湿有自外而得者，有自内而生者，有风湿相搏者，有湿热相搏者，有独伤于寒湿者。自外而得
者，如在天之湿，雾露雨雪是也。在地之湿，冰水泥泞是也，在人之湿，汗出沾衣，未经解换是也。但
清邪则先伤上部。先伤表之营卫。故《金匮》曰∶雾伤于上。又曰∶雾伤皮腠。其症头重如裹，面目
浮肿，鼻息不利。声浊不清，发热身疼，宜轻清散之。可用羌活胜湿汤。浊邪则先伤下部，先伤肌肉筋
骨血脉。故《金匮》曰∶湿伤于下，又曰∶湿流关节。又经曰∶地之湿气，感则害人皮肉筋脉。其症
足跗〔足面。〕先肿，〔肿肉如泥，按之不起。〕渐至腿膝，行动重着，关节疼痛，倦怠体重，宜升阳
渗湿兼行，可用羌防四苓散，勿但用降下渗泄之剂。赵氏云∶湿淫从外入里，当用升阳风药即愈。经所谓
湿淫所胜，助风以平之。又曰∶下者举之。得阳气升腾而愈矣。又曰∶客者除之。以湿从外入者，使之
仍从外出也。然宜兼健脾之药投之，如有汗加白术，无汗加苍术之类。自内而生者，如饮食之湿，酒水
瓜果乳酪是也。经曰∶诸湿肿满，皆属于脾。
脾主肌肉，其性恶湿，内受湿淫，肌体肿满。又曰∶湿胜则濡泄，脾湿不运，则水谷不分，故或痞
满、或肿胀、或泄泻，总宜健脾燥湿利水为主。经曰∶治湿不利小便，非其治也。《金匮》云∶一身
尽疼，发热日晡更剧者，此名风湿。此因汗出当风取凉所致，法当汗出而解。但宜微汗，不宜大
汗，大汗则风去湿存，微微似汗，则风湿俱去也。湿热一症，夏月最多。盖夏月地之湿气，上合于天之
热气，日之暑气，结为炎蒸，湿热相合，病多发热烦闷，身体沉重，走注疼痛，皆湿热相搏，郁而不
伸，故烦热也。宜清热渗湿汤加减，可加柴胡、银花之属。嘉言谓∶湿土寄旺于四季之末，其气每随四
时之气而变迁。在夏为热湿，在冬为寒湿。故寒湿之病，于冬月春初，居寒湿之地，感而病者为多。
可用桂枝附子汤，或加羌活、苍术之属，温以散之。以上诸法，皆究湿家之所不容废也。
羌活胜湿汤 通治外感诸湿及风湿症。〔症见论中。〕
羌活 独活 防风〔各钱许。〕川芎 本 蔓荆子〔风能胜湿，如湿地经风则干。又无
窍不入，惟风为能，凡关节不利之病，非风药不可。且羌、独、防风能散周身之湿。上下无不宜之。如
湿症只在下焦，川芎、 本去之亦可。〕炙甘草〔恐风药悍燥，用以调之。此谓有制之兵也，各
五、七分。〕汗多或加白术，无汗可加茅术。〔湿家不可发汗。以身本多汗，易至亡阳也。其久冒风凉，
乃至以水灌汗，抑遏其阳者，不微汗之，邪无从解。〕下焦湿症加
汉防己。〔酒炒。〕发黄加茵陈。〔湿郁为热，蒸腾发黄，《金匮》云∶湿家之为病，一身尽疼，发
热身色如熏黄也。〕
此升阳散湿之剂，凡湿从外受者。无论在上在下，俱以此方随症加减治之。按《金匮》云∶太阳
病，关节疼痛而烦，脉沉而细者，此名中湿，亦名湿痹。言太阳病则必有发热恶风之候，湿流关节则
痛，阳郁不伸则烦，脉不沉细，则非有外风与之相搏，故只名中湿。亦名湿痹者，谓湿邪痹闭其身中之
阳气也。治宜此方，微汗以通其阳，若兼见小便不利，大便反快，当利其小便，宜羌防四苓散治之。
活人败毒散 外感诸湿，及风湿症，挟虚之人，主此加减。
羌活 独活 柴胡 川芎〔轻清开发，使邪毒败散。〕
前胡 枳壳 桔梗〔利气。各钱许。〕人参〔三、五、七分。〕茯苓〔一钱。〕甘
草〔扶正气，以胜邪。五分。〕烦热口干加黄芩，日二、三服，以愈为度。
此扶正驱邪之方也。嘉言云∶湿、热、暑三气门中，当推此方为第一。以其功之着也。观经言，
三阳并至，如风雨，如霹雳，人莫能当。然则夏月三气聚合，其为病也，岂同一气之易当乎？人感三气
而病，病而死，其气互传，乃至十百千万，则为疫矣。嘉靖乙未，五、六、七月间，江南淮北，时
行瘟疫，沿门阖境，传染相似，用本方倍人参，去前、独服者尽活。倍人参者，以疫气易染之人，体
必素虚也，去前、独者，以体虚之人，不敢用复药表汗也。又饥馑兵荒之余，人已内虚久困，非得人参
之大力，负荷其正，驱逐其邪，邪必不去。凡服此者，亦无不全活，所以以活人名方。若去人参，
何异众方之发散，而能活人耶。观吴又可知治瘟疫用药以疏
利为主，与嘉言之治法不同。有瘟疫论宜参酌合宜而用可也。
羌防四苓散 治太阳中〔同伤。〕湿，发热恶风，关节疼痛。〔湿犹在表也。〕小便不利。〔邪
入膀胱，气化不行也。〕大便反快。〔湿流大肠也。〕
羌活 独活 防风〔发表驱湿。〕白术〔健脾去湿。〕
茯苓 猪苓 泽泻〔利水渗湿。〕
此发表驱湿，健脾利水之剂。如兼热者，芩、连、栀、柏、益元散之属，可采加入。嘉言云∶夏
月当会暑、热、湿三气交病之义，审脉辨症，用药庶不误治。此方益元消暑，芩、连清热，苓、泽渗
湿，三法兼有，可遵而加减用之。
胃苓汤 治湿淫于内，胸腹痞满，泄泻纯水，小便不利，或肢体肿胀。
苍术〔燥脾胜湿。〕浓朴〔散结泄满。〕陈皮〔下气。〕甘草〔调中。即平胃
散也。〕白术 茯苓 猪苓 泽泻〔健脾利水渗湿，即四苓散也。〕可加木香、砂仁，发黄加
茵陈，身痛加羌、防，有痰饮加半夏，有食积加神曲。
此燥湿、快气、健脾、利水之剂，原方有桂枝。喻云∶桂枝、麻黄遇湿热时令不可轻用，以桂枝
辛热，麻黄发汗也。果内有寒，方可舍时从症，少少加桂。
清热渗湿汤 治一切湿热、加减用之。
黄连 黄柏〔清热〕。苍术〔燥湿。苍、柏即二妙散，治
湿热腰膝疼痛，然上下皆效也。〕白术〔健脾。〕茯苓 泽泻〔渗湿。〕甘草〔调中。〕可
加银花。〔清热除湿。〕有表症加柴胡。〔除在表之湿热。〕
此清热祛湿，亦夏月之尤宜也。喻云∶夏月所受之湿，为热湿、暑湿，而群方所主之药，多在寒
