（风湿 湿热 寒湿 暑湿 中湿附）
湿为阴邪，乃重浊有质，不比暑热弥漫无形，其自外受者，雾露泥水，由地气之上蒸，经所谓地之湿气感
则害人皮肉筋脉也。自内生者，水谷生冷，由脾阳之不运，经所谓诸湿肿满，皆属于脾也。湿蒸于上，则头
胀如蒙，经所谓因于湿，首如裹也。湿感于下，则跗肿攻注，经所谓伤于湿者，下先受之也。在经络则痹痿重
着，经所谓湿热不攘，大筋 短，小筋弛长， 短为拘，弛长为痿也。在脏腑，则呕恶肿胀，小水赤涩，经所
谓湿胜则濡泻也。又或在肌表，则恶寒自汗；在肉分，则麻木浮肿；其身重如山，不利转侧；腰膝肿，筋骨痛；
小溲秘，大便溏。则有湿兼风者，有湿兼热者，有湿兼寒者，有湿兼暑者，有中湿而口 舌强，昏不知人，
类中风者。不得误作中风症治。在表在上，宜微汗；在里在下，宜渗泄；中虚，宜实脾；挟风而外感者，宜
解肌；挟寒而在半表半里者，宜温散；挟暑热而滞于三焦者，宜清利分消；其湿热蒸痰，内闭昏厥者，宜宣窍
逐秽，此治湿之要也。
〔湿阻上焦〕头胀脘闷，不饥溺涩，宜开肺气，通膀胱。桔梗、通草、滑石、半夏、栝蒌、浓朴、杏仁、
蔻仁、薏米、茯苓、香豉、淡竹叶等。
〔湿滞中焦〕肠胃属腑，湿久生热，传送既钝，大便不爽，宜主温通，佐淡渗，如枳壳、砂仁壳、橘白、
草果、藿香、半夏曲、大腹皮、猪苓、泽泻之类。脾阳不运，湿郁腹膨，用术、朴、姜、半之类，以温运之。
以苓、泽、腹皮、滑石之类，以渗泄之。兼寒，实脾饮。兼风，胜湿汤。
〔湿痰阻窍〕湿郁蒸痰，神呆语謇。宜主开郁，佐辛香。郁金、石菖蒲、浓朴、半夏、佩兰、金银花、
茯神、栝萎、枳壳之类。神昏内闭，邪入心包，宜芳香宣窍。佩兰、银花露、犀角、连翘心等送至宝丹。
〔湿流关节〕体酸骨痛，不利屈伸，独活寄生汤，羌活胜湿汤。其夹风者，必加烦热，流走拘急。防风汤。
夹寒者，必加挛痛浮肿。五积散加减。风寒湿合则成痹。详痹。
〔风湿〕一身尽痛，属风湿相搏。除湿羌活汤。肢体烦痛，头重鼻塞，或泻利，或下清血，为风木之邪，
内干湿土，神术汤。脉浮身重，汗出恶风，防己黄 汤。仲景论风湿之脉，浮虚而涩。
〔湿热〕脉滑数，溺赤涩，引饮自汗，属湿热。宜主清火，佐分利，清热渗湿汤，或小厘清饮。湿盛身
痛，溺涩体重，发渴，五苓散加羌活。身黄如橘色，溺涩腹微满，茵陈蒿汤。身黄溺涩而渴，五苓散加茵陈。
烦热溺涩而渴，桂苓甘露饮。湿热相搏，清热渗湿汤。肩背沉重，肢节烦痛，或遍身痛，脚膝肿痛，属外因湿
热，当归拈痛饮。湿热之内因，则水肿小便不利，五苓散、神芎丸之类。分轻重之泄，后用实脾之剂调理。六
君子汤，异功散。阴虚多火，兼走精者，湿袭精窍也，虎潜丸，或加白术、牡蛎。有气如火，从脚下起入腹，
属湿郁成热，二妙丸加牛膝、防己。叔和《脉经》云∶湿热之脉滑疾。
〔寒湿〕脉不滑数，溺清便利，身痛无汗，关节不利，牵掣作痛，属寒湿，宜温利，七味渗湿汤、五苓散。
脉虚者宜温补，理中汤加茯苓、薏米。四肢浮肿，不利屈伸，大便多溏，除湿汤。或升阳除湿汤。腰痛身重，
小便不利，肾着汤。如寒热之气中于外，此与内生之湿不同，宜温而兼散，五积散，或加味五苓散。叔和《脉经》
云∶脉大而浮，虚而涩，皆寒湿。
〔暑湿〕溽暑酿湿，呕吐泻利，六和汤。先伤于湿，因而中暑，两胫逆冷，胸满头重，妄言多汗，脉阳弱
阴急，病名湿温，切不可汗。苍术白虎汤。 仲景论中暑之脉，弦细芤迟，若兼湿，则虚濡，或虚涩。
〔中湿〕关节重痛，浮肿喘满腹胀，昏闷不知人，脉必沉缓或沉微，属中湿。除湿汤。有破伤处，因澡浴
湿入疮口，昏迷沉重，身强直，口噤，状类中湿，名破伤湿。白术酒，或用 牡蛎粉二钱，甘草汤调服。仍取
粉敷疮口。叔和《脉经》云∶脉沉而缓，沉而细，皆中湿。
沈氏云∶湿在上，宜防风，风能燥湿也；湿在中，宜苍术，土干燥湿也；湿在下，宜利溺，开沟利湿
也。湿在周身，宜乌药、羌活。湿在两臂，宜桑条、威灵仙。湿在两股，宜牛膝、防风、萆 。分部位治之。
其伤湿由肾虚者，腰冷如坐水中，肾着汤。由脾虚者，腹满吐酸，苓姜术桂汤。体气虚弱者，身重便溏，清
