有天气大热时。劳役得病。或路途劳役。或田野中劳役。或身体怯弱。食少劳役。或长斋久
素。胃气久虚劳
役。其病肌体壮热。躁热闷乱。大恶热。渴饮水、此与阳明伤寒热白虎汤证相似。鼻口中气短促上
喘。此乃脾胃久虚。元气不足之证。身亦疼痛。至日西作。必谵语热渴。闷不止。脉洪大空虚。或微弱。
白虎汤证其脉洪大有力。与此内伤中热不同。治用清暑益气汤。
人参 白术 陈皮 神曲 泽泻（各半钱） 黄 （一钱半。少汗者减半钱） 甘草（炙）
黄柏（酒浸） 葛根 青皮 当归身
麦门冬（各三分） 苍术（一钱半） 升麻（一钱） 五味子（九枚）
上十五味锉。作一服。水二盏。煎至一盏。去渣。稍热服。食远。
有因劳力坐卧阴凉处。后病表虚。不任风寒。少气短促。懒言语声。困弱无力。○此因劳役辛
苦。肾中阴火沸腾。后因脱衣。或沐浴歇息于阴凉处。其阴火不行。还归皮肤。腠理极虚。无阳。
被风与阴凉所遏。以此表虚不任风寒。与外感恶风相似。不可同外感治。宜用补中益气汤。（方见
前）
劳役形体。饮食失节。脾胃中州。变寒走痛而发黄。治用小建中汤。或大建中汤。或理中汤。
（方见前）
【小建中汤】
芍药（六两） 桂枝 甘草（各二两） 大枣（七个）
生姜（三两） 胶饴（一升）
上 咀。以水七升。煎至三升。去渣。入胶饴。更上微火消解。温服一升。日三服。
在天气酷热之时，因过度劳累而患病。无论是路途奔波劳作，还是在田野间辛勤劳作，亦或是身体本就虚弱、饮食减少却仍从事劳役，又或是长期吃素导致胃气久虚并伴随劳役损伤。其病症表现为肌肤壮热、烦躁闷热、极度怕热、口渴想喝水，这与阳明伤寒热盛证（使用白虎汤治疗的证候）相似。但患者鼻中呼吸短促且上逆作喘，这是由于脾胃长期虚弱、元气不足所致。身体也会疼痛，到了傍晚时分发作，必定出现胡言乱语、高热口渴、烦闷不止的症状，脉象洪大但按之空虚，或者微弱。白虎汤证的脉象是洪大有力，这与内伤导致的体内中热不同。治疗应使用清暑益气汤。
药材包括：人参、白术、陈皮、神曲、泽泻（各半钱）、黄芪（一钱半，出汗少者减半钱）、炙甘草、酒浸黄柏、葛根、青皮、当归身、麦门冬（各三分）、苍术（一钱半）、升麻（一钱）、五味子（九枚）。
以上十五味药切碎，作为一剂服用。加水两盏，煎煮至一盏，去渣滓，稍温热时服用，在饭后较远的时间服用。
有的人因为用力劳作后坐在或躺在阴凉处，随后患上表虚证，不能耐受风寒，气息短促，懒于说话声音低微，困倦虚弱无力。这是因为劳役辛苦，导致肾中阴火沸腾，之后脱去衣物，或在沐浴后歇息于阴凉处，使得阴火无法正常运行，反而回归皮肤，导致腠理极度虚弱，阳气不足，被风邪与阴凉之气郁遏，因此表虚不能耐受风寒，症状与外感恶风相似，但不能按照外感病来治疗。适宜使用补中益气汤。（方剂见前文）
因形体劳役、饮食不节制，导致脾胃（中州）变生寒湿，走注疼痛并发黄，治疗应使用小建中汤，或大建中汤，或理中汤。（方剂见前文）
During periods of extreme heat, illness may arise from overexertion. Whether one labors on long journeys or in the fields, or if the body is inherently weak with reduced food intake yet still subjected to labor, or if one maintains a long-term vegetarian diet leading to chronic deficiency of Stomach Qi (Stomach Energy) compounded by physical strain, the symptoms include intense fever of the skin and muscles, restlessness and stifling sensation, extreme aversion to heat, and thirst with desire to drink water. This resembles the Yangming Cold Damage Heat Syndrome (a syndrome treated with Baihu Tang / White Tiger Decoction). However, the patient experiences shortness of breath and wheezing rising from the nose and mouth; this is a syndrome of chronic Spleen and Stomach deficiency and insufficiency of Yuan Qi (Original Qi). The body also aches, with symptoms worsening towards sunset, inevitably accompanied by delirium, high fever, thirst, and unceasing stifling discomfort. The pulse is flooding (Hong) but empty upon pressure, or faint and weak. In the Baihu Tang syndrome, the pulse is flooding and forceful, which differs from internal injury causing middle-heat. Treatment should employ Qingshu Yiqi Tang (Clear Summerheat and Boost Qi Decoction).
Ingredients: Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Shenqu (Massa Medicata Fermentata), Zexie (Alismatis Rhizoma) (each 0.5 qian); Huangqi (Astragali Membranacei Radix) (1.5 qian, reduce by 0.5 qian if sweating is slight); Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma); Huangbai (Phellodendri Cortex soaked in wine); Gegen (Puerariae Lobatae Radix); Qingpi (Citri Reticulatae Pericarpium Viride); Dangguishen (Angelicae Sinensis Radix); Maimendong (Ophiopogonis Tuber) (each 0.3 qian); Cangzhu (Atractylodis Rhizoma) (1.5 qian); Shengma (Cimicifugae Rhizoma) (1 qian); Wuweizi (Schisandrae Chinensis Fructus) (9 berries).
The above fifteen ingredients are chopped. Prepare as one dose. Add two zhan of water, decoct until one zhan remains, remove the dregs, and take slightly warm after meals at a considerable distance from eating.
Some individuals, after laboring physically and sitting or lying in cool places, subsequently develop a Wei Xu (Deficiency of the Defensive Level) syndrome, rendering them unable to tolerate wind and cold. They suffer from shortness of breath, reluctance to speak with low voice, lassitude, weakness, and lack of strength. This occurs because strenuous labor causes Yin Fire (Yin Huo) in the Kidney to boil up. Subsequently, removing clothes or resting in cool places after bathing prevents the Yin Fire from dispersing properly, causing it to return to the skin. The Cou Li (pores and interstices) become extremely deficient, lacking Yang Qi. Constrained by wind and coolness, the exterior becomes deficient and cannot tolerate wind and cold. The presentation resembles external contraction with aversion to wind, but it must not be treated as an external contraction. It is appropriate to use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). (Formula seen previously)
Due to physical overexertion and irregular diet, the Spleen and Stomach (Central Pivot) transform into cold-dampness, leading to wandering pain and jaundice. Treatment should employ Xiaojianzhong Tang (Minor Construct the Middle Decoction), or Dajianzhong Tang (Major Construct the Middle Decoction), or Lizhong Tang (Regulate the Middle Decoction). (Formulas seen previously)
[Xiaojianzhong Tang]
Shaoyao (Paeoniae Radix Alba) (6 liang); Guizhi (Cinnamomi Ramulus); Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) (each 2 liang); Dazao (Ziziphi Jujubae Fructus) (7 pieces); Shengjiang (Zingiberis Rhizoma Recens) (3 liang); Jiaoyi (Maltose) (1 sheng).
Chop the above ingredients. Add seven sheng of water, decoct until three sheng remain, remove the dregs, add Jiaoyi, and gently heat over a low fire until dissolved. Take one sheng warm, three times daily.