伏暑发热，喘不得卧，痰嘶胸板，此暑滞肺络。
宜用葶苈大枣汤合六一散、枇杷叶等味，彻清肺饮
也。
上条胁痛痰多而咳，此条胸板痰嘶而喘，病甚深于咳
矣。虽喘有虚实之分，治有肺肾之异。今由伏暑内发，身热
胸板痰嘶，其候舌必黄腻，脉必滑数，溺必黄赤，体必丰盛，
斯为肺实，故宜葶苈苦寒以泻肺热。然古人犹恐损胃，合大
枣之甘以缓之，得渐驯以除上焦之软。凡用葶苈而不用大枣
者，末识仲景之心法也。再兼六一、枇杷叶，清气利湿也。
伏暑恶寒发热，乍有乍无，或轻或重，如疟非
疟，舌白脉大，此暑必挟湿，薰蒸粘腻之邪，伏于肺
胃。宜用温胆汤加杏仁、通草、青蒿、黄芩等味，通
胃泄邪也。
凡伏暑湿，亦有轻重之分。其重者 势难延缓，乘时窃
发;其轻者，直至露冷气肃，金飙飒爽，阳气渐收，腠理渐
闭，所伏之邪，遂无隙可容，然后发出。其见症，如疟非疟，
或有微寒，或单发热，但无六经之可辨，无表里之可分。其
舌白，其脉大者，正虚湿盛也明矣。若不从中驱泄，必致变
成疟患。故用温胆汤通胃腑，加杏仁，通草清肋泄湿，黄芩、
青蒿清气泄肝，则邪可尽解也。
伏暑热甚，烦躁昏谵，至夜更甚，舌燥脉数，此
邪传入里。宜用沙参、甜杏仁、花粉、川贝、桑叶、
细生地、鲜菖蒲、连翘、益元散等味，两清营卫也。
此言伏邪不解，渐化为热也。烦躁昏谵，夜则尤甚，乃
由卫入营，从阳转阴。故舌必渐燥，脉必渐数。邪既入里，
徙清表分，无益于事，惟用沙参、杏仁、川贝、花粉、生地、
桑叶、连翘，菖蒲、益元散，清气凉血，不致传陷入血，可
免昏痉之变。
伏暑病出现发热，气喘严重到无法平卧，喉间痰鸣音重且胸部痞闷板硬，这是暑邪阻滞于肺络所致。
适宜使用葶苈大枣汤（Tingli Dazao Decoction）合六一散（Liuyi Powder）、枇杷叶等药物，以彻底清除肺部的郁热。
上一条论述的是胁痛、痰多且咳嗽的症状，这一条论述的是胸部痞闷板硬、痰鸣音重且气喘的症状，病情比单纯的咳嗽更为深重。虽然气喘有虚证和实证的区分，治疗上有针对肺脏和肾脏的不同侧重。如今由于伏藏的暑邪从体内发作，身体发热、胸部痞闷板硬、痰鸣音重，其征象表现为舌苔必定黄腻，脉象必定滑数，小便必定黄赤，体质必定丰盛壮实，这属于肺气实证，因此适宜用葶苈子的苦寒之性来泻除肺热。然而古人仍然担心苦寒伤及胃气，所以配合大枣的甘味来缓和药性，使药效逐渐驯服地消除上焦的痰湿壅滞。凡是使用葶苈子却不用大枣的，是不了解张仲景（Zhang Zhongjing）的心法精髓。再兼用六一散和枇杷叶，是为了清气分热并利湿。
伏暑病出现恶寒发热，症状时轻时重、时有时无，像疟疾又不是疟疾，舌苔白，脉象大，这是暑邪必定夹杂湿气，这种熏蒸粘腻的病邪潜伏在肺和胃中。适宜使用温胆汤（Wendan Decoction）加杏仁（Apricot Seed）、通草（Tetrapanacis Medulla）、青蒿（Artemisiae Annuae Herba）、黄芩（Scutellariae Radix）等药物，以疏通胃腑、泄出邪气。
凡是有伏暑夹湿的情况，也有轻重之分。病情重的，势态难以延缓，会趁时机突然发作；病情轻的，直到秋露冷气肃杀，秋风飒爽，阳气逐渐收敛，腠理逐渐闭合，所潜伏的邪气便没有空隙可以容纳，然后才发散出来。其出现的症状，像疟疾又不是疟疾，或者伴有轻微恶寒，或者只有发热，但没有六经（Six Channels）辨证的可辨之处，也没有表里（Exterior and Interior）分辨的依据。其舌苔白，脉象大的，显然是正气虚弱而湿气旺盛。如果不从中焦驱除泄出邪气，必然导致演变成疟疾病患。因此使用温胆汤来疏通胃腑，加入杏仁和通草以清肋部、泄除湿气，加入黄芩和青蒿以清气分、泄肝火，这样邪气就可以完全解除。
伏暑病热势很盛，烦躁不安甚至神志昏迷胡言乱语，到了夜晚更加严重，舌面干燥，脉象数急，这是邪气传入体内深处。适宜使用沙参（Glehniae Radix）、甜杏仁（Sweet Apricot Seed）、花粉（Trichosanthis Radix）、川贝母（Fritillariae Cirrhosae Bulbus）、桑叶（Mori Folium）、细生地（Rehmanniae Radix Preparata）、鲜石菖蒲（Acori Tatarinowii Rhizoma Fresh）、连翘（Forsythiae Fructus）、益元散（Yiyuan Powder）等药物，以同时清解营分和卫分的邪热。
这里说的是伏藏的邪气未能解除，逐渐转化为热邪。烦躁、神志昏迷胡言乱语，夜间尤其严重，这是由卫分进入营分，从阳转阴的表现。因此舌苔必定逐渐变干，脉象必定逐渐变快。邪气既然已经入里，如果仅仅清解表分，对病情没有帮助，只有使用沙参、杏仁、川贝母、花粉、生地、桑叶、连翘、石菖蒲、益元散，清气凉血，防止邪气传变陷入血分，可以避免发生昏厥和抽搐的变证。
In cases of latent summerheat (Latent Summerheat) presenting with fever, severe asthma (Asthma) preventing lying flat, hoarse phlegm sounds, and a stiff, oppressive sensation in the chest, this indicates summerheat stagnation obstructing the lung collaterals.
