仲景论湿病。未尝明言湿温。然湿温之病状。可即仲景论中。比类得之。王叔和于仲景
伤寒
论。剔出痉湿 三种以为宜应别论。其于湿病首列湿痹。即从太阳辨证。曰太阳病关节疼痛
而烦。脉沉而细者。此名湿痹。则是湿证中同有头项强痛恶寒之太阳病。其类于伤寒者以此
。
然湿痹之病其人小便不利。大便反快。故当利小便。使湿邪从太阳之腑而解。是湿也。而不
必其兼温也。又云。湿家之为病。一身尽疼。发热。身色如似熏黄。此又示人以谛实湿病之
法。然湿病多端。亦不必尽属兼温。因思仲景已分明揭出太阳病发热而渴不恶寒者为温病。
以所言种种湿证。与此条之温病互勘。则湿温之病状。可得而言矣。湿温初起。所见之太阳
病。头痛。腰痛。骨节烦痛。与太阳伤寒同。以湿病本主身疼也。发热。汗出。恶风。与太
阳中风同。以温邪本易汗出也。但风寒之邪。由表入里。湿温之邪。由里出表。故当太阳病
初起时。其蒸郁之气。即已弥布三焦。故或往来寒热。胸膈痞满。呕吐。不欲食。或腹中痛
。
不大便。或下利稀臭水。表里之病。往往一时并见。以上各证。不必悉具。必兼口渴舌上
胎
者。此属湿温之定证。又湿病脉多沉细。湿既兼温。脉不尽沉。温病脉浮。温复挟湿。其脉
又不尽浮。不浮不沉之间。其中候必数。以数之甚与不甚。别邪之轻重。病之缓急。合此脉
证互参。始知仲景不言湿温。而湿温之脉证在其中。湿温之治法。即在其中矣。读仲景书。
当知比类。不知比类。即风寒之显然者，尚且目眩。奚况湿温哉。
张仲景在论述湿病时，未曾明确提及“湿温”这一病名。然而，湿温病的症状表现，可以通过类比张仲景的论述推导出来。王叔和在整理《伤寒论》时，将痉、湿、暍三种病症剔除出来，认为应当作为独立的篇章讨论。他在论述湿病时首先列出“湿痹”，并从太阳经进行辨证，说：“太阳病，关节疼痛而烦闷，脉象沉而细的，这叫做湿痹。”这说明在湿证中，同样存在头项强痛、恶寒等太阳病的表现，其类似于伤寒的地方就在这里。
然而，湿痹这种病，患者小便不通利，大便反而通畅（稀溏），所以应当采用利小便的方法，使湿邪从太阳膀胱腑排出而解除。这是单纯的湿邪，不一定兼夹温邪。又说：“患湿病的人，全身疼痛，发热，身体颜色像被烟熏过的黄色。”这又是向人们展示确凿无疑的湿病治法。然而湿病的表现多种多样，也不一定都兼夹温邪。我想到张仲景已经明确指出：“太阳病，发热且口渴，不恶寒的，叫做温病。”将前面所说的各种湿证与此条关于温病的描述相互对照，那么湿温病的症状就可以说清楚了。
湿温病初起时，出现的太阳病症状如头痛、腰痛、骨节烦痛，与太阳伤寒相同，因为湿病本来就以身体疼痛为主症。发热、汗出、恶风，与太阳中风相同，因为温邪本来就容易导致汗出。但是风寒之邪是由表入里，湿温之邪是由里出表。所以在太阳病初起时，其蒸腾郁结之气，就已经弥漫遍布三焦。因此有时会出现往来寒热、胸膈痞满、呕吐、不想吃东西，或者腹痛、不大便，或者下利稀臭水。表证和里证的病状，往往同时出现。以上这些症状，不一定全部具备。但必须兼有口渴、舌苔厚腻的表现，这才属于湿温病的确定证候。
另外，湿病的脉象多沉细；湿邪既兼夹温邪，脉象就不完全是沉脉；温病的脉象浮；温邪又挟带湿邪，脉象又不完全是浮脉。在不浮不沉之间，其中取脉位（中候）必然数急。根据数脉的程度轻重，来辨别邪气的轻重和病势的缓急。结合这些脉象和证候相互参照，才知道张仲景虽然没有明言湿温，但湿温的脉证已经包含在其中了。湿温的治疗方法，也就包含在其中了。阅读张仲景的书籍，应当懂得类比推理；不懂得类比，即使是明显的风寒之邪，也会让人眼花缭乱，何况是湿温呢？
Zhang Zhongjing, in his discussion of dampness diseases, never explicitly mentioned "damp-warmth" (Shiwen). However, the clinical manifestations of damp-warmth can be deduced by analogy from Zhang Zhongjing's discussions. Wang Shuhe, when compiling the *Shanghan Lun* (Treatise on Cold Damage), extracted three categories—spasm (Jing), dampness (Shi), and heatstroke (He)—arguing they should be treated as separate treatises. In his discussion of dampness diseases, he first listed "damp-bi" (Shibi) and differentiated it according to the Taiyang (Greater Yang) pattern, stating: "In a Taiyang disease, if there is pain and vexation in the joints, and the pulse is deep and thin, this is called damp-bi." This indicates that among dampness patterns, there are simultaneously Taiyang disease symptoms such as stiffness of the head and nape, and aversion to cold; this similarity to cold damage is the key point.
