(附暑风、注夏)
暑证,用黄连香薷饮。挟痰,加半夏、南星;虚,加人参、黄 。暑病内伤者,用
清暑益气汤,着暑气是痰,用吐。注夏属阴虚,元气不足,夏初春末,头疼脚软,食少体热
者是,宜补中益气汤,去柴胡、升麻,加炒柏、白芍药。挟痰者,加南星、半夏、陈皮,煎
服,又或用生脉汤。暑风挟痰挟火,实者可用吐法。
暑乃夏月炎暑也,盛热之气者火也,有冒、有伤、有中,三者有轻重之分,虚实之辨。
或腹痛水泻者,胃与大肠受之,恶心者,胃口有痰饮也。此二者冒暑也,可用黄连香薷饮、
清暑益气汤,盖黄连退暑热,香薷消蓄水。或身热头疼,燥乱不宁者,或身如针刺者,此为
热伤在分内也,当以解毒汤、白虎汤,加柴胡,气如虚者,加人参。或咳嗽发寒热,盗汗出
不止,脉数者,热在肺经,用清肺汤、柴胡天水散之类急治则可,迟则不救,成火乘金也,
此为中暑。凡治病,须要明白辨别,慎勿混同施治。春秋间亦或有之,切莫执一,随病处方
为妙。戴云∶暑风者,夏月卒倒,不省人事者是也。有因火者,有因痰者。火,君相二火也
;暑,天地二火也。内外合而炎烁,所以卒倒也。痰者,人身之痰饮也,因暑气入而鼓激痰
饮,塞碍心之窍道,则手足不知动蹑而卒倒也。此二者皆可吐。《内经》曰∶火郁则发之。
吐即发散也。量其虚实而吐之,吐醒后,可用清剂调治之。
〔入方〕
暑渴
生地黄 麦冬 牛膝 炒柏 知母 葛根 甘草
上锉。水煎服。
〔附录〕中 是阳证,中暑是阴证。脉沉弱者,切不可用寒凉药。清热宜天水散、五苓、白
虎汤皆可。热闷恍惚,辰砂五苓散。脉弦实,黄连香薷汤。热甚,自汗而渴,便涩者,五苓
分利之,或桂苓甘露饮。吐泻,脉沉微甚者,可用附子大顺散。伏热伤冷,缩脾饮、冷香饮
子皆可浸冷服之。或剥蒜肉入鼻中,或研蒜水解灌之,盖蒜气臭烈,能通诸窍故也。
〔附方〕
生脉汤
人参 麦冬 五味子
上锉。水煎服。
黄龙丸 治一切暑毒。
赤亮雄黄(五钱) 硫黄 硝石(各一两) 滑石 明矾(各半两) 好面(四两)
上为末,丸梧子大。每服五七十丸,白汤下。
却暑散 治冒暑伏热,头目眩晕,呕吐,泄痢,烦渴,背寒,面垢。
赤茯苓 生草(各四两) 寒食面 生姜(各一斤)
上为末。每服二钱,白汤调下。
香薷饮 治伤暑,脏腑不和调,霍乱吐利,烦渴引饮。
白扁豆(炒) 川朴(姜制,八两) 香薷(一斤)
上水煎,入酒少许,沉冷服。
黄连香薷饮
香薷(一斤) 川朴(制,半斤) 黄连
上 咀。每二三钱,水煎服。
大顺散
甘草(断寸长,三两) 干姜 杏仁 桂(四两)
上将甘草用白沙炒黄,次入干姜同炒,令姜裂,次入杏仁同炒,不作声为度。筛去沙
,入桂为末,每服二三钱,水煎温服,如烦燥,井花水调服,以沸汤点服亦得。
十味香薷饮
香薷(一两) 人参 陈皮 白术 茯苓 黄 木瓜 川朴(姜炒) 扁豆 甘草(炙,各半
上为末。每二钱,热汤或冷水调服, 咀煎亦得。
清暑益气汤 治长夏湿热蒸人,人感之四肢困倦,精神少,懒于动作,胸满气促,支节
疼,或气高而喘,身热而烦,心下膨闭,小便黄而数,大便溏而频,或痢或渴,不思饮食,
自汗体虚。
黄 苍术(锉) 升麻(各一钱) 人参 白术 神曲 陈皮(各半钱) 甘草(炙) 酒柏 麦
冬当归(各三分) 葛根(二分) 五味子(九个) 泽泻(五分) 青皮(二分半)
上 咀。作一服,水二大盏,煎至一盏,去渣,大温服,食远。
补中益气汤 见内伤类。
天水散
滑石(六两) 甘草(炙,一两)
上为极细末。水调服。
五苓散
白术 猪苓 茯苓(各一两半) 桂(一两) 泽泻(二两半)
加辰砂,名辰砂五苓散。
人参白虎汤 治暑热,发渴,脉虚。
人参(一钱半)知母(二钱) 石膏(半两) 甘草(一钱)
上 咀。入粳米一合,水煎服。
桂苓甘露饮(《宣明方》)
茯苓 泽泻(各一两) 石膏 寒水石(各二两) 滑石(四两) 白术 桂 猪苓(各半两)
上为末。每服三钱,白汤调下。
缩脾饮 解伏热,除烦渴,消暑毒,止吐泻霍乱。
砂仁 草果 乌梅肉 甘草(炙,各四两) 扁豆(炒) 葛根(各一两)
上 咀。每服四钱,水煎冷服。
冷香饮子 治伤暑渴,霍乱腹痛烦躁,脉沉微,或伏。
草果仁(三两) 附子 陈皮(各一两) 甘草(半两)
上 咀。每服一两,入姜煎,水旋冷服。
黄连解毒汤
黄连 黄柏 黄芩 栀子(等分)
上 咀。水煎。
(附注:暑风、注夏)
