湿有天之湿，雾露雨是也。天本乎气，故先中表之荣卫。有地之湿，水泥是也。
地本乎形，故先伤皮肉筋骨血脉。有饮食之湿，酒水乳酪之类是也。胃为水谷之海，
故伤于脾胃。有汗液之湿，汗液亦气也，止感于外。有人气之湿，太阴湿土之所化也，
乃动于中。治天之湿，当同司天法，湿上甚而热者，平以苦温，佐以甘辛，以汗为
效而止。如《金匮要略》诸条之谓，风湿相搏，身上疼痛者是也。治地之湿，当同
在泉法，湿淫于内，治以苦热，佐以酸淡，以苦燥之，以淡泄之。治饮食之湿，在
中夺之，在上吐之，在下引而竭之。汗液之湿，同司天者治。虽人气属太阴脾土所
化之湿者，在气交之分也，与前四治有同有异。何者？土兼四气，寒热温凉，升降
浮沉，备在其中。脾胃者，阴阳异位，更实更虚，更逆更从，是故阳盛则木胜，合
为风湿；至阳盛则火胜，合为湿热，阴盛则金胜，合为燥湿；至阴盛则水胜，合为
阴湿。为兼四气，故淫 上下中外，无处不到。大率在上则病呕吐，头重胸满，在
外则身重肿，在下则足胫 肿，在中腹胀中满痞塞，当分上下中外而治，随其所兼
寒热温凉以为佐使。至若先因乘克，以致脾虚津积而成湿者，则先治胜克之邪。或
脾胃本自虚而生湿者，则用补虚为主。或郁热而成湿者，则以发热为要。或脾胃之
湿淫 流于四脏，筋骨皮肉血脉之间者，大概湿主乎痞塞，以致所受之脏，涩不得
通疏，本脏之病因而发焉。其筋骨皮肉血脉受之则发为痿痹，缓弱痛重，不任为用，
所治之药，各有所入，能入于此者，不能入于彼，且湿淫为病，《内经》所论，叠出
于各篇，本草治湿，亦不一而见，凡切于治功者，便是要药。今丹溪书乃止归重苍
术一味，岂理也哉。伤湿为病，发热恶寒，身重自汗，骨节疼痛，小便秘涩，大便
多泄，腰脚痹冷，皆因坐卧卑湿，或冒雨露，或着湿衣所致，并除湿汤。具前诸症，
而腰痛特甚，不可转侧，如缠五六贯重者。湿气入肾，肾主水，水流湿，从其类也。
肾着汤、渗湿汤。小便秘，大便溏，雨淫腹疾故也。五苓散吞戊己丸。戊己属土，
土克水，因以得名。五苓乃湿家要药，所谓治湿不利小便，非其治也。伤湿而兼感
风者，既有前项证，而又恶风不欲去衣被，或额上微汗，或身体微肿，汗渍衣湿，
当风坐卧，多有此证。宜除湿汤、桂枝汤各半帖和服，令微发汗。若大发其汗，则
风去湿在。已得汗而发热不去者，败毒散加苍术一钱，防己半钱。伤湿又兼感寒，
有前诸症，但无汗惨惨烦痛，宜五积散和除湿汤半帖，和五苓散半帖。伤湿而兼感
风寒者，汗出身重，恶风喘满，骨节烦疼，状如历节风，脐下连脚冷痹不能屈伸，
所谓风寒湿合而成痹。宜防己黄 汤，或五痹汤。若因浴出，未解裙衫，身上未干，
忽尔熟睡，攻及肾经，外肾肿痛，腰背挛曲，只以五苓散一帖，入真坏少许，下青
木香丸，如此三服，脏腑才过，肿消腰直，其痛自止。湿热相搏者，清热渗湿汤。
其证肩背沉重疼痛，上热胸膈不利，及遍身疼痛者，拈痛汤。酒面乳酪停滞不能运
化，而湿自内盛者，除湿散及苍白二陈汤，加消息之药燥之。
湿邪有来自天空的湿，如雾、露、雨等。天属于气，所以这种湿邪首先侵犯体表的营卫。有来自地面的湿，如泥土、积水等。地属于形质，所以这种湿邪首先损伤皮肉筋骨和血脉。有来自饮食的湿，如酒水、乳酪之类。胃是水谷汇聚的海，所以这种湿邪伤害脾胃。有来自汗液的湿，汗液也属于气，只感受于体表。有人体内的湿，这是太阴湿土所化生的，动生于体内。
治疗天之湿，应当遵循司天（主管上半年气候）的法则：湿邪在上且伴有热象的，用苦温药来平抑它，辅以甘辛药，以出汗为见效标准即停止。就像《金匮要略》中提到的那些条文所说，风湿相互搏结，导致身体疼痛的情况就是这类。治疗地之湿，应当遵循在泉（主管下半年气候）的法则：湿邪淫溢于内，用苦热药治疗，辅以酸淡药，用苦味燥湿，用淡味渗泄湿邪。治疗饮食之湿，病位在中焦则截断病势，病位在上则催吐，病位在下则引导并竭除湿邪。汗液之湿，治疗方法同于治天之湿。虽然人气的湿属于太阴脾土所化生的湿，处于气交之分，与前四种治法有相同也有不同之处。为什么呢？因为土兼有四时之气，寒、热、温、凉，升、降、浮、沉，都包含在其中。脾胃阴阳位置不同，虚实交替，逆从变化，所以阳气盛则木气胜，合而为风湿；阳气极盛则火气胜，合而为湿热；阴气盛则金气胜，合为燥湿；阴气极盛则水气胜，合为阴湿。因为兼夹四气，所以湿气淫溢于上下内外，无处不到。大体来说，湿邪在上则引起呕吐、头重胸满；在外则身体沉重浮肿；在下则足胫浮肿；在中则腹胀、痞塞不通。应当分上下中外而治，根据所兼夹的寒热温凉作为佐使药。至于如果先因相乘相克，导致脾虚津液积聚而成湿的，则先治疗胜克之邪。或者脾胃本身虚弱而生湿的，则以补虚为主。或者郁热而成湿的，则以清热为主要目标。或者脾胃的湿邪淫溢流注于四脏、筋骨皮肉血脉之间的，大概湿邪主要导致痞塞，使得受病的脏腑涩滞不得通疏，本脏的病因而发作。其筋骨皮肉血脉受湿邪影响则发为痿痹，表现为缓弱、疼痛沉重，不能正常使用，治疗的药物各有所入，能进入此处的，不能进入彼处。况且湿邪致病，《内经》在各篇中论述重叠出现，本草书中治疗湿邪的方法也不止一种，凡是切于治疗功效的，就是关键药物。现在朱丹溪的书却只归重于苍术一味药，这难道合乎道理吗？
伤湿致病，出现发热恶寒、身体沉重、自汗、骨节疼痛、小便秘涩、大便多泄泻、腰脚痹冷等症状，都是因为坐卧低洼潮湿之地，或冒犯雨露，或穿着湿衣所致，可用除湿汤。具备上述诸症，且腰痛特别严重，不可转侧，感觉像缠绕着五六贯重物一样。这是湿气入肾，肾主水，水流向湿处，是同类相求的缘故。可用肾着汤、渗湿汤。小便秘涩，大便溏薄，是因为雨水淫溢导致的腹疾。可用五苓散吞服戊己丸。戊己属土，土克水，因此得名。五苓散是治湿家的关键药物，所谓治疗湿邪如果不通利小便，就不是正确的治法。
