某,长夏之月,身热不扬,头重如裹,胸脘痞闷,纳呆泛恶,肢体困倦沉重,大便溏而不爽,舌苔白腻,脉濡缓。
A patient in late summer with smoldering fever lacking vigor, head as if swathed in cloth, chest and epigastric glomus and oppression, poor appetite with nausea, body heavy and fatigued, loose but unsatisfying stools, a slimy white tongue coating, and a soggy moderate pulse.
湿温初起,湿邪困遏中焦脾胃,阳气不伸。
Early damp-warmth disease: damp pathogen encumbering the middle-burner Spleen and Stomach, so that yang qi cannot extend.
以藿香正气散芳香化湿、理气和中。三剂后头重胸闷大减,纳食渐开;继以平胃散加减调理,旬日而瘥。
Huo Xiang Zheng Qi San was used to aromatically transform dampness and rectify qi to harmonize the middle. After three doses the head-heaviness and chest oppression much reduced, appetite gradually opened; subsequently a Ping Wei San modification was used for regulation, with recovery in ten days.
湿温之病,徒清热则湿不去,纯祛湿则热愈炽。叶氏示以芳香辛散之法先开中焦气机,使湿有出路,湿去则热孤而易清。此即'治湿不利小便非其治也'以外的另一捷径。
In damp-warmth disease, clearing heat alone will not remove the dampness, while purely expelling dampness makes the heat more intense. Ye demonstrates that aromatic acrid-dispersing methods should first open the middle-burner qi dynamic so that dampness has a way out; once dampness leaves, the heat stands alone and is easily cleared. This is a shortcut alongside the familiar rule 'in treating dampness, failing to free the urine is not treatment.'
@misc{bencaodian-ye-tianshi-shi-wen-kun-pi,
author = {{Bencaodian Editorial}},
title = {叶天士治湿温困脾案 (Ye Tianshi: Damp-Warmth Encumbering the Spleen)},
year = {2026},
howpublished = {Bencao Dian: A Bilingual Knowledge Graph of Traditional Chinese Medicine},
url = {https://bencaodian.org/zh/cases/ye-tianshi-shi-wen-kun-pi},
urldate = {2026-04-09},
note = {CC BY-SA 4.0}
}