夫湿乃重浊之邪，其伤人也最广。考《难经》、
《金柜》有伤湿、中湿、风湿、湿温之名。殆伤则
伤其表，表者，乃阳明之表，肌内也，四肢也;中则
中其内，内者，乃太阴之内，脾阴也，湿土也。故
伤表则肢节必痛，中里则腕腹必闷。及湿与风搏，
而周身痛楚，湿与热合，而烦闷热蒸，都甚于夏秋。
盖江南地卑气湿，沿江濒海，雾露风潮，较别处尤
甚，且易感染。故医者，亦不务伤寒，专事湿温。
然比之伤寒，尤为琐屑，更难调治。所谓能医大江
南之病者，思过半矣。矧其症，不独夏秋，四时兼
有。其湿之盛者，犹有微热恶寒，身痛、舌白、胸
痞、溺赤等症可凭，若湿之微者，依然外无痛楚，
内不烦扰，但觉倦怠嗜卧，脉证缓弱，一如虚损。
斯候也，误补之则湿遽化热而病反增剧，误消之则
湿留正损而更觉难堪。又要分别阳湿阴湿，阳湿者，
胃热恒多，即为湿热，阴湿者，脾阳必衰，即为湿
寒。更审其伤内伤外，伤内者，脾土必虚，《内经》
所谓卑隘之土，易于聚湿，胸腹必满，气机必滞;
伤外者，阳气必亏，河间所谓表虚之体，易于着湿，
肢体必重，关节必痛，伤内者，理脾为主;伤外者，
宜气为先。阳湿者，主以苦辛;阴湿者，主以苦
温。俱当以淡渗佐之。茍能明其阴阳，分其内外，临
机应变，神而明之，庶不愧为医中之司命焉。
湿邪是性质沉重、秽浊的病邪，它伤害人体最为广泛。考察《难经》和《金匮要略》，有伤湿、中湿、风湿、湿温的名称。大概“伤”是指损伤其体表，体表，指的是阳明经的体表，即肌肉和四肢；“中”是指侵害其体内，体内，指的是太阴经的体内，即脾阴和湿土（脾属土，主运化水湿）。所以，伤及体表则肢体关节必然疼痛，侵害体内则脘腹必然闷胀。等到湿邪与风邪相搏结，则周身疼痛苦楚；湿邪与热邪相合，则烦热闷热蒸腾，这种情况在夏秋两季尤为严重。
大概江南地区地势低洼，气候潮湿，沿江沿海，雾露风潮比别处尤其严重，且容易感染。所以医生们，也不致力于治疗伤寒，专门从事湿温病的治疗。然而比起伤寒来，湿温病更为琐碎繁杂，更难调治。所谓能治好江南大地的疾病，医术就超过一半了。况且这种病症，不仅限于夏秋两季，四季都有。湿邪盛重的，还有微热恶寒、身痛、舌苔白、胸膈痞闷、小便赤等症候可以作为凭据；若湿邪轻微的，依然体外无疼痛苦楚，体内不烦扰，只感到倦怠嗜睡，脉象证候缓弱，完全像虚损病一样。
这种证候，误用补法则湿邪迅速化热而病情反而加剧，误用消导法则湿邪滞留正气受损而更加难以忍受。又要分别阳湿和阴湿，阳湿者，胃热通常较多，即为湿热；阴湿者，脾阳必然衰弱，即为湿寒。更要审察是伤内还是伤外，伤内的，脾土必然虚弱，《内经》所说的卑隘之土（指脾土虚弱），易于聚积湿邪，胸腹必然胀满，气机必然阻滞；伤外的，阳气必然亏损，河间（刘完素）所说的表虚之体，易于附着湿邪，肢体必然沉重，关节必然疼痛。伤内的，以调理脾土为主；伤外的，以宣畅气机为先。阳湿者，主治以苦辛之法；阴湿者，主治以苦温之法。都应当以淡渗利湿之法辅助。如果能明了阴阳之分，区分内外之别，临证时随机应变，神妙通达，才不愧为医家中的主宰生命之人。
*Author:* Lu Tingzhen (Zixian) of Chongming
*Revised by:* Qiu Shixin (Yunchu) of Shaoxing
Dampness is a pathogenic factor characterized by heaviness and turbidity, and its injury to the human body is the most widespread. Examining the *Nan Jing* (Classic of Difficult Issues) and the *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet), there are names for Shang Shi (Injury by Dampness), Zhong Shi (Strike by Dampness), Feng Shi (Wind-Dampness), and Shi Wen (Damp-Heat Febrile Disease). Generally, "Shang" refers to injuring the exterior; the exterior refers to the exterior of the Yangming channel, namely the muscles and limbs. "Zhong" refers to striking the interior; the interior refers to the interior of the Taiyin channel, namely the Yin of the Spleen and the Earth of Dampness (the Spleen belongs to Earth and governs the transformation of water-dampness). Therefore, when injured at the exterior, the joints and limbs must ache; when struck in the interior, the epigastrium and abdomen must feel stuffy. When dampness combats with wind, the whole body suffers from pain; when dampness combines with heat, there is vexation, heat, and steaming sensation, which are more severe in summer and autumn.
Generally, the Jiangnan region has low terrain and humid climate. Along the rivers and seas, fog, dew, wind, and tide are more severe than in other places, making it easy to become infected. Therefore, physicians do not focus on treating Shang Han (Cold Damage), but specialize in Shi Wen (Damp-Heat Febrile Disease). However, compared to Shang Han, it is even more trivial and complicated, and harder to treat. It is said that one who can cure diseases in the great Jiangnan region has mastered more than half of medicine. Moreover, these symptoms occur not only in summer and autumn but throughout all four seasons. When dampness is abundant, there may be slight fever, aversion to cold, body pain, white tongue coating, chest stuffiness, and dark urine as reliable signs. If dampness is slight, there is still no external pain or internal vexation, only feeling fatigue and drowsiness, with a slow and weak pulse and syndrome, exactly like Xu Sun (Deficiency Consumption).
In this condition, if mistakenly treated with tonification, dampness will quickly transform into heat and the disease will worsen; if mistakenly treated with resolution/digestion, dampness will remain while healthy qi is damaged, making it even more unbearable. One must distinguish between Yang Dampness and Yin Dampness. In Yang Dampness, stomach heat is often abundant, constituting Shi Re (Damp-Heat); in Yin Dampness, Spleen Yang must be deficient, constituting Shi Han (Damp-Cold). Furthermore, one must examine whether it is an internal or external injury. In internal injury, the Spleen Earth must be deficient; as stated in the *Nei Jing* (Inner Canon), "low and narrow earth" (referring to deficient Spleen Earth) easily accumulates dampness, leading to fullness in the chest and abdomen and stagnation of Qi mechanism. In external injury, Yang Qi must be deficient; as Liu Hejian (Liu Wansu) stated, a "deficient exterior constitution" easily attracts dampness, leading to heaviness in the limbs and pain in the joints. For internal injury, regulating the Spleen is primary; for external injury, promoting Qi movement is prioritized. For Yang Dampness, the main treatment is Bitter-Pungent (Ku Xin); for Yin Dampness, the main treatment is Bitter-Warm (Ku Wen). Both should be assisted by Dan Shen (Light Percolation/Draining Dampness). If one can clarify Yin and Yang, distinguish internal and external, and adapt flexibly during clinical practice with divine understanding, then one truly deserves to be called the master of life among physicians.