大意
暑之为气。在天为热。在地为火。在人脏为心。故暑者。相火行令也。夏月人感之。自口齿而入。伤心胞络之
经。（贾元良）
内因
有素虚卫弱。纵暑中伤者。必兼内伤之病。有素壮盛。暑气偶侵者。必兼外感之形。故自袭暑气而言。曰中
暑。自被日逼而言。曰中 。（入门）
外候
因于暑。汗烦喘渴。静则多言。体若燔炭。汗出而散。（内经）暑之中人。先着心胞。则为头疼身热。自汗心烦。口
渴面垢而已。余症皆后传变。入肝则眩晕顽麻。入脾则昏睡不觉。入肺则喘嗽痿蹶。入肾则消渴烦躁。其
暑邪归心。则神昏卒倒也。（入门）
中暑
中暑者。深居密室。先受暑气。又为房室之阴寒所遏。静而得之。伤心脾二经。外症汗退场门渴。背微恶寒。身
热头痛。面垢烦躁。其脉弦细芤迟。又有心烦浮热而扪之似无。洒淅无汗。或微有冷汗。小便已则洒然毛
耸。手足逆冷。小有劳。身即发热。此乃时令之火郁极于内。心胞之阳不行于外。则荣卫之开阖不调。所以
腠理开则洒然寒。腠理闭则热而闷也。宜清解暑热为主。香薷饮、六和汤。加干葛。（汇补）
中
中 者。由劳役辛苦于田野道途。动而得之。伤足太阳膀胱经。重者昏迷卒倒。轻者头疼恶热。发热烦躁。
扪之肌肤大热。唇干舌赤。前板齿燥。大渴引饮。汗雨大泄。无气以动。无气以言。脉洪大浮数而虚豁。此天
暑外伤。疏泄肺气。宜清热养津为主。人参白虎汤。加麦冬、花粉。（汇补）
伤暑
伤暑者。禀质素弱。不任外邪。故略感即病。比中暑稍轻。当分三法治之。若日间发热。夜分乃凉。自汗倦怠。
食少脉虚。此暑伤元气。宜清暑益气汤。若头胀眩晕。周身烦躁。肤如针刺。或兼赤肿。此暑伤肉分。宜六和
汤。若咳嗽烦渴。寒热盗汗。脉数不减。此暑伤肺经。宜甘桔汤。加黄芩、山栀、麦门冬、丹皮、贝母。（汇补）
冒暑
冒暑者。禀气充实。但不辞辛苦。暑热冒于肌表。而复传于里以成暑病也。其候腹痛水泻。小便短赤。口渴
欲饮。恶心呕吐。有时眩晕。心烦躁热。胃与大肠受之。（绳墨）宜胃苓散。加藿香。或六一散。又有内伤饮食。外
着暑气而成暑湿伤脾之病者。其候腹痛作泻。泻下黄糜。口渴溺热。宜理脾清暑。平胃散。加连、通、曲、泻。
（汇补）
伏暑
伏暑者。久而藏伏三焦肠胃之间。热伤气而不伤形。旬月莫觉。变出寒热不定。体倦神昏。头重潮热。甚或
霍乱吐泻。膨胀中满。疟痢斑黄。腹痛下血等症。消暑丸主之。亦有夏月晒衣。遽藏箱柜。炎蒸未退。虽移他
时。偶尔开视。体惫之人。亦能染之。不可不知。（汇补）
暑风
暑风由冲斥道途。中暑热极。火盛金衰。木旺生风。脾土受邪。故卒然昏倒。手足搐搦。内扰神舍。志识不清。
而瞀闷无知。宜清时令之火。则金清而木有制。开郁闷之痰。则神安而气自宁。慎勿以风药误治。（良方）连
薷饮。加薄荷、荆芥。若其人先有痰热在内。外又感暑而成昏冒者。可用吐法。盖吐中有发越之义也。（汇补）
暑厥
暑厥者。即暑 病兼手足厥冷。与伤寒发厥义同。（入门）大概兼恶寒发热而渐厥者。为心脾中暑症。不恶
寒。但恶热而渐厥者。为膀胱中 症。若夫但恶寒不发热而渐厥者。又为夏月感寒阴症。不与暑 症同
类也。（汇补）
绞肠痧
绞肠痧者。暑郁中焦。腹痛连心。上下攻绞。不得吐泻。或手足皆冷。乃肠绞缩腹。须臾杀人。急用生熟水调
白矾三钱。少顷探吐。去其暑毒即安。或刺委中穴。及指爪甲。令出血。如胸背四肢发红点者。以菜油灯火
遍之。（汇补）
暑病脉法
脉虚身热。得之伤暑。（内经）或浮大而散。或弦细芤迟。（杂着）夫暑 之症。与夏月热病往往相似。但暑脉或
洪或虚。重按无力。热病脉盛弦长。重按有力。即或有热病发于阴经。其脉沉小。非若暑脉之见于浮分也。（汇补）
暑病治法
暑乃六淫中无形之火。大率以五行中有形之水制之。（奇效良方）中暑宜解暑和中。中 宜泻火益元。伤暑宜
补元气。冒暑宜清利二便。（汇补）
治暑三禁
若发汗。则恶寒愈甚。若温针。则发热愈甚。若下之。则淋涩愈甚。（仲景）
中 救法
道途卒倒。急扶阴凉干处。掬道上热土。放脐间。拨开作窍。令人尿其中。后用姜蒜嚼烂。以滚水童便送下。
不可灌凉水。入腹即死。外用布蘸沸汤。摩心腹脐下。（入门）
杂症宜辨
夏月出汗太过。则津液伤。筋骨失养。或痛或渴。不可便作暑治。即卒倒不省。亦有气郁生痰而厥者。有劳
役色欲并伤而厥者。有食滞太阴清浊痞隔而厥者。岂可尽作暑症。如果冲斥道途。劳役而中。身热脉虚。
方可以暑风暑厥治之。（三锡）
用药总法
暑症主以香薷饮。呕恶。加半夏、藿香。身热。加黄芩。口渴。加干葛。若舌干口燥。去半夏。用花粉、麦冬。燥
甚者。用石膏、知母。若腹痛胸满呕吐者。不用石膏、知母、花粉、黄芩、麦冬。宜枳壳、木香。若饱胀而兼泻。又不
可用枳壳。宜浓朴代之。凡夏月泻泄。干葛为要药。暑火泻者。加黄连。泻而胀者。加苍术、浓朴。泻而虚者。加白术、
芍药。暑食泻者。加神曲、煨木香。暑湿泻者。加苍术、木通、泽泻。并加干葛为佐。小便赤涩。须加木通、泽泻。烦
躁。加山栀、辰砂。烦呕。用竹茹。暑症初起。汗多面赤者。不可即用黄 固表。恐滞邪气也。暑清则汗自止。惟
日久面色枯白。脉虚自汗。方可以参 敛之。暑症初起。脉细或迟者。多有暑湿痰食壅滞而致。不可即用
参、术、姜、桂。但当疏理中气。脉自起耳。惟舌色唇色淡白灰黯者。方可用温散之剂。至于虚人着暑。病气元
气俱虚者。宜用生脉散、清暑益气汤、十味香薷饮。切不可过投克伐寒凉。设或太过。变现阴寒症者。宜用
理中汤温之。乃舍时从症法也。大抵心脾中暑。可饮鲜藿香汤。膀胱中 。可饮西瓜汁。以上诸法。皆治暑
之方。若在暑月而内挟劳役生冷。外挟风露寒湿者。详列后条。（汇补）
【附疰夏】
天地五行。更迭衰旺。人之脏气亦应之。四月属巳。五月属午。为火。火太旺则金衰。六月属未为土。土火交
旺则水衰。（丹溪）金水两衰。不能滋生。所以童男少女虚弱之人。每遇春夏之交。日长暴暖。患头眩眼黑。或
头胀痛。身倦脚软。身热食少。心烦躁扰。自汗盗汗。名曰疰夏。此皆时令之火为患。非纳凉受暑而病也。久
而不治。乃劳怯之根。宜滋化源。使脾土转生肺金。肺金转生肾水。乃为根本之治。（立斋）
【附煎厥说】
人身肾与膀胱。竭绝于巳午之际。（孙真人）故倦怠欲睡。痿弱无力。尔时即宜补益。（汇补）若或劳役犯房。精血
内耗。阴火沸腾。致目盲不明。耳闭不聪。举动懒倦。失其常度。五心烦热。如火燔灼。名曰煎厥。（内经）此亦虚
弱之症。所以古人夏月必独宿远酒色者。良有意也。
【附湿温】
湿温者。亦外感病中之一症也。因先伤湿而又伤暑。湿与热搏。病在心脾二经。其症恶寒壮热。头目痛。胸
腹满。口虽渴而不能饮冷。多汗妄言。不省人事。两胫逆冷。其脉寸濡而弱。尺小而急者是也。宜茯苓二术
汤加减。不可汗下。误汗。则不能言。耳聋呕恶。身变赤色。不知痛处者。名曰重 。死。误下。则头汗喘急。二便
不止者。亦死。（伤寒书）
暑症选方
香藿饮 治暑症。头胀身热。呕恶吐利。心烦口渴。
香薷（二斤） 白扁豆（炒半斤） 浓朴（姜炒半斤）
每服三钱。煎后。沉冷服。 加黄连。名黄连香薷饮。 加陈皮、人参、白术、黄 、木瓜、甘草。名十味香薷饮。
六和汤（澹寮） 治伏暑霍乱吐泻。或寒热。或痢疾。
香薷（二钱） 砂仁 半夏 杏仁 人参 甘草（各五钱） 赤苓 藿香 扁豆（姜炒） 浓朴（姜炒） 木瓜（一
钱） 生姜（五片） 枣（一枚）
水煎服。
消暑丸（和剂） 治伏暑。口渴引饮。脾胃不调。
半夏 生甘草 茯苓
为末。姜汁煮糊丸。桐子大。每服五十丸。热汤下。
清暑益气汤（东垣） 治脾胃不足。伤暑伏暑之症。
黄 （一钱） 苍术（一钱） 升麻（一钱） 人参（七分） 白术（五分） 陈皮（五分） 神曲（五分） 泽
泻（五分） 甘草（二分） 黄柏（三分盐炒） 葛根（三分） 青皮（二分） 当归（二分） 麦冬（四分） 五味
子（五粒）
水二盏。煎一半。温服。
生脉散（孙真人） 治元气不足。脾胃衰弱。脉虚无力之暑症。并治疰夏之疾。
人参 麦门冬 北五味
水一钟。煎服。
六味地黄丸（仲景） 肾水不足人。夏月宜常服之。以壮水之主而制阳光。（方见中风）
平胃散 治夏月暑食伤脾诸症。
茅山苍术 紫浓朴 陈皮 甘草
为末。砂仁汤下。 此方亦可红糖丸。小儿夏月每晨服一丸。代肥儿丸方。
胃苓散 健脾利水。为水泻要药。
即五苓散合平胃散。
大顺散（和剂） 治避暑着寒。生冷伤脾。呕吐霍乱。
甘草 干姜 杏仁 肉桂
为末。每服二钱。水煎。温服。如烦躁。井花水调服。
理中汤 治服暑药过度寒凉。伤脾变阴寒症者。（方见中寒）
升阳汤 治夏月感寒症。
羌活 藿香 苍术 苏叶 浓朴 陈皮 干葛 生姜
清燥汤（方见似中风） 补中益气汤（方见中风） 冷香饮子（方见霍乱）
人参白虎汤（仲景） 治中 。大热大渴大汗。烦躁喘促。
石膏（半熟三钱） 知母（一钱半） 甘草（五分） 人参（一钱） 粳米（一撮） 竹叶（十片）
水煎服。
益元散（河间） 治冒暑。口渴溺涩。自汗身热。
滑石（水飞六两） 甘草（一两）
为末。每服三钱。白汤调下。此方一名天水散。又名六一散。加薄荷。名鸡苏散。加青黛。名碧玉散。
加辰砂。名辰砂益元散。
辰砂五苓散（金匮） 治水泻烦躁。口渴溺赤。
猪苓（七钱半） 泽泻（一两二钱） 茯苓（七钱半） 白术（七钱半） 肉桂（五钱） 辰砂（五钱）
为末。灯心汤调方寸匕服。
【大意】
暑气这种邪气，在天上表现为热，在地上表现为火，在人身体内对应心脏。所以暑是相火当令的时节之气。夏季人们感受了它，病邪从口鼻进入，损伤心包络的经脉。（贾元良）
【内因】
有素来卫气虚弱的人，即使被暑邪轻微伤及，也必然兼有内伤的病症；有素来身体强壮的人，只是偶然受到暑气侵袭，也必然兼有外感的症状。所以从直接感受暑气的角度说，叫“中暑”；从被烈日暴晒的角度说，叫“中暍”。（《入门》）
【外候】
因为感受暑邪，会出现出汗、心烦、气喘、口渴，安静时却多言，身体像燃烧的炭一样热，汗出后热度才散。（《内经》）暑邪伤人，先侵犯心包络，就会出现头痛、身热、自汗、心烦、口渴、面色污垢等症状。其他症状都是后来传变产生的。暑邪入肝则出现眩晕、肢体麻木；入脾则昏睡不醒；入肺则气喘咳嗽、肢体痿废无力；入肾则消渴、烦躁。如果暑邪归于心，则会导致神志昏迷、突然跌倒。（《入门》）
【中暑】
中暑者，是因为深居密室，先受了暑气，又被房室中的阴寒之气遏制，属于静而得之。损伤心脾二经。外在症状表现为汗退、肠门干燥、口渴、背部微微恶寒、身体发热头痛、面色污垢、烦躁。脉象弦细、芤或迟。也有心中烦热、体表摸起来似乎无热，身体洒淅怕冷无汗，或者微有冷汗，小便结束后感到毛发竖起，手足逆冷，稍微活动身体就发热。这是时令之火郁结在内，心胞的阳气不能运行于外，导致营卫的开阖功能失调。所以腠理开泄时感到洒然寒冷，腠理闭塞时则感到热而闷。治疗应以清解暑热为主，可用香薷饮、六和汤，加干葛。（《汇补》）
【中暍】
中暍者，是因为在田野道路间劳役辛苦，动而得之。损伤足太阳膀胱经。重症者昏迷突然跌倒，轻症者头痛、怕热、发热、烦躁。触摸肌肤大热，嘴唇干燥、舌头红赤，前板齿干燥，极度口渴想喝水，大汗如雨，没有力气活动，没有力气说话。脉象洪大浮数但按之空虚。这是天暑从外部侵袭，疏泄肺气。治疗应以清热养津为主，用人参白虎汤，加麦冬、花粉。（《汇补》）
【伤暑】
伤暑者，体质素来虚弱，不能耐受外邪，所以稍微感受就会生病，比中暑稍轻。应当分三种方法治疗。如果是白天发热，夜间才凉，自汗倦怠，食少脉虚，这是暑伤元气，宜用清暑益气汤。如果是头胀眩晕，周身烦躁，皮肤如针刺感，或者兼有红肿，这是暑伤肉分，宜用六和汤。如果是咳嗽、烦渴、寒热往来、盗汗，脉数不减，这是暑伤肺经，宜用甘桔汤，加黄芩、山栀、麦门冬、丹皮、贝母。（《汇补》）
【冒暑】
冒暑者，禀赋充实，但不辞辛苦，暑热之气冒犯肌表，然后传入体内形成暑病。其症状为腹痛水泻，小便短赤，口渴想喝水，恶心呕吐，有时眩晕，心中烦躁发热。病位在胃与大肠。（《绳墨》）宜用胃苓散，加藿香。或者用六一散。又有因内伤饮食，外受暑气而形成的暑湿伤脾的病证，其症状为腹痛作泻，泻下黄色糜烂物，口渴，小便热。宜健脾清暑，用平胃散，加黄连、通草、神曲、大黄。（《汇补》）
【伏暑】
伏暑者，暑邪长久藏伏在三焦肠胃之间，热伤气而不伤形，经过旬月都不觉得异常，后来变出寒热不定、身体疲倦、神志昏沉、头重、潮热，甚至霍乱吐泻、腹胀满、疟疾痢疾、发斑发黄、腹痛下血等症状。主方用消暑丸。也有夏天晒衣服，急忙收进箱柜，热气未退，虽然过了那个季节，偶尔打开查看，体弱之人也能染上此病，不可不知道。（《汇补》）
【暑风】
暑风是由于在道路上奔波，中暑热至极，火盛金衰，木旺生风，脾土受邪，所以突然昏倒，手足抽搐，内扰心神，意识不清，郁闷无知。宜清时令之火，则金清而木有所制；开郁闷之痰，则神安而气自宁。千万不要误用治风药。（《良方》）连薷饮，加薄荷、荆芥。如果其人先有痰热在内，外又感暑而导致昏冒的，可以用吐法。因为吐法中有发散越出的意义。（《汇补》）
【暑厥】
暑厥，就是暑病兼见手足厥冷，与伤寒发厥的意义相同。（《入门》）大概兼有恶寒发热而后逐渐四肢厥冷的，是心脾中暑症；不恶寒，只恶热而后逐渐四肢厥冷的，是膀胱中暍症。如果是只恶寒不发热而后逐渐四肢厥冷的，又是夏季感寒的阴症，不与暑暍症同类。（《汇补》）
【绞肠痧】
绞肠痧者，暑气郁结在中焦，腹痛牵连心脏，上下攻绞，不能吐泻，或者手足都冷，乃肠道绞缩腹部，一会儿就能杀人。急用生水和熟水调服白矾三钱，过了一会儿探喉催吐，去除暑毒即安。或者刺委中穴，以及手指脚趾甲缝，令其出血。如果胸背四肢出现红点的，用菜油灯火遍灼。（《汇补》）
【暑病脉法】
脉虚身热，是得了伤暑。（《内经》）或者脉浮大而散，或者弦细芤迟。（《杂着》）夫暑暍的病证，与夏季的热病往往相似，但暑脉或洪或虚，重按无力；热病脉盛弦长，重按有力。即使有热病发于阴经，其脉沉小，也不像暑脉那样见于浮分。（《汇补》）
【暑病治法】
暑是六淫中无形的火，大体上用五行中有形的“水”来制约它。（《奇效良方》）中暑宜解暑和中，中暍宜泻火益元，伤暑宜补元气，冒暑宜清利二便。（《汇补》）
【治暑三禁】
如果用发汗法，则恶寒更甚；如果用温针，则发热更甚；如果用下法，则淋涩更甚。（张仲景）
【中暍救法】
在道路上突然跌倒，急扶到阴凉干处，捧起路上的热土，放在肚脐上，拨开做成一个小孔，让人尿在里面，然后用姜蒜嚼烂，用滚水和童便送下。不可灌凉水，入腹即死。外用布蘸沸水，摩擦心腹脐下。（《入门》）
【杂症宜辨】
夏天出汗太多，则津液受伤，筋骨失养，或者痛或者渴，不可立即当作暑症治疗。即使突然跌倒不省人事，也有因气郁生痰而厥逆的，有因劳役色欲并伤而厥逆的，有因食滞太阴导致清浊痞隔而厥逆的，怎么可以全都当作暑症？如果确实是在道路上奔波，劳役而中暑，身热脉虚，才可以按照暑风、暑厥治疗。（三锡）
【用药总法】
暑症主以香薷饮。呕恶，加半夏、藿香。身热，加黄芩。口渴，加干葛。如果舌干口燥，去半夏，用花粉、麦冬。燥甚者，用石膏、知母。如果腹痛胸满呕吐者，不用石膏、知母、花粉、黄芩、麦冬，宜用枳壳、木香。如果饱胀而兼腹泻，又不可用枳壳，宜用厚朴代替。凡夏天腹泻泄泻，干葛是重要药物。暑火泻者，加黄连。泻而胀者，加苍术、厚朴。泻而虚者，加白术、芍药。暑食泻者，加神曲、煨木香。暑湿泻者，加苍术、木通、泽泻，并加干葛作为佐使。小便赤涩，须加木通、泽泻。烦躁，加山栀、辰砂。烦呕，用竹茹。暑症初起，汗多面赤者，不可立即用黄芪固表，恐怕滞留邪气。暑清则汗自止，只有日久面色枯白，脉虚自汗，才可以用人参收敛。暑症初起，脉细或迟者，多有暑湿痰食壅滞而致，不可立即用参、术、姜、桂，但当疏理中气，脉自然恢复。只有舌色唇色淡白灰黯者，才可用温散之剂。至于虚人感受暑邪，病气和元气都虚者，宜用生脉散、清暑益气汤、十味香薷饮。切不可过投克伐寒凉的药物。假如太过，变现出阴寒症者，宜用理中汤温之，这是舍时从症的方法。大概心脾中暑，可饮鲜藿香汤；膀胱中暍，可饮西瓜汁。以上诸法，都是治暑的方子。如果在暑月而内挟劳役生冷，外挟风露寒湿者，详细列在后条。（《汇补》）
【附疰夏】
天地五行，更迭衰旺，人的脏气也随之相应。四月属巳，五月属午，为火。火太旺则金衰。六月属未为土。土火交旺则水衰。（朱丹溪）金水两衰，不能滋生，所以童男少女虚弱之人，每遇春夏之交，日长暴暖，患头眩眼黑，或者头胀痛，身体疲倦脚软，身热食少，心中烦躁扰攘，自汗盗汗，名叫疰夏。这都是时令之火为患，不是纳凉受暑而病的。久治不愈，成为劳怯的根本原因。宜滋化源，使脾土转生肺金，肺金转生肾水，才是根本的治疗。（薛立斋）
【附煎厥说】
人身肾与膀胱，在巳午之际竭绝。（孙思邈）所以倦怠想睡，痿弱无力。这个时候就宜补益。（《汇补》）如果劳役犯房事，精血内耗，阴火沸腾，导致目盲不明，耳闭不聪，举动懒倦，失去常态，五心烦热，如火烧灼，名叫煎厥。（《内经》）这也是虚弱的病症，所以古人夏天一定独宿远离酒色，是有深意的。
【附湿温】
湿温，也是外感病中的一种病症。因为先伤湿而又伤暑，湿与热搏结，病在心脾二经。其症状为恶寒壮热，头目痛，胸腹满，口虽渴但不能饮冷，多汗妄言，不省人事，两胫逆冷，其脉寸部濡而弱，尺部小而急的就是。宜茯苓二术汤加减，不可发汗攻下。误汗，则不能言语，耳聋呕恶，身体变赤色，不知疼痛部位，名叫重暍，死。误下，则头汗喘急，二便不止，也死。（《伤寒书》）
