问曰∶药之温者入肝，而药之大热者又直入肾，何也？
答曰∶此正足见厥阴主风，属阴中之
故入肝，巴戟，茴香之类是矣。少阴主热，依积阳之气，故
性大热者，直入下焦膀胱肾中，附子是也。
问曰∶治风寒之药？
答曰∶寒者，水气也。水属北方壬癸，在卦为坎，在人属肾。《内经》
云诸寒收引，皆属于肾，肾之腑为膀胱，代肾司化，是为寒水之府，经名太阳。《内经》言
太阳之上，寒气治之，寒者太阳膀胱之本气也。夫坎中一阳，实人身元气，寄于膀胱水府之
中，化气而上行，外达为人身卫外之气，名曰太阳，阳之大者也。阳气卫外，安得有寒，其
有寒者，乃阳气不伸，而寒水独胜，于是乎有寒病矣。冬月水结成冰，即是水中之阳不伸，
是以纯阴互结而为寒。人身膀胱水中之阳气，透膜膈，出肌肉，达皮毛，则能卫外而不受寒。
寒主收塞，故受寒则闭其毛孔，汗不得出。发热者，内之阳不通于外而凑集皮间，遂郁而发
热。阳为所遏，故愈恶寒。法用麻黄通阳气，出于毛孔，汗出而寒去。麻黄茎细丛生，中空
直上，气味轻清，故能透达膀胱寒水之阳气，以出于皮毛，为伤寒要药。后人用羌独活代麻
黄，羌独活根深茎直，能引膀胱下焦之阳，以达于经脉，而发散其表。惟味辛烈，较麻黄更
燥兼能去湿，不似麻黄轻清直走皮毛。薄荷亦轻清，但薄荷升散在味，故力稍逊。麻黄升散
纯在于气，故力更峻。葱管通阳，与麻黄之义同。然麻黄茎细象毛空，葱茎粗象鼻孔，故葱
能治鼻塞。辛夷花亦升散鼻孔脑 之寒，又以花在树梢，尖皆向上，故主升散。荆芥性缓于
薄
荷，紫苏亦然，二物皆色赤，能入血分，味辛香能散寒，故皆主散血分肌肉中之寒。人身外
为皮膜是气分，内为肌肉是血分，寒入血分在肌肉中堵截，其气不得外出，以卫外为固，故
毛孔虚而汗漏出。法当温散肌肉，桂枝色赤味辛散入血分，故主之。枝又四达，故主四肢。
紫苏性同桂枝，然较轻，不如桂枝之大温。防风以味甘入肌肉，气香而温，故散肌肉中之寒
气。皮与肌肉之交有膜相连，名曰腠理，柴胡茎中白瓤象膜，一茎直上，能达清阳，故治腠
理之寒热也。荆芥得木火之势，入少阳经，亦能发腠理之寒热，肌肉中寒凝血滞则为痹痛。
仲景名曰“血痹”，是指血分而言。故五物汤用桂枝、当归，四逆汤用桂枝以温血分。
用羌独活、荆芥，不及桂枝力
优。寒入于筋脉或拘急不能屈伸，或 缓不能收引，或疼
痛不可忍耐，总宜续断、秦艽引入筋脉。寒入骨节、腰膝周身疼痛，手足厥冷，宜附子以温
肾，肾主骨，用细辛以引经，入骨驱寒。寒循太阳经发为痉，用葛根引麻桂循经脉以散之，
寒入脑髓名“真头痛”，用细辛以引经上达，用附子以助阳上行，皆从督脉以上入于脑也。
肝脉亦入脑髓，故仲景用吴茱萸治脑髓寒痛。鼻孔通脑，故北人以鼻烟散脑中之寒。西洋有
用药吹鼻以治脑髓之法，又西医云脑筋多聚于胃，故白芷、辛夷皆从胃能达脑以散寒。寒由
皮毛入肺，闭肺之窍，则鼻塞，薄荷、辛夷治之。肺主行水，寒伤肺阳，水不得行，则停胃
而为饮，上逆气咳，仲景用细辛以行水，用干姜以散寒，用麻桂以驱寒外出，小青龙汤是也
。但温肺而不兼胃治者，则用甘草干姜汤，其姜炮过，则轻而上浮，故但温肺。后人用白芥
逐水，陈皮降气，冬花温肺，苏子降气，皆是仿仲景小青龙汤以辛温去肺寒也。总之膀胱主
寒水，内含坎阳，阳气升则水化而下，无阳气矣。阳气不升则水停不化，为寒饮。故用细辛
以达水中之阳，用附子以助水中之阳，用干姜以温土中之阳，阳出则阴消，而寒饮之水自化，
寒水犯中宫，上吐下泻为霍乱洞泄，干姜温中故主之。砂仁、白蔻、良姜亦治之，凡去寒必
兼利水，以寒即水之气，去水即是去寒。大寒纽结作痛，阳气不通，用乌头、细辛、川椒、
小茴、吴萸助肾阳，兼达肝阳，阳气畅则寒散痛止。四肢逆冷者，由于肾阳不达，附子温水
中之阳，故治之。故纸温肾但能温敛而不伸达，故但治腰痛而不治手足逆冷。肉桂本木火之
气，大辛入下焦，火交于水则阳生，而寒水自化，故肾气丸用桂附温补坎阳，以化气行水，
寒在腰肾精冷者宜之。寒在膀胱，水停不化，名曰蓄水，用苓泽以利之，而尤必用桂枝以宣
水中之阳，五苓散是也。乌药色紫入血分，又气温入肝，肝主血室，故乌药入血室以散寒。
《本经》言治膀胱肾间冷气，即指血室中之冷气也。凝血作痛用艾叶，亦是
入血室也。寒水凌心，必用
桂枝、远志、公丁香，以宣心阳。寒挟肝风则生
蛔虫，侮脾土则用川椒、姜附以温肝。若硫黄石中之液，而能然，是水中火也。其味酸，是
得木味水中之阳，发则生木，故味酸而能燃。是为水中之火，为温下焦肝肾之猛药。天生黄，
生于云南，下有硫黄，上有温泉，泉气熏岩，结成天生黄。真水中之阳气所化，纯而不燥，
然人之阳气上达则归于肺，天生黄生在岩上，故为温肺妙药，不得作硫黄本性论也。夫热药
具辛味者，虽大温犹不至烈以得木性，而未得木味，非纯于生火之性，故不烈惟温而味酸。
则既得木性又得木味，纯于生火，故性烈，硫黄砒石是也。
问曰∶病有上热下寒，外热内寒，
当用何药？
答曰∶此以在下在内之寒为主，用姜桂附而兼胆汁、人尿、麦冬、牛膝等以抑之
使下。
问曰∶病有内热外寒，下热上寒，又当用何药？
答曰∶此以在下在内之热为主，用苓
连知柏而兼生姜、桂枝、薄荷、荆芥、葱白以引之使上，要在用药之妙，未可责效于一药已
也。
问曰∶五行惟土主湿，李东垣重脾胃，专于燥土去湿。而仲景治太阴不专用燥药，
何也？
答曰∶东垣知已成之湿，而不知湿何由生，则以为土不治水也。岂知湿者土之本
