人有常言，伤暑做出百般病，其果浓诬哉？盖暑之入人，伏于三焦、肠胃之间，至有兼
旬累月而不可测识者，如呕吐、如中满、如泄泻、如下痢、如焦渴、如发疟、如腹痛、如下
血，以至诸热等证。苟因暑得之，其根未除，虽百药遍尝，难施其巧。夫人心包络与胃口相
应，胃气稍虚，或因饥冒暑，故暑气自口鼻而入，凝之于牙颊，达之于心胞络，如附应声。
遇暑以还，急漱口而勿咽可也，若觉暑毒逼塞咽喉，尤当灌涤而吐之。伤暑脉虚，面垢，自
汗，身热背寒，烦闷大渴，倦怠少气，毛耸恶寒，或头疼，或霍乱，或四肢厥冷，但身体无
痛。经云∶热则诸毛孔开，故洒然恶寒。体认不精，妄以伤暑为伤寒，误人不小。然而暑家
何以脉虚？暑能消气，气消则血散，脉安得而不虚？其或六脉沉伏，冷汗自出，闷绝而昏不
知人，此则中暑证候又加重耳。
治法大要，虽贵于驱暑，尤贵于和中，二者并行，则其间杂证不战而自屈。若汗、若下、
若用药差冷，古人戒之。虽然，夏月伏阴在内，暑家气虚脉虚，或饮水过多，或冷药无度，
伤动其中，呕吐不食，自利不渴，此则外热里寒，无惑乎伤暑伏热之说，非理中汤不可也。
又有冷药过度，胃寒停水，潮热而呕，或身热微烦，此则阳浮外而不内，非小半夏茯苓汤不
可也。抑犹有戒焉，暑家脉虚，面黧，冷汗，洒然毛耸，手足微寒，苟不明辨其里热之证，
误以刚剂投之，抱薪救焚，不发黄则发斑，甚者蓄血，闷乱而毙矣，吁！可畏哉。
人们常说，中暑会引发各种各样的疾病，这难道不是严重的夸大其词吗？暑邪侵入人体，潜伏在三焦（上、中、下三焦的总称）和肠胃之间，甚至经过数十天或数月都无法被察觉识别，表现为呕吐、胃脘胀满、泄泻、痢疾、极度口渴、发作疟疾样症状、腹痛、便血，以及其他的热证。如果是因为中暑而致病，病根未除，即使尝试上百种药物，也难以施展疗效。人的心包络（保护心脏的外膜及其相关功能系统）与胃口相应，若胃气稍虚，或因饥饿时冒犯暑气，暑气便从口鼻进入，凝结于牙颊，通达于心包络，如同回声应声般迅速。遇到暑气后，应立即漱口但不要咽下；如果感觉暑毒阻塞咽喉，更应当灌服催吐剂以吐出毒物。
伤暑的脉象虚弱，面色污浊晦暗，自汗，身体发热但背部发冷，心烦闷乱且极度口渴，倦怠乏力、气短，毫毛竖起并恶寒，或者头痛，或者霍乱，或者四肢厥冷，但身体没有疼痛感。《内经》说：热则腠理开泄，所以会有洒然恶寒的感觉。如果不能精准体认，错误地将伤暑当作伤寒治疗，对人的危害不小。然而，中暑患者为什么脉象虚弱？因为暑邪能消耗正气，正气消耗则血液散漫，脉象怎么能不虚弱呢？如果出现六部脉象沉伏，冷汗自出，昏闷窒息、昏迷不省人事，这是中暑证候加重的表现。
治疗的大要，虽然贵在驱除暑邪，但更贵在调和脾胃（和中），两者并行，那么夹杂的其他病症不战而自退。如果是发汗法、攻下法，或者用药过于寒凉，古人都对此有所禁忌。尽管如此，夏季体内潜伏阴寒之气，中暑患者气虚脉虚，如果饮水过多，或者无节制地服用冷药，损伤了中焦脾胃，出现呕吐、不能进食、自发性腹泻且不口渴，这属于外热里寒，不必怀疑是伤暑伏热的说法，非理中汤（温中散寒方剂）不可用。又有因冷药过度，导致胃寒停聚水饮，出现潮热而呕吐，或者身热微烦，这属于阳气浮越于外而不能内守，非小半夏茯苓汤（化痰止呕利湿方剂）不可用。
还要特别警惕的是，中暑患者脉象虚弱，面色黧黑枯槁，冷汗淋漓，毫毛竖起，手足轻微发凉，如果不明辨其里有热证的本质，错误地使用刚燥温热之剂投治，无异于抱薪救火，结果不是发黄疽就是发斑疹，严重的话会导致蓄血（瘀血内停），使人昏乱而死，唉！真是令人畏惧啊。
It is commonly said that heatstroke (Zhongshu) gives rise to myriad diseases; is this not a gross exaggeration? When pathogenic heat enters the human body, it lurks between the Sanjiao (Triple Burner) and the intestines and stomach. It may remain undetected for decades or months, manifesting as vomiting, epigastric fullness, diarrhea, dysentery, extreme thirst, malaria-like paroxysms, abdominal pain, hematochezia, and various other heat syndromes. If the disease originates from heatstroke, and the root cause remains uneliminated, even if hundreds of medicines are tried, their efficacy will be difficult to achieve. The Pericardium (Xinbao) corresponds to the stomach opening. If Stomach Qi is slightly deficient, or if one exposes oneself to heat while hungry, pathogenic heat enters through the mouth and nose, condenses in the teeth and cheeks, and reaches the Pericardium swiftly, like an echo responding to sound. Upon exposure to heat, one should rinse the mouth immediately without swallowing. If one feels pathogenic heat blocking the throat, it is imperative to induce vomiting to expel the toxin.