【暑症选方】
香薷饮 治暑症。头胀身热，呕恶吐利，心烦口渴。
香薷（二斤） 白扁豆（炒半斤） 厚朴（姜炒半斤）
每服三钱。煎好后，沉淀冷却服用。 加黄连，名黄连香薷饮。 加陈皮、人参、白术、黄芪、木瓜、甘草，名十味香薷饮。
六和汤（出自《澹寮方》） 治伏暑霍乱吐泻。或寒热，或痢疾。
香薷（二钱） 砂仁 半夏 杏仁 人参 甘草（各五钱） 赤茯苓 藿香 扁豆（姜炒） 厚朴（姜炒） 木瓜（一钱） 生姜（五片） 枣（一枚）
水煎服。
消暑丸（出自《和剂局方》） 治伏暑。口渴引饮，脾胃不调。
半夏 生甘草 茯苓
研为末，姜汁煮糊丸，梧桐子大。每服五十丸，热汤送下。
清暑益气汤（李东垣） 治脾胃不足，伤暑伏暑之症。
黄芪（一钱） 苍术（一钱） 升麻（一钱） 人参（七分） 白术（五分） 陈皮（五分） 神曲（五分） 泽泻（五分） 甘草（二分） 黄柏（三分盐炒） 葛根（三分） 青皮（二分） 当归（二分） 麦冬（四分） 五味子（五粒）
水二盏，煎至一半，温服。
生脉散（孙思邈） 治元气不足，脾胃衰弱，脉虚无力之暑症。并治疰夏之疾。
人参 麦门冬 北五味子
水一钟，煎服。
六味地黄丸（张仲景） 肾水不足人，夏月宜常服之。以壮水之主而制阳光。（方见中风）
平胃散 治夏月暑食伤脾诸症。
茅山苍术 紫厚朴 陈皮 甘草
研为末，砂仁汤送下。 此方也可制成红糖丸。小儿夏月每晨服一丸，代肥儿丸方。
大顺散（出自《和剂局方》） 治避暑着寒，生冷伤脾，呕吐霍乱。
甘草 干姜 杏仁 肉桂
研为末，每服二钱，水煎，温服。如烦躁，井花水调服。
升阳汤 治夏月感寒症。
羌活 藿香 苍术 苏叶 厚朴 陈皮 干葛 生姜
清燥汤（方见似中风） 补中益气汤（方见中风） 冷香饮子（方见霍乱）
人参白虎汤（张仲景） 治中暍。大热大渴大汗，烦躁喘促。
石膏（半熟三钱） 知母（一钱半） 甘草（五分） 人参（一钱） 粳米（一撮） 竹叶（十片）
水煎服。
益元散（刘河间） 治冒暑。口渴溺涩，自汗身热。
滑石（水飞六两） 甘草（一两）
研为末，每服三钱，白开水调下。此方一名天水散，又名六一散。加薄荷，名鸡苏散。加青黛，名碧玉散。加辰砂，名辰砂益元散。
辰砂五苓散（《金匮要略》） 治水泻烦躁，口渴溺赤。
猪苓（七钱半） 泽泻（一两二钱） 茯苓（七钱半） 白术（七钱半） 肉桂（五钱） 辰砂（五钱）
研为末，灯心汤调方寸匕服。
[General Principle]
The pathogenic factor of Summerheat (Shu) manifests as heat in the heavens, as fire on the earth, and corresponds to the Heart in the human body. Therefore, Summerheat is the qi of Ministerial Fire (Xianghuo) when it is in command. In summer, humans contract it, and the pathogen enters through the mouth and nose, damaging the Pericardium Collateral (Xinbaoluojing). (Jia Yuanliang)
[Etiology: Internal Factors]
Those with inherent deficiency of Defensive Qi (Wei Qi) may suffer from mild Summerheat injury but will inevitably have concurrent internal injury syndromes. Those who are inherently robust may be occasionally invaded by Summerheat qi but will inevitably present with external contraction symptoms. Thus, referring to direct exposure to Summerheat qi, it is called "Zhongshu" (Heatstroke); referring to being pressed by the scorching sun, it is called "Zhonghe" (Sunstroke). (*Rumen*)
[External Manifestations]
Due to contracting Summerheat, there is sweating, vexation, panting, thirst; although quiet, the patient speaks excessively; the body feels like burning charcoal, and the heat dissipates only after sweating. (*Neijing*) When Summerheat invades humans, it first affects the Pericardium, causing headache, fever, spontaneous sweating, mental restlessness, thirst, and a dirty complexion. Other symptoms appear later through transmission. If entering the Liver, it causes dizziness and numbness; if entering the Spleen, it causes lethargy and unconsciousness; if entering the Lung, it causes panting, coughing, and flaccidity; if entering the Kidney, it causes Xiao Ke (Wasting-Thirst) and irritability. If the Summerheat pathogen returns to the Heart, it leads to coma and sudden collapse. (*Rumen*)
[Zhongshu / Heatstroke]
Zhongshu occurs when one stays deep in a closed room, first absorbing Summerheat qi, which is then suppressed by the yin-cold of the dwelling environment. This is "obtained while at rest." It damages the Heart and Spleen meridians. External symptoms include cessation of sweating, dryness of the anus, thirst, slight aversion to cold on the back, fever, headache, dirty complexion, and irritability. The pulse is wiry, fine, knotted (Kou), or slow. There may also be internal heart vexation and floating heat that feels absent upon palpation, shivering without sweat, or slight cold sweat. After urination, there is a sensation of goosebumps, cold extremities, and immediate fever upon slight exertion. This is due to seasonal fire郁 (stagnating) internally, preventing Pericardium Yang from circulating externally, leading to disharmony in the opening and closing of Ying and Wei (Nutritive and Defensive) levels. Thus, when pores open, there is a chill; when pores close, there is heat and stuffiness. Treatment should focus on clearing and resolving Summerheat heat. Formulas include Xiangru Yin (Elsholtzia Decoction) or Liuhe Tang (Six Harmonies Decoction), added with Gegen (Pueraria Root). (*Huibu*)