湿，殊不兼耳。此方甚合鄙意。
白术酒 治中湿、骨节疼痛。
白术〔一两。〕酒〔三盏。〕白术投于酒，煎一盏，不时频服。不能饮酒者，以水代之。
此方专一补脾，不多功于利小便。盖以脾能健运，湿自不留，而从水道出耳，然则胃中津液不
充、不敢利其小便者，此方岂非圣药乎。
仲淳丸方〔亦作煎服。〕阴虚人，有湿热不能服燥剂者宜之。
生地〔凉血祛诸湿热。〕甘菊〔各一斤。〕牛膝〔补阴，〕人参〔益脾。各半
斤。〕真茅术〔缘脾虚有湿，不得不用。故以黑芝麻水浸，研浆拌蒸用之。二斤。〕茯苓〔半
斤。乳制至一斤。〕车前子〔利水而不走气，与茯苓同功。半斤。〕用天冬熬膏为丸服。
此方凉血补阴，益脾祛湿，亦治湿之一法也，肾为水脏，水则流湿。肾阴虚，则脾湿易流入，故用
参、苍，益脾胜湿；地、冬、菊、膝补肾清热；肾得补而湿邪自无所容，况有茯苓、车前以导之乎。
金匮肾着汤 治肾着之病，〔此寒湿但留着肾之外廓也。〕身重腰冷，〔寒湿凝聚故也。〕如坐
水中，〔溶溶不定之貌。〕形如水状。〔微胀如水也。〕腰以下冷痛，腰重如带
五千钱，口不渴，小便自利，饮食如故。〔肠胃无病也。〕此因身劳汗出，衣里冷湿，久久得之所致。
白术 茯苓〔健脾利水。〕甘草〔恐其僭上。〕干姜〔温散寒湿。〕
此散寒、驱湿、健脾、利水之剂。病在肾之经络，与肾之中脏无预，若用桂、附，反伤肾之
阴矣。果如上症，方可用之。
金匮桂枝附子汤 治真中寒湿，〔或居处寒湿，或冒雨经雪。或涉水涂河等类。〕肢体重着，骨
节疼痛，不得屈伸。
桂枝〔宣行荣卫。〕附子〔最散寒湿，以桂、附治湿，如湿地得太阳，曝之则干。〕
白术〔脾能健运。湿自不流。〕炙甘草〔能缓热性。〕
此散寒、驱湿、健脾之剂，果属寒湿，未郁为热者，方可用之。经论湿寒之中人，皮肤不收，而
为纵缓；肌肉坚紧，而为瘦削。荣血涩于脉中，卫气祛于脉外，故曰虚。虚者，语言轻小，足弱难
行，气虚乃痛，按之则止。又嘉言谓∶人身阳盛则轻矫，湿盛则重着，乃至身重如山，百脉痛楚，不
能转侧，此而不用附子回阳胜湿，更欲何待。在表之湿，其有可汗者，用附子合桂、甘、姜、枣以驱之
外出。其有可下者，用附子合细辛、大黄以驱之下出。在中之湿，则用附子合白术，以温中而燥其脾。
若不固护其阳，纵以风药胜湿，是为操刃，即从温药理脾，亦为待弊，其识高，其论甚精，然非常用之
法，备此以俟对症采用。
湿家下之，额上汗出，微喘，小便利者死。〔治湿始终不可下，若阳虚之人，误用汗、下之药，肾
阳先脱，经曰∶肾先病，心为应，额为心部，而肾水乘之，则额上汗出微喘，孤阳上脱也。小便利，则
上下交脱，故死。〕若下利不止者，亦死。〔肾主二便，误下而利不止，肾阴脱也，亦死。〕
湿邪有从外部侵入的，有从内部产生的，有风湿相互搏结的，有湿热相互搏结的，有单独受寒湿侵袭的。从外部侵入的，如天空中的湿气，就是雾、露、雨、雪；大地上的湿气，就是冰水、泥泞；人体内的湿气（指外感），就是出汗后衣服沾湿，没有及时更换。但清轻的邪气（如雾露）首先伤害上部。先伤及体表的营卫之气。所以《金匮要略》说：“雾邪伤于上部。”又说：“雾邪伤及皮腠。”其症状是头部沉重像被包裹一样，面目浮肿，呼吸不畅，声音浑浊不清，发热身体疼痛，宜用轻清之品发散治疗。可用羌活胜湿汤。重浊的邪气（如雨湿）首先伤害下部，先伤及肌肉、筋骨、血脉。所以《金匮要略》说：“湿邪伤于下部”，又说：“湿气流注关节。”又经书说：“大地的湿气，感受它则伤害人的皮肉筋脉。”其症状是足背先肿（肿起的肉像泥一样，按下去不起），逐渐蔓延至腿膝，行动沉重，关节疼痛，倦怠乏力，身体困重，宜用升阳渗湿兼行的方法治疗，可用羌防四苓散，不要只用降下渗泄的药物。赵氏说：湿邪从外入里，应当用升阳的风药即可痊愈。经书所说“湿淫过盛，助风以平之”。又说：“在下位的病证，用升提的方法。”得到阳气升腾而痊愈。又说：“客邪应当祛除。”对于从外侵入的湿邪，使其仍从外出。然而应当配合健脾的药物投服，如有汗加白术，无汗加苍术之类。从内部产生的，如饮食造成的湿气，酒水、瓜果、乳酪等即是。经书说：“各种湿邪导致的肿胀满闷，都归属于脾。”脾主肌肉，其性质厌恶湿气，内受湿邪淫溢，肌体就会肿胀满闷。又说：“湿邪偏胜则导致濡泄（大便稀溏），脾湿不运化，则水谷不分，所以出现痞满、或肿胀、或泄泻，总宜以健脾燥湿利水为主。经书说：“治疗湿邪如果不通利小便，就不是正确的治法。”《金匮要略》说：“全身疼痛，发热在傍晚加重，这名叫风湿。”这是因为出汗时当风取凉所致，治法应当通过发汗来解除。但宜微汗，不宜大汗，大汗则风去湿存，微微似有汗出，则风湿俱去。湿热这一病症，夏季最多。因为夏季大地的湿气，上合于天空的热气、日月的暑气，结为炎热蒸腾，湿热相合，病多表现为发热烦闷，身体沉重，游走性疼痛，都是湿热相互搏结，郁滞不能舒展，所以感到烦热。宜用清热渗湿汤加减，可加柴胡、金银花之类。嘉言（喻昌）说：湿土之气寄旺于四季之末，其气往往随着四时的气候而变化。在夏季为热湿，在冬季为寒湿。所以寒湿的病，在冬季和初春，居住在寒湿之地，感受而发病的人较多。可用桂枝附子汤，或加羌活、苍术之类，用温法来发散。以上诸法，都是研究湿家（湿病患者）所不容废弃的。
羌活胜湿汤 通用治疗外感各种湿邪及风湿症。（症状见上文论述。）
