伤湿初起，无汗恶寒，发热头痛，身重肢节痛
楚，舌白脉缓，此阳湿伤表。宜用羌活、防风、薄
荷、大力、杏仁、厚朴、豆卷、通草，赤苓、薏仁
等味，祛风利湿也
此言阳湿伤表。阳湿者，即湿温也。凡人坐卧湿地，披
着汗衣，皆能为息。盖其重浊薰之气，阻遏卫阳，则恶寒
而无汗;闭塞腠理，则发热而身重。且阳明者，胃也，中州
之土也。其主肌肉，又主四肢，湿邪袭之，则经气不宜，关
节久利，而致头痛身疼，斯时之脉缓而且大，皆为湿热熏蒸
而然。须知湿为土余，非风不胜，故用羌活，防风，薄荷、
大力扶风走表，杏仁、厚朴苦温理脾，豆卷，薏仁，赤苓，
通草淡渗利湿，正合（内经）湿淫于内，治以苦温，佐以淡
渗之旨也。
伤湿汗多，头额不痛，而肢节欠利，渴不引饮，
身热脉大，此湿渐化热。宜用杏仁、厚朴、连翘、黄
芩、豆卷、滑石、通草、芦根、鲜荷叶、枇杷叶等
味，利湿清热也。
上条无汗头痛 湿袭卫阳之表，仲景云：湿家忌汗，汗
之则变痉者，为伤阴也。所以垂训后人，不可过于升散，以
伤阴液为戒。此条既汗而头不痛，是表邪已泄，而湿犹未
化，所以肢节仍痛，湿从热化，则液不升而口渴，热被湿
蕴，则气不清不喜引饮;脉渐大者，燎原之势渐炽也，须用
杏仁、厚朴苦温理脾，连翘、黄芩苦寒清热，仍兼豆卷、滑
石、通草、芦根甘渗湿，荷叶、枇杷叶辛凉清气，俾湿化
热清，阴液不伤，庶无热陷昏谵之险耳。
伤湿初起，无汗恶寒，发热头痛，身重肢节痛楚，舌白脉缓，此阳湿伤表。宜用羌活、防风、薄荷、大力、杏仁、厚朴、豆卷、通草，赤苓、薏仁等味，祛风利湿也。
【译文】
伤湿病初期，表现为无汗、怕冷、发热、头痛，身体沉重且关节疼痛不适，舌苔白，脉象缓，这是阳湿侵袭体表所致。适宜使用羌活、防风、薄荷、牛蒡子（大力）、杏仁、厚朴、大豆黄卷、通草、赤茯苓、薏苡仁等药物，以祛除风邪、通利湿气。
此言阳湿伤表。阳湿者，即湿温也。凡人坐卧湿地，披着汗衣，皆能为息。盖其重浊薰之气，阻遏卫阳，则恶寒而无汗；闭塞腠理，则发热而身重。且阳明者，胃也，中州之土也。其主肌肉，又主四肢，湿邪袭之，则经气不宜，关节久利，而致头痛身疼，斯时之脉缓而且大，皆为湿热熏蒸而然。须知湿为土余，非风不胜，故用羌活，防风，薄荷、大力扶风走表，杏仁、厚朴苦温理脾，豆卷，薏仁，赤苓，通草淡渗利湿，正合《内经》湿淫于内，治以苦温，佐以淡渗之旨也。
【译文】
这里论述的是阳湿侵袭体表。所谓的阳湿，就是湿温病。普通人如果坐在或躺在潮湿的地方，或者穿着出汗后未干的衣服，都会导致这种病症发生。因为那种沉重浑浊的熏蒸之气，会阻遏卫气（护卫体表的阳气），从而导致怕冷且无汗；闭塞毛孔腠理，就会导致发热且身体沉重。另外，阳明经对应的是胃，属于中焦的土行。它主管肌肉，又主管四肢，当湿邪侵袭时，经络之气运行不畅，关节松弛不利，进而导致头痛和身体疼痛，此时的脉象缓而大，都是由于湿热熏蒸造成的。必须知道，湿是土的余气，没有风邪就不能驱散它，所以使用羌活、防风、薄荷、牛蒡子来扶助风药以疏散在表的风邪，使用杏仁、厚朴的苦温之性来调理脾胃，使用大豆黄卷、薏苡仁、赤茯苓、通草的淡渗之性来利湿，这完全符合《黄帝内经》中“湿邪盛行于体内，用苦温之法治疗，辅以淡渗利湿”的宗旨。
伤湿汗多，头额不痛，而肢节欠利，渴不引饮，身热脉大，此湿渐化热。宜用杏仁、厚朴、连翘、黄芩、豆卷、滑石、通草、芦根、鲜荷叶、枇杷叶等味，利湿清热也。
【译文】
伤湿病患者出汗较多，额头头部不痛，但关节活动不便，口渴但不想多喝水，身体发热且脉象大，这是湿气逐渐转化为热邪的表现。适宜使用杏仁、厚朴、连翘、黄芩、大豆黄卷、滑石、通草、芦根、鲜荷叶、枇杷叶等药物，以利湿清热。
上条无汗头痛 湿袭卫阳之表，仲景云：湿家忌汗，汗之则变痉者，为伤阴也。所以垂训后人，不可过于升散，以伤阴液为戒。此条既汗而头不痛，是表邪已泄，而湿犹未化，所以肢节仍痛，湿从热化，则液不升而口渴，热被湿蕴，则气不清不喜引饮；脉渐大者，燎原之势渐炽也，须用杏仁、厚朴苦温理脾，连翘、黄芩苦寒清热，仍兼豆卷、滑石、通草、芦根甘渗湿，荷叶、枇杷叶辛凉清气，俾湿化热清，阴液不伤，庶无热陷昏谵之险耳。
【译文】
上一条提到的无汗头痛，是因为湿邪侵袭了卫阳所在的体表，张仲景曾说：患有湿病的人忌讳发汗，如果强行发汗导致变成痉病（抽搐强直），是因为损伤了阴液。因此留下教诲告诫后人，不可过度使用升提发散的药物，以免损伤阴液作为警戒。这一条既然已经出汗且头部不痛，说明表层的邪气已经宣泄出去，但湿气仍未化解，所以关节仍然疼痛。湿气从热而化，津液不能上升故而口渴；热邪被湿气郁闭包裹，导致气机不清爽，所以不喜欢喝水饮水；脉象逐渐变大，是因为火热之势像烈火燎原一样逐渐炽盛。必须使用杏仁、厚朴的苦温之性来调理脾胃，使用连翘、黄芩的苦寒之性来清热，同时配合大豆黄卷、滑石、通草、芦根的甘淡渗湿之性，以及荷叶、枇杷叶的辛凉清气之性，使得湿气化解、热邪清除，阴液不受损伤，这样才不会有热邪内陷导致神志昏迷、胡言乱语的险境。
**Initial Stage of Injury by Dampness**
In the initial stage of injury by dampness, there is absence of sweating, aversion to cold, fever, headache, heaviness of the body, and pain/discomfort in the limbs and joints. The tongue coating is white, and the pulse is slow. This indicates that Yang-dampness (Wet-Warmth) is injuring the exterior. It is appropriate to use herbs such as Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Bohe (Menthae Haplocalycis Herba), Dalili (Arctii Fructus), Xingren (Armeniacae Semen Amarum), Houpo (Magnoliae Officinalis Cortex), Doujuan (Sojae Semen Praeparatum), Tongcao (Tetrapanacis Medulla), Chiling (Poria Cocos with Red Sandalwood), and Yiren (Coicis Semen). These are used to dispel wind and promote diuresis to resolve dampness.