暑证,使用黄连香薷饮。若兼夹痰湿,加入半夏、天南星;若属虚证,加入人参、黄芪。暑病中因内伤饮食所致者,使用清暑益气汤;若暑气与痰浊相搏结,可使用吐法。注夏属于阴虚,元气不足,表现为夏初春末时节出现头痛、脚软、食欲不振、身体发热等症状,适宜使用补中益气汤,去掉柴胡、升麻,加入炒黄柏、白芍药。若兼夹痰湿者,加入天南星、半夏、陈皮,煎服,或者也可以使用生脉汤。暑风若兼夹痰湿和火邪,实证者可以使用吐法。
暑是夏季的炎热之气,极盛的热气属于火,有冒暑、伤暑、中暑三种情况,这三者在病情轻重和虚实性质上有区别。如果出现腹痛水样腹泻,说明胃和大肠受邪;出现恶心,说明胃口有痰饮停留。这两种情况属于冒暑,可以使用黄连香薷饮、清暑益气汤,因为黄连能退暑热,香薷能消除体内蓄水。如果身体发热、头痛、烦躁不安,或者身体感觉像被针刺一样疼痛,这是热邪伤害在分肉腠理之间,应当使用解毒汤、白虎汤,加入柴胡,如果气虚则加入人参。如果咳嗽并伴有寒热往来、盗汗不止、脉搏数疾,这是热邪在肺经,使用清肺汤、柴胡天水散之类急治即可,拖延则无法救治,会形成火克金的局面,这属于中暑。凡是治病,必须明白辨别,千万不要混淆施治。春秋季节也可能发生,切勿固执一端,根据病情灵活处方才是妙法。戴元礼说:暑风是指夏季突然昏倒、不省人事的情况。有的因火邪引起,有的因痰邪引起。火,指君火和相火;暑,指天火和地火。内外之火合而炎灼,所以导致突然昏倒。痰,指人体内的痰饮,因暑气侵入而鼓动激荡痰饮,堵塞心之窍道,则手足不能活动而突然昏倒。这两种情况都可以用吐法。《内经》说:火郁结则发散它。吐法就是发散的方法。根据其虚实情况施用吐法,吐醒后,可以用清热剂调理治疗。
〔入方〕
暑渴证
生地黄、麦冬、牛膝、炒黄柏、知母、葛根、甘草。
以上药材切碎。加水煎服。
〔附录〕中暍(zhòng yē,即中暑轻症或特定类型)是阳证,中暑是阴证。脉象沉弱的,切不可使用寒凉药物。清热适宜使用天水散、五苓散、白虎汤皆可。若感到闷热、神志恍惚,使用辰砂五苓散。脉象弦实,使用黄连香薷汤。热势严重,自汗且口渴,小便涩滞者,使用五苓散分利水道,或者使用桂苓甘露饮。出现呕吐腹泻,脉象沉微严重者,可以使用附子大顺散。若是伏热伤冷,缩脾饮、冷香饮子皆可浸泡冷却后服用。或者将蒜肉塞入鼻孔中,或者研磨蒜汁灌服,因为蒜气臭烈,能够通达诸窍的缘故。
黄龙丸 治疗一切暑毒。
赤亮雄黄(五钱)、硫黄、硝石(各一两)、滑石、明矾(各半两)、好面粉(四两)。
以上研为细末,制成梧桐子大小的丸药。每次服用五七十丸,白开水送下。
却暑散 治疗冒暑伏热,头目眩晕,呕吐,泄痢,烦渴,背部发冷,面部污垢。
赤茯苓、生甘草(各四两)、寒食面、生姜(各一斤)。
以上研为细末。每次服用二钱,白开水调下。
香薷饮 治疗伤暑,脏腑不和调,霍乱吐利,烦渴引饮。
白扁豆(炒)、川朴(姜制,八两)、香薷(一斤)。
以上加水煎煮,加入少许酒,沉淀冷却后服用。
黄连香薷饮
香薷(一斤)、川朴(制,半斤)、黄连。
以上切碎。每次二三钱,加水煎服。
大顺散
甘草(切断寸长,三两)、干姜、杏仁、桂枝(四两)。
先将甘草用白沙炒至黄色,其次加入干姜同炒,令姜裂开,其次加入杏仁同炒,以没有响声为度。筛去沙子,加入桂枝研为细末,每次服用二三钱,加水煎温服,如果烦躁,用井花水调服,用沸水点服也可以。
十味香薷饮
香薷(一两)、人参、陈皮、白术、茯苓、黄芪、木瓜、川朴(姜炒)、扁豆、甘草(炙,各半两)。
以上研为细末。每次二钱,热汤或冷水调服,切碎煎煮也可以。
清暑益气汤 治疗长夏湿热蒸人,人感受后四肢困倦,精神减少,懒于动作,胸满气促,肢节疼痛,或者气高而喘,身体发热而烦躁,心下膨闷闭塞,小便黄而频数,大便溏而频繁,或者痢疾或者口渴,不思饮食,自汗体虚。
黄芪、苍术(锉)、升麻(各一钱)、人参、白术、神曲、陈皮(各半钱)、甘草(炙)、酒黄柏、麦冬、当归(各三分)、葛根(二分)、五味子(九个)、泽泻(五分)、青皮(二分半)。
以上切碎。作一服,水两大盏,煎至一盏,去渣,大温服,饭后服用。
补中益气汤 见内伤类。
天水散
滑石(六两)、甘草(炙,一两)。
以上研为极细末。水调服。
五苓散
白术、猪苓、茯苓(各一两半)、桂枝(一两)、泽泻(二两半)。
加入辰砂,名为辰砂五苓散。
人参白虎汤 治疗暑热,发渴,脉虚。
人参(一钱半)、知母(二钱)、石膏(半两)、甘草(一钱)。
以上切碎。加入粳米一合,加水煎服。
桂苓甘露饮(出自《宣明方论》)
茯苓、泽泻(各一两)、石膏、寒水石(各二两)、滑石(四两)、白术、桂枝、猪苓(各半两)。
以上研为细末。每次服用三钱,白开水调下。
缩脾饮 解伏热,除烦渴,消暑毒,止吐泻霍乱。