气，先要解
得土字，然后解得湿字。金木水火各居四方，而土属中央。中者，四方之所交央者，阴阳之
所会，诗夜未央，言天未明，是阴未会于阳之义。鸳鸯鸟不独宿，字从鸯，取阴阳交会之义。
盖阴阳二字，双声合为一音，即央字也。土居中央者，是阴阳相交而化成。盖水以火交，遇
木则腐而成土，遇金则化而归土，故河图之数一水二火三木四金，土居五行之末，犹能旺于
四季。盖水火木金交合而成土也，故土于四季皆旺。夫五行名为土，是就其形论；六气名为
湿，是就其气论。气之所以湿，亦只是水火木金交妒而成，未有腐质金含水润，故皆能
生土生湿。究竟金木之气交少，而水火之气交多。夫火不蒸水，则为寒水，非湿也。水不濡
火，则为烈火，亦非湿也。譬如甑中有米，无火以蒸之，则不湿；无水以濡之，亦不湿。必
水火相交，而后成为湿矣。长夏之时，湿气用事，正阴阳交妒之时，水火相蒸之候。故当夏
月，墙壁皆湿，而人之湿病多感于此，人之脾土本天之湿气，为心火肾水交会而成。能化物
运四脏，皆功在湿也。胃以燥纳谷，全借脾之湿以濡之，而始能化。脾生油膜，上腹中之物
既化为汁，则引入油膜，达于各脏，而充周身。长膏油主润泽，皆其湿之功用也。顾脾气不
及则为燥，而太过又反病湿，所以《内经》言脾主湿，又言脾恶湿。故凡湿病皆以治脾为主，
水火相蒸为湿，故湿之为病，水火兼具。治湿之药，其性皆平，正是水火兼能治之也。茯苓、
扁豆、苡仁，其味皆淡，是为利湿正药，湿甚则土困，故利湿即能健脾。莲米、芡实，微甘
而涩，能收湿气，故健脾。白术有油，以补脾之膏油，而油又不粘米，故能利水。气香温亦
主利水，又能升发，使脾土之气上达，故白术为补脾正药。苍术气温而烈，故带燥性，补胃
不补脾，且色苍，得木之性，更能疏泄，为治寒湿之品。夫湿兼水化，水化有余，为湿兼寒，
病则腹胀，溏泻。花椒辛温以散寒湿，能杀湿化之虫。吴萸辛烈，去湿尤速。白蔻、干姜等，
皆治寒湿，吞酸、吐酸有二病。一是寒湿，宜吴萸、苍术、桂枝、生姜，一是热湿，宜黄连、
黄柏、黄芩、石决明、青皮、胆草等药。微加吴萸、花椒，以反佐之。夫酸者，湿所化也，
湿挟热而化酸。如夏月肉汤，经宿则酸；有冰养之，则不酸。麦麸发热，则成醋而酸。皆是
以热蒸湿而酸也。故黄连等苦燥之品，正治其热化之湿。其一是寒湿，又如菜入坛腌则化为
酸，是为寒化之湿，吴萸等辛燥之品，正治其寒化之湿。湿注于脚，则为香港脚肿病，西医言
香港脚病，其尿必酸，知是湿也。凡香港脚，寒湿者多，宜以温药为主，再加木瓜、苡仁、牛膝
为引导，所以利脚下之湿也。然而香港脚亦有系热湿者，宜防己、黄柏、苍术、木通、胆草等
苦降之品治之。湿积于脾，则腹中胀，久则水多为臌，宜逐其水，甘遂、大戟、芫花、牵牛
功力峻猛，随用大枣、参、术、甘草以补脾土去其太过，又恐损其不足也。脾停饮食，则湿
不化，宜神曲以散湿，枳壳、陈皮、木香行气以行湿。夫水火交而为湿土，人身之脾应之。
白术温而有汁，正是水火相交之物，故正补脾经。黄精甘平有汁液，得水火气交之平，故正
补脾经。山药有质色白，故补脾之火以补湿。苍术有汁而味烈，则扶脾之火以燥湿。赤石脂，
土之质也，能燥湿。橘朴、槟榔之去湿，以木疏土也。桑皮、蒺藜之利湿，以金行水也。湿
溢于腠理则肿，桑皮象人之膜故治之。防己中空，纹如车轮，能外行腠理、内行三焦，能通
水气。木通中空与防己同，味苦泄，故均为行湿之要药。腰脚之湿，土茯苓、萆 、威灵仙、
苡仁，凡利降者皆治之。再宜随寒热加减，湿蒸皮肤为发黄，宜茵陈、秦皮、益母草以散兼
利者治之，膀胱不利，宜泽泻、车前、昆布、海藻诸物，多生水石间，故化膀胱之水，此清
火利水，为治湿之法。湿与热蒸，则为暑。各书论暑，不知暑之原，而分阴暑、阳暑，与中
热、中寒热无异，非暑之实义也。陈修园以暑为热，而不知热合湿乃为暑。月令云土润溽暑，
惟其润溽，然后成暑。故治暑者，必兼湿热二字，乃为得宜。夏秋瘟疫痢疟皆感于暑，即湿
热也。此断不可用燥药，燥则壅湿而不流；又不可用表药，用表则发热而湿蒸。唯一味清利，
六一散虽轻，为清热利湿之正药。黄连苦能泻热，又能燥湿，亦为去暑之正药。伤暑发热，
宜香薷以散皮肤之湿热。暑变瘟疫，石膏、黄连为主。已有专书，未能枚举，总之不可
发表，但宜泻热利湿。伤暑变痢，不可发汗，更不可利水，但宜清热而湿自化，黄连、黄芩
为主。伤暑变疟，贵于散湿清热，三焦膀胱之小便清则疟自除，土茯苓、猪苓、葛根、独活
散湿，以治太阳膀胱；黄芩、鳖甲、青皮、胆草清热，以利少阳三焦，两腑兼治为宜。痰疟
是湿积而成，常山苗能透达以吐之。疟母是痰与血合，鳖甲、牡蛎、山甲能破之，此湿之兼
证也，未能尽详。又如五加皮引治皮肤，五苓散用桂枝以治寒湿，五淋汤用山栀以治热湿，
要之湿为脾所司。脾之膏油连焦膜而彻内外，以达膀胱，所以治湿兼治各处。究湿之
水火合化者也，故有寒热二
证。
答：这正体现了厥阴（足厥阴肝经）主风，属于阴中之阴的特性，所以温性的药物入肝，如巴戟天、小茴香之类。少阴（足少阴肾经）主热，依附于积聚的阳气，所以药性大热的药物，直接入下焦膀胱和肾中，如附子就是这类。
