伤暑必自汗背寒。面垢。或口热烦闷。或头疼发热。神思倦怠殊甚。所谓暑伤气。而不
伤形。是也。但身体不痛。与感风寒异。宜香薷饮。六和汤。香薷汤。
呕而渴者。浸冷香薷汤。或五苓散。兼吞消暑丸。呕不止者。枇杷叶散。去茅根。吞来
复丹。呕而痰。却暑散。吞消暑丸。或小半夏茯苓汤。或消暑饮。
泻而渴者。生料平胃散。和生料五苓散各半帖。名胃苓饮。间进来复丹。此丹本非治
泻之药。惟施之暑泻则宜。然泻甚亦不可用。泻定仍渴。春泽汤。或缩脾饮。伤暑心头痞闷
人皆谓暑毒攻心。不知有暑即有痰。痞闷者痰为之也。
盛暑涂中。仓卒无水。渴甚。急嚼葱头二寸许。抵饮水二升。
泻而复痛。有积者。生料五苓散。藿香正气饮。匀各半帖。若泻虽无积。其腹痛甚。生
料
五苓散。加木香七分。或六和汤。加木香半钱。或不加木香。止与二药。煎熟去滓。调下苏
合香丸。
又有不渴而腹干痛者。六和汤煎熟。调苏合香丸尤宜。
泻而发热者。胃苓饮。泻而发渴者。胃苓饮。兼进缩脾饮。泻渴兼作未透者。汤化苏合
香丸。
吞来复丹。或研来复丹作末。白汤调下。已透者。香薷饮。感冒外发热者。六
和汤、香薷汤、香薷饮。身热烦者。五苓散。或香薷汤。加黄连一钱。热而汗多。畏风甚者
生料五苓散。热而渴者。五苓散。兼进缩脾饮。
暑气攻里。热不解。心烦口干。辰砂五苓散。或香薷饮。加黄连一钱。若大渴不止。辰
砂五苓散。吞酒煮黄连丸。
暑气攻里。腹内刺痛。小便不通。生料五苓散。加木香七分。
冒暑饮酒。引暑入肠内。酒热与暑气相并。发热大渴。小便不利。其色如血。生料五苓
散去官桂。加黄连一钱。五苓散去桂。吞酒煮黄连丸。
暑气入肠胃。而小便艰涩不通者加味香薷饮。仍佐以三黄丸。
暑气入心。身烦热而肿者。宜辰砂五苓散。或香薷饮。加黄连一钱。
伤暑而伤食者。其人头疼背寒。自汗发热。畏食恶心。噫酸臭气。胸膈痞满。六和汤、
倍砂仁。
若因暑渴。饮食冷物。致内伤生冷。外伤暑气。亦宜此药。暑偏要入心者。心属南方离
火。
暑气所入。各从其类。小肠为心之腑。利心经暑毒。使由小肠中出。五苓散。利小便。为治
暑上剂也。
有伤于暑。因而露卧。又为冷气所入。其人感暑复感冷。自汗怯风。身疼头痛去衣则凛
着
衣则烦或已发热。或未发热。并宜六和汤。内加扁豆砂仁。一方用藿香一方用紫苏。正治已
感于
暑。而复外感于风寒。或内伤生冷。以藿香紫苏。兼能解表。砂仁扁豆。兼能温中。然感暑
又感冷。亦有无汗者。只宜前药。若加以感风。则断然多汗。审是此证。宜生料五苓散。内
用桂枝为佳。市井中多有病。往往日间冒热经营。夜间开窗眠卧。欲取清凉。失盖不觉。用
药所当详审。有此证而发潮热。似疟。犹未成疟者。六和汤。养胃汤。各半帖。相和煎。有
此证而鼻流清涕。或鼻孔热气时出。六和汤加川芎半钱。羌活七分。
有因伤暑。遂极饮以冷水。致暑毒留结心胸。精神昏愦。语音不出。煎香薷汤。化苏合
香丸服。
有因伤暑。用水沃面。或入水洗浴。暑湿相搏。自汗发热。身重。小便不利。宜五苓散
伤暑而大汗不止。甚则真元耗散。宜急收其汗生料五苓散倍官桂。或加黄 如术之数。
此亦古法也。伤暑自汗。手足厥冷者。煎六和汤。调苏合香丸。
伤暑自汗。手足时自搐搦者。谓之暑风。缘已伤于暑。毛孔开。而又邪风乘之。宜香薷
饮。或香薷汤。并可加羌活一钱。痰盛者。六和汤半帖。和星香散半帖。
