防己一两 甘草半两 白术七钱半 黄耆（去芦）一两一分
右锉麻豆大，每炒五钱匕，生姜四片，大枣一枚，水盏半，煎八分，去滓，温服，良
久再服。
喘者，加麻黄半两。胃中不和者，加芍药三分。气上冲者，加桂枝三分。下有陈寒者
，加细辛三分。
服后当如虫行皮中，从腰下如冰，后坐被上，又以一被绕腰以下，温令微汗差。
@@@
风湿相搏，一身尽疼痛，法当汗出而解，值天阴雨不止，医云此可发汗，汗之病不愈
者，何也？盖发其汗，汗大出者，但风气去，湿气在，是故不愈也。若治风湿者，发
其汗，但微微似欲汗出者，风湿俱去也。
【注】
风湿相搏，一身尽痛，法当从汗而解，而汗亦不可失其宜也。值雨淫湿盛之时，若发
其汗使大出，亦不能愈，以风气去，湿气在，故不愈。然治风湿者，必俟其天气晴明
发其汗，使微微似欲汗出者，则风湿皆去，病斯愈矣。
【集注】
徐彬曰：此言风湿当汗解，而不可过也。谓风湿相搏疼痛，原当汗解，值天阴雨，则
湿更甚，可汗无疑。而不愈何故？盖风性急可骤驱，湿性滞当渐解，汗大出则骤，风
去而湿不去，故不愈。若发之微，则出之缓，缓则风湿俱去矣。然则湿在人身，粘滞
难去，骤汗且不可，而况骤下乎？故前章曰下之死，此但云不愈，见用法不当，而非
误下比也。
@@@
伤寒八、九日，风湿相搏，身体疼烦，不能自转侧，不呕不渴，脉浮虚而涩者，桂枝
附子汤主之；若大便坚，小便自利者，去桂枝加白术汤主之。
【注】
此承上条详申脉证，以明其治也。谓此风湿之病，虽得之伤寒八、九日，而不呕不渴
，是无伤寒里病之证也。脉浮虚涩，是无伤寒表病之脉也。脉浮虚，表虚风也。涩者
，湿也。身体烦疼，风也。不能转侧，湿也。乃风湿相搏之身体疼痛，非伤寒骨节疼
痛也。与桂枝附子汤温散其风湿，从表而解也。若脉浮实者，则又当以麻黄加术汤，
大发其风湿也。如其人有是证，虽大便□，小便自利，而不议下者，以其非邪热入里
之□，乃风燥湿去之□。故仍以桂枝附子汤。去桂枝者，以大便坚，小便自利，不欲
其发汗，再夺津液也。加白术者，以身重□湿在肌分，用以佐附子逐水气于皮中也。
【集注】
程林曰：风淫所胜，则身烦疼，湿淫所胜，则身体难转侧。风湿相搏于荣卫之间，不
干于里，故不呕不渴也。脉浮为风，涩为湿，以其脉近于虚，故用桂枝附子汤温经以
散风湿。小便利者，大便必□，桂枝近于解肌，恐大汗故去之；白术能去肌湿，不妨
乎内，故加之。凡服方后有如虫、如醉、如冒等状者，皆药势将行使然。
周扬俊曰：伤寒至八、九日，亦云久矣。既不传经，复不入府者，因风湿持之也。所
现外证烦疼者，风也，不能转侧者，湿也，不呕不渴者，无里证也，其脉浮虚而涩，
正与相应。然后知风湿之邪，在肌肉而不在筋节，故以桂枝表之。不发热为阳气素虚
，故以附子逐湿，两相绾合，自不能留矣。
防己一两，甘草半两，白术七钱半，黄耆（去除芦头）一两一分。
以上药物捣碎如麻豆大小，每次取五钱匕，加入生姜四片，大枣一枚，水一盏半，煎至八分满，滤去药渣，温服，效果良好，隔很久后再服。
气喘的，加麻黄半两。胃中不和的，加芍药三分。气上冲的，加桂枝三分。下部有陈寒的，加细辛三分。
服药后应当感觉像虫子在皮肤中爬行，腰部以下感觉像冰一样冷，之后坐在被子上，再用一条被子围绕腰部以下，使其温暖并微微出汗即可痊愈。
风湿相互搏结，全身都疼痛，按照法度应当通过出汗来解除，正值阴雨天气不停，医生说此病可以发汗，发汗后病不愈，为什么呢？大概是因为发汗时汗出太多，只有风气去了，湿气还在，所以不愈。如果治疗风湿，发汗时只要微微似要出汗的样子，风湿就能一起去除。
【注】
风湿相互搏结，全身都疼痛，按照法度应当从汗而解，但发汗也不可以失去适宜的程度。正值雨水淫湿盛行的时候，如果发汗使汗大出，也不能痊愈，因为风气去了，湿气还在，所以不愈。然而治疗风湿，必须等到天气晴朗明亮时发汗，使微微似要出汗的样子，那么风湿都能去除，病就痊愈了。
【集注】
徐彬说：这里说的是风湿应当通过汗解，但不可以过度。说风湿相互搏结疼痛，原本应当汗解，正值天阴下雨，则湿气更重，可以发汗无疑。为什么不愈呢？大概风性急骤可以迅速驱除，湿性滞涩应当逐渐化解，汗大出则过于急骤，风去了而湿不去，所以不愈。如果发汗轻微，则排出缓慢，缓慢则风湿都能去除。既然这样，湿在人体，粘滞难去，急汗尚且不可以，何况急下呢？所以前章说下法的致死，这里只说不愈，说明用法不当，而不是与误用下法相比。
@@@
伤寒八、九天，风湿相互搏结，身体疼痛烦扰，不能自行翻身转侧，不呕吐不口渴，脉浮虚而涩的，用桂枝附子汤主治；如果大便坚硬，小便自利的，去掉桂枝加白术汤主治。
【注】
这是承接上一条详细阐述脉证，以明确其治疗方法。说这种风湿的病，虽然是得于伤寒八、九天，但不呕吐不口渴，是没有伤寒里病的证候。脉浮虚涩，是没有伤寒表病的脉象。脉浮虚，是表虚风邪。涩者，是湿邪。身体烦疼，是风邪。不能转侧，是湿邪。这是风湿相互搏结的身体疼痛，不是伤寒的骨节疼痛。给予桂枝附子汤温散其风湿，从表而解。如果脉浮实，则又应当用麻黄加术汤，大发其风湿。如果其人有了这些证候，虽然大便□，小便自利，而不议用下法，因为其不是邪热入里的□，而是风燥湿去的□。所以仍以桂枝附子汤为主。去掉桂枝的原因，是因为大便坚硬，小便自利，不希望它再发汗，再次劫夺津液。加白术的原因，是因为身重□湿在肌分，用来辅助附子在皮中驱逐水气。
