成 身重之由有风湿有风寒有风湿俱见有火逆有易病有三阳合病虽所得不一然悉属三阳非若身疼兼有三阴里寒
也坏病有矣寒则无之识者鉴焉
太阳 伤寒脉浮缓身不疼但重乍有轻时无少阴证者大青龙汤发之（详太阳病）发汗已身犹灼热名曰风温脉浮汗出身
重多眠鼻息鼾（详风温宜活人葳蕤汤）风温脉浮身重汗出恶风者宜防己黄 汤
防己（一两） 甘草（半两） 白术（七钱半） 黄 （去芦一两一钱）上 咀每服五钱生姜四片大枣一枚水一盏
半煎至八分温服良久再服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瘥喘者加麻黄半两胃中不
和者加芍药三分气上冲者加桂三分下有沉寒者加细辛三分脉浮宜以汗解用火炙之邪无从出因火而盛病从腰以下必重而
痹名火逆也脉浮数者法当汗出而愈若下之身重心悸者不可发汗当自汗出以解所以然者尺中脉微此里虚须表里实津液自
和便自汗出愈伤寒八九日下之胸满烦惊小便不利谵语一身尽重不可转侧者柴胡加龙骨牡蛎汤主之（方见惊张 病有身重
不能转侧下后血虚津液不荣于外也身疼不能转侧者风湿相搏于经而里无邪也经曰伤寒八九日风湿相搏身疼体烦而不能
自转侧不呕不渴脉浮虚而涩者以桂枝附子汤主之此以柴胡加龙骨牡蛎汤主之以上二证言不能转侧颇相似论疼与重俱不
相侔各从本法为宜也
阳明 病脉迟汗出不恶寒身重短三腹满而喘或潮热或不潮热承气汤证（详腹满）阳明病脉浮紧口苦咽燥腹满而喘发
热汗出不恶寒身重忌汗忌烧针忌下（详自汗注云此证宜和解之）
三阳合病 腹满身重难以转侧口不仁而面垢谵语遗尿发汗则谵语下之则额上生汗手足逆冷若自汗出者白虎汤主之
（成 腹满身重难以转侧口不仁谵语者阳明也针经曰少阳病甚则面微尘此面垢者少阳也遗尿者太阳也三者以阳明证多
故出阳明篇中三阳合病为表里有邪若发汗攻表则燥热益甚必愈谵语若下之攻里表热乘虚内陷必额上汗出手足逆冷其自
汗出者三阳经热甚也内经曰热则腠理开荣卫通汗大泄与白虎汤以解内外之热）
少阴 病腹痛小便不利四肢沉重疼痛下利者真武汤
中 发热恶寒身重而痛手逆递冷小有劳身即热小便已洒洒然毛耸其脉弦细芤迟口开前板齿燥此为太阳中 忌汗
下温针（宜白虎加人参汤详暑病）
阴阳易 身重少气少腹里急或引阴中热上胸冲眼花者此为阴阳易宜烧 汤（方论见阴阳易）
成无己：身重的原因有风湿、风寒、风湿并见、火逆误治以及“易病”（指大病初愈因房事复发的疾病）五种情况。此外还有三阳合病，虽然病因各不相同，但都属于三阳经病变，不像身疼兼有三阴里寒证那样属于阴证。坏病（指误治后病情恶化变杂的病证）会出现身重，但单纯的寒证不会出现。明眼人应当仔细鉴别。
太阳病篇：
伤寒脉象浮缓，身体不疼痛只是沉重，症状时轻时重，且没有少阴病证候的，可用大青龙汤发汗治疗。（详见太阳病章节）
发汗之后，身体仍然灼热，这叫做风温。脉象浮，出汗，身体沉重，嗜睡，鼻息有声如鼾。（详见风温证，宜用《活人书》中的葳蕤汤）
风温脉象浮，身体沉重，出汗，恶风的，适宜用防己黄芪汤。
防己（一两）、甘草（半两）、白术（七钱半）、黄芪（去芦头，一两一钱）。以上药物捣碎成粗末，每次服用五钱，加生姜四片、大枣一枚，水一盏半，煎至八分，温服。隔较长时间后再服一次。服药后感觉皮肤中有虫爬行的感觉，腰部以下像冰一样凉，随后坐在被子上，再用一条被子围绕腰部以下，使其微微出汗则病愈。若有喘症，加麻黄半两；胃中不和者，加芍药三分；气上冲者，加桂枝三分；下有沉寒者，加细辛三分。
脉象浮，应当用发汗法解表，若用火灸法，邪气无法排出，反而因火而炽盛，导致病从腰部以下必然沉重且麻痹，这叫火逆。
脉象浮数，依法应当通过出汗而痊愈，如果误用下法，出现身体沉重、心悸的，不可再发汗，应当等待其自汗出而解。之所以这样，是因为尺中脉微，这是里虚的表现，需要使表里之气充实，津液自然调和，就会自汗出而痊愈。
伤寒八九日，误用下法后，出现胸满、烦惊、小便不利、谵语、全身沉重不能转侧的，用柴胡加龙骨牡蛎汤主治。（方剂见惊悸张仲景相关篇章）
有的医家认为：病有身重不能转侧，是下法后血虚、津液不能濡养体表所致；身体疼痛不能转侧，是风湿相搏于经脉而里没有邪气。经文说：伤寒八九日，风湿相搏，身体疼痛、烦躁不能自行转侧，不呕不渴，脉浮虚而涩的，用桂枝附子汤主治。此处用柴胡加龙骨牡蛎汤主治。以上两种证言所述“不能转侧”颇为相似，但论述疼痛与沉重的机理截然不同，应各自遵循其本来的治疗方法为宜。
阳明病篇：
病脉迟，出汗，不恶寒，身体沉重，呼吸短促，腹部胀满而喘，或有潮热，或无潮热，属承气汤证。（详见腹满章节）
阳明病，脉浮紧，口苦，咽干，腹部胀满而喘，发热，出汗，不恶寒，身体沉重，忌用发汗、烧针和下法。（详见自汗注：此证适宜和解）
三阳合病篇：
腹部胀满，身体沉重，难以转侧，口舌麻木不知味（口不仁）且面部污垢，谵语，遗尿。发汗则谵语加重；攻下则额头出汗，手足逆冷。若自汗出的，用白虎汤主治。
成无己按：腹部胀满、身体沉重、难以转侧、口不仁、谵语，这是阳明病。《针经》说：少阳病严重时面色如蒙尘，这就是面垢，属于少阳病。遗尿属于太阳病。三者中以阳明证为主，所以列在阳明篇中。三阳合病为表里有邪，若发汗攻表，则燥热更甚，必定加重谵语；若下之攻里，表热乘虚内陷，必致额头出汗、手足逆冷。若自汗出，是三阳经热势亢盛。《内经》说：热则腠理开，营卫通，大汗泄。给予白虎汤以解除内外之热。
少阴病篇：
病腹痛，小便不利，四肢沉重疼痛，下利的，用真武汤。
中暍（中暑）篇：
发热，恶寒，身体沉重而痛，手足厥冷，稍作劳作身体即发热，小便结束后洒淅恶寒、毫毛竖起，脉象弦、细、芤、迟，张口前板齿干燥，此为太阳中暍。忌用发汗、下法和温针。（宜用白虎加人参汤，详见暑病章节）
