脉 沉细微缓。或涩或濡。皆为湿脉。浮濡为风湿。沉涩为寒湿。滑疾。身热。烦喘。胸满
。口燥。发黄。为湿热自甚。洪而动。湿热为痛。
症 内经云∶地之湿气。感则害人皮肉筋脉。又云∶诸湿肿满。皆属于脾土。按戴氏云∶东
南地下。多阴雨。地湿。凡受多从外入。多从下起。腿肿香港脚者多。治当汗散。久者宜疏利
。渗泄。西北地高。多食生冷。湿面乳酪鱼肉辛香炙爆之物。或饮酒后。寒气拂郁。湿热之
邪。不能发越。故作肿胀。甚则水气胀满。通身浮肿如泥。按之不起。此则自内出也。辩其
多少。通利二便而渗泄之。贾氏云湿为土气。火热能生湿土。故夏热而万物湿润。秋凉则万
物干燥。湿本不自生。因热拂郁而不能宣行。故停滞而生湿也。况脾脆弱之人。易于感冒。
岂必水不流而后为湿哉。人只知风寒之威严。不知暑湿之炎暄。感人于冥冥之中也。治湿之
法。宜理脾清热。利小便为上。故曰治湿不利小便。非知治也。
治 丹溪云∶六气之中。湿热为病。十居八九。湿有自外入者。谓阴雨地湿。皆自外入。宜
微汗散。经曰∶湿上甚而热。治以苦温。佐以甘辛。以防风、羌活、白术、苍术、茯苓、甘
草、微汗为动而已。不欲汗多。故不用麻黄桂枝等剂。湿在中下。宜淡渗利小便也。在下宜
升提。贾氏谓治湿用葶苈木香散。煎下神芎丸。下水湿。消肿胀利小便。理脾胃。无出乎此
。亦妙法也。
方 加味五苓散治诸湿身重。小便不利。
白术（二钱） 白茯苓（一钱五分） 猪苓（一钱） 肉桂（五分） 泽泻 苍术（各二钱） 羌活（
一钱五分）
上作一服。姜一片。枣一枚。煎服。
如湿在上。肩背疼。头重项强者。加防风、白芷（各一钱）、升麻（五分）、微汗之。
湿在中。腹胀脐突。小便不利。加木通、姜皮（各一钱五分）、湿在下。腰膝痛。足重不能移
。加薏芯仁（二钱）、木瓜、汉防己、黄柏（各一钱）。
湿热郁成黄胆。两服及遍身如金色者。加茵陈、石膏（各二钱）。
寒湿在下。腰重足痛。加酒防己、附子（各一钱）。
湿症汗多者。加黄 （一钱）、桂枝、当归（各七分）、麻黄根（一钱五分）、风寒湿三气合而为
痹。手足缓弱。肌体不仁。加防风防己当归、牛蒡子、威灵仙（各等分）。
诸痿因肺热所致。加人参、黄 、生地黄、麦门冬、防己、黄柏（各一钱）、五味子（十五
粒）、薏芯仁（一钱五分）。
风湿相抟。一身尽痛。手足痿痹。加防风、白芷（各一钱）、当归（一钱五分）、乌药、五加皮
（各一钱二分）、木香（五分）。
臂痛。加当归（一钱五分）、白芍药、防风、川芎、白芷（各一钱）、升麻（五分），去猪苓、泽
泻、桂。
香港脚。防己、当归、木瓜（各一钱五分）、黄柏、防风、白芷（各一钱）、槟榔、苏叶（各七
分），去猪苓、泽泻、忌补剂。并洗。
诸湿浮肿。并水气上多者。加防风、白芷（各一钱五分）、麻黄（一钱）、以汗之。下多者。加
茯苓皮、生姜皮、大腹皮、五加皮（各一钱）、木通（一钱五分）、以利之。
暑湿熏蒸。令人燥闷。自汗烦渴。加香薷（二钱）、黄连、扁豆、浓朴（各一钱），去羌活、名
薷苓汤。
麻木属气虚湿痰及死血。加人参、黄 、当归（各一钱二分）、白芍药、防风、白芷（各八
分）、柴胡、升麻（各五分）、黄柏、半夏（各一钱）。
四肢百节走痛。名痛风。在上。加川芎、白芷、酒芩、桔梗（各八分）、当归（一钱）、威灵
