程（二八） 温热病。已伤少阴之阴。少壮阴未易复者。恰当夏令发泄。百益酒酿造有灰。辛热劫阴泄
气。致形体颓然。药难见效。每日饵鸡距子生用。其汤饮用马料豆汤。（邪热兼酒热伤阴）
冬伤于寒。春必病温者。重在冬不藏精也。盖烦劳多欲之人。阴精久耗。入春则里气大泄。
木火内燃。强阳无制。燔燎之势。直从里发。始见必壮热烦冤。口干舌燥之候矣。故主治以
存津液为第一。黄芩汤坚阴却邪。即此义也。再者在内之温邪欲发。在外之新邪又加。葱
豉汤最为快捷方式。表分可以整肃。至于因循贻误。岂止一端。或因气燥津枯。或致阴伤液涸。
先生用挽救诸法。如人参白虎汤。黄连阿胶汤。玉女煎。复脉法。申明条例甚详。余则治痉
厥以甘药缓肝。昏闭用幽芳开窍。热痰之温胆。蓄血而论通瘀。井井有条。法真周到。（邵新甫）
徐评 细详诸案。俱是热邪误治入脏之坏症居多。时邪温热之症绝少。
某 大凡暑与热。乃地中之气。吸受致病。亦必伤人气分。气结则上焦不行。下脘不通。不饥
不欲食。不大便。皆气分有阻。如天地不交。遂若否卦之义。然无形无质。所以清之攻之不效。（暑
伤气分上焦闭郁）
杏仁 通草 象贝 栝蒌皮 白蔻 郁金汁
姚 奔走气乱。复饮烧酒。酒气辛热。有升无降。肺气 郁。上下不通。舌白消渴。气结自胸及腹。
自利不爽。周身肤腠皆痛。汗大出不解。无非暑湿热气。始由肺受。漫布三焦。群医消导
苦药。但攻肠胃。在上痞结仍然。议淡渗佐以微辛。合乎轩岐上病治上之方。
西瓜翠衣 川白通草 大豆黄卷 马兜铃 射干 苡仁
范 伏暑阻其气分。烦渴。咳呕喘急。二便不爽。宜治上焦。
杏仁 石膏 炒半夏 黑栀皮 浓朴 竹茹
又 痰多咳呕。是暑郁在上。医家乱投沉降。所以无效。
石膏 杏仁 炒半夏 郁金 香豉 黑山栀
王 舌白烦渴。心中胀闷。热邪内迫。气分阻闭。当治肺经。倘逆传膻中。必致昏厥。
杏仁 郁金 滑石 黄芩 半夏 橘红 栝蒌皮
陈（四五） 暑湿伤气。肺先受病。诸气皆痹。当午后阳升。烦喘更加。夫无形气病。医以重药推消。多见
不效。
西瓜翠衣 活水芦根 杏仁 苡仁
又 酒客中虚。重镇攻消。清气愈伤。夫暑邪皆着气分。苟肺司清肃。则其邪不攻自罢。议仍以
廓清为法。若雨露从天下降。炎HT 自荡扫无余。威喜丸二钱十服。
某（二二） 身热。头胀脘闷。咳呛。此暑邪外袭于肺卫。当清上焦。
丝瓜叶（三钱） 大杏仁（三钱） 香薷（七分） 通草（一钱半） 飞滑石（三钱） 白蔻仁（五分）
陈 脉左劲。右濡。头痛脘闷。麻痹欲厥。舌白。此暑邪内中。蒙闭清空。成疟之象。平昔阴虚。勿犯
中下二焦。
嫩竹叶 连翘 飞滑石 野郁金汁 大杏仁 川贝母
龚（二四） 脉寸大。头晕。脘中食不多下。暑热气从上受。治以苦辛寒方。
竹叶 杏仁 郁金 滑石 香豉 山栀
张（四七） 三疟之邪在阴。未经向愈。春季洞利不食。想春雨外湿。水谷内聚亦湿。即湿多成五泄之
谓。疮痍仅泄经隧湿邪。而里之湿邪未驱。长夏吸受暑邪。上蒙清空诸窍。咳嗽耳聋。的系新
邪。非得与宿病同日而语。
连翘 飞滑石 嫩竹叶 荷叶边汁 桑叶 杏仁 象贝 黑山栀
程（三六） 暑风必挟湿。湿必伤于气分。断疟疮发。即湿邪内发之征。湿伏热蕴。致气壅塞咽底脘中。
及至进谷无碍。二便通调。中下无病显然。
白通草 西瓜翠衣 活水芦根 苡仁
吴 连朝骤热。必有暑气内侵。头热目瞑。吸短神迷。此正虚邪痹。清补两难。先与益元散三四
钱。用嫩竹叶心二钱。煎汤凉用三四小杯。常用绿豆煎汤服。
龚（六十） 暑必挟湿。二者皆伤气分。从鼻吸而受。必先犯肺。乃上焦病。治法以辛凉微苦。气分上焦
廓清则愈。惜乎专以陶书六经看病。仍是与风寒先表后里之药。致邪之在上。漫延结锢。四
十余日不解。非初受六经。不须再辨其谬。经云。病自上受者治其上。援引经义以论治病。非
邪僻也宗河间法。
杏仁 栝蒌皮 半夏 姜汁 白蔻仁 石膏 知母 竹沥 秋露水煎。
又 脉神颇安。昨午发疹。先有寒战。盖此病起于湿热。当此无汗。肌腠气窒。至肤间皮脱如麸。
犹未能全泄其邪。风疹再发。乃湿因战栗为解。一月以来病魔。而肌无膏泽。瘦削枯槁。古谓
瘦人之病。虑涸其阴。阴液不充。补之以味。然腥 浊味。徒助上焦热痰。无益培阴养液。况宿
滞未去。肠胃气尚窒钝。必淡薄调理。上气清爽。痰热不至复聚。从来三时热病。怕反复于病
后之复。当此九仞。幸加意留神为上。
元参心 细生地 银花 知母 生甘草 川贝 丹皮 橘红（盐水炒） 竹沥
此煎药方。只用二剂可停。未大便时。用地冬汁膏。大便后。可用三才汤。