伤湿又兼感风邪的，既有前面的证候，又恶风不想脱去衣被，或者额头微汗，或者身体微肿，汗水浸湿衣服，如果在风口坐卧，多有此证。宜用除湿汤、桂枝汤各半帖混合服用，令微微出汗。如果大发其汗，则风邪去而湿邪留。已经出汗但发热不退的，用败毒散加苍术一钱、防己半钱。伤湿又兼感寒邪的，有前面诸症，只是无汗、凄惨烦痛，宜用五积散与除湿汤半帖混合，再与五苓散半帖混合服用。伤湿又兼感风寒的，出汗后身体沉重，恶风喘满，骨节烦疼，症状像历节风，脐下连及脚部冷痹不能屈伸，这就是所谓的风寒湿合而成痹。宜用防己黄芪汤，或五痹汤。如果因为洗澡出来，未解开裙衫，身上未干，忽然熟睡，邪气攻及肾经，导致外肾肿痛，腰背挛曲，只用五苓散一帖，加入少许真珠末（注：原文“真坏”疑为“真珠”或特定辅料，此处依语境推测为贵重收敛药或笔误，暂译作真珠末/特殊辅料），送服青木香丸，如此服用三次，脏腑之气才通畅，肿胀消退腰背挺直，疼痛自然停止。
湿热相搏结的，用清热渗湿汤。其证候为肩背沉重疼痛，上热胸膈不利，以及遍身疼痛的，用拈痛汤。酒面乳酪停滞不能运化，而湿邪自内盛起的，用除湿散及苍白二陈汤，加入斟酌适量的药物以燥湿。
Dampness originates from the sky, such as fog, dew, and rain. The sky belongs to Qi (vital energy), so this type of dampness first invades the Ying and Wei (nutritive and defensive qi) at the exterior. Dampness originates from the earth, such as mud and water accumulation. The earth belongs to Form (material structure), so this type of dampness first injures the skin, flesh, sinews, bones, and blood vessels. Dampness originates from diet, such as wine, beer, milk, and cheese. The Stomach is the sea of food and fluids, so this type of dampness injures the Spleen and Stomach. Dampness originates from sweat; sweat also belongs to Qi, affecting only the exterior. Dampness originates from human internal processes; this is transformed by Taiyin Damp Earth and arises internally.
To treat dampness from the sky, one should follow the method of Si Tian (the ruling climate of the first half of the year): when dampness is excessive above accompanied by heat, use Bitter-Warm herbs to level it, assisted by Sweet-Acrid herbs, stopping once sweating occurs as a sign of efficacy. This is akin to the clauses in *Jin Gui Yao Lue* describing Wind-Dampness intermingling, causing body pain. To treat dampness from the earth, one should follow the method of Zai Quan (the ruling climate of the second half of the year): when dampness floods internally, treat with Bitter-Hot herbs, assisted by Sour-Bland herbs, using Bitter herbs to dry dampness and Bland herbs to drain it. To treat dampness from diet, if located in the Middle Jiao, intercept it; if in the Upper Jiao, induce vomiting; if in the Lower Jiao, guide and exhaust it. Dampness from sweat is treated similarly to dampness from the sky. Although dampness from human internal processes belongs to the dampness transformed