(或名暑风,以与中风相似也。)
其证卒然闷倒,汗多,(先出之汗多热,后出之汗多冷。)面垢,(汗多则面油腻。)昏不知人,手
足微冷,或吐或泻,或喘或满,多于田间路上烈日中得之。以来复丹末同苏合香丸,
(见诸中。)用汤调灌。或单用来复丹调灌,或却暑散水调灌亦得。如仓卒无药,急研蒜
水以灌之。盖中暑毒,阳外阴内,(阳气随汗大泄,在内之血液,痰、食,无气以温,皆变寒凝)
故诸暑药多用热剂。如大顺散之用姜、桂,枇杷散之用丁香是也。大蒜辛暖,暖取
其回阳,辛取其通窍散结。(阴寒凝结,痰涎阻滞,则关窍不通也。)又蒜气臭烈,能通诸窍,大
概极香极臭之物,皆能通窍也。候稍苏,继以益元散。(见伤暑。)气实者,苍术白虎汤,
气虚者,人参白虎汤。(并见发热。)热死人切勿便与冷水,(恐热血得冷而凝结也。)及卧冷地,
正如冻死人不得遽近火也。故凡行路 死者,惟得置日中热地上,令人溺热土,取
罨其脐,或令近火,以热汤灌之,或布蘸热汤,更易熨其心腹脐下,(以引热外出也。观
汤火伤者,误以冷水洗之,即激火内攻,可见。)急以二气丹汤灌之。一方用不蛀皂角,刮去黑皮,
烧烟欲尽,盆合地上,周遭令勿透烟,每用皂角灰一两,甘草末六钱,和匀,每服
一钱,温浆水调下,昏迷不醒者,不过两服。盖中暑人,痰塞关窍,皂角能疏利去
痰也。又有暑迷一证,似中而轻,(但昏迷耳,未至闷倒。)欲睡懒语,(暑气乘心,烦闷所致。)壮人
香薷饮加黄连一钱,虚人星香散(见中风)加香薷一钱。醒后冷汗不止,手足尚逆,烦闷
多渴者,香薷饮。若过投冷剂、致吐利不止,外热内寒,烦躁多渴,(内寒何以渴,
汗出津竭也。)甚欲裸形,此阴盛格阳,宜温药,香薷饮加附子,浸冷服。渴者,缩脾饮
加附子,亦浸冷服。(详伤暑门。)
其临床表现是突然昏闷倒地,出汗多,(先出的汗感觉热,后出的汗感觉冷。)面色污垢,(因为出汗多导致面部油腻。)神志昏迷不省人事,手脚微微发凉,或者呕吐或者腹泻,或者气喘或者胸腹胀满,大多是在田间或路上的烈日下得病。用来自复丹的粉末配合苏合香丸,(见诸中章节。)用汤药调匀后灌服。或者单用来复丹调服灌下,或者用却暑散用水调服灌下也可以。如果仓促间没有药物,紧急研磨大蒜水来灌服。这是因为中暑毒邪,属于阳气外泄而阴寒内盛,(阳气随着大汗大量流失,体内的血液、痰浊、食积等,因为没有阳气温煦,都变成寒凝状态)所以治疗中暑的药物多用热性药剂。比如大顺散中使用干姜、肉桂,枇杷散中使用丁香就是例子。大蒜味道辛温,利用它的温热性质来回阳救逆,利用它的辛味来通窍散结。(阴寒凝结,痰涎阻滞,就会导致关窍不通。)而且蒜气气味臭烈,能够通达各种关窍,大概极香或极臭的东西,都能通窍。等到患者稍微苏醒后,接着服用益元散。(见伤暑章节。)体质壮实的人,用苍术白虎汤;体质虚弱的人,用人参白虎汤。(并见发热章节。)被热致死的人千万不要立刻给予冷水,(恐怕热血遇到冷气而凝结。)也不要睡在冷的地面上,这就像冻死的人不能立刻靠近火源一样。所以凡是走路途中热死的人,只能放置在太阳下的热地上,让人尿在热土上,取这种热土敷盖在肚脐处,或者让人靠近火源,用热水灌服,或者用布蘸热水,更换着熨烫心腹和脐下部位,(这是为了引导热气向外发散。观察烫伤的人,误用冷水清洗,就会激惹火热之气向内攻伐,由此可见。)紧急用二气丹汤剂灌服。另一方法是用不蛀蚀的皂角,刮去黑皮,烧至烟将尽时,用盆扣在地上,周围密封不让烟气漏出,每次取皂角灰一两,甘草末六钱,混合均匀,每次服用一钱,用温浆水调服,昏迷不醒的人,不过两服即可。这是因为中暑的人,痰浊堵塞关窍,皂角能够疏利去除痰浊。又有暑迷这一证候,类似中暑但较轻,(只是昏迷而已,未到昏闷倒地的程度。)想睡觉且言语懒慢,(暑气侵犯心脏,因烦闷所致。)身体强壮的人用香薷饮加黄连一钱,身体虚弱的人用星香散(见中风章节)加香薷一钱。清醒后冷汗不止,手脚依然逆冷,烦闷多口渴的,用香薷饮。如果过度投用冷性药剂,导致呕吐腹泻不止,外热内寒,烦躁多口渴,(内寒为什么会口渴,是因为出汗过多津液枯竭。)甚至想要脱衣裸体,这是阴盛格阳,适宜用温性药物,香薷饮加附子,浸泡冷却后服用。口渴的,用缩脾饮加附子,也浸泡冷却后服用。(详见伤暑门章节。)
(Sometimes referred to as Summerheat Wind, due to its similarity to Stroke.)