仙（一钱）、桂枝（七分），去猪苓、泽泻、在下。加当归（一钱五分）、牛膝、陈皮、桃仁、
木通、黄柏、防己（各一钱），去羌活，加川独活（七分）。
两手挛急。加半夏、当归、防风、天麻、白芷（各一钱），去猪苓、泽泻桂。
两脚挛急。加当归、杜仲、黄柏、木瓜、牛膝、薏苡仁（各一钱五分），去羌活。
走注疼痛。加当归、川芎、威灵仙（各一钱）、木香、枳壳（各七分）。
脚跟痛。加当归、白芍药、薏苡仁（各一钱五分）、知母、黄柏、牛膝（各一钱），去羌活，加独
活。
脉象：沉、细、微、缓，或者涩、濡，这些都是湿邪致病的脉象。浮而濡是风湿；沉而涩是寒湿。滑而疾速，伴有身体发热、烦躁气喘、胸部胀满、口干燥、发黄，这是湿热邪气极盛的表现。洪大且跳动有力，是湿热引起的疼痛。
症状：《内经》说：“地上的湿气，侵入人体就会伤害皮肉筋脉。”又说：“所有的湿病导致的肿胀和腹满，都归属于脾土。”据戴氏所说：东南地区地势低洼，多阴雨天气，地气潮湿，凡受湿邪大多从外部侵入，多从下部开始，所以腿部肿胀患香港脚的人很多。治疗应当用发汗的方法疏散；病程久的适宜用疏利、渗泄的方法。西北地区地势高，人们多吃生冷、湿面、乳酪、鱼肉以及辛辣香燥、炙烤爆炒的食物，或者在饮酒后，寒气拂郁，湿热之邪不能发散，从而造成肿胀，严重时水气胀满，全身浮肿像泥一样，按下去不起。这是从内部产生的。辨别其多少，通过通利大小便来渗泄湿邪。贾氏说湿是土的气化，火热能生湿土，所以夏天热万物湿润，秋天凉万物干燥。湿本来不是自己产生的，是因为热邪拂郁而不能宣通运行，所以停滞而生湿。况且脾脏虚弱的人，容易感受外邪，难道一定要水流不通才算是湿吗？人们只知道风寒的威严，不知道暑湿的炎热带给人体的危害是在不知不觉中发生的。治疗湿病的方法，适宜调理脾胃、清热，以利小便为最佳原则。所以说治疗湿病如果不利于小便，是不懂得治疗的道理。
治法：丹溪说：六气之中，湿热致病占十之八九。湿邪有从外部侵入的，指阴雨天气和地湿，都是从外部侵入的，适宜用微汗法疏散。经书说：“湿邪在上部且伴有热，用苦温药治疗，佐以甘辛药。”以防风、羌活、白术、苍术、茯苓、甘草为主，目的是微微出汗即可。不希望出汗过多，所以不用麻黄、桂枝等方剂。湿邪在中下焦，适宜用淡味渗利小便的方法。在下焦适宜升提。贾氏说治疗湿邪用葶苈木香散，煎服后送服神芎丸，以排出下水湿，消除肿胀，利小便，调理脾胃，没有比这更好的了，也是妙法。
方剂：加味五苓散治疗各种湿邪导致的身重、小便不利。
白术（二钱）、白茯苓（一钱五分）、猪苓（一钱）、肉桂（五分）、泽泻、苍术（各二钱）、羌活（一钱五分）。
以上为一服的量，加生姜一片、大枣一枚，煎煮后服用。
如果湿邪在上部，肩背疼痛，头重项强，加防风、白芷（各一钱）、升麻（五分），以微微发汗。
湿邪在中部，腹胀肚脐突出，小便不利，加木通、姜皮（各一钱五分）。
湿邪在下部，腰膝疼痛，脚沉重不能移动，加薏苡仁（二钱）、木瓜、汉防己、黄柏（各一钱）。
湿热郁结形成黄疸，服用两剂后全身如金色者，加茵陈、石膏（各二钱）。
寒湿在下部，腰部沉重足痛，加酒制防己、附子（各一钱）。
