杨如侯曰∶两胫逆冷，胸满，头目痛，妄言多汗，此先伤于湿，又中于暑，湿得暑邪，遏抑阳气而病也。头痛，妄
言，多汗，脉阳濡而弱，阴小而急，此先受暑，后受湿，暑挟湿邪，郁蒸为热而病也。朱南阳、许学士，均名为湿温。
雷少逸以湿温当以夏末秋初为界限，方与《内经》秋伤于湿之训不相龃龉，亦与四时之气，大暑至白露，湿土用事，若
合符节。兹于上所列二证，病在夏月，故不以湿温名，而以暑湿称之。
周禹载曰∶湿病缓，暑病速。
沈尧封曰∶《难经》所谓湿温，指湿热并至之病，不名为暑。
杨如侯曰∶冬月头痛，微恶寒，面赤烦渴，舌白，脉濡而数，此冬月触动伏暑之邪而病者也。按虽在冬月，独太阴
伏暑，不得误作伤寒。盖头痛恶寒，内伤寒无异，而面赤烦渴，则非伤寒矣。然犹似伤寒阳明证，至脉濡而数，则断非
伤寒矣。盖寒脉紧，风脉缓，暑脉弱。濡则弱之象，弱则濡之体也。濡即离中虚，火之象也；紧即坎中满，水之象也。
火之性热，水之性寒，象各不同，性则各异。故曰∶虽在冬月，定非伤寒，而为伏暑也。冬月犹为伏暑，秋日可知。伏
暑之与伤寒，犹男女之别，一则外实中虚，一则外虚中实，安得混而同之。
又曰∶伏暑有九似∶头疼壮热似伤寒；往来寒热似疟疾；翻胃吐食似膈气；大便下血似肠风；小便不利似淋沥；饮
食无度似消渴；四肢困倦似虚痨；眼睛黄赤似酒疸；遍身黄肿似食黄，皆伏暑变象也。
雷少逸曰∶伏天所受之暑者，其邪盛，患于当时；其邪微，发于秋后。时贤谓秋时晚发，即伏暑之病也。是时凉风
飒飒，侵袭肌肤，新邪欲入，伏气欲出，以致寒热如疟。或微寒，或微热，不能如疟厘清。其脉必滞，其舌必腻，脘痞
气塞，渴闷烦冤，每到午后则甚，入暮更剧，热至天明得汗，则诸恙稍缓，日日如是，必要二三候外，方得全解。倘调
理非法，不治者甚多。不比风寒之邪，一汗而解；温热之气，投凉则安。拟用清宣温化法，使其气分开，则新邪先解，
而伏气亦随解也。然是证变易为多，其初起如疟，先服清宣温化法，倘畏寒已解，独发热淹绵，可加芦、竹、连翘，
本法内之半夏、陈皮，乃可删去，恐其温燥之品，伤津液也。其舌苔本腻，倘渐黄、渐燥、渐黑、渐焦，是伏暑之热，
已伤其阴，于本法内，可加洋参、麦冬、玄参、细地治之。倘神色昏蒙者，是邪逼近心包，益元散、紫雪丹，量其证之
轻重而用。倘壮热舌焦，神昏谵语，脉实不虚，是邪热归并阳明，宜用润下救津法治之。如年壮体强，以生军易熟军，
更为有力。种种变证，务在临证之时，细审病之新久，体之虚实，按法用之，庶无差忒耳。
又或问曰∶曾见禹载书中论伏暑，谓三伏之时，以书晒曝烈日之中，随即收藏于笥，火气未散，冬时启笥，触之遂
病。今是论中全未言及，得毋遗漏乎？答曰∶子诚刻舟求剑也。此不过偶一有之之证。若此论之，则伏暑之证，专病晒
书之家，而无书晒者则不病；专病在冬，而三秋则不病。可发一笑。
杨如侯说：两条小腿逆冷，胸部胀满，头痛目痛，胡言乱语且多汗，这是先被湿邪所伤，又中于暑邪，湿气得到暑邪的侵袭，遏制压抑阳气而导致的疾病。头痛，胡言乱语，多汗，脉象寸部濡软而弱，尺部细小而急迫，这是先感受暑邪，后感受湿邪，暑气挟带湿邪，郁结蒸腾化为热邪而导致的疾病。朱南阳、许学士，都将此病命名为湿温（Shiwen, Damp-Heat）。雷少逸认为湿温应当以夏末秋初为界限，这样才与《黄帝内经》中“秋季受伤于湿”的教诲不相违背，也与四季之气在从大暑到白露期间，湿土主事的情况，完全吻合。这里所列出的两种证候，发病在夏季月份，所以不称之为湿温，而称之为暑湿（Shushi, Summerheat-Dampness）。
周禹载说：湿病的病程缓慢，暑病的发病迅速。
沈尧封说：《难经》中所说的湿温，指的是湿热并至的疾病，不将其命名为暑病。
杨如侯说：冬季出现头痛，轻微怕冷，面色发红，心烦口渴，舌苔白，脉象濡软而数，这是冬季触动体内潜伏的暑邪而导致的疾病。虽然是在冬季，唯独太阴伏暑（Fushu, Latent Summerheat），不能误当作伤寒（Shanghan, Cold Damage）治疗。因为头痛恶寒，内感寒邪并无不同，但面色发红、心烦口渴，就不是伤寒了。然而这还类似于伤寒阳明证（Yangming Syndrome），直到脉象濡软而数，就断定绝对不是伤寒了。因为寒邪脉象紧，风邪脉象缓，暑邪脉象弱。濡脉是弱脉的表现，弱脉是濡脉的本质。濡脉即离卦中虚，是火的征象；紧脉即坎卦中满，是水的征象。火的性质热，水的性质寒，征象各不相同，性质则截然不同。所以说：虽然在冬季，定不是伤寒，而是伏暑。冬季尚且是伏暑，秋季的情况就可以推知了。伏暑与伤寒的区别，就像男女之别一样，一个外实内虚，一个外虚内实，怎么能混淆在一起呢？
又说：伏暑有九种类似症状：头痛高热类似伤寒；寒热往来类似疟疾（Nueji, Malaria）；翻胃吐食类似膈气（Geqi, Dysphagia）；大便下血类似肠风（Changfeng, Intestinal Wind）；小便不利类似淋沥（Linli, Strangury）；饮食无度类似消渴（Xiaoke, Wasting-Thirst）；四肢困倦类似虚痨（Xulao, Deficiency Consumption）；眼睛黄赤类似酒疸（Jiudan, Wine Jaundice）；遍身黄肿类似食黄（Shihuang, Food Jaundice），这些都是伏暑变化的征象。
雷少逸说：伏天所受的暑邪，邪气盛者，在当时发病；邪气微者，在秋后发病。当时的名医认为秋季晚发，就是伏暑的病证。此时凉风飒飒，侵袭肌肤，新邪欲入，伏气欲出，导致寒热像疟疾一样。或轻微怕冷，或轻微发热，不能像疟疾那样界限分明。其脉象必然滞涩，舌苔必然腻浊，脘腹痞闷气塞，口渴胸闷烦冤，每到午后加重，入夜更剧烈，热至天明出汗，诸症稍缓，日日如此，必要经过三个候（约二十一天）以外，才能完全解除。如果调理方法不当，不治者很多。不像风寒之邪，一汗而解；温热之气，投用凉药则安。拟用清宣温化法（Qingxuan Wenhuafa, Clearing and Dispersing with Warming Transformation Method），使气机分开，则新邪先解，而伏气也随之解除。但是这个证候变化较多，初起像疟疾，先服用清宣温化法，如果畏寒已解，唯独发热缠绵，可加芦根、竹茹、连翘，本法内的半夏、陈皮，才可以删去，恐怕它们是温燥之品，会损伤津液（Jinye, Body Fluids）。舌苔本来腻浊，如果逐渐变黄、逐渐干燥、逐渐变黑、逐渐焦枯，这是伏暑的热邪，已经损伤了阴液（Yin），在本法内，可加西洋参、麦冬、玄参、细生地来治疗。如果出现神色昏蒙，是邪气逼近心包（Xinbao, Pericardium），益元散（Yiyuan San）、紫雪丹（Zixue Dan），根据病证的轻重而使用。如果出现高热舌焦，神志昏迷胡言乱语，脉象实而不虚，这是邪热归并于阳明，宜用润下救津法治之。如年壮体强的人，用生大黄代替熟大黄，更为有力。种种变证，务必在临证之时，仔细审察病的新久，体质的虚实，按照法则使用，这样才能没有差错。
又有人问：曾见周禹载书中论伏暑，说在三伏时节，把书晒曝在烈日之中，随即收藏在箱子里，火气未散，冬天打开箱子，接触它就生病了。现在的这篇论述中完全没有提到，难道遗漏了吗？回答说：你真是刻舟求剑啊。这不过是偶尔有的证候。如果像你说的那样，那么伏暑的病，专门得病于晒书的人家，而没有晒书的人就不会生病；专门得病在冬季，而三秋季节就不生病。这足以让人发笑。
Yang Ruhou stated: Coldness reversing upwards in both calves, chest fullness, headache and eye pain, delirious speech, and profuse sweating. This is a disease caused by initial injury from dampness (Dampness), followed by summerheat (Summerheat) strike. The dampness, interacting with the summerheat pathogen, suppresses and obstructs the yang qi, leading to illness. Headache, delirious speech, and profuse sweating, accompanied by a pulse that is soggy and weak at the cun (inch) position, and small and rapid at the chi (cubit) position, indicates an initial contraction of summerheat followed by dampness. The summerheat carries the dampness pathogen, which stagnates and steams into heat, causing the disease. Zhu Nanyang and Xu Xueshi both named this condition Shiwen (Damp-Heat). Lei Shaoyi held that Shiwen should be demarcated by the end of summer and early autumn, which aligns with the teaching in *Huangdi Neijing* (Yellow