脉∶暑伤于气，所以脉虚，弦细芤迟，体状无余。夏月有四证，伤寒伤风，脉证互见，中暑热病，疑似难明。
脉紧恶寒谓之伤寒，脉缓恶风谓之伤风，脉盛壮热谓之热病，脉
虚身热谓之伤暑。
中暑中阳，皆热症也，动而得之谓中热，静而得之谓中暑，乃夏火之气也。吐泻或呕哕躁闷，重则热极而
昏不省人事，俱用香薷散加减；元气虚脱者，用生脉散加减。
香薷饮 治伏暑引饮、口燥咽干，或吐或泻并治。若卒中昏冒倒仆、角弓反张、不省人事、手足或发
搐溺，此为暑风，不可作风治之，当以本方加羌活治之。
香薷 浓朴（姜汁炒） 白扁豆（炒） 加黄连（姜汁炒尤妙）
上锉剂，水煎熟以凉水沉冷服。如有搐搦加羌活；泻利加白术、茯苓；脉虚弱加人参、五味子、麦门冬；
虚汗不止加黄 、白术；心烦加栀子、黄连、姜汁炒，调辰砂末服，胸胀加枳壳、桔梗；夹痰加南星、半夏；虚
加人参、黄 ；小便不利加赤茯苓、滑石；呕吐加藿香、陈皮、姜汁少许；渴加葛根、天花粉。
十味香薷饮 治伏暑身倦体困，神昏头重，吐利。
黄 （蜜水炒） 人参（去芦） 白术（去芦） 茯苓（去皮） 陈皮 木瓜（各五分） 香薷（一钱）
浓朴（姜汁炒） 扁豆（炒。各五分） 甘草（炙，五分）
上锉剂，水煎服。暑风，减黄 ，加羌活一钱五分。
生脉散 滋生精气，培养真元，清心润肺。
人参（去芦，三分） 麦门冬（去心，三钱） 五味子（十五粒） 加白术（去芦，二钱）
上锉剂，水煎，不拘时服，渣再煎，则可充百茶汤。
中暑者，热伤膀胱经也。其症身热头痛、洒然毛耸、微寒口开、前板齿燥、舌燥生苔、大烦渴者，用人参
白虎汤加香薷、扁豆。有身重疼痛者，用人参败毒散加香薷、黄连主之。
人参白虎汤 治夏月中 、即中热，舌燥生苔刺。
人参（五分） 石膏 知母（各一钱半） 甘草（三分） 麦门冬（去心） 白术（各七分） 栀子 茯苓
芍药（各一钱） 陈皮（七分） 香薷（一钱） 扁豆（八个）
上锉剂，莲肉十个、乌梅一个，水煎服。热极小便遗尿不止加黄柏炒；烦躁加辰砂末、酸枣仁；若腹痛
呕哕、吐泻饱闷，切不可用石膏。
中暑身热而烦、四肢沉困者，此热伤元气也。
清暑益气汤 治长夏湿热蒸人，人感之，四肢困倦、精神减少、懒于动作、胸满气促、肢节疼痛或气
高而喘、身热而烦、心下膨闷、小便黄而数、大便溏而频、或利或渴、不思饮食、自汗体虚。
黄 （蜜炒） 苍术（米泔制） 升麻（各一钱） 人参 白术（去芦） 陈皮 神曲（炒） 泽泻 黄柏
（酒炒） 当归 青皮（去穣） 麦门冬（去心） 干葛（各三分） 五味子（九粒） 甘草（三分）
上锉剂，水煎温服。
中暑热渴、小便赤涩者，宜清利三焦也。
益元散 治中暑身热、小便不利。此药性凉，除胃脘积热，又淡能渗湿，故利小便散湿热也。
白滑石（六钱） 甘草（微炒，一钱）
上为末，每服二三钱。加蜜少许，煎汤，冷水任下。如欲发汗，用葱白、豆豉汤调下。
中暑热渴、大便泄泻者，宜分利阴阳也。
五苓散 治中暑烦渴、身热头痛、霍乱泄泻、小便赤少、心神恍惚。
猪苓 泽泻（各一钱） 白术（去芦） 茯苓（去皮，各钱五分） 肉桂（五分）
上锉一剂，水煎服。若本方去桂，名四苓散。
夏月感寒者，乃取凉之过也。因暑热之时，或纳凉于深堂大厦凉亭冷馆、大扇风车，风寒以伤其外，或饮
食生冷瓜果冰水，寒冷复伤其内。其痛或头疼身痛，发热恶寒，或恶心呕吐、泄泻腹痛，此内伤生冷、外感风
寒所致也，宜藿香正气散治之。此非治暑也，因暑而致之病也。藿香正气散。（方见霍乱。）根据本方，外感重加
苍术、羌活，去白术；内伤重加砂仁、神曲。
注夏者，属阴血虚、元气不足也。夏初春末头疼脚软、食少体弱者是。其症头眩眼花、腿酸脚软、五心烦热
、口苦舌干、精神困倦、无力好睡、饮食减少、胸膈不利、形如虚怯、脉数无力，是名注夏，宜参归益元汤多服
，兼服补阴丸调理。
参归益元汤 治注夏病。
人参（去芦，五分） 当归 白芍 熟地黄 白茯苓（去皮） 麦门冬（去心。各一钱） 五味子（十粒）
陈皮 黄柏（酒炒） 知母（酒炒。各七分） 甘草（一分）
上锉一剂，枣一枚、乌梅一个、炒米一撮，水煎服。饱闷加砂仁、白豆蔻；恶心加乌梅、莲肉、炒米；哕
加竹茹；烦躁加辰砂、酸枣仁、竹茹；泻加炒白术、山药、砂仁、乌梅，去熟地、知母、黄柏；小水短赤加木