[Zhonghe / Sunstroke]
Zhonghe results from laborious work in fields or on roads, "obtained while in motion." It damages the Foot-Taiyang Bladder Meridian. Severe cases involve coma and sudden collapse; mild cases involve headache, aversion to heat, fever, and irritability. Palpation reveals hot skin, dry lips, red tongue, dry anterior teeth, extreme thirst with desire to drink, profuse sweating like rain, lack of energy to move or speak. The pulse is surging, large, floating, rapid, yet empty upon pressure. This is heavenly heat invading externally, dispersing Lung Qi. Treatment should focus on clearing heat and nourishing fluids. Formula: Renshen Baizhu Tang (Ginseng and White Tiger Decoction), added with Maidong (Ophiopogon Radix) and Huafen (Trichosanthes Root). (*Huibu*)
[Shangshu / Summerheat Injury]
Shangshu occurs in those with inherently weak constitutions who cannot tolerate external pathogens, so illness arises from slight exposure. It is slightly milder than Zhongshu. It should be treated in three ways. If there is fever during the day and cooling at night, spontaneous sweating, fatigue, poor appetite, and a deficient pulse, this is Summerheat damaging Yuan Qi (Original Qi). Use Qingshu Yiqi Tang (Clear Summerheat and Tonify Qi Decoction). If there is head distension and dizziness, whole-body irritability, skin feeling like needle pricks, or swelling/redness, this is Summerheat damaging the flesh layer. Use Liuhe Tang (Six Harmonies Decoction). If there is cough, vexation, thirst, alternating chills and fever, night sweats, and an unrelenting rapid pulse, this is Summerheat damaging the Lung meridian. Use Ganjie Tang (Licorice and Platycodon Decoction), added with Huangqin (Scutellaria Root), Shanzhi (Gardenia Fruit), Maimendong (Ophiopogon Radix), Danpi (Moutan Cortex), and Beimu (Fritillaria Bulb). (*Huibu*)
[Mao Shu / Exposure to Summerheat]
Mao Shu occurs in individuals with solid constitutions who endure hardship. Summerheat heat assaults the muscle surface and then transmits inward to form Summerheat disease. Symptoms include abdominal pain with watery diarrhea, scanty dark urine, thirst with desire to drink, nausea and vomiting, occasional dizziness, and mental irritability with heat. The pathology involves the Stomach and Large Intestine. (*Shengmo*) Use Weiling San (Stomach-Lining Powder), added with Huoxiang (Patchouli Herb). Or use Liuyi San (Six-to-One Powder). Another type involves internal dietary injury combined with external Summerheat, forming Damp-Heat injuring the Spleen. Symptoms include abdominal pain with diarrhea of yellow, mushy stool, thirst, and hot urine. Treatment should strengthen the Spleen and clear Summerheat. Use Pingwei San (Calm the Stomach Powder), added with Lian (Coptis Rhizome), Tong (Lysimachia Herbs/Tongcao), Qu (Medicated Leaven), and Xie (Rhubarb Root). (*Huibu*)
[Fu Shu / Latent Summerheat]