羌活、独活、防风（各约一钱）。川芎、藁本、蔓荆子（风能胜湿，如湿地经风吹则干。又无孔不入，只有风能通达，凡关节不利的病，非风药不可。且羌活、独活、防风能疏散周身之湿，上下无不适宜。如果湿症只在下焦，去掉川芎、藁本也可以）。炙甘草（担心风药悍烈燥燥，用来调和它们。这叫有节制的军队，各五、七分）。汗多可加白术，无汗可加茅术（苍术）。（患湿病的人不可大发汗，因为身体本来多汗，容易亡阳。如果是久冒风寒，甚至用水冲洗汗水，遏制阳气的人，不微汗之，邪气无从解除。）下焦湿症加汉防己（酒炒）。发黄加茵陈。（湿郁化为热，蒸腾发黄，《金匮要略》说：“患湿病的人，全身疼痛，发热，面色像熏黄一样。”）
这是升阳散湿的方剂，凡是湿邪从外感受的，无论在上部还是下部，都用此方随症加减治疗。按《金匮要略》说：“太阳病，关节疼痛而烦躁，脉沉而细的，这名叫中湿，也名叫湿痹。”说太阳病则必有发热恶风的候象，湿流注关节则痛，阳气郁滞不能伸展则烦躁，脉不沉细，则不是有外风与之相搏，所以只名叫中湿。也名叫湿痹的，是说湿邪痹闭了身体中的阳气。治宜此方，微汗以通其阳气，如果兼见小便不利，大便反而快（稀），当利其小便，宜用羌防四苓散治疗。
活人败毒散 治疗外感各种湿邪，及风湿症，夹杂虚损之人，主治此方加减。
羌活、独活、柴胡、川芎（轻清开发，使邪毒败散）。前胡、枳壳、桔梗（利气。各约一钱）。人参（三、五、七分）。茯苓（一钱）。甘草（扶助正气，以战胜邪气。五分）。烦躁口渴加黄芩，每日二、三次服用，以痊愈为度。
这是扶正驱邪的方剂。嘉言说：在湿、热、暑三门疾病中，应当推此方为第一。因为其功效显著。看经书所言，三阳并至，如风雨，如霹雳，人不能抵挡。那么夏季三气聚合，其致病，难道同一种气那样容易抵挡吗？人感受三气而病，因病而死，其气互相传变，乃至十百千万，就变成瘟疫了。嘉靖乙未年，五、六、七月间，江南淮北，流行瘟疫，沿门阖境，传染相似，用本方倍用人参，去掉前胡、独活服用的人都活了。倍用人参，是因为易染疫气的人，体质必定素来虚弱。去掉前胡、独活，是因为体质虚弱的人，不敢用发表发汗的药。又在饥荒兵乱之后，人已经内虚久困，不得人参的大力，负荷正气，驱逐邪气，邪气必不去除。凡是服用此方的，也没有不活的，所以用“活人”命名此方。如果去掉人参，与众方发散有何不同，又能救活人吗？看吴又可可知治疗瘟疫用药以疏利为主，与嘉言的治疗法不同。有《瘟疫论》可供参考，选择适宜的使用即可。
羌防四苓散 治疗太阳中（同伤）湿，发热恶风，关节疼痛。（湿邪仍在表。）小便不利。（邪入膀胱，气化不行。）大便反快。（湿流大肠。）
羌活、独活、防风（发表驱湿）。白术（健脾去湿）。茯苓、猪苓、泽泻（利水渗湿）。
这是发表驱湿，健脾利水的方剂。如果兼有热者，黄芩、黄连、栀子、黄柏、益元散之类，可以加入。嘉言说：夏季应当领会暑、热、湿三气交杂致病的意义，审脉辨症，用药才不会误治。此方益元消暑，黄芩、黄连清热，茯苓、泽泻渗湿，三法兼有，可遵照而加减使用。
胃苓汤 治疗湿邪淫溢于内，胸腹痞满，泄泻纯水，小便不利，或肢体肿胀。
苍术（燥脾胜湿）。厚朴（散结泄满）。陈皮（下气）。甘草（调中。即平胃散）。白术、茯苓、猪苓、泽泻（健脾利水渗湿，即四苓散）。可加木香、砂仁，发黄加茵陈，身痛加羌活、防风，有痰饮加半夏，有食积加神曲。
这是燥湿、快气、健脾、利水的方剂，原方有桂枝。喻嘉言说：桂枝、麻黄遇到湿热时令不可轻用，因为桂枝辛热，麻黄发汗。如果体内确有寒，方可舍时从症，少量加桂。
清热渗湿汤 治疗一切湿热，加减使用。
黄连、黄柏（清热）。苍术（燥湿。苍术、黄柏即二妙散，治疗湿热腰膝疼痛，上下皆有效）。白术（健脾）。茯苓、泽泻（渗湿）。甘草（调中）。可加金银花（清热除湿）。有表症加柴胡（除在表之湿热）。
这是清热祛湿的方剂，也是夏季尤为适宜的。喻嘉言说：夏季所受之湿，为热湿、暑湿，而群方所主的药物，多在寒湿，殊不兼顾。此方很合我的心意。
白术酒 治疗中湿、骨节疼痛。
白术（一两）。酒（三盏）。将白术投入酒中，煎至一盏，不时频服。不能饮酒者，以水代替。
此方专一补脾，不多功于利小便。因为脾能健运，湿自然不留，而从水道排出。那么胃中津液不充、不敢利其小便的人，此方岂不是圣药吗？
仲淳丸方（也可作煎剂服用）。阴虚之人，有湿热不能服燥剂者适宜。
生地（凉血祛诸湿热）。甘菊（各一斤）。牛膝（补阴）。人参（益脾。各半斤）。真茅术（因为脾虚有湿，不得不使用。所以用黑芝麻水浸，研浆拌蒸使用。二斤）。茯苓（半斤，乳制至一斤）。车前子（利水而不走气，与茯苓同功。半斤）。用天冬熬膏为丸服用。
此方凉血补阴，益脾祛湿，也是治疗湿的一种方法。肾为水脏，水则流湿。肾阴虚，则脾湿容易流入，故用人参、苍术，益脾胜湿；地黄、天冬、菊花、牛膝补肾清热；肾得补而湿邪自然无所容身，何况有茯苓、车前来引导呢？
金匮肾着汤 治疗肾着病。（这是寒湿仅留着于肾之外廓。）身重腰冷。（寒湿凝聚的缘故。）如坐水中。（溶溶不定的样子。）形如水状。（微胀像水一样。）腰以下冷痛，腰重如带五千钱，口不渴，小便自利，饮食如故。（肠胃无病。）这是因为身体劳作出汗，衣里冷湿，久久积累所致。
白术、茯苓（健脾利水）。甘草（恐其僭上）。干姜（温散寒湿）。
这是散寒、驱湿、健脾、利水的方剂。病在肾的经络，与肾之中脏无关，如果用桂枝、附子，反而损伤肾的阴气。果真如上症，才可使用。
金匮桂枝附子汤 治疗真中寒湿。（或居处寒湿，或冒雨经雪，或涉水涂河等类。）肢体重着，骨节疼痛，不得屈伸。
桂枝（宣行荣卫）。附子（最散寒湿，用桂枝、附子治湿，如同湿地得到太阳曝晒则干）。白术（脾能健运，湿自然不流）。炙甘草（能缓热性）。
