伤暑，脉洪而虚。
大蒜新汲水方
治中暑法。
大蒜一把，同新黄土研烂。以新汲水和之，滤去渣，灌入即活。凡中暑伤者，不可便与
冷物。俟稍苏，方可投冷物，则中气运动无患也。
田中干泥圈脐方
治中暑昏眩，烦闷欲绝，急救法。
取田中干泥，做一圈，堆在病患肚上。使少壮人撒尿于泥圈肚脐中，片时即得生苏矣。
后不可饮冷汤，须进温米汤。
丝瓜白梅方
治中暑霍乱。
丝瓜叶（一片） 白霜梅（一枚，并核中仁）
上同研极烂，将新汲水调服。入口立瘥，切不可饮热汤。
陈皮藿香汤
治伤暑急暴霍乱吐泻方。
陈皮（五钱） 藿香（五钱）
上用土澄清水二杯，煎一杯，服之立愈。
扁豆饮
治伤暑。
取扁豆叶捣汁一碗，饮之立愈。
盐姜汤
治伤暑霍乱，上不得吐，下不得泻，身出冷汗，危在顷刻者。
食盐（一两） 生姜（五钱，切片）
同炒变色，以水一大碗煎服，吐出自愈。不可热服，好后切不可遽吃饭食，俟饿极后，
方可吃稀粥。
取新汲水法（俱见《种福堂》）
治中暑昏眩，烦闷欲绝。急救，挖地深三尺，取新汲水倾入坑内，搅浊，饮数瓯即愈。
（肿者，肿于外，胀者，胀于内。二症宜分看。然二症相因亦宜合看。）
肿者，皮肤肿大。古人有气水之分，其实气滞则水不行，水不行则气愈滞，二者相因为
病。水胀篇，以按其腹 而不起者，为气肿；按其腹随手而起，如囊裹水之状者，为水肿
。景岳反其说，以水症按之 而不起，此水在肉中，如糟如泥之象，未必如水囊之比；
按之随起，惟虚无之气，其速乃然。余阅历之久，知二说亦不必拘。大抵肿微则按之随起，肿甚则按之不起。两胁及转
动之处，按之即起；足面及膝股内侧，按之不起。辨症不必以此为凭。当于小便之利与不利，以
分阴阳。身之多热与多寒，脉之洪大与细微，以分寒热。病之起于骤然，与成于积渐，及年
高多病，与少壮无病之人，分其虚实。以先腹而后四肢，或先四肢而后及于腹，分其顺逆
。景岳云∶水气本为同类。治水者当兼理气，盖气化水自化也；治气者亦当兼行水，以气
行而水亦行也。此症当与癃闭症参看。
初患肿病，气喘不得卧，以五皮饮为第一方。盖此方以皮治皮，不伤中气，所以为妙。
若肿而兼胀，小水不利，宜胃苓汤主之。或以四苓散，以半熟蒜捣丸服，极妙。
五皮散
按上身肿，宜发汗，加苏叶、荆芥、秦艽各一钱五分；下体肿，宜利水，加赤小豆、木通各一钱五分，防己一钱。
口渴多热，小便不利，为阳水，加滑石、木通、车前子、麦冬各一钱五分，木香五分；
不渴，小便自利，多寒，为阴水，加白术、苍术各二钱，附子、干姜、木香各一钱。
脉滑实，腹胀胁满，加生菔子一钱五分、白芥子八分、枳实一钱、半夏二钱。
妇人经水不调而肿，是血化为水，名水分，加红花八分，桃仁、香附各一钱五分；妇人
经水适断即肿，是水化为血，名气分，加当归三钱、五灵脂醋炒一钱五分、香附一钱五分。
按服此方愈后，必加减肾气丸及六君子汤之类收功。
胃苓散（俱见《妙用》）
四苓散加味为丸
白术（一两，炒） 茯苓（二两） 猪苓（一两） 泽泻（一两）
研末，以半熟蒜为丸，如绿豆大，开水送下三五钱。
肿症，积渐而成，及久而不愈。气喘口渴，不卧，腹胀，小便短少，大便微溏，一切危
症，不外薛氏加减肾气丸主之。
张景岳曰∶《内经》云∶肾为胃关，开门不利，故聚水而从其类也。然关门而何以不利也？《经》
曰∶膀胱者，州都之官，津液藏焉，气化则能出矣。夫所谓气化者，即肾中之气也，即阴中
之火也。阴中无阳，则气不能化，所以水道不通，溢而为肿。故凡治气者，必先治水；治水
者，必先治气。若气不能化，则水必不利。惟下焦之真气得行，始能传化。惟下焦之真水得位
，始能厘清。求之古法，惟薛立斋先生加味肾气丸，诚对症之方也。余屡用之，无不见效。
薛氏加减肾气丸
熟地（四两） 茯苓（三两） 牛茱肉 山药 丹皮 牛膝 泽泻 车前 肉桂（各一两） 附子（五钱）
炼蜜丸如桐子大。每服三钱，开水送下，一日两服。如素禀阳盛，三焦多火，烦渴，面
赤喘嗽，脉滑实，此湿热相因，阴虚之证，去桂、附，加麦冬主之。
《医学心悟》云∶下焦湿热，去桂、附，加黄柏、蛤蜊粉最妙。
麻黄附子汤（方见《金匮》）
去附子加杏子、石膏，名杏子汤。
