桃仁（十粒） 元明粉（三钱） 大黄（四钱） 桂枝（八分） 炙甘草（五分）水煎。
或加泽兰二钱以行气分。
脉候伤寒之脉。缓大者昌。沉微小促。症反仓皇。洪紧滑数。初病则康。若遇日久。何
敢云臧。温邪脉象。微涩者殃。弦紧则甚。非躁即狂。若云类症。
泻宜凉。阴脉见之。温通之方。症象一反。不必商
（附中暑 冒暑 伤暑 症 暑风 伏暑 暑厥）
暑者。后夏至而起。因天气一动。而蒸淫热迫。地气一升。而秽浊上腾。人之患也。由
口鼻
其病
若
不能外卫。先有伏寒在内。一触暑邪。即晕眩昏迷。不省人事。指甲青。唇口青。肢冷如冰
。自汗如珠。凝而不流。系内受伏寒。外应暑热。脉必双伏。法在不治。危在旦夕。急用通
关散以吹入鼻中。得嚏则生。无嚏则死。即用大顺散为主。加附子以祛内寒。加川连以清心
营。或用独参汤以先扶正气。然后用药为妥。缓则不救。○冒暑者。必奔走道路。吞饥受饿
。气不充体。暑邪上冒。头目眩晕。心神慌乱。壮热气粗。脉必浮滑。急用黄连香薷饮。以
温散之。或有腹泻者。以缩脾饮清之。凡世俗间动云痧气。妄加针刺。伤其营血。致血不荣
筋。有昏痉转筋之变。而不可救药。宜加察之可也。○夫伤暑者。因受暑而伤。暑热伤气。
一受暑邪。不急调治。渐入营分。阳已外泄。阴气更被耗散。阴阳两虚。形若虚劳。内热外
寒。脉必虚数。东垣清暑益气汤最妙。如胃中痞满者。去黄 甘草可也。○ 者。是重伤于
暑也。金匮云。太阳中 。发热恶寒。身重而疼痛。其脉弦细芤迟。小便已。洒洒然毛耸。
手足逆冷。小有劳。身即热。口开。前齿板燥。若发其汗。则恶寒甚。加温针。则发热甚。
数下之。则淋甚。以白虎加人参汤。最为妥恰。然后人鲜有增减。宜细玩之。○暑风者。是
夏月伤风也。宜香葛汤治之。○又有伏暑之病。古所未着。并无发明。近时所云伏暑者。即
叶天士先生为伏气之疾。从秋分以前。暑邪未消。至秋分以后。而患暑病。名为伏气。又云
秋时晚发即俗名伏暑之病耳。其脉滞。其形怯。口舌粘腻。或微有寒。或单发热。热时脘痞
气窒。渴闷烦 。每至午后。则病甚矣。入
必三候外邪气方解。日减一日而始全愈。
润燥清气。最为妥洽。○又暑厥之病。
而升。阳气升腾。阴热内灼。自下而
自制抑阳清暑汤治之。大忌发散峻表
桃仁（十粒） 元明粉（三钱） 大黄（四钱） 桂枝（八分） 炙甘草（五分）用水煎煮。
或者加入泽兰二钱以行气分。
脉候伤寒的脉象。脉象缓大者预后良好。若见沉、微、小、促脉，病情反而危急。若见洪、紧、滑、数脉，初病时预后良好。若病程日久，怎敢说预后良好。温邪的脉象，若见微涩则预后不良。若见弦紧脉则病情加重，患者不是烦躁就是狂乱。如果说类似的症状，
治疗宜用凉泻法。若见到阴脉，则不宜使用温通之方。症状表现相反，不必多议。
（附中暑、冒暑、伤暑、中暍、暑风、伏暑病症）
暑病，发生在夏至之后。因天气变动，蒸腾淫热逼迫；地气上升，秽浊之气上腾。人因此患病。由口鼻侵入。
其病……
如果……
不能固护体表，先有伏寒在内，一旦触动暑邪，立即出现晕眩昏迷，不省人事。指甲发青，唇口发青，四肢冰冷如冰。自汗如珠，凝滞不流。这是内受伏寒，外应暑热。脉象必定双伏，治法认为难以治愈，危在旦夕。急用通关散吹入鼻中，能打喷嚏则生，不能打喷嚏则死。随即以大顺散为主方，加附子以祛除内寒，加黄连以清心营。或者先用独参汤扶助正气，然后再用药为妥。迟缓则无法救治。○冒暑者，必定是在道路上奔走，忍受饥饿，气不充体，暑邪上冒头部。头目眩晕，心神慌乱，高热气粗。脉象必定浮滑。急用黄连香薷饮，以温散之法治疗。如果有腹泻者，用缩脾饮清热。凡世俗间动不动就说痧气，妄加针刺，损伤营血，导致血不能荣养筋脉，出现昏厥、痉挛、转筋的变化，而不可救药。应当仔细考察即可。○所谓伤暑者，是因为感受暑邪而受伤。暑热伤气，一旦感受暑邪，不及时调治，逐渐进入营分，阳气已经外泄，阴气更被耗散，阴阳两虚，形体如同虚劳，内热外寒。脉象必定虚数。东垣的清暑益气汤最为巧妙。如果胃中痞满者，去掉黄芩、甘草即可。○中暍者，是重伤于暑也。《金匮要略》说，太阳中暍，发热恶寒，身体沉重而疼痛，脉象弦细芤迟，小便后，洒洒然毛发耸立，手足逆冷，稍微劳作，身体即发热，张口呼吸，前齿板干燥。如果发汗，则恶寒更甚；加温针，则发热更甚；多次攻下，则淋证更甚。用白虎加人参汤，最为妥帖恰当。然后很少有人增减此方，应当仔细玩味。○暑风者，是夏季伤风也。宜用香葛汤治疗。○又有伏暑的病，古代未曾记载，并无发明。近时所称的伏暑，即叶天士先生所说的伏气之疾。从秋分以前，暑邪未消，到秋分以后，而患暑病，名为伏气。又说秋季晚发即俗名伏暑的病。其脉滞涩，形体怯弱，口舌粘腻，或微有恶寒，或单发热，发热时脘腹痞闷气窒，口渴烦闷，每至午后，则病情加重。入……必须经过三个候期外邪气才解除，日减一日才开始痊愈。
