反弦细而迟者。虽名中 。而实兼湿邪也。小便已。洒洒毛耸者。太阳主表。内合膀胱。便已而气馁也。
手足逆冷者。阳内聚而不外达。故小有劳。即气出而身热也。口开前板齿燥者。热盛于内。而气淫于外
也。盖暑虽阳邪。而气恒与湿相合。阳求阴之义也。暑因湿入。而暑反居湿之中。阴包阳之象也。治
之者一如分解风湿之法。辛以散湿。寒以凉暑可矣。若发汗则徒伤其表。温针则更益其热。下之则热且内陷。变证
随出。皆非正治暑湿之法也。
太阳中热者。 是也。汗出恶寒。身热而渴。白虎加人参汤主之。
中热亦即中暑。 即暑之气也。恶寒者。热气入则皮肤缓。腠理开。开则洒然寒。与伤寒恶寒者
不同。发热汗出而渴。表里热炽。胃阴待涸。求救于水。故与白虎加人参以清热生阴。为中暑而无湿
者之法也。
白虎加人参汤方
知母(六两) 石膏(一斤碎绵裹) 甘草(二两炙) 粳米(六合) 人参(三两)
上五味。以水一斗。煮米熟汤成。去滓。温服一升。日三服。
太阳中 。身热疼重而脉微弱。此以夏月伤冷水。水行皮中所致也。一物瓜蒂汤主之。
暑之中人也。阴虚而多火者。暑即寓于火之中。为汗出而烦渴。阳虚而多湿者。暑即伏于湿之内。
为身热而疼重。故暑病恒以湿为病。而治湿即所以治暑。瓜蒂苦寒。能吐能下。去身面四肢水气。水
去而暑无所根据。将不治而自解矣。此治中暑兼湿者之法也。
瓜蒂汤方
瓜蒂(二十个)
上锉。以水一升。煮取五合。去滓顿服。
脉象反见弦细而迟的,虽然名为中暍(中暑),但实际上兼夹了湿邪。小便排完后,感到怕冷、毫毛竖立的,是因为太阳经主司体表,内合膀胱,小便排出后,正气暂时虚弱所致。
手足逆冷的,是阳气内聚而不能外达四肢,所以稍微劳作,就会气泄而身体发热。张口时前侧门牙干燥的,是热邪盛于体内,而热气淫溢于体外的表现。大概暑邪虽然是阳邪,但气机常常与湿邪相合,这是阳寻求阴的道理。暑邪因湿邪而入,反而居于湿邪之中,这是阴包裹阳的现象。治疗的方法完全像分解风湿病的方法一样,用辛味药以发散湿邪,用寒凉药以清解暑热就可以了。如果发汗,则只会徒然损伤表气;如果用温针,则会更加助长热势;如果攻下,则热邪会进一步内陷,变证随之而出,这些都不是治疗暑湿的正治之法。
太阳经受邪的中热病,就是中暍。表现为汗出、恶寒、身热且口渴,用白虎加人参汤主治。
中热也就是中暑,“暍”字即指暑热之气。出现恶寒症状,是因为热气侵入导致皮肤松弛,腠理开泄,腠理开泄则使人洒然感到寒冷,这与伤寒病的恶寒不同。发热、汗出且口渴,说明表里热势炽盛,胃中阴液即将枯竭,向水求救,所以给予白虎加人参汤以清热生津,这是治疗中暑而无湿邪的方法。
白虎加人参汤方
知母(六两) 石膏(一斤,打碎,用绵布包裹) 甘草(二两,炙烤) 粳米(六合) 人参(三两)
以上五味药,用水一斗,煮至米熟汤成,去渣,每次温服一升,每日服用三次。
太阳经受邪的中暍病,表现为身热、身体疼痛沉重而脉象微弱,这是因为夏季贪凉饮冷或接触冷水,水气行于皮肤之间所导致的,用一物瓜蒂汤主治。
暑邪侵犯人体,阴虚火旺的人,暑邪就寓居在火邪之中,表现为汗出、心烦口渴;阳虚多湿的人,暑邪就潜伏在湿邪之内,表现为身热、身体疼痛沉重。所以暑病常常兼夹湿邪为患,治疗湿邪也就等于治疗暑邪。瓜蒂味苦性寒,能催吐也能泻下,能去除身体、面部及四肢的水气。水气去除后,暑邪就失去了依附的基础,不用特别治疗也会自行解除。这是治疗中暑兼夹湿邪的方法。
If the pulse is string-like, thin, and slow, although it is named Zhong Ye (heatstroke), it actually involves dampness. After urination, feeling chilly with gooseflesh on the skin occurs because the Taiyang channel governs the exterior and internally connects with the Bladder; after urination, the Qi temporarily becomes deficient.