池 伏暑至深秋而发。头痛烦渴少寐。
薄荷 淡竹叶 杏仁 连翘 黄芩 石膏 赤芍 木通
张 病几一月。犹然耳聋。神识不慧。嗽甚痰粘。呼吸喉间有音。此非伤寒暴感。皆夏秋间暑湿
热气内郁。新凉引动内伏之邪。当以轻剂清解三焦。奈何医者不晓伏气为病。但以发散消
食寒凉清火为事。致胃汁消亡。真阴尽烁。舌边赤。齿板燥裂血。邪留营中。有内闭螈 厥逆
之变。况右脉小数。左脉涩弱。热固在里。当此阴伤日久。下之再犯亡阴之戒。从来头面。都是
清窍。既为邪蒙。精华气血不肯流行。诸窍失司聪明矣。此轻清清解。断断然也。议清上焦气
血之壅为先。不投重剂苦寒。正仿古人肥人之病。虑虚其阳耳。
连翘心 元参 犀角 郁金 橘红（蜜水炒） 黑栀皮 川贝 鲜菖蒲根 加竹沥
又 昨进清上焦法。诸症虽然略减。而神识犹未清爽。总由病久阴液内耗。阳津外伤。聪明智
慧之气。俱被浊气蒙蔽。所以子后午前稍清。他时皆不清明。以阳盛时。人身应之也。拟进局
方至宝丹。藉其芳香。足以护阳逐邪。庶无内闭外脱之虞。
至宝丹每服三分。灯心嫩竹叶汤送。
又 脉右缓大。左弱。面垢色已减。痰嗽不爽。良由胃中津液。为辛散温燥所伤。心营肺卫。悉受
热焰蒸迫。致神呆喘急耳聋。清阳阻痹。九窍不利。首方宣解气血。继方芳香通窍。无形令其
转旋。三焦自有专司。岂与俗医但晓邪滞攻击而已。今已获效。当与清养胃阴肺气。体素丰
盛。阳弱不耐沉寒。然深秋冬交。天气降则上焦先受。试观霜露下垂。草木皆改容色。人在气
交。法乎天地。兼参体质施治。
枇杷叶 炒黄川贝 橘红 郁金 茯苓 苡仁
王 暑风热气入肺。上热。痰喘嗽。（暑风伤肺）
石膏 连翘 竹叶 杏仁 桑皮 苡仁 橘红 生甘草
又 肺气壅遏。身热喘咳。溺少。苇茎合葶苈大枣汤。
某（二五） 暑风外袭。肺卫气阻。头胀咳呛。畏风微热。防作肺疟。
丝瓜叶 大杏仁 香薷 桔梗 连翘 六一散
某 舌灰黄。头痛咳逆。左肢掣痛。此烦劳阳动。暑风乘虚袭入。最虑风动中厥。
鲜荷叶（三钱） 鲜莲子（五钱） 茯神（一钱半） 益元散（三钱） 川贝母（一钱半） 橘红（一钱）
杨（女） 暑热秽浊。阻塞肺部。气痹腹满。宜以轻可去实。
西瓜翠衣 白通草 活水芦根 生苡仁
临好。加入石膏末二钱。
周（二三） 暑风热。神呆。
鲜荷叶 苦丁茶 滑石 木通 杏仁 浓朴
广皮 白蔻仁
郁（二六） 暑热。头胀。咳喉痛。
鲜荷叶 杏仁 射干 橘红 桑皮 桔梗 木通 滑石
胡 不饥不食不便。此属胃病。乃暑热伤气所致。味变酸浊。热痰聚脘。苦辛自能泄降。非无据
也。（暑热阻气中痞不运） 半夏泻心汤去甘草干姜加杏仁枳实。
王 身热自汗。腹痛。大小便不利。脉虚。右大左小。暑热内闭。拟和表里法。
薄荷 枳实 黄芩 生白芍 竹叶心 黑山栀 通草 甘草
程（四二） 秽热由清窍入。直犯募原。初头痛肌胀。今不饥痞闷。以苦辛寒法。
杏仁 半夏 浓朴 橘红 竹叶 黄芩 滑石
又 脉虚。舌赤消渴。伏暑热气。过卫入营。治在手厥阴。
竹叶 犀角 生地 麦冬 元参
某（六一） 舌黄。脘闷。头胀。口渴。溺短。此吸受秽气所致。
飞滑石（三钱） 白蔻仁（七分） 杏仁（三钱） 浓朴（一钱半） 通草（一钱半） 广皮白（一钱半）
某（三三） 秽暑吸入。内结募原。脘闷腹痛。便泄不爽。法宜芳香逐秽。以疏中焦为主。
藿香梗 杏仁 浓朴 茯苓皮 半夏曲 广皮 香附 麦芽
杨 秋暑内烁。烦渴。喜得冷冻饮料。脉右小弱者。暑伤气分。脉必芤虚也。此非结胸症。宜辛寒以彻
里邪。
石膏 知母 浓朴 杏仁 半夏 姜汁
沈（二三） 脉小色白。气分不足。兼之胃弱少食。闻秽浊要刮痧。阴柔之药。妨胃助浊。常以猪肚丸养
胃。入夏令。热更伤气。每食远进生脉四君子汤一剂。恪守日服。可杜夏季客暑之侵。生脉
四君子汤 长服猪肚丸。
卜（二八） 春夏必吞酸。肢痿麻木。此体虚不耐阳气升泄。乃热伤气分为病。宗东垣清暑益气之议。
人参 黄 白术 甘草 麦冬 五味 青皮 陈皮 泽泻
葛根 升麻 黄柏 归身 神曲
任（十六） 冲年真阴未长。逢长夏湿热交迫。斯气泄烦倦。当静坐凉爽。过月凉 至。炎HT 去。乃却病
之期。与清暑益气之属。清暑益气汤。
徐（十四） 长夏湿热令行。肢起脓窠。烦倦不嗜食。此体质本怯。而湿与热邪。皆伤气分。当以注夏同
参．用清暑益气法。
人参 白术 广皮 五味 麦冬 川连 黄柏 升麻 葛根 神曲 麦芽 谷芽
鲜荷叶汁泛丸。
施（四七） 以烦劳伤阳。交长夏发泄令加。见症都是气弱。亦热伤气也。烦渴有痰。先治其胃。盖阳明