这是散寒、驱湿、健脾的方剂，果真属于寒湿，未郁结为热的，才可使用。经论说湿寒中人，皮肤不收，而为纵缓；肌肉坚紧，而为瘦削。营血涩于脉中，卫气祛于脉外，所以叫虚。虚者，语言轻小，足弱难行，气虚乃痛，按之则止。又嘉言说：人身阳盛则轻矫，湿盛则重着，乃至身重如山，百脉痛楚，不能转侧，此时不用附子回阳胜湿，还等待什么？在表之湿，其有可汗者，用附子合桂枝、甘草、生姜、大枣以驱之外出。其有可下者，用附子合细辛、大黄以驱之下出。在中之湿，则用附子合白术，以温中而燥其脾。若不固护其阳气，纵使用风药胜湿，是为操刃（危险），即使从温药理脾，也为待弊（弊端），其见识高，其论述甚精，但这非常用之法，备录于此以待对症采用。
湿家误用下法，额上汗出，微喘，小便利者死。（治疗湿始终不可下，若阳虚之人，误用汗、下之药，肾阳先脱，经书说：肾先病，心为应，额为心部，而肾水乘之，则额上汗出微喘，孤阳上脱也。小便利，则上下交脱，故死。）如果下利不止者，亦死。（肾主二便，误下而利不止，肾阴脱也，亦死。）
Dampness pathogenic factors may originate from external invasion or internal generation; they may involve the interplay of wind and dampness, heat and dampness, or isolated cold-dampness. External dampness includes atmospheric moisture such as fog, dew, rain, and snow; terrestrial moisture such as ice water and mud; and external moisture affecting humans, such as sweat-soaked clothing not changed promptly. Clear (light) pathogens first injure the upper body, initially affecting the Ying (Nutrient) and Wei (Defensive) Qi at the exterior. Thus, *Jingui Yaolue* states: "Fog pathogens injure the upper." It also says: "Fog pathogens injure the skin and pores." Symptoms include a heavy sensation in the head as if bound, edema of the face and eyes, nasal congestion, hoarse voice, fever, and body ache. Treatment should employ light and clear dispersing methods, using Qianghuo Shengshi Tang (Notopterygium Decoction to Overcome Dampness). Turbid (heavy) pathogens first injure the lower body, initially affecting muscles, sinews, bones, and blood vessels. Thus, *Jingui Yaolue* states: "Dampness injures the lower," and "Dampness flows into the joints." Another classic text says: "Terrestrial dampness, when contracted, harms the skin, flesh, sinews, and vessels." Symptoms include initial edema of the dorsum of the foot (swollen flesh like mud, pitting upon pressure), gradually extending to the legs and knees, heavy movement, joint pain, fatigue, and bodily heaviness. Treatment should combine raising Yang and leaching out dampness, using Qiangfang Siling San (Qianghuo and Fangfeng Powder with Four Poria Decoction); one should avoid using only descending and draining agents. Zhao Shi stated: When dampness invades from outside into the interior, employing ascending wind herbs can lead to recovery. The classics state: "When dampness is excessive, assist