雨露本乎天，清阳也，故伤于上，止犯皮毛；（汗多衣湿不换，致湿气返入于内者，同之。）
泥水本乎地，浊阴也，故伤于下，侵及骨肉，二者皆自外入。饮食之湿、脾土
所生之湿，本乎人，皆自内出。在外在上者汗之，以苦温甘卒之剂，（辛散湿，苦燥湿，
甘温益气以散邪。）在内在下者利之，以苦热酸淡之品。（恐其上行，故用酸以敛而降之，以淡泄之。）
治饮食之湿，在上则吐之，在下则泻之、（食湿则泻大便。）利之。（饮湿则利小便。）治脾土所生
之湿，则察其兼化，盖土德兼该，挟风则为风湿，（走注者是。）挟火则热湿，（烦热者
是。）挟寒则为寒湿。（痹痛者是。）又上下中外，无处不到，（在上则头重、胸满、呕吐；在中则
腹胀痞塞；在下则足胫 肿；在外则身肿重、骨节痛。）当分部位为治，随所兼寒热温凉以用药。又
须察其为何脏之邪，如自病土虚生湿则补土；如火盛生湿则清心；如气郁成湿则升
肝；如金寒水冷泛溢为灾则暖肾。所治之药，各从所入，不特二术也。其症发
热恶寒，恶湿身重，自汗，骨节疼，小便秘涩，大便多泄，腰脚痹冷，跗肿肉如泥，
除湿汤。（见中湿。）若兼腰痛特甚，不可转侧，如缠五六贯钱重者，湿入肾也，肾着汤、
渗湿汤。小便秘，大便溏，五苓散吞戊己丸（见泻）。若兼感风则证兼恶风，或额上
微汗，除湿汤、桂枝汤各半帖，令微发汗。（不可大发。）已得汗而发热不去者，败毒
散加苍术一钱、防己五分。若兼感寒则无汗，惨凛烦痛，五积散（见中寒）和除湿汤
（见中湿）、五苓散各半帖。若感寒又感风者，汗出身重，恶风喘满，骨节烦痛，状如历
节风，脐下至脚冷痹，不能屈伸，所谓风寒湿合而为痹也，防己黄 汤或五痹汤（见
痹）。若浴出未解湿裙裤，忽尔熟睡，湿侵肾经，外肾肿痛，腰背弯曲，五苓散
加入真坏少许，下青木香丸。（见气）三服，脏腑通，肿消腰直痛止。坐湿处，肾
丸肿痛，六味地黄（见损虚）加柴胡、吴茱萸、肉桂各一钱，独活五分。若湿
与热相搏，清热渗湿汤。其证肩背沉重疼痛，（有热则上行于肩背也。）上热胸膈不利，
及通身疼痛者，拈痛汤（见身体痛）。湿热发黄，当从郁治，（凡湿热之物，必郁而后黄。）逍遥散。
（勿用茵陈五苓。）酒面乳酪，停滞不化，除湿汤及苍白二陈汤消息之。（即二陈加二术。二
陈见痰饮。）上吐下利二法，利比吐为多，以湿水也多就下。又利大便小便二法，利小
便比利大便为多，以湿非挟痰食等浊物者，皆当由小便出也。故曰∶利湿不利小便，
非其治也。燥湿三法∶风以胜之，风动而地干也，羌防等；土以涸之，水得泥干也，
苓术等；酸以收之，敛约不使泛滥也，（肉紧缩则不糟）。黄丹、白矾等。（肉紧实则水不能
藏，不得不从二便泄去。）湿脉必缓，兼浮为在表，兼沉为在里，兼弦为风湿，兼数为热湿，
兼迟为寒湿。通用苍术、茯苓、猪苓、木通、木瓜、石斛。在上加防风，在中倍苍
术，在通身加乌药、羌活，在两臂加桑枝、威灵仙，在两足加牛膝、萆 、防己，
寒湿虽暑月亦觉清冷加虎骨、官桂，血必虚加当归。
雨露源于天，属于清阳之气，所以被其伤害时，仅侵犯皮毛；（如果出汗多而衣服湿了不换，导致湿气反侵入体内，情况与此相同。）
泥水源于地，属于浊阴之气，所以被其伤害时，从下部开始，侵及骨肉，这两者都是从外部入侵。饮食产生的湿、脾土所化生的湿，源于人体内部，都是从内部产生。对于在体表、在上部的湿邪，用发汗法治疗，使用苦温甘辛的药剂；（辛味能发散湿气，苦味能燥湿，甘温能益气以驱散邪气。）对于在体内、在下部的湿邪，用利小便法治疗，使用苦热酸淡的药物。（担心药性上行，所以用酸味药物收敛并使其下行，用淡味药物渗泄。）治疗饮食引起的湿邪，在上部则用催吐法，在下部则用泻下法；（食积之湿通过泻大便排出。）利小便法。（饮停之湿通过利小便排出。）