交夏至后。炎暑司令。相火用事。人有发热身疼不恶寒。但大热而大渴者为热病。
仲景以白虎汤为主治。今人以此汤治伤寒者误也。热病下发上。内发外。必经阳
明。故无论三阳。总以石膏之辛凉。乘势升散。知母之苦寒。靖少阴伏邪之源。甘草、
粳米。维持中气。一了百当。至伤寒既非其时。复非其病。邪自外来。未入者解表。已
入者下夺。石膏本非表药。又非下药。即欲解热。热何从解。况有知母。引入少阴。为
害不浅。理自如此。达者自会。愚不敢好与今人辩也。故除以上见证正方外。补集方治。
一法。热病之脉本洪大。若见浮紧。是又感夏时暴寒。谓轻举见紧。略按则仍洪盛。
以内伏已发也。治宜通解散。去麻黄、苍术。或加葱白、香豉。或先以连须葱白香
豉汤。减生姜撒其外。后用白虎加人参汤。
一法。热病凡客邪所感。不论脉浮紧。恶风恶寒。宜解不宜下者。通用双解散去硝
黄。于中加减。如去白术、芍药、桔梗二三味。加知母葱豉最妥。
一法。凡温病之发。因暴寒者居多。热病之发。兼暑 者为盛。若始病见谵语面垢
遗溺。背微恶寒者。白虎加人参汤。
一法。若本病兼衄。于本汤中加生地黄、牡丹皮。喘加栝蒌根、浓朴、杏子仁。
一法。若恶热烦渴腹满。舌黄燥或黑干。五六日不大便。凉膈散或三一承气汤。
一法。若本病兼暑湿者。或凉膈合天水散。若小便不利者。竹叶石膏汤倍石膏。
一法。若兼风痰者。用双解散。煎一大豌。先饮半作探吐。法以引痰出外。再尽剂。微
以被覆。令汗出解。盖用凉药热饮。发汗百无一损也。河间制双解散。子和演为
吐法甚妙。
一法。误用辛温药。致发斑谵语。喘满昏乱者。黄连解毒汤加减。
一法。屡下后热势犹盛。不便再下。或诸湿内盛。小便黄涩。大便溏。小腹痛者。欲作利也。宜黄连解毒汤。
夏至过后，炎暑当令，相火主事。人出现发热、身体疼痛但不恶寒，只是大热且大渴的，称为热病。
张仲景以白虎汤作为主要治疗方剂。现在的人用这个方子治疗伤寒是错误的。热病的邪气由内发于外，或由下发于上，必定经过阳明经。所以无论是三阳经的病，总要用石膏的辛凉之性，顺势升散；知母的苦寒之性，平息少阴伏邪的根源；甘草、粳米，维持中焦之气。这样处理就一劳永逸了。至于伤寒，既不在其时令，也不是这种病，邪气从外来，未入里的应当解表，已入里的应当攻下。石膏本来不是解表药，也不是攻下药，即使想解除热邪，热邪从哪里解除呢？况且还有知母，会将邪气引入少阴，危害不浅。道理自然如此。通达的人自会明白，我不敢喜欢与今人争辩。所以除了以上见证的正方之外，补充收集治疗方法。
第一种方法：热病的脉象本来洪大，如果见到浮紧，这是又感受了夏季暴发的寒邪，叫做轻举时见紧脉，稍微按压则仍然洪盛，因为内部伏邪已经发作。治疗宜用通解散，去掉麻黄、苍术，或者加葱白、香豉。或者先用连须葱白香豉汤，减少生姜以发散表邪，后用白虎加人参汤。
第二种方法：热病凡是外邪所感，不论脉象浮紧，有恶风恶寒，适宜解表不适宜攻下的，通用双解散去掉硝石、大黄，在中间加减。如去掉白术、芍药、桔梗二三味，加知母、葱、豉最妥当。
第三种方法：凡是温病发作，因暴发寒邪的多，热病发作，兼夹暑邪的更盛。如果初病出现谵语、面部污垢、遗尿，背部微微恶寒的，用白虎加人参汤。
第四种方法：如果本病兼有鼻衄，在本汤中加入生地黄、牡丹皮；气喘加栝蒌根、浓朴、杏子仁。
第五种方法：如果恶热、烦渴、腹满，舌苔黄燥或黑干，五六天不大便，用凉膈散或三一承气汤。
第六种方法：如果本病兼夹暑湿，或者凉膈散合天水散。如果小便不利的，用竹叶石膏汤加倍石膏。
第七种方法：如果兼夹风痰，用双解散，煎一大碗，先喝半碗作为探吐法，用来引出痰液排出体外，再喝完剩下的药汁，微微盖被，让出汗而解。大概是用凉药热饮，发汗百无一失。河间刘完素制双解散，子和张从正演绎为吐法非常巧妙。
第八种方法：误用辛温药，导致发斑、谵语、喘满昏乱的，用黄连解毒汤加减。
第九种方法：多次攻下后热势仍然旺盛，不便再次攻下，或者各种湿邪内盛，小便黄涩，大便溏薄，小腹痛的，想要作痢疾。宜用黄连解毒汤。
After the Summer Solstice, intense heat and summer heat take command, and Ministerial Fire (Xianghuo) is in operation. If a person presents with fever, body pain, aversion to cold absent, but only severe heat and extreme thirst, this is termed Heat Disease (Rebing).