with wind to pacify it." Also: "For conditions below, lift them up." Recovery occurs through the rising of Yang Qi. Also: "Exogenous pathogens should be expelled." For dampness entering from outside, allow it to exit outward. However, spleen-strengthening herbs should be combined; add Baizhu (Atractylodis Macrocephalae Rhizoma) if sweating, or Cangzhu (Atractylodis Rhizoma) if no sweating. Internal dampness arises from diet, such as alcohol, fruits, melons, milk, and cheese. The classics state: "All dampness-related swelling and fullness belong to the Spleen." The Spleen governs the muscles and dislikes dampness; internal dampness excess leads to bodily swelling and fullness. It is also said: "Excess dampness causes loose stools; if Spleen dampness fails to transform, water and grain are not separated," resulting in epigastric fullness, swelling, or diarrhea. The primary treatment is always to strengthen the Spleen, dry dampness, and promote urination. The classics state: "Treating dampness without promoting urination is incorrect." *Jingui Yaolue* states: "Generalized body pain and fever worsening in the late afternoon is named Wind-Damp." This results from sweating and exposing oneself to wind for cooling. The method requires sweating to resolve, but mild sweating is preferred over profuse sweating; profuse sweating expels wind but retains dampness, while mild sweating expels both wind and dampness. Heat-Dampness is most common in summer. Summer terrestrial dampness combines with celestial heat and solar暑 (summer heat) to create steaming heat. Heat and dampness combine, causing fever, irritability, bodily heaviness, and migratory pain due to the stagnation and inability of heat-dampness to expand, leading to irritability. Treat with Qingre Shenshi Tang (Clear Heat and Leach Out Dampness Decoction) with modifications, adding Chaihu (Bupleuri Radix) and Yinhua (Lonicerae Flos). Jiayan (Yu Chang) stated: Damp-earth qi peaks at the end of each season and changes with seasonal climates. In summer, it is heat-damp; in winter, it is cold-damp. Thus, cold-damp diseases are common in winter and early spring among those living in cold-damp environments. Use Guizhi Fuzi Tang (Cinnamon Twig and Aconite Root Decoction) or add Qianghuo and Cangzhu, treating with warming dispersion. These methods are essential for managing dampness patients.