润燥清气，最为妥帖恰当。○又有暑厥的病，
气……而升，阳气升腾，阴热内灼，自下而……
自制抑阳清暑汤治疗。大忌发散峻表。
Tao Ren (Persicae Semen, 10 grains), Yuan Ming Fen (Mirabilite, 3 qian), Da Huang (Rhei Radix et Rhizoma, 4 qian), Gui Zhi (Cinnamomi Ramulus, 8 fen), Zhi Gan Cao (Prepared Licorice Root, 5 fen). Decoct in water.
Alternatively, add Ze Lan (Leonuri Herba, 2 qian) to move Qi in the Qi level.
Regarding pulse diagnosis for Shang Han (Cold Damage): A slow and large pulse indicates a favorable prognosis. A deep, minute, small, or hurried pulse indicates a critical condition. A surging, tight, slippery, or rapid pulse at the onset of illness indicates recovery. If the disease has persisted for a long time, how can one claim a good prognosis? For Wen Xie (Warm Pathogens), a minute and choppy pulse indicates misfortune. A wiry and tight pulse indicates worsening condition; the patient is either restless or manic. If discussing similar symptoms, cool purgation is appropriate. If Yin pulses are observed, warm and unblocking formulas should not be used. When symptoms contradict expectations, no further discussion is needed.
(Attached: Zhong Shu [Heat Stroke], Mao Shu [Exposure to Summer Heat], Shang Shu [Summer Heat Injury], Zhong Yue [Heat Apoplexy], Shu Feng [Summer Wind], Fu Shu [Stagnant Summer Heat])
Shu (Summer Heat) arises after the Summer Solstice. Due to changes in weather, steaming and excessive heat press down; Earth Qi rises, carrying turbid and foul air upward. Humans suffer from this. It enters through the mouth and nose.
Its pathology...
If...