答：寒，是水气。水属北方壬癸，在八卦中为坎卦，在人体对应肾。《黄帝内经》说：“各种寒冷收缩牵引的症状，都归属于肾。”肾的腑是膀胱，代替肾主持气化功能，所以称为寒水之府，经脉名称为太阳。《黄帝内经》说：“太阳之上，由寒气主治。”寒是太阳膀胱的本气。坎卦中间的一阳爻，实际上是人身元气，寄居在膀胱水府之中，化生为气向上运行，向外达出成为人身卫护体外的气，名为太阳，是最大的阳。阳气卫护体表，怎么会有寒呢？之所以有寒，是因为阳气不能伸展，而寒水之气独盛，于是产生了寒病。冬天水结成冰，就是水中的阳气不能伸展，所以纯阴互相凝结而成寒。人身的膀胱水中阳气，透过膜膈，出于肌肉，达于皮毛，就能卫护体外而不受寒邪侵袭。寒邪主收引闭塞，所以受寒后毛孔闭合，汗液无法排出。发热，是因为体内的阳气不能通达于外，聚集在皮间，于是郁结而发热。阳气被寒邪遏制，所以更加怕冷。治法应用麻黄通利阳气，从毛孔透出，汗出则寒邪去除。麻黄茎细丛生，中空直立向上，气味轻清，所以能透达膀胱寒水中的阳气，使其出于皮毛，是治疗伤寒的要药。后人用羌活、独活代替麻黄，羌活、独活根深茎直，能引膀胱下焦的阳气，到达经脉，从而发散表邪。只是它们味道辛烈，比麻黄更燥，兼能去湿，不像麻黄那样轻清直达皮毛。薄荷也轻清，但薄荷的升散作用在于其味，所以力量稍弱。麻黄的升散纯粹在于其气，所以力量更峻猛。葱管通阳，与麻黄的意义相同。然而麻黄茎细像毛孔，葱茎粗像鼻孔，所以葱能治疗鼻塞。辛夷花也能升散鼻孔和脑中的寒邪，又因为花在树梢，尖端都向上，所以主要起升散作用。荆芥的药性比薄荷缓和，紫苏也是如此，这两者颜色赤红，能入血分，味道辛香能散寒，所以都主治散除血分和肌肉中的寒邪。人身外部是皮膜，属于气分；内部是肌肉，属于血分。寒邪侵入血分，在肌肉中堵截，导致气不得外出以固护卫表，所以毛孔虚开而汗漏出。治法应当温散肌肉中的寒邪，桂枝色赤味辛，散入血分，所以主治此证。桂枝枝条四向通达，所以主治四肢病症。紫苏药性与桂枝相同，但较轻，不如桂枝的大温。防风味甘入肌肉，气香而温，所以能散肌肉中的寒气。皮肤与肌肉交接处有膜相连，名叫腠理。柴胡茎中白瓤象膜，一茎直立向上，能达清阳，所以治疗腠理的寒热。荆芥得木火之势，入少阳经，也能发越腠理的寒热。肌肉中寒凝血滞则产生痹痛。张仲景称之为“血痹”，是指血分而言。所以黄芪桂枝五物汤用桂枝、当归，四逆汤用桂枝来温补血分。如果用羌活、独活、荆芥，效果不及桂枝优越。寒邪侵入筋脉，或拘急不能屈伸，或弛缓不能收引，或疼痛不可忍耐，总宜用续断、秦艽引入筋脉。寒邪侵入骨节，腰膝周身疼痛，手足厥冷，宜用附子温肾，肾主骨，用细辛引经，入骨驱寒。寒邪循太阳经发作成痉病，用葛根引导麻黄、桂枝循经脉以散寒。寒邪侵入脑髓名为“真头痛”，用细辛引经上达，用附子助阳上行，都是从督脉以上入于脑。肝脉也入脑髓，所以张仲景用吴茱萸治疗脑髓寒痛。鼻孔通脑，所以北方人用鼻烟散除脑中之寒。西洋有用药吹鼻治疗脑髓的方法，又有西医说脑筋多聚于胃，所以白芷、辛夷都能从胃达脑以散寒。寒邪由皮毛入肺，闭阻肺之窍，则鼻塞，用薄荷、辛夷治疗。肺主行水，寒伤肺阳，水不得运行，则停聚于胃而为饮，上逆致咳喘，张仲景用细辛以行水，用干姜以散寒，用麻黄、桂枝以驱寒外出，这就是小青龙汤。但如果只温肺而不兼治胃的，则用甘草干姜汤，其姜炮制过后，药性轻而上浮，所以只温肺。后人用白芥子逐水，陈皮降气，款冬花温肺，苏子降气，都是仿效张仲景小青龙汤，用辛温之法去肺寒。总之，膀胱主寒水，内含坎阳，阳气升则水化为下流，若无阳气，则阳气不升，水停不化，成为寒饮。所以用细辛以达水中之阳，用附子以助水中之阳，用干姜以温土中之阳，阳出则阴消，而寒饮之水自然化解。寒水侵犯中宫，上吐下泻为霍乱洞泄，干姜温中，所以主治此证。砂仁、白豆蔻、高良姜也治疗此证，凡去寒必兼利水，因为寒即水之气，去水即是去寒。大寒凝结作痛，阳气不通，用乌头、细辛、川椒、小茴香、吴茱萸助肾阳，兼达肝阳，阳气通畅则寒散痛止。四肢逆冷，由于肾阳不达，附子温水中之阳，所以治疗此证。故纸（补骨脂）温肾，但只能温敛而不能伸展通达，所以只治腰痛而不治手足逆冷。肉桂本具木火之气，大辛入下焦，火交于水则阳生，而寒水自化，所以肾气丸用肉桂、附子温补坎阳，以化气行水，适用于寒在腰肾精冷者。寒在膀胱，水停不化，名为蓄水，用茯苓、泽泻以利之，而尤其必须用桂枝以宣通水中之阳，这就是五苓散。乌药色紫入血分，又气温入肝，肝主血室，所以乌药入血室以散寒。《神农本草经》说治疗膀胱肾间冷气，即指血室中的冷气。凝血作痛用艾叶，也是入血室。寒水凌心，必须用桂枝、远志、公丁香，以宣通心阳。寒挟肝风则生蛔虫，侮脾土则用川椒、姜附以温肝。若硫黄石中之液，能够燃烧，这是水中火。其味酸，是得木味水中之阳，点燃则生木，所以味酸而能燃。这是水中之火，是温补下焦肝肾的猛药。天生黄，生于云南，下有硫黄，上有温泉，泉气熏蒸岩石，结成天生黄。这是真水中之阳气所化，纯和不燥，然而人的阳气上达则归于肺，天生黄生在岩上，所以是温肺妙药，不能当作硫黄本性来论述。热药具备辛味的，虽然大温，却不至于猛烈，因为得木性而未得木味，不是纯于生火的性质，所以不烈，只是温和而味酸。如果既得木性又得木味，纯于生火，所以性质猛烈，硫黄、砒石就是这类。
答：这种情况以下部、内部的寒为主，用干姜、肉桂、附子，并兼用胆汁、人尿、麦冬、牛膝等药来抑制它，使其下行。
答：这种情况以下部、内部的热为主，用茯苓、黄连、知母、黄柏，并兼用生姜、桂枝、薄荷、荆芥、葱白来引导它，使其上行，关键在于用药的巧妙，不能指望靠一味药就见效。