经脉。主乎束筋骨以流利机关耳。（烦劳伤暑胃虚） 金匮麦门冬汤。
吴 诊脉肝胆独大。尺中动数。先天素弱。水亏。木少滋荣。当春深长夏。天地气机泄越。身中烦
倦食减。皆热伤元气所致。进以甘酸。充养胃阴。少俟秋肃天降。培植下焦。固纳为宜。
炒麦冬 木瓜 北沙参 生甘草 乌梅
程 暑久入营。夜寐不安。不饥微痞。阴虚体质。议理心营。（暑入心营）
鲜生地 元参 川连 银花 连翘 丹参
顾（十三） 阴虚遗热。小便淋沥。近日冒暑。初起寒热头痛。汗出不解。肌肉麻木。手足牵强。神昏如寐。
成疟则轻。痉厥则重。
犀角 元参 小生地 连翘心 竹叶心 石菖蒲 滑石 化牛黄丸 二服
某 初病伏暑。伤于气分。微热渴饮。邪犯肺也失治邪张。逆走膻中遂舌绛缩。小便忽闭。鼻煤
裂血。口疮耳聋神呆。由气分之邪热。漫延于血分矣。夫肺主卫。心主营。营卫二气。昼夜行于
经络之间。与邪相遇。或凉或热。今则入于络。津液被劫。必渐昏寐。所谓内闭外脱。
鲜生地 连翘 元参 犀角 石菖蒲 金银花
汪 暑风久入营络。微热忽凉。议用玉女煎。（暑风入营）
玉女煎去麦冬牛膝加丹皮竹叶。
金 热止。津津汗出。伏暑已解。只因病魔日久。平素积劳。形色脉象虚衰。深虑变病。今饮食未
进。寤寐未宁。议以敛液补虚。（暑病久延伤液）
人参 茯神 麦冬 五味 炒白芍
块辰砂一两。绵裹同煎。
又 热久。胃汁被劫。不饥不便。亦病后常事耳。古人论病。必究寝食。今食未加餐难寐。神识未
清。为病伤元气。而热病必消烁真阴。议用三才汤意。
人参 天冬 生地 麦冬 五味子
顾 右脉空大左脉小芤。寒热麻痹。腰痛冷汗。平素积劳内虚。秋暑客邪。遂干脏阴。致神迷心
热烦躁。刮痧似乎略爽。病不肯解。此非经络间病。颇虑热深劫阴。而为痉厥。张司农集诸贤
论暑病。谓入肝则麻痹。入肾为消渴。此其明征。议清阴分之邪。仍以养正辅之。（暑热深入劫阴）
阿胶 小生地 麦冬 人参 小川连 乌梅肉
某 暑湿热气。触入上焦孔窍。头胀脘闷不饥。腹痛恶心。延久不清。有疟痢之忧。医者不明三
焦治法。混投发散消食。宜乎无效。（暑湿弥漫三焦）
杏仁 香豉 橘红 黑山栀 半夏 浓朴 滑石 黄芩
张 舌白罩灰黑。胸脘痞闷。潮热呕恶。烦渴汗出。自利。伏暑内发。三焦均受。然清理上中为要。
杏仁 滑石 黄芩 半夏 浓朴 橘红 黄连 郁金 通草
某（二六） 暑热郁遏。头胀脘痛。口渴溺短。当清三焦。
丝瓜叶 飞滑石 淡竹叶 茯苓皮 浓朴 藿香
广皮 通草
何 暑湿皆客邪也。原无质。故初起头胀胸满。但伤上焦气分耳。酒家少谷。胃气素薄。一派消
导。杂以辛散苦寒。胃再伤残。在上湿热。延及中下。遂协热自利。三焦邪蒸。气冲塞填胸。躁乱
Cheng (18 years old): Suffering from warm-heat disease. The Yin of the Shaoyin (Lesser Yin) has been damaged. Since the Yin essence of young people is not easily restored, and it coincides with the summer season when Yang Qi disperses outward, he mistakenly drank Baiyi Jiu (Hundred Benefits Wine), brewed with wine lees. This wine is pungent and hot in nature, depleting Yin fluids and dissipating Zheng Qi (Upright Qi), resulting in extreme physical debility, making medicinal treatment difficult to take effect. He was advised to consume fresh Ji Ju Zi (Caltrop Fruit) daily and drink Ma Liao Dou Tang (Vigna Angularis Decoction). (This case involves Yin damage due to pathogenic heat combined with the heat of alcohol.)