Zhang Zhongjing used Baihu Tang (White Tiger Decoction) as the primary treatment formula. It is erroneous for contemporary practitioners to use this decoction to treat Cold Damage (Shanghan). The pathogenic factors of Heat Disease emerge from within to without, or from lower to upper, and must pass through the Yangming channel. Therefore, regardless of whether it involves the three Yang channels, one should generally utilize the acrid-cool nature of Shigao (Gypsum Fibrosum) to ascend and disperse along the momentum, the bitter-cold nature of Zhimu (Anemarrhenae Rhizoma) to quell the source of latent pathogens in Shaoyin, and Gancao (Licorice Root) and Jingmi (Glutinous Rice) to sustain Middle Qi (Zhongqi). This approach achieves comprehensive resolution. As for Cold Damage, it does not occur in its proper season, nor is it this type of disease; the pathogen comes from outside. Those not yet entered into the interior should be resolved via the exterior (Jiebiao), while those already entered should be purged downward (Xiaduo). Gypsum is neither an exterior-resolving drug nor a purgative. Even if one wishes to resolve heat, how can heat be resolved? Moreover, with Anemarrhenae Rhizoma present, it guides the pathogen into Shaoyin, causing significant harm. The logic is self-evident. Those who are enlightened will understand on their own; I dare not indulge in debating with contemporaries. Thus, apart from the correct formulas for the aforementioned manifestations, supplementary treatment methods are collected here.
Method 1: The pulse of Heat Disease is originally flooding and large. If a floating-tight pulse appears, it indicates contraction of sudden cold during summer, termed "light lifting reveals tightness, slight pressing remains flooding and abundant," due to internal latent pathogens having erupted. Treatment should employ Tongjie San (Unblocking and Resolving Powder), removing Mahuang (Ephedrae Herba) and Cangzhu (Atractylodis Rhizoma), or adding Congbai (Allii Fistulosi Bulbus) and Chidouchi (Fermented Soybean). Alternatively, first administer Lianxu Congbai Chidou Tang (Scallion White and Fermented Soybean Decoction with roots), reducing Shengjiang (Zingiberis Rhizoma Recens) to scatter the exterior, followed by Baizhu Jia Renshen Tang (White Tiger Decoction plus Ginseng).
Method 2: For Heat Disease caused by external pathogens, regardless of whether the pulse is floating-tight, or there is aversion to wind and cold, where resolution via the exterior is indicated rather than purging, Shuangjie San (Double-Resolving Powder) with Xiaoshi (Natrii Sulfas) and Dahuang (Rhei Radix et Rhizoma) removed should be used generally, with modifications. Removing Baizhu (Atractylodis Macrocephalae Rhizoma), Shaoyao (Paeoniae Radix Alba), and Jiegeng (Platycodonis Radix) among others, and adding Zhimu (Anemarrhenae Rhizoma), Congbai (Allii Fistulosi Bulbus), and Chidou (Fermented Soybean) is most appropriate.
Method 3: Most Warm Disease (Wenbing) eruptions are caused by sudden cold, whereas Heat Disease eruptions are more prevalent when combined with summer heat. If initial symptoms include delirium, greasy facial complexion, urinary incontinence, and slight aversion to cold on the back, use Baizhu Jia Renshen Tang (White Tiger Decoction plus Ginseng).
Method 4: If the primary disease is accompanied by epistaxis, add Shengdihuang (Rehmanniae Radix) and Mudanpi (Moutan Cortex) to the base decoction. If wheezing occurs, add Gualougen (Trichosanthis Radix), Houpo (Magnoliae Officinalis Cortex), and Xingren (Armeniacae Semen Amarum).
Method 5: If there is aversion to heat, vexation and thirst, abdominal fullness, yellow-dry or black-dry tongue coating, and no bowel movement for five to six days, use Liangge San (Cooling the Diaphragm Powder) or Sanyi Chengqi Tang (Three-One Descending Qi Decoction).
Method 6: If the primary disease is complicated by summer-dampness, combine Liangge San (Cooling the Diaphragm Powder) with Tianshui San (Heavenly Water Powder). If urination is difficult, use Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) with doubled Shigao (Gypsum Fibrosum).
Method 7: If complicated by wind-phlegm, use Shuangjie San (Double-Resolving Powder). Decoct a large bowl, drink half first to induce vomiting, a method to draw phlegm out externally, then finish the remaining dose. Cover slightly with a blanket to induce sweating for resolution. Generally, taking cooling medicines hot induces sweating effectively without harm. Liu Wansu of Hejian formulated Shuangjie San (Double-Resolving Powder), and Zhang Congzheng (Zihe) ingeniously adapted it for emesis therapy.
Method 8: If mistaken use of acrid-warm drugs leads to macules, delirium, wheezing, fullness, and confusion, modify Huanglian Jiedu Tang (Coptis Decoction for Detoxification).
Method 9: If after repeated purging the heat intensity remains strong, making further purging inadvisable, or if various damp pathogens are abundant internally, presenting with yellow-astringent urine, loose stools, and lower abdominal pain indicating impending dysentery, use Huanglian Jiedu Tang (Coptis Decoction for Detoxification).