经云。春伤于风。夏生飧泄。飧泄者。谓飧食不化也。
发挥云。难经有五泻之辨。脉诀云。湿多成五泻。又有胃风汤证。虽大小不同。间亦有
之。不可不知也。
如伤风吐泻者。风属木。脾胃属土。土虚故木乘之。水谷不化。谓之完谷也。此从胃中
不化。若自小肠来。则半腐化。出来成糟粕矣。自大肠来水谷已别。谷多水少矣。故伤风飧
泻。有恶风表证者。宜发散之。桂枝汤加羌活黄芩防风。或泻青丸去大黄。加炙甘草。或加
减败毒散。无表证者神术散。风疟柴苓汤。
加减败毒散去独活枳壳加当归。（各等分。姜枣引。）神术散治春伤于风。夏生飧泄。
苍术（一钱半） 本 川芎（各六分） 羌活（四分） 甘草（炙六分） 细辛（二分） 上为
末。分二服。姜水煎。
如下鲜血者。此风热也。胃风汤主之。
伤风咳嗽。此风入肺也。宜发散。人参荆芥散主之。（见惊风条内。）
夏月伤暑作吐泻者。宜加味五苓散主之。
猪苓 泽泻 白术 白茯苓 桂枝 藿香叶 砂仁（各等分） 为末。白汤化下。
夏月泄泻。小儿极多。治有三法。清暑一也。利小便二也。温中三也。以凉药止之。治
坏病也。
发挥云。初泻有发热口渴者。此宜以清暑气为先。不可便用理中汤丸。恐内有热。干姜
犯时禁。加减香薷饮主之。
香薷 黄连 炙甘草（各等分） 上煎汤热服。
或理中汤冷服之。或六一散。生姜汤调服。
如初水泻无热无渴者。不可服玉露散太多。恐犯胃气也。宜理中汤加藿香煎成汤。澄冷
服。或理中丸用冷水化开服之。
玉露散
寒水石（ 三两） 滑石（三两） 甘草（末一两） 共研匀。冷水调服。
如上法不止者。宜利小便。有热有渴者。六一散同服。无热无渴者。入理中丸化开服之
。此吾家传治夏月泻泄之良方也。从吾法者有发有降。违吾教者得少失多。详见前。
予甘外家初生男未周岁。六月病泻。外家兄甘大用吾所传者。治之不效。反加大热大渴。予
。曰所服者理中丸。吾盖料其不知用热远热之戒。犯时禁也。乃制玉露散以解时令之热。冷
水调服。一剂而安。玉露散自此收入小儿方也。
本县一屠家徐姓者。有儿十二岁。六月病泻。请大用。用因前失。以玉露散服之。不知
即止恐犯胃气之戒。又失之。此儿初服药后泻渴俱止。再服之泻益甚。又服之大热大渴。面
赤如火。张口喘呼。用见事急。自邀我同看。予问所服者何药也。云前所制玉露散也。又问
服几次。其父母应云。初服一次效。后连服三日。越服越不好。望相公救之。予教用理中汤
加熟附子一片服之。又教云。服药后若安静即止。药后若烦躁。再与一剂。用受教往治。果
加烦躁。连进二服而安。用获浓谢。特至吾家。拜曰。以报日前之教。因问予。二子病证相
同。治法各别何也。予曰。夏至后泻者。七分热。三分寒。治此泻者。当七分寒药。三分热
药。前证因汝多服理中汤。犯用热远热之戒。故用玉露散。以解火令之热。后证因汝过服玉
露散。伤其中气。故用理中汤加附子以救里也。用曰。何以安静者不治。烦躁者反可治也。
曰。夏至后垢卦用事。伏阴在内。六月建未。其位在坤。坤为腹而生土。土爱暖而恶寒。玉
露性寒。伤其脾土。阴盛于内。阳脱于外。故用理中附子之辛热。所以收敛欲脱之阳。胜其
方长之阴。服药安静者。脾气败绝。投药不知。故不可治。如烦躁者。寒热相搏。脾有生意
。故再投药。使胜其寒也。用曰。如此神妙。予初何以知之。下次治此热泻。当如之何。予
。看其病证何如。泻多热渴少者。急以温中为主。先进理中汤。后以玉露散微解之。不渴者
不可用也。先大热大渴泻少者。此里热甚也。急解其暑毒。以玉露散解之。热渴略止后。用
理中汤补其中气。泄止不可再服也。如渴不止。只用白术散治之。理中玉露皆不可服也。切
记吾言。再勿误也。白术散治泻渴不止要药也。如服白术散渴泻不止者。此水壅以犯肾。肾
得水而反燥。故转渴泻。宜白术散去干葛加炒干姜等分服之。辛以润燥。致津液。用自此后
医术渐通。家道颇昌。
暑疟者。柴胡白虎汤。即小柴胡合白虎汤。
暑咳者。甘桔汤合黄连阿胶丸。
经云。夏伤于暑。秋发 疟。予谓疟之为病。不唯中暑有之。凡风寒暑湿饮食劳倦。皆
