伤湿又兼寒，名曰寒湿。盖因先伤于湿，又伤生冷也。夫寒湿之证，头有汗而身无汗，遍身拘急而痛，
不能转侧，近之则痛剧，脉缓近迟，小便清白，宜以辛热燥湿法治之。毋使其酝酿成温，而成湿温之病，温
甚成热，而成湿热之病；又毋使其变为痰饮，伏而不发，交冬发为咳嗽之病。由是观之，可不速罄其湿乎！须
知寒湿之病，患于阳虚寒体者为多，辛热燥湿之法，未尝不为吻合。湿热之证，患于阴虚火体者为多，此法又
宜酌用耳。贸贸者，不别病之寒湿热湿，体之阴虚阳虚，一遇
湿病，概投通利之方，若此鲁莽，未有不误人者也。
湿温之病，议论纷纷，后学几无成法可遵。有言温病复感乎湿，名曰湿温，据此而论，是病乃在乎春。
有言素伤于湿，因而中暑，暑湿相搏，名曰湿温，据此而论，是病又在乎夏。有言长夏初秋，湿中生热，即
暑病之偏于湿者，名曰湿温，据此而论，是病又在乎夏末秋初。细揆三论，论湿温在夏末秋初者，与《内经》
秋伤于湿之训，颇不龃龉；又与四之气大暑至白露，湿土主气，亦属符节；当宗夏末
秋初为界限也。所有前言温病
复感于湿，盖温病在春，当云温病夹湿；言素伤于湿，因而中暑，暑病在夏，当云中暑夹湿；皆不可以湿
温名之。考其致病之因，良由湿邪踞于气分，酝酿成温，尚未化热，不比寒湿之病，辛散可瘳，湿热之病，
清利乃解耳。是病之脉，脉无定体，或洪或缓，或伏或细，故难以一定之脉，印定眼目也。其证始
恶寒，后但热不寒，汗出胸痞，舌苔白，或黄，口渴不引饮。宜用清宣温化法去连翘，加浓朴、豆卷治之。
倘头痛无汗，恶寒身重，有邪在表，宜用宣疏表湿法，加葛、羌、神曲治之。倘口渴自利，是湿流下焦，宜本
法内去半夏，加生米仁、泽泻治之。倘有胫冷腹满，是湿邪抑遏阳气，宜用宣阳透伏法去草果、蜀漆，加陈
皮、腹皮治之。如果寒热似疟，舌苔白滑，是为邪遏膜原，宜用宣透膜原法治之。如或失治，变为神昏谵语，
或笑或痉，是为邪逼心包，营分被扰，宜用祛热宣窍法，加羚羊、钩藤、元参、生地治之。如撮空理线，苔黄
起刺，或转黑色，大便不通，此湿热化燥，闭结胃腑，宜用润下救津法，以生军易熟军，更加枳壳，庶几攻
下有力耳。倘苔不起刺，不焦黄，此法不可乱投。湿温之病，变证最多，殊难罄述，宜临证时活法可也。
因感受湿邪又兼受寒邪，称为寒湿。这通常是因为先受了湿邪，又吃了生冷食物所致。寒湿的证候，表现为头部出汗而身体无汗，全身拘挛急迫且疼痛，不能翻身转动，触碰则疼痛加剧，脉象缓而近于迟，小便颜色清亮，应当用辛热燥湿的方法来治疗。不要让它酝酿转化为温病，进而形成湿热病；也不要让它变为痰饮，潜伏体内不发作，到了冬天引发咳嗽病。由此看来，难道不应该迅速祛除体内的湿邪吗！必须知道寒湿之病，多见于阳气虚弱、体质偏寒的人，辛热燥湿的方法，未尝不适合。湿热之证，多见于阴液亏虚、体质偏火的人，这种方法就应当斟酌使用了。那些粗疏的医者，不辨别病是寒湿还是湿热，也不辨体质是阴虚还是阳虚，一遇到湿病，就一概投用通利小便的方剂，像这样鲁莽行事，没有不误人的。
关于湿温病的议论纷纷，后学者几乎没有固定的法则可以遵循。有人说温病再次感受湿邪，称为湿温，据此而论，这种病发生在春季。有人说素来伤于湿，因而中暑，暑与湿相互搏结，称为湿温，据此而论，这种病发生在夏季。有人说长夏初秋，湿气中生热，即暑病中偏向于湿的一类，称为湿温，据此而论，这种病发生在夏末秋初。仔细推敲这三种论述，认为湿温发生在夏末秋初的观点，与《内经》“秋伤于湿”的教诲，颇为吻合；又与四之气（大暑至白露期间），湿土主气的时令特点，也相符合；应当以夏末秋初作为界限。所有前面说的温病复感于湿，因为温病在春季，应当称为温病夹湿；说素来伤于湿，因而中暑，因为暑病在夏季，应当称为中暑夹湿；都不可以称为湿温。考察其致病的原因，确实是由于湿邪占据气分，酝酿而成温，尚未化热，不像寒湿之病，用辛散法可以痊愈，湿热之病，用清利法可以解除罢了。这种病的脉象，没有固定的形态，或洪大或缓和，或沉伏或细弱，所以难以用单一的脉象来确定诊断。其症状开始是恶寒，后来只发热不恶寒，出汗且胸部痞闷，舌苔白或黄，口渴但不想喝水。应当用清宣温化法，去掉连翘，加入浓朴、豆卷来治疗。如果头痛无汗，恶寒身重，说明邪气在表，应当用宣疏表湿法，加入葛根、羌活、神曲来治疗。