许叔微治一人，头痛身热，心烦燥渴。诊其脉，大而虚，授以白虎汤数服愈。仲景云∶脉虚身热，得之伤
暑。又云∶其脉弦细芤迟何也？《素问》曰∶寒伤形，热伤气。盖伤气不伤形，则气消而脉虚弱，所谓弦细芤
迟者，皆虚脉也。仲景以弦为阴，朱庞亦云中暑脉微细，则虚可知。
癸丑年，故人王彦龙作毗陵仓官，季夏时胸项多汗，两足逆冷，且谵语。医者不晓，杂进药，已经旬日。
诊之，其脉关前濡，关后数，曰∶当作湿温治之。盖先暑后受湿，暑湿相搏，是名湿温。先以白虎加人参汤，
次白虎加苍术汤，头痛渐退，足渐温，汗渐止，三日愈。此名贼邪，误用药，有死之理。有人难曰∶何名贼邪？
曰∶《难经》云，五邪有实邪、虚邪、正邪、微邪、贼邪。从后来者曰虚邪，从前来者曰实邪，从所不胜来者
为贼邪，从所胜来者为微邪，自病者为正邪。假令心病，中暑为正邪，中湿得之为贼邪，五邪之中最逆也。《难
经》曰∶湿温之脉，阳濡而弱，阴小而急。濡弱见于阳部，湿气搏暑也；小急见于阴部，暑气蒸湿也。故经曰∶
暑湿相搏，名曰湿温，是谓贼邪也。不特此，予素有停饮之疾，往往至暑月汗，两足 未尝干，每服此药二
三盏即愈。
张子和治小郑，年十五，田中中暑，头痛，困卧不起，以双解散汗之，又以米泔汤投之，未解。晚又以三
花神 丸大下之，遂愈。
张子和治张叟，年七十一，暑月田中因饥困伤暑，食饮不进，时时呕吐，口中常流痰水，腹胁作痛。医者
概用平胃散、理中丸、导气丸不效。又加针灸，皆云胃冷，乃问张。张曰∶痰属胃，胃热不收，故流痰水。以
公年高，不敢上涌。乃使以一箸探之，不药而吐痰涎一升。次用黄连清心散、导饮丸、玉露散以调之，饮食加
进。惟大便秘，以生姜、大枣煎调胃承气汤一两夺之，遂愈。
万密斋治县丞李天泉，六月中暑腹痛。渠有婢外家，医谓病寒，进理中汤，一剂痛止。乃发热，一身骨节尽
痛，又进十神汤发汗，热退身不痛矣。万候之，李称病愈，观其面色带赤，知病未解。请脉之，洪滑而数。（色
脉相对。）经曰∶大则病进。今汗后脉犹洪数，病方进也，而彼自称愈。万未去，食顷而病作矣。满腹急痛，状如
奔豚，上下左右，举手按摩。亟延万至，曰∶汝先诊脉，不言而去，知我病也，幸急救我。万曰∶无伤。乃进
建中汤，一服而痛定。次日，有省祭官万朴来问疾。朴善医，诊之，且骇且顾，李亦疑惧。万诊之，谓朴曰∶
汝怪其脉之促止乎？盖心下怔忡，故脉如是耳。李即应曰∶我心下跳乱不宁。即命取药，方用人参、麦冬、甘
草、白芍、生地、五味， 猪心煮汤煎，一服心跳止，脉不促矣。盖心恶热，用热治热，向服理中、十神，俱
犯禁，故病复作也。
李少华知医，六月得暑病，服九味羌活汤一剂，汗出不解。谓药剂少，发汗不透，复作大剂服之，汗大泄
而热转甚。连进三剂，病益亟。如痴如狂，舌强，言语謇涩，手足掣动，小便不利，茎中痛，以手捏之，才下
一二滴。不食，唯能饮水。万脉之，微弱而迟。或问病可治否？曰∶坏病也，医之过耳。心恶热，壮火食气，
方今盛夏，火气正壮，而重发其汗，汗之过多，则伤心。心藏神，如狂如痴者，神气乱也。（非蓄血。）舌内应乎心，
汗多则血虚不能荣舌，故强不能言也。手中掣动者，汗多筋惕肉 也。（非中风。）渴饮水，汗多津液涸也。（
非阳明发渴。）小便不利者，心移热于小肠，小肠移热于膀胱，津液少而气不化，故茎中痛。连五剂而愈。（未
载所用何方，殊嫌疏漏。）
汪怀江中暑复伤食。一医用五积燥热之剂，阳气外散，阴津内竭，阳强阴弱，皮肤燥而无汗。当先养其阴，
而后制其阳，使汗出而表和。遂以凉膈散去大黄、芒硝，加知母、石膏、淡豉、竹叶，一服微汗出而身润矣。
方议下之，又一医至，称是阴虚火动，不可下也，用四物汤加炒干姜，触动阳明之火，齿缝出血，足冷成阳厥
矣。乃复用凉膈散服之，利三行而病愈。
龚子才治一妇人，暑月因厨房热极，遂出当风处，脱衣乘凉，即头痛发热，恶寒身痛。医误以为伤寒，用
附子理中汤，一服下咽，立时不语，口中无气，唇口青紫，心头微温。诊之，六脉洪大而数，此热症误用热药。
令以烧酒喷其胸，将镜扑之，更以新汲水和蜜，用鸡翎沃入其口数次。少顷，患人即伸舌探水，以益元汤灌下即活。
李士材治张邑尊令郎，六月间，未申时晕绝不知人，更余未醒。此得之生冷太过也。皂角末吹鼻中无嚏，
举家惊惶。教以皂角灰存性，新汲水灌之，更取沉、檀焚之，俾香气满室，以达其窍，至子后方苏。服十味香
薷饮而安。
吴孚先治一人，奔驰烈日下，忽患头疼发热，或时烦躁，汗大出，大渴引饮，喘急乏气，服香薷饮尤甚，
此暑症也。然受暑有阳有阴，道途劳役之人，所受者炎热，名曰伤暑。亭馆安逸得之，为中暑也。香薷饮只宜
于阴暑，若阳暑服之，反为害矣。与人参白虎汤而愈。
董仁仲，当暑天纳凉饮冷，忽头疼发热，霍乱吐泻，烦躁口渴，舌苔白滑，此阴暑也。得之过于寒凉，致
周身阳气为阴邪所遏。宜香薷之辛热，发越阳气，散水和脾，四剂而愈。（藜按∶此夏月感寒之症，乃指为阴
暑，而以伤暑者为阳暑，治虽不误，而称名实谬。上条亦然。）
一刍荛妇，夏月贪凉饮冷，胸如有一团之火，凡冷水凉茶入咽，觉从火团上分流而下，目则羞明畏火，口
鼻间频出火气。诊之，六脉俱阴，舌苔紫青而滑，吴曰∶此寒格反见热化也。与干姜、肉桂温散，少加黄连为
向导。移时，觉胸中之火，顿化清凉而愈。
孙文垣治弟淑南，额痛，遍身疼，口干，舌苔黄浓，左脉浮大，六部俱数。时当仲秋初旬，以小柴胡合白
虎汤加羌活，热不退。下午用六神通解散，以葱汤调服三钱，热稍退。至半夜后，又复热，额痛，颠顶尤甚，
舌根黄且焦黑，小水赤痛，烦躁不睡，遍身又痛。此三阳合病暑症也。次日以小柴胡汤大加石膏为君， 本、
白芷、竹叶、粳米、生姜、大枣。少顷，汗出至足，（必至足乃为正汗。）热始尽退。犹烦躁不睡，仍以小柴
胡汤加桂枝、山栀、竹茹、竹叶，饮下遂愈。
张路玉治内兄顾九玉，大暑中患胸痞颅胀。脉得虚大而濡，气口独显滑象，此湿热泛滥于膈上也。与清暑益
气二剂，颅胀止而胸痞不除。与半夏泻心汤，减炮姜，去大枣，加枳实，一服而愈。
范文学治孙振麟，于大暑中患厥冷自利。六脉弦细芤迟，按之欲绝，舌色淡白，中心黑润无苔，口鼻气息
微冷，阳缩入腹，精滑如水。问其所起之由，因卧地昼寝受寒，是夜连走精二度，忽觉颅胀如山，坐起晕倒，
四肢厥逆，腹痛自利，胸中兀兀欲吐，口中喃喃妄言，与湿温之症不殊。医者误以为停食感冒，与发散消导二
剂，服后胸前头项汗出如流，背上愈加畏寒，下体如冷水，一日昏愦数次。此阴寒挟暑，入中手足少阴之候。