Qianghuo Shengshi Tang (Notopterygium Decoction to Overcome Dampness): Universally treats exogenous dampness and wind-damp syndromes. [Symptoms described above.]
Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Fangfeng (Saposhnikoviae Radix) [approx. 1 qian each]. Chuanxiong (Ligustici Chuanxiong Rhizoma), Bencao (Ligustici Rhizoma), Manjingzi (Viticis Semen) [Wind overcomes dampness, as wind dries wet ground. Wind penetrates all openings; for joint obstruction, wind herbs are indispensable. Qianghuo, Duhuo, and Fangfeng disperse dampness throughout the body, suitable for upper and lower parts. If dampness is only in the Lower Jiao, remove Chuanxiong and Bencao.]. Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma) [To moderate the harsh/dry nature of wind herbs, like disciplined troops, approx. 5-7 fen]. Add Baizhu if sweating excessively; add Maoyu (Cangzhu) if no sweating. [Dampness patients should not induce profuse sweating as they already sweat easily, risking Yang collapse. However, for chronic wind-cold exposure or suppressed Yang from cold water washing, mild sweating is necessary to release pathogens.] Add Han Fangji (Stephaniae Tetrandrae Radix) [wine-fried] for Lower Jiao dampness. Add Yinchen (Artemisiae Scopariae Herba) for jaundice. [Dampness stagnating into heat steams upward causing jaundice; *Jingui Yaolue* states: "Dampness disease presents with generalized pain, fever, and sallow complexion."]
This is an ascending-Yang and dispersing-dampness formula. For exogenous dampness, regardless of location, modify this formula based on symptoms. According to *Jingui Yaolue*: "Taiyang disease with joint pain and irritability, deep and fine pulse, is named Zhongshi (Struck by Dampness) or Shib Bi (Damp Bi)." Taiyang disease implies fever and aversion to wind; dampness in joints causes pain; Yang stagnation causes irritability; if the pulse is not deep/fine, there is no external wind interaction, hence only Zhongshi. Named Shib Bi because dampness obstructs the body's Yang Qi. Treat with this formula to mildly sweat and unblock Yang. If accompanied by dysuria and loose stools, promote urination using Qiangfang Siling San.