暑月身痒如针刺。间有赤肿处。亦名暑风。末子六和汤。和消风散。酒调服。暑风而加
以吐泻兼作者。六和汤。藿香正气散。各半帖。加全蝎三个。
有毒暑客于上焦。胸膈痞塞。汤药至口即出。不能过关。或上气喘急。六和汤浸冷。调
入麝香少许。
伏暑烦渴而多热痰者。于消暑丸中。每两入黄连末二钱。名黄连消暑丸。或二陈汤。或
小半
夏茯苓汤。并可加黄连一钱。暑气久而不解。遂成伏暑。内外俱热。烦躁自汗。大渴喜冷。
宜
香薷饮加黄连一钱。继进白虎汤。若服药不愈者。暑毒深入。结热在里。谵语烦渴。罔顾去
近衣。大便秘结。小便赤涩。当作热病治。可于伤寒阳明证求药。
伤暑必然出现自汗、背部恶寒。面色垢浊。或者口热、烦闷。或者头痛、发热。精神思虑极度倦怠。这就是所谓的“暑邪伤气,而不伤形”。只是身体不痛,这与感受风寒不同。适宜使用香薷饮、六和汤、香薷汤。
呕吐且口渴的,用浸冷后的香薷汤。或者五苓散。同时吞服消暑丸。呕吐不止的,用枇杷叶散,去掉茅根,吞服来复丹。呕吐且有痰的,用却暑散,吞服消暑丸。或者用小半夏茯苓汤。或者用消暑饮。
腹泻且口渴的,用生料平胃散与生料五苓散各半帖合用,名为胃苓饮。间或服用来复丹。这个方子本来不是治疗腹泻的药,只有用于暑湿腹泻才适宜。然而如果腹泻严重也不可使用。腹泻停止后仍然口渴的,用春泽汤。或者用缩脾饮。伤暑导致心下痞闷,人们都认为是暑毒攻心,不知道有暑邪就有痰饮,痞闷是由痰引起的。
在盛夏烈日之下,仓促间没有水,口渴非常严重,急忙咀嚼葱头约两寸长,其效果相当于饮用两升水。
腹泻且再次疼痛,体内有积滞的,用生料五苓散、藿香正气饮,匀分各半帖。如果腹泻虽然没有积滞,但腹痛剧烈,用生料五苓散,加入木香七分。或者用六和汤,加入木香半钱。或者不加木香,只用这两种药,煎熟去渣,调服苏合香丸。
又有不口渴但腹部干燥疼痛的,用六和汤煎熟,调服苏合香丸尤为适宜。
腹泻且发热的,用胃苓饮。腹泻且发渴的,用胃苓饮,兼进缩脾饮。腹泻与口渴同时发作但未透发的,用汤剂化开苏合香丸。
吞服来复丹。或者研来复丹为末,用白开水调下。已经透发的,用香薷饮。感冒外感而发热的,用六和汤、香薷汤、香薷饮。身体发热且烦躁的,用五苓散。或者用香薷汤,加入黄连一钱。发热且出汗多,特别怕风的,用生料五苓散。发热且口渴的,用五苓散,兼进缩脾饮。
暑气攻入体内,热势不退,心烦口干,用辰砂五苓散。或者用香薷饮,加入黄连一钱。如果大渴不止,用辰砂五苓散,吞服酒煮黄连丸。
暑气攻入体内,腹内刺痛,小便不通,用生料五苓散,加入木香七分。
冒受暑气时饮酒,引暑气进入肠内,酒热与暑气相搏结,发热大渴,小便不利,颜色如血。用生料五苓散去官桂,加入黄连一钱。或者用五苓散去桂枝,吞服酒煮黄连丸。
暑气进入肠胃,而小便艰涩不通的,用加味香薷饮。仍辅助以三黄丸。
暑气进入心脏,身体烦躁发热且浮肿的,适宜用辰砂五苓散。或者用香薷饮,加入黄连一钱。
伤暑又伤食的,其人头痛背寒,自汗发热,畏食恶心,嗳出酸臭气味,胸膈痞满,用六和汤,加倍砂仁。
如果因为暑天口渴,饮食生冷之物,导致内伤生冷,外伤暑气,也适宜用此药。暑邪偏要进入心脏,是因为心属南方离火。
暑气所入之处,各从其同类。小肠是心的腑,通过利小便来排出心经的暑毒,使其从小肠中排出。五苓散利小便,是治疗暑病的上佳方剂。