病也。大抵民病疟痢者多。盖四时之气。太阴湿土之令。手太阴肺经。受风寒暑湿之气。病
疟多。足太阴脾经。受饮食水谷之邪。则病痢多。二经俱受邪则疟又病痢也。病疟者。平疟
养脾丸主之。病痢者。和中丸主之。此家传不易之秘法也。宝之重之。勿轻示人也。难云。
形寒饮冷则伤肺。肺主皮毛。秋冬病宜攻者多。因伤寒得之。鼻塞声重。宜发散。麻黄汤主之。
麻黄（连根水泡去沫） 杏仁（去皮尖炒） 生甘草（各等分） 上用水煎服。热甚者加生石
膏末。腊茶叶。名五虎汤神效。
湿伤肾。利而下重。秋月病痢者。皆肾病也。宜地黄丸去丹皮。加黄柏酒炒。破故纸炒
。小茴香炒。各二两。干姜炒黑五钱。研末丸服。
经云。冬伤于寒。春必病温。温热之病也。况冬月暄热令行。则阳气暴泄。不能闭藏
寒所折。至春则发为热病也。小儿得之。则发疮疹病者。亦温热之类也。如有此气。宜预服
代天宣化解毒丸。甚有良验。
《黄帝内经》说：春季感受风邪，到了夏季就会发生飧泄（指大便中含有未消化的食物）。所谓飧泄，就是指饮食不能消化。
万全在《幼科发挥》中论述：《难经》中有五种泄泻的辨别，《脉诀》中说湿气多会导致五种泄泻。另外还有胃风汤的证候，虽然病情大小轻重有所不同，但偶尔也会出现这种情况，不可不知道。
如果是伤风引起的呕吐和腹泻，风属木，脾胃属土，因为脾土虚弱，所以被肝木所乘克。水谷无法消化，称为完谷不化。这是从胃中来的，因为胃中没有消化；如果来自小肠，则食物半腐熟，排出时已成糟粕；如果来自大肠，则水谷已经分离，谷物多而水分少。因此，伤风导致的飧泄，如果有恶风等表证，适宜用发散法治疗。可用桂枝汤加羌活、黄芩、防风；或者用泻青丸去掉大黄，加入炙甘草；或者使用加减败毒散。如果没有表证，可用神术散；若是风疟，可用柴苓汤。
加减败毒散的组成是：去掉独活、枳壳，加入当归。（各药等分，用生姜、大枣为引。）神术散用于治疗春季伤于风邪，夏季发生飧泄。药材包括：苍术（一钱半）、藁本、川芎（各六分）、羌活（四分）、炙甘草（六分）、细辛（二分）。以上药物研成末，分两次服用，用姜水煎服。
伤风引起的咳嗽，这是风邪侵入肺脏，适宜用发散法，用人参荆芥散主治。（详见惊风条目内。）
药材包括：猪苓、泽泻、白术、白茯苓、桂枝、藿香叶、砂仁（各等分）。研成末，用开水冲服。
夏季小儿患泄泻的情况极多，治疗方法有三种：一是清暑，二是利小便，三是温中。如果用凉药来止泻，会治坏病。
万全在《幼科发挥》中论述：刚开始腹泻且有发热口渴症状的，这适宜以清解暑气为先，不可以立即使用理中汤或理中丸，恐怕体内有热，干姜违反时令禁忌。用加减香薷饮主治。
药材包括：香薷、黄连、炙甘草（各等分）。以上药物煎汤，热服。
如果开始是水样腹泻，没有发热也没有口渴，不可以服用玉露散太多，恐怕损伤胃气。适宜用理中汤加入藿香，煎成汤后澄清放冷服用。或者用理中丸，用冷水化开服下。
玉露散的组成：寒水石（三两）、滑石（三两）、甘草（研末一两）。共同研匀，用冷水调服。
如果按照上述方法治疗仍不止泻，适宜利小便。如果有热有渴，可与六一散同服；如果没有热没有渴，可加入理中丸化开服下。这是我家族传承的治疗夏季泄泻的良好方剂。遵循我的方法，有的发汗有的降逆；违背我教导的人，得到的少失去的多。详细情况见前文。
我岳父家初生男孩未满周岁，六月患病腹泻。岳父家的哥哥甘大用了我所传授的方法，治疗无效，反而加重了高热和大渴的症状。我去诊治，问他说：“你服用的是什么药？”回答说：“是理中丸。”我心想他大概不知道“用热远热”（夏季慎用热药）的戒律，违反了时令禁忌。于是制作玉露散以解除时令之热，用冷水调服，一剂药后病情安定。玉露散从此被收入小儿方剂中。