砂仁、草果、乌梅肉、甘草(炙,各四两)、扁豆(炒)、葛根(各一两)。
以上切碎。每次服用四钱,加水煎冷服。
冷香饮子 治疗伤暑渴,霍乱腹痛烦躁,脉沉微,或者伏匿。
草果仁(三两)、附子、陈皮(各一两)、甘草(半两)。
以上切碎。每次服用一两,加入生姜煎煮,水随时冷却后服用。
(Attached: Summerwind, Summer Sickness)
For summerheat syndrome, use Huanglian Xiangru Yin (Coptis and Mosla Decoction). If complicated by phlegm, add Banxia (Pinellia Rhizome) and Nanting (Arisaema Rhizome); if deficiency, add Renshen (Ginseng Root) and Huangqi (Astragalus Root). For summerheat disease caused by internal injury (dietary indiscretion), use Qingshu Yiqi Tang (Clear Summerheat and Boost Qi Decoction); if summerheat qi is bound with phlegm, emesis may be used. "Zhu Xia" (Summer Sickness/Seasonal Malaise) belongs to yin deficiency and insufficient primordial qi, manifesting as headache, weak legs, poor appetite, and body heat in early summer or late spring; it is suitable for Buzhong Yiqi Tang (Decoction to Tonify the Middle and Augment Qi), removing Chaihu (Bupleurum Root) and Shengma (Cimicifuga Rhizome), and adding fried Baicao (Phellodendron Bark) and Shaoyao (Peony Root). If complicated by phlegm, add Nanting, Banxia, and Chenpi (Tangerine Peel), decoct and take; alternatively, Shengmai Tang (Generate the Pulse Decoction) may be used. If summerwind is complicated by phlegm and fire, emesis can be used for excess patterns.
Summerheat is the blazing heat of summer; extreme heat belongs to Fire. There are three types: Mao (encountering), Shang (injuring), and Zhong (smitten), which differ in severity and deficiency/excess nature. Abdominal pain with watery diarrhea indicates invasion of the Stomach and Large Intestine; nausea indicates phlegm-fluid retention in the stomach opening. These two belong to Mao (encountering) summerheat and can be treated with Huanglian Xiangru Yin or Qingshu Yiqi Tang, as Huanglian clears summerheat heat, and Xiangru eliminates accumulated water. Fever, headache, restlessness, or a sensation like needle pricks on the body indicates heat injuring the fenli (interstices/muscle layers); Jiedu Tang (Detoxification Decoction) and Baihu Tang (White Tiger Decoction) should be used, adding Chaihu if qi is deficient. Cough with alternating chills and fever, incessant night sweats, and rapid pulse indicate heat in the Lung Meridian; Qingfei Tang (Clear the Lung Decoction) or Chaihu Tianshui San (Bupleurum and Celestial Water Powder) should be used urgently; delay leads to incurability, resulting in Fire overcoming Metal (Lung), which constitutes Zhong (smitten) summerheat. In treating diseases, one must clearly distinguish and differentiate; do not treat indiscriminately. It may also occur in spring and autumn; do not adhere rigidly to one method, but prescribe according to the disease condition. Dai Yun said: Summerwind refers to sudden collapse and loss of consciousness in summer. It can be caused by Fire or Phlegm. Fire refers to Ministerial Fire and Sovereign Fire; Summerheat refers to Heavenly Fire and Earthly Fire. Internal and external fires combine to scorch, causing sudden collapse. Phlegm refers to phlegm-fluids in the body; summerheat qi enters and agitates the phlegm-fluids, blocking the orifices of the Heart, causing limbs to become immobile and leading to sudden collapse. Both cases can be treated with emesis. The *Neijing* states: "When Fire is constrained, disperse it." Emesis is a form of dispersion. Apply emesis according to deficiency or excess; after waking from emesis, regulate treatment with cooling agents.
[Prescription]
Summerheat Thirst
Shengdihuang (Rehmannia Root), Maidong (Ophiopogon Tuber), Niuxi (Achyranthes Root), Fried Baicao (Phellodendron Bark), Zhimu (Anemarrhena Rhizome), Gegen (Pueraria Root), Gancao (Licorice Root).
Chop the herbs. Decoct in water and take.