问：五行中只有土主湿，李东垣重视脾胃，专门用燥土去湿的方法。而张仲景治疗太阴病不专用燥药，这是为什么呢？
答：李东垣只知道已成之湿，却不知道湿是如何产生的，就认为是土不能治水。岂不知湿是土的本气，先要理解“土”字，然后才能理解“湿”字。金木水火各居四方，而土属中央。中，是四方交汇之处；央，是阴阳交会之处。“夜未央”诗句，意思是天未明，即阴未会于阳的意思。鸳鸯鸟不单独住宿，字形从“鸯”，取阴阳交会之意。大概“阴阳”二字双声合为一音，就是“央”字。土居中央，是阴阳相交而化成。水遇火交，遇木则腐而成土，遇金则化而归土，所以河图之数一水二火三木四金，土居五行之末，却能旺于四季。这是因为水火木金交合而成土，所以土于四季皆旺。五行名为土，是从形体而论；六气名为湿，是从气机而论。气之所以湿，也只是水火木金交妒而成，未有腐质金含水润，所以都能生土生湿。究竟金木之气交少，而水火之气交多。火不蒸水，则为寒水，不是湿；水不濡火，则为烈火，也不是湿。譬如甑中有米，无火以蒸之，则不湿；无水以濡之，亦不湿。必须水火相交，而后成为湿。长夏之时，湿气当令，正是阴阳交妒之时，水火相蒸之候。所以在夏季，墙壁皆湿，而人之湿病多感于此。人之脾土本天之湿气，为心火肾水交会而成。能化物运化四脏，功效都在湿。胃以燥纳谷，全借脾之湿以濡润它，然后才能消化。脾生油膜，上腹中之物既化为汁，则引入油膜，达于各脏，而充养周身。长膏油主润泽，都是湿的功用。顾脾气不及则为燥，太过又反病湿，所以《黄帝内经》说脾主湿，又说脾恶湿。所以凡湿病都以治脾为主。水火相蒸为湿，所以湿之为病，水火兼具。治湿之药，其性皆平，正是水火兼能治之。茯苓、扁豆、薏苡仁，其味皆淡，是为利湿正药，湿甚则土困，所以利湿即能健脾。莲米、芡实，微甘而涩，能收湿气，所以健脾。白术有油，以补脾之膏油，而油又不粘米，所以能利水。气香温亦主利水，又能升发，使脾土之气上达，所以白术为补脾正药。苍术气温而烈，故带燥性，补胃不补脾，且色苍，得木之性，更能疏泄，为治寒湿之品。夫湿兼水化，水化有余，为湿兼寒，病则腹胀，溏泻。花椒辛温以散寒湿，能杀湿化之虫。吴茱萸辛烈，去湿尤速。白蔻、干姜等，皆治寒湿。吞酸、吐酸有二病。一是寒湿，宜吴茱萸、苍术、桂枝、生姜；一是热湿，宜黄连、黄柏、黄芩、石决明、青皮、胆草等药。微加吴茱萸、花椒，以反佐之。夫酸者，湿所化也，湿挟热而化酸。如夏月肉汤，经宿则酸；有冰养之，则不酸。麦麸发热，则成醋而酸。都是以热蒸湿而酸。所以黄连等苦燥之品，正治其热化之湿。其一是寒湿，又如菜入坛腌则化为酸，是为寒化之湿，吴茱萸等辛燥之品，正治其寒化之湿。湿注于脚，则为香港脚肿病，西医言香港脚病，其尿必酸，知是湿也。凡香港脚，寒湿者多，宜以温药为主，再加木瓜、薏苡仁、牛膝为引导，所以利脚下之湿。然而香港脚亦有系热湿者，宜防己、黄柏、苍术、木通、胆草等苦降之品治之。湿积于脾，则腹中胀，久则水多为臌，宜逐其水，甘遂、大戟、芫花、牵牛功力峻猛，随用大枣、人参、白术、甘草以补脾土去其太过，又恐损其不足也。脾停饮食，则湿不化，宜神曲以散湿，枳壳、陈皮、木香行气以行湿。夫水火交而为湿土，人身之脾应之。白术温而有汁，正是水火相交之物，故正补脾经。黄精甘平有汁液，得水火气交之平，故正补脾经。山药有质色白，故补脾之火以补湿。苍术有汁而味烈，则扶脾之火以燥湿。赤石脂，土之质也，能燥湿。橘皮、厚朴、槟榔之去湿，以木疏土也。桑白皮、蒺藜之利湿，以金行水也。湿溢于腠理则肿，桑白皮象人之膜故治之。防己中空，纹如车轮，能外行腠理、内行三焦，能通水气。木通中空与防己同，味苦泄，故均为行湿之要药。腰脚之湿，土茯苓、萆薢、威灵仙、薏苡仁，凡利降者皆治之。再宜随寒热加减，湿蒸皮肤为发黄，宜茵陈、秦皮、益母草以散兼利者治之，膀胱不利，宜泽泻、车前、昆布、海藻诸物，多生水石间，故化膀胱之水，此清火利水，为治湿之法。湿与热蒸，则为暑。各书论暑，不知暑之原，而分阴暑、阳暑，与中热、中寒热无异，非暑之实义也。陈修园以暑为热，而不知热合湿乃为暑。月令云土润溽暑，惟其润溽，然后成暑。故治暑者，必兼湿热二字，乃为得宜。夏秋瘟疫痢疟皆感于暑，即湿热也。此断不可用燥药，燥则壅湿而不流；又不可用表药，用表则发热而湿蒸。唯一味清利，六一散虽轻，为清热利湿之正药。黄连苦能泻热，又能燥湿，亦为去暑之正药。伤暑发热，宜香薷以散皮肤之湿热。暑变瘟疫，石膏、黄连为主。已有专书，未能枚举，总之不可发表，但宜泻热利湿。伤暑变痢，不可发汗，更不可利水，但宜清热而湿自化，黄连、黄芩为主。伤暑变疟，贵于散湿清热，三焦膀胱之小便清则疟自除，土茯苓、猪苓、葛根、独活散湿，以治太阳膀胱；黄芩、鳖甲、青皮、胆草清热，以利少阳三焦，两腑兼治为宜。痰疟是湿积而成，常山苗能透达以吐之。疟母是痰与血合，鳖甲、牡蛎、山甲能破之，此湿之兼证也，未能尽详。又如五加皮引治皮肤，五苓散用桂枝以治寒湿，五淋汤用山栀以治热湿，要之湿为脾所司。脾之膏油连焦膜而彻内外，以达膀胱，所以治湿兼治各处。究湿之水火合化者也，故有寒热二证。
Q: Why do medicines with a warm nature enter the Liver, while those with a very hot nature directly enter the Kidney?