本县有一位姓徐的屠户，有个十二岁的儿子，六月患腹泻。请甘大用诊治。甘大用因为之前的失误，用玉露散给他服用。不知道即止（见效就停药）恐怕违反损伤胃气的戒律，又犯了错误。这个孩子初次服药后，腹泻和口渴都停止了，再次服用后腹泻更加严重，第三次服用后出现大热大渴，面色红赤如火，张口喘呼。甘大用见状紧急，邀请我一同去看诊。我问他们服用了什么药，他们说：“之前您制作的玉露散。”又问服了几次，父母回答：“初次服用一次有效，后来连续服用三天，越服越不好，希望相公救治。”我教他们用理中汤加一片熟附子服用。又教导说：“服药后如果安静就停药；如果服药后烦躁，再给一剂。”甘大用接受教导去治疗，果然出现烦躁，连续进服两剂后病情安定。甘大用获得丰厚感谢，特意来到我家，拜谢说：“以此报答日前您的教导。”于是问我：“这两个孩子病症相同，治疗方法却不同，为什么呢？”我说：“夏至后的腹泻，七分是热，三分是寒。治疗这种腹泻，应当用七分寒药，三分热药。前面的病例是因为你多服了理中汤，违反了‘用热远热’的戒律，所以用玉露散来解火令之热。后面的病例是因为你过服玉露散，损伤了中气，所以用理中汤加附子来救里。”甘大用问：“为什么安静的不治，烦躁的反可治呢？”我说：“夏至后垢卦当令，伏阴在内。六月建未，其位在坤，坤代表腹部且生土，土性喜欢温暖而厌恶寒冷。玉露散性质寒凉，损伤了脾土，导致阴盛于内，阳脱于外，所以用理中汤和附子的辛热，来收敛将要脱失的阳气，战胜正在生长的阴气。服药后安静的，是脾气败绝，投药不知反应，所以不可治。如服药后烦躁的，是寒热相搏，脾脏还有生机，所以再投药，使其战胜寒气。”甘大用说：“如此神妙，我当初怎么知道的呢？下次治疗这种热泻，应该怎么做？”我说：“看他的病症如何。如果腹泻多而热渴少的，急以温中为主，先进服理中汤，后用玉露散轻微解热。如果不渴，不可使用。如果先有大热大渴而腹泻少的，这是里热甚，急解暑毒，用玉露散解之。热渴稍微停止后，用理中汤补其中气。腹泻停止后不可再服用。如果口渴不止，只用白术散治疗，理中汤和玉露散都不可服用。切记我的话，不要再误。白术散是治疗腹泻口渴不止的要药。如果服用白术散后口渴腹泻不止，这是水湿壅盛侵犯肾脏，肾得水反而燥，所以转为口渴腹泻，宜用白术散去干葛，加入炒干姜等分服用。辛味可以润燥，促进津液生成。”甘大用从此医术逐渐通达，家道颇为昌盛。
《黄帝内经》说：夏季伤于暑气，秋季发作疟疾。我认为疟疾这种疾病，不仅仅是中暑才有，凡是风寒暑湿、饮食劳倦，都会导致此病。大致百姓患疟痢的很多。盖因四时之气，太阴湿土当令，手太阴肺经受风寒暑湿之气，病疟多；足太阴脾经受饮食水谷之邪，则病痢多。二经受邪，则既病疟又病痢。病疟的，用平疟养脾丸主治；病痢的，用和中丸主治。这是我家族传承不易的秘密方法，要珍重它，不要轻率示人。
《难经》说：形体受寒、饮食生冷则伤肺。肺主皮毛，秋冬季节发病适宜攻邪者多，因伤寒所致，鼻塞声重，适宜发散，用麻黄汤主治。
药材包括：麻黄（连根水泡去沫）、杏仁（去皮尖炒）、生甘草（各等分）。以上用水煎服。热甚者加生石膏末、腊茶叶，名为五虎汤，神效。
湿邪伤肾，导致利下（腹泻）且肛门重坠。秋月患痢疾的，都是肾病。宜用地黄丸去掉丹皮，加入酒炒黄柏、炒破故纸、炒小茴香，各二两，炒黑干姜五钱，研末制丸服用。
《黄帝内经》说：冬季伤于寒邪，春天必定发生温病，属于温热性质的疾病。况且冬季气候异常温暖，则阳气暴泄，不能闭藏，寒邪被折损，到春季则发为热病。小儿得了这种病，就会发生疮疹病，也属于温热之类。如果有这种气候，适宜预先服用代天宣化解毒丸，很有良验。
The *Yellow Emperor's Inner Classic* states: If wind pathogen is injured in spring, sunken diarrhea (diarrhea containing undigested food) will occur in summer. Sunken diarrhea refers to the inability to digest food.