However, in the disease of damp-bi, the patient experiences difficulty in urination, while the stool is loose or frequent. Therefore, one should employ methods to promote diuresis, allowing the damp pathogen to resolve through the bladder fu-organ of the Taiyang channel. This represents pure dampness, which does not necessarily involve concurrent warmth. He also stated: "For those suffering from dampness diseases, the entire body aches, there is fever, and the complexion resembles the yellow hue of smoke curing." This illustrates the definitive treatment approach for confirmed dampness diseases. Nevertheless, dampness diseases manifest in various ways and do not necessarily always involve concurrent warmth. I recall that Zhang Zhongjing clearly pointed out: "In a Taiyang disease, if there is fever accompanied by thirst and no aversion to cold, this is called a warm disease." By cross-referencing the aforementioned various dampness patterns with this specific description of warm disease, the clinical picture of damp-warmth can be elucidated.
At the onset of damp-warmth, the Taiyang disease symptoms observed—such as headache, lower back pain, and painful soreness of the bone joints—are identical to those of Taiyang cold-damage, because dampness inherently causes body ache. Fever, sweating, and aversion to wind are identical to Taiyang wind-strike, because warmth pathogens inherently tend to cause sweating. However, wind-cold pathogens move from the exterior to the interior, whereas damp-warmth pathogens move from the interior to the exterior. Thus, at the initial stage of the Taiyang disease, the steaming and stagnant qi has already permeated the Sanjiao (Triple Burner). Consequently, one may observe alternating chills and fever, fullness and obstruction in the chest and epigastrium, vomiting, loss of appetite, abdominal pain, constipation, or diarrhea with foul-smelling watery stools. Exterior and interior pathological changes often appear simultaneously. Not all the above-mentioned symptoms need to be present. However, the presence of thirst and a coated tongue are essential criteria; only then can it be classified as a definitive damp-warmth pattern.
Furthermore, the pulse in dampness diseases is typically deep and thin. Since dampness is combined with warmth, the pulse is not entirely deep. The pulse in warm diseases is floating; since warmth is complicated by dampness, the pulse is not entirely floating. Between floating and deep, the middle position (Zhonghou) must be rapid (Shu). The degree of rapidity helps distinguish the severity of the pathogen and the urgency of the disease. By correlating these pulse characteristics with the clinical signs, one realizes that although Zhang Zhongjing did not explicitly name damp-warmth, its pulse and symptomatology are implicitly contained within his text. Similarly, the therapeutic principles for damp-warmth are inherent therein. When studying Zhang Zhongjing's works, one must understand the method of analogical reasoning. Without this skill, even obvious wind-cold patterns may cause confusion; how much more so would damp-warmth?