如果口渴且自发性腹泻，这是湿邪流注下焦，应当在本法内去掉半夏，加入生薏苡仁、泽泻来治疗。如果有小腿发冷、腹部胀满，这是湿邪抑制遏阻了阳气，应当用宣阳透伏法，去掉草果、蜀漆，加入陈皮、腹皮来治疗。如果出现寒热往来像疟疾一样，舌苔白滑，这是邪气遏制在膜原，应当用宣透膜原法来治疗。如果延误治疗，变为神志昏迷、胡言乱语，或笑或抽搐痉挛，这是邪气逼迫心包，营分被扰乱，应当用祛热宣窍法，加入羚羊角、钩藤、玄参、生地来治疗。如果出现撮空理线（手指在空中抓摸、整理丝线），舌苔黄起刺，或转为黑色，大便不通，这是湿热化燥，闭结在胃腑，应当用润下救津法，用生大黄代替熟大黄，再加枳壳，这样才能攻下有力。如果舌苔不起刺，不焦黄，这种方法不可乱用。湿温病的变证最多，很难详尽叙述，应当在临证时灵活处理即可。
When dampness is injured and accompanied by cold, it is called Cold-Dampness (Han Shi). This occurs because one is first injured by dampness and then by raw or cold food. In cases of Cold-Dampness, there is sweat on the head but no sweat on the body; the whole body feels stiff, tight, and painful, making it difficult to turn over; touching the area exacerbates the pain; the pulse is slow and near-deficient (Huan Jin Chi); urination is clear and white. Treatment should employ the method of pungent-hot drying-dampness (Xin Re Zao Shi). One must prevent it from fermenting into Warmth (Wen), leading to Damp-Heat (Shi Re); nor allow it to transform into Phlegm-Fluids (Tan Yin) that lie dormant and do not manifest, only to trigger coughing illnesses in winter. From this perspective, is it not urgent to exhaustively eliminate the dampness? It must be known that Cold-Dampness diseases occur mostly in individuals with Yang deficiency and cold constitutions, so the method of pungent-hot drying-dampness is indeed suitable. Conversely, Damp-Heat syndromes occur mostly in individuals with Yin deficiency and fire constitutions, so this method should be used with discretion. Rash practitioners who fail to distinguish between Cold-Damp and Damp-Heat, or between Yin-deficient and Yang-deficient constitutions, indiscriminately administer diuretic formulas for all dampness diseases. Such reckless behavior inevitably leads to medical errors.