by Taiyin Spleen Earth and exists at the junction of Qi, its treatment shares similarities and differences with the previous four types. Why? Because Earth encompasses the Four Qi: Cold, Heat, Warmth, and Coolness; Ascending, Descending, Floating, and Sinking are all included. The Spleen and Stomach have different Yin-Yang locations, alternating between Excess and Deficiency, Reversal and Compliance. Thus, Yang Excess leads to Wood dominance, combining into Wind-Dampness; extreme Yang Excess leads to Fire dominance, combining into Damp-Heat; Yin Excess leads to Metal dominance, combining into Dryness-Dampness; extreme Yin Excess leads to Water dominance, combining into Yin-Dampness. Because it combines with the Four Qi, dampness floods up, down, inside, and outside, reaching everywhere. Generally, dampness in the Upper causes vomiting, heavy head, and chest fullness; on the Exterior causes heavy body and edema; in the Lower causes swelling of the shins and feet; in the Middle causes abdominal distension and stuffiness. Treatment should be divided by upper, lower, interior, and exterior, with assistants and guides chosen according to the combined Cold, Heat, Warmth, or Coolness. If dampness forms due to Spleen deficiency caused by overacting or underacting pathogenic factors, first treat the pathogenic factor. If dampness arises from inherent Spleen-Stomach deficiency, prioritize tonifying deficiency. If dampness arises from stagnant heat, prioritize clearing heat. If Spleen-Stomach dampness floods into the Four Zang organs or the sinews, bones, skin, flesh, and blood vessels, dampness primarily causes stuffiness, leading to obstruction and stagnation in the affected organs, triggering their diseases. When sinews, bones, skin, flesh, and blood vessels are affected, it manifests as Wei Bi (flaccidity and numbness), characterized by weakness, painful heaviness, and inability to function. Medicines for treatment have specific affinities; those entering one area cannot enter another. Moreover, regarding dampness diseases discussed in *Nei Jing* across various chapters, and treatments found in Materia Medica, any herb effective for treating dampness is considered a key medicine. However, Zhu Danxi’s book focuses solely on Cang Zhu (Atractylodis Rhizoma), which seems unreasonable.
