尝观医书林立,并无伏暑之名。惟(己任编)有
秋时晚发,以感证之法治之一语,因着伏暑之称。盖
人于盛暑之际,汗泄气疏,百节弛涨,设或有隙,
邪乘虚入,《内经》所谓至虚之处,便是容邪之处
也(1)。又云:春伤于风,夏必餐(2)泄,夏伤于暑,秋必
发疟;秋伤于燥(3),冬生咳嗽;冬伤于寒,春必病温。
可知四时伏气,皆能为病。即伏寒、伏风、伏燥,皆
可与伏暑立名主病。故春温为冬令之伏寒,肠风为春
令之伏风,疟痢为夏间之伏暑,咳嗽为秋天之伏燥,
以类而推。古人治病立法,良有以也,藉后人语焉不
察,漫不关心耳。予苦心斯道,廿载虚名,何敢妄为
(1)至虚之处,便是容邪之处也:按《内经》有此文·但无此语。
(2)餐:此处音、义俱同,飧,下问。
(3)燥:(内经)中俱作"湿"。
议论。特前贤既启其端,后人末穷其旨,聊为引伸,
以备葑菲之遗,庶可测伏暑之有由名。且不但可测伏
暑之有由名,更可测伏暑之有由病,而有由治焉矣。
伏暑秋发,头痛无汗,恶寒发热,身痛,胸腹满
闷,或吐或泻,此新感外邪,引动伏暑。宜用香莆饮
合正气散,表里两和也。
此伏暑之提纲。凡夏间伏暑,因遇秋令凄惀之寒,袭于
腠理,致内邪亦为引动·故无汗头痛身疼,发热恶寒,系新
感之见证,病尚在表。胸腹满闷,吐泻交作,系伏暑之发
动,病涉在里。大凡看法,须辨明新感与伏邪,何有何无,
孰轻孰重。故用香薷饮合正气散者。藉香薷、藿香,苏叶、
芷、桔之苦辛走表而散新邪,夏、朴、陈皮、大腹、神曲之
辛温理中而疏伏邪,则内外办通彻,邪自疏泄矣。
我曾经观察医书林立,并没有“伏暑”这一名称。只有《己任编》中有“秋时晚发,以感证之法治之一语”,因此确立了“伏暑”的名称。大概是因为人在盛夏之际,汗出气疏,关节弛缓肿胀,如果身体有间隙,邪气便乘虚而入,《内经》所说的“至虚之处,便是容邪之处也”(1)。又说:春伤于风,夏必飧泄(2);夏伤于暑,秋必发疟;秋伤于燥(3),冬生咳嗽;冬伤于寒,春必病温。可知四季的伏气,都能导致疾病。即使是伏寒、伏风、伏燥,都可以与伏暑并列作为命名和主治疾病的依据。所以春温是冬季潜伏的寒邪所致,肠风是春季潜伏的风邪所致,疟疾痢疾是夏季潜伏的暑邪所致,咳嗽是秋季潜伏的燥邪所致,以此类推。古人治病立法,确实有其道理,只是后人言语考察不细致,漫不经心罢了。我苦心钻研此道,二十载虚名,怎敢妄加议论。(1)至虚之处,便是容邪之处也:按《内经》有此文,但无此语。(2)餐:此处音、义俱同,飧,下问。(3)燥:(内经)中俱作“湿”。特以前贤既然开启了端绪,后人未能穷尽其旨意,我姑且加以引申,以备采择,或许可以推测伏暑之所以命名的由来。而且不但可以推测伏暑之所以命名的由来,更可推测伏暑之所以致病的缘由,以及治疗的法则了。
伏暑在秋季发作,头痛无汗,恶寒发热,身痛,胸腹满闷,或吐或泻,这是新感外邪引动了伏暑。适宜使用香薷饮合正气散,以调和表里。
这是伏暑的提纲。凡是夏季潜伏的暑邪,因为遇到秋季凄冷的寒气,侵袭腠理,导致内邪也被引动,所以无汗、头痛、身疼、发热、恶寒,是新感的见证,病尚在表。胸腹满闷,吐泻交作,是伏暑的发动,病涉在里。大凡诊察看法,必须辨明新感与伏邪,何者存在何者不存在,孰轻孰重。所以用香薷饮合正气散,借香薷、藿香、苏叶、芷、桔梗之苦辛走表而发散新邪,半夏、厚朴、陈皮、大腹皮、神曲之辛温理中而疏解伏邪,则内外通达彻透,邪气自然疏泄了。
Lu Tingzhen Zixian of Chongming authored this; Qiu Shiyun Yuchu of Shaoxing re-collated it.