Winter injury by cold leads to warm diseases in spring; the key lies in the failure to store Jing Essence during winter. Individuals who are overworked and have excessive desires suffer long-term depletion of Yin essence. Upon entering spring, the internal Qi leaks significantly, causing Liver and Kidney Wood-Fire to burn internally. Unrestrained strong Yang creates a blazing fire that erupts directly from within. Initially, symptoms such as high fever, irritability and oppression, dry mouth, and dry tongue appear. Therefore, the primary treatment principle is to preserve Jin Ye (Body Fluids). Huang Qin Tang (Scutellaria Decoction) strengthens Yin and expels pathogens, embodying this principle. Furthermore, if internal warm pathogens desire to emerge while external new pathogens add to the condition, Cong Chi Tang (Scallion and Fermented Soybean Decoction) is the most rapid method to restore order to the Exterior level. However, delays in treatment can lead to various complications, such as Qi dryness and fluid exhaustion, or severe Yin and fluid depletion. Mr. Ye employed various rescue methods, including Ren Shen Bai Hu Tang (Ginseng and White Tiger Decoction), Huang Lian E Jiao Tang (Coptis and Donkey-Hide Gelatin Decoction), Yu Nu Jian (Jade Woman Decoction), and Fu Mai Fa (Pulse-Restoring Method), with detailed explanations of the principles. Other treatments for spasms and convulsions used sweet herbs to soothe the Liver; for coma and obstruction, aromatic opening agents were used; for hot phlegm, Wen Dan Tang (Warm Gallbladder Decoction) was applied; and for blood stasis, blood-invigorating methods were discussed. The approach was orderly and comprehensive. (Comment by Shao Xinpu)
Xu Lingtai's Comment: Careful examination of these cases reveals that most are severe conditions where pathogenic heat was mismanaged and entered the Zang organs. Genuine seasonal warm diseases are rare.
Certain Patient: Generally, Summerheat and Heat are Qi arising from the earth. Inhalation causes disease, inevitably damaging the Qi of the Human body. When Qi stagnates, the Upper Jiao fails to circulate, and the Lower Stomach becomes obstructed, leading to anorexia, lack of desire to eat, and constipation. These are all obstructions in the Qi level, resembling the hexagram Pi (Standstill) where Heaven and Earth do not interact. However, since Summerheat is formless and substance-less, both clearing and purging methods are ineffective. (Summerheat damages the Qi level, causing Upper Jiao closure and depression)
Prescription: Xing Ren (Apricot Seed), Tong Cao (Tetrapanax Pith), Xiang Bei Mu (Fritillaria Thunbergii Bulb), Gua Lou Pi (Trichosanthes Peel), Bai Kou Ren (Cardamom Seed), Yu Jin Zhi (Curcuma Juice).
Yao: Running around caused Qi chaos, followed by drinking distilled spirits. The pungent and hot nature of alcohol rises but does not descend, causing Lung Qi stagnation and obstruction between upper and lower parts. Symptoms include white tongue coating, thirst, Qi knot extending from chest to abdomen, unsatisfactory diarrhea, pain throughout the skin and pores, profuse sweating without relief. This is essentially Summerheat-Damp-Heat, initially affecting the Lung and spreading through the Three Jiaos. Physicians only used bitter digestive herbs targeting the intestines and stomach, leaving the upper Jiao obstruction unresolved. The proposed method is light diuresis aided by slightly pungent herbs, aligning with Xuandi’s principle of "treating upper diseases from above."
Prescription: Xi Gua Cui Yi (Watermelon Rind), Chuan Bai Tong Cao (Akebia Stem), Da Dou Huang Juan (Soybean Sprout), Ma Dou Ling (Aristolochia), She Gan (Belamcanda Rhizome), Yi Yi Ren (Coix Seed).
Fan: Latent Summerheat obstructs the Qi level, causing irritability, thirst, cough, vomiting, wheezing, and unsatisfactory urination and defecation. Treatment should focus on the Upper Jiao.
Prescription: Xing Ren, Shi Gao (Gypsum), Chao Ban Xia (Processed Pinellia), Hei Zhi Pi (Black Gardenia Peel), Hou Po (Magnolia Bark), Zhu Ru (Bamboo Shavings).
Second visit: Excessive phlegm, cough, and vomiting indicate Summerheat stagnation in the upper part. Physicians indiscriminately used sinking and descending herbs, hence the ineffectiveness.
Prescription: Shi Gao, Xing Ren, Chao Ban Xia, Yu Jin, Xiang Chi (Fermented Soybean), Hei Shan Zhi (Black Gardenia).
Wang: White tongue coating, irritability, thirst, chest fullness, internal pressure from pathogenic heat, and Qi obstruction in the Qi level. Treatment should target the Lung Meridian. If it reversely transmits to the Dan Zhong (Conception Vessel at the chest), it will cause coma and syncope.
Prescription: Xing Ren, Yu Jin, Hua Shi (Talcum), Huang Qin (Scutellaria Root), Ban Xia, Ju Hong (Tangerine Red Pulp), Gua Lou Pi.
Chen (45 years old): Summerheat-Dampness damages Qi; the Lung suffers first, causing obstruction of all Qi mechanisms. In the afternoon, when Yang Qi rises, irritability and wheezing worsen. For this formless Qi disease, physicians using heavy pushing and eliminating drugs often see no effect.
Prescription: Xi Gua Cui Yi, Huo Shui Lu Gen (Fresh Reed Rhizome), Xing Ren, Yi Yi Ren.