治疗脾土自身产生的湿邪，则要观察其兼夹转化的情况，因为土德兼备，挟带风邪则为风湿，（表现为游走性疼痛的是。）挟带火邪则为湿热，（表现为烦热的是。）挟带寒邪则为寒湿。（表现为痹痛的是。）湿邪又上下中外无处不到，（在上部则头重、胸满、呕吐；在中部则腹胀痞塞；在下部则足胫肿胀；在体表则身体沉重、骨节疼痛。）应当根据部位分别治疗，并根据所兼夹的寒热温凉性质来用药。还需要观察是哪一脏腑的邪气，如脾土虚弱生湿则补脾；如心火旺盛生湿则清心；如肝气郁结成湿则疏肝升提；如肺金寒冷肾水泛溢为灾则温肾。治疗的药物，各随其入路，不仅仅是白术、苍术两种。其症状表现为发热恶寒，厌恶潮湿身体沉重，自汗，骨节疼痛，小便短少涩滞，大便多泄泻，腰脚痹冷，足背肿胀肌肉如泥状，可用除湿汤。（见中湿篇。）若兼腰痛特别严重，不能转身侧卧，感觉像缠绕了五六贯铜钱那样沉重，这是湿邪入肾，可用肾着汤、渗湿汤。若小便短少，大便溏薄，可用五苓散吞服戊己丸（见泻痢篇。）若兼感风邪则证候兼有恶风，或额头微汗，可用除湿汤、桂枝汤各半帖，令微微发汗。（不可大发汗。）已经发汗但发热不退的，用败毒散加苍术一钱、防己五分。若兼感寒邪则无汗，凛冽烦痛，可用五积散（见中寒篇）与除湿汤（见中湿篇）、五苓散各半帖同服。若既感寒邪又感风邪，则汗出后身体沉重，恶风气喘胸闷，骨节烦痛，症状像历节风，脐下至脚冷痹，不能屈伸，这就是所谓的风寒湿合而为痹，可用防己黄芪汤或五痹汤（见痹证篇。）若洗澡后未解开湿裙裤，忽然熟睡，湿邪侵入肾经，外生殖器肿痛，腰背弯曲，可用五苓散加入少量真珠末，服用青木香丸。（见气病篇。）连服三剂，脏腑通畅，肿胀消退，腰直痛止。坐在潮湿处，导致肾丸（睾丸）肿痛，可用六味地黄丸（见虚损篇）加柴胡、吴茱萸、肉桂各一钱，独活五分。若湿与热相互搏结，用清热渗湿汤。其症状为肩背沉重疼痛，（有热邪则向上行于肩背。）上部热胸膈不利，以及全身疼痛的，用拈痛汤（见身体痛篇。）湿热发黄，应当从郁证治疗，（凡是湿热的东西，必须郁结之后才会发黄。）用逍遥散。（不要用茵陈五苓散。）酒、面食、乳酪等停滞不化，用除湿汤及苍白二陈汤斟酌调治。（即二陈汤加苍术、白术。二陈汤见痰饮篇。）上吐下利两种方法中，利小便比催吐用的多，因为湿水也多向下流。另外利大便和小便两种方法中，利小便比利大便用的多，因为湿邪如果不夹杂痰食等浊物，都应当从小便排出。所以说：利湿而不利小便，不是正确的治疗方法。燥湿的三种方法：用风药胜湿，风动则地干，如羌活、防风等；用土药涸湿，水得泥则干，如茯苓、白术等；用酸药收湿，收敛约束不使泛滥，（肌肉紧缩则不松弛）。黄丹、白矾等。（肌肉紧实则水液不能藏留，不得不从二便泄去。）湿邪的脉象必然缓，兼浮脉表示在表，兼沉脉表示在里，兼弦脉表示风湿，兼数脉表示热湿，兼迟脉表示寒湿。通用药物有苍术、茯苓、猪苓、木通、木瓜、石斛。湿邪在上部加防风，在中部加倍苍术，在通身加乌药、羌活，在两臂加桑枝、威灵仙，在两足加牛膝、萆薢、防己，若是寒湿即使在暑月也觉清冷，加虎骨、官桂；若血虚加当归。
Rain and dew originate from Heaven, belonging to Clear Yang Qi (Qingyang Qi), so when injured by them, the pathogen only affects the skin and hair; (if sweating is excessive and wet clothes are not changed, causing dampness to re-enter the interior, the condition is the same.)