A: This precisely demonstrates that Jueyin (Foot-Jueyin Liver Meridian) governs Wind and belongs to Yin within Yin; therefore, warm-natured medicines enter the Liver, such as Morinda officinalis Root (Bajitian, 巴戟天) and Fennel Seed (Huixiang, 茴香). Shaoyin (Foot-Shaoyin Kidney Meridian) governs Heat and relies on accumulated Yang Qi; thus, medicines with a very hot nature directly enter the Lower Jiao Bladder and Kidney, such as Aconite Lateralis Radix Praeparata (Fuzi, 附子).
Q: What are the medicines for treating Wind-Cold?
A: Cold is Water Qi. Water belongs to North Ren-Gui, corresponds to the Kan trigram in the Eight Trigrams, and in the human body corresponds to the Kidney. The *Neijing* states: "All coldness causing contraction and pulling symptoms belong to the Kidney." The Fu organ of the Kidney is the Bladder, which acts on behalf of the Kidney to govern Qi transformation, hence it is called the House of Cold Water, and its meridian is named Taiyang. The *Neijing* says: "Above Taiyang, Cold Qi governs." Cold is the fundamental Qi of the Taiyang Bladder. The single Yang line in the center of the Kan trigram is actually the Yuan Qi (Primordial Qi) of the human body, residing within the Bladder's Water House, transforming into Qi that ascends and reaches outward to become the Wei Qi (Defensive Qi) that protects the exterior, named Taiyang, the greatest Yang. Since Yang Qi protects the exterior, how can there be Cold? The presence of Cold occurs because Yang Qi cannot extend, allowing Cold Water Qi to prevail exclusively, thereby generating Cold diseases. In winter, water freezes into ice, which means the Yang within the water cannot extend, resulting in pure Yin condensing to form Cold. The Yang Qi within the Bladder's water in the human body penetrates the membranes and diaphragm, emerges from the muscles, and reaches the skin and hair, thereby protecting the exterior from Cold pathogens. Cold primarily causes contraction and obstruction; thus, upon contracting Cold, the pores close, and sweat cannot exit. Fever occurs because internal Yang Qi cannot reach the exterior, gathering between the skin layers, leading to stagnation and fever. Because Yang Qi is constrained, chills become more severe. The treatment method uses Ephedrae Herba (Mahuang, 麻黄) to unblock Yang Qi, allowing it to emerge through the pores; when sweat is produced, the Cold pathogen is expelled. Mahuang has thin, clustered stems, hollow and growing straight upward, with a light and clear aroma and flavor, enabling it to penetrate the Yang Qi of the Bladder's Cold Water and bring it out through the skin and hair, making it an essential medicine for treating Shanghan (Cold Damage). Later practitioners used Notopterygii Rhizoma et Radix (Qianghuo, 羌活) and Saposhnikoviae Radix (Duhuo, 独活) to replace Mahuang. Qianghuo and Duhuo have deep roots and straight stems, capable of guiding the Yang Qi from the Lower Jiao Bladder to the meridians to disperse the exterior. However, their flavors are pungent and acrid, making them drier than Mahuang, and they also eliminate dampness, unlike Mahuang which is light, clear, and goes directly to the skin and hair. Bohe (Menthae Haplocalycis Herba, 薄荷) is also light and clear, but its ascending and dispersing action lies in its flavor, so its power is slightly weaker. Mahuang's ascending and dispersing action lies purely in its Qi, so its power is more intense. Scallion stem promotes Yang transmission, sharing the same principle as Mahuang. However, Mahuang stems are thin like hair follicles, while scion stems are thick like nasal passages, so scion can treat nasal congestion. Xin Yi (Magnolia Flower Bud, 辛夷) also ascends and disperses Cold in the nasal passages and brain; furthermore, since the flower is at the tree's tip with all points facing upward, it primarily serves to ascend and disperse. Jingjie (Schizonepetae Herba, 荆芥) has a milder nature than Bohe, and Zisu (Perillae Folium, 紫苏) is similar. Both have red colors and can enter the Blood aspect; their pungent and fragrant flavors can disperse Cold, so they both mainly disperse Cold in the Blood aspect and muscles. The exterior of the human body consists of skin and membranes, belonging to the Qi aspect; the interior consists of muscles, belonging to the Blood aspect. When Cold enters the Blood aspect and blocks within the muscles, Qi cannot exit to solidify the exterior defense, causing the pores to become deficient and sweat to leak out. The treatment should warm and disperse Cold in the muscles. Cinnamon Twig (Guizhi, 桂枝) has a red color and pungent flavor, dispersing into the Blood aspect, so it treats this condition. Its branches extend in four directions, so it treats limb conditions. Zisu has a nature similar to Guizhi but is lighter and less warming than Guizhi. Fangfeng (Saposhnikoviae Radix, 防风) has a sweet taste entering the muscles, with an aromatic and warm Qi, so it disperses Cold Qi in the muscles. At the junction of skin and muscle, there are connecting membranes named Couli (interstices). Bupleuri Radix (Chaihu, 柴胡) has white pith in the stem resembling membranes, growing straight upward, capable of reaching Clear Yang, thus treating Cold-Heat in the Couli. Jingjie obtains the momentum of Wood and Fire, enters the Shaoyang meridian, and can also release Cold-Heat in the Couli. Cold coagulating blood and stasis in the muscles leads to Bi pain (obstruction syndrome). Zhang Zhongjing named this "Blood Bi," referring to the Blood aspect. Therefore, Huangqi Guizhi Wuwu Tang (Astragalus and Cinnamon Twig Five-Ingredient Decoction) uses Guizhi and Danggui (Angelica Sinensis Root, 当归), and Sini Tang (Four Counterflow Decoction) uses Guizhi to warm the Blood aspect. Using Qianghuo, Duhuo, and Jingjie is inferior to Guizhi in efficacy. When Cold enters the sinews and vessels, causing spasms preventing flexion and extension, flaccidity preventing contraction, or unbearable pain, Xuduan (Dipsaci Radix, 续断) and Qinjiao (Gentianae Macrophyllae Radix, 秦艽) should always be used to guide the medicine into the sinews. When Cold enters bone joints, causing whole-body pain in waist and knees, and cold