Second visit: A habitual drinker has deficient Middle Qi. Heavy sedative and attacking drugs further damage Clear Qi. Summerheat pathogens adhere to the Qi level. If the Lung maintains its clearing and descending function, the pathogen will subside without forceful attack. The proposed method is still to clear and disperse, like rain and dew falling from heaven, washing away heat. Weixi Wan (Weixi Pill) 2 qian, taken ten times.
Certain Patient (22 years old): Fever, head distension, epigastric stuffiness, coughing and retching. This is Summerheat pathogen externally attacking the Lung and Wei levels. Treatment should clear the Upper Jiao.
Prescription: Si Gua Ye (Luffa Leaf, 3 qian), Da Xing Ren (Large Apricot Seed, 3 qian), Xiang Ru (Mosla Herb, 7 fen), Tong Cao (1.5 qian), Fei Hua Shi (Flying Talcum, 3 qian), Bai Kou Ren (Cardamom Seed, 5 fen).
Chen: Left pulse is wiry/tense, right pulse is soggy. Headache, epigastric stuffiness, numbness approaching syncope, white tongue coating. This indicates Summerheat pathogen invading internally, clouding the Clear Orifices, presenting as malaria-like symptoms. Given chronic Yin deficiency, avoid treating the Middle and Lower Jiaos.
Prescription: Nen Zhu Ye (Young Bamboo Leaf), Lian Qiao (Forsythia), Fei Hua Shi, Ye Yu Jin Zhi (Wild Curcuma Juice), Da Xing Ren, Chuan Bei Mu (Sichuan Fritillaria Bulb).
Gong (24 years old): Pulse is large at the Cun position. Dizziness, difficulty swallowing food in the epigastrium. Summerheat-Qi enters from above. Treat with Bitter-Pungent-Cold formula.
Prescription: Zhu Ye (Bamboo Leaf), Xing Ren, Yu Jin, Hua Shi, Xiang Chi, Shan Zhi (Gardenia).
Zhang (47 years old): Pathogens of recurrent malaria reside in the Yin. Not yet healed. Spring brings profuse diarrhea and anorexia. Likely due to external dampness from spring rain and internal accumulation of dampness from food and water ("dampness becoming five types of diarrhea"). Skin lesions only drain dampness from meridians, not internal dampness. Summerheat absorbed in late summer clouds the Clear Orifices, causing cough and deafness. This is a new pathogen, distinct from chronic illness.
Prescription: Lian Qiao, Fei Hua Shi, Nen Zhu Ye, He Ye Bian Zhi (Lotus Leaf Rim Juice), Sang Ye (Mulberry Leaf), Xing Ren, Xiang Bei Mu, Hei Shan Zhi.
Cheng (36 years old): Summerwind must carry Dampness; Dampness always damages the Qi level. Malaria cessation and skin eruptions are signs of internal Dampness emergence. Dampness hides and Heat accumulates, causing Qi congestion in the throat and epigastrium. Once eating is normal and urination/defecation are regulated, it is clear that the Middle and Lower Jiaos are unaffected.
Prescription: Bai Tong Cao, Xi Gua Cui Yi, Huo Shui Lu Gen, Yi Yi Ren.
Wu: Sudden heat over consecutive days implies internal invasion of Summerheat Qi. Hot head, closed eyes, shortness of breath, and confusion indicate Right Qi deficiency and pathogenic obstruction, making clearing and tonifying difficult. First, administer Yiyuan San (Benefit Origin Powder) 3-4 qian, decocted with 2 qian of Nen Zhu Ye Xin (Heart of Young Bamboo Leaf), cooled and drunk in small cups. Regularly drink Mung Bean Decoction.
Gong (60 years old): Summerheat must carry Dampness; both damage the Qi level, entering via the nose, first affecting the Lung (Upper Jiao Disease). Treatment should be Pungent-Cool and slightly Bitter. Once the Upper Jiao Qi is cleared, recovery follows. Regrettably, physicians relied solely on Tao Hongjing’s Six Channels theory, using exterior-releasing then interior-purging methods for wind-cold. This allowed upper pathogens to spread and bind, unresolved for over 40 days. It is not the initial Six Channels pattern, so there is no need to debate its errors. The Classic states: "Diseases entering from above should be treated from above." Citing classics to discuss treatment is not heretical. Following Liu Wansu’s (Hejian) method.
Prescription: Xing Ren, Gua Lou Pi, Ban Xia, Jiang Zhi (Ginger Juice), Bai Kou Ren, Shi Gao, Zhi Mu (Anemarrhena Rhizome), Zhu Li (Bamboo Juice), decocted with Autumn Dew Water.
Second visit: Pulse and Spirit are relatively stable. Rash appeared yesterday noon, preceded by chills. The disease originated from Damp-Heat. Due to lack of sweat, Qi was blocked in muscle pores, leading to peeling skin like bran. The pathogen was not fully expelled. Recurrent wind-rash indicates Dampness resolving through shivering. Over a month, the patient has become emaciated and dry. Ancient texts warn that for thin patients, one must fear Yin exhaustion. If Yin fluids are insufficient, tonify with flavor. However, greasy/turbid flavors only aid Upper Jiao hot-phlegm and do not nourish Yin. Moreover, residual stagnation remains, and intestinal Qi is dull. Light dietary regulation is needed to keep Upper Qi clear and prevent phlegm-heat recurrence. Seasonal heat diseases often relapse after recovery. At this critical stage, careful attention is urged.
