中湿证脉沉缓，一身尽痛，及身黄，大便反快，小便涩是也。
【利】五苓散。
【温】小便自利，术苓附子汤。小便不利，大便反快，甘草附子汤。
夏月自汗烦渴为中 。面垢背寒，身不痛，外证大率似热病中暑。有四证可审∶自
汗，一也；烦渴，二也；脉虚，三也；面垢，四也。但不恶寒，不身痛，为中 。手足
虽冷，脉虽虚，不可用热药，当以清暑之剂及利小便为佳。
【清暑】香薷饮。中 ，手足微冷烦渴，四肢不痛，白虎汤。中暑发热不恶寒，竹叶
石膏汤。中 身热恶寒，汗出而渴，及太阳中 ，发热恶寒，身重脉弦细，小便已洒然毛
耸，手足冷，劳则热，手足汗，口烂而燥，俱宜白虎加人参汤。
【分利】发热头痛，小便不利色赤，头痛恶寒，心烦躁，心下不快，五苓散、益元散。
【和】发热头痛烦躁，小柴胡汤。
【豁痰】痰逆恶寒者，橘皮汤。
【降火】热甚者，黄连解毒汤加香薷。
【熨法】昏愦不省人事，葱饼熨脐。
脏结之候，其状如结胸，饮食如故，时时自下利，舌上白胎，脐痛引阴筋，不往来寒
热，云寒而不热，其人反静，此脏结也。仲景谓病胁下素有痞，连在脐旁，痛引小腹入阴
筋者，此名脏结，死。盖昔宿积之结于胁为痞，今因伤寒邪气入里，与宿积相合，使真脏之
气结而不通，致连在脐旁，痛引小腹入阴筋而死。仲景无治法。舌上白胎者不可攻。
【和】小柴胡汤。
【针】关元穴。
中湿证的脉象沉缓，全身疼痛，身体发黄，大便反而通畅，小便涩滞，这就是中湿证的表现。
【利水渗湿】五苓散。
【温阳】如果小便自利，用术苓附子汤。如果小便不利，大便反而通畅，用甘草附子汤。
夏季出现自汗、心烦口渴属于中湿（注：原文此处“中”后缺字，结合上下文及中医常识，此处指“中湿”，但根据后文“似热病中暑”及症状描述，部分版本或语境下可能指“中喝/中暑”之轻症或变证，然前文明确为“中湿”，且症状有面垢背寒身不痛，与典型中暑不同，此处依原文直译）。面色污垢，背部发冷，身体不痛，外在证候大体类似热病中的中暑。有四条证候可以审察：一是自汗；二是心烦口渴；三是脉虚；四是面色污垢。但是不恶寒，身体不痛，这是中湿（同上，依原文逻辑）。手足虽然发冷，脉象虽然虚弱，不可使用热性药物，应当以清暑的方剂以及通利小便的方法为佳。
【清暑】香薷饮。中湿（同上），手足微冷、心烦口渴，四肢不痛，用白虎汤。中暑发热且不恶寒，用竹叶石膏汤。中湿（同上）身热恶寒，出汗而口渴，以及太阳经中湿（注：原文“太阳中”后缺字，通常指太阳中湿或太阳中风等，此处依原文保留结构），发热恶寒，身体沉重，脉象弦细，小便结束后感觉洒然毛耸（寒战感），手足冷，劳累后发热，手足出汗，口腔溃烂而干燥，这些都适宜用白虎加人参汤。
【分利水湿】发热头痛，小便不利且颜色赤红，头痛恶寒，心中烦躁，胃脘部不适，用五苓散、益元散。
【和解】发热、头痛、烦躁，用小柴胡汤。
【豁痰】痰气上逆且恶寒的，用橘皮汤。
【降火】热势严重的，用黄连解毒汤加香薷。
【熨法】神志昏愦、不省人事的，用葱饼熨烫脐部。
脏结的证候，其表现像结胸证，饮食如常，时常自行腹泻，舌苔白，脐部疼痛牵引至阴筋（生殖器部位），没有往来寒热的症状，表现为只有寒而没有热，病人反而安静，这就是脏结。张仲景说，如果病人胁下素有痞块，连接在脐旁，疼痛牵引小腹进入阴筋的，这名叫脏结，预后不良（死证）。大概是因为过去宿积凝结在胁下形成痞块，现在因为伤寒邪气入里，与宿积相结合，导致真脏之气结聚不通，致使疼痛连接在脐旁，牵引小腹进入阴筋而死。张仲景没有给出治疗方法。舌苔白的不可攻下。
【和解】小柴胡汤。
【针灸】关元穴。
The pulse of dampness-stroke (Zhong Shi) is deep and slow, with pain throughout the body, yellowing of the skin, loose stools, and difficult urination.