【集注】
程林说：风淫胜气，则身体烦疼，湿淫胜气，则身体难以转侧。风湿相互搏结于荣卫之间，不干扰于里，所以不呕吐不口渴。脉浮为风，涩为湿，因其脉近于虚，所以用桂枝附子汤温经以散风湿。小便利者，大便必□，桂枝近于解肌，恐怕大汗故去掉它；白术能去肌湿，不妨碍于内，所以加上它。凡是服用方剂后有像虫爬、像醉酒、像头昏等状况的，都是药势将要发作所以如此。
周扬俊说：伤寒到了八、九天，也算久了。既不传经，又不入腑，是因为风湿持留所致。所表现的外证烦疼，是风邪，不能转侧的是湿邪，不呕吐不口渴的是无里证，其脉浮虚而涩，正与相应。然后知道风湿之邪，在肌肉而不在筋节，所以用桂枝解表。不发热是因为阳气素来虚弱，所以用附子逐湿，两者相结合，自然不能停留了。
Fangji (Stephaniae Tetrandrae Radix) 1 liang, Gancao (Glycyrrhizae Radix et Rhizoma) ban liang, Baizhu (Atractylodis Macrocephalae Rhizoma) 7 qian half, Huangqi (Astragali Membranacei Radix) (remove the radicle) 1 liang 1 fen.
The above herbs are crushed to the size of hemp seeds. Each time, take 5 qian bi (a measure), add 4 slices of Shengjiang (Zingiberis Rhizoma Recens), 1 date (Jujubae Fructus), and 1.5 cups of water. Decoct until 0.8 cup remains, remove the dregs, and take warm. It is effective; take again after a long interval.
For wheezing, add Mahuang (Ephedrae Herba) ban liang. For disharmony in the stomach, add Shaoyao (Paeoniae Radix Alba) 3 fen. For qi rushing upward, add Guizhi (Cinnamomi Ramulus) 3 fen. For chronic cold below, add Xixin (Asari Radix) 3 fen.
After taking the medicine, one should feel as if insects are crawling in the skin, and the lower waist will feel like ice. Afterwards, sit on a quilt, and wrap another quilt around the lower waist to keep it warm until a slight sweat appears, which indicates recovery.
When Wind-Dampness mutually combats, causing pain throughout the whole body, the method dictates that sweating should resolve it. If it happens during continuous rainy weather, and the physician says this can be treated by inducing sweat, but the disease does not heal after sweating, why is this? Generally, if sweat is profuse, only the Wind pathogen leaves, while Dampness remains; therefore, it does not heal. When treating Wind-Dampness, inducing sweat should result only in a slight, continuous perspiration ("as if about to sweat"), so that both Wind and Dampness are expelled.
