香薷饮乃夏月通用之药饵，常见富贵之家多有备此。令老少时常服之，用以防暑。而不
知人之宜此者少，不宜此者多也。若误用之，必反致疾，何也？盖香薷一物，气香窜而性沉
寒。惟其气窜，所以能通达上下，而去菀蒸之湿热。惟其性寒，所以能解渴除烦，而清搏
结之火邪。然必果属阳脏，果有火邪，果脾胃气强，肥甘过度，而宜寒畏热者，乃足以当之
，且赖其清凉，未必无益。若气本不充，则服之最能损气。火本非实，而服之乃以败阳。凡
素禀阴柔，及年质将半，饮食不健，躯体素弱之辈，不知利害而效尤妄用者，未有不反助伏
阴，损伤胃气，而致为吐泻腹痛，及阴寒危败等证。若加黄连，其寒尤甚，浓朴破气，均非
所宜。用者不可不审。
仲景曰∶其伤于四时之气皆能为病。冬时严寒，中而即病者，名曰伤寒。不即病者，寒
毒藏于肌肤，至春变为温病，至夏变为暑病。暑病者，热极重于温也。是以辛苦之人，春夏
多温热病，皆由冬时触寒所致，非时行之气也。凡时行者，春时应暖而复大寒，夏时应大热
而反大凉，秋时应凉而反大热，冬时应寒而反大温。此非其时而有其气，是以一岁之中，长
幼之病多相似者，此则时行之气也。
曰∶太阳中热者， 是也。其人汗出恶寒，身热而渴，白虎加人参汤主之。太阳中
者，身热疼痛而脉微弱，此亦夏月伤冷水，水行皮中所致也，一物瓜蒂汤吐之。太阳
中者，发热恶寒，身重而疼痛，其脉弦细芤迟，小便已，洒洒然毛丛，手足逆冷，小
有劳，身即热，口开，前板齿燥。若发汗则恶寒甚，加温针则发热甚，数下之则淋甚。
洁古曰∶静而得之为中暑，动而得之为中热。中暑者阴证，中热者阳证。
陈无择曰∶暑热喜归心，心中之，使人噎闷，昏不知人。入肝则眩晕顽痹。入脾则昏睡
不觉，入肺则喘满痿 ，入肾则消渴。凡中 死者，治之切不可用冷，惟宜温养。
道途中无汤，即以热土熨脐中，仍使更溺其土，取以罨于脐上，概可见矣。凡觉中暑，急嚼
生姜一大块，水送下。如已迷闷，嚼大蒜一大瓣，水送下，如不能嚼，水研灌之，立醒。
戴氏曰∶夏月卒倒，不省人事，名曰暑风。
王节斋曰∶治暑之法，清心利小便最好。暑伤气，宜补真气为要。又有恶寒，或四肢逆
冷，甚者迷闷不省，而为霍乱吐痢，痰滞呕逆，腹痛泻痢，此则非暑伤人，乃因暑而自致之
病也。以其因暑而得，故亦谓之暑病，治法不同。若吐泻，脉沉微甚者，不可用凉药，可用
附子大顺散，或附子理中汤加芍药。若夏月多食冷物，及过饮茶水，致伤脾胃，则吐泻霍乱
。故治暑药多宜温脾消食。治湿利小便，医者要识此意。
薛立斋曰∶按东垣先生云∶暑热之时，无病之人，或避暑热，纳凉于深堂大厦得之者，
名曰中暑。其病必头痛恶寒，身形拘急，肢节疼痛，烦热无汗，为房室阴寒之气所遏，使周
身阳气不得伸越，以大顺散热药主之。若行人或农夫，于日中劳役得之者，名曰中热，其病
必苦头痛，躁热恶热，肌热大渴，汗泄懒动，为天热外伤肺气，以苍术白虎汤凉剂主之。
若人元气不足，用前药不应，宜补中益气汤主之。大抵夏月阳气浮于外，阴气伏于内。若人
饮食劳倦，内伤中气，或酷暑劳役，外伤阳气者多患之，法当调补元气为主，而佐以解暑。
若中暑，乃阴寒之证，法当补阳气为主，少佐以解暑。故先哲多用姜、桂、附子之类，此推
《内经》舍时从证之良法也。今患暑证殁，而手足指甲或肢体青黯，此皆不究其因，不温补
其内，而泛用香薷饮之类所误也。又曰∶前证当分别中暑、中 ，脉虚、脉沉，无汗、
有汗，发热、不热，作渴、不渴，或泻、不泻，饮寒、饮热。辨其阴阳虚实，不可泛投寒凉
之剂。盖谓夏月伏阴在内，古人用附子大顺散之类，温补阳气，厥有旨哉。何今人之老弱，
至夏月患食少体倦，发热作渴，或吐泻腹痛头痛诸证，反服香薷饮，复伤元气，无不招引暑
证，以致不起。至若清暑益气汤内用泽泻、苍术、黄柏之类，必审其果有湿热壅滞，方可用
之。否则反致亏损其阴，用当审察。
香薷饮是夏季通用的药物，常见富贵人家多有备此药。让老人和小孩时常服用，用来预防中暑。却不知道适合用它的人少，不适合用它的人多。如果误用，必定反而导致疾病，为什么呢？因为香薷这一味药，气味香窜而性质沉寒。正因为其气窜，所以能通达上下，去除郁积蒸腾的湿热。正因为其性寒，所以能解渴除烦，清除搏结的火邪。然而必须确实是阳脏体质，确实有火邪，确实脾胃气强，肥甘厚味过度，且宜寒畏热的人，才足以承受它，并且依赖它的清凉，未必没有益处。如果元气本来不充足，那么服用它最能损伤元气。火邪本非实证，而服用它却会败坏阳气。凡是素来禀赋阴柔，以及年岁将近半百，饮食不健旺，躯体素来虚弱之辈，不知利害而效仿胡乱使用的人，没有不反而助长伏留的阴寒，损伤胃气，而导致出现呕吐腹泻、腹痛，以及阴寒危重败绝等证候的。如果加入黄连，其寒性尤其严重，厚朴破气，都不适宜。使用者不可不审慎。
张仲景说：人伤于四时的气候都能致病。冬季严寒，受寒后立即发病的，名叫伤寒。不立即发病的，寒毒藏于肌肤，到春天变为温病，到夏天变为暑病。暑病，比温病热势更重。因此劳苦之人，春夏季节多患温热病，都是由冬季触寒所致，并非时行之气。凡是时行病，春季应该温暖却突然大寒，夏季应该大热却反而大凉，秋季应该凉爽却反而大热，冬季应该寒冷却反而大温。这不是在相应的季节却有相应的气候，所以一年之中，老少得的病大多相似，这就是时行之气。
《内经》说：太阳经受中热邪气的，就是中暍（中暑）。其人汗出恶寒，身热而口渴，用白虎加人参汤主治。太阳经受中湿邪气的，身热疼痛而脉微弱，这也是夏季伤于冷水，水气运行于皮中所致，用一物瓜蒂汤催吐治疗。太阳经受中风湿邪气的，发热恶寒，身体沉重而疼痛，脉象弦细芤迟，小便后，感觉洒洒然恶寒毛竖，手足逆冷，稍微劳作，身体即发热，张口呼吸，前板齿干燥。如果发汗则恶寒更甚，加温针则发热更甚，多次攻下则淋证更重。
李东垣（洁古）说：静处而得的是中暑，运动而得的是中热。中暑属于阴证，中热属于阳证。
陈无择说：暑热喜欢归于心，心中之邪，使人噎闷，昏不知人。侵入肝则眩晕顽痹。侵入脾则昏睡不觉，侵入肺则喘满痿弱，侵入肾则消渴。凡是中暑死亡的患者，治疗时切不可用冷药，只宜温养。