[Promote Urination] Wu Ling San (Five-Ingredient Powder with Poria).
[Warm Yang] If urination is spontaneous and free, use Shu Ling Fu Zi Tang (Atractylodes Macrocephala, Poria, and Aconite Decoction). If urination is difficult but stools are loose, use Gan Cao Fu Zi Tang (Licorice and Aconite Decoction).
In summer, spontaneous sweating, irritability, and thirst indicate dampness-stroke (Zhong Shi). The face appears dirty, the back feels cold, and there is no body pain; the external symptoms generally resemble heatstroke in febrile diseases. There are four signs for differentiation: first, spontaneous sweating; second, irritability and thirst; third, a deficient pulse; fourth, a dirty-looking face. However, since there is no aversion to cold and no body pain, it is identified as dampness-stroke (Zhong Shi). Although the hands and feet may be cold and the pulse deficient, hot medicines should not be used. It is best to employ cooling-dampness formulas and methods that promote urination.
[Cool Summerheat] Xiang Ru Yin (Mosla Decoction). For dampness-stroke (Zhong Shi) with slightly cold hands and feet, irritability, thirst, and no pain in the four limbs, use Bai Hu Tang (White Tiger Decoction). For heatstroke with fever and no aversion to cold, use Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction). For dampness-stroke (Zhong Shi) with fever, aversion to cold, sweating, and thirst, as well as Taiyang channel dampness-stroke (Taiyang Zhong Shi) presenting with fever, aversion to cold, heaviness of the body, a string-taut and fine pulse, chills after urination, cold hands and feet, fever upon exertion, sweaty hands and feet, and oral ulcers with dryness, all are suitable for treatment with Bai Hu Jia Ren Shen Tang (White Tiger Decoction plus Ginseng).
[Separate and Drain Dampness] For fever, headache, difficult urination with red urine, headache with aversion to cold, mental restlessness, and epigastric discomfort, use Wu Ling San (Five-Ingredient Powder with Poria) or Yi Yuan San (Benefit Origin Powder).
[Harmonize] For fever, headache, and irritability, use Xiao Chai Hu Tang (Minor Bupleurum Decoction).
[Resolve Phlegm] For phlegm counterflow with aversion to cold, use Ju Pi Tang (Tangerine Peel Decoction).
[Descend Fire] For severe heat, use Huang Lian Jie Du Tang (Coptis Decoction to Relieve Toxicity) added with Xiang Ru (Mosla).
[Moxibustion/Warming Therapy] For coma and unconsciousness, apply warm ginger-onion cakes to the navel.
The presentation of Zang-Jie (Organ Knotting) resembles Jie-Xiong (Chest Binding), with normal appetite, frequent spontaneous diarrhea, a white tongue coating, pain at the umbilicus radiating to the genital tendons, absence of alternating chills and fever, manifesting as cold without heat, and the patient appearing quiet. This is Zang-Jie. Zhang Zhongjing stated that if a patient has a chronic mass under the hypochondrium connected to the side of the umbilicus, with pain radiating from the lower abdomen into the genital tendons, this is named Zang-Jie, which is fatal. This is because old accumulated pathogenic factors formed a mass (Pi) in the hypochondrium; now, due to Shaoyin Cold Damage pathogens entering the interior and combining with the old accumulation, the Qi of the True Zang becomes knotted and blocked, causing pain connecting to the side of the umbilicus and radiating into the genital tendons, leading to death. Zhang Zhongjing did not provide a treatment method. If the tongue coating is white, purgation is contraindicated.
[Harmonize] Xiao Chai Hu Tang (Minor Bupleurum Decoction).
[Acupuncture] Guan Yuan (CV4).