Injuries from dampness manifest as fever, aversion to cold, heavy body, spontaneous sweating, joint pain, urinary retention or difficulty, frequent diarrhea, and cold numbness in the waist and legs. These are caused by sitting or lying in low, damp places, exposure to rain and dew, or wearing wet clothes. Use Chu Shi Tang (Dampness-Expelling Decoction). If these symptoms are present but lower back pain is particularly severe, preventing turning or side-bending, feeling like being bound by several strings of weights, this indicates dampness entering the Kidney. The Kidney governs Water; water flows toward dampness, following its kind. Use Shen Zhuo Tang (Kidney-Targeting Decoction) or Shen Shi Tang (Dampness-Percolating Decoction). Urinary retention with loose stools results from rain-induced abdominal disorders. Use Wu Ling San (Five-Ingredient Powder with Poria) taken with Wu Ji Wan (Wu-Ji Pill). Wu and Ji belong to Earth; Earth controls Water, hence the name. Wu Ling San is a key medicine for dampness patients; as stated, treating dampness without promoting urination is not the correct method.
When dampness injury is complicated by Wind invasion, in addition to the aforementioned symptoms, there is aversion to wind, reluctance to remove clothing, slight sweating on the forehead, slight body swelling, and sweat-soaked clothes. Sitting or lying in drafts often causes this. Use half a dose of Chu Shi Tang and half a dose of Gui Zhi Tang (Cinnamon Twig Decoction) mixed together to induce slight sweating. Profuse sweating will expel Wind but retain Dampness. If fever persists after sweating, use Bai Du San (Detoxify the Toxins Powder) with 1 qian of Cang Zhu and 0.5 qian of Fang Ji (Stephaniae Tetrandrae Radix). When dampness injury is complicated by Cold invasion, with the aforementioned symptoms but no sweat, chilling discomfort, and irritability/pain, use half a dose of Wu Ji San (Five-Accumulations Powder) mixed with half a dose of Chu Shi Tang, and another half dose of Wu Ling San. When dampness injury is complicated by Wind-Cold, with sweating, heavy body, aversion to wind, panting, and fullness, vexing joint pain resembling Li Jie Feng (Gout-like joint disease), and cold numbness below the navel extending to the legs preventing flexion and extension, this is Wind-Cold-Dampness combining to form Bi syndrome. Use Fang Ji Huang Qi Tang (Stephania and Astragalus Decoction) or Wu Bi Tang (Five-Obstructions Decoction). If after bathing, one does not change clothes while still wet, falls into deep sleep, and pathogens attack the Kidney meridian causing external genital swelling and pain, and curved back and waist, use one dose of Wu Ling San with a small amount of Zhen Zhu (Pearl Powder), followed by Qing Mu Xiang Wan (Green Costus Root Pill). After three doses, the Zang-Fu qi will circulate, swelling will subside, the waist will straighten, and pain will cease.
When Damp-Heat intermingles, use Qing Re Shen Shi Tang (Clear Heat and Percolate Dampness Decoction). For symptoms of heavy and painful shoulders and back, upper heat with chest diaphragm discomfort, and generalized body pain, use Nian Tong Tang (Relieve Pain Decoction). When wine, noodles, milk, and cheese stagnate and fail to transform, causing internal dampness abundance, use Chu Shi San (Dampness-Expelling Powder) or Cang Bai Er Chen Tang (Atractylodes and Tangerine Peel Two-Aged-Chen Decoction), adding appropriate herbs to dry dampness based on clinical assessment.