Fu Shu refers to Summerheat hiding for a long time between the Triple Burner (Sanjiao) and intestines/stomach. Heat damages Qi but not形体 (form/structure), remaining unnoticed for weeks or months. Later, it manifests as irregular chills and fever, body fatigue, mental confusion, heavy head, tidal fever, or even cholera-like vomiting and diarrhea, abdominal distension and fullness, malaria, dysentery, macules, jaundice, abdominal pain with bloody stool, etc. The main formula is Xiaoshu Wan (Summerheat-Relieving Pill). Also, clothes dried in summer stored quickly in chests while still hot, though opened later in other seasons, can infect frail individuals. This must be known. (*Huibu*)
[Shu Feng / Summerwind]
Shu Feng results from rushing on roads, contracting extreme Summerheat. Fire is excessive and Metal is deficient, causing Wood to flourish and generate Wind. Spleen Earth is injured, leading to sudden coma, convulsions of hands and feet, internal disturbance of the Spirit House (Shen She), unclear consciousness, and闷 (depression) with loss of awareness. Clear seasonal fire so Metal clears and Wood is controlled; resolve stagnant phlegm so Spirit calms and Qi settles. Do not mistakenly treat with Wind-dispelling drugs. (*Liangfang*) Lianru Yin (Isatis and Elsholtzia Decoction), added with Bohe (Mint Leaf) and Jingjie (Schizonepeta Spike). If the person has internal Phlegm-Heat and contracts Summerheat externally leading to coma, emesis (vomiting method) can be used, as emesis contains the meaning of dispersing and ascending. (*Huibu*)
[Shu Jue / Summer Syncope]
Shu Jue is Summerheat disease accompanied by cold extremities, sharing the same principle as Cold Damage (Shanghan) syncope. (*Rumen*) Generally, if accompanied by aversion to cold and fever progressing to cold limbs, it is Heart-Spleen Zhongshu. If no aversion to cold, only aversion to heat progressing to cold limbs, it is Bladder Zhonghe. If only aversion to cold without fever progressing to cold limbs, it is Winter-Cold Yin syndrome contracted in summer, not similar to Summerheat. (*Huibu*)
[Jiao Chang Sha / Intestinal Colic Sha]
Jiao Chang Sha is Summerheat stagnating in the Middle Jiao, abdominal pain radiating to the heart, attacking and twisting up and down, unable to vomit or defecate, or cold hands and feet. The intestines twist and contract, killing within moments. Immediately use raw and cooked water to mix Bai Fan (Alum), 3 qian, induce vomiting after a short while to remove Summerheat toxin. Or prick Weizhong (BL40) acupoint and fingernails/toenails to bleed. If red spots appear on chest, back, and limbs, cauterize with oil-soaked lamp wicks. (*Huibu*)
[Pulse Diagnosis of Summerheat Diseases]
Deficient pulse with body heat indicates Shangshu. (*Neijing*) Or floating-large and scattered, or wiry-fine-knotted-slow. (*Zazhe*) The symptoms of Summerheat often resemble summer febrile diseases. However, Summerheat pulses are either surging or deficient, powerless upon deep pressure; febrile disease pulses are strong, wiry, and long, powerful upon deep pressure. Even if febrile disease originates in Yin meridians with deep-small pulses, it differs from Summerheat pulses appearing in the floating layer. (*Huibu*)
[Treatment Principles of Summerheat Diseases]
Summerheat is formless fire among the Six Excesses (Liuyin); generally, it is controlled by formless Water in the Five Elements. (*Qixiao Liangfang*) Zhongshu requires resolving Summerheat and harmonizing the middle; Zhonghe requires purging fire and benefiting Yuan Qi; Shangshu requires tonifying Original Qi; Mao Shu requires clearing and draining the two bowels. (*Huibu*)
[Three Prohibitions in Treating Summerheat]