Emperor's Inner Canon) regarding "autumn injury from dampness," and corresponds perfectly with the seasonal qi where damp-earth governs from Great Heat to White Dew. Regarding the two syndromes listed above, since they occur in summer months, they are not named Shiwen but rather Shushi (Summerheat-Dampness).
Zhou Yuzai stated: Damp diseases progress slowly, while summerheat diseases progress rapidly.
Shen Yaofeng stated: The Shiwen mentioned in *Nan Jing* (Classic of Difficult Issues) refers to diseases where dampness and heat arrive simultaneously, and it is not named as a summerheat disease.
Yang Ruhou stated: In winter, headache, slight aversion to cold, red face, vexation and thirst, white tongue coating, and a soggy yet rapid pulse indicate that latent summerheat (Latent Summerheat) has been triggered by winter conditions. Although it occurs in winter, specifically Taiyin Latent Summerheat must not be mistaken for Shanghan (Cold Damage). While headache and aversion to cold resemble internal cold damage, a red face, vexation, and thirst do not. Although it may resemble Yangming Syndrome of Shanghan, a soggy and rapid pulse definitively rules out Shanghan. Cold pulses are tight; wind pulses are slow; summerheat pulses are weak. A soggy pulse is a manifestation of weakness; a weak pulse is the substance of sogginess. Sogginess corresponds to the emptiness in the center of the Li trigram, representing fire; tightness corresponds to fullness in the center of the Kan trigram, representing water. Fire’s nature is hot; water’s nature is cold. Their signs differ, and their natures vary. Therefore, it is said: Even in winter, it is definitely not Shanghan, but Latent Summerheat. If it is Latent Summerheat in winter, one can infer its nature in autumn. The distinction between Latent Summerheat and Shanghan is like the difference between men and women: one is exteriorly solid and interiorly deficient, the other is exteriorly deficient and interiorly solid. How can they be confused?