This passage discusses Yang-dampness injuring the exterior. Yang-dampness refers to Wet-Warmth disease. Whenever people sit or lie on wet ground, or wear clothes soaked with sweat, it can generate this condition. The heavy, turbid, and miasmic qi obstructs Wei-yang (Defensive Yang), resulting in aversion to cold and absence of sweating; it blocks the Cou-li (pores and interstices), resulting in fever and bodily heaviness. Furthermore, the Yangming channel corresponds to the Stomach, which is the Earth element of the Middle Jiao. It governs the muscles and the four limbs. When dampness invades, the Qi of the channels becomes stagnant, leading to laxity of the joints, headache, and body pain. At this time, the pulse is slow and large, all caused by the steaming effect of damp-heat. One must understand that dampness is the remainder of Earth; without Wind, it cannot be overcome. Therefore, Qianghuo, Fangfeng, Bohe, and Dalili are used to assist Wind herbs to move to the exterior; Xingren and Houpo use their bitter-warm nature to regulate the Spleen; Doujuan, Yiren, Chiling, and Tongcao use their bland-leaching nature to promote diuresis and resolve dampness. This perfectly aligns with the principle in the *Neijing* (Inner Canon): "When dampness prevails internally, treat it with bitter-warm methods, assisted by bland-leaching methods."
**Dampness Transforming into Heat**
If a patient with injury by dampness sweats profusely, has no forehead/headache, but experiences stiffness/impairment in the limbs and joints, feels thirsty but does not desire to drink, has a feverish body, and a large pulse, this indicates that dampness is gradually transforming into heat. It is appropriate to use herbs such as Xingren (Armeniacae Semen Amarum), Houpo (Magnoliae Officinalis Cortex), Lianqiao (Forsythiae Fructus), Huangqin (Scutellariae Radix), Doujuan (Sojae Semen Praeparatum), Huashi (Talcum), Tongcao (Tetrapanacis Medulla), Lugeng (Phragmitis Rhizoma), Xianheye (Nelumbinis Folium), and Pipaye (Eriobotryae Folium). These are used to promote diuresis to resolve dampness and clear heat.
The previous paragraph described absence of sweating and headache due to dampness invading the exterior where Wei-yang resides. Zhang Zhongjing stated: "Patients with dampness should avoid sweating; inducing sweat may lead to spasms (Jing syndrome) because it injins Yin." Thus, he left instructions for future generations, warning against excessive ascending and dispersing methods that might damage Yin fluids. In this current paragraph, since the patient is sweating and has no headache, it indicates that the exterior pathogen has been released, but the dampness has not yet transformed. Therefore, the limbs and joints still hurt. As dampness transforms from heat, fluids do not ascend, causing thirst; heat is trapped by dampness, causing the Qi to be unclear, hence the lack of desire to drink. The pulse gradually becoming large indicates that the fire-like momentum is intensifying like a prairie fire. One must use the bitter-warm nature of Xingren and Houpo to regulate the Spleen; the bitter-cold nature of Lianqiao and Huangqin to clear heat; and simultaneously employ the sweet-bland leaching nature of Doujuan, Huashi, Tongcao, and Lugeng to resolve dampness, along with the acrid-cool nature of Heye and Pipaye to clear the Qi. This ensures that dampness resolves and heat clears, Yin fluids are not injured, thereby avoiding the danger of heat sinking inward leading to coma and delirium.