Discussions on Warm-Dampness (Shi Wen) are numerous, leaving later learners with few established methods to follow. Some argue that Warm Disease (Wen Bing) re-infected by dampness is called Warm-Dampness; based on this, the disease occurs in spring. Others state that chronic dampness injury followed by Summerheat (Shu) infection, where Summerheat and dampness struggle together, is called Warm-Dampness; based on this, the disease occurs in summer. Still others claim that in late summer and early autumn, heat generates within dampness—specifically the damp-predominant type of Summerheat illness—is called Warm-Dampness; based on this, the disease occurs at the end of summer and beginning of autumn. Carefully evaluating these three theories, the view that Warm-Dampness occurs at the end of summer and beginning of autumn aligns well with the *Neijing*’s teaching that "dampness injures in autumn"; it also corresponds with the climatic characteristics of the Fourth Qi period (from Major Heat to White Dew), where damp-earth governs the qi. Therefore, the boundary should be set at the end of summer and beginning of autumn. The previously mentioned "Warm Disease re-infected by dampness," since Warm Disease occurs in spring, should be termed "Warm Disease complicated by dampness" (Wen Bing Jia Shi); "Chronic dampness injury followed by Summerheat," since Summerheat occurs in summer, should be termed "Summerheat complicated by dampness" (Shu Bing Jia Shi). Neither should be named Warm-Dampness. Investigating the etiology, this disease arises because damp pathogens occupy the Qi level, fermenting into warmth without yet transforming into heat. Unlike Cold-Dampness, which can be cured with pungent dispersal, or Damp-Heat, which is resolved with clearing and draining, this condition requires different handling. The pulse of this disease has no fixed form; it may be surging (Hong), slow (Huan), hidden (Fu), or fine (Xi), making it difficult to diagnose definitively by a single pulse characteristic. Symptoms begin with aversion to cold, progressing to fever without aversion to cold; there is sweating and chest stuffiness; the tongue coating is white or yellow; there is thirst but no desire to drink. Treatment should use the method of Clearing, Disseminating, and Transforming Warmth (Qing Xuan Wen Hua), removing Lian Qiao (Forsythiae Fructum) and adding Hou Po (Magnoliae Officinalis Cortex) and Dou Juan (Glycines Sojae Germinatus). If there is headache, no sweat, aversion to cold, and heavy body, indicating pathogen in the exterior, use the method of Disseminating and Dispersing Exterior Dampness (Xuan Shu Biao Shi), adding Ge Gen (Puerariae Lobatae Radix), Qiang Huo (Notopterygii Rhizoma et Radix), and Shen Qu (Mashihuang). If there is thirst and spontaneous diarrhea, indicating dampness flowing to the Lower Jiao, remove Ban Xia (Pinelliae Rhizoma) from this formula and add Yi Yi Ren (Coicis Semen) and Ze Xie (Alismatis Rhizoma). If there is coldness in the shins and abdominal fullness, indicating dampness suppressing and obstructing Yang Qi, use the method of Disseminating Yang and Revealing Latent Pathogens (Xuan Yang Tou Fu), removing Cao Guo (Tsaoko Fructus) and Shu Qi (Perillae Folium) and adding Chen Pi (Citri Reticulatae Pericarpium) and Fu Pi (Zanthoxyli Pericarpium). If there are alternating chills and fever resembling malaria, with a white and slippery tongue coating, this indicates pathogen restraining the Membrane Source (Mo Yuan); treat with the method of Disseminating and Penetrating the Membrane Source (Xuan Tou Mo Yuan). If treatment is delayed, leading to coma and delirious speech, or laughing and spasms, this indicates pathogen forcing its way to the Pericardium, disturbing the Ying level; treat with the method of Dispelling Heat and Opening Orifices (Qu Re Xuan Qiao), adding Ling Yang Jiao (Capricornis Cornu), Gou Teng (Uncariae Ramulus cum Uncis), Xuan Shen (Scrophulariae Radix), and Sheng Di Huang (Rehmanniae Radix). If the patient exhibits grasping at empty air and tracing lines (Cuo Kong Li Xian), with a yellow tongue coating becoming prickly, or turning black, and constipation, this indicates damp-heat transforming into dryness and closing off the Stomach Fu organs; use the method of Moistening and Purging to Save Fluids (Run Xia Jiu Jin), replacing cooked Da Huang (Rhei Radix et Rhizoma) with raw Da Huang, and adding Zhi Ke (Aurantii Fructus), to ensure effective purgation. If the tongue coating does not become prickly or scorched-yellow, this method must not be used indiscriminately. Warm-Dampness presents with the most varied complications, which are difficult to enumerate completely; thus, flexible application during clinical practice is essential.