He further stated: Latent Summerheat presents nine similar manifestations: Headache and high fever resembling Shanghan; alternating chills and fever resembling Nueji (Malaria); regurgitation and vomiting resembling Geqi (Dysphagia); blood in stool resembling Changfeng (Intestinal Wind); difficult urination resembling Linli (Strangury); excessive eating and drinking resembling Xiaoke (Wasting-Thirst); fatigue in the four limbs resembling Xulao (Deficiency Consumption); yellow-red eyes resembling Jiudan (Wine Jaundice); generalized yellow swelling resembling Shihuang (Food Jaundice). All these are variable manifestations of Latent Summerheat.
Lei Shaoyi stated: Summerheat contracted during the Dog Days, if the pathogen is strong, manifests immediately; if weak, it manifests after autumn. Contemporary physicians consider late-onset cases in autumn as Latent Summerheat. At this time, cool winds invade the skin; new pathogens attempt to enter, while latent qi attempts to exit, resulting in chills and fever resembling malaria. There may be slight chills or slight fever, without the clear demarcation seen in malaria. The pulse will necessarily be stagnant, and the tongue coating greasy. There will be epigastric stuffiness and qi obstruction, thirst, chest oppression, and vexation, worsening in the afternoon and intensifying at night. Fever subsides slightly with sweat at dawn, repeating daily until resolution after approximately three pentads (21 days). If management is improper, many cases prove fatal. Unlike wind-cold pathogens resolved by sweating, or warm-heat qi soothed by cooling agents, this case requires the Qingxuan Wenhuafa (Clearing and Dispersing with Warming Transformation Method) to separate the qi, resolving the new pathogen first, followed by the latent qi. However, this syndrome varies greatly. Initially resembling malaria, if chills resolve but fever lingers, add Equisetum hiemale (Lugen), Phyllostachys nigra var. henonis rhizome (Zhuru), and Forsythia suspensa (Lianqiao). Banxia (Pinelliae Rhizoma) and Chenpi (Citri Reticulatae Pericarpium) within the base formula should be removed to avoid damaging Jinye (Body Fluids) due to their warming and drying nature. If the greasy tongue coating turns yellow, then dry, then black, then scorched, it indicates that Latent Summerheat heat has damaged Yin (Yin). Add Panax quinquefolius (Yangshen), Ophiopogon japonicus (Maidong), Scrophularia ningpoensis (Xuanshen), and Rehmannia glutinosa prepared with wine (Xidi) to the formula. If spirit and color become dull and confused, indicating the pathogen approaching Xinbao (Pericardium), use Yiyuan San (Yiyuan Powder) and Zixue Dan (Purple Snow Pill) according to severity. If high fever, scorched tongue, coma, and delirium occur with a full and non-deficient pulse, the pathogenic heat has merged into Yangming; treat with Runxia Jiujinfa (Moistening Purging to Rescue Fluids Method). For robust individuals, replace cooked Rheum palmatum (Shujun) with raw Rheum palmatum (Shengjun) for greater efficacy. In all variable syndromes, carefully assess the duration of the disease and the constitution’s excess or deficiency when applying methods to avoid errors.
Another asked: I have seen Zhou Yuzai discuss Latent Summerheat, stating that books exposed to the sun during the Dog Days and stored away while still hot can cause illness upon opening in winter. Why is this not mentioned in your discussion? Is it an omission? The reply was: You are indeed carving a mark on the boat to find the sword. This is merely an occasional occurrence. If your logic held, Latent Summerheat would only affect those who dry books, sparing those who do not; it would only occur in winter, sparing autumn. This is laughable.