Cheng Wuji: The causes of heaviness of the body include wind-dampness, wind-cold, simultaneous presence of wind and dampness, fire-therapy adverse reaction (Huo Ni), and "Yi Bing" (a disease recurring due to sexual intercourse after recovery from a major illness). Additionally, there is the syndrome of simultaneous involvement of the three Yang meridians. Although the etiologies differ, all belong to the Three Yang meridians, unlike body ache accompanied by interior cold of the Three Yin meridians. Adverse conditions (Huai Bing) may present with body heaviness, but pure cold syndromes do not. Discerning practitioners should be vigilant in differentiation.
Taiyang Chapter:
In Cold Damage (Shanghan), if the pulse is floating and slow, the body is not painful but heavy, symptoms fluctuate in intensity, and there are no Shaoyin syndrome signs, Da Qing Long Tang (Major Blue Green Dragon Decoction) should be used to induce sweating. (See Taiyang Disease chapter).
After inducing sweating, if the body remains burning hot, this is called Wind-Warmth (Feng Wen). The pulse is floating, there is sweating, body heaviness, somnolence, and snoring nasal breathing. (See Wind-Warmth; Yi Ren Tang [Reed Rhizome Decoction] from *Liu Ren Shu* is appropriate).
If Wind-Warmth presents with a floating pulse, body heaviness, sweating, and aversion to wind, Fang Ji Huang Qi Tang [Stephania and Astragalus Decoction] is indicated.
Fang Ji (Stephaniae Tetrandrae Radix, 1 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, 0.5 liang), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 7 qian 5 fen), Huang Qi (Astragali Radix, de-lumened, 1 liang 1 qian). The above herbs are coarsely crushed. Take 5 qian per dose, add 4 slices of fresh ginger (Sheng Jiang), 1 jujube (Da Zao), and 1.5 units of water. Decoct until 0.8 units remain. Take warm. Repeat after a considerable interval. After ingestion, one may feel a sensation like insects crawling under the skin. If the lower waist feels cold as ice, sit on blankets and wrap another blanket around the lower waist to induce slight sweating for recovery. If wheezing occurs, add Ma Huang (Ephedrae Herba, 0.5 liang); if stomach disharmony exists, add Shao Yao (Paeoniae Radix Alba, 3 fen); if qi rushes upward, add Gui Zhi (Cinnamomi Ramulus, 3 fen); if deep cold exists below, add Xi Xin (Asari Radix et Rhizoma, 3 fen).
