb pain, inability to turn over, slight sweating on the forehead, aversion to removing blankets, or slight edema. To induce sweat, but... Gui Zhi (Cinnamon Twig), Gan Cao Fu Zi Tang, added with Fang Feng (Saposhnikovia Root).
Formula:
Ma Huang Xing Ren Yi Yi Ren Gan Cao Tang (Ephedra, Apricot Seed, Coix Seed, and Licorice Decoction): Treats Wen Wen, whole-body pain, fever, worsening in the late afternoon. This disease results from exposure to wind while sweating, or chronic injury...
Ma Huang (Ephedrae Herba, 3 liang, roots and nodes removed, foam skimmed off during decoction), Xing Ren (Armeniacae Semen Amarum, 30 double-kernel seeds, peeled and tips removed, stir-fried), Yi Yi Ren (Coicis Semen, 1 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 liang, honey-fried).
[Process]...
Jia Shu Ma Huang Tang (Ma Huang Tang plus Atractylodes): Treats bodily irritability and pain in dampness-prone individuals; diaphoresis is appropriate. Strictly avoid fire therapy.
Ma Huang (Ephedrae Herba, 3 liang, roots and nodes removed), Gui Zhi (Cinnamomi Ramulus, 2 liang, bark removed), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 liang, honey-fried), Xing Ren (Armeniacae Semen Amarum, 70 double-kernel seeds, peeled and tips removed), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 4 liang).
Fang Ji Huang Qi Tang (Stephania and Astragalus Decoction): Treats Wind-Damp with floating pulse, heavy body, sweating, and aversion to wind. Also treats Feng Shui (Wind Edema) with floating pulse, heavy body, and absence of sweat.
Fang Ji (Stephaniae Tetrandrae Rhizoma, 4 liang), Huang Qi (Astragali Radix, 5 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, 2 liang, honey-fried), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 3 liang). [Herbs are] coarsely crushed; take 5 qian bi per dose with 1.5 zhan of water...
Huang Qi... Xia Ru...
Xing Ren Tang (Apricot Seed Decoction): Treats Wind-Damp, bodily pain, aversion to wind, slight edema.
Xing Ren (Armeniacae Semen Amarum, 15 double-kernel seeds, peeled, tips removed, stir-fried), Gui Zhi (Cinnamomi Ramulus, bark removed), Ma Huang (Ephedrae Herba, roots and nodes removed, boiled first for one boil, then dried), Shao Yao (Paeoniae Radix Alba), Tian Men Dong (Asparagi Radix)... Shi Hou...
Wen Feng Wan (Warm Wind Pill): Treats Wen Wen, cold and cool body, short pulse, daily sweating, deficiency below, attacking above causing dizziness and headache.
Bai Fu Zi (Typhonii Rhizoma), Yang Qi Shi (Leucogyni Concretio), Hua Shi (Talcum, 1 liang each), Han Shui Shi (Alumen Rubrum, 4 liang, calcined). [Herbs are] pounded and ground into powder, mixed with glutinous rice porridge drink to form pills, size of Wutong seeds.
An Xi Xiang Wan (Styrax Pill): Treats Wen Wen Shanghan, after four to five days, sweating, cold limbs.
An Xi Xiang (Styrax, 1 fen), Wu Ling Zhi (Trogopterori Faeces, 2.5 liang), Ma Huang (Ephedrae Herba, 0.5 liang, roots and nodes removed), Fu Zi Jian (Aconiti Lateralis Radix Praeparata tips, 7 pieces), Ba Dou (Crotonis Fructus, 0.5 liang, peel removed, vinegar-boiled). Nature... Take with Ginger Decoction to dissolve.
Yin Chen Wu Ling San (Artemisiae Scopariae and Five-Ingredient Powder with Poria): Treats Jaundice following Cold Damage, Wet-Warmth, or febrile disease complications, with red urine, irritability, thirst, fever, and restlessness. This is due to premature sweating or purgation, incorrect medication, contracting Damp-Heat, leading to generalized yellowing. I have used Yin Chen Wu Ling San to treat this with excellent results.
Take 1 liang of raw material Wu Ling San, add 0.5 liang of Yin Chen (Artemisiae Scopariae Herba), 1 qian of Che Qian Zi (Plantaginis Semen), 1.5 qian of Mu Tong (Akebiae Caulis), 1.5 qian of Chai Hu (Bupleuri Radix), taken after wine... Previous doses...
Bai Hu Jia Cang Zhu Tang (White Tiger plus Cang Zhu Decoction): Treats Wen Wen with profuse sweating.
Zhi Mu (Anemarrhenae Rhizoma, 6 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, 2 liang, honey-fried), Shi Gao (Gypsum Fibrosum, 1 jin), Cang Zhu (Atractylodis Rhizoma, 3 liang), Jing Mi (Oryza Sativa Germen, 3 liang). [Herbs are] coarsely chopped; take per dose... 5 qian... Chest and neck...
I say: Add Cang... Zei Xie (Robbing Pathogen)... Pathogen... Is Zheng... Most... At...
Every month of summer, both feet sweat and never dry. Taking 2-3 zhan of this medicine cures it immediately.
Fu Ling Bai Zhu Tang (Poria and Atractylodes Decoction): Treats Wen Wen.
Fu Ling (Poria), Gan Jiang (Zingiberis Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Gui Zhi (Cinnamomi Ramulus, 1.5 qian each). Add 2 zhan of water, decoct to 0.8 zhan, remove dregs, and take.
Ma Huang Jia Ge Gen Tang (Ma Huang Tang plus Puerariae Radix): Treats Taiyang exterior syndrome, Wind-Damp struggling, Ying and Wei both diseased, whole-body pain, disharmony of exterior Qi, requiring resolution through diaphoresis.
Xing Ren (Armeniacae Semen Amarum, 25, peeled and tips removed), Ma Huang (Ephedrae Herba), Gui Zhi (Cinnamomi Ramulus), Ge Gen (Puerariae Lobatae Radix, 1 liang each), Gan Cao (Glycyrrhizae Radix et Rhizoma, 0.5 liang). [Herbs are] finely chopped; take 5 qian per dose... Or...
Zhi Mu Gan Ge Tang (Anemarrhena and Pueraria Decoction): Treats Wind-Damp with severe internal heat.
Zhi Mu (Anemarrhenae Rhizoma, 3 qian), Gan Ge (Puerariae Radix, 8 fen), Shi Gao (Gypsum Fibrosum, 6 qian), Wei Yu (Polygonati Odorati Rhizoma, 5 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried), Huang Qin (Scutellariae Radix), Mu Xiang (Aucklandiae Radix), Sheng Ma (Cimicifugae Rhizoma), Sheng Nan... Take 5 qian per dose.
Gua Lou Gen Tang (Trichosanthis Radix Decoction): Treats Wind-Damp with thirst.
Gua Lou Gen (Trichosanthis Radix, 3 fen), Shi Gao (Gypsum Fibrosum, 2 liang), Sheng Ge Gen (Puerariae Lobatae Radix, fresh 1.5 liang, dried 3 qian), Ren Shen (Ginseng Radix et Rhizoma), Fang Feng (Saposhnikoviae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, 0.5 liang each). [Herbs are]...