The clinical presentation involves sudden fainting and collapse, profuse sweating, (the initial sweat feels hot, while the subsequent sweat feels cold.) a dirty complexion, (due to excessive sweating causing facial oiliness.), unconsciousness, slightly cold hands and feet, vomiting or diarrhea, dyspnea or abdominal fullness. It is commonly contracted in open fields or on roads under the scorching sun. One may administer Suhe Xiang Wan (Styrax Pill) mixed with powder of Laifu Dan (Revival Pill), (see section on various types of stroke,) dissolved in decoction for forced administration. Alternatively, Laifu Dan alone can be used for administration, or Que Shu San (Heat-Resisting Powder) mixed with water is also acceptable. In an emergency without medicine, crushed garlic water should be prepared and administered urgently. This is because Summerheat toxin presents as Yang deficiency on the exterior and Yin excess on the interior, (Yang Qi escapes massively through sweating; blood, phlegm, and food retention inside lack Qi to warm them, leading to cold coagulation.) Therefore, most summerheat remedies use hot-natured agents. For instance, Da Shun San (Great Harmony Powder) uses Sheng Jiang (Dried Ginger) and Rou Gui (Cinnamon Bark), and Pi Pa San (Loquat Powder) uses Ding Xiang (Clove). Garlic is pungent and warm; its warmth serves to restore Yang, and its pungency serves to open orifices and dissipate nodules. (When Yin-cold coagulates and phlegm-fluids obstruct, the orifices become blocked.) Moreover, garlic has a strong odor that can unblock all orifices; generally, substances that are extremely fragrant or foul-smelling can open orifices. Once the patient regains slight consciousness, Yi Yuan San (Benefit Primordial Powder) should be administered next. (See section on Summerheat Injury.) For those with robust constitution, Cang Zhu Bai Hu Tang (Atractylodes White Tiger Decoction) is indicated; for those with deficient constitution, Ren Shen Bai Hu Tang (Ginseng White Tiger Decoction) is indicated. (Also see section on Fever.) Do not immediately give cold water to those who have died from heatstroke, (as cold blood might congeal upon contact with cold.) nor let them lie on cold ground, just as one should not immediately bring frozen corpses near fire. Thus, anyone who dies while traveling should be placed on hot ground in the sun. Urine should be applied to hot soil, which is then used to compress the umbilicus, or the person should be brought near fire, given hot water to drink, or have cloths soaked in hot water alternately pressed against the heart, abdomen, and below the umbilicus, (to guide heat outward. Observing burn victims, if washed with cold water by mistake, it provokes fire to attack inwardly, demonstrating this principle.) Urgently administer Er Qi Dan (Two-Qi Pill) decoction. Another method uses non-boring Sichuan soapberry (Zao Jiao), scraping off the black skin, burning it until smoke nearly ceases, covering it with a basin on the ground, ensuring no smoke leaks around. Take one tael of soapberry ash and six qian of licorice powder, mix well, take one qian per dose,调和 with warm grain water. For coma patients, two doses suffice. This is because summerheat patients suffer from phlegm blocking the orifices, and soapberry can disperse and eliminate phlegm. There is also a condition called Summerheat Confusion, which resembles summerheat but is milder, (merely confusion without fainting/collapse.) characterized by drowsiness and slurred speech, (caused by summerheat invading the Heart, resulting in irritability and oppression.) For robust individuals, Xiang Ru Yin (Mosla Decoction) plus one qian of Huang Lian (Scutellaria Root); for deficient individuals, Xing Xiang San (Star-Aromatic Powder) (see section on Stroke) plus one qian of Xiang Ru (Mosla Herb). After waking up, if cold sweat persists, limbs remain inverted (cold), and there is irritability and excessive thirst, use Xiang Ru Yin. If excessive use of cold agents leads to persistent vomiting and diarrhea, external heat with internal cold, irritability and excessive thirst, (why does internal cold cause thirst? Because sweating depletes body fluids.), even desiring to strip naked, this indicates Yin excess repelling Yang. Warm medicines are suitable: Xiang Ru Yin plus Fu Zi (Aconite Root), taken after cooling in cold water. For thirst, Suo Pi Yin (Spleen-Restraining Decoction) plus Fu Zi, also taken after cooling in cold water. (See detailed section on Summerheat Injury.)