Wan Quan elaborated in *Youke Fahui*: The *Nan Jing* distinguishes between five types of diarrhea, and the *Mai Jue* states that dampness often causes five types of diarrhea. There is also the syndrome of Weifeng Tang. Although the severity varies, such cases occasionally occur and must not be ignored.
If vomiting and diarrhea are caused by wind injury, wind belongs to Wood, while Spleen and Stomach belong to Earth. Due to deficiency of Earth, Wood overacts upon it. Water and grain cannot be digested, termed "complete grain" (undigested food). This originates from the Stomach where digestion has not occurred; if it comes from the Small Intestine, the food is half-digested and becomes residue upon excretion; if from the Large Intestine, water and grain have already separated, with more grain and less water. Therefore, for sunken diarrhea caused by wind injury, if there are exterior signs such as aversion to wind, dispersing methods are appropriate. Use Guizhi Tang (Cinnamon Twig Decoction) added with Qianghuo, Huangqin, and Fangfeng; or Xieqing Wan (Drain Green Pill) without Dahuang, added with Zhi Gancao (Honey-fried Licorice); or Jiabian Baidu San (Modified Defeat Poison Powder). If there are no exterior signs, use Shenzhu San (Divine Skill Powder); for wind malaria, use Chailing Tang.
Jiabian Baidu San consists of removing Duhuo and Zhike, adding Danggui. (Equal parts of each, using Shengjiang [Fresh Ginger] and Dazao [Jujube] as guides.) Shenzhu San treats sunken diarrhea occurring in summer due to wind injury in spring. Ingredients: Cangzhu (1.5 qian), Ben Cao (Ligusticum sinense), Chuanxiong (each 0.6 qian), Qianghuo (0.4 qian), Zhi Gancao (0.6 qian), Xixin (0.2 qian). Grind into powder, divide into two doses, decoct with ginger water.