Prescription: Yuan Shen Xin (Heart of Scrophularia Radix), Xi Sheng Di (Fine Rehmannia Root), Yin Hua (Honeysuckle), Zhi Mu, Sheng Gan Cao (Raw Licorice), Chuan Bei (Fritillaria), Dan Pi (Moutan Bark), Ju Hong (Salt-fried Tangerine Pulp), Zhu Li.
This decoction should stop after two doses. Before bowel movement, use Di Dong Zhi Gao (Ophiopogon and Asparagus Juice Paste). After bowel movement, use San Cai Tang (Three Capabilities Decoction).
Chi: Latent Summerheat emerges in late autumn, causing headache, irritability, thirst, and insomnia.
Prescription: Bo He (Mint), Dan Zhu Ye (Light Bamboo Leaf), Xing Ren, Lian Qiao, Huang Qin, Shi Gao, Chi Shao (Red Peony Root), Mu Tong (Akebia Stem).
Zhang: Ill for nearly a month, still deaf, mental confusion, severe cough with sticky sputum, audible breathing sounds. This is not acute Taiyang cold damage, but internal depression of Summerheat-Damp-Heat from summer/autumn, triggered by new coolness. Light agents should clear and resolve the Three Jiaos. Alas, physicians do not understand latent Qi disease, focusing only on releasing exterior, digesting food, and cooling fire. This consumes Stomach juices and destroys True Yin. Red tongue edges, dry/cracked gums with bleeding, pathogen remaining in Ying Level, risking internal closure and convulsive syncope. Right pulse is fine-rapid, left pulse is choppy-weak. Heat is firmly internal. With long-term Yin damage, purging violates the warning against losing Yin. Head and face are Clear Orifices; when clouded by pathogens, essence and Qi cannot circulate, causing loss of sensory function. Light clearing and resolving is essential. Prioritize clearing Qi and Blood congestion in the Upper Jiao, avoiding heavy bitter-cold drugs, imitating ancients’ caution against damaging Yang in obese patients.
Prescription: Lian Qiao Xin (Forsythia Heart), Yuan Shen, Xi Jiao (Rhinoceros Horn - *Note: Substitute with Buffalo Horn in modern practice*), Yu Jin, Ju Hong (Honey-water fried Tangerine Pulp), Hei Zhi Pi, Chuan Bei, Xian Chang Pu Gen (Fresh Acorus Root), add Zhu Li.
Second visit: Yesterday’s Upper Jiao clearing reduced symptoms slightly, but mental clarity remains poor. Long illness consumes internal Yin and injures external Yang fluids. Turbid Qi clouds wisdom. Clarity is better between 9 PM and noon due to Yang peak. Prescribe Ju Fang Zhi Bao Dan (Bureau Formula Treasure Precious Pill) for its aromatic properties to protect Yang and expel pathogens, preventing internal closure and external collapse.
Dosage: Zhi Bao Dan 3 fen each time, delivered with Deng Xin (Rush Pith) and Nen Zhu Ye Decoction.
Third visit: Right pulse is slow-large, left is weak. Facial grease has decreased, but cough/sputum persists. Caused by Stomach fluids damaged by pungent-dispersing and warm-drying drugs. Heart Ying and Lung Wei are steamed by heat flames, causing stupor, wheezing, deafness, obstruction of Clear Yang, and nine orifices dysfunction. Initial formulas dispersed Qi/Blood; subsequent formulas used aromatics to open orifices, allowing formless Qi to rotate. The Three Jiaos have their own functions, unlike vulgar physicians who only attack stagnation. Now effective, transition to clearing and tonifying Stomach Yin and Lung Qi. Constitution is robust, but Yang is weak and intolerant of deep cold. Late autumn/winter transition sees Heaven’s Qi descending, affecting Upper Jiao first. Humans follow Heaven and Earth, adjusting treatment based on constitution.
Prescription: Pi Pa Ye (Loquat Leaf), Chao Huang Chuan Bei (Yellow-fried Sichuan Fritillaria), Ju Hong, Yu Jin, Fu Ling (Poria), Yi Yi Ren.
Wang: Summerwind-Heat enters the Lung, causing upper heat, phlegm, wheezing, and cough. (Summerwind damages Lung)
Prescription: Shi Gao, Lian Qiao, Zhu Ye, Xing Ren, Sang Pi (Mulberry Root Bark), Yi Yi Ren, Ju Hong, Sheng Gan Cao.
Second visit: Lung Qi obstruction, fever, wheezing, cough, scanty urine. Use Wei Jing Tang (Eupatorium Decoction) combined with Ting Li Da Zao Tang (Descurainia Seed and Jujube Decoction).
Certain Patient (25 years old): Summerwind externally attacks, obstructing Lung and Wei Qi. Head distension, coughing, aversion to wind, slight fever. Prevent lung malaria.
Prescription: Si Gua Ye, Da Xing Ren, Xiang Ru, Jie Geng (Platycodon Root), Lian Qiao, Liu Yi San (Six-to-One Powder).
Certain Patient: Grey-yellow tongue, headache, reverse cough, left limb twitching/pain. Irritation moves Yang, Summerwind exploits deficiency. Fear wind stirring leading to stroke/syncope.
Prescription: Xian He Ye (Fresh Lotus Leaf, 3 qian), Xian Lian Zi (Fresh Lotus Seed, 5 qian), Fu Shen (Poria with Hostwood, 1.5 qian), Yi Yuan San (Benefit Origin Powder, 3 qian), Chuan Bei Mu (1.5 qian), Ju Hong (1 qian).
Yang (Female): Summerheat-turbid qi blocks the Lung, causing Qi obstruction and abdominal fullness. Use light agents to remove excess.