[Annotation]
When Wind-Dampness mutually combats, causing pain throughout the whole body, the method dictates resolution through sweating, but sweating must not exceed appropriate limits. During times of excessive rain and dampness, if sweating causes profuse perspiration, it will not cure the disease because the Wind pathogen leaves while Dampness remains. However, when treating Wind-Dampness, one must wait for clear and sunny weather to induce sweating, resulting in only a slight, continuous perspiration. Then both Wind and Dampness are expelled, and the disease heals.
[Collected Annotations]
Xu Bin said: This passage states that Wind-Dampness should be resolved through sweating, but it must not be excessive. It explains that pain from Wind-Dampness combat originally requires sweating. During cloudy and rainy weather, dampness is even heavier, so sweating is undoubtedly indicated. Why does it not heal? The nature of Wind is rapid and can be driven out suddenly; the nature of Dampness is stagnant and must be resolved gradually. Profuse sweating is too sudden; Wind leaves but Dampness does not, hence no healing. If sweating is mild, the expulsion is slow; being slow allows both Wind and Dampness to be expelled. Since Dampness in the human body is sticky and hard to remove, sudden sweating is inadvisable, let alone sudden purgation. Thus, the previous chapter stated that purgation leads to death, whereas here it only says "does not heal," indicating improper usage rather than a mistake comparable to erroneous purgation.
@@@
After eight or nine days of Shanghan (Cold Damage), with Wind-Dampness mutually combating, causing painful and vexatious body sensations, inability to turn over independently, without vomiting or thirst, and with a floating, deficient, and choppy pulse, Guizhi Fuzi Tang (Cinnamon Twig and Aconite Decoction) is the primary treatment. If the stool is hard and urination is spontaneous, remove Guizhi and add Baizhu Tang (Atractylodes Macrocephala Decoction without Cinnamon Twig) as the primary treatment.
[Annotation]
This continues from the previous clause to detail the pulse and symptoms, clarifying the treatment. It states that although this Wind-Dampness disease occurs after eight or nine days of Shanghan, the absence of vomiting and thirst indicates no interior Shanghan syndrome. The floating, deficient, and choppy pulse indicates no exterior Shanghan pulse pattern. A floating and deficient pulse signifies exterior deficiency and Wind pathogen; a choppy pulse signifies Dampness. Vexatious body pain signifies Wind; inability to turn over signifies Dampness. This is body pain from Wind-Dampness combat, distinct from the joint pain of Shanghan. Guizhi Fuzi Tang is administered to warm and disperse Wind-Dampness, resolving it from the exterior. If the pulse is floating and excess, then Mahuang Jia Zhu Tang (Ephedra plus Atractylodes Decoction) should be used to vigorously expel Wind-Dampness. Even if the patient has these symptoms, with hard stool [blank] and spontaneous urination, purgation is not considered because it is not an interior [blank] of evil heat, but rather a [blank] of Wind dryness and departing Dampness. Therefore, Guizhi Fuzi Tang remains the choice. Guizhi is removed because hard stool and spontaneous urination suggest avoiding further sweating to prevent depletion of fluids. Baizhu is added because body heaviness [blank] indicates Dampness in the muscle layer; it assists Fuzi in driving fluid qi from the skin.
[Collected Annotations]
Cheng Lin said: Excess Wind causes vexatious body pain; excess Dampness causes difficulty in turning the body. When Wind-Dampness combats between Ying and Wei, without affecting the interior, there is no vomiting or thirst. A floating pulse indicates Wind, a choppy pulse indicates Dampness; since the pulse is near deficient, Guizhi Fuzi Tang is used to warm the meridians and disperse Wind-Dampness. When urination is free, stool must be [blank]; Guizhi acts to release the muscle layer, fearing profuse sweat, so it is removed; Baizhu removes muscle dampness and does not harm the interior, so it is added. Any sensations after taking the formula, such as feeling like insects crawling, drunkenness, or dizziness, occur due to the impending action of the medicinal potency.
Zhou Yangjun said: By the eighth or ninth day of Shanghan, it has been quite long. If it neither transmits to other meridians nor enters the fu organs, it is because Wind-Dampness persists. The external symptom of vexatious pain is Wind; the inability to turn over is Dampness; the absence of vomiting and thirst indicates no interior syndrome. The floating, deficient, and choppy pulse corresponds exactly. Thus, we know the Wind-Dampness pathogen resides in the muscles, not the sinews and joints, so Guizhi is used to release the exterior. The absence of fever indicates inherent deficiency of Yang Qi, so Fuzi is used to drive out Dampness. The two combine, and the pathogen cannot remain.