extremities, Fuzi should be used to warm the Kidney (Kidney governs bones), and Xixin (Asari Radix et Rhizoma, 细辛) should be used to guide the meridian, entering the bones to expel Cold. When Cold follows the Taiyang meridian to develop into Spasm (Jing), Ge Gen (Puerariae Lobatae Radix, 葛根) guides Mahuang and Guizhi along the meridians to disperse it. When Cold enters the brain marrow, named "True Headache" (Zhen Toutong, 真头痛), Xixin guides the meridian upward, and Fuzi assists Yang to ascend, all entering the brain via the Du Mai (Governing Vessel). The Liver meridian also enters the brain marrow, so Zhang Zhongjing uses Evodiae Fructus (Wuzhuyu, 吴茱萸) to treat Cold pain in the brain marrow. Nasal passages connect to the brain, so people in the North use snuff to dispel Cold in the brain. Westerners have methods of blowing medicine into the nose to treat brain marrow; some Western doctors claim nerves gather mostly in the Stomach, so Baizhi (Angelicae Dahuricae Radix, 白芷) and Xin Yi can reach the brain from the Stomach to disperse Cold. Cold entering the Lung via skin and hair closes the Lung's orifices, causing nasal congestion, treated with Bohe and Xin Yi. The Lung governs water movement; if Cold injures Lung Yang, water cannot move, stagnating in the Stomach as fluid retention, rising to cause cough and wheezing. Zhang Zhongjing uses Xixin to promote water movement, Ganjiang (Zingiberis Rhizoma, 干姜) to disperse Cold, and Mahuang and Guizhi to drive Cold outward; this is Xiao Qinglong Tang (Minor Blue Dragon Decoction, 小青龙汤). If only warming the Lung without treating the Stomach, Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction, 甘草干姜汤) is used; processed ginger becomes light and floats upward, thus only warming the Lung. Later practitioners used Baijiezi (Sinapis Semen, 白芥子) to drain water, Chenpi (Citri Reticulatae Pericarpium, 陈皮) to direct Qi downward, Kuandonghua (Farfarae Flos, 冬花) to warm the Lung, and Suzi (Perillae Fructus, 苏子) to direct Qi downward, all imitating Zhang Zhongjing's Xiao Qinglong Tang to use Pungent-Warm methods to remove Lung Cold. In summary, the Bladder governs Cold Water, containing Kan Yang. When Yang ascends, water transforms and flows down; without Yang, Yang does not ascend, water stagnates and fails to transform, becoming Cold Fluid Retention. Thus, Xixin reaches the Yang within the water, Fuzi assists the Yang within the water, and Ganjiang warms the Yang within the Earth (Spleen/Stomach). When Yang emerges, Yin dissipates, and Cold Fluid Retention naturally resolves. When Cold Water invades the Central Palace, causing vomiting and diarrhea known as Huoluan (Cholera-like disorder, 霍乱) and Dongxie (Profuse Diarrhea, 洞泄), Ganjiang warms the Middle and thus treats it. Sharen (Amomi Fructus, 砂仁), Baixiandou (Amomi Fructus Rotundus, 白蔻), and Liangjiang (Galangal Rhizome, 良姜) also treat this. To remove Cold, one must necessarily promote urination, because Cold is the Qi of Water; removing Water is removing Cold. Severe Cold knotting causing pain and blocked Yang requires Chuwu (Aconiti Radix, 乌头), Xixin, Chuanjiao (Sichuan Pepper, 川椒), Xiaohui (Fennel, 小茴), and Wuzhuyu to assist Kidney Yang and reach Liver Yang; when Yang flows freely, Cold scatters and pain stops. Cold extremities result from Kidney Yang failing to reach; Fuzi warms the Yang within the water, thus treating this. Guzhi (Psoraleae Fructus, 故纸/Buguzhi) warms the Kidney but can only warm and astringe, not extend and reach, so it only treats lower back pain, not cold extremities. Rougui (Cinnamomi Cortex, 肉桂) possesses the Qi of Wood and Fire, is highly pungent entering the Lower Jiao; when Fire intersects with Water, Yang generates, and Cold Water transforms. Therefore, Shenqi Wan (Kidney Qi Pill, 肾气丸) uses Rougui and Fuzi to warm and tonify Kan Yang to transform Qi and move Water, suitable for Cold in the waist and Kidney with cold essence. When Cold is in the Bladder and water stagnates without transforming, named Shuixu (Water Accumulation, 蓄水), Lingzey Tang (Poria and Alisma Decoction components) uses Poria (Fuling, 茯苓) and Alisma Rhizome (Zexie, 泽泻) to promote urination, but crucially uses Guizhi to circulate Yang within the water; this is Wuling San (Five-Ingredient Powder with Poria, 五苓散). Wuyao (Linderae Radix, 乌药) is purple entering the Blood aspect, and its warm Qi enters the Liver; the Liver governs the Blood Chamber, so Wuyao enters the Blood Chamber to disperse Cold. The *Shennong Ben Cao Jing* states it treats Cold Qi between the Bladder and Kidney, referring to Cold Qi in the Blood Chamber. For pain caused by coagulated blood, Aiye (Artemisiae Argyi Folium, 艾叶) is used, also entering the Blood Chamber. When Cold Water overwhelms the Heart, Guizhi, Yuanzhi (Polygalae Radix, 远志), and Gongdingxiang (Caryophylli Flos, 公丁香) must be used to circulate Heart Yang. When Cold carries Liver Wind, roundworms are generated; when it insults Spleen Earth, Chuanjiao, Jiang (Ginger), and Fuzi are used to warm the Liver. If sulfur stone liquid can burn, it is Fire within Water. Its sour taste indicates obtaining Wood flavor and Yang within Water; ignition generates Wood, hence sour and flammable. This is Fire within Water, a fierce medicine for warming the Lower Jiao Liver and Kidney. Tianshenghuang (Natural Yellow/Sulfur deposit, 天生黄) grows in Yunnan, with sulfur below and hot springs above; spring vapor steams the rock to form Tianshenghuang. It is transformed from true Yang Qi within Water, pure and not drying. However, human Yang Qi ascending returns to the Lung; since Tianshenghuang grows on rocks, it is a wonderful medicine for warming the Lung and should not be judged by the nature of sulfur alone. Hot medicines possessing pungent flavors, though very warm, are not fierce because they obtain Wood nature but not Wood flavor, lacking the pure nature of generating fire, so they are mild and sour. If they possess both Wood nature and Wood flavor, being pure in generating fire, their nature is fierce, such as Sulfur (Liuhuang, 硫黄) and Realgar (Pishi, 砒石).
Q: In diseases with Upper Heat and Lower Cold, or Exterior Heat and Interior Cold, what medicines should be used?