[Appendix] Zhongye (Mild Summerheat/Sunstroke) is a Yang syndrome; Zhongshu (Severe Summerheat) is a Yin syndrome. With a deep and weak pulse, cold-cooling medicines must absolutely not be used. To clear heat, Tianshui San (Celestial Water Powder), Wuling San (Five-Ingredient Powder with Poria), or Baihu Tang (White Tiger Decoction) are all suitable. For stifling heat and mental confusion, Chencha Wuling San (Cinnabar Five-Ingredient Powder with Poria) is used. With a wiry and excess pulse, Huanglian Xiangru Tang (Coptis and Mosla Decoction) is used. For severe heat, spontaneous sweating, thirst, and scanty/difficult urination, Wuling San (Five-Ingredient Powder with Poria) is used to separate fluids, or Guiling Ganlu Yin (Cassia, Poria, and Honeyed Dew Decoction). For vomiting and diarrhea with a deep and faint pulse, Fuzi Dashun San (Aconite Great Harmony Powder) can be used. For latent heat injured by cold, Suopi Yin (Contract the Spleen Decoction) or Lengxiang Yinzi (Cold Fragrance Infusion) can be soaked and taken cold. Alternatively, insert garlic flesh into the nostrils, or grind garlic and mix with water to灌 (pour/administer), because the pungent odor of garlic can open all orifices.
[Attached Prescriptions]
Shengmai Tang (Generate the Pulse Decoction)
Renshen (Ginseng Root), Maidong (Ophiopogon Tuber), Wuweizi (Schisandra Berry).
Chop the herbs. Decoct in water and take.
Huanglong Wan (Yellow Dragon Pill) treats all summerheat toxins.
Chiliang Xionghuang (Bright Red Realgar, 5 qian), Liuhuang (Sulfur), Xiaoshi (Niter) (each 1 liang), Huashi (Talcum), Mingfan (Alum) (each half liang), Hao Mian (Good Wheat Flour, 4 liang).
Grind into powder, make pills the size of wutong seeds. Take 50-70 pills each time with warm water.
Queshu San (Summer-Repelling Powder) treats encountering summerheat and latent heat, dizziness, vertigo, vomiting, dysentery, irritability and thirst, cold back, and greasy face.
Chi Fuling (Red Poria, 4 liang), Sheng Cao (Raw Licorice, 4 liang), Hanshi Mian (Cold Food Flour), Shengjiang (Fresh Ginger) (each 1 jin).
Grind into powder. Take 2 qian each time mixed with warm water.
Xiangru Yin (Mosla Infusion) treats summerheat injury, disharmony of the zang-fu, cholera-like vomiting and diarrhea, irritability, thirst, and desire to drink.
Baibian Dou (Fried White Hyacinth Bean), Chuanpu (Prepared Magnolia Bark, 8 liang), Xiangru (Mosla Herb, 1 jin).
Decoct in water, add a little wine, let settle, and take cold.
Huanglian Xiangru Yin (Coptis and Mosla Infusion)
Xiangru (Mosla Herb, 1 jin), Chuanpu (Prepared Magnolia Bark, half jin), Huanglian (Coptis Rhizome).
Chop the herbs. Take 2-3 qian each time, decoct in water and take.
Dashun San (Great Harmony Powder)
Gancao (Licorice Root cut into inch-length pieces, 3 liang), Ganjiang (Dried Ginger), Xingren (Apricot Seed), Gui (Cinnamon Twig) (4 liang).
First, stir-fry Gancao with white sand until yellow. Then add Ganjiang and stir-fry together until the ginger cracks. Then add Xingren and stir-fry until no sound is produced. Sieve out the sand, add Gui and grind into powder. Take 2-3 qian each time, decoct in water and take warm. If irritable, mix well with well-water; taking with boiling water is also acceptable.
Shiwei Xiangru Yin (Ten-Ingredient Mosla Infusion)
Xiangru (Mosla Herb, 1 liang), Renshen (Ginseng Root), Chenpi (Tangerine Peel), Baizhu (Atractylodes Rhizome), Fuling (Poria), Huangqi (Astragalus Root), Mugua (Chaenomeles Fruit), Chuanpu (Stir-fried with Ginger), Bian Dou (Hyacinth Bean), Gancao (Roasted Licorice) (each half liang).
Grind into powder. Take 2 qian each time mixed with hot or cold water; chopping and decocting is also acceptable.