Huoren Baidu San (Living People's Toxin-Resolving Powder): Treats exogenous dampness and wind-damp syndromes in deficient individuals. Modify as needed.
Qianghuo, Duhuo, Chaihu, Chuanxiong [Light and clear to open and defeat toxins]. Qianhu (Peucedani Radix), Zhike (Aurantii Fructus), Jiegeng (Platycodonis Radix) [Regulate Qi, approx. 1 qian each]. Renshen (Ginseng Radix et Rhizoma) [3-5-7 fen]. Fuling (Poria) [1 qian]. Gancao (Licorice Root) [Support Zheng Qi to overcome pathogens, 5 fen]. Add Huangqin (Scutellariae Radix) for irritability and dry mouth. Take 2-3 times daily until cured.
This is a formula to support healthy Qi and expel pathogens. Jiayan stated: Among wind-damp, heat, and summerheat categories, this is the premier formula due to its efficacy. Classics state that simultaneous arrival of Three Yang is like wind, rain, and thunder, unstoppable. Summer aggregation of these three pathogens is more severe than single pathogens. Contracting these leads to illness and death, with pathogens transmitting, becoming epidemics. In Yiwei year of Jiajing, during May-July, Jiangnan and Huabei suffered plague. Using this formula with doubled Renshen and removing Qianhu/Duhuo saved all patients. Doubled Renshen supports the inherently weak constitution susceptible to epidemic Qi. Removing Qianhu/Duhuo avoids harsh diaphoresis in the weak. Post-famine/war, internal deficiency requires Renshen to support Zheng Qi and expel pathogens. Hence the name "Huoren" (Living People). Without Renshen, it differs little from other dispersing formulas. Wu Youke advocated疏利 (ventilating and purging) for plague, differing from Jiayan. Consult *Wenyi Lun* for appropriate application.
Qiangfang Siling San (Qianghuo and Fangfeng Powder with Four Poria Decoction): Treats Taiyang Zhongshi, fever, aversion to wind, joint pain [dampness still at exterior], dysuria [pathogen in Bladder, Qi transformation failed], and loose stools [dampness in Large Intestine].
Qianghuo, Duhuo, Fangfeng [Release exterior and驱 dampness]. Baizhu [Strengthen Spleen and drain dampness]. Fuling, Zhuling (Polyporus), Zexie (Alismatis Rhizoma) [Promote urination and leach dampness].
This releases the exterior, drives out dampness, strengthens the Spleen, and promotes urination. If heat is present, add Huangqin, Huanglian (Coptidis Rhizoma), Zhizi (Genkwa Flos), Huangbai (Phellodendri Cortex), or Yiyuan San. Jiayan stated: In summer, understand the interaction of summerheat, heat, and dampness; examine pulse and symptoms to avoid misdiagnosis. This formula uses Yiyuan San for summerheat, Huangqin/Huanglian for heat, and Fuling/Zexie for dampness, combining three methods.
Weiling Tang (Stomach-Pacifying Decoction): Treats internal dampness excess with chest/abdominal fullness, watery diarrhea, dysuria, or limb edema.
Cangzhu [Dry Spleen and overcome dampness]. Houpo (Magnoliae Officinalis Cortex) [Disperse knots and relieve fullness]. Chenpi (Citri Reticulatae Pericarpium) [Descend Qi]. Gancao [Harmonize Middle; i.e., Pingwei San]. Baizhu, Fuling, Zhuling, Zexie [Strengthen Spleen, promote urination and leach dampness; i.e., Siling San]. Add Muxiang (Aucklandiae Radix), Sharen (Amomi Fructus) for fullness; Yinchen for jaundice; Qianghuo/Fangfeng for body pain; Banxia (Pinelliae Rhizoma) for phlegm-fluids; Shenqu (Meditativae Mass) for food stagnation.
This dries dampness, moves Qi, strengthens Spleen, and promotes urination. Original formula contains Guizhi. Yu Chang stated: Guizhi and Mahuang should not be used lightly in heat-damp seasons due to Guizhi's acrid-warm nature and Mahuang's diaphoretic action. Only use small amounts of Guizhi if internal cold is confirmed.
Qingre Shenshi Tang (Clear Heat and Leach Out Dampness Decoction): Treats all heat-damp conditions, modify as needed.
Huanglian (Coptidis Rhizoma), Huangbai [Clear heat]. Cangzhu [Dry dampness; Cangzhu + Huangbai = Ermiao San for damp-heat knee/lower back pain, effective everywhere]. Baizhu [Strengthen Spleen]. Fuling, Zexie [Leach dampness]. Gancao [Harmonize Middle]. Add Yinhua for clearing heat/dampness. Add Chaihu for exterior syndromes [clear exterior heat-damp].
This clears heat and dispels dampness, highly suitable for summer. Yu Chang noted: Summer dampness is heat-damp or summerheat-damp, whereas many formulas target cold-damp. This formula aligns well with my views.
Baizhu Jiu (Atractylodes Wine): Treats Zhongshi and joint pain.
Baizhu (1 liang), Wine (3 zhan). Simmer Baizhu in wine to 1 zhan, take frequently. Non-drinkers may use water.
This formula specifically tonifies the Spleen rather than focusing on diuresis. A strong Spleen prevents dampness retention, allowing it to exit via urine. For those with insufficient Stomach fluids who cannot tolerate diuretics, this is a sage prescription.
Zhongchun Wan Formula (also taken as decoction): Suitable for Yin-deficient patients with damp-heat who cannot tolerate drying agents.
Shengdi (Rehmanniae Radix) [Cool blood and clear damp-heat]. Ganju (Chrysanthemi Flos) [1 jin each]. Niuxi (Achyranthis Bidentatae Radix) [Tonify Yin]. Renshen [Benefit Spleen, 0.5 jin each]. Zhen Maoyu (True Cangzhu) [Required for Spleen deficiency with dampness; soaked in black sesame water, ground, mixed, and steamed, 2 jin]. Fuling [0.5 jin, processed with milk to 1 jin]. Cheqianzi (Plantaginis Semen) [Promotes urination without depleting Qi, same function as Fuling, 0.5 jin]. Form pills with Tiandong (Asparagi Rhizoma) paste.
This cools blood, tonifies Yin, benefits Spleen, and removes dampness. Kidney is the water organ; water flows with dampness. Kidney Yin deficiency allows Spleen dampness to flow inward. Thus, Renshen/Cangzhu benefit Spleen and overcome dampness; Shengdi/Tiandong/Ganju/Niuxi tonify Kidney and clear heat. Tonified Kidney leaves no room for dampness, aided by Fuling/Cheqianqi to guide it out.
Jingui Shen Zhuo Tang (Golden Cabinet Kidney-Lodging Decoction): Treats Shen Zhuo disease [Cold-damp lodging on the exterior of the Kidney region]. Heavy body, cold waist [cold-damp accumulation]. Sensation of sitting in water [fluctuating instability]. Swollen appearance. Cold pain below waist, heavy waist as if carrying 5000 coins. No thirst, normal urination, normal appetite [no gastrointestinal disease]. Caused by labor-induced sweating, cold/wet clothing, long-term accumulation.
Baizhu, Fuling [Strengthen Spleen, promote urination]. Gancao [Prevent rebellion upward]. Ganjiang (Zingiberis Rhizoma) [Warm and disperse cold-damp].
This disperses cold, drives dampness, strengthens Spleen, and promotes urination. Disease is in Kidney meridians, not the Zang organ itself. Using Guizhi/Fuzi would damage Kidney Yin. Use only if symptoms match.
Jingui Guizhi Fuzi Tang (Golden Cabinet Cinnamon Twig and Aconite Root Decoction): Treats true cold-damp strike [living in cold-damp, exposed to rain/snow, wading rivers]. Heavy limbs, joint pain, inability to flex/extend.
Guizhi (Cinnamomi Ramulus) [Disseminate Ying and Wei]. Fuzii (Aconiti Lateralis Radix Praeparata) [Best for dispersing cold-damp; Guizhi+Fuzi treat dampness like sun drying wet ground]. Baizhu [Spleen transforms, dampness does not flow]. Zhi Gancao [Moderates heat properties].
This disperses cold, drives dampness, and strengthens Spleen. Use only for cold-damp not yet transformed into heat. Classics state cold-damp makes skin lax and muscles tight/thin. Ying blood stasis in vessels, Wei Qi dispersion outside vessels causes deficiency. Deficiency manifests as quiet speech, weak legs, pain relieved by pressure. Jiayan stated: Yang excess leads to agility; damp excess leads to heaviness. Severe heaviness and pain require Fuzi to restore Yang and overcome dampness. Exterior dampness amenable to sweating: use Fuzi with Guizhi, Gancao, Shengjiang, Dazao to expel outward. Amenable to purging: use Fuzi with Xixin (Asari Radix), Dahuang (Rhei Radix et Rhizoma) to expel downward. Interior dampness: use Fuzi with Baizhu to warm middle and dry Spleen. Without protecting Yang, wind herbs are dangerous; even warming Spleen herbs have drawbacks. This is a high-level theory for specific cases.
If a dampness patient is treated with purgatives, sweating on the forehead, slight wheezing, and free urination indicate death. [Purgatives are contraindicated in dampness. In Yang-deficient patients, mistaken sweating/purging causes Kidney Yang collapse. Classics: Kidney disease affects Heart; forehead belongs to Heart; Kidney water overwhelms, causing forehead sweat and wheezing (isolated Yang floating up). Free urination indicates upper/lower depletion, hence death.] Profuse diarrhea after purgation also indicates death. [Kidney governs two passages; mistaken purgation causing persistent diarrhea indicates Kidney Yin collapse, hence death.]