Prescription: Xi Gua Cui Yi, Bai Tong Cao, Huo Shui Lu Gen, Sheng Yi Yi Ren.
Near recovery, add Shi Gao Mo (Gypsum Powder) 2 qian.
Zhou (23 years old): Summerwind-Heat, mental stupor.
Prescription: Xian He Ye, Ku Ding Cha (Ilex Kudingcha), Hua Shi, Mu Tong, Xing Ren, Hou Po, Guang Pi (Tangerine Peel), Bai Kou Ren.
Yu (26 years old): Summerheat, head distension, cough/throat pain.
Prescription: Xian He Ye, Xing Ren, She Gan, Ju Hong, Sang Pi, Jie Geng, Mu Tong, Hua Shi.
Hu: Anorexia, no desire to eat, constipation. This belongs to Stomach disease, caused by Summerheat damaging Qi. Taste turns sour/turbid, hot-phlegm gathers in the epigastrium. Bitter-pungent naturally drains and descends. (Summerheat obstructs Qi, causing middle jiao stagnation)
Prescription: Ban Xia Xie Xin Tang (Pinellia Decoction to Drain the Epigastrium) minus Gan Cao and Gan Jiang, add Xing Ren and Zhi Shi.
Wang: Fever, spontaneous sweating, abdominal pain, unsatisfactory urination/defecation, deficient pulse, right larger than left. Summerheat internally closes. Propose harmonizing Interior and Exterior.
Prescription: Bo He (Mint), Zhi Shi (Immature Bitter Orange), Huang Qin, Sheng Bai Shao (Raw White Peony Root), Zhu Ye Xin (Bamboo Leaf Heart), Hei Shan Zhi, Tong Cao, Gan Cao.
Cheng (42 years old): Turbid-Heat enters via clear orifices, directly attacking the Mu Yuan (Sea of Origin). Initially headache and muscle distension, now anorexia and stuffiness. Use Bitter-Pungent-Cold method.
Prescription: Xing Ren, Ban Xia, Hou Po, Ju Hong, Zhu Ye, Huang Qin, Hua Shi.
Second visit: Deficient pulse, red tongue, thirst. Latent Summerheat-Qi passes Wei and enters Ying. Treat at the Pericardium (Hand Jueyin).
Prescription: Zhu Ye, Xi Jiao, Sheng Di (Rehmannia Root), Mai Dong (Ophiopogon Root), Yuan Shen.
Certain Patient (61 years old): Yellow tongue, epigastric stuffiness, head distension, thirst, scanty urine. Caused by inhaling turbid Qi.
Prescription: Fei Hua Shi (3 qian), Bai Kou Ren (7 fen), Xing Ren (3 qian), Hou Po (1.5 qian), Tong Cao (1.5 qian), Guang Pi Bai (Tangerine White Pulp, 1.5 qian).
Certain Patient (33 years old): Turbid-summer inhaled, internally binding at Mu Yuan. Epigastric stuffiness, abdominal pain, unsatisfactory diarrhea. Method: Aromatic expulsion of turbidity, focusing on soothing the Middle Jiao.
Prescription: Huo Xiang Geng (Agastache Stem), Xing Ren, Hou Po, Fu Ling Pi (Poria Peel), Ban Xia Qu (Pinellia Fermented), Guang Pi, Xiang Fu (Cyperus Rhizome), Mai Ya (Barley Sprout).
Yang: Autumn Summerheat scorches internally, causing irritability and thirst, preferring cold drinks. Right pulse is small-weak, indicating Summerheat damaging Qi (pulse should be hollow-deficient). This is not Jie Xiong (Chest Binding) syndrome. Use Pungent-Cold to penetrate internal pathogens.
Prescription: Shi Gao, Zhi Mu, Hou Po, Xing Ren, Ban Xia, Jiang Zhi.
Shen (23 years old): Small pulse, pale complexion, insufficient Qi level. Combined with weak Stomach and poor appetite. Smelling turbidity requires scraping (Gua Sha). Yin-nourishing drugs hinder Stomach and assist turbidity. Often use Zhu Du Wan (Pork Stomach Pill) to nourish Stomach. Entering summer heat further damages Qi. Take Sheng Mai Si Jun Zi Tang (Generate Pulse Four Gentlemen Decoction) once daily after meals to prevent seasonal Summerheat invasion. Long-term use of Zhu Du Wan.
Bu (28 years old): Acid regurgitation in spring/summer, limb flaccidity/numbness. Body deficiency cannot tolerate Yang rising/dispersing. Heat damages Qi level. Follow Dong Yuan’s Qing Shu Yi Qi (Clear Summerheat Benefit Qi) proposal.
Prescription: Ren Shen (Ginseng), Huang Qi (Astragalus), Bai Zhu (Atractylodes), Gan Cao, Mai Dong, Wu Wei Zi (Schisandra), Qing Pi (Green Tangerine Peel), Chen Pi (Aged Tangerine Peel), Ze Xie (Alisma), Ge Gen (Kudzu Root), Sheng Ma (Cimicifuga), Huang Bo (Phellodendron), Gui Shen (Angelica Sinensis Root Body), Shen Qu (Medicated Leaven).
Ren (16 years old): Youthful True Yin is not fully developed. Encounters late summer Damp-Heat oppression, causing Qi leakage, irritability, and fatigue. Sit quietly in coolness. When the month passes and heat subsides, it is time to recover. Use Qing Shu Yi Qi Tang (Clear Summerheat Benefit Qi Decoction).
Xu (14 years old): Late summer Damp-Heat season arrives. Pustules on limbs, fatigue, anorexia. Constitution is timid; Damp and Heat both damage Qi level. Treat similar to Zhu Xia (Summer Complaint) with Qing Shu Yi Qi method.