Cold hands and feet indicate that Yang Qi gathers internally and fails to reach the extremities; therefore, upon slight exertion, Qi leaks out and the body becomes hot. Dryness of the anterior teeth when the mouth is open indicates that heat is excessive internally and steaming externally. Generally, although Summerheat is a Yang pathogen, its Qi often combines with Dampness, reflecting the principle of Yang seeking Yin. Summerheat enters via Dampness and thus resides within Dampness, reflecting the image of Yin enveloping Yang. Treatment should follow the same method as resolving Wind-Damp: use acrid herbs to disperse Dampness and cold herbs to cool Summerheat. If sweating methods are used, they will only injure the exterior; if warm needle therapy is applied, it will further increase heat; if purgatives are used, heat will sink inward, leading to various complications. None of these are correct treatments for Summerheat-Dampness.
Taiyang Zhong Re (Summerheat-Heat in the Taiyang channel) refers to Zhong Ye. Symptoms include sweating, aversion to cold, fever, and thirst; Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng) is the primary formula.
Zhong Re is also known as Zhong Shu (heatstroke); "Ye" refers to the Qi of Summerheat. The aversion to cold occurs because heat entering causes the skin to relax and pores to open; when open, one feels chilly. This differs from the aversion to cold seen in Cold Damage diseases. Fever, sweating, and thirst indicate blazing heat in both the interior and exterior, with Stomach Yin nearly exhausted, seeking relief from water. Therefore, Baihu Jianshen Tang is given to clear heat and generate Yin; this is the method for treating heatstroke without Dampness.
Baihu Jia Renshen Tang Formula
Zhi Mu (Anemarrhenae Rhizoma, 6 liang)
Shi Gao (Gypsum Fibrosum, 1 jin, crushed, wrapped in cotton cloth)
Gan Cao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, 2 liang, honey-fried)
Jing Mi (Oryzae Semen, 6 he)
Renshen (Panacis Ginseng Radix, 3 liang)
Take the above five ingredients, add ten dou of water, and boil until the rice is cooked and the decoction is ready. Strain the dregs. Take one sheng warm, three times a day.
Taiyang Zhong Ye presents with fever, heavy body pain, and a weak or faint pulse. This is caused by injuring oneself with cold water during summer, causing water Qi to circulate within the skin. Yiwu Goudi Tang (Single-Ingredient Melon Peduncle Decoction) is the primary formula.
When Summerheat invades the human body, those with Yin deficiency and abundant Fire have Summerheat residing within the Fire, manifesting as sweating, restlessness, and thirst. Those with Yang deficiency and abundant Dampness have Summerheat lurking within the Dampness, manifesting as fever and heavy body pain. Thus, Summerheat diseases often involve Dampness, and treating Dampness is equivalent to treating Summerheat. Gou Di (Cucumeris Fructus) is bitter and cold; it can induce vomiting or purging, removing water retention from the body, face, and limbs. Once the water is removed, Summerheat loses its basis and resolves spontaneously without specific treatment. This is the method for treating heatstroke complicated by Dampness.
Goudi Tang Formula
Gou Di (Cucumeris Fructus, 20 pieces)
Chop the Gou Di, add one sheng of water, boil to obtain five he of liquid, strain the dregs, and take in one dose.