The pulse in heat injury is weak; the face appears grimy and dull; there is spontaneous sweating, body heat with coldness in the back, mental restlessness and extreme thirst, fatigue and shortness of breath, piloerection with aversion to cold, headache, cholera-like symptoms, or cold extremities, yet the body lacks pain. The Classics state: "Heat causes the pores to open, thus resulting in a chill." Failure to recognize this precisely and mistakenly treating heat injury as cold damage (Shanghan) causes significant harm. Why is the pulse weak in heatstroke? Heat consumes Qi; when Qi is consumed, Blood scatters, so how can the pulse not be weak? If all six pulse positions are deep and hidden, with spontaneous cold sweat, suffocation, coma, and unconsciousness, this indicates a severe exacerbation of the heatstroke syndrome.
The general principle of treatment values dispelling heat, but places even greater emphasis on harmonizing the Middle Jiao (Zhonghe). When both approaches are applied concurrently, complicated syndromes will subside without resistance. Methods such as diaphoresis (sweating), purgation, or using excessively cold medications are cautioned against by ancient masters. Nevertheless, in summer, Yin latent within the interior combined with Qi deficiency and a weak pulse in heatstroke patients, especially if they drink excessive water or consume cold medicines without restraint, can injure the Middle Jiao. This leads to vomiting, anorexia, spontaneous diarrhea without thirst, indicating exterior heat and interior cold. In such cases, the theory of heatstroke with latent heat applies, and Lizhong Tang (Regulate the Middle Decoction) is indispensable. Furthermore, excessive intake of cold medicines may cause Cold in the Stomach with retained fluids, leading to tidal fever with vomiting, or slight body heat with mild irritability. This represents Yang floating externally without returning inward, requiring Xiaobanxia Fuling Tang (Minor Pinellia and Poria Decoction).
One must remain vigilant: heatstroke patients present with a weak pulse, sallow complexion, cold sweat, piloerection, and slightly cold hands and feet. If one fails to clearly distinguish the underlying heat syndrome and erroneously administers harsh, warm-tonifying agents, it is akin to carrying firewood to save a burning house. The result will be jaundice or maculopapular eruptions; in severe cases, blood stasis may accumulate, leading to confusion and death. Alas, how terrifying this is!