Prescription: Ren Shen, Bai Zhu, Guang Pi, Wu Wei, Mai Dong, Chuan Lian (Coptis), Huang Bo, Sheng Ma, Ge Gen, Shen Qu, Mai Ya, Gu Ya (Rice Sprout), made into pills with Xian He Ye Zhi (Fresh Lotus Leaf Juice).
Shi (47 years old): Overwork damages Yang. Late summer dispersal season exacerbates symptoms, showing Qi weakness. Heat also damages Qi. Irritability, thirst, phlegm. First treat the Stomach. Yangming Meridian governs binding sinews and facilitating joints. (Overwork damages Summerheat, Stomach deficiency)
Prescription: Jin Kui Mai Men Dong Tang (Golden Cabinet Ophiopogon Decoction).
Wu: Pulse shows Liver/Gallbladder alone is large, Chi position is moving-rapid. Innate weakness, Water deficiency, Wood lacks nourishment. In deep spring/late summer, Heaven/Earth Qi disperses. Internal fatigue and reduced appetite are caused by Heat damaging Yuan Qi. Administer Sweet-Sour to replenish Stomach Yin. Wait for Autumn’s肃 (clearing/descending) Qi to cultivate Lower Jiao and consolidate/grasp.
Prescription: Chao Mai Dong (Fried Ophiopogon), Mu Gua (Chaenomeles), Bei Sha Shen (Glehnia Root), Sheng Gan Cao, Wu Mei (Dark Plum).
Cheng: Summerheat lingers in Ying Level, causing sleep disturbance, anorexia, mild stuffiness. Yin-deficient constitution. Propose regulating Heart Ying. (Summerheat enters Heart Ying)
Prescription: Xian Sheng Di (Fresh Rehmannia), Yuan Shen, Chuan Lian (Coptis), Yin Hua, Lian Qiao, Dan Shen (Salvia Root).
Gu (13 years old): Yin deficiency leaves residual heat, dribbling urination. Recently exposed to Summerheat. Initial chills, fever, headache, sweating without relief. Muscle numbness, limb stiffness, coma-like sleep. Malaria would be mild; spasms/syncope would be severe.
Prescription: Xi Jiao, Yuan Shen, Xiao Sheng Di (Small Rehmannia), Lian Qiao Xin, Zhu Ye Xin, Shi Chang Pu (Acorus), Hua Shi, Hua Niu Huang Wan (Calculus Bovis Pill), two doses.
Certain Patient: Initial latent Summerheat, damaging Qi level. Slight fever, thirst/drinking. Pathogen attacks Lung; mismanagement allows pathogen to expand, reversely traveling to Dan Zhong, causing crimson/shrunken tongue, sudden urinary retention, blackened nostrils, cracked lips/bleeding, mouth ulcers, deafness, stupor. Qi-level pathogenic heat spreads to Blood level. Lung governs Wei, Heart governs Ying. Ying and Wei Qi circulate meridians day/night. Meeting pathogens causes alternating cold/heat. Now entering collaterals, fluids are robbed, leading to gradual coma. This is "Internal Closure, External Collapse."
Prescription: Xian Sheng Di, Lian Qiao, Yuan Shen, Xi Jiao, Shi Chang Pu, Jin Yin Hua (Honeysuckle Flower).
Wang: Summerwind lingers in Ying/Collaterals, slight fever alternating with chill. Propose Yu Nu Jian (Jade Woman Decoction). (Summerwind enters Ying)
Prescription: Yu Nu Jian minus Mai Dong and Niu Xi, add Dan Pi and Zhu Ye.
Jin: Heat stops, gentle sweating, latent Summerheat resolved. But illness duration and chronic overwork show deficient appearance/pulse. Deeply worry about transformation. Cannot eat/sleep. Propose astringing fluids and tonifying deficiency. (Summerheat lingering damages fluids)
Prescription: Ren Shen, Fu Shen, Mai Dong, Wu Wei, Chao Bai Shao (Fried White Peony), Chen Sha (Cinnabar, 1 liang, wrapped in silk, decocted together).
Second visit: Long heat, Stomach juices robbed, anorexia/constipation, common post-illness. Ancients investigated sleep/appetite. Current inability to eat/sleep and unclear spirit indicates Qi damage. Heat diseases consume True Yin. Propose San Cai Tang (Three Capabilities Decoction) concept.
Prescription: Ren Shen, Tian Dong (Asparagus Root), Sheng Di, Mai Dong, Wu Wei Zi.
Gu: Right pulse empty-large, left pulse small-hollow. Chills/fever, numbness, lower back pain, cold sweat. Chronic overwork/internal deficiency. Autumn Summerheat guest pathogen invades Zang Yin, causing confusion, heart heat, irritability. Scraping provides slight relief, but disease persists. Not a meridian disease, but fear deep heat robbing Yin leading to spasms/syncope. Zhang Sinong collected theories on Summerheat: entering Liver causes numbness, entering Kidney causes thirst. This is clear evidence. Propose clearing Yin-level pathogens, assisted by tonifying Righteous Qi. (Summerheat deeply invades, robbing Yin)
Prescription: E Jiao (Donkey-Hide Gelatin), Xiao Sheng Di, Mai Dong, Ren Shen, Xiao Chuan Lian (Coptis), Wu Mei Rou (Dark Plum Flesh).
Certain Patient: Summerheat-Damp-Heat touches Upper Jiao orifices. Head distension, epigastric stuffiness, anorexia, abdominal pain, nausea. Prolