治暑月饮冷卧风腹痛四肢逆冷吐泻脉微
即理中汤加附子煎服(理中汤方见中寒门)
治夏月忽然猝仆不省人事
防风 黄连 木香 陈皮 半夏 香薷 茯苓 白术
治伏暑烦渴引饮小便不利
五苓散加人参 柴胡 麦门冬 水二钟灯心十根煎八分不拘时服
治暑伤元气四肢困倦手指麻木
黄 甘草 升麻 芍药 人参 五味子 柴胡 水二钟煎六分不拘时服
治热伤肌肉身如芒刺烦躁作渴自汗脉数
人参 黄 知母 石膏 黄连 天花粉 甘草 柴胡 麦门冬(不用引子)
治日中劳苦头疼壮热
石膏 人参 麦门冬 甘草 知母 竹叶 水二钟煎八分不拘时服
一人于暑月日中劳苦忽然晕仆其气将绝予思内经云阳气者烦劳则张精绝辟积于夏使人煎
厥是中暑晕厥之候也速移病者于阴处徐以温汤灌之尚有微息仍煎生脉散灌之方醒
一新妇于暑月偶患腹疼肢冷脉微不能言语众作阴寒症治七日不解惟唇红面赤后命以凉水
饮二小杯即醒能发声此因暑伏心气故不发声仍用麦冬饮子数服而安
湿乃地之体风雨蒸气流行于四时而于秋则为正令经曰地之湿气感则害人皮肉筋脉盖湿本
属土脾主肌肉故也或为风雨所袭或卧卑湿之地或感山岚蒸气皆令人一身尽痛身目俱黄肢体沉
重不能转侧声如瓮中出此皆外气而受之也外气郁久变而为热湿热伤血不能养筋故大筋 短而
为拘挛小筋弛长而为痿弱矣又有内伤生冷湿面醪酪灸爆浓味伤于脾土脾受怫郁湿热之气不能
发越而为肿满经曰因于湿首如KT 此由内伤而致也大抵湿病有热有寒又当以脉证辨之若脉
数小便赤引饮身热者为湿热宜清利之脉沉濡而小便清大便泄身痛不热者宜温补之按气察色切
脉酌方则疾可以瘳矣
治疗暑月因贪凉饮冷、卧于风中导致腹痛、四肢厥冷、呕吐腹泻、脉象微弱的病症。
立即使用理中汤(温中散寒的方剂)加入附子煎煮服用。(理中汤的方剂组成见“中寒”章节)
治疗夏季突然猝然昏倒、不省人事的病症。
防风 黄连 木香 陈皮 半夏 香薷 茯苓 白术
治疗暑气潜伏体内导致心烦口渴、大量饮水、小便不利的病症。
五苓散(利水渗湿的方剂)加入人参、柴胡、麦门冬,用水两钟(古代量器单位),灯心草十根,煎至八分,不拘时间服用。
治疗暑气损伤元气,导致四肢困倦、手指麻木的病症。
黄芪 甘草 升麻 芍药 人参 五味子 柴胡,用水两钟,煎至六分,不拘时间服用。
治疗热邪损伤肌肉,身体感觉如芒刺扎入、烦躁作渴、自汗、脉象数快的病症。
人参 黄芪 知母 石膏 黄连 天花粉 甘草 柴胡 麦门冬(不加药引)
治疗白天劳作辛苦导致头痛、高热壮热的病症。
石膏 人参 麦门冬 甘草 知母 竹叶,用水两钟,煎至八分,不拘时间服用。
有一人在暑月白天劳作辛苦后突然晕倒,气息将绝。我思考《内经》所说:“阳气者,烦劳则张,精绝,辟积于夏,使人煎厥。”这是中暑晕厥的证候。迅速将病人移至阴凉处,慢慢用温水浇灌,尚存微弱呼吸,再煎生脉散(益气养阴的方剂)灌服,方才苏醒。
一位新媳妇在暑月偶然患腹痛、四肢冰冷、脉象微弱、不能言语。众人当作阴寒症治疗,七日未愈。后来只用凉水让她喝了两小杯,她就醒了并能发声。这是因为暑气伏于心气,导致不能发声,随后仍用麦冬饮子(滋阴清热的方剂)服用几剂而安定。
湿气是地的本体,风雨蒸气流行于四季,而在秋季则是其正令。经书说:“地之湿气,感则害人皮肉筋脉。”大概湿气本属土,脾主肌肉的缘故。或者被风雨侵袭,或者卧于低洼潮湿之地,或者感受山间岚气蒸气,都让人全身疼痛,身体和眼睛都发黄,肢体沉重无法转动,声音像从瓮中发出一样沉闷。这些都是外受之气所致。外受之气郁结日久变为热,湿热损伤血液,不能滋养筋脉,所以大筋收缩变短而导致拘挛,小筋松弛变长而导致痿弱。又有内伤生冷、湿面、酒酪、烧烤浓味,损伤脾土,脾受到郁遏,湿热之气不能发散,从而形成肿满。经书说:“因于湿,首如裹。”这是由内伤导致的。大致湿病有热有寒,又应当通过脉象和证候来辨别。如果脉数、小便赤红、想喝水、身体发热的是湿热,适宜用清利之法;如果脉沉濡、小便清亮、大便泄泻、身体疼痛但不发热的是寒湿,适宜用温补之法。观察气色、切按脉象、斟酌处方,疾病就可以痊愈了。
To treat abdominal pain, cold limbs (cold extremities), vomiting and diarrhea, with a faint pulse, caused by drinking cold beverages and lying in the wind during the summer heat.