If the pulse is floating, sweating therapy is indicated to release the exterior. If moxibustion/fire therapy is applied, the pathogenic factor cannot exit, and instead becomes exacerbated by fire, leading to heaviness and numbness from the waist down. This is called Fire Adverse Reaction (Huo Ni).
If the pulse is floating and rapid, recovery via sweating is expected according to standard principles. If purgation is mistakenly applied, resulting in body heaviness and palpitations, sweating therapy must not be used. Recovery will occur through spontaneous sweating. The reason is that the pulse at the cun-guan-chi position (specifically chi) is faint, indicating interior deficiency. The interior and exterior must be strengthened, and fluids harmonized naturally, leading to spontaneous sweating and recovery.
After eight or nine days of Cold Damage, if purgation is mistakenly applied, presenting with chest fullness, irritability and fright, dysuria, delirium, and whole-body heaviness preventing turning over, Chai Hu Jia Long Gu Mu Li Tang [Bupleurum Plus Dragon Bone and Oyster Shell Decoction] is the primary treatment. (Formula see Zhang Zhongjing's chapters on Fright/Palpitations).
Some physicians argue: Body heaviness preventing turning over after purgation is due to blood deficiency and failure of body fluids to nourish the exterior. Body pain preventing turning over is due to wind-dampness battling in the meridians without interior pathogens. The classic states: After eight or nine days of Cold Damage, wind-dampness battles, causing body pain, restlessness, inability to turn over spontaneously, no vomiting, no thirst, and a floating, deficient, and choppy pulse. Gui Zhi Fu Zi Tang [Cinnamon Twig and Aconite Decoction] is indicated. Here, Chai Hu Jia Long Gu Mu Li Tang is used. Although the symptom of "inability to turn over" is similar in both cases, the discussions on pain versus heaviness differ significantly; each should follow its respective standard method.
Yangming Chapter:
If the pulse is slow, there is sweating, no aversion to cold, body heaviness, shortness of breath, abdominal fullness, and wheezing, possibly with tidal fever or without, it belongs to Cheng Qi Tang [Ordering the Qi Decoction] syndrome. (See Abdominal Fullness chapter).
Yangming disease presenting with a floating-tight pulse, bitter taste in mouth, dry throat, abdominal fullness, wheezing, fever, sweating, no aversion to cold, and body heaviness, contraindicates sweating, fire needling, and purgation. (See Spontaneous Sweating note: This syndrome is suitable for harmonizing).
Simultaneous Involvement of Three Yang Chapters:
Abdominal fullness, body heaviness, difficulty turning over, oral insensibility (Kou Bu Ren) with a greasy facial appearance, delirium, and urinary incontinence. Inducing sweating worsens delirium; purgation causes sweating on the forehead and cold extremities. If there is spontaneous sweating, Bai Hu Tang [White Tiger Decoction] is the primary treatment.
Cheng Wuji commentary: Abdominal fullness, body heaviness, difficulty turning over, oral insensibility, and delirium indicate Yangming disease. *Zhen Jing* states: When Shaoyang disease is severe, the face appears dusty; this is Shaoyang. Urinary incontinence indicates Taiyang. Since Yangming symptoms predominate, it is listed in the Yangming chapter. Simultaneous involvement of Three Yang involves exterior and interior pathogens. Sweating attacks the exterior, increasing dryness-heat and worsening delirium. Purgation attacks the interior, allowing exterior heat to sink inward due to deficiency, causing forehead sweating and cold extremities. Spontaneous sweating indicates excessive heat in the Three Yang meridians. *Nei Jing* states: Heat opens pores, allows Ying and Wei to flow freely, and causes profuse sweating. Bai Hu Tang is given to resolve interior and exterior heat.
Shaoyin Chapter:
Disease presenting with abdominal pain, dysuria, heaviness and pain in the four limbs, and diarrhea, is treated with Zhen Wu Tang [True Warrior Decoction].
Zhong Yue (Heat Stroke/Miasma) Chapter:
Fever, aversion to cold, body heaviness and pain, cold extremities, fever upon slight exertion, chills and piloerection after urination, pulse that is string-like, fine, hollow, and slow, dry anterior teeth when opening the mouth. This is Taiyang Zhong Yue. Contraindicate sweating, purgation, and warm needling. (Use Bai Hu Jia Ren Shen Tang [White Tiger Plus Ginseng Decoction]; see Heat Stroke chapter).
Yin Yang Yi (Sexual Transmission/Exchange) Chapter:
Body heaviness, shortness of breath, urgency and tension in the lower abdomen, or heat drawing up from the genitalia to the chest, dizziness. This is Yin Yang Yi. Use Shao Kun San [Burnt Undergarment Powder]. (Formula theory see Yin Yang Yi chapter).