缘肾中真阳虚极，所以不能发热。遂拟四逆加人参汤，方中用人参一两，熟附三钱，炮姜二钱，炙甘草二钱，
昼夜兼进，三日中连进六剂，决定第四日寅刻回阳。是日悉屏姜、附，改用保元，方用人参五钱，黄 三钱，
炙甘草二钱，麦冬二钱，五味子一钱，清肃膈上之虚阳。四剂食进，改用生料六味，加麦冬、五味。每服用熟
地八钱，以救下焦将竭之水，使阴平阳秘，精神乃治。
申叔 触热过梁溪，归而眩晕麻瞀，发热便秘，服黄连香薷不应。用凉膈散，便通。或时昏眩不省，或时
四肢清冷，而晡时为甚。诊之，脉弦细而芤，此暑伤心包，阳气郁伏，所以有似阴寒也。与生脉合保元，清理
肺胃，则包络自宁矣。
柴屿青治陈忍之患病，医以温散之药投之，遂至彻夜不能合眼，时见鬼物，两脉沉伏。症属受暑，用加减
清暑益气汤，去参、苓，一剂热减，六脉俱现洪大。再服六一散，数剂而病退。惟夜间尚不能熟睡，遂以滋补
安神之剂调理而安。
壬戌夏，五营缮朱载常，早间入署，舆中呕吐，昏愦遗尿。医以中风治，开附子理中汤加僵蚕。后又以两
脉鼓指，危笃已极，参、附尚少，恐难挽回。柴曰∶此暑风也，脉无死象，力保无事。伊芳同寓水部钱筑岩不信，
急煎前药，将进，幸禾中朱汝能进以六一散，一服神气稍定。钱虽不知医，固知六一散之与理中冰炭，因停前
药。次日遂以黄连香薷饮加羌活治之，调理数日而康。
陆祖愚治陈元甫，七月间，因构讼事，忍饥食冷粥数碗，少顷即吐出。自此茶饮皆吐，头痛身热，咽喉不
利，昏冒，口中常流痰液。医知为中暑，用冷香薷饮投之，随吐。又以井水调益元散投之，亦吐，昏沉益甚。
脉之，阳部洪数无伦，阴部沉微无力，此邪在上焦。在上者因而越之，此宜涌吐者也。盖饥饿之时，胃中空虚，
暑热之气，乘虚而入于胃。胃热极，而以寒冷之水饮投之，冷热相反，所以水入即吐，即口中流涎，亦胃热上
溢之故也。因用沸汤入盐少许， 汁数匙，乘热灌之。至二三碗不吐，至一时许方大吐，水饮与痰涎同出，约
盆许。即以生脉散投之，人事清爽，诸症顿减。又合四物调理而安。
张绍甫治一人，暑热患头痛，身热昏睡，大渴引饮。众以感冒治，不效。诊之，脉大而虚，曰∶此暑疾也。
即令撤幔开窗，前后左右各置凉水，顿觉清爽。仍令二童食以西瓜，取其便，连饮四五钟即愈。（治法精妙。）
张为诸生时，万历戌子夏，患暑症，势极气索，瞀然自昏愦。庸医以为内伤，或以为劳役，中折几不自持。
医者汪韫玉适在旁，蹙然曰∶心烦面垢，此暑症也。闻者皆骇其名，予于瞀中微解，根据之服益元散，二剂而苏。
仍调以苏薷饮，数剂而愈。（张绍甫名凤逵，着《暑热全书》，天启年间刊本。）
李 垢治朱竹 夫人冯氏，病热七日不汗，又七日又不汗，逾二旬矣。诸医皆云∶伤寒不可治，请办丧具。
朱乃邀李徒步登阁诊视， 垢笑曰∶君夫人所居阁，四面俱木围之，木生火，触暑脉伏耳，脏腑无他恙也，亟
以甘瓜井水投之，可不药而愈。从其言，越宿而 粥糜，再宿主中馈如故。（《曝书亭集》。）
文选姚海山，中暑头痛发热，气高而喘，肢体怠倦，两手麻木。胃热伤元气，用人参益气汤顿安。又用补
中益气汤，加麦冬、五味而痊。
昔有人暑月深藏不出，因客至，坐于窗下，忽似倦怠，自作补中汤服之，反剧。医问其由，连进香薷饮，
两服而安。（万密斋《养生四要》。）
马元仪治陆太史，时值秋暑，偶发热头痛。诊得脉大而虚，谓中气大虚，非补不克。彼云∶伤暑小恙，况
饮食不甚减，起居不甚衰，何虚之有？但清暑调中，去邪即已，何用补为。乃勉与清暑益气而别。明晨复诊，
脉之大者变为虚微，发热如故，曰∶今日不惟用补，更当用温，宜亟服之，迟则生变矣。遂用理中汤，服下少
顷，出汗如涌泉。午后复诊，两脉虚微特甚，汗如贯珠，乃连进人参四两，附子两许。日夜约用人参十两，附
子四两，汗止精藏，渐调而愈。
任邱裴在涧，弃家逃禅，持戒茹素，遍游五岳，足迹几遍天下。偶客金坛，寓西禅寺僧舍，酷暑坐卧水楼，
日持准提咒三千，念佛号三万，（未是俊物。）忽患头痛如斧劈，身热发躁，口干，日饮冷水斗余，渴犹未解，自分
必死。庄敛之怜其旅病，时过视疾。一日急走仓头，召敛之永诀，以携来书画玩器，尽授敛之，揖而言曰∶（未
尝得道。）兄其为我收藏。吾死后，切勿用世俗礼葬我，惟以两缸盛吾尸其中，以三尺地埋之耳。敛之涕泗填胸，
束手无策，促缪仲淳诊之。余此时游梁溪、阳羡间，敛之命余仆克勤相追。归视其脉，知系受暑，为疏竹叶石
膏汤。不二剂，热渴俱止。几十剂，病始退。旋加健脾药十余帖而安。（《广笔记》。）
来天培治蔡氏女，病经六七日。时七月初旬，发热头痛，胸满腹痛，烦躁口渴，目闭神昏，时有独语，脉
浮细而数，按之模糊。问曾手足抽掣乎？曰∶然。曰∶此俗所谓暑风伤寒也，用香薷、青蒿、羌、防、枳、桔、
秦艽、钩藤、菖蒲、半夏曲、藿香、柴胡、黄连，一剂症减神清，脉亦和。前方去羌活、菖蒲、枳、桔、香薷，
加广皮、浓朴、花粉、丹皮，一剂渐安，惟热未尽退，此津液不生之故耳。改用生地、麦冬、茯苓、花粉、黄
芩、石斛、广皮、谷芽、半夏曲，又二剂全痊。
沈明生治王明甫，长夏神昏不语，伏枕信宿。午前往视，曰∶脉虚身热，此中暑耳，非风也，曷不用参？
其长君曰∶早间一友，因用参而转加烦懑。问用几何？曰∶五分。曰∶宜其转甚也，当四倍之，乃克有济耳。
乃愕眙不信，因晓之曰∶凡参少用则壅滞，今病正台东垣避暑于深堂大厦，得之者属阴，且古人用清暑益气、
许叔微治疗一个人，出现头痛、身体发热、心烦、躁动、口渴的症状。诊察他的脉搏，脉象大而虚弱，给予白虎汤服用几剂后痊愈。张仲景说：脉虚且身体发热，这是由伤暑引起的。又说：为什么脉象会呈现弦、细、芤、迟的特点？《素问》说：寒邪损伤形体，热邪损伤气机。既然是伤气而不伤形，那么气就会消耗而表现为脉象虚弱，所谓的弦、细、芤、迟，都属于虚脉。张仲景认为弦脉属阴，朱庞也说中暑时脉象微细，由此可知是虚证。