又《明医指掌》云∶肿势太盛，内而膀胱，外而阴囊，相连紧急，阻塞道路。虽加利
水之剂，苦无一线之通，病何由去。必开大便以逐其水，随下而随补，则病已去而脾无恙。
渐为调理，庶可得生。慎毋守利水之旧规也。如肿势未盛，还以利水为上策。
按∶此法惟少年体壮，可以偶用，否则不可轻试。
伤暑，脉象洪大而按之空虚。
大蒜新汲水方
治疗中暑的方法。
取一把大蒜，与新鲜黄土一起研磨成泥状。用刚打上来的井水调和，过滤掉药渣，灌服即可苏醒。凡是中暑受伤的人，不可立即给予冷物。等到患者稍微清醒后，才可以投予冷物，这样中气运行就不会有祸患了。
田中干泥圈脐方
治疗中暑导致昏眩、烦闷欲绝的急救方法。
取田地里的干泥土，做成一个圆圈，堆放在患者的肚子上。让年轻力壮的人在泥圈的肚脐部位撒尿，片刻之后患者就能苏醒过来。此后不可饮用冷汤，必须进服温热的米汤。
丝瓜白梅方
治疗中暑引起的霍乱。
丝瓜叶（一片）、白霜梅（一枚，连同核中的仁）
以上两味药一起研磨至极烂，用新汲水调匀服用。入口后立即痊愈，切不可饮用热汤。
陈皮藿香汤
治疗伤暑引起的急暴霍乱吐泻的方子。
陈皮（五钱）、藿香（五钱）
以上两味药用澄清过的土井水两杯，煎煮至一杯，服用后立即痊愈。
盐姜汤
治疗伤暑引起的霍乱，症见上不能吐、下不能泻，身上出冷汗，生命垂危在顷刻之间者。
食盐（一两）、生姜（五钱，切片）
一同炒至变色，用一大碗水煎煮后服用，吐出后自然痊愈。不可热服，病好后切不可立即吃饭食，等到极度饥饿后，才可以吃稀粥。
取新汲水法（均见于《种福堂》）
治疗中暑导致的昏眩、烦闷欲绝的急救方法。挖地深三尺，将新汲水倒入坑内，搅浑，饮用几口即可痊愈。
（肿，是指体表皮肤肿胀；胀，是指体内腹部胀满。这两种症状应当分开看待。然而二者相互关联，也应当合起来看。）
肿，是指皮肤肿大。古人有气和水的区分，其实气滞则水不行，水不行则气更加阻滞，二者互为因果致病。《灵枢·水胀篇》中，按压腹部凹陷不起的，称为气肿；按压腹部随手而起，像囊袋裹着水的样子的，称为水肿。张景岳反驳了这种说法，认为水证按压凹陷不起，是因为水在肌肉之中，像糟粕或泥浆的样子，未必像水囊那样；按压随手起，只有虚无之气才会这么快恢复。我阅历已久，知道这两种说法也不必拘泥。大抵肿轻微时按压随手而起，肿严重时按压不起。两胁及身体转动之处，按压即起；足面及膝股内侧，按压不起。辨别症状不必以此为凭据。应当根据小便的通利与否，来分辨阴阳。根据身体的多热或多寒，脉象的洪大或细微，来分辨寒热。根据病的起于骤然，还是形成于积渐，以及年老多病之人，与少壮无病之人，来分辨虚实。根据先腹部后四肢，或先四肢后波及腹部，来分辨顺逆。张景岳说：水气本为同类。治水者应当兼理气，因为气化则水自化；治气者也应当兼行水，因为气行而水亦行。此症应当与癃闭症参看。
初患肿病，气喘不能平卧，以五皮饮为第一方。因为这个方子以皮治皮，不伤中气，所以为妙。
如果肿兼有胀，小便不利，宜用胃苓汤主治。或者用四苓散，配合半熟蒜捣制成丸服用，极妙。
五皮散
按：上身肿，宜发汗，加苏叶、荆芥、秦艽各一钱五分；下体肿，宜利水，加赤小豆、木通各一钱五分，防己一钱。
口渴多热，小便不利，为阳水，加滑石、木通、车前子、麦冬各一钱五分，木香五分；
不渴，小便自利，多寒，为阴水，加白术、苍术各二钱，附子、干姜、木香各一钱。
脉滑实，腹胀胁满，加生菔子一钱五分、白芥子八分、枳实一钱、半夏二钱。
妇人经水不调而肿，是血化为水，名为水分，加红花八分，桃仁、香附各一钱五分；妇人经水适断即肿，是水化为血，名为气分，加当归三钱、五灵脂醋炒一钱五分、香附一钱五分。
按：服用此方痊愈后，必须加减肾气丸及六君子汤之类收功。
胃苓散（均见于《妙用》）
四苓散加味为丸
白术（一两，炒）、茯苓（二两）、猪苓（一两）、泽泻（一两）
研成粉末，用半熟蒜做丸，如绿豆大小，开水送下三五钱。
肿症，积渐而成，及久而不愈。气喘口渴，不能平卧，腹胀，小便短少，大便微溏，一切危症，不外乎薛氏加减肾气丸主治。
张景岳说：《内经》云：肾为胃关，开门不利，故聚水而从其类也。然而关门为何不利呢？《经》曰：膀胱者，州都之官，津液藏焉，气化则能出矣。所谓气化，就是肾中之气，也就是阴中之火。阴中无阳，则气不能化，所以水道不通，溢而为肿。所以凡治气者，必先治水；治水者，必先治气。若气不能化，则水必不利。只有下焦的真气得行，始能传化。只有下焦的真水得位，始能厘清。求之于古法，只有薛立斋先生的加味肾气丸，诚然是对症的方子。我屡次使用，没有不见效的。
薛氏加减肾气丸
熟地黄（四两）、茯苓（三两）、山茱萸、山药、牡丹皮、牛膝、泽泻、车前子、肉桂（各一两）、附子（五钱）
炼蜜为丸，如梧桐子大。每服三钱，开水送下，一日两次服用。如果素禀阳盛，三焦多火，烦渴，面赤喘嗽，脉滑实，这是湿热相因，阴虚之证，去掉肉桂、附子，加麦冬主治。
《医学心悟》说：下焦湿热，去掉肉桂、附子，加黄柏、蛤蜊粉最妙。
麻黄附子汤（方见《金匮要略》）
去掉附子加杏子、石膏，名为杏子汤。
又《明医指掌》说：肿势太盛，内连膀胱，外连阴囊，相连紧急，阻塞道路。虽然加利水之剂，苦无一线之通，病从何去。必须开大便以逐其水，随下而随补，则病已去而脾无恙。渐为调理，庶可得生。千万不要守持利水的旧规。如果肿势未盛，还以利水为上策。
按：此法只适用于少年体壮者，可以偶尔使用，否则不可轻试。
Heatstroke presents with a pulse that is surging (Hong) yet empty upon pressure.
Garlic and Fresh Well Water Prescription
Method for treating heatstroke.
Take one bunch of garlic, grind it thoroughly together with fresh yellow earth. Mix with freshly drawn well water, filter out the dregs, and administer orally to restore consciousness. For those injured by heatstroke, cold substances must not be administered immediately. Wait until the patient regains slight consciousness before administering cold substances; this ensures the movement of Middle Qi (Middle Jiao energy) without causing harm.
Dried Field Mud Circle Around Umbilicus Method
Emergency method for treating heatstroke-induced vertigo, severe oppression, and impending collapse.
Take dried mud from fields, form it into a circle, and pile it on the patient's abdomen. Have a young, robust person urinate into the center of the mud circle over the umbilicus; the patient will revive within a short time. Afterwards, do not drink cold liquids; warm rice soup must be ingested.
Luffa Leaf and White Frost Plum Prescription
Treating heatstroke-induced cholera-like vomiting and diarrhea.
Luffa leaf (one piece), White frost plum (one piece, including the kernel).
Grind these two ingredients together until extremely fine. Mix with freshly drawn well water and take orally. Recovery occurs immediately upon ingestion. Do not drink hot liquids.
Tangerine Peel and Agastache Decoction
Prescription for acute heatstroke-induced cholera with sudden vomiting and diarrhea.
Chenpi (Aged Tangerine Peel, 5 qian), Huoxiang (Patchouli, 5 qian).
Use two cups of clarified well water, decoct to one cup, and administer for immediate recovery.
Lablab Bean Drink
Treating heatstroke.
Extract juice from Lablab bean leaves, take one bowl orally for immediate recovery.
Salt and Ginger Decoction
Treating heatstroke-induced cholera where there is inability to vomit or defecate, accompanied by cold sweat and imminent danger.
Table salt (1 liang), Fresh ginger (5 qian, sliced).
Stir-fry together until color changes. Decoct in one large bowl of water and administer. Spontaneous recovery follows vomiting. Do not take hot. After recovery, do not eat solid food immediately; wait until extreme hunger before consuming thin porridge.
Method for Obtaining Fresh Well Water (All found in *Zhongfu Tang*)
Emergency treatment for heatstroke-induced vertigo and severe oppression.
Dig a pit three chi deep. Pour fresh well water into the pit, stir until turbid, and drink several mouthfuls for recovery.
(Swelling [Zhong] refers to external skin edema; distension [Zhang] refers to internal abdominal fullness. These two conditions should be viewed separately. However, since they are interrelated, they should also be viewed together.)
Swelling refers to enlarged skin. The ancients distinguished between Qi and Water. In reality, Qi stagnation leads to Water stasis, and Water stasis exacerbates Qi stagnation; the two cause disease mutually. In the *Shuizhang* chapter of the *Ling Shu*, pressing the abdomen leaving an indentation that does not rise is called Qi swelling; pressing the abdomen where the indentation rises immediately, resembling a bag wrapped around water, is called Water swelling. Zhang Jingyue reversed this theory, stating that for Water syndromes, if pressing leaves an indentation that does not rise, it is because water is in the flesh, resembling dregs or mud, not necessarily like a water bag; if it rises immediately upon release, it is due to deficient emptiness of Qi. Having extensive clinical experience, I know neither theory should be rigidly adhered to. Generally, mild swelling rises immediately upon pressure, while severe swelling does not. Areas such as the hypochondrium and joints rise immediately upon pressure; the dorsum of the foot and medial knee/thigh do not. Differentiation of symptoms should not rely solely on this. One should differentiate Yin and Yang based on the patency or obstruction of urination. Differentiate Cold and Heat based on whether the body exhibits more heat or cold, and whether the pulse is surging/large or thready/fine. Differentiate Deficiency and Excess based on whether the disease arose suddenly or developed gradually, and whether the patient is elderly and sickly or young and robust. Differentiate favorable and unfavorable progression based on whether swelling starts in the abdomen then spreads to limbs, or vice versa. Zhang Jingyue stated: Water and Qi belong to the same category. Those treating Water must simultaneously regulate Qi, for when Qi transforms, Water transforms; those treating Qi must simultaneously promote Water flow, for when Qi moves, Water moves. This condition should be referenced alongside Lin Syndrome (dysuria/retention).
For initial onset of swelling with asthma and inability to lie flat, Wupi Yin (Five-Peel Decoction) is the primary prescription. This formula treats skin with skins, avoiding damage to Middle Qi, which makes it excellent.
If swelling is accompanied by distension and difficult urination, Weiling Tang (Gastrodia and Atractylodes Macrocephala Decoction) should be used. Alternatively, Siling San (Four-Ling Powder) combined with half-cooked garlic pills is extremely effective.
Wupi San (Five-Peel Powder)
Note: For upper body swelling, induce sweating by adding Perilla Leaf, Schizonepeta, and Gentian Root each at 1.5 qian; for lower body swelling, promote diuresis by adding Adzuki Bean and Akebia Stem each at 1.5 qian, and Stephania Root at 1 qian.
For thirst, excessive heat, and difficult urination (Yang Water), add Talc, Akebia Stem, Plantago Seed, and Ophiopogon Root each at 1.5 qian, and Aucklandia Root at 0.5 qian.
For no thirst, spontaneous normal urination, and excessive cold (Yin Water), add Atractylodes Macrocephala Rhizome and Atractylodes Lancea Rhizome each at 2 qian, Aconite Lateral Root and Dried Ginger each at 1 qian, and Aucklandia Root at 1 qian.
For slippery/excess pulse, abdominal distension, and hypochondriac fullness, add Radish Seed at 1.5 qian, White Mustard Seed at 0.8 fen, Immature Bitter Orange at 1 qian, and Pinellia Tuber at 2 qian.
For women with irregular menstruation and swelling, where blood transforms into water (Water Division), add Safflower at 0.8 fen, Peach Kernel and Cyperus Rhizome each at 1.5 qian. For women whose menstruation just ceased followed by swelling, where water transforms into blood (Qi Division), add Angelica Sinensis Root at 3 qian, Dysentery Flower Pollen (Vitality Fat) vinegar-fried at 1.5 qian, and Cyperus Rhizome at 1.5 qian.
Note: After recovery with this formula, consolidate results with modified Shenqi Wan (Kidney Qi Pill) or Liujunzi Tang (Six-Gentlemen Decoction).
Weiling San (Gastrodia and Atractylodes Macrocephala Powder) (Found in *Miaoyong*)
Siling San Modified Pills
Atractylodes Macrocephala Rhizome (1 liang, stir-fried), Poria (2 liang), Polyporus (1 liang), Alisma Rhizome (1 liang).
Grind into powder, make pills with half-cooked garlic, size of mung beans. Take 3-5 qian with boiled water.
Swelling syndromes develop gradually and persist for long periods. Symptoms include asthma, thirst, inability to lie flat, abdominal distension, scanty urine, and loose stools. All critical conditions are primarily treated with Xue Shi Jiawei Shenqi Wan (Xue’s Modified Kidney Qi Pill).
Zhang Jingyue said: The *Nei Jing* states: "The Kidney is the gate of the Stomach; if the gate is obstructed, water accumulates following its kind." Why is the gate obstructed? The *Jing* says: "The Bladder is the official of the capital, storing fluids; transformation allows them to exit." This so-called transformation refers to Qi within the Kidney, i.e., Fire within Yin. Without Yang within Yin, Qi cannot transform, leading to blocked water pathways and overflow causing swelling. Therefore, those treating Qi must first treat Water; those treating Water must first treat Qi. If Qi cannot transform, Water will certainly not drain. Only when the True Qi of the Lower Jiao moves can transmission and transformation occur. Only when the True Water of the Lower Jiao assumes its proper position can clarity be restored. Seeking ancient methods, only Mr. Xue Lizai’s Modified Kidney Qi Pill is truly appropriate. I have used it frequently with consistent efficacy.
Xue Shi Jiawei Shenqi Wan (Xue’s Modified Kidney Qi Pill)
Prepared Rehmannia Root (4 liang), Poria (3 liang), Cornus Fruit, Chinese Yam, Moutan Cortex, Achyranthes Root, Alisma Rhizome, Plantago Seed, Cinnamon Twig (each 1 liang), Prepared Aconite Root (5 qian).
Make pills with refined honey, size of paulownia seeds. Take 3 qian per dose with boiled water, twice daily. If the constitution is inherently Yang-excessive with abundant fire in the Three Jiao, presenting with irritability, thirst, red face, asthma/cough, and slippery/excess pulse, indicating damp-heat and Yin deficiency, remove Cinnamon Twig and Aconite Root, and add Ophiopogon Root.
*Molecular Awakening* states: For Lower Jiao damp-heat, removing Cinnamon Twig and Aconite Root and adding Phellodendron Bark and Clam Shell Powder is most excellent.
Mahuang Fuzi Tang (Ephedra and Aconite Decoction) (Formula seen in *Jingui Yaolue*)
Remove Aconite Root, add Apricot Seed and Gypsum, named Xingzi Tang (Apricot Seed Decoction).
Furthermore, *Mingyi Zhizhang* states: When swelling is too severe, connecting internally to the Bladder and externally to the scrotum, causing tightness and blocking pathways, even with diuretic agents, there is no passage. How can the disease leave? One must open the bowels to expel water, tonifying as one purges, so the disease leaves while the Spleen remains intact. Gradual regulation may lead to survival. Do not adhere to old rules of mere diuresis. If swelling is not severe, diuresis remains the best strategy.
Note: This method is only suitable for robust youths for occasional use; otherwise, it should not be tried lightly.