If bright red blood is passed, this is due to wind-heat, treated primarily with Weifeng Tang.
Cough caused by wind injury indicates wind entering the Lung; dispersing is appropriate, treated primarily with Renshen Jingjie San (Ginseng and Schizonepeta Powder). (See section on Convulsions.)
For vomiting and diarrhea caused by summerheat injury in summer, Jiawei Wuling San (Modified Five-Ling Powder) is used.
Ingredients: Zhuling, Zexie, Baizhu, Bai Fuling, Guizhi, Huoxiang Ye, Sharen (equal parts). Grind into powder, take with warm water.
Summer diarrhea is very common in children. There are three treatment methods: clearing summerheat, promoting urination, and warming the middle. Using cold medicines to stop diarrhea damages the disease process.
Wan Quan elaborated: If initial diarrhea presents with fever and thirst, clearing summerheat should be prioritized. Do not immediately use Lizhong Tang or Lizhong Wan, as internal heat may exist, and Jiangtang (Dried Ginger) violates seasonal prohibitions. Use Jiawei Xuru Yin (Modified Elsholtzia Decoction).
Ingredients: Xuru, Huanglian, Zhi Gancao (equal parts). Decoct and take hot.
Alternatively, take Lizhong Tang cold. Or use Liuyi San, mixed with Shengjiang Tang.
If initial watery diarrhea presents without fever or thirst, do not take Yulu San excessively, lest it damage Stomach Qi. Use Lizhong Tang added with Huoxiang, decoct, clarify, and take cold. Or dissolve Lizhong Wan in cold water and take.
Yulu San ingredients: Hanshuishi (Halloysitum Rubrum, 3 liang), Huashi (Talcum, 3 liang), Gancao powder (1 liang). Grind uniformly, mix with cold water and take.
If diarrhea persists despite the above methods, promoting urination is appropriate. If there is heat and thirst, take with Liuyi San; if no heat and no thirst, dissolve Lizhong Wan and take. This is a valuable family prescription for treating summer diarrhea. Those following my method experience release and descent; those violating my teachings gain little and lose much. See previous sections for details.
My maternal grandfather’s grandson, under one year old, suffered diarrhea in June. His uncle, Gan Dayong, used my transmitted method but failed, worsening high fever and intense thirst. I examined him and asked, "What medicine did you take?" He replied, "Lizhong Wan." I suspected he did not know the prohibition against using heat in heat seasons ("avoid heat when treating heat"), violating seasonal rules. Thus, I prepared Yulu San to resolve seasonal heat, taken with cold water. One dose brought peace. Yulu San was subsequently included in pediatric formulas.