有因伤暑,因而露天睡觉,又被冷气侵入。其人既感暑邪又感冷邪,自汗怯风,身体疼痛头痛,脱衣则凛冽寒冷,穿衣则烦热。或者已经发热,或者尚未发热,都适宜用六和汤。内部加入扁豆、砂仁。一方用藿香,一方用紫苏。这是正治法,即已感于暑,而又外感风寒,或内伤生冷。用藿香、紫苏,兼能解表;用砂仁、扁豆,兼能温中。然而感暑又感冷,也有无汗的情况,只适宜用前面的药。如果再加上感风,则肯定多汗。仔细审察是这个证候,适宜用生料五苓散,内部用桂枝为佳。市井中多有这种病,往往白天冒着热气经营劳作,夜间开窗睡眠,想要取得清凉,忘记盖被子不知不觉就染病了。用药应当详细审察。有此证候而发潮热,类似疟疾,但尚未形成疟疾的,用六和汤、养胃汤,各半帖,混合煎煮。有此证候而鼻流清涕,或者鼻孔热气不时排出的,用六和汤加入川芎半钱,羌活七分。
有因伤暑,于是大量饮用冷水,导致暑毒留结在心胸,精神昏愦,语音不出,煎香薷汤,化开苏合香丸服用。
有因伤暑,用水浇面,或者入水洗浴,暑湿相互搏结,自汗发热,身体沉重,小便不利,适宜用五苓散。
伤暑而大汗不止,甚至真元耗散,适宜紧急收敛其汗,用生料五苓散加倍官桂。或者加入黄耆如术药的份量。这也是古法。伤暑自汗,手足厥冷的,煎六和汤,调服苏合香丸。
伤暑自汗,手足时常抽搐痉挛的,称为暑风。因为已经伤于暑邪,毛孔开张,而邪风乘虚而入,适宜用香薷饮。或者用香薷汤,都可以加入羌活一钱。痰盛的,用六和汤半帖,和星香散半帖。
暑月身体瘙痒如针刺,间或有赤肿处,也称为暑风。末子六和汤,和消风散,用酒调服。暑风而加上呕吐腹泻同时发作的,用六和汤、藿香正气散,各半帖,加入全蝎三个。
有毒暑客居在上焦,胸膈痞塞,汤药到口即吐出,不能过关。或者上气喘急,用浸冷的六和汤,调入少许麝香。
伏暑烦渴且多热痰的,在消暑丸中,每两加入黄连末二钱,名为黄连消暑丸。或者用二陈汤。或者用小半夏茯苓汤,都可以加入黄连一钱。暑气久而不解,遂成伏暑,内外俱热,烦躁自汗,大渴喜冷饮,适宜用香薷饮加入黄连一钱。接着进服白虎汤。如果服药不愈的,是暑毒深入,结热在里,谵语烦渴,不顾远近地脱去衣服,大便秘结,小便赤涩,当作热病治疗,可以从伤寒阳明证中寻求药物。
Heatstroke inevitably presents with spontaneous sweating and coldness in the back. The face appears greasy. Or there is heat in the mouth, irritability, and oppression. Or headache and fever. Mental fatigue is extremely severe. This is what is meant by "heat damaging Qi, but not damaging Form." The body does not ache, which differs from contracting Wind-Cold. Xiangru Yin (Perilla Leaf Decoction), Liuhe Tang (Six Harmonies Decoction), or Xiangru Tang (Perilla Leaf Decoction) are suitable.