A: In these cases, the Cold in the Lower and Interior is primary. Use Ginger (Jiang, 姜), Cinnamon (Gui, 桂), and Aconite (Fu, 附), combined with Gallbladder bile, Human urine (Ren Niao, 人尿), Ophiopogon Tuber (Maidong, 麦冬), and Achyranthes Root (Niuxi, 牛膝) to suppress and guide them downward.
Q: In diseases with Interior Heat and Exterior Cold, or Lower Heat and Upper Cold, what medicines should be used?
A: In these cases, the Heat in the Lower and Interior is primary. Use Poria (Ling, 苓), Coptis Rhizome (Lian, 连), Anemarrhena Rhizome (Zhi, 知), and Phellodendron Bark (Bai, 柏), combined with Fresh Ginger (Shengjiang, 生姜), Guizhi, Bohe, Jingjie, and Scallion white (Congbai, 葱白) to guide them upward. The key lies in the skillful use of medicines; one cannot expect efficacy from a single herb.
Q: Among the Five Elements, only Earth governs Dampness. Li Dongyuan emphasized the Spleen and Stomach, specializing in drying Earth to remove Dampness. Why did Zhang Zhongjing not solely use drying medicines to treat Taiyin disease?
A: Li Dongyuan knew about established Dampness but did not understand its origin, assuming it was Earth's failure to control Water. Does he not know that Dampness is the fundamental Qi of Earth? One must first understand "Earth" before understanding "Dampness." Metal, Wood, Water, and Fire occupy the four directions, while Earth belongs to the Center. The Center is where the four directions intersect; "Yang" (center/peak) implies the convergence of Yin and Yang. The poem "Night is not yet over" (Ye Wei Yang) means the sky is not yet bright, signifying Yin has not yet converged with Yang. Mandarin ducks do not sleep alone; the character 'Yang' takes the meaning of Yin-Yang convergence. Essentially, the characters Yin and Yang combine phonetically to form the sound 'Yang'. Earth residing in the Center signifies Yin and Yang interacting to transform. Water interacts with Fire; encountering Wood, it rots to become Earth; encountering Metal, it transforms and returns to Earth. Thus, in Hetu numbers, Water is 1, Fire is 2, Wood is 3, Metal is 4, and Earth is last, yet it thrives in the four seasons. This is because Water, Fire, Wood, and Metal combine to form Earth, so Earth thrives in all four seasons. Naming the element "Earth" refers to its form; naming the Six Qi "Dampness" refers to its Qi. The reason for Dampness is merely the interaction of Water, Fire, Wood, and Metal. Without rotting quality and Metal containing moistening Water, Earth and Dampness would not generate. Ultimately, the interaction of Metal and Wood is less, while the interaction of Water and Fire is greater. If Fire does not steam Water, it becomes Cold Water, not Dampness. If Water does not moisten Fire, it becomes Fierce Fire, also not Dampness. For example, rice in a steamer: without Fire to steam it, it is not damp; without Water to moisten it, it is not damp. Only when Water and Fire interact does Dampness form. During Late Summer, Dampness is dominant, precisely the time of Yin-Yang interaction and Water-Fire steaming. Hence, in summer, walls are wet, and humans often contract Dampness diseases then. Human Spleen Earth originates from Heaven's Dampness, formed by the convergence of Heart Fire and Kidney Water. It transforms substances and transports the Four Zang organs, with functions relying on Dampness. The Stomach accepts food via dryness, relying entirely on Spleen Dampness to moisten it before digestion. The Spleen produces oily membranes; once abdominal contents are transformed into juice, they are introduced into the oily membranes, reaching various organs and nourishing the whole body. Long fat/oil provides lubrication, all functions of Dampness. If Spleen Qi is insufficient, it becomes Dryness; if excessive, it becomes Dampness disease. Thus, the *Neijing* says the Spleen governs Dampness and also dislikes Dampness. Therefore, all Dampness diseases focus on treating the Spleen. Since Water-Fire interaction creates Dampness, Dampness diseases involve both Water and Fire. Medicines for Dampness generally have neutral properties, capable of treating both Water and Fire. Poria (Fuling, 茯苓), Lablab Bean (Biandou, 扁豆), and Coix Seed (Yiyiren, 薏苡仁) have bland tastes, making them correct medicines for promoting urination to remove Dampness. When Dampness is severe, Earth is troubled, so promoting urination strengthens the Spleen. Lotus Seed (Lianmi, 莲米) and Euryale Seed (Qianshi, 芡实) are slightly sweet and astringent, able to collect Dampness, thus strengthening the Spleen. Atractylodes Macrocephala Rhizome (Baizhu, 白术) contains oil, replenishing the Spleen's oily substance; since the oil does not stick to rice, it promotes water drainage. Its aromatic and warm Qi also promotes water drainage and ascending, raising Spleen Earth Qi, making Baizhu the correct medicine for tonifying the Spleen. Atractylodes Lancea Rhizome (Cangzhu, 苍术) has warm and fierce Qi, thus carrying drying properties; it tonifies the Stomach, not the Spleen. Being dark-colored, it obtains Wood nature, enhancing draining and purging, making it a product for treating Cold-Dampness. Dampness combines with Water transformation; excess Water transformation results in Cold-Dampness, causing abdominal distension and loose stools. Sichuan Pepper (Huajiao, 花椒) is pungent and warm to disperse Cold-Dampness and kill parasites generated by Dampness. Evodia Fruit (Wuyu, 吴萸) is pungent and fierce, removing Dampness rapidly. White Cardamom (Baokou, 白蔻) and Dried Ginger (Ganjiang, 干姜) etc., all treat Cold-Dampness. Acid regurgitation has two pathologies. One is Cold-Dampness, treated with Wuyu, Cangzhu, Guizhi, and Shengjiang. The other is Heat-Dampness, treated with Coptis Rhizome (Huanglian, 黄连), Phellodendron Bark (Huangbai, 黄柏), Scutellaria Root (Huangqin, 黄芩), Mother-of-Pearl (Shijueming, 石决明), Tangerine Peel (Qingpi, 青皮), and Garden Broom Twig (Danshen/Caocao, 胆草). Add small amounts of Wuyu and Huajiao as counter-agents. Sourness is transformed from Dampness; Dampness carrying Heat transforms into Sour. For example, meat soup in summer turns sour overnight; kept with ice, it does not turn sour. Wheat bran heating up turns into vinegar and becomes sour. All are due to Heat steaming Dampness to create Sour. Thus, bitter-drying herbs like Huanglian correctly treat Heat-transformed Dampness. The other type is Cold-Dampness, such as vegetables