湿症出汗多的，加黄芪（一钱）、桂枝、当归（各七分）、麻黄根（一钱五分）。
风寒湿三气合而为痹证，手足软弱无力，肌肤麻木不仁，加防风、防己、当归、牛蒡子、威灵仙（各等分）。
各种痿证因肺热所致，加人参、黄芪、生地黄、麦门冬、防己、黄柏（各一钱）、五味子（十五粒）、薏苡仁（一钱五分）。
风湿相搏，全身疼痛，手足痿痹，加防风、白芷（各一钱）、当归（一钱五分）、乌药、五加皮（各一钱二分）、木香（五分）。
手臂疼痛，加当归（一钱五分）、白芍药、防风、川芎、白芷（各一钱）、升麻（五分），去掉猪苓、泽泻、桂枝。
香港脚，用防己、当归、木瓜（各一钱五分）、黄柏、防风、白芷（各一钱）、槟榔、苏叶（各七分），去掉猪苓、泽泻，忌用补剂，并配合洗浴。
各种湿邪导致的浮肿，并且水气上逆较多的，加防风、白芷（各一钱五分）、麻黄（一钱），以发汗法治疗。水气下行较多的，加茯苓皮、生姜皮、大腹皮、五加皮（各一钱）、木通（一钱五分），以利水法治疗。
暑湿熏蒸，使人燥热烦闷，自汗、烦躁口渴，加香薷（二钱）、黄连、扁豆、浓朴（各一钱），去掉羌活，名为薷苓汤。
麻木属于气虚、湿痰及死血（瘀血），加人参、黄芪、当归（各一钱二分）、白芍药、防风、白芷（各八分）、柴胡、升麻（各五分）、黄柏、半夏（各一钱）。
四肢百节游走性疼痛，名叫痛风。在上部的，加川芎、白芷、酒黄芩、桔梗（各八分）、当归（一钱）、威灵仙（一钱）、桂枝（七分），去掉猪苓、泽泻。在下部的，加当归（一钱五分）、牛膝、陈皮、桃仁、木通、黄柏、防己（各一钱），去掉羌活，加川独活（七分）。
两手拘挛紧急，加半夏、当归、防风、天麻、白芷（各一钱），去掉猪苓、泽泻、桂枝。
两脚拘挛紧急，加当归、杜仲、黄柏、木瓜、牛膝、薏苡仁（各一钱五分），去掉羌活。
走注疼痛（疼痛游走不定），加当归、川芎、威灵仙（各一钱）、木香、枳壳（各七分）。
脚跟痛，加当归、白芍药、薏苡仁（各一钱五分）、知母、黄柏、牛膝（各一钱），去掉羌活，加独活。
(Shangshi [Injury by Dampness], Swelling, Jaundice, Various Pains, Asthma and Cough)
Pulse: Deep (Chen), Fine (Xi), Minute (Wei), Slow (Huan), or Choppy (Se) and Soggy (Ru) are all pulses indicating Dampness. Floating and Soggy indicate Wind-Damp; Deep and Choppy indicate Cold-Damp. Slippery and Rapid, accompanied by fever, restlessness, asthma, chest fullness, dry mouth, and yellowing of the skin, indicate severe Heat-Damp. Surging (Hong) and pulsating indicate pain caused by Heat-Damp.
Symptoms: The *Neijing* states: "The dampness of the earth, when it affects humans, harms the skin, flesh, sinews, and vessels." It also states: "All swelling and fullness due to Dampness belong to the Spleen Earth." According to Dai Shi: In the southeast, where the land is low and there is much rain and dampness, Dampness usually enters from the exterior and rises from below, leading to many cases of leg swelling and Hongjiaojiao (Gouty Arthritis). Treatment should employ sweating to disperse; for chronic cases, draining and leaching methods are appropriate. In the northwest, where the land is high, people often consume raw/cold foods, wet noodles, dairy, fish/meat, and spicy, aromatic, roasted, or fried items. After drinking alcohol, cold qi may become stagnant, preventing Heat-Damp from venting, thus causing swelling. Severe cases involve water qi accumulation, with whole-body edema resembling mud that does not rise upon pressure. This originates from within. One must distinguish the degree and treat by promoting urination and defecation to drain Dampness. Jia Shi stated that Dampness is the qi of Earth; Fire/Heat generates Wet Earth, hence summer heat brings moisture to all things, while autumn coolness brings dryness. Dampness does not generate itself but arises from stagnation due to Heat obstructing free flow. Moreover, those with weak Spleens easily contract pathogens; one need not wait for water stagnation to define Dampness. People only recognize the severity of Wind-Cold, unaware of how silently Summerheat-Damp affects them. The method for treating Dampness involves regulating the Spleen and clearing Heat, with promoting urination as the superior approach. Thus, it is said: "Treating Dampness without promoting urination shows ignorance of treatment principles."
Treatment Methods: Danxi stated: Among the Six Qi, diseases caused by Heat-Damp account for eight or nine out of ten. Dampness can enter from the exterior, such as from rainy weather or ground dampness, requiring mild sweating to disperse. The Classics state: "For Dampness affecting the upper body with Heat, treat with Bitter-Warm herbs, assisted by Sweet-Acrid ones." Use Fangfeng (Saposhnikoviae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Cangzhu (Atractylodis Rhizoma), Fuling (Poria), and Gancao (Glycyrrhizae Radix et Rhizoma) to induce mild sweating. Sweating should not be excessive, so Mahuang (Ephedrae Herba) and Guizhi (Cinnamomi Ramulus) formulas are avoided. For Dampness in the Middle and Lower Jiao, bland diuretics are used to promote urination. For lower Jiao involvement, lifting methods are appropriate. Jia Shi suggested using Tingli Muxiang San (Descurainiae Semen et Lepidii Semen et Aucklandiae Decoction) taken with Shenxiong Wan (Diviner's Xiongan Pill) to drain water-damp, reduce swelling, promote urination, and regulate the Spleen and Stomach—a brilliant method.
Formulas: Jiawei Wuling San (Modified Five-Ingredient Powder with Poria) treats various Dampness conditions causing heaviness and difficult urination.
Baizhu (Atractylodis Macrocephalae Rhizoma) (2 qian), Baifuling (Poria cum Mycelium) (1.5 qian), Zhuling (Polyporus), Rougui (Cinnamomi Cortex) (0.5 qian), Zexie (Alismatis Rhizoma), Cangzhu (Atractylodis Rhizoma) (each 2 qian), Qianghuo (Notopterygii Rhizoma et Radix) (1.5 qian).
Take as one dose. Add one slice of Shengjiang (Zingiberis Rhizoma Recens) and one date. Decoct and take orally.
If Dampness is in the Upper Jiao, causing shoulder/back pain, heavy head, and stiff neck, add Fangfeng (Saposhnikoviae Radix) and Baizhi (Angelicae Dahuricae Radix) (each 1 qian), Shengma (Cimicifugae Rhizoma) (0.5 qian) to induce mild sweating.
If Dampness is in the Middle Jiao, causing abdominal distension, protruding umbilicus, and difficult urination, add Mutong (Akebiae Caulis) and Jiangpi (Zingiberis Pericarpium) (each 1.5 qian).
If Dampness is in the Lower Jiao, causing waist/knee pain and heavy legs unable to move, add Yiyiren (Coicis Semen) (2 qian), Mugua (Chaenomelis Fructus), Hanfangji (Stephaniae Tetrandrae Rhizoma), and Huangbo (Phellodendri Cortex) (each 1 qian).
If Heat-Damp stagnates into Jaundice, turning the body golden after two doses, add Yinchen (Artemisiae Scopariae Herba) and Shigao (Gypsum Fibrosum) (each 2 qian).
If Cold-Damp is in the Lower Jiao, causing heavy waist and painful feet, add Jiu Fangji (Stephaniae Tetrandrae Rhizoma prepared with wine) and Fuzi (Aconiti Lateralis Radix Praeparata) (each 1 qian).
If Dampness symptoms present with excessive sweating, add Huangqi (Astragali Radix) (1 qian), Guizhi (Cinnamomi Ramulus), Danggui (Angelicae Sinensis Radix) (each 0.7 qian), and Mahuanggen (Ephedrae Radix et Rhizoma) (1.5 qian).
If Wind, Cold, and Damp combine to form Bi Syndrome, causing weak limbs and insensible skin, add Fangfeng (Saposhnikoviae Radix), Fangji (Stephaniae Tetrandrae Rhizoma), Danggui (Angelicae Sinensis Radix), Niubangzi (Arctii Fructus), and Weilingxian (Clematidis Radix et Rhizoma) (equal parts).
For Wei Syndrome caused by Lung Heat, add Renshen (Ginseng Radix), Huangqi (Astragali Radix), Shengdihuang (Rehmanniae Radix), Maidong (Ophiopogonis Radix), Fangji (Stephaniae Tetrandrae Rhizoma), Huangbo (Phellodendri Cortex) (each 1 qian), Wuweizi (Schisandrae Chinensis Fructus) (15 grains), and Yiyiren (Coicis Semen) (1.5 qian).
If Wind and Damp contend, causing whole-body pain and flaccid paralysis of limbs, add Fangfeng (Saposhnikoviae Radix), Baizhi (Angelicae Dahuricae Radix) (each 1 qian), Danggui (Angelicae Sinensis Radix) (1.5 qian), Wuyao (Linderae Radix), and Wujiaopi (Acanthopanacis Cortex) (each 1.2 qian), Muxiang (Aucklandiae Radix) (0.5 qian).
For arm pain, add Danggui (Angelicae Sinensis Radix) (1.5 qian), Baishao (Paeoniae Radix Alba), Fangfeng (Saposhnikoviae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baizhi (Angelicae Dahuricae Radix) (each 1 qian), Shengma (Cimicifugae Rhizoma) (0.5 qian). Remove Zhuling (Polyporus), Zexie (Alismatis Rhizoma), and Gui (Cinnamomi Ramulus/Cortex).
For Hongjiaojiao (Gouty Arthritis), use Fangji (Stephaniae Tetrandrae Rhizoma), Danggui (Angelicae Sinensis Radix), Mugua (Chaenomelis Fructus) (each 1.5 qian), Huangbo (Phellodendri Cortex), Fangfeng (Saposhnikoviae Radix), Baizhi (Angelicae Dahuricae Radix) (each 1 qian), Binglang (Arecae Semen), and Ziye (Perillae Folium) (each 0.7 qian). Remove Zhuling (Polyporus), Zexie (Alismatis Rhizoma). Avoid tonics. Combine with external washing.
For general Dampness edema with significant upward rushing of water qi, add Fangfeng (Saposhnikoviae Radix), Baizhi (Angelicae Dahuricae Radix) (each 1.5 qian), Mahuang (Ephedrae Herba) (1 qian) to induce sweating. If downward accumulation predominates, add Fulingpi (Poria Peridium), Jiangpi (Zingiberis Pericarpium), Dafupi (Arecae Pericarpium), Wujiaopi (Acanthopanacis Cortex) (each 1 qian), Mutong (Akebiae Caulis) (1.5 qian) to promote urination.
For Summerheat-Damp steaming causing irritability, spontaneous sweating, restlessness, and thirst, add Xiangru (Moslae Herba) (2 qian), Huanglian (Coptidis Rhizoma), Bidou (Dolichoris Semen), Houpo (Magnoliae Officinalis Cortex) (each 1 qian). Remove Qianghuo (Notopterygii Rhizoma et Radix). Name this formula Ru Ling Tang (Xiangru and Poria Decoction).
For numbness attributed to Qi deficiency, Damp-Phlegm, and static blood, add Renshen (Ginseng Radix), Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix) (each 1.2 qian), Baishao (Paeoniae Radix Alba), Fangfeng (Saposhnikoviae Radix), Baizhi (Angelicae Dahuricae Radix) (each 0.8 qian), Chaihu (Bupleuri Radix), Shengma (Cimicifugae Rhizoma) (each 0.5 qian), Huangbo (Phellodendri Cortex), Banxia (Pinelliae Rhizoma) (each 1 qian).
For wandering pain in all joints, known as Tongfeng (Gout), if located above, add Chuanxiong (Ligustici Chuanxiong Rhizoma), Baizhi (Angelicae Dahuricae Radix), Jiu Huangqin (Scutellariae Radix prepared with wine), Jiegeng (Platycodonis Radix) (each 0.8 qian), Danggui (Angelicae Sinensis Radix) (1 qian), Weilingxian (Clematidis Radix et Rhizoma) (1 qian), Guizhi (Cinnamomi Ramulus) (0.7 qian). Remove Zhuling (Polyporus), Zexie (Alismatis Rhizoma). If located below, add Danggui (Angelicae Sinensis Radix) (1.5 qian), Niuxi (Achyranthis Bidentatae Radix), Chenpi (Citri Reticulatae Pericarpium), Taoren (Persicae Semen), Mutong (Akebiae Caulis), Huangbo (Phellodendri Cortex), Fangji (Stephaniae Tetrandrae Rhizoma) (each 1 qian). Remove Qianghuo (Notopterygii Rhizoma et Radix), add Du Huo (Angelicae Pubescentis Radix) (0.7 qian).
For spasms and cramping of both hands, add Banxia (Pinelliae Rhizoma), Danggui (Angelicae Sinensis Radix), Fangfeng (Saposhnikoviae Radix), Tianma (Gastrodiae Rhizoma), Baizhi (Angelicae Dahuricae Radix) (each 1 qian). Remove Zhuling (Polyporus), Zexie (Alismatis Rhizoma), Gui (Cinnamomi Ramulus/Cortex).
For spasms and cramping of both feet, add Danggui (Angelicae Sinensis Radix), Duzhong (Eucommiae Cortex), Huangbo (Phellodendri Cortex), Mugua (Chaenomelis Fructus), Niuxi (Achyranthis Bidentatae Radix), Yiyiren (Coicis Semen) (each 1.5 qian). Remove Qianghuo (Notopterygii Rhizoma et Radix).
For wandering pain, add Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Weilingxian (Clematidis Radix et Rhizoma) (each 1 qian), Muxiang (Aucklandiae Radix), Zhike (Aurantii Fructus Immaturus) (each 0.7 qian).
For heel pain, add Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Yiyiren (Coicis Semen) (each 1.5 qian), Zhimu (Anemarrhenae Rhizoma), Huangbo (Phellodendri Cortex), Niuxi (Achyranthis Bidentatae Radix) (each 1 qian). Remove Qianghuo (Notopterygii Rhizoma et Radix), add Duhuo (Angelicae Pubescentis Radix).