Mud and water originate from Earth, belonging to Turbid Yin Qi (Zhuoyin Qi), so when injured by them, it starts from the lower part and invades the bones and flesh; both of these enter from the exterior. Dampness from diet and dampness generated by the Spleen Earth originate from within the human body, all arising from the interior. For dampness in the exterior and upper parts, treat with diaphoresis (sweating method), using agents that are bitter, warm, sweet, and pungent; (Pungent flavors disperse dampness, bitter flavors dry dampness, and sweet-warm flavors tonify Qi to dispel pathogens.) For dampness in the interior and lower parts, treat with diuresis (urination-promoting method), using substances that are bitter, hot, sour, and bland. (To prevent the medicinal properties from ascending, sour flavors are used to astringe and direct downward, while bland flavors are used to leach out dampness.) To treat dampness caused by diet, if located in the upper part, use emesis; if in the lower part, use purgation; (dampness from food stagnation is expelled via stool.) or diuresis. (dampness from fluid retention is expelled via urine.) To treat dampness generated by the Spleen Earth itself, observe its accompanying transformations, as the virtue of Earth encompasses all; accompanied by Wind, it becomes Wind-Dampness (manifesting as wandering pain); accompanied by Fire, it becomes Damp-Heat (manifesting as vexatious heat); accompanied by Cold, it becomes Cold-Dampness (manifesting as Bi syndrome pain). Furthermore, dampness reaches everywhere above, below, inside, and outside; (in the upper part: heavy head, chest fullness, vomiting; in the middle part: abdominal distension and obstruction; in the lower part: swelling of shins and feet; on the exterior: heavy body, joint pain.) Treatment should be differentiated by location, and herbs selected according to the accompanying Cold, Heat, Warmth, or Coolness. One must also observe which Zang-Fu organ is affected: if Spleen Earth deficiency generates dampness, tonify Earth; if Heart Fire excess generates dampness, clear the Heart; if Liver Qi stagnation forms dampness, soothe and raise the Liver; if Lung Metal cold and Kidney Water overflow cause disaster, warm the Kidney. The medicaments used follow their respective entry pathways, not limited merely to Atractylodis Rhizoma (Cangzhu) and Atractylodis Macrocephalae Rhizoma (Baizhu). Symptoms include fever and aversion to cold, aversion to dampness with heaviness of the body, spontaneous sweating, joint pain, scanty and difficult urination, frequent loose stools, cold Bi sensation in waist and legs, edema of dorsum pedis with flesh resembling mud; use Shiqu Tang (Dampness-Dispersing Decoction) (see Zhongshi chapter). If accompanied by severe lower back pain, inability to turn or lie sideways, feeling as heavy as five or six strings of coins, this indicates Dampness entering the Kidney; use Shen Zhuo Tang (Kidney-Attaching Decoction) or Shen Shi Tang (Dampness-Leaching Decoction). If urine is scanty and stool is loose, use Wuling San (Five-Ingredient Powder with Poria) taken with Wuji Wan (Wuji Pill) (see Xie chapter). If accompanied by Wind invasion, symptoms include aversion to wind or slight sweating on the forehead; use half a dose each of Shiqu Tang and Guizhi Tang (Cinnamon Twig Decoction) to induce mild sweating. (Do not induce profuse sweating.) If fever persists after sweating, use Baidu San (Decoction for Resolving Toxicity) plus 1 qian of Cangzhu and 0.5 qian of Fangji. If accompanied by Cold invasion, there