It is appropriate to use Tingli Dazao Decoction (Celandine and Jujube Decoction) combined with Liuyi Powder (Six-to-One Powder), Loquat Leaf, and other ingredients, to thoroughly clear the lung heat.
The previous clause discussed symptoms of hypochondriac pain, excessive phlegm, and cough; this clause discusses symptoms of chest oppression/stiffness, hoarse phlegm sounds, and asthma, indicating the disease is deeper than mere cough. Although asthma has distinctions between deficiency and excess syndromes, and treatments differ between targeting the Lung and Kidney, in this case, due to the internal emergence of latent summerheat, accompanied by body fever, chest oppression, and hoarse phlegm, the signs must include a yellow and greasy tongue coating, a slippery and rapid pulse, yellow-red urine, and a robust/abundant physique. This constitutes an Excess Syndrome of the Lung (Lung Excess). Therefore, it is suitable to use the bitter-cold nature of Celandine Fruit (Fructus Lepidii) to drain lung heat. However, ancient physicians feared damage to the stomach, so they combined it with the sweet nature of Jujube (Fructus Ziziphus Jujubae) to moderate the effect, allowing the medicine to gradually tame and eliminate the damp-phlegm obstruction in the Upper Jiao. Those who use Celandine Fruit without Jujube fail to understand the core methodology of Zhang Zhongjing. Additionally, combining Liuyi Powder and Loquat Leaf serves to clear qi-level heat and promote diuresis to remove dampness.
Latent summerheat presenting with aversion to cold and fever, fluctuating in intensity and intermittently appearing, resembling malaria but not being malaria, with a white tongue coating and a large pulse, indicates that summerheat is necessarily complicated by dampness. This miasmic, sticky, and turbid pathogen lies latent in the Lung and Stomach. It is appropriate to use Wendan Decoction (Warm the Gallbladder Decoction) added with Apricot Seed (Semen Armeniacae Amarum), Tetrapanacis Medulla (Medulla Tetrapanacis), Artemisiae Annuae Herba (Herba Artemisiae Annuae), and Scutellariae Radix (Radix Scutellariae) to unblock the Stomach Fu organ and vent the pathogen.
Cases of latent summerheat with dampness also have distinctions in severity. In severe cases, the momentum is difficult to delay, and the pathogen emerges suddenly when conditions are ripe; in mild cases, the pathogen remains latent until the autumn dew brings cold air, the wind becomes crisp, yang qi gradually收敛 (converges/retracts), and the interstices (Cou Li) close, leaving no gap for the latent pathogen, which then finally emerges. The manifested symptoms resemble malaria but are not malaria, possibly accompanied by slight aversion to cold or only fever, without distinguishable Six Channel (Six Channels) patterns or separable Exterior-Interior (Exterior and Interior) relationships. A white tongue coating and a large pulse clearly indicate deficient righteous qi and abundant dampness. If the pathogen is not driven out from the middle jiao, it will inevitably transform into a malaria disorder. Therefore, using Wendan Decoction to unblock the Stomach Fu, adding Apricot Seed and Tetrapanacis Medulla to clear the hypochondrium and vent dampness, and adding Scutellariae Radix and Artemisiae Annuae Herba to clear qi-level heat and vent liver fire, allows the pathogen to be completely resolved.
When latent summerheat presents with intense heat, restlessness, delirium, and confusion, worsening at night, with a dry tongue and rapid pulse, this indicates the pathogen has transmitted inward. It is appropriate to use Glehniae Radix (Radix Glehniae), Sweet Apricot Seed (Semen Armeniacae Amarum), Trichosanthis Radix (Radix Trichosanthis), Fritillariae Cirrhosae Bulbus (Bulbus Fritillariae Cirrhosae), Mori Folium (Folium Mori), Rehmanniae Radix Preparata (Radix Rehmanniae Preparata), fresh Acori Tatarinowii Rhizoma (Rhizoma Acori Tatarinowii), Forsythiae Fructus (Fructus Forsythiae), and Yiyuan Powder (Yiyuan Powder) to simultaneously clear both the Ying (Nutrient) and Wei (Defensive) levels.
This passage states that unresolved latent pathogens gradually transform into heat. Restlessness, delirium, and confusion, worsening at night, indicate the pathogen has moved from the Wei level to the Ying level, transitioning from Yang to Yin. Thus, the tongue coating becomes increasingly dry, and the pulse becomes increasingly rapid. Since the pathogen has entered the interior, merely clearing the exterior level is of no benefit. Only by using Glehniae Radix, Apricot Seed, Fritillariae Cirrhosae Bulbus, Trichosanthis Radix, Rehmanniae Radix Preparata, Mori Folium, Forsythiae Fructus, Acori Tatarinowii Rhizoma, and Yiyuan Powder to clear qi-level heat and cool blood can one prevent the pathogen from transmitting into the Blood level, thereby avoiding complications such as coma and convulsions.