如果在道途中没有热水，就用热土熨烫脐中，再让人尿在土上，取来敷在脐上，大概可以见到效果。凡是觉得中暑，急嚼一大块生姜，用水送下。如果已经昏迷闷乱，嚼一大瓣大蒜，用水送下，如果不能嚼，用水研磨灌服，立刻苏醒。
王节斋说：治疗暑病的方法，清心利小便最好。暑邪伤气，补益真气是首要任务。又有恶寒，或四肢逆冷，严重的昏迷不省，以及霍乱吐痢，痰滞呕逆，腹痛泻痢，这些不是暑邪伤人，而是因为暑天自己导致的病。因为它因暑而得，所以也叫暑病，治法不同。如果出现吐泻，脉象沉微严重的，不可用凉药，可用附子大顺散，或附子理中汤加芍药。如果夏季多吃冷物，及过饮茶水，导致损伤脾胃，则发生吐泻霍乱。所以治疗暑病的药多宜温脾消食。治疗湿邪利小便，医生要明白这个意思。
薛立斋说：按东垣先生所说：暑热之时，无病的人，或者避暑热，纳凉于深堂大厦得病的，名叫中暑。他的病一定头痛恶寒，身形拘急，肢节疼痛，烦热无汗，为房室阴寒之气所遏阻，使周身阳气不得伸越，用大顺散这类热药主治。如果是行人或农夫，在日中劳役得病的，名叫中热，他的病一定苦头痛，躁热恶热，肌热大渴，汗泄懒动，为天热外伤肺气，用苍术白虎汤这类凉剂主治。如果人元气不足，用前面的药不应效，宜用补中益气汤主治。大抵夏季阳气浮于外，阴气伏于内。如果人饮食劳倦，内伤中气，或酷暑劳役，外伤阳气的人多患此病，治法应当以调补元气为主，而佐以解暑。如果是中暑，乃是阴寒之证，治法应当以补阳气为主，少佐以解暑。所以先哲多用姜、桂、附子之类，这是推演《内经》舍时从证的良法。现在患暑证而死，而手足指甲或肢体青黯，这都是不究其因，不温补其内，而泛用香薷饮之类所误。又说：前面的证候应当分别中暑、中湿，脉虚、脉沉，无汗、有汗，发热、不热，作渴、不渴，或泻、不泻，饮寒、饮热。辨别其阴阳虚实，不可泛投寒凉之剂。这是因为夏季伏阴在内，古人用附子大顺散之类，温补阳气，很有深意啊。为什么今人老弱，到了夏季患食少体倦，发热作渴，或吐泻腹痛头痛诸证，反而服香薷饮，再次损伤元气，无不招引暑证，以致不起。至于清暑益气汤内用泽泻、苍术、黄柏之类，必须审察其果有湿热壅滞，方可用之。否则反而导致亏损其阴，用药应当审察。
Xiangru Yin (Mosla Decoction) is a general-purpose medication for summer, and it is common for wealthy families to keep this medicine on hand. They let the elderly and children take it frequently to prevent heatstroke. However, few people are suitable for its use, while many are not. If used mistakenly, it will inevitably cause illness. Why? Because Mosla (Xiangru), as a single herb, has an aromatic and penetrating aroma but a sinking-cold nature. Precisely because of its penetrating nature, it can penetrate through the upper and lower parts of the body to remove damp-heat that is stagnant and steaming. Precisely because of its cold nature, it can relieve thirst and remove irritability, and clear fire pathogens that are knotted and struggling. However, only those who truly have a Yang constitution, truly possess fire pathogens, truly have strong Spleen and Stomach Qi, consume excessive rich and sweet foods, and prefer cold while fearing heat, can tolerate it. Relying on its cooling properties, it may not be without benefit. But if one's original Qi is inherently insufficient, taking it can most easily damage Qi. If the fire pathogen is not an excess condition, taking it will ruin Yang Qi. Those who are naturally endowed with Yin-deficient or soft constitutions, those approaching middle age, those with poor dietary health, and those with inherently weak physiques, who do not understand the benefits and harms and blindly imitate by using it recklessly, will invariably aggravate latent Yin-cold, damage Stomach Qi, and lead to symptoms such as vomiting, diarrhea, abdominal pain, and even critical Yin-cold collapse syndromes. If Coptis Rhizome (Huanglian) is added, its coldness becomes even more severe; Magnolia Bark (Houpo) breaks Qi, so neither is suitable. Users must exercise caution.