癸丑年，老朋友王彦龙担任毗陵仓官，在夏季末时节，胸部和颈部多汗，两脚逆冷，并且胡言乱语。医生不懂此病，混杂用药，已经过了十天。诊察其脉象，关前脉濡软，关后脉数，说：应当作为湿温病来治疗。这是因为先受暑邪，后又感受湿邪，暑湿相互搏结，这就叫作湿温。先用白虎加人参汤，再用白虎加苍术汤，头痛逐渐消退，双脚逐渐变暖，汗逐渐停止，三天后痊愈。这叫做“贼邪”，如果误用药物，有死亡的道理。有人责问道：什么叫作贼邪？回答说：《难经》说，五邪有实邪、虚邪、正邪、微邪、贼邪。从后来者称为虚邪，从前来者称为实邪，从所不胜（即克我）的一方来的称为贼邪，从所胜（即我克）的一方来的称为微邪，自己生病的称为正邪。假如是心病，中暑为正邪，中湿得之为贼邪，在五邪之中是最为凶逆的。《难经》说：湿温病的脉象，阳部（寸部）濡弱，阴部（尺部）小而急。濡弱出现在阳部，是湿气搏结暑气；小急出现在阴部，是暑气蒸腾湿气。所以经文说：暑湿相互搏结，名叫湿温，这就是所谓的贼邪。不仅如此，我素有停饮（水液停滞）的疾病，往往到了暑月出汗，双脚未曾干过，每次服用这种药两三盏就能痊愈。
张子和治疗小郑，十五岁，在田里中暑，头痛，困倦卧床不起，用双解散发汗，又用米泔水投服，症状未解。晚上又用三花神丸大力攻下，于是痊愈。
张子和治疗张老头，七十一岁，暑月在田里因饥饿困顿而伤暑，饮食不进，时时呕吐，口中常流出痰水，腹部和胁部疼痛。医生一概使用平胃散、理中丸、导气丸，都没有效果。又加上针灸，都说是胃冷，于是来问张子和。张子和说：痰属于胃，胃热不能收摄，所以流痰水。因为你年纪大，不敢使用涌吐法。于是让你用筷子探喉，不药而吐出一升痰涎。接着用黄连清心散、导饮丸、玉露散来调理，饮食逐渐增加。只有大便秘结，用生姜、大枣煎调胃承气汤一两攻下，于是痊愈。
万密斋治疗县丞李天泉，六月中暑腹痛。他有个婢女来自外家，医生认为是寒病，进服理中汤，一剂后疼痛停止。于是发热，全身骨节都痛，又进服十神汤发汗，热退身不痛了。万密斋诊察，李天泉称病愈，观察他的面色带赤色，知道病未解除。请他诊脉，脉象洪滑而数。（面色与脉象相对照。）经文说：脉大则病势进展。现在发汗后脉仍然洪数，病势正在进展，而他自称痊愈。万密斋还没离开，过了一会儿病又发作了。满腹急痛，状如奔豚，上下左右，举手按摩。急忙延请万密斋到，说：你先前诊脉，不说话就走了，知道我的病，幸急救我。万密斋说：不要紧。于是进服建中汤，一服后疼痛安定。第二天，有位省祭官万朴来探病。万朴擅长医术，诊脉后，既惊讶又回头看，李天泉也怀疑恐惧。万密斋诊脉后，对万朴说：你奇怪他的脉象时有间歇吗？这是因为心下悸动怔忡，所以脉象如此。李天泉立即应答：我心下跳动混乱不安。随即命取药，方用人参、麦冬、甘草、白芍、生地、五味子，猪心煮汤煎服，一服心跳停止，脉象不再间歇。因为心恶热，用热药治热病，之前服的理中汤、十神汤，都犯了禁忌，所以病复发。
李少华懂医术，六月患暑病，服九味羌活汤一剂，汗出但病不解。认为药量太少，发汗不透，又做大剂服用，大汗淋漓而热势更重。连续进服三剂，病情更加危急。神志恍惚如痴如狂，舌体僵硬，言语不清，手足抽搐，小便不利，尿道疼痛，用手捏挤，才滴下一二滴。不吃东西，只能饮水。万密斋诊脉，脉微弱而迟。有人问病可治吗？回答说：这是坏病，是医生的过错。心恶热，壮火食气，正值盛夏，火气正盛，却重重发汗，汗出过多则伤心。心藏神，如狂如痴，是神气紊乱。（不是蓄血证。）舌内应于心，汗多则血虚不能滋养舌体，所以舌硬不能言语。手中抽搐，是汗多导致筋惕肉瞤。（不是中风证。）渴欲饮水，是汗多津液枯竭。（不是阳明病发渴。）小便不利，是心移热于小肠，小肠移热于膀胱，津液少而气化不行，所以尿道痛。连续服用五剂而愈。（未记载所用何方，颇为疏漏。）
汪怀江中暑又伤食。一个医生用五积散等燥热之剂，导致阳气外散，阴津内竭，阳强阴弱，皮肤干燥而无汗。应当先滋养其阴，然后制约其阳，使汗出而表气和。于是用凉膈散去大黄、芒硝，加知母、石膏、淡豆豉、竹叶，一服后微汗出而身体滋润。正要议定用下法，又一个医生来到，说是阴虚火动，不可用下法，用四物汤加炒干姜，触动阳明之火，齿缝出血，足冷成为阳厥。于是复用凉膈散服用，利下三次而病愈。
龚子才治疗一个妇人，暑月因厨房极热，遂走出到风口处，脱衣乘凉，随即头痛发热，恶寒身痛。医生误以为是伤寒，用附子理中汤，一服下咽，立刻不语，口中无气，唇口青紫，心头微温。诊察六脉洪大而数，这是热症误用热药。让人用烧酒喷其胸，将镜子扑打，再用新汲水和蜜，用鸡毛蘸入其口中数次。片刻后，病人即伸舌探水，用益元汤灌下即活。
李士材治疗张邑尊的公子，六月间，下午时分晕倒不知人，过了一夜未醒。这是由于生冷太过所致。用皂角末吹鼻中无喷嚏，全家惊慌。教他用皂角灰存性，新汲水灌服，再取沉香、檀香焚烧，让香气充满房间，以通达窍道，到半夜才苏醒。服用十味香薷饮而安。
吴孚先治疗一个人，在烈日下奔驰，忽然患头疼发热，有时烦躁，大汗出，大渴引饮，喘急乏气，服香薷饮反而加重，这是暑症。然而受暑有阳暑和阴暑之分，道路劳役之人，所受的是炎热，名叫伤暑。亭馆安逸之人得之，为中暑。香薷饮只适宜于阴暑，若阳暑服之，反而有害。给予人参白虎汤而愈。
董仁仲，在暑天纳凉饮冷，忽然头疼发热，霍乱吐泻，烦躁口渴，舌苔白滑，这是阴暑。由于过于寒凉，导致周身阳气被阴邪遏制。宜用香薷的辛热，发越阳气，散水和脾，四剂而愈。（黎按：这是夏月感寒之症，却称之为阴暑，而以伤暑者为阳暑，治疗虽不误，但名称实在谬误。上一条也是如此。）
一个割草喂牛的妇女，夏月贪凉饮冷，胸中像有一团火，凡冷水凉茶入咽，觉得从火团上分流而下，眼睛羞明畏火，口鼻间频频出火气。诊察六脉俱阴，舌苔紫青而滑，吴曰：这是寒格反见热化。给予干姜、肉桂温散，少加黄连为向导。过了一会儿，觉得胸中之火，顿时化为清凉而愈。
孙文垣治疗弟弟孙淑南，额痛，遍身疼，口干，舌苔黄浓，左脉浮大，六部俱数。时值仲秋初旬，用小柴胡合白虎汤加羌活，热不退。下午用六神通解散，用葱汤调服三钱，热稍退。到半夜后，又复发热，额痛，颠顶尤其严重，舌根黄且焦黑，小便赤痛，烦躁不睡，遍身又痛。这是三阳合病暑症。次日用小柴胡汤大加石膏为君药，加川芎、白芷、竹叶、粳米、生姜、大枣。片刻后，汗出至足，（必至足才是正汗），热始尽退。仍烦躁不睡，仍用小柴胡汤加桂枝、山栀、竹茹、竹叶，饮下遂愈。
张路玉治疗内兄顾九玉，大暑中患胸痞颅胀。脉得虚大而濡，气口独显滑象，这是湿热泛滥于膈上。给予清暑益气汤二剂，颅胀止而胸痞不除。给予半夏泻心汤，减炮姜，去大枣，加枳实，一服而愈。