is no sweating, with chilling and vexatious pain; mix half a dose each of Wuji San (Five-Accumulations Powder) (see Zhonghan chapter), Shiqu Tang, and Wuling San. If invaded by both Cold and Wind, symptoms include sweating followed by body heaviness, aversion to wind, wheezing and chest fullness, vexatious joint pain, resembling Lijie Feng (Gout-like Bi), cold Bi from umbilicus to feet, inability to flex and extend; this is Wind-Cold-Dampness combining to form Bi syndrome; use Fangji Huangqi Tang (Fangji and Astragalus Decoction) or Wu Bi Tang (Five-Bi Decoction) (see Bi chapter). If bathing without removing wet skirts/pants leads to sudden deep sleep, allowing Dampness to invade the Kidney Meridian, causing swelling and pain of the external genitals, curvature of waist and back; add a small amount of Zhenzhu Mu (Pearl Shell) to Wuling San, and administer Qingmuxiang Wan (Blue Musk Pill) (see Qi chapter). After three doses, the Zang-Fu become unobstructed, swelling subsides, waist straightens, and pain stops. Sitting in damp places causing swelling and pain of the "Kidney Pills" (testicles); use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) (see Xu Xu chapter) plus Chaihu, Wuzhuyu, Rougui each 1 qian, and Duhuo 0.5 qian. If Dampness and Heat struggle against each other, use Qingre Shenshi Tang (Clear Heat and Leach Out Dampness Decoction). Symptoms include heavy and painful shoulders and back (Heat ascends to shoulders and back), upper body heat with chest/diaphragm discomfort, and whole-body pain; use Niantong Tang (Relieve Pain Decoction) (see Shenti Tong chapter). For Jaundice due to Damp-Heat, treat from the perspective of Stagnation (all Damp-Heat substances must stagnate before turning yellow); use Xiaoyao San (Free and Easy Wanderer Powder). (Do not use Yinchen Wuling San.) For stagnation of alcohol, noodles, milk, and cheese that fail to transform, use Shiqu Tang and Cangbai Erchen Tang (Bitter-Warm Two-Chen Decoction) for careful management. (This is Erchen Tang added with Cangzhu and Baizhu. Erchen Tang see Tanyin chapter.) Between emesis and purgation/leaching methods, leaching is used more often because water-dampness tends to flow downward. Between promoting bowel movements and promoting urination, promoting urination is used more often because Dampness, unless mixed with Phlegm-Food turbid matter, should exit via urine. Thus it is said: Treating dampness without promoting urination is not the correct method. Three methods of drying dampness: Use Wind herbs to overcome dampness (wind moves, earth dries), such as Qianghuo, Fangfeng; Use Earth herbs to desiccate dampness (water dries with mud), such as Fuling, Baizhu; Use Sour herbs to astringe dampness (preventing overflow, muscle tightness prevents looseness), such as Huangdan, Baifan. (When muscle is tight, water cannot be retained and must exit via two excretions.) Pulse of dampness is invariably Hu (Slow/Slack); combined with Fu (Floating) indicates Exterior; combined with Chen (Deep) indicates Interior; combined with Xian (Wiry) indicates Wind-Damp; combined with Shuo (Rapid) indicates Damp-Heat; combined with Chi (Delayed) indicates Cold-Damp. Commonly used herbs include Cangzhu, Fuling, Zhuling, Mutong, Mugua, Shihu. Add Fangfeng for upper part; double Cangzhu for middle part; add Wuyao, Qianghuo for whole body; add Sangzhi, Weilingxian for arms; add Niuxi, Bibi, Fangji for legs. For Cold-Damp, even in summer months if feeling cold, add Hugujia (Tiger Bone - *note: substitute legally*), Guigui. If Blood deficiency, add Danggui.