For vomiting accompanied by thirst, use Xiangru Tang (Perilla Leaf Decoction) cooled in ice water. Or Wuling San (Five-Ingredient Powder with Poria). Swallow Xiaoshu Wan (Summerheat-Relieving Pill) concurrently. For persistent vomiting, use Pipaye San (Loquat Leaf Powder), remove Mao Gen (Imperatae Rhizoma), and swallow Laifu Dan (Reviving Return Pill). For vomiting with phlegm, use Queshu San (Summerheat-Expelling Powder), swallow Xiaoshu Wan (Summerheat-Relieving Pill). Or use Xiaobanxia Fuling Tang (Minor Pinellia and Poria Decoction). Or use Xiaoshu Yin (Summerheat-Relieving Drink).
For diarrhea accompanied by thirst, combine half a dose of Shengliao Pingwei San (Raw Material Spleen-Stabilizing Powder) and half a dose of Shengliao Wuling San (Raw Material Five-Ingredient Powder with Poria), named Weiling Yin (Stomach-Poria Drink). Intermittently administer Laifu Dan (Reviving Return Pill). This pill is originally not a medicine for treating diarrhea; it is only appropriate for summerheat-induced diarrhea. However, if the diarrhea is severe, it should not be used. If thirst persists after the diarrhea stops, use Chunze Tang (Spring Spring Decoction). Or use Suopi Yin (Spleet-Restraining Drink). In heatstroke causing epigastric fullness and oppression, people generally attribute it to summerheat toxin attacking the Heart, unaware that where there is summerheat, there is Phlegm-Dampness; the fullness and oppression are caused by Phlegm.
During intense midsummer heat, if water is suddenly unavailable and thirst is extreme, urgently chew about two cun of scallion bulb heads, which is equivalent to drinking two sheng of water.
If diarrhea recurs with pain and there is food retention, use Shengliao Wuling San (Raw Material Five-Ingredient Powder with Poria) and Huoxiang Zhengqi Yin (Agarwood and Magnolia Bark Drink), mixing half a dose of each. If there is no retention despite diarrhea, but abdominal pain is severe, use Shengliao Wuling San (Raw Material Five-Ingredient Powder with Poria) added with Muxiang (Aucklandiae Radix) 7 fen. Or use Liuhe Tang (Six Harmonies Decoction) added with Muxiang (Aucklandiae Radix) 0.5 qian. Or do not add Muxiang, using only these two medicines. After decocting and straining, mix with Suhexiang Wan (Liquid Amber Pill).
In cases without thirst but with dry abdominal pain, Liuhe Tang (Six Harmonies Decoction) decocted and mixed with Suhexiang Wan (Liquid Amber Pill) is particularly suitable.
For diarrhea with fever, use Weiling Yin (Stomach-Poria Drink). For diarrhea with thirst, use Weiling Yin (Stomach-Poria Drink), concurrently advancing Suopi Yin (Spleet-Restraining Drink). For simultaneous diarrhea and thirst that has not yet fully manifested, dissolve Suhexiang Wan (Liquid Amber Pill) in soup.
Swallow Laifu Dan (Reviving Return Pill). Or grind Laifu Dan into powder and take with warm water. If the pathogen has penetrated outward, use Xiangru Yin (Perilla Leaf Decoction). For external contraction with fever, use Liuhe Tang (Six Harmonies Decoction), Xiangru Tang (Perilla Leaf Decoction), or Xiangru Yin (Perilla Leaf Decoction). For body heat and irritability, use Wuling San (Five-Ingredient Powder with Poria). Or use Xiangru Tang (Perilla Leaf Decoction) added with Huanglian (Coptidis Rhizoma) 1 qian. For heat with profuse sweating and severe aversion to wind, use Shengliao Wuling San (Raw Material Five-Ingredient Powder with Poria). For heat with thirst, use Wuling San (Five-Ingredient Powder with Poria), concurrently advancing Suopi Yin (Spleet-Restraining Drink).