范文学治疗孙振麟，在大暑中患厥冷自利。六脉弦细芤迟，按之欲绝，舌色淡白，中心黑润无苔，口鼻气息微冷，阳缩入腹，精滑如水。问起病的缘由，是因为卧地昼寝受寒，当夜连走精二度，忽然觉得颅胀如山，坐起晕倒，四肢厥逆，腹痛自利，胸中兀兀欲吐，口中喃喃妄言，与湿温之症不殊。医生误以为是停食感冒，给予发散消导二剂，服后胸前头项汗出如流，背上愈加畏寒，下体如冷水，一日昏愦数次。这是阴寒挟暑，入中手足少阴之候。因为肾中真阳虚极，所以不能发热。于是拟四逆加人参汤，方中用人参一两，熟附子三钱，炮姜二钱，炙甘草二钱，昼夜兼进，三日中连进六剂，决定第四日寅刻回阳。那天全屏弃姜、附，改用保元汤，方用人参五钱，黄芪三钱，炙甘草二钱，麦冬二钱，五味子一钱，清肃膈上之虚阳。四剂后进食，改用生料六味丸，加麦冬、五味。每服用熟地黄八钱，以救下焦将竭之水，使阴平阳秘，精神乃治。
申叔 触热经过梁溪，回来而眩晕麻瞀，发热便秘，服黄连香薷不应。用凉膈散，便通。有时昏眩不省人事，有时四肢清冷，而傍晚时为甚。诊察，脉弦细而芤，这是暑伤心包，阳气郁伏，所以有似阴寒。给予生脉散合保元汤，清理肺胃，则包络自宁矣。
柴屿青治疗陈忍之患病，医生用温散之药投之，遂至彻夜不能合眼，时见鬼物，两脉沉伏。症属受暑，用加减清暑益气汤，去参、苓，一剂热减，六脉俱现洪大。再服六一散，数剂而病退。惟夜间尚不能熟睡，遂以滋补安神之剂调理而安。
壬戌夏，五营缮朱载常，早间入署，舆中呕吐，昏愦遗尿。医生以中风治，开附子理中汤加僵蚕。后来又因两脉鼓指，危笃已极，参、附尚少，恐难挽回。柴曰：这是暑风，脉无死象，力保无事。伊芳同寓水部钱筑岩不信，急煎前药，将进，幸好禾中朱汝能用六一散，一服神气稍定。钱虽不知医，固知六一散之与理中汤冰炭不同，因而停前药。次日遂以黄连香薷饮加羌活治之，调理数日而康。
陆祖愚治疗陈元甫，七月间，因构讼事，忍饥食冷粥数碗，少顷即吐出。自此茶饮皆吐，头痛身热，咽喉不利，昏冒，口中常流痰液。医生知为中暑，用冷香薷饮投之，随吐。又以井水调益元散投之，亦吐，昏沉益甚。诊脉，阳部洪数无伦，阴部沉微无力，这是邪在上焦。在上者因而越之，此宜涌吐者也。盖饥饿之时，胃中空虚，暑热之气，乘虚而入于胃。胃热极，而以寒冷之水饮投之，冷热相反，所以水入即吐，即口中流涎，也是胃热上溢的缘故。因此用沸汤入盐少许，醋汁数匙，乘热灌之。至二三碗不吐，至一时许方大吐，水饮与痰涎同出，约盆许。即以生脉散投之，人事清爽，诸症顿减。又合四物汤调理而安。
张绍甫治疗一个人，暑热患头痛，身热昏睡，大渴引饮。众人以感冒治，不效。诊察，脉大而虚，说：这是暑疾。即令撤幔开窗，前后左右各置凉水，顿觉清爽。仍令两个童仆喂食西瓜，取其便利，连饮四五钟即愈。（治法精妙。）
张为诸生时，万历戊子夏，患暑症，势极气索，神志昏愦。庸医以为内伤，或以为劳役，中折几不自持。医者汪韫玉适在旁，皱眉说：心烦面垢，这是暑症。闻者皆骇其名，予于昏愦中微解，根据之服益元散，二剂而苏。仍调以苏薷饮，数剂而愈。（张绍甫名凤逵，着《暑热全书》，天启年间刊本。）
李 垢治疗朱竹 夫人冯氏，病热七日不汗，又七日又不汗，逾二旬矣。诸医皆云：伤寒不可治，请办丧具。朱乃邀李徒步登阁诊视，李 垢笑曰：君夫人所居阁，四面俱木围之，木生火，触暑脉伏耳，脏腑无他恙也，亟以甘瓜井水投之，可不药而愈。从其言，越宿而 粥糜，再宿主中馈如故。（《曝书亭集》。）
文选姚海山，中暑头痛发热，气高而喘，肢体怠倦，两手麻木。胃热伤元气，用人参益气汤顿安。又用补中益气汤，加麦冬、五味而痊。
昔有人暑月深藏不出，因客至，坐于窗下，忽似倦怠，自作补中汤服之，反剧。医问其由，连进香薷饮，两服而安。（万密斋《养生四要》。）
马元仪治疗陆太史，时值秋暑，偶发热头痛。诊得脉大而虚，谓中气大虚，非补不克。彼云：伤暑小恙，况饮食不甚减，起居不甚衰，何虚之有？但清暑调中，去邪即已，何用补为。乃勉与清暑益气而别。明晨复诊，脉之大者变为虚微，发热如故，曰：今日不惟用补，更当用温，宜亟服之，迟则生变矣。遂用理中汤，服下少顷，出汗如涌泉。午后复诊，两脉虚微特甚，汗如贯珠，乃连进人参四两，附子两许。日夜约用人参十两，附子四两，汗止精藏，渐调而愈。
任邱裴在涧，弃家逃禅，持戒茹素，遍游五岳，足迹几遍天下。偶客金坛，寓西禅寺僧舍，酷暑坐卧水楼，日持准提咒三千，念佛号三万，（未是俊物。）忽患头痛如斧劈，身热发躁，口干，日饮冷水斗余，渴犹未解，自分必死。庄敛之怜其旅病，时过视疾。一日急走仓头，召敛之永诀，以携来书画玩器，尽授敛之，揖而言曰：（未尝得道。）兄其为我收藏。吾死后，切勿用世俗礼葬我，惟以两缸盛吾尸其中，以三尺地埋之耳。敛之涕泗填胸，束手无策，促缪仲淳诊之。余此时游梁溪、阳羡间，敛之命余仆克勤相追。归视其脉，知系受暑，为疏竹叶石膏汤。不二剂，热渴俱止。几十剂，病始退。旋加健脾药十余帖而安。（《广笔记》。）
来天培治疗蔡氏女，病经六七日。时七月初旬，发热头痛，胸满腹痛，烦躁口渴，目闭神昏，时有独语，脉浮细而数，按之模糊。问曾手足抽掣乎？曰：然。曰：此俗所谓暑风伤寒也，用香薷、青蒿、羌、防、枳、桔、秦艽、钩藤、菖蒲、半夏曲、藿香、柴胡、黄连，一剂症减神清，脉亦和。前方去羌活、菖蒲、枳、桔、香薷，加广皮、浓朴、花粉、丹皮，一剂渐安，惟热未尽退，此津液不生之故耳。改用生地、麦冬、茯苓、花粉、黄芩、石斛、广皮、谷芽、半夏曲，又二剂全痊。
沈明生治疗王明甫，长夏神昏不语，伏枕信宿。午前往视，曰：脉虚身热，此中暑耳，非风也，曷不用参？其长君曰：早间一友，因用参而转加烦懑。问用几何？曰：五分。曰：宜其转甚也，当四倍之，乃克有济耳。乃愕眙不信，因晓之曰：凡参少用则壅滞，今病正台东垣避暑于深堂大厦，得之者属阴，且古人用清暑益气、
Xu Shuwei treated a patient who presented with headache, feverish body, mental restlessness, irritability, and thirst. Upon palpation, the pulse was large and deficient. He prescribed Baihu Tang (White Tiger Decoction) for several doses, after which the patient recovered. Zhang Zhongjing stated: "A deficient pulse accompanied by fever is caused by heatstroke." He also asked: "Why does the pulse appear wiry, fine, hollow, or slow?" The *Suwen* (Basic Questions) states: "Cold damages the form, while heat damages the qi." Since heat damages the qi without damaging the form, the qi becomes depleted, resulting in a weak pulse. Therefore, wiry, fine, hollow, and slow pulses are all types of deficient pulses. Zhang Zhongjing considered the wiry pulse to be yin, and Zhu Pang also stated that a faint and fine pulse indicates heatstroke, confirming it as a deficiency syndrome.
In the year Guichou, my old friend Wang Yanlong, serving as the granary official in Piling, experienced excessive sweating on the chest and neck during late summer, cold feet, and delirium. Physicians unfamiliar with this condition administered mixed medications for ten days. Upon examination, the pulse at the Guan position anteriorly was soggy (Ru), and posteriorly was rapid (Shu). I said: "This should be treated as Damp-Warmth disease." This occurs when one first contracts summerheat and then dampness; the interplay of summerheat and dampness is named Damp-Warmth. Initially, Baizhu Jia Renshen Tang (White Tiger Decoction plus Ginseng) was administered, followed by Baizhu Jia Cangzhu Tang (White Tiger Decoction plus Atractylodes Lancea Rhizome). The headache gradually subsided, the feet warmed, and sweating ceased, leading to recovery in three days. This is termed "Thief Pathogen" (Zeixie); if misdiagnosed and mistreated, death may result. Someone questioned: "What is meant by Thief Pathogen?" I replied: "The *Nanjing* (Classic of Difficult Issues) states there are five pathogenic factors: Excess, Deficiency, Direct, Minor, and Thief. Coming from the subsequent element is Deficiency; from the preceding element is Excess; from the element that overcomes me is Thief; from the element I overcome is Minor; and arising from one's own organ is Direct. For example, in Heart disease, summerheat is Direct; contracting dampness constitutes Thief Pathogen, which is the most adverse among the five. The *Nanjing* states: 'In Damp-Warmth, the Yang portion (Cun) is soggy and weak, while the Yin portion (Chi) is small and urgent.' Soggy and weak appearing in the Yang portion indicates dampness clashing with summerheat; small and urgent appearing in the Yin portion indicates summerheat steaming dampness. Thus, the classics say: 'Summerheat and dampness clashing is named Damp-Warmth,' which is the Thief Pathogen. Furthermore, I have a chronic condition of fluid retention. Often during summer months, my feet remain wet despite sweating. Taking two or three cups of this medication cures me."
Zhang Zihe treated Xiao Zheng, aged fifteen, who contracted heatstroke in the fields, suffering from headache, lethargy, and inability to rise. He was given Shuangjie San (Double Release Powder) to induce sweating, and rice wash water was administered, but symptoms persisted. In the evening, Sanhua Shenwan (Three-Flower Divine Pill) was used for strong purgation, after which he recovered.
Zhang Zihe treated an elderly man surnamed Zhang, aged seventy-one, who suffered from heatstroke due to hunger and exhaustion in the fields during summer. He had no appetite, frequent vomiting, constant salivation of phlegm-water, and abdominal and hypochondriac pain. Physicians indiscriminately used Pingwei San (Regulate the Stomach Powder), Lizhong Wan (Regulate the Middle Pill), and Daoqi Wan (Guide Qi Pill) without effect. Acupuncture was added, with diagnoses of Cold Stomach. When consulted, Zhang Zihe said: "Phlegm belongs to the Stomach; stomach heat fails to contain it, causing phlegm-water discharge. Given your advanced age, I dare not use emesis." Instead, he instructed using a chopstick to stimulate the throat, inducing the expectoration of one sheng (approx. 200ml) of phlegm-saliva without medicine. Subsequently, Huanglian Qingxin San (Coptis Clear Heart Powder), Daoyin Wan (Guide Fluid Pill), and Yulu San (Jade Dew Powder) were used to regulate him, improving his diet. Only constipation remained; a decoction of Weicheng Qi Tang (Regulate the Stomach and Purge Qi Decoction) with fresh ginger and jujube was administered to purge, leading to recovery.
Wan Mizhai treated Li Tianquan, a county deputy magistrate, who suffered from abdominal pain due to heatstroke in June. His maid, coming from another household, suggested the doctor diagnosed cold and prescribed Lizhong Tang (Regulate the Middle Decoction). After one dose, pain stopped, but fever ensued, along with generalized joint pain. Shishen Tang (Ten Spirits Decoction) was then given to induce sweating; fever subsided, and pain ceased. Wan Mizhai examined the patient; Li claimed recovery, but his complexion showed redness, indicating unresolved pathology. The pulse was surging, slippery, and rapid. (Color and pulse correspond.) The classics state: "Large pulse indicates advancing disease." Now, post-sweating, the pulse remains surging and rapid, meaning the disease is progressing, yet he claims cure. Before Wan left, the illness recurred. Severe abdominal pain resembling Ben Tun (Rushing Bull) syndrome occurred, with rubbing of the abdomen. Wan was urgently summoned. Li said: "You diagnosed my pulse earlier but left silently, knowing my condition. Please save me urgently." Wan said: "No harm." He prescribed Jianzhong Tang (Establish the Middle Decoction). One dose stabilized the pain. The next day, Wan Pu, a provincial examiner and skilled physician, visited. Upon palpation, Wan Pu was startled and looked around; Li was suspicious and fearful. Wan Mizhai told Wan Pu: "Are you surprised by the intermittent pulse? This is due to palpitations in the epigastrium." Li immediately confirmed: "My heart feels chaotic and restless." Medicine was prepared containing Renshen (Ginseng Root), Maidong (Ophiopogon Tuber), Gancao (Licorice Root), Baishao (White Peony Root), Shengdi (Rehmannia Root), and Wuweizi (Schisandra Fruit), decocted with pig heart soup. One dose stopped the palpitations and regularized the pulse. Since the Heart dislikes heat, using hot medicines to treat heat violated contraindications, causing recurrence.
Li Shaohua, knowledgeable in medicine, contracted summerheat in June. After one dose of Jiuwei Qianghuo Tang (Nine-Ingredient Notopterygium Decoction), sweating occurred but the disease did not resolve. Believing the dosage was insufficient for effective sweating, he took a larger dose, resulting in profuse sweating and intensified fever. Three consecutive doses worsened the condition. He became delirious like a madman, with a stiff tongue, slurred speech, limb twitching, difficulty urinating, and penile pain (only one or two drops upon pressure). He ate nothing, drinking only water. Wan Mizhai found the pulse weak, minute, and slow. Asked if curable, Wan replied: "This is a ruined disease, the fault of the physician. The Heart dislikes heat; vigorous fire consumes qi. In midsummer, fire qi is strong; excessive sweating damages the Heart. The Heart houses the Spirit; delirium indicates spirit disorder (not blood stasis). The tongue corresponds to the Heart; excessive sweating causes blood deficiency failing to nourish the tongue, hence stiffness and inability to speak. Limb twitching results from excessive sweating causing muscle tremors (not wind-stroke). Thirst for water indicates fluid depletion from sweating (not Yangming thirst). Difficulty urinating stems from Heart heat transferring to the Small Intestine, then to the Bladder; fluid scarcity and failed qi transformation cause penile pain. Five doses cured him." (The specific formula was not recorded, which is a omission.)
Wang Huaijiang suffered from heatstroke complicated by food stagnation. A physician used Wujii San (Five Accumulations Powder) and other drying-hot agents, dispersing yang qi externally and depleting yin fluids internally, resulting in hyperactive yang and deficient yin, dry skin, and anhidrosis. The treatment should first nourish yin, then restrain yang, allowing sweat to emerge and harmonize the exterior. Liangge San (Cool the Chest Powder) was modified by removing Dahuang (Rhubarb Root) and Mangxiao (Mirabilite), adding Zhimu (Anemarrhena Rhizome), Shigao (Gypsum Fibrosum), Danshi (Fermented Soybean), and Zhuye (Bamboo Leaf). One dose produced slight sweating and moistened the body. Just as downward purgation was planned, another physician arrived, diagnosing yin deficiency with fire hyperactivity, advising against purgation. Siwu Tang (Four Substance Decoction) with fried Ganjiang (Dried Ginger) was used, stirring up Yangming fire, causing gingival bleeding and cold feet (Yang reversal). Liangge San was then reused, resulting in three bowel movements and recovery.
Gong Zicai treated a woman who, in summer, exited a hot kitchen to cool off in the wind, removing clothes. She immediately developed headache, fever, aversion to cold, and body pain. Misdiagnosed as Cold Damage (Shanghan), Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction) was given. Immediately after swallowing, she fell silent, breathless, with blue-purple lips, though the heart area remained warm. The six pulses were large, rapid, and forceful, indicating heat syndrome mistreated with hot medicine. Burnt wine was sprayed on her chest, and a mirror was waved to cool her. Fresh well water mixed with honey was applied to her mouth with a chicken feather several times. Soon, she extended her tongue seeking water. Yi Yuan Tang (Benefit Origin Decoction) was poured down, reviving her.