Zhang Zhongjing stated: Injury by the Qi of the four seasons can all result in disease. In winter, severe cold strikes; if illness occurs immediately upon injury, it is named Cold Damage (Shanghan). If illness does not occur immediately, cold toxins hide within the skin and muscles, transforming into Warm Disease (Wenbing) in spring, and into Summerheat Disease (Shubing) in summer. Summerheat disease involves heat that is more severe than that of warm diseases. Therefore, laborers often suffer from warm-heat diseases in spring and summer, all caused by cold exposure in winter, not by epidemic Qi. Epidemic Qi refers to situations where spring should be warm but suddenly becomes extremely cold; summer should be extremely hot but turns extremely cool; autumn should be cool but turns extremely hot; winter should be cold but turns extremely warm. This is having the Qi of a different season at the wrong time. Thus, throughout the year, illnesses among young and old are often similar; this is called epidemic Qi.
The *Neijing* states: When the Taiyang channel suffers from Summerheat-Heat, it is called Zhong Yue (heatstroke/sunstroke). The patient sweats, fears cold, has body heat, and feels thirsty; Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng) is the primary treatment. When the Taiyang channel suffers from Dampness, the body is hot and painful with a faint pulse; this is also caused by injuring cold water in summer, with water qi circulating within the skin; Yiwu Gaudi Tang (Single Melon Pedicel Decoction) should be used to induce vomiting. When the Taiyang channel suffers from Wind-Dampness, there is fever, aversion to cold, heaviness and pain in the body, and the pulse is wiry, fine, hollow, and slow. After urination, the patient feels chilly with goosebumps, hands and feet are cold, slight exertion causes body heat, the mouth opens (gasping), and the front teeth are dry. If sweating methods are used, aversion to cold worsens; if moxibustion/warming needles are added, fever worsens; if purgatives are used repeatedly, strangury worsens.
Li Dongyuan (Jiegu) stated: Obtained while resting is Summerheat (Zhongshu); obtained while moving/exerting is Heatstroke (Zhongre). Summerheat is a Yin syndrome; Heatstroke is a Yang syndrome.