When Summerheat Qi attacks the interior and heat does not resolve, causing mental restlessness and dry mouth, use Chencha Wuling San (Cinnabar Five-Ingredient Powder with Poria). Or use Xiangru Yin (Perilla Leaf Decoction) added with Huanglian (Coptidis Rhizoma) 1 qian. If excessive thirst persists, use Chencha Wuling San (Cinnabar Five-Ingredient Powder with Poria) and swallow Jiuzhu Huanglian Wan (Wine-Boiled Coptis Pill).
When Summerheat Qi attacks the interior, causing stabbing abdominal pain and urinary obstruction, use Shengliao Wuling San (Raw Material Five-Ingredient Powder with Poria) added with Muxiang (Aucklandiae Radix) 7 fen.
Exposure to summerheat while drinking alcohol draws summerheat into the intestines. The heat of alcohol combines with summerheat, causing fever and extreme thirst, difficult urination, with urine color resembling blood. Use Shengliao Wuling San (Raw Material Five-Ingredient Powder with Poria) removing Gu Gui (Cinnamomi Cortex), added with Huanglian (Coptidis Rhizoma) 1 qian. Or use Wuling San (Five-Ingredient Powder with Poria) removing Gui Zhi (Cinnamomi Ramulus), swallowing Jiuzhu Huanglian Wan (Wine-Boiled Coptis Pill).
When Summerheat Qi enters the stomach and intestines, causing difficult and obstructed urination, use Jiawei Xiangru Yin (Modified Perilla Leaf Decoction). Assist with Sanhuang Wan (Three-Yellow Pill).
When Summerheat Qi enters the Heart, causing body irritability, heat, and swelling, use Chencha Wuling San (Cinnabar Five-Ingredient Powder with Poria). Or use Xiangru Yin (Perilla Leaf Decoction) added with Huanglian (Coptidis Rhizoma) 1 qian.
For heatstroke complicated by food stagnation, the patient has headache, back coldness, spontaneous sweating, fever, aversion to eating, nausea, belching with sour foul odor, and chest/diaphragm fullness. Use Liuhe Tang (Six Harmonies Decoction) with doubled Ren (Amomi Fructus).
If due to thirst in summer, consuming cold foods causes internal injury from cold/rawness and external injury from summerheat, this medicine is also suitable. Summerheat tends to enter the Heart because the Heart belongs to the South and Li Fire. Summerheat enters according to its affinity. The Small Intestine is the Fu organ of the Heart; promoting urination expels summerheat toxin from the Heart Meridian via the Small Intestine. Wuling San (Five-Ingredient Powder with Poria) promotes urination and is the premier formula for treating summerheat.
Those injured by summerheat who sleep outdoors are additionally invaded by cold air. The person contracts both summerheat and cold, presenting with spontaneous sweating, fear of wind, body pain, headache. Removing clothes causes chilling; wearing clothes causes irritability. Whether fever has already appeared or not, Liuhe Tang (Six Harmonies Decoction) is suitable. Add Dou (Dolichoris Semen) and Ren (Amomi Fructus). One prescription uses Huoxiang (Pogostemonis Herba), another uses Zisu (Perillae Folium). This is the standard treatment for having contracted summerheat and then externally contracting Wind-Cold, or internally injuring with cold/rawness. Huoxiang and Zisu can release the exterior; Ren and Dou can warm the middle. However, contracting summerheat and cold may also result in no sweating; only the previous medicines are suitable. If Wind is added, there will definitely be profuse sweating. Carefully examine this syndrome; Shengliao Wuling San (Raw Material Five-ingredient Powder with Poria) with Gui Zhi (Cinnamomi Ramulus) inside is best. Many in the marketplace suffer from this, often working in the heat during the day and sleeping with windows open at night seeking coolness, forgetting to cover themselves. Medication must be carefully considered. For this syndrome with tidal fever resembling malaria but not yet formed malaria, use Liuhe Tang (Six Harmonies Decoction) and Yangwei Tang (Stomach-Nourishing Decoction), half a dose each, mixed and decocted. For this syndrome with clear nasal discharge or hot air occasionally coming from the nose, use Liuhe Tang (Six Harmonies Decoction) added with Chuanxiong (Ligustici Chuanxiong Rhizoma) 0.5 qian and Qianghuo (Notopterygii Rhizoma et Radix) 7 fen.