Qingshu Yiqi Tang (Clear Summerheat and Boost Qi Decoction) treats long summer damp-heat steaming people; upon contraction, limbs feel heavy and tired, spirit is low, reluctance to move, chest fullness and shortness of breath, joint pain, or high breathing and panting, body heat and irritability, epigastric distension and closure, yellow and frequent urination, loose and frequent stools, or dysentery or thirst, lack of appetite, spontaneous sweating, and physical weakness.
Huangqi (Astragalus Root), Cangzhu (Coarse Atractylodes Rhizome, chopped), Shengma (Cimicifuga Rhizome) (each 1 qian), Renshen (Ginseng Root), Baizhu (Atractylodes Rhizome), Shenqu (Medicated Leaven), Chenpi (Tangerine Peel) (each half qian), Gancao (Roasted Licorice), Jiubaicao (Wine-processed Phellodendron Bark), Maidong (Ophiopogon Tuber), Danggui (Angelica Sinensis Root) (each 3 fen), Gegen (Pueraria Root, 2 fen), Wuweizi (Schisandra Berry, 9 berries), Zexie (Alisma Rhizome, 5 fen), Qingpi (Green Tangerine Peel, 2.5 fen).
Chop the herbs. Make one dose, add two large cups of water, decoct to one cup, remove dregs, take warm, after meals.
Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction) see Internal Injury category.
Tianshui San (Celestial Water Powder)
Huashi (Talcum, 6 liang), Gancao (Roasted Licorice, 1 liang).
Grind into extremely fine powder. Mix with water and take.
Wuling San (Five-Ingredient Powder with Poria)
Baizhu (Atractylodes Rhizome), Zhuling (Polyporus), Fuling (Poria) (each 1.5 liang), Gui (Cinnamon Twig, 1 liang), Zexie (Alisma Rhizome, 2.5 liang).
Add Chencha (Cinnabar), named Chencha Wuling San (Cinnabar Five-Ingredient Powder with Poria).
Renshen Baihu Tang (Ginseng White Tiger Decoction) treats summerheat, thirst, and deficient pulse.
Renshen (Ginseng Root, 1.5 qian), Zhimu (Anemarrhena Rhizome, 2 qian), Shigao (Gypsum Fibrosum, half liang), Gancao (Licorice Root, 1 qian).
Chop the herbs. Add 1 he of Jingmi (Rice Grain), decoct in water and take.
Guiling Ganlu Yin (Cassia, Poria, and Honeyed Dew Decoction) (*from Xuansheng Fang*)
Fuling (Poria), Zexie (Alisma Rhizome) (each 1 liang), Shigao (Gypsum Fibrosum), Hanshuishi (Halloysitum Rubrum) (each 2 liang), Huashi (Talcum, 4 liang), Baizhu (Atractylodes Rhizome), Gui (Cinnamon Twig), Zhuling (Polyporus) (each half liang).
Grind into powder. Take 3 qian each time mixed with warm water.
Suopi Yin (Contract the Spleen Decoction) resolves latent heat, removes irritability and thirst, clears summerheat toxins, stops vomiting, diarrhea, and cholera.
Sharen (Amomum Fruit), Caoguo (Tsaoko Fruit), Wumei Rou (Dark Plum Flesh), Gancao (Roasted Licorice) (each 4 liang), Biandou (Fried Hyacinth Bean), Gegen (Pueraria Root) (each 1 liang).
Chop the herbs. Take 4 qian each time, decoct in water and take cold.
Lengxiang Yinzi (Cold Fragrance Infusion) treats summerheat injury with thirst, cholera abdominal pain and irritability, deep/faint pulse, or hidden pulse.
Caoguoren (Tsaoko Seed, 3 liang), Fuzi (Prepared Aconite Root), Chenpi (Tangerine Peel) (each 1 liang), Gancao (Licorice Root, half liang).
Chop the herbs. Take 1 liang each time, add ginger, decoct in water, and take when cooled.
Huanglian Jiedu Tang (Coptis Detoxification Decoction)
Huanglian (Coptis Rhizome), Huangbai (Phellodendron Bark), Huangqin (Scutellaria Root), Zhizi (Gardenia Fruit) (equal parts).
Chop the herbs. Decoct in water.