Chen Wuyue stated: Summerheat-heat tends to enter the Heart. Pathogens in the Heart cause chest oppression and stuffiness, leading to unconsciousness. Entering the Liver causes dizziness and numbness/paralysis. Entering the Spleen causes drowsiness and unawareness. Entering the Lung causes wheezing, fullness, and flaccidity. Entering the Kidney causes Xiao Ke (wasting-thirst syndrome). For patients dying of heatstroke, treatment must absolutely avoid cold medicines; only warming and nourishing methods are appropriate.
If no hot water is available on the road, apply hot earth to the umbilicus, then have someone urinate on the earth, collect it, and apply it to the umbilicus; this demonstrates the principle. Whenever one feels heatstroke, urgently chew a large piece of fresh ginger and swallow with water. If already comatose or stifled, chew a large clove of garlic and swallow with water; if unable to chew, grind it in water and force-feed; the patient will awaken immediately.
Dai Shi stated: Sudden collapse in summer with loss of consciousness is named Summerwind (Shufeng).
Wang Jiezhai stated: The best method for treating summerheat is to clear the Heart and promote urination. Summerheat damages Qi, so tonifying True Qi is essential. There are also cases of aversion to cold, or cold extremities, severe coma/unconsciousness, Huoluan (cholera-like vomiting and diarrhea), phlegm-stagnation retching, abdominal pain, and dysentery. These are not injuries by summerheat per se, but diseases self-induced due to summer conditions. Because they arise from summer factors, they are also called summerheat diseases, but the treatment differs. If vomiting and diarrhea occur with a deep, faint pulse, cold medicines must not be used; Fuzi Dashun San (Aconite Great Harmony Powder) or Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction) plus Shaoyao (Peony) may be used. If excessive consumption of cold foods and over-drinking of tea in summer damages the Spleen and Stomach, resulting in vomiting, diarrhea, and Huoluan, then summerheat medications should generally favor warming the Spleen and digesting food. To treat dampness, promote urination; physicians must understand this principle.
Xue Lizhai stated: According to Mr. Dongyuan: During times of summerheat, healthy individuals who seek relief from heat by staying in deep halls and large buildings may contract what is named Summerheat (Zhongshu). Their illness definitely includes headache, aversion to cold, stiff body posture, joint pain, irritability, heat, and absence of sweat. This is caused by Yin-cold air from indoor environments obstructing the body's Yang Qi, preventing it from extending and ascending; Dadun San (Great Harmony Powder), a hot-natured drug, is the primary treatment. If pedestrians or farmers contract illness from labor under the midday sun, it is named Heatstroke (Zhongre). Their illness definitely includes severe headache, restlessness, heat, aversion to heat, burning skin, extreme thirst, sweating, and lethargy. This is caused by heavenly heat externally injuring Lung Qi; Cangzhu Baizhu Tang (Atractylodes and White Tiger Decoction), a cooling formula, is the primary treatment. If the patient's Original Qi is insufficient and previous remedies fail, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) should be used. Generally, in summer, Yang Qi floats outward, while Yin Qi hides inward. If diet and fatigue internally injure Middle Qi, or intense summer heat and labor externally injure Yang Qi, many suffer from this. The method should primarily focus on regulating and tonifying Original Qi, assisted by resolving summerheat. If it is Summerheat (Zhongshu), it is a Yin-cold syndrome; the method should primarily tonify Yang Qi, assisted slightly by resolving summerheat. Thus, ancient sages often used Ginger, Cinnamon Twig, Aconite, and similar substances. This is a good application of the *Neijing* principle of "abandoning the season to follow the syndrome." Now, patients dying of summerheat presentations often have blue-black fingernails or limbs. This is due to failing to investigate the cause, failing to warm and tonify the interior, and indiscriminately using Xiangru Yin and similar formulas. He further stated: Previous syndromes should be differentiated between Summerheat and Dampness, empty vs. deep pulses, absence vs. presence of sweat, fever vs. no fever, thirst vs. no thirst, diarrhea vs. no diarrhea, preference for cold vs. hot drinks. Differentiate their Yin-Yang and deficiency-excess nature; do not indiscriminately administer cold-cooling agents. This is because latent Yin resides inside during summer. Ancients used Fuzi Dashun San and similar formulas to warm and tonify Yang Qi; this had profound significance. Why do modern frail and elderly people, suffering from poor appetite, body fatigue, fever, thirst, or vomiting/diarrhea/abdominal pain/headache in summer, instead take Xiangru Yin, further damaging Original Qi, invariably attracting summerheat pathogens, leading to death? Regarding Qing Shu Yi Qi Tang (Clear Summerheat and Augment Qi Decoction), which contains Ze Xie, Cang Zhu, and Huang Bo, one must verify the presence of damp-heat stagnation before using it. Otherwise, it will inadvertently damage Yin. Medication usage requires careful examination.