A butcher surnamed Xu in our county had a twelve-year-old son who suffered diarrhea in June. Dr. Gan Dayong was consulted. Having erred previously, he used Yulu San. Ignoring the warning to stop once effective to avoid damaging Stomach Qi, he erred again. The child’s diarrhea and thirst stopped after the first dose, worsened after the second, and after the third, presented with severe fever, intense thirst, red face like fire, and gasping. Desperate, Gan invited me to consult. I asked what medicine was taken; they said, "Your Yulu San." How many doses? Parents replied, "One dose worked, then three days of continuous dosing made it worse. Please save him." I instructed using Lizhong Tang with one slice of Shu Fuzi (Prepared Aconite Root). I added, "Stop if calm; if restless after medication, give another dose." Gan followed instructions. Restlessness appeared; two more doses brought peace. Gan thanked me richly, visited my home, and bowed, saying, "To repay your teaching." He asked, "Why different treatments for similar symptoms?" I said, "Post-Solstice diarrhea is 70% heat, 30% cold. Treatment should be 70% cold herbs, 30% hot herbs. The first case resulted from excessive Lizhong Tang, violating 'avoid heat in heat season,' hence Yulu San to clear fire-season heat. The second case resulted from excessive Yulu San, damaging Middle Qi, hence Lizhong Tang plus Fuzi to rescue the interior." Gan asked, "Why is the calm case untreatable, while the restless is treatable?" I said, "After Solstice, Gou hexagram governs, hidden yin inside. June corresponds to Wei, position Kun, representing abdomen and generating Earth. Earth loves warmth and hates cold. Yulu San is cold, damaging Spleen Earth, causing yin excess internally and yang collapse externally. Hence, spicy-hot Lizhong and Fuzi converge escaping yang and overcome growing yin. Calmness indicates Spleen Qi exhaustion, unresponsive to medicine, thus untreatable. Restlessness indicates cold-heat struggle, Spleen still has life force, so further medication can overcome cold." Gan said, "So miraculous, how did you know initially? How to treat such heat diarrhea next time?" I said, "Assess symptoms. If diarrhea is profuse with slight heat/thirst, urgently warm the middle: first Lizhong Tang, then mild Yulu San. If no thirst, do not use. If initial severe heat/thirst with slight diarrhea, interior heat is severe: urgently resolve summerheat toxin with Yulu San. After heat/thirst subside slightly, use Lizhong Tang to tonify Middle Qi. Stop when diarrhea ceases. If thirst persists, only use Baizhu San; neither Lizhong nor Yulu San should be used. Remember my words, do not err again. Baizhu San is essential for persistent diarrhea and thirst. If Baizhu San fails, water accumulation invades Kidney; Kidney gets water but becomes dry, turning to thirst/diarrhea. Use Baizhu San removing Gegen, adding equal parts fried Jiangtang. Spicy moistens dryness, generates fluids." Gan’s medical skills improved, and his family prospered.
Summerheat malaria uses Chaihu Baihu Tang (Bupleurum and White Tiger Decoction), i.e., Xiao Chaihu Tang combined with Baihu Tang.
Summerheat cough uses Ganjie Tang combined with Huanglian Ejiao Wan.
The *Inner Classic* states: Summerheat injury in summer leads to malaria in autumn. I believe malaria arises not only from summerheat but also from wind-cold, dampness, diet, and fatigue. Generally, people suffer much malaria and dysentery. This is because during the four seasons, Taiyin Damp-Earth governs. Hand-Taiyin Lung Meridian receives wind-cold-summerheat-dampness, leading to much malaria; Foot-Taiyin Spleen Meridian receives food/water/grain pathogens, leading to much dysentery. If both meridians receive pathogens, both malaria and dysentery occur. For malaria, Pingma Yangpi Wan is used; for dysentery, Hezhong Wan is used. This is an unchangeable family secret method. Treasure it, do not show it lightly.
*Nan Jing* states: Cold form and cold drinks injure the Lung. Lung governs skin and hair. Autumn/Winter diseases often require attacking pathogens. Caused by cold injury, nasal congestion and heavy voice indicate need for dispersing, treated with Mahuang Tang.
Ingredients: Mahuang (soaked to remove foam), Xingren (peeled, tip removed, fried), Sheng Gancao (equal parts). Decoct in water. For severe heat, add Sheng Shigao powder and La Cha Ye (Winter Tea Leaves), named Wuhu Tang, extremely effective.
Dampness injuring Kidney causes diarrhea with heaviness/tenesmus. Autumn dysentery is all Kidney disease. Use Dihuang Wan removing Danpi, adding wine-fried Huangbai, fried Pogostemon cablin (Guozhi), fried Huixiang, each 2 liang, fried black Jiangtang 5 qian. Grind and make pills.
*Inner Classic* states: Winter cold injury leads to warm disease in spring, which is a type of warm-heat disease. Moreover, if winter weather is abnormally warm, yang qi leaks violently, failing to store. Cold is折 (broken/restrained), emerging in spring as heat disease. Children contracting this develop sores/rashes, also warm-heat types. If such climate exists, preemptively take Taitian Xuanhua Jiedu Wan, which is highly effective.