The body fails to defend the exterior, while latent Cold exists internally. Upon contact with Summer Heat pathogen, dizziness and coma occur immediately, with loss of consciousness. Nails turn cyanotic, lips and mouth turn cyanotic, limbs are cold as ice. Spontaneous sweating occurs like pearls, congealing and not flowing. This indicates internal latent Cold responding to external Summer Heat. The pulse must be double-hidden (Shuang Fu). The treatment method considers it incurable, with danger imminent. Immediately use Tong Guan San (Pass-Through Powder) blown into the nose. Sneezing indicates life; lack of sneezing indicates death. Then use Da Shun San (Great Smoothness Powder) as the main formula, add Fu Zi (Aconiti Lateralis Radix Praeparata) to dispel internal Cold, add Chuan Lian (Coptidis Rhizoma) to clear Heart Ying (Nutritive Level). Alternatively, first use Du Shen Tang (Single Ginseng Decoction) to support Righteous Qi, then administer medication appropriately. Delay means no rescue. ○ Mao Shu (Exposure to Summer Heat) occurs when running on roads, enduring hunger, with Qi insufficient to fill the body. Summer Heat pathogen attacks the head. Dizziness of head and eyes, panic of Heart Spirit, high fever and coarse breathing. The pulse must be floating and slippery. Immediately use Huang Lian Xiang Ru Yin (Coptis and Elsholtzia Decoction) to disperse with warmth. If diarrhea occurs, use Suo Pi Yin (Spleen-Restraining Decoction) to clear heat. In common society, people often mention Sha Qi (Sha Poison), recklessly adding acupuncture, damaging Ying Blood, causing blood to fail to nourish sinews, leading to convulsions, spasms, and tendon retraction, which are incurable. One should examine carefully. ○ Shang Shu (Summer Heat Injury) is caused by injury from Summer Heat. Summer Heat damages Qi. Once exposed to Summer Heat pathogen, if not treated promptly, it gradually enters the Ying level. Yang Qi has leaked outward, Yin Qi is further depleted. Both Yin and Yang are deficient, resembling Xu Lao (Consumptive Disease). Internal heat and external cold. The pulse must be deficient and rapid. Dong Yuan's Qing Shu Yi Qi Tang (Clear Summer Heat and Benefit Qi Decoction) is most excellent. If there is epigastric fullness, remove Huang Qin (Scutellariae Radix) and Gan Cao (Licorice Root). ○ Zhong Yue (Heat Apoplexy) is severe injury from Summer Heat. The Jin Gui Yao Lue states: Tai Yang Zhong Yue presents with fever and aversion to cold, heaviness and pain in the body, wiry, fine, knotted, and slow pulse. After urination, there is chills and hair standing on end. Hands and feet are cold. Slight exertion causes body heat. Mouth opens, anterior teeth plates are dry. If sweating is induced, aversion to cold becomes severe. If moxibustion/heat needle is added, fever becomes severe. If purged multiple times, strangury becomes severe. Bai Hu Jia Ren Shen Tang (White Tiger plus Ginseng Decoction) is most appropriate. Few people modify this formula thereafter; it should be studied carefully. ○ Shu Feng (Summer Wind) is Wind injury in summer. Use Xiang Ge Tang (Elsholtzia and Pueraria Decoction) to treat. ○ There is also the disease of Fu Shu (Stagnant Summer Heat), unrecorded in ancient texts, without explanation. Recent references to Fu Shu refer to Ye Tianshi's concept of Fu Qi (Latent Pathogen). Before Autumn Equinox, Summer Heat pathogen has not dissipated; after Autumn Equinox, Summer Heat disease occurs, named Fu Qi. Also called late-onset in autumn, commonly known as Fu Shu. The pulse is stagnant, the form is timid, mouth and tongue are sticky, or slight aversion to cold, or isolated fever. During fever, epigastric fullness and qi obstruction occur, thirst and stifling sensation. Every afternoon, the disease worsens. Entering... must pass three Hou periods before external pathogen resolves, decreasing day by day until complete recovery.
Moistening dryness and clearing Qi is most appropriate. ○ There is also the disease of Shu Jue (Summer Heat Syncope),
Qi... rises, Yang Qi ascends, Yin Heat burns internally, from below...
Self-made Yi Yang Qing Shu Tang (Suppress Yang and Clear Summer Heat Decoction) is used. Severely avoid harsh diaphoretic methods.