I have observed that among the numerous medical books, there is no mention of "Fu Shu" (Latent Summerheat). Only in *Jiren Bian* (Compilation of Self-Reliance) is there a phrase stating, "Late onset in autumn, treated with methods for exogenous patterns," which led to the establishment of the term "Fu Shu." This is because during the height of summer, sweat flows and qi becomes sparse, joints become flaccid and swollen. If there are gaps or weaknesses, pathogenic factors enter due to deficiency. As stated in *Neijing* (The Inner Canon), "The most deficient places are where pathogens reside"(1). It also states: Wind injury in spring leads to undigested stool diarrhea in summer; Summerheat injury in summer leads to malaria in autumn; Dryness injury in autumn leads to cough in winter; Cold injury in winter leads to warm diseases in spring. Thus, it can be known that latent qi from the four seasons can all cause disease. Even latent cold, latent wind, and latent dryness can be named and treated alongside latent summerheat. Therefore, Spring Warmth is caused by latent cold from winter; Intestinal Wind is caused by latent wind from spring; Malaria and dysentery are caused by latent summerheat from summer; Cough is caused by latent dryness from autumn. By analogy, one can deduce others. The ancients' legislation for treating diseases was indeed well-founded, but later generations failed to examine these words carefully and paid little attention. I have devoted myself to this field for twenty years under a false reputation; how dare I make rash comments? (1) "The most deficient places are where pathogens reside": According to *Neijing*, this text exists, but not this exact phrasing. (2) Can: Here pronunciation and meaning are identical to Sun (undigested stool diarrhea). (3) Zao: In *Neijing*, it is uniformly written as Shi (Dampness). Since former sages had already initiated this line of inquiry, and later generations did not exhaust its principles, I merely extend it slightly, leaving it for selection, so that one may infer the origin of the name "Fu Shu." Moreover, not only can one infer the origin of the name, but also the etiology of the disease and its treatment.
When Fu Shu manifests in autumn, symptoms include headache, absence of sweating, aversion to cold and fever, body pain, chest and abdominal fullness and oppression, or vomiting and diarrhea. This indicates that new exogenous pathogens are triggering latent summerheat. Xiangru Yin (Elsholtzia Decoction) combined with Zhengqi San (Regulating Qi Powder) should be used to harmonize both exterior and interior.
This serves as the outline for Fu Shu. Generally, summerheat latent during summer, when exposed to the chilly cold of autumn, invades the Couli (interstitial spaces/skin pores), thereby stirring up internal pathogens. Thus, absence of sweating, headache, body ache, fever, and aversion to cold are signs of new external contraction, indicating the disease remains at the Exterior level. Chest and abdominal fullness/oppression, along with alternating vomiting and diarrhea, indicate the activation of latent summerheat, involving the Interior level. In general diagnostic assessment, one must clearly distinguish between new contraction and latent pathogens, determining what exists and what does not, and assessing their relative severity. Therefore, Xiangru Yin combined with Zhengqi San is employed. Elsholtzia, Agastache, Perilla Leaf, Angelica Dahurica, and Platycodon use bitter and acrid properties to travel to the exterior and disperse new pathogens. Pinellia, Magnolia Bark, Tangerine Peel, Areca Peel, and Medicated Leaven use acrid and warm properties to regulate the middle jiao and resolve latent pathogens. Consequently, the interior and exterior are thoroughly unblocked, and pathogens are naturally dispersed and excreted.