Some, due to heatstroke, drink large amounts of cold water, causing summerheat toxin to accumulate in the chest and heart, leading to mental confusion and inability to speak. Decoct Xiangru Tang (Perilla Leaf Decoction) and dissolve Suhexiang Wan (Liquid Amber Pill) to take.
Some, due to heatstroke, wash their face with water or bathe, causing summerheat and dampness to struggle, resulting in spontaneous sweating, fever, heavy body, and difficult urination. Use Wuling San (Five-Ingredient Powder with Poria).
For heatstroke with incessant profuse sweating, even depleting True Yuan, urgently stop the sweating with Shengliao Wuling San (Raw Material Five-Ingredient Powder with Poria) doubling Gu Gui (Cinnamomi Cortex). Or add Huang Qi (Astragali Radix) in the amount of Bai Zhu (Atractylodis Macrocephalae Rhizoma). This is an ancient method. For heatstroke with spontaneous sweating and cold extremities, decoct Liuhe Tang (Six Harmonies Decoction) and mix with Suhexiang Wan (Liquid Amber Pill).
For heatstroke with spontaneous sweating and intermittent spasms of hands and feet, it is called Heatwind (Shufeng). Because the body is injured by summerheat, pores are open, and evil wind takes advantage. Use Xiangru Yin (Perilla Leaf Decoction). Or Xiangru Tang (Perilla Leaf Decoction), both can add Qianghuo (Notopterygii Rhizoma et Radix) 1 qian. For abundant phlegm, use half a dose of Liuhe Tang (Six Harmonies Decoction) and half a dose of Xingxiang San (Star Anise and Aucklandia Powder).
Itchy skin like needle pricks during summer months, with occasional red swelling, is also named Heatwind (Shufeng). Take Liuhe Tang (Six Harmonies Decoction) as powder, mix with Xiaofeng San (Wind-Expelling Powder), and take with wine. For Heatwind (Shufeng) accompanied by simultaneous vomiting and diarrhea, use Liuhe Tang (Six Harmonies Decoction) and Huoxiang Zhengqi San (Agarwood and Magnolia Bark Powder), half a dose each, adding Quanxie (Scorpio) three pieces.
Toxic summerheat lodging in the Upper Jiao causes chest and diaphragm obstruction; medicinal soup vomits out immediately upon reaching the mouth and cannot pass through. Or there is upper jiao panting and urgency. Use cooled Liuhe Tang (Six Harmonies Decoction) mixed with a small amount of She Xiang (Moschus).
For latent summerheat with irritability, thirst, and much heat-phlegm, add 2 qian of Huanglian (Coptidis Rhizoma) powder to every liang of Xiaoshu Wan (Summerheat-Relieving Pill), named Huanglian Xiaoshu Wan (Coptis Summerheat-Relieving Pill). Or use Erchen Tang (Two-Aged Decoction). Or Xiaobanxia Fuling Tang (Minor Pinellia and Poria Decoction), all can add Huanglian (Coptidis Rhizoma) 1 qian. When summerheat lingers unresolved, it becomes latent summerheat. Interior and exterior are both hot, with irritability, spontaneous sweating, extreme thirst preferring cold drinks. Use Xiangru Yin (Perilla Leaf Decoction) added with Huanglian (Coptidis Rhizoma) 1 qian. Subsequently advance Baihu Tang (White Tiger Decoction). If medication fails, summerheat toxin has deeply entered, heat knots in the interior, with delirium, irritability, thirst, disregarding clothing removal, constipation, and dark scanty urination. Treat as a Heat Disease. Seek medication from the Yangming Syndrome of Cold Damage.