pickled in jars turning sour; this is Cold-transformed Dampness, correctly treated by pungent-drying herbs like Wuyu. When Dampness settles in the feet, it causes Hong Kong Foot (Gout/Podagra, 香港脚) swelling. Western medicine states that patients with Hong Kong Foot have acidic urine, indicating Dampness. Most cases of Hong Kong Foot are Cold-Dampness, best treated with warm medicines, supplemented with Qu木瓜 (Chaogueua, 木瓜), Yiyiren, and Niuxi as guides to drain Dampness from the lower limbs. However, some cases are Heat-Dampness, treated with Stephania Root (Fangji, 防己), Huangbai, Cangzhu, Tongcao (Mutong, 木通), and Danshen using bitter-draining herbs. When Dampness accumulates in the Spleen, abdominal distension occurs; long-term accumulation leads to Ascites (Gu, 臌). Draining water is appropriate. Kansui Root (Gansui, 甘遂), Oldenlandia Root (Daji, 大戟), Genkwa Flower (Yuanhua, 芫花), and Morning Glory Seed (Qianniu, 牵牛) have fierce powers. They should be used with Jujube (Dazao, 大枣), Ginseng (Renshen, 参), Baizhu, and Licorice (Gancao, 甘草) to tonify Spleen Earth and mitigate excess, fearing damage to deficiency. If Spleen stagnates food, Dampness fails to transform. Schisandra Berry (Shenqu, 神曲) disperses Dampness; Aurantium Fruit (Zhike, 枳壳), Chenpi, and Aucklandia Root (Muxiang, 木香) move Qi to move Dampness. Water and Fire combine to form Wet Earth, corresponding to the human Spleen. Baizhu is warm and juicy, exactly the product of Water-Fire interaction, thus correctly tonifying the Spleen Meridian. Polygonatum Rhizome (Huangjing, 黄精) is sweet, neutral, and juicy, obtaining the balance of Water-Fire Qi interaction, thus correctly tonifying the Spleen Meridian. Yam (Shanyao, 山药) has white substance, thus tonifying Spleen Fire to supplement Dampness. Cangzhu has juice and fierce taste, supporting Spleen Fire to dry Dampness. Red Kaolin (Chishizhi, 赤石脂) is Earth's substance, able to dry Dampness. Citrus Peel (Jupi, 橘皮), Magnolia Bark (Houpo, 厚朴), and Areca Seed (Binglang, 槟榔) remove Dampness by Wood疏 (draining) Earth. Mulberry Root Bark (Sangpí, 桑皮) and Tribulus Fruit (Jili, 蒺藜) promote urination to remove Dampness by Metal moving Water. When Dampness overflows into Couli, swelling occurs; Sangpi resembles human membranes, thus treating it. Stephania Root (Fangji) is hollow with wheel-like veins, able to act externally on Couli and internally on the Triple Burner, promoting Water Qi. Uncaria Rhynchophylla (Mutong/Tongcao context here likely refers to Akebia Stem Mutong, 木通) is hollow like Fangji, bitter and draining, so both are important medicines for moving Dampness. Dampness in waist and feet is treated by Smilax Glabra Rhizome (Tufu Ling, 土茯苓), Dioscorea Hypoglauca Rhizome (Bixie, 萆薢), Spirit Peony Root (Weilingxian, 威灵仙), and Yiyiren; all draining and descending herbs treat it. Adjustments should be made according to Cold or Heat. When Dampness steams the skin causing Jaundice (Fahuang, 发黄), Yinchen (Artemisiae Scopariae Herba, 茵陈), Qipi (Fraxini Cortex, 秦皮), and Motherwort Herb (Yimucao, 益母草) are used to disperse and promote urination. When Bladder function is impaired, Ze Xie (Alismatis Rhizoma, 泽泻), Plantago Seed (Cheqian, 车前), Kelp (Kunbu, 昆布), and Seaweed (Haizao, 海藻) are used; growing mostly between water and stones, they transform Bladder Water. This clears Fire and promotes urination, a method for treating Dampness. When Dampness and Heat steam together, it becomes Summerheat (Shu, 暑). Various texts discuss Summerheat without knowing its origin, dividing it into Yin Summerheat and Yang Summerheat, indistinguishable from Heatstroke and Cold-Heat stroke, which is not the true meaning of Summerheat. Chen Xiuyuan considered Summerheat as Heat, not knowing that Heat combined with Dampness constitutes Summerheat. The *Monthly Ordinances* state: "Earth moist, humid heat." Only through moisture and humidity is Summerheat formed. Therefore, treating Summerheat must include both Heat and Dampness to be appropriate. Epidemics, dysentery, and malaria in summer and autumn are contracted from Summerheat, which is Heat-Dampness. Drying medicines must absolutely not be used, as they obstruct Dampness and prevent flow. Exterior-releasing medicines must not be used, as they cause fever and steam Dampness. Only clearing and draining is suitable. Liu Yi San (Six-to-One Powder, 六一散), though mild, is the correct medicine for clearing Heat and promoting urination to remove Dampness. Huanglian is bitter, able to purge Heat and dry Dampness, also a correct medicine for removing Summerheat. For Summerheat injury with fever, Xiangru (Elsholtziae Herba, 香薷) disperses Damp-Heat in the skin. For Summerheat transforming into epidemic, Gypsum (Shigao, 石膏) and Huanglian are primary. Dedicated books exist, unable to enumerate all. In summary, exterior release is contraindicated; purging Heat and promoting urination to remove Dampness is indicated. For Summerheat transforming into dysentery, sweating is contraindicated, and promoting urination is doubly contraindicated; only clearing Heat is needed, and Dampness will resolve spontaneously. Huanglian and Huangqin are primary. For Summerheat transforming into malaria, dispersing Dampness and clearing Heat is precious. When Urine of the Triple Burner and Bladder becomes clear, malaria self-resolves. Tufuling, Polyporus (Zhuling, 猪苓), Ge Gen, and Duhuo disperse Dampness to treat Taiyang Bladder; Huangqin, Turtle Shell (Biejia, 鳖甲), Qingpi, and Danshen clear Heat to benefit Shaoyang Triple Burner. Treating both Fu organs is appropriate. Phlegm-Malaria is formed by Dampness accumulation; Changshan (Dichroae Radix, 常山) can penetrate and induce vomiting. Malaria Mass (Numu, 疟母) is Phlegm combined with Blood; Biejia, Oyster Shell (Muli, 牡蛎), and Pangolin Scales (Shanjia, 山甲) can break it. These are concurrent syndromes of Dampness, detailed incompletely here. For example, Acanthopanacis Senticosi Cortex (Wujia Pi, 五加皮) guides treatment to the skin; Wuling San uses Guizhi to treat Cold-Dampness; Wulin Tang uses Gardenia (Shanzhi, 山栀) to treat Heat-Dampness. Ultimately, Dampness is governed by the Spleen. The Spleen's oily membrane connects the scorched membrane, penetrating inside and outside to reach the Bladder, so treating Dampness concurrently treats various locations. Investigating Dampness, it is the combination of Water and Fire, thus presenting Cold and Heat syndromes.