Immediately decoct and administer Lizhong Tang (Spleen-Regulating Decoction) with added Fuzi (Prepared Aconite Root). (The formula for Lizhong Tang is found in the chapter on Cold Damage to the Middle Jiao.)
To treat sudden collapse and loss of consciousness occurring suddenly in summer.
Fangfeng (Saposhnikovia Root), Huanglian (Coptis Rhizome), Muxiang (Aucklandia Root), Chenpi (Tangerine Peel), Banxia (Pinellia Tuber), Xiangru (Elsholtzia Herb), Fuling (Poria), Baizhu (Atractylodes Macrocephala Rhizome).
To treat latent summerheat causing irritability, thirst with excessive drinking, and difficult urination.
Wuling San (Five-Ingredient Powder with Poria) added with Renshen (Ginseng Root), Chaihu (Bupleurum Root), and Maidong (Ophiopogon Tuber). Decoct two cups of water with ten roots of Dengxincao (Juncus Effusus Pith) until reduced to eight-tenths; take at any time.
To treat summerheat damaging Yuan Qi (Original Qi), resulting in fatigue of the four limbs and numbness of the fingers.
Huangqi (Astragalus Root), Gancao (Licorice Root), Shengma (Cimicifuga Rhizome), Shaoyao (Peony Root), Renshen (Ginseng Root), Wuweizi (Schisandra Fruit), Chaihu (Bupleurum Root). Decoct two cups of water until reduced to six-tenths; take at any time.
To treat heat damaging muscle tissue, causing a sensation of prickling like thorns, irritability, thirst, spontaneous sweating, and a rapid pulse.
Renshen (Ginseng Root), Huangqi (Astragalus Root), Zhimu (Anemarrhena Rhizome), Shigao (Gypsum Fibrosum), Huanglian (Coptis Rhizome), Tianhuafen (Trichosanthes Root), Gancao (Licorice Root), Chaihu (Bupleurum Root), Maidong (Ophiopogon Tuber). (Do not use a guiding herb.)
To treat headache and high fever caused by labor and hardship during midday.
Shigao (Gypsum Fibrosum), Renshen (Ginseng Root), Maidong (Ophiopogon Tuber), Gancao (Licorice Root), Zhimu (Anemarrhena Rhizome), Zhuye (Bamboo Leaf). Decoct two cups of water until reduced to eight-tenths; take at any time.
One person collapsed suddenly after hard labor under the sun in summer, with breath nearly exhausted. I reflected on the statement from *Neijing* (The Inner Canon): "When Yang Qi is overworked due to exertion, it expands; when Jing (Essence) is exhausted and accumulates through repetition in summer, it causes Jian Jue (Exhaustion Collapse)." This is a presentation of heatstroke syncope. Quickly move the patient to a shady place and slowly pour warm water over them. If there is still slight respiration, decoct and administer Shengmai San (Generate the Pulse Powder); only then will they awaken.
A newlywed woman suffered from abdominal pain, cold limbs, a faint pulse, and inability to speak during summer. The practitioners treated her as a Yin-cold syndrome for seven days without improvement. Later, she was given two small cups of cool water, upon which she awakened and could speak. This was because summerheat was latent in the Heart Qi, suppressing speech. Subsequently, several doses of Maidong Yinzi (Ophiopogon Infusion) were administered to restore peace.
Dampness is the substance of the earth; wind, rain, and vapor circulate through the four seasons, with autumn being its proper season. The classics state: "Earthly dampness, when contracted, harms the skin, flesh, sinews, and vessels." Generally, dampness belongs to Earth, and the Spleen governs the flesh. Whether attacked by wind and rain, lying on low and damp ground, or contracting mountain mists and vapors, all cause whole-body pain, yellowing of the body and eyes, heaviness of the limbs making turning difficult, and a voice sounding muffled as if from within an urn. These are all caused by external pathogenic factors. When external pathogens stagnate for a long time, they transform into heat. Damp-heat damages Blood, failing to nourish the sinews; thus, large sinews shorten leading to spasms/contractures, while small sinews relax and lengthen leading to flaccidity/weakness. Additionally, internal injury from raw/cold foods, wet noodles, wine/dairy, roasted/spicy strong flavors injures Spleen Earth. The Spleen becomes constrained, and damp-heat cannot disperse, resulting in swelling and fullness. The classics state: "Due to dampness, the head feels bound." This is caused by internal injury. Generally, damp diseases involve either heat or cold, and must be differentiated by pulse and symptoms. If the pulse is rapid, urine is red, there is thirst, and body heat, it is damp-heat, suitable for clearing and draining methods. If the pulse is deep and soggy, urine is clear, stool is loose, there is body pain but no heat, it is cold-damp, suitable for warming and tonifying methods. By observing Qi and complexion, palpating the pulse, and prescribing accordingly, the disease can be cured.