燥汤。酒湿者，呕泻发热，葛花解酲汤。坐卧湿地，当风凉，足膝拘挛者，独活寄生汤。年老衰惫，妇人肾
虚血竭，致腰脚痛者，独活寄生汤。脾胃不和，伏湿水泻者，加味平胃散。脾湿泄泻者，胃苓汤、苍术丸。
湿家治法，大概宜发微汗，利小便，使上下分消。仲景谓湿家忌汗，以身本有汗，易至亡阳，故
湿温症误发其汗，名曰重 ，所宜深戒。然久冒风凉，以水灌汗，遏郁生阳，又不得不微汗之。不可大发汗，
大发汗则湿去热留，防其变症。东垣谓治湿不利小便，非其治也。然真阳素虚之人，汗出，小便滴沥，正泉竭
而阳欲亡之候。若以为湿热而大利之，真阳无水，顷刻脱离而死矣。不宜过利，第去其六七，即改用理脾之
剂，否则亏其肾水。罗氏曰∶春夏之交，病如伤寒，其人汗自出，肢体重痛，转侧难，小便不利，此名风湿。
因时令阴雨，或坐卧卑湿，或引饮过多，宜利小便，五苓散。湿去则愈。切忌汗下，误则不救。医不识症，误
作伤风治之，发汗死，下之亦死。丹溪曰∶湿本土气，火热能生湿土，故夏热则万物润，秋凉则万物燥也。
夫热郁生湿，湿生痰，用二陈汤加酒黄芩、羌活、防风，去风行湿。以风能胜湿也。又曰∶湿甚而热，治
以苦温，佐以甘辛。平胃散主之。湿在上，宜微汗而解，不欲汗多。忌麻黄葛根等，宜防己黄 汤。湿在中下，
宜利小便，五苓散主之。此淡渗治湿也。
湿是阴邪，性质沉重浑浊且有形质，不同于暑热那样弥漫无形。从外部感受的湿，来自雾露、泥水，是由地气向上蒸腾所致，《内经》说：“地的湿气被人体感受，就会伤害人的皮肉筋脉。”从内部产生的湿，源于饮食生冷，是因为脾阳不能运化，《内经》说：“各种湿邪导致的肿胀满闷，都归属于脾。”湿气熏蒸于上部，则头部胀满像被包裹蒙蔽一样，《内经》说：“因受湿邪，头感觉像被裹住。”湿气侵袭于下部，则足背浮肿且病势向下注注，《内经》说：“伤于湿邪，下部先受病。”在经络中，则出现痹证、痿证、身体沉重着滞，《内经》说：“湿热不除，大筋收缩变短，小筋松弛变长；大筋缩短导致拘挛，小筋松弛导致痿废。”在脏腑中，则出现呕吐恶心、肿胀、小便短赤涩痛，《内经》说：“湿邪偏胜则导致大便稀溏。”又或在肌表，则恶寒自汗；在肌肉腠理，则麻木浮肿；身体沉重如坐山中，转动侧身不便；腰膝肿痛；小便闭塞，大便溏薄。其中有的湿兼风邪，有的湿兼热邪，有的湿兼寒邪，有的湿兼暑邪，有的中湿导致口舌僵硬、神志昏迷不知人，症状类似中风，但不能误作中风症治疗。病位在表在上，宜用微汗法；病位在里在下，宜用渗泄法；中气虚弱，宜实脾；挟风邪而外感的，宜解肌；挟寒邪而在半表半里的，宜温散；挟暑热邪而阻滞在三焦的，宜清利分消；如果是湿热蒸腾成痰，内闭导致昏厥的，宜宣通窍道、驱逐秽浊，这是治疗湿病的要点。
【湿阻上焦】表现为头胀、胃脘闷塞、不思饮食、小便涩滞，宜宣开肺气，通利膀胱。用药如桔梗、通草、滑石、半夏、瓜蒌、厚朴、杏仁、豆蔻仁、薏苡仁、茯苓、香豉、淡竹叶等。
【湿滞中焦】肠胃属于腑，湿邪久留易生热，传导功能迟钝，大便不爽利，宜以温通为主，佐以淡渗利湿，如枳壳、砂仁壳、橘白、草果、藿香、半夏曲、大腹皮、猪苓、泽泻之类。若脾阳不运，湿郁导致腹部膨隆，用白术、厚朴、干姜、半夏之类，以温运脾阳。用茯苓、泽泻、大腹皮、滑石之类，以渗泄湿邪。兼有寒邪者，用实脾饮。兼有风邪者，用胜湿汤。
【湿痰阻窍】湿郁蒸腾成痰，神情呆滞、言语謇涩。宜以开郁为主，佐以辛香之品。用药如郁金、石菖蒲、厚朴、半夏、佩兰、金银花、茯神、瓜蒌、枳壳之类。若神志昏迷、邪气内闭心包，宜用芳香宣通窍道之法。用药如佩兰、银花露、犀角、连翘心等，送服至宝丹。
【湿流关节】身体酸痛、骨节疼痛，屈伸不利，用独活寄生汤、羌活胜湿汤。其中夹风邪的，必定伴有烦热，疼痛游走不定且拘急，用防风汤。夹寒邪的，必定伴有痉挛疼痛、浮肿，用五积散加减。风寒湿三气合而为痹，详见“痹证”篇。
【风湿】全身疼痛，属风湿相搏。用除湿羌活汤。肢体烦痛、头重鼻塞，或腹泻痢疾，或下清血，此为风木之邪内伤湿土，用神术汤。脉浮、身重、汗出、恶风，用防己黄芪汤。仲景论述风湿的脉象，是浮虚而涩。
【湿热】脉滑数，小便赤涩，口渴引饮、自汗，属湿热。宜以清火为主，佐以分利水道，用清热渗湿汤，或小厘清饮。湿盛导致身痛、小便涩滞、身体沉重、发渴，用五苓散加羌活。身体发黄如橘子色、小便涩滞、腹部微满，用茵陈蒿汤。身体发黄、小便涩滞且口渴，用五苓散加茵陈。烦热、小便涩滞且口渴，用桂苓甘露饮。湿热相搏，用清热渗湿汤。肩背沉重、肢节烦痛，或遍身疼痛、脚膝肿痛，属外因湿热，用当归拈痛汤。湿热之内因，则导致水肿、小便不利，用五苓散、神芎丸之类。根据轻重分别泄湿，后用实脾之剂调理，如六君子汤、异功散。阴虚多火，兼有精液流失者，是湿邪袭扰精窍，用虎潜丸，或加白术、牡蛎。若有气如火，从脚下起入腹，属湿郁成热，用二妙丸加牛膝、防己。叔和《脉经》说：“湿热的脉象滑疾。”
【寒湿】脉不滑数，小便清长便利，身体疼痛无汗，关节不利，牵掣作痛，属寒湿，宜温利，用七味渗湿汤、五苓散。脉虚者宜温补，用理中汤加茯苓、薏苡仁。四肢浮肿、屈伸不利、大便多溏，用除湿汤。或用升阳除湿汤。腰痛身重、小便不利，用肾着汤。如果是寒热之气从外部侵入，这与内生之湿不同，宜温散并用，用五积散，或加味五苓散。叔和《脉经》说：“脉大而浮，虚而涩，都是寒湿。”
【暑湿】溽暑酿成湿邪，呕吐腹泻，用六和汤。先伤于湿，进而中暑，两小腿逆冷，胸满头重，胡言乱语、多汗，脉象阳弱阴急，病名湿温，切不可发汗。用苍术白虎汤。仲景论述中暑的脉象，是弦细芤迟，若兼有湿邪，则脉虚濡，或虚涩。
【中湿】关节沉重疼痛，浮肿喘满腹胀，昏闷不知人，脉必沉缓或沉微，属中湿。用除湿汤。如果有破伤处，因洗澡时湿邪进入疮口，导致昏迷沉重、身体强直、口噤，症状类似中湿，名叫破伤湿。用白术酒，或用牡蛎粉二钱，甘草汤调服。仍取粉敷于疮口。叔和《脉经》说：“脉沉而缓，沉而细，都是中湿。”
沈氏说：湿邪在上部，宜用防风，风能燥湿；湿邪在中部，宜用苍术，土能干燥湿；湿邪在下部，宜利小便，开沟渠以利湿。湿邪在周身，宜用乌药、羌活。湿邪在两臂，宜用桑条、威灵仙。湿邪在两股，宜用牛膝、防风、萆薢。按部位治疗。其伤湿由肾虚引起的，腰部冷如坐水中，用肾着汤。由脾虚引起的，腹部胀满吐酸水，用苓姜术桂汤。体质虚弱者，身体沉重便溏，用清燥汤。酒湿者，呕吐腹泻发热，用葛花解酲汤。坐卧湿地，当风受凉，足膝拘挛者，用独活寄生汤。年老衰惫、妇人肾虚血竭导致腰脚痛者，用独活寄生汤。脾胃不和，伏湿水泻者，用加味平胃散。脾湿泄泻者，用胃苓汤、苍术丸。
治疗湿家的大概原则，宜发微汗，利小便，使湿邪上下分消。仲景说湿家忌用大汗法，因为患者本身已有汗出，容易亡阳，所以湿温症误发其汗，名为重暍，应当深以为戒。然而如果久冒风凉，用水灌洗出汗，遏郁生阳，又不得不微汗之。不可大发汗，大发汗则湿去热留，防止发生变症。东垣说治疗湿邪不利小便，不是正确的治法。然而真阳素虚之人，汗出后小便滴沥，是真阴枯竭而阳气欲脱的征候。如果认为是湿热而过度利小便，真阳无水，顷刻间就会脱离而死。不宜过度利小便，只要去掉六七成的湿邪，就改用理脾之剂，否则会亏损肾水。罗氏说：春夏之交，病状如伤寒，其人汗自出，肢体沉重疼痛，转侧困难，小便不利，这名叫风湿。因时令阴雨，或坐卧卑湿之地，或饮水过多，宜利小便，用五苓散。湿去则病愈。切忌发汗和下法，误用则无法救治。医生不识病症，误作伤风治疗，发汗致死，下法亦致死。丹溪说：湿是本乎土的气化，火热能生湿土，所以夏天热则万物湿润，秋天凉则万物干燥。热郁而生湿，湿生痰，用二陈汤加酒黄芩、羌活、防风，去风行湿。因为风能胜湿。又说：湿甚而热，用苦温法治疗，佐以甘辛。以平胃散为主。湿邪在上部，宜微汗而解，不欲汗多。忌用麻黄、葛根等，宜用防己黄芪汤。湿邪在中下部，宜利小便，以五苓散为主。这是淡渗治湿的方法。
(Rheumatic Wind, Damp-Heat, Cold-Damp, Summerheat-Damp, with Appendix: Central Dampness)
Dampness is a Yin pathogen; it is heavy, turbid, and has substantial form, unlike Summerheat-Heat which is pervasive and formless. When contracted from the exterior, it comes from mist, dew, mud, and water, steaming upward from the earth's qi. As stated in the *Classic of Difficult Issues* (*Jing*), "The dampness of the earth, when felt by humans, harms the skin, flesh, sinews, and vessels." When generated internally, it arises from consuming raw and cold food and drink due to the failure of Spleen Yang to transform and transport. As stated in the *Classic*, "All dampness-induced swelling and fullness belong to the Spleen." When dampness steams upward, the head feels distended as if wrapped or hooded, as stated in the *Classic*: "Affected by dampness, the head feels like it is bound." When dampness invades downward, edema attacks and flows downward on the dorsum of the feet, as stated in the *Classic*: "Those injured by dampness are first affected below." In the meridians and collaterals, it causes Bi syndrome (painful obstruction), Wei syndrome (flaccidity), heaviness, and stagnation, as stated in the *Classic*: "If Damp-Heat is not dispelled, the large sinews shorten and the small sinews relax and lengthen; shortening leads to spasm, and relaxation/lengthening leads to flaccidity." In the Zang-Fu organs, it causes vomiting, nausea, swelling, and dark, scanty, painful urination, as stated in the *Classic*: "When Dampness prevails, loose stools occur." Furthermore, if at the muscle surface, there is aversion to cold and spontaneous sweating; if in the muscle layers, there is numbness and edema; the body feels heavy as if carrying a mountain, making turning difficult; waist and knees swell and bones/joints ache; urine is obstructed, and stools are loose. There may be Dampness combined with Wind, Dampness combined with Heat, Dampness combined with Cold, or Dampness combined with Summerheat. There is also Central Dampness causing stiffness of the mouth and tongue, coma, and unconsciousness, resembling Stroke (Zhong Feng); this must not be mistakenly treated as Stroke. If the pathology is in the exterior and upper, mild diaphoresis (sweating) is indicated; if in the interior and lower, seepage and drainage (diuresis) are indicated; if Middle Qi is deficient, strengthening the Spleen is indicated; if accompanied by Wind and exterior contraction, releasing the muscle layer is indicated; if accompanied by Cold and located in the half-exterior/half-interior, warming and dispersing is indicated; if accompanied by Summerheat-Heat and stagnant in the San Jiao (Triple Burner), clearing, draining, and separating/dispersing is indicated; if Damp-Heat steams into Phlegm, causing internal closure and syncope, opening the orifices and expelling filth is indicated. These are the essentials of treating Dampness.
[Dampness Obstructing the Upper Jiao] Symptoms include head distension, epigastric stuffiness, lack of appetite, and scanty/stagnant urination. The treatment should open Lung Qi and unblock the Bladder. Herbs such as Platycodon Root (Jiegeng), Akebia Stem (Tongcao), Talcum (Huashi), Pinellia Rhizome (Banxia), Trichosanthes Fruit (Gualou), Magnolia Bark (Houpo), Apricot Seed (Xingren), Cardamom Seed (Kouren), Coix Seed (Yimi), Poria (Fuling), Fermented Soybean (Xiangchi), and Bamboo Leaf (Dan Zhuye) are suitable.
[Dampness Stagnating in the Middle Jiao] The Intestines and Stomach are Fu organs; prolonged Dampness generates Heat, leading to sluggish transportation and unsatisfactory bowel movements. The treatment should prioritize warming and unblocking, assisted by bland leaching herbs, such as Aurantium Peel (Zhiqiao), Amomum Shell (Sharen Qiao), Tangerine Peel (Ju Bai), Black Cardamom (Caoguo), Patchouli (Huoxiang), Fermented Pinellia (Banxia Qu), Areca Peel (Dafupi), Polyporus (Zhuling), and Alisma (Zexie). If Spleen Yang fails to transform and Dampness stagnates causing abdominal distension, use Atractylodes Macrocephala Rhizome (Baizhu), Magnolia Bark (Houpo), Ginger (Jiang), and Pinellia (Banxia) to warm and transform. Use Poria (Ling), Alisma (Ze), Areca Peel (Fupi), and Talcum (Huashi) to drain and leak. If accompanied by Cold, use Shipi Yin (Spleen-Strengthening Decoction). If accompanied by Wind, use Shengshi Tang (Wind-Dispelling Decoction).
[Damp-Phlegm Blocking the Orifices] Stagnant Dampness steams into Phlegm, causing mental dullness and slurred speech. The treatment should prioritize resolving stagnation, assisted by acrid-aromatic herbs. Herbs such as Curcuma Tuber (Yujin), Salvia Miltiorrhiza Root (Shichangpu - *Note: Standard is Rhizoma Polygoni Tenellii*), Magnolia Bark (Houpo), Pinellia (Banxia), Eupatorium Herb (Peilan), Honeysuckle Flower (Jinyinhua), Poria with Hostwood (Fushen), Trichosanthes Fruit (Gualou), and Aurantium Peel (Zhiqiao) are suitable. If there is coma and internal closure with pathogens entering the Pericardium, use aromatic herbs to open the orifices. Herbs such as Eupatorium Herb (Peilan), Honeysuckle Dew, Rhinoceros Horn (Xijiao - *Note: Substitute with Buffalo Horn in modern practice*), and Forsythia Heart (Lianqiao Xin) are used to deliver Zhibao Dan (Treasure Guard Pill).
[Dampness Flowing into Joints] Body soreness and bone pain with limited flexion and extension are treated with Du Huo Ji Sheng Tang (Decoction for Expelling Rheumatism and Nourishing the Liver and Kidneys) or Qiang Huo Sheng Shi Tang (Notopterygium Decoction for Dispelling Dampness). If accompanied by Wind, there will necessarily be vexatious heat, wandering pain, and spasms; treat with Fang Feng Tang (Saposhnikovia Decoction). If accompanied by Cold, there will necessarily be cramping pain and edema; treat with Wu Ji San (Five Accumulations Powder) with modifications. The combination of Wind, Cold, and Dampness forms Bi Syndrome; see the section on Bi Syndrome.
[Rheumatic Wind] Whole-body pain indicates Wind-Dampness struggling against each other. Treat with Chushi Qiang Huo Tang (Dampness-Expelling Notopterygium Decoction). Vexatious pain in limbs, heavy head, nasal congestion, diarrhea/dysentery, or passage of clear blood indicates Wind-Wood pathogen injuring Damp-Earth internally. Treat with Shen Zhu Tang (Divine Atractylodes Decoction). Floating pulse, heavy body, sweating, and aversion to wind indicate treatment with Fang Ji Huang Qi Tang (Stephania and Astragalus Decoction). Zhang Zhongjing discusses the pulse of Wind-Dampness as floating, deficient, and choppy.
[Damp-Heat] Slippery and rapid pulse, dark/scanty urination, thirst with desire to drink, and spontaneous sweating indicate Damp-Heat. The treatment should prioritize clearing Fire, assisted by separating and draining methods. Use Qingre Shenshi Tang (Heat-Clearing and Damp-Draining Decoction) or Xiao Li Qing Yin (Minor Clearing Decoction). If Dampness predominates causing body pain, scanty uritation, heavy body, and thirst, use Wuling San (Five-Ling Powder) plus Qiang Huo. Yellow complexion like an orange, scanty urination, and slight abdominal fullness indicate Yinchen Hao Tang (Artemisiae Scopariae Decoction). Yellow complexion, scanty urination, and thirst indicate Wuling San plus Yinchen. Vexatious heat, scanty urination, and thirst indicate Guiling Ganlu Yin (Cassia and Licorice Sweet Dew Drink). Struggle between Dampness and Heat is treated with Qingre Shenshi Tang. Heaviness in shoulders/back, vexatious pain in joints, or whole-body pain with swollen/painful feet/knees indicates external Damp-Heat; treat with Danggui Niang Tong Yin (Angelica Pain-Relieving Drink). Internal Damp-Heat causes edema and difficult urination; treat with Wuling San or Shenxiong Wan (Divine Ligusticum Pill). Drain according to severity, then regulate with Spleen-strengthening agents such as Liu Jun Zi Tang (Six-Gentlemen Decoction) or Yigong San (Extraordinary Assistance Powder). If Yin deficiency with excessive Fire and seminal emission occurs, it is Dampness invading the essence orifice; treat with Hujian Wan (Tiger-Knee Pill) or add Baizhu and Muli. If Qi rises like fire from the feet into the abdomen, it is Dampness stagnating into Heat; treat with Ermiao Wan (Two-Marvels Pill) plus Niuxi and Fangji. Shuhe's *Mai Jing* states: "The pulse of Damp-Heat is slippery and swift."
[Cold-Damp] Pulse is not slippery/rapid; urine is clear and frequent; body pain without sweat; joint stiffness and pulling pain indicate Cold-Damp. The treatment should be warming and draining, using Qiwei Shenshi Tang (Seven-Ingredient Damp-Draining Decoction) or Wuling San. If the pulse is deficient, warming and tonifying is indicated: Lizhong Tang (Regulate the Middle Decoction) plus Fuling and Yimi. Edema of four limbs, limited flexion/extension, and frequent loose stools are treated with Chushi Tang (Dampness-Expelling Decoction) or Shengyang Chushi Tang (Raising-Yang Dampness-Expelling Decoction). Lower back pain, heavy body, and difficult urination are treated with Shen Zhuo Tang (Kidney-Dwelling Decoction). If Cold-Heat Qi invades from outside, differing from internally generated Dampness, use warming and dispersing methods: Wu Ji San or Jiawei Wuling San (Modified Five-Ling Powder). Shuhe's *Mai Jing* states: "Pulse large and floating, deficient and choppy, all indicate Cold-Damp."
[Summerheat-Damp] Humid summer heat brews Dampness, causing vomiting and diarrhea; treat with Liuhe Tang (Harmonizing Six Decoction). If initially injured by Dampness and subsequently struck by Summerheat, with reverse coldness in calves, chest/head heaviness, delirium, and profuse sweating, and a pulse that is weak in Yang and urgent in Yin, the disease name is Wet Warmth (Shi Wen). Diaphoresis must strictly be avoided. Use Cangzhu Baitu Tang (Atractylodes White Tiger Decoction). Zhang Zhongjing discusses the pulse of Summerheat stroke as wiry, fine, hollow, and slow; if accompanied by Dampness, it becomes deficient and soggy, or deficient and choppy.
[Central Dampness] Heavy/painful joints, edema, wheezing/fullness, abdominal distension, coma/unconsciousness, with a sinking-slow or sinking-micro pulse, indicate Central Dampness. Treat with Chushi Tang. If there is a wound where bathwater/Dampness entered the sore, causing coma, heaviness, body rigidity, and lockjaw, resembling Central Dampness, it is named Traumatic Dampness (Po Shang Shi). Use Baizhu Wine, or 2 qian of Oyster Shell Powder (Muli Fen) mixed with Licorice Decoction for oral administration. Apply powder topically to the wound. Shuhe's *Mai Jing* states: "Pulse sinking and slow, sinking and fine, all indicate Central Dampness."
Mr. Shen says: For Dampness in the upper part, use Fangfeng, as Wind can dry Dampness; for Dampness in the middle, use Cangzhu, as Earth can dry Dampness; for Dampness in the lower part, promote urination to open ditches and drain Dampness. For Dampness throughout the body, use Wayao and Qianghuo. For Dampness in both arms, use Sangtiao (Mulberry Twig) and Weilingxian. For Dampness in both thighs, use Niuxi, Fangfeng, and Bibi. Treat according to location. If Dampness injury is due to Kidney deficiency, with cold waist as if sitting in water, use Shen Zhuo Tang. If due to Spleen deficiency, with abdominal fullness and sour regurgitation, use Lingjiang Shugui Tang. If constitution is weak, with heavy body and loose stools, use Qingzao Tang. For Dampness from alcohol, with vomiting, diarrhea, and fever, use Gegua Jie Cheng Tang (Honeysuckle Flower Relieving Intoxication Decoction). For sitting/lying in damp places, exposure to cool wind, causing foot/knee spasms, use Du Huo Ji Sheng Tang. For elderly debility or women with Kidney deficiency and blood exhaustion causing waist/foot pain, use Du Huo Ji Sheng Tang. For Spleen-Stomach disharmony with latent Dampness and watery diarrhea, use Jiawei Pingwei San. For Spleen-Damp diarrhea, use Weiling Tang or Cangzhu Wan.
Generally, the treatment for Dampness patients involves mild diaphoresis and promoting urination to separate and drain Dampness from above and below. Zhang Zhongjing states that Dampness patients should avoid strong sweating because they already have sweat, risking Yang collapse. Therefore, mistakenly inducing sweat in Wet Warmth is called "Chong Yue" (Heavy Miasma) and must be deeply guarded against. However, if one has been exposed to Wind/Cool for a long time and washed with water causing sweat, suppressing Yang generation, mild sweating is necessary. Do not induce strong sweating; strong sweating removes Dampness but leaves Heat, preventing complications. Dong Yuan states that treating Dampness without promoting urination is incorrect. However, in those with inherent True Yang deficiency, sweating followed by dribbling urine indicates exhaustion of True Yin and impending Yang collapse. If mistaken for Damp-Heat and heavily drained, death will occur instantly due to lack of water for Yang. Do not over-drain; remove 60-70% of Dampness, then switch to Spleen-regulating agents, otherwise Kidney Water will be depleted. Mr. Luo says: In spring-summer transition, symptoms resembling Taiyang disease with spontaneous sweating, heavy/painful limbs, difficulty turning, and difficult urination are named Rheumatic Wind. Due to seasonal rain, lying in damp low places, or excessive drinking, promote urination with Wuling San. Once Dampness is gone, the disease resolves. Strictly avoid sweating and purging; errors are fatal. Physicians who fail to recognize the syndrome and treat it as Wind-Cold injury cause death by sweating or purging. Danxi states: Dampness originates from Earth Qi; Fire/Heat generates Damp-Earth, hence summer heat makes things moist, while autumn coolness makes things dry. Heat stagnation generates Dampness; Dampness generates Phlegm. Use Erchen Tang plus Jiu Huangqin (Wine-fried Scutellaria), Qianghuo, and Fangfeng to move Wind and expel Dampness, as Wind overcomes Dampness. Also states: When Dampness is severe with Heat, treat with Acrid-Warm methods, assisted by Sweet-Acrid. Pingwei San is primary. For Dampness in the upper part, resolve with mild sweating, avoiding excessive sweat. Avoid Mahuang and Gegen; use Fangji Huangqi Tang. For Dampness in the middle/lower parts, promote urination with Wuling San. This is the method of bland-leaching to treat Dampness.