通、山栀，胃脘不开、不思饮食加浓朴、白豆蔻、益智、砂仁、莲肉，去熟地、黄柏、知母；腰痛加杜仲、故纸
、茴香，腿酸无力加牛膝、杜仲；皮焦加地骨皮，头目眩晕加川芎；虚汗加黄 、白术、酸枣仁；梦遗加牡蛎、
辰砂、山药、椿根皮；虚惊烦热加辰砂、酸枣仁、竹茹；口苦舌干加山栀、乌梅、干葛。
发热恶寒、身重疼痛、小便涩、洒然毛耸、手足厥冷、小有劳身即热、口开前板齿燥、脉弦细虚迟，表里
中也。用补中益气汤加香薷、扁豆，有热加黄芩。
一妇人，因暑月厨房热极，遂出当风处脱衣乘凉，被风吹即头痛发热、恶寒身痛。草医不识，误认为寒，
用附子理中汤，一服下咽，立时不语，口中无气，唇口青紫，心口微温，举家哭泣求救于予。诊六脉洪大而数，
此热症而误用热药。以烧酒喷胸前，将镜扑之，更将新汲水入蜜，将鸡翎沃入其口数次。少顷，患人即伸舌探
水，以益元汤灌下即活。
李北川，仲夏患腹痛吐泻，两手扪之则热，按之则冷，其脉轻诊则浮大，重诊则微细。余曰∶此阴寒之
症也。急服附子理中汤，不应，仍服至四剂而愈。
Pulse: Summerheat damages Qi, therefore the pulse is deficient, presenting as wiry (Xian), fine (Xi), hollow (Kou), or slow (Chi), with distinct morphological characteristics. There are four types of syndromes in summer: Cold Damage (Shanghan) and Wind Strike (Shangfeng) have intermingled pulses and symptoms, while Summerheat Stroke (Zhongshu) and Heat Disease (Rebing) are easily confused and difficult to distinguish clearly.
A tight pulse with aversion to cold is called Cold Damage; a relaxed pulse with aversion to wind is called Wind Strike; a surging pulse with high fever is called Heat Disease; a deficient pulse with body heat is called Summerheat Injury (Shangshu).
Summerheat Stroke (Zhongshu) and Yang Summerheat (Zhongyang) both belong to heat syndromes. Those contracted during activity are called Heat Stroke (Zhongre); those contracted during rest are called Summerheat Stroke (Zhongshu), caused by the fire energy of summer. Symptoms include vomiting, diarrhea, dry heaving, irritability, and chest oppression. In severe cases, extreme heat leads to coma and loss of consciousness. All these should be treated with Xiangru San (Elsholtzia Decoction) modified; if there is collapse of Yuan Qi (Original Qi), use Shengmai San (Generate the Pulse Powder) modified.
Xiangru Yin (Elshiotia Drink): Treats latent summerheat leading to excessive drinking, dry mouth and throat, or simultaneous vomiting and diarrhea. If sudden fainting, opisthotonos (arched back), coma, or convulsions with enuresis occur, this is Summerwind (Shufeng). It must not be treated as ordinary wind; instead, treat with this formula plus Qianghuo (Notopterygii Rhizoma et Radix).
Ingredients: Xiangru (Moslae Herba), Nongpu (Magnoliae Officinalis Cortex) stir-fried with ginger juice, Bai Biandou (Phaseoli Semen) stir-fried. Add Huanglian (Coptidis Rhizoma) stir-fried with ginger juice for best effect.
Crush the ingredients into pieces, decoct with water, cool by immersing in cold water, then take orally. If convulsions occur, add Qianghuo; if diarrhea, add Baizhu (Atractylodis Macrocephalae Rhizoma) and Fuling (Poria); if pulse is weak, add Renshen (Ginseng Radix), Wuweizi (Schisandrae Fructus), and Maimendong (Ophiopogonis Radix); if spontaneous sweating persists, add Huangqi (Astragali Radix) and Baizhu; if vexation, add Zhizi (Gardeniae Fructus) and Huanglian (stir-fried with ginger juice), mixed with Chen Sha (Cinnabar) powder; if chest distension, add Zhiqiao (Aurantii Fructus) and Jiegeng (Platycodonis Radix); if phlegm retention, add Nanxing (Arisaematis Rhizoma Praeparatum) and Banxia (Pinelliae Rhizoma); if deficiency, add Renshen and Huangqi; if difficult urination, add Chi Fuling (Poria cum Rubro) and Huashi (Talcum); if vomiting, add Huoxiang (Agastaches Herba), Chenpi (Citri Reticulatae Pericarpium), and a little ginger juice; if thirst, add Gegen (Puerariae Lobatae Radix) and Tianhuafen (Trichosanthis Radix).
Shiwei Xiangru Yin (Ten-Ingredient Elsholtzia Drink): Treats latent summerheat causing fatigue and heaviness, mental cloudiness and heavy head, vomiting and diarrhea.
Ingredients: Huangqi (Astragali Radix) stir-fried with honey water, Renshen (Ginseng Radix) de-gorged, Baizhu (Atractylodis Macrocephalae Rhizoma) de-gorged, Fuling (Poria) peeled, Chenpi (Citri Reticulatae Pericarpium), Mugua (Chaenomelis Fructus) (each 5 fen), Xiangru (Moslae Herba) (1 qian), Nongpu (Magnoliae Officinalis Cortex) stir-fried with ginger juice, Biandou (Phaseoli Semen) stir-fried (each 5 fen), Gancao (Glycyrrhizae Radix et Rhizoma) roasted (5 fen).
Crush into pieces, decoct with water and take orally. For Summerwind, reduce Huangqi and add Qianghuo (1.5 qian).
Shengmai San (Generate the Pulse Powder): Generates essence and Qi, nourishes true Yuan Qi, clears the heart and moistens the lungs.
Ingredients: Renshen (Ginseng Radix) de-gorged (3 fen), Maimendong (Ophiopogonis Radix) de-heart (3 qian), Wuweizi (Schisandrae Fructus) (15 grains). Add Baizhu (Atractylodis Macrocephalae Rhizoma) de-gorged (2 qian).
Crush into pieces, decoct with water, take at any time. The dregs can be decocted again to serve as Baitang Tea.
Summerheat stroke involves heat damaging the Bladder Meridian. Symptoms include body heat, headache, aversion to cold with piloerection, slightly cold open mouth, dry anterior teeth, dry tongue with coating, extreme thirst and vexation. Use Ren Shen Bai Hu Tang (Ginseng White Tiger Decoction) plus Xiangru and Biandou. If there is body heaviness and pain, use Ren Shen Bai Du San (Ginseng Detoxification Powder) plus Xiangru and Huanglian as the main treatment.
Ren Shen Bai Hu Tang: Treats summer heatstroke, i.e., Zhongre, with dry tongue and prickly coating.
Ingredients: Renshen (Ginseng Radix) (5 fen), Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma) (each 1.5 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (3 fen), Maimendong (Ophiopogonis Radix) de-heart, Baizhu (Atractylodis Macrocephalae Rhizoma) (each 7 fen), Zhizi (Gardeniae Fructus), Fuling (Poria), Shaoyao (Paeoniae Radix Alba) (each 1 qian), Chenpi (Citri Reticulatae Pericarpium) (7 fen), Xiangru (Moslae Herba) (1 qian), Biandou (Phaseoli Semen) (8 grains).
Crush into pieces, add Lotus Seeds (Lianrou) (10) and Wumei (Mume Fructus) (1), decoct with water and take orally. If extreme heat causes involuntary urination, add Chao Huangbai (Phellodendri Cortex prepared). If irritable, add Chen Sha powder and Suanzaoren (Ziziphi Spinosae Semen). If abdominal pain, dry heaving, vomiting, diarrhea, and fullness occur, do not use Shigao.
Summerheat stroke with body heat and vexation, and heavy limbs, indicates heat damaging Yuan Qi.
Qing Shu Yi Qi Tang (Clear Summerheat and Benefit Qi Decoction): Treats damp-heat steaming during late summer affecting people, causing fatigue in limbs, reduced spirit, reluctance to move, chest fullness and shortness of breath, joint pain, or high breathing and panting, body heat and vexation, epigastric distension, yellow and frequent urination, loose and frequent stool, or diarrhea or thirst, loss of appetite, spontaneous sweating, and physical weakness.
Ingredients: Huangqi (Astragali Radix) stir-fried with honey, Cangzhu (Atractylodis Rhizoma) processed with rice wash water, Shengma ( Cimicifugae Rhizoma) (each 1 qian), Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma) de-gorged, Chenpi (Citri Reticulatae Pericarpium), Shenqu (Massa Medicata Fermentata) stir-fried, Zexie (Alismatis Rhizoma), Huangbai (Phellodendri Cortex) wine-fried, Danggui (Angelicae Sinensis Radix), Qingpi (Citri Reticulatae Pericarpium Viride) de-pith, Maimendong (Ophiopogonis Radix) de-heart, Gange (Puerariae Lobatae Radix) (each 3 fen), Wuweizi (Schisandrae Fructus) (9 grains), Gancao (Glycyrrhizae Radix et Rhizoma) (3 fen).
Crush into pieces, decoct with water and take warm.
Summerheat with heat and thirst, and red, scanty, and difficult urination, requires clearing and draining the Triple Burner.
Yiyuan San (Benefit Origin Powder): Treats summerheat with body heat and difficult urination. This medicine is cool in nature, removes accumulated heat in the stomach, and due to its bland taste, promotes dampness drainage, thus benefiting urination and dispersing damp-heat.
Ingredients: Bai Huashi (Talcum) (6 qian), Gancao (Glycyrrhizae Radix et Rhizoma) lightly roasted (1 qian).
Grind into powder, take 2-3 qian per dose. Add a little honey, decoct in soup, and take freely with cold water. To induce sweating, mix with Congbai (Allii Fistulosi Bulbus) and Douchi (Sojae Semen Praeparatum) soup.
Summerheat with heat and thirst, and loose stools, requires separating and regulating Yin and Yang.
Wu Ling San (Five-Ingredient Powder): Treats summerheat with vexation and thirst, body heat and headache, cholera-like diarrhea, red and scanty urine, and mental confusion.
Ingredients: Zhuling (Polyporus), Zexie (Alismatis Rhizoma) (each 1 qian), Baizhu (Atractylodis Macrocephalae Rhizoma) de-gorged, Fuling (Poria) peeled (each 1.5 qian), Rougui (Cinnamomi Cortex) (5 fen).
Crush one dose, decoct with water and take orally. If Cinnamon is removed from this formula, it is named Si Ling San (Four-Ingredient Powder).
Contracting cold in summer is due to excessive cooling. During summer heat, one may seek coolness in deep halls, pavilions, or cold rooms, or fan oneself vigorously, allowing wind and cold to damage the exterior; or consume raw/cold food, fruits, and ice water, allowing cold to damage the interior. Pain may manifest as headache and body ache, fever and aversion to cold, or nausea, vomiting, diarrhea, and abdominal pain. This is caused by internal injury from raw/cold food and external contraction of wind-cold. Treat with Huoxiang Zhengqi San (Patchouli Corrective Qi Powder). This does not treat summerheat directly but treats diseases caused by summer conditions. Huoxiang Zhengqi San. (Formula see Cholera.) Based on this formula, if external contraction is severe, add Cangzhu and Qianghuo, remove Baizhu; if internal injury is severe, add Sharen (Amomi Fructus) and Shenqu.
Zhu Xia (Stagnant Summer) belongs to Yin-blood deficiency and insufficient Yuan Qi. It presents in early summer/late spring with headache, weak legs, poor appetite, and physical weakness. Symptoms include dizziness and blurred vision, sore and weak legs, five-palm heat, bitter taste and dry tongue, mental fatigue, lethargy, reduced diet, chest discomfort, frail appearance, and rapid but weak pulse. This is named Zhu Xia. Take many doses of Shengui Yiyuan Tang, combined with Buyin Wan (Nourish Yin Pill) for regulation.
Shengui Yiyuan Tang: Treats Zhu Xia disease.
Ingredients: Renshen (Ginseng Radix) de-gorged (5 fen), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Shudihuang (Rehmanniae Radix Preparata), Bai Fuling (Poria) peeled, Maimendong (Ophiopogonis Radix) de-heart (each 1 qian), Wuweizi (Schisandrae Fructus) (10 grains), Chenpi (Citri Reticulatae Pericarpium), Huangbai (Phellodendri Cortex) wine-fried, Zhimu (Anemarrhenae Rhizoma) wine-fried (each 7 fen), Gancao (Glycyrrhizae Radix et Rhizoma) (1 fen).
Crush one dose, add one Jujube, one Wumei, and a pinch of fried rice, decoct with water and take orally. For fullness, add Sharen and Baiddoukou (Cardamomi Fructus); for nausea, add Wumei, Lianrou, and fried rice; for dry heaving, add Zhuru (Bambusae Caulis in Taenia); for irritability, add Chen Sha, Suanzaoren, and Zhuru; for diarrhea, add Chao Baizhu, Shanyao, Sharen, and Wumei, remove Shudihuang, Zhimu, and Huangbai; for short red urine, add Mutong (Akebiae Caulis) and Shanzhi (Gardeniae Fructus); for epigastric blockage and loss of appetite, add Nongpu, Baiddoukou, Yizhi (Alpiniae Oxymiscae Fructus), Sharen, and Lianrou, remove Shudihuang, Huangbai, and Zhimu; for lower back pain, add Duzhong (Eucommiae Cortex), Guozhi (Drynariae Rhizoma), and Huixiang (Foeniculi Fructus); for leg soreness and weakness, add Niuxi (Achyranthis Bidentatae Radix) and Duzhong; for scorched skin, add Digupi (Lycii Cortex); for dizziness, add Chuanxiong (Ligustici Chuanxiong Rhizoma); for spontaneous sweating, add Huangqi, Baizhu, and Suanzaoren; for nocturnal emission, add Muli (Concha Ostreae), Chen Sha, Shanyao, and Chun Genpi (Toosendan Cortex); for fright and heat, add Chen Sha, Suanzaoren, and Zhuru; for bitter taste and dry tongue, add Shanzhi, Wumei, and Gange.
Fever, aversion to cold, body heaviness and pain, difficult urination, piloerection, cold hands and feet, immediate heat upon slight exertion, open mouth with dry anterior teeth, wiry, fine, deficient, and slow pulse indicate simultaneous exterior and interior involvement. Use Buzhong Yiqi Tang (Tonify the Middle and Benefit Qi Decoction) plus Xiangru and Biandou; if heat is present, add Huangqin (Scutellariae Radix).
A woman, due to extreme heat in the kitchen during summer, went out to a windy place to strip and cool off. After being blown by the wind, she suffered from headache, fever, aversion to cold, and body pain. A folk doctor failed to recognize the condition, mistakenly diagnosing it as cold, and administered Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction). After one dose, she immediately became speechless, ceased breathing, her lips and mouth turned cyanotic, and only her heart area remained slightly warm. Her family cried and sought my help. I palpated six pulses which were surging and rapid. This was a heat syndrome mistakenly treated with hot medicine. I sprayed warm wine on her chest, used a mirror (to reflect/cool?), and repeatedly applied fresh well water mixed with honey using a chicken feather into her mouth. Shortly after, she extended her tongue seeking water. I administered Yiyuan Tang, and she revived.
Li Beichuan suffered from abdominal pain, vomiting, and diarrhea in mid-summer. His hands felt hot when touched lightly but cold when pressed deeply. His pulse was floating and large when lightened, but minute and fine when pressed heavily. I said: This is a Yin-cold syndrome. Urgently administer Fuzi Lizhong Tang. It did not work initially, but after continuing to four doses, he recovered.