Li Shicai treated the son of Prefect Zhang, who fainted and lost consciousness in June between 3-5 PM, remaining unconscious until midnight. This was caused by excessive consumption of raw/cold foods. Soapberry powder blown into the nose failed to induce sneezing, causing family panic. He was taught to use soapberry ash (preserved nature) mixed with fresh well water, and burning Chenxiang (Agarwood) and Tanxiang (Sandalwood) to fill the room with fragrance to open the orifices. He revived at midnight and was settled with Shiwei Xiangru Yin (Ten-Ingredient Elsholtzia Decoction).
Wu Fuxian treated a man who, running under the scorching sun, suddenly developed headache, fever, occasional irritability, profuse sweating, extreme thirst with desire to drink, panting, and fatigue. Symptoms worsened with Xiangru Yin (Elsholtzia Decoction), indicating Summerheat Syndrome. Summerheat contraction has Yin and Yang types. Laborers on roads contract intense heat, named Shangshu (Injury by Summerheat). Those in pavilions contracting ease suffer Zhongshu (Midst Summerheat). Xiangru Yin is suitable only for Yin Summerheat; using it for Yang Summerheat causes harm. Ren Shen Baihu Tang (Ginseng White Tiger Decoction) cured him.
Dong Renzhong, cooling off and drinking cold beverages in summer, suddenly developed headache, fever, cholera-like vomiting and diarrhea, irritability, thirst, and white-slippery tongue coating. This is Yin Summerheat, caused by excessive cold inhibiting whole-body yang qi. Xiangru’s pungent-warm nature should be used to vent yang qi, disperse water, and harmonize the spleen. Four doses cured him. (Li notes: This is cold contraction in summer, termed Yin Summerheat, while Shangshu is Yang Summerheat. Treatment was correct, but nomenclature is erroneous. Same applies to the previous case.)
A grass-cutting woman, indulging in cold drinks in summer, felt a ball of fire in her chest. Cold tea flowed down from this fire ball. Her eyes feared light and fire, and fire seemed to emanate from her mouth and nose. The six pulses were all yin-type (deep/slow), and the tongue coating was purple-green and slippery. Wu said: "This is cold rejection manifesting as false heat." Ganjiang (Dried Ginger) and Rougui (Cinnamon Bark) were used for warming dispersion, with a little Huanglian (Coptis Rhizome) as a guide. After a while, the chest fire turned cool, and she recovered.
Sun Wen yuan treated his brother Sun Shunan with forehead pain, generalized body pain, dry mouth, thick yellow tongue coating, floating-large left pulse, and rapid pulses in all positions. It was early autumn. Xiaochaihu Tang (Minor Bupleurum Decoction) combined with Baihu Tang plus Qianghuo (Notopterygium Rhizome) failed to reduce fever. In the afternoon, Liutong Shenjie San (Six-Awakening Unblocking Powder) taken with green onion soup slightly reduced fever. After midnight, fever returned, forehead pain worsened (especially vertex), tongue root became yellow and scorched-black, urine was red and painful, irritability prevented sleep, and body pain recurred. This is Summerheat syndrome with simultaneous involvement of the Three Yang channels. The next day, Xiaochaihu Tang was used with Gypsum as the sovereign herb, plus Chuanxiong (Szechwan Lovage Rhizome), Baizhi (Angelica Dahurica Root), Zhuye (Bamboo Leaf), Jingmi (Rice), Shengjiang (Fresh Ginger), and Dazao (Jujube). Sweating reached the feet (true sweating), and fever completely subsided. Irritability persisted, so Xiaochaihu Tang was continued with Guizhi (Cinnamon Twig), Zhizi (Gardenia Fruit), Zhuru (Bamboo Shavings), and Zhuye. Drinking this cured her.
Zhang Luyu treated his sister-in-law Gu Jiuyu, who suffered from chest oppression and head distension during peak summer. The pulse was deficient, large, and soggy; the Qi Kou (Radial Artery at Cunkou) alone showed a slippery image, indicating damp-heat flooding above the diaphragm. Qing Shu Yi Qi Tang (Clear Summerheat Benefit Qi Decoction) for two doses stopped head distension but not chest oppression. Banxia Xiexin Tang (Pinellia Drain the Epigastrium Decoction) was used, reducing Paojiang (Fried Ginger), removing Dazao, and adding Zhishi (Immature Bitter Orange). One dose cured her.
Fan Wenxue treated Sun Zhenlin, who suffered from cold limbs and spontaneous diarrhea during peak summer. The six pulses were wiry, fine, hollow, and slow, nearly imperceptible upon pressure. The tongue was pale white with a black-moist center and no coating. Breath from mouth and nose was slightly cold, genitals retracted into the abdomen, and seminal emission was watery. The cause was lying on the ground for a nap in cold, followed by two nocturnal emissions that night. Suddenly, severe head distension like a mountain occurred, leading to fainting upon sitting up, cold limbs, abdominal pain, diarrhea, nausea, and muttering delirium, resembling Damp-Warmth. Physicians misdiagnosed food stagnation and cold damage, prescribing dispersing and digesting agents. Post-medication, sweating flowed from chest/head/neck, back chill increased, lower body felt like cold water, and confusion occurred multiple times daily. This is Yin-Cold夹 (accompanied by) Summerheat entering the Foot-Shaoyin and Hand-Shaoyin channels. Kidney true yang is extremely deficient, preventing fever. Sini Jia Renshen Tang (Four Reversal plus Ginseng Decoction) was prescribed: Renshen 1 liang, Shufu 3 qian, Paojiang 2 qian, Zhigancao 2 qian. Administered day and night, six doses over three days. Recovery of yang was expected on the fourth day at Yin hour. That day, Jiang and Fu were discarded; Baoyuan Tang (Protect Origin Decoction) was used: Renshen 5 qian, Huangqi (Astragalus Root) 3 qian, Zhigancao 2 qian, Maidong 2 qian, Wuweizi 1 qian, to clear deficient yang above the diaphragm. After four doses, eating improved; Shengli Liuwei Wan (Raw Six-Ingredient Pill) with Maidong and Wuweizi was used. Each dose contained Shudi (Prepared Rehmannia Root) 8 qian to rescue exhausted lower jiao yin, achieving yin-yang balance and spiritual health.
Shen Shu contracted heat while crossing Liangxi. Returning home, he suffered dizziness, numbness, blurred vision, fever, and constipation. Huanglian Xiangru Yin was ineffective. Liangge San cleared bowels. Sometimes he fainted or had cold limbs, worse in the afternoon. Pulse was wiry, fine, and hollow. This indicated Summerheat damaging the Pericardium, with yang qi depressed, mimicking yin-cold. Shengmai San (Generate Pulse Powder) combined with Baoyuan Tang cleared Lung/Stomach, calming the Pericardium.
Chai Yuqing treated Chen Renzhi, whose physician used warming-dispersing drugs, causing insomnia and hallucinations, with deep-hidden pulses. Diagnosed as summerheat, Jiajian Qing Shu Yi Qi Tang (Modified Clear Summerheat Benefit Qi Decoction) without Renshen/Fuling was given. One dose reduced fever; six pulses became surging-large. Liuyi San (Six-to-One Powder) cured the fever. Insomnia persisted, resolved by tonifying and calming spirits.
In summer of Renxu, Zhu Zaichang vomited and fainted with incontinence in his carriage. Treated as wind-stroke with Fuzi Lizhong Tang plus Jiangcan (Silkworm). Later, pulsing vessels indicated critical condition; more Ginseng/Aconite needed. Chai said: "This is Summerwind; no death signs. I will ensure safety." Qian Zhuyan, lodging with him, disagreed, preparing the previous medicine. Fortunately, Zhu Runeng gave Liuyi San, stabilizing spirit. Qian knew Liuyi San contradicted Lizhong Tang, stopping the previous meds. Next day, Huanglian Xiangru Yin plus Qianghuo cured him after days of regulation.
Lu Zuyu treated Chen Yuanfu, who in July, after litigation and fasting, ate cold porridge, vomiting shortly after. All tea/water vomited. Headache, fever, sore throat, dizziness, salivation. Diagnosed as summerheat, Leng Xiangru Yin (Cold Elsholtzia Decoction) caused immediate vomiting. Well water mixed with Yi Yuan San also caused vomiting, worsening coma. Pulse: Yang portion surging-rapid, Yin portion deep-weak. Pathogen in Upper Jiao. "Those above should be expelled upwards." Emesis was indicated. Hunger emptied the stomach; summerheat entered. Extreme stomach heat met cold water, causing rejection and salivation. Boiled water with salt and vinegar was drunk hot. After 2-3 bowls, massive vomiting occurred (water/phlegm ~1 basin). Shengmai San restored clarity and reduced symptoms. Siwu Tang regulated recovery.
Zhang Shaofu treated a person with summerheat headache, fever, somnolence, and extreme thirst. Treated as cold damage unsuccessfully. Pulse large-deficient. Diagnosed as summerheat. Curtains removed, windows opened, cool water placed around. Patient felt refreshed. Fed watermelon by servants. Drinking 4-5 cups cured him. (Exquisite method.)
When Zhang was a student, in summer of Wuzi (Wanli era), he suffered severe summerheat, gasping, and fainting. Quacks diagnosed internal injury or fatigue. Physician Wang Yunyu nearby frowned: "Mental restlessness and dirty face indicate summerheat." Zhang, partially conscious, took Yi Yuan San, recovering in two doses. Su Rui Yin regulated recovery. (Zhang Shaofu, name Fengkui, authored *Shu Re Quan Shu*, published Tianqi era.)
Li Gou treated Lady Feng, wife of Zhu Zhu, with seven days of fever without sweating, then another seven days without sweating, exceeding twenty days. Physicians declared untreatable cold damage, preparing funeral items. Zhu invited Li to climb the tower for diagnosis. Li laughed: "Your lady's tower is surrounded by wood; wood generates fire, triggering summerheat, hiding the pulse. Organs are healthy. Quickly give melon well water; she will recover without medicine." Following advice, she ate gruel overnight and resumed housekeeping. (*Pashu Ting Ji*.)
Yao Haishan, a civil servant, suffered summerheat headache, fever, panting, fatigue, and hand numbness. Stomach heat damaged original qi. Ren Shen Yi Qi Tang brought instant relief. Buzhong Yiqi Tang plus Maidong/Wuweizi completed cure.
Once, someone hid indoors in summer. Guest arrived; sitting by window, he felt fatigued, took Buzhong Tang himself, worsening condition. Doctor asked cause, gave Xiangru Yin twice, curing him. (*Wan Mizhai Yangsheng Siyao*.)
Ma Yuanyi treated Lu Taishi during autumn summerheat with occasional fever/headache. Pulse large-deficient. Said middle qi was greatly deficient, requiring tonification. Patient argued: "Minor summerheat injury, diet/rest normal, why deficient? Just clear summerheat and regulate middle, remove pathogen, why tonify?" Reluctantly given Qing Shu Yi Qi Tang. Next morning, pulse changed from large to weak-minute, fever persisted. Ma said: "Today, not only tonify, but warm. Take immediately, or complications arise." Lizhong Tang given. Shortly after, sweating like a spring. Afternoon: pulses very weak-minute, sweat like pearls. Continued with 4 liang Renshen and approx. 1 liang Fuzi. Daily total: 10 liang Renshen, 4 liang Fuzi. Sweat stopped, essence stored, gradual recovery.
Pei Zaijian from Renqiu abandoned family for Zen, vegetarian, traveled widely. Lodged in Jintan West Chan Temple, sat/slept in cool tower in extreme heat, chanting 3000 Zhunti mantras and 30,000 Buddha names daily. Suddenly severe headache like axe-chop, fever, irritability, dry mouth, drinking >1 dou cold water daily without relief, expecting death. Zhuang Lianzhi pitied him, visited often. One day, Pei summoned Lianzhi for farewell, giving paintings/artifacts, saying: "After my death, bury me simply in two jars, 3 chi deep." Lianzhi wept, helpless, urged Miao Zhongchun to diagnose. Miao was traveling; sent servant Keqin to catch up. Returned, diagnosed summerheat, prescribed Zhuye Shigao Tang (Bamboo Leaf Gypsum Decoction). Two doses stopped fever/thirst. Dozens of doses reduced illness. Added spleen-strengthening herbs for stability. (*Guang Biji*.)
Lai Tianpei treated Ms. Cai, ill 6-7 days. Early July, fever, headache, chest fullness, abdominal pain, irritability, thirst, closed eyes, coma, muttering. Pulse floating-fine-rapid, vague on pressure. Asked about convulsions: Yes. Lai said: "Commonly called Summerwind Cold Damage." Prescribed Xiangru, Qinghao, Qianghuo, Fangfeng, Zhishi, Jiegeng, Qinjiao, Gouteng, Shichangpu, Banxiaqu, Huoxiang, Chaihu, Huanglian. One dose reduced symptoms, clarified spirit, harmonized pulse. Removed Qianghuo, Shichangpu, Zhishi, Jiegeng, Xiangru; added Guangpi, Houpo, Huafen, Danpi. One dose stable, fever lingering due to fluid non-generation. Changed to Shengdi, Maidong, Fuling, Huafen, Huangqin, Shihu, Guangpi, Guya, Banxiaqu. Two doses fully cured.
Shen Mingsheng treated Wang Mingfu, comatose and mute in long summer, bedridden two nights. Visited noon: "Deficient pulse, feverish body, this is summerheat, not wind. Why not use Ginseng?" Elder brother said: "Friend used Ginseng this morning, worsened agitation." Asked amount: 5 fen. Shen said: "Expected worsening. Should quadruple dose to work." Brother skeptical. Shen explained: "Small doses of Ginseng cause stagnation. Dongyuan advised resting in cool halls for summerheat (yin type). Ancients used..."