If using diaphoresis (sweating), aversion to cold worsens. If using warm needle, fever worsens. If using purgation, strangury/wetness worsens. (Zhang Zhongjing)
[Rescue Method for Zhonghe]
If suddenly collapsing on the road, urgently support to a cool, dry place. Scoop hot soil from the road, place on the umbilicus, make a hole, and let someone urinate into it. Then chew ginger and garlic, swallow with boiling water and child's urine. Do not pour cold water; it causes death if ingested. Externally, dip cloth in boiling water and rub the heart, abdomen, and below the umbilicus. (*Rumen*)
[Differentiation of Miscellaneous Syndromes]
Excessive sweating in summer injures Jin Ye (Body Fluids), causing malnutrition of sinews and bones, leading to pain or thirst. Do not immediately treat as Summerheat. Even sudden collapse and unconsciousness may be due to Qi stagnation generating Phlegm, or injury from labor and sexual excess, or food stagnation in Taiyin causing turbid obstruction. How can all be treated as Summerheat? Only if indeed rushing on roads, laboring, contracting Summerheat with fever and deficient pulse, can it be treated as Shu Feng or Shu Jue. (Sanxi)
[General Medication Principles]
Summerheat primarily uses Xiangru Yin (Elsholtzia Decoction). For nausea/vomiting, add Banxia (Pinellia Tuber) and Huoxiang (Patchouli Herb). For body heat, add Huangqin (Scutellaria Root). For thirst, add Gegen (Pueraria Root). If tongue is dry and mouth parched, remove Banxia, use Huafen (Trichosanthes Root) and Maidong (Ophiopogon Radix). For severe dryness, use Shigao (Gypsum Fibrosum) and Zhimu (Anemarrhena Rhizome). For abdominal pain, chest fullness, and vomiting, do not use Shigao, Zhimu, Huafen, Huangqin, or Maidong; use Zhike (Aurantii Fructus) and Muxiang (Aucklandiae Radix). For fullness with diarrhea, do not use Zhike; use Houpo (Magnolia Bark) instead. For any summer diarrhea, Gegen is essential. For Summer-Fire diarrhea, add Huanglian (Coptis Rhizome). For diarrhea with bloating, add Cangzhu (Atractylodis Rhizoma) and Houpo. For diarrhea with deficiency, add Baizhu (Atractylodis Macrocephalae Rhizoma) and Shaoyao (Paeoniae Radix). For Summer-Food diarrhea, add Shenqu (Medicated Leaven) and Wei Muxiang (Baked Aucklandiae Radix). For Summer-Damp diarrhea, add Cangzhu, Mutong (Akebia Caulis), and Zexie (Alisma Rhizoma), with Gegen as assistant. For red/scanty urine, add Mutong and Zexie. For irritability, add Shanzhi (Gardenia Fruit) and Chen Sha (Cinnabar). For vexation and vomiting, use Zhuru (Bambusa Textilis Sap). In early Summerheat with profuse sweating and red face, do not immediately use Huangqi (Astragalus Root) to consolidate the exterior, lest it trap the pathogen. Once Summerheat clears, sweating stops naturally. Only if after long duration the face is withered-white, pulse is deficient with spontaneous sweating, can Renshen (Ginseng Radix) be used to astringe. In early Summerheat, if pulse is fine or slow, it is often due to stagnation of Summerheat-Damp-Phlegm-Food; do not immediately use Renshen, Baizhu, Jiang (Ginger), or Guizhi (Cinnamon Twig). Instead, regulate Middle Qi, and the pulse will recover. Only if tongue and lips are pale-white-gray-dull can warming-dispersing agents be used. For frail people contracting Summerheat with both pathogenic and Original Qi deficiency, use Shengmai San (Generate Pulse Powder), Qingshu Yiqi Tang, or Shiwei Xiangru Yin (Ten-Ingredient Elsholtzia Decoction). Do not overuse harsh, cold-draining drugs. If too much is used, manifesting Yin-Cold symptoms, use Lizhong Tang (Regulate the Middle Decoction) to warm; this is the method of abandoning season for symptom. Generally, Heart-Spleen Zhongshu can drink fresh Huoxiang soup; Bladder Zhonghe can drink watermelon juice. These are all Summerheat formulas. If in summer there is internal labor/cold-food and external wind/dew-cold-damp, see subsequent items. (*Huibu*)
[Appendix: Zhu Xia / Summer Malaise]
Heaven and Earth's Five Elements alternate decline and prosperity; human organ qi responds accordingly. April is Si, May is Wu, belonging to Fire. Excessive Fire weakens Metal. June is Wei, belonging to Earth. Earth and Fire flourishing together weaken Water. (Zhu Danxi) With Metal and Water both weak, they fail to nourish. Thus, weak boys and girls, encountering the transition of spring and summer with long days and sudden warmth, suffer dizziness, black eyes, head distension/pain, body fatigue, weak legs, fever, poor appetite, mental irritability, spontaneous and night sweats. This is named Zhu Xia. This is caused by seasonal Fire, not by cooling off and contracting Summerheat. If untreated long-term, it becomes the root of Lao Que (Consumptive Disease). Nourish the source of transformation, allowing Spleen Earth to generate Lung Metal, and Lung Metal to generate Kidney Water. This is the fundamental treatment. (Xue Lijia)
[Appendix: Jian Jue / Frying Syncope]
Kidney and Bladder exhaust themselves during Si and Wu hours. (Sun Simiao) Hence fatigue, desire to sleep, flaccidity, and weakness. At this time, tonification is appropriate. (*Huibu*) If laboring or engaging in sexual activity, consuming essence and blood internally, causing Yin Fire to boil, leading to blindness, deafness, laziness, loss of normal function, five-palm heat, and burning sensation, it is named Jian Jue. (*Neijing*) This is also a deficiency syndrome. Hence ancients slept alone and avoided alcohol and sex in summer, which was intentional.
[Appendix: Wen Wen / Damp-Warmth]
Wen Wen is one of the external contraction diseases. Caused by first injuring Dampness and then Summerheat, where Damp and Heat struggle. Pathology involves Heart and Spleen meridians. Symptoms include aversion to cold and high fever, head/eye pain, chest/abdominal fullness, thirst but inability to drink cold liquids, profuse sweating, delirium, unconsciousness, cold lower legs. Pulse is superficial-rheum-weak at Cun (inch) position, small-rapid at Chi (cubit) position. Use Er Zhu Tang (Two Atractylodes Decoction) modified. Do not use sweating or purging. Mistaken sweating leads to inability to speak, deafness, vomiting, red body, unawareness of pain, named Chong He (Heavy Heatstroke), fatal. Mistaken purging leads to head sweat, panting urgency, incontinence, also fatal. (*Shanghan Shu*)
[Selected Formulas for Summerheat Diseases]
Xiangru Yin (Elsholtzia Decoction) Treats Summerheat: head distension, body heat, nausea/vomiting/diarrhea, heart vexation, thirst.
Xiangru (Elsholtzia Herba) - 2 jin; Baibian Dou (Faba Seed, stir-fried) - 0.5 jin; Houpo (Magnolia Bark, ginger-fried) - 0.5 jin.
Take 3 qian per dose. Decoct, settle, and take cold. Add Huanglian (Coptis Rhizome), name is Huanglian Xiangru Yin. Add Chenpi (Citrus Peel), Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Huangqi (Astragalus Root), Mugua (Chaenomelis Fructus), Gancao (Licorice Root), name is Shiwei Xiangru Yin (Ten-Ingredient Elsholtzia Decoction).
Liuhe Tang (Six Harmonies Decoction) (From *Danliao Fang*) Treats latent Summerheat with cholera-like vomiting/diarrhea. Or chills/fever, or dysentery.
Xiangru (Elsholtzia Herba) - 2 qian; Sharen (Amomi Fructus); Banxia (Pinellia Tuber); Xingren (Prunus Armeniaca Seed); Renshen (Ginseng Radix); Gancao (Licorice Root) - each 5 qian; Chifuling (Red Poria); Huoxiang (Patchouli Herb); Bian Dou (Faba Seed, ginger-fried); Houpo (Magnolia Bark, ginger-fried); Mugua (Chaenomelis Fructus) - 1 qian; Shengjiang (Fresh Ginger) - 5 slices; Zao (Jujube) - 1 piece.
Decoct in water and take.
Xiaoshu Wan (Summerheat-Relieving Pill) (From *Heji Ju Fang*) Treats latent Summerheat: thirst with desire to drink, spleen-stomach dysfunction.
Banxia (Pinellia Tuber); Sheng Gancao (Raw Licorice Root); Fuling (Poria).
Grind to powder, make pills with ginger juice paste, size of paulownia seeds. Take 50 pills per dose with hot water.
Qingshu Yiqi Tang (Clear Summerheat and Tonify Qi Decoction) (Li Dongyuan) Treats Spleen-Stomach insufficiency, Summerheat and latent Summerheat syndromes.
Huangqi (Astragalus Root) - 1 qian; Cangzhu (Atractylodis Rhizoma) - 1 qian; Shengma (Cimicifugae Rhizoma) - 1 qian; Renshen (Ginseng Radix) - 7 fen; Baizhu (Atractylodis Macrocephalae Rhizoma) - 5 fen; Chenpi (Citrus Peel) - 5 fen; Shenqu (Medicated Leaven) - 5 fen; Zexie (Alisma Rhizoma) - 5 fen; Gancao (Licorice Root) - 2 fen; Huangbai (Phellodendri Cortex, salt-fried) - 3 fen; Gegen (Pueraria Root) - 3 fen; Qingpi (Aurantii Fructus Immaturus) - 2 fen; Danggui (Angelicae Sinensis Radix) - 2 fen; Maidong (Ophiopogon Radix) - 4 fen; Wuweizi (Schisandrae Fructus) - 5 grains.
Decoct in 2 zhan of water until half remains, take warm.
Shengmai San (Generate Pulse Powder) (Sun Simiao) Treats Summerheat with insufficient Original Qi, weak Spleen-Stomach, deficient/powerless pulse. Also treats Zhu Xia.
Renshen (Ginseng Radix); Maimendong (Ophiopogon Radix); Bei Wuwei (Schisandrae Fructus).
Decoct in 1 zhong of water and take.
Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) (Zhang Zhongjing) For those with Kidney Water deficiency, suitable for regular use in summer to strengthen the Master of Water to control Solar Fire. (Formula seen in Stroke)
Pingwei San (Calm the Stomach Powder) Treats various Summerheat-food injuries to Spleen in summer.
Maoshan Cangzhu (Atractylodis Rhizoma from Maoshan); Zi Houpo (Magnolia Bark); Chenpi (Citrus Peel); Gancao (Licorice Root).
Grind to powder, take with Amomum decoction. Can also be made into red sugar pills. Children take one pill every morning in summer, replacing Fei'er Wan.
Weiling San (Stomach-Lining Powder) Strengthens Spleen and promotes urination. Essential medicine for watery diarrhea.
Combination of Wuling San (Five-Ingredient Powder for Promoting Urination) and Pingwei San.
Dashun San (Great Harmony Powder) (From *Heji Ju Fang*) Treats catching cold while avoiding heat, cold/raw food injuring Spleen, vomiting, cholera.
Gancao (Licorice Root); Ganjiang (Dried Ginger); Xingren (Prunus Armeniaca Seed); Rougui (Cinnamon Bark).
Grind to powder, take 2 qian per dose, decoct in water, take warm. If irritable, take well-water mixed.
Lizhong Tang (Regulate the Middle Decoction) Treats Yin-Cold syndrome resulting from Spleen injury due to excessive cold-draining Summerheat medicines. (Formula seen in Cold Damage)
Shengyang Tang (Raise Yang Decoction) Treats Cold contraction in summer.
Qianghuo (Notopterygii Rhizoma et Radix); Huoxiang (Patchouli Herb); Cangzhu (Atractylodis Rhizoma); Suye (Perilla Leaf); Houpo (Magnolia Bark); Chenpi (Citrus Peel); Gan Ge (Pueraria Root); Shengjiang (Fresh Ginger).
Qingzao Tang (Clear Dryness Decoction) (See Similar to Stroke); Buzhong Yiqi Tang (Tonify Middle and Benefit Qi Decoction) (See Stroke); Lengxiang Yinzi (Cold Fragrance Infusion) (See Cholera).
Renshen Baizhu Tang (Ginseng and White Tiger Decoction) (Zhang Zhongjing) Treats Zhonghe: great heat, great thirst, profuse sweating, vexation, panting/urgency.
Shigao (Gypsum Fibrosem, semi-cooked) - 3 qian; Zhimu (Anemarrhena Rhizome) - 1.5 qian; Gancao (Licorice Root) - 5 fen; Renshen (Ginseng Radix) - 1 qian; Jingsmi (Glutinous Rice) - a pinch; Zhuye (Bamboo Leaf) - 10 leaves.
Decoct in water and take.
Yiyuan San (Benefit Origin Powder) (Liu Hejian) Treats Mao Shu: thirst, scanty/hesitant urination, spontaneous sweating, body heat.
Huashi (Talcum, water-flown) - 6 liang; Gancao (Licorice Root) - 1 liang.
Grind to powder, take 3 qian per dose with white water. Also named Tianshui San or Liuyi San. Add Bohe (Mint Leaf), name is Jisu San. Add Qingdai (Indigo Naturalis), name is Biyu San. Add Chen Sha (Cinnabar), name is Chen Sha Yiyuan San.
Chensha Wuling San (Cinnabar Five-Ingredient Powder for Promoting Urination) (Jingui Yaolue) Treats watery diarrhea with irritability, thirst, red urine.
Zhuling (Polyporus) - 7.5 qian; Zexie (Alisma Rhizoma) - 1.2 liang; Fuling (Poria) - 7.5 qian; Baizhu (Atractylodis Macrocephalae Rhizoma) - 7.5 qian; Rougui (Cinnamon Bark) - 5 qian; Chen Sha (Cinnabar) - 5 qian.
Grind to powder, take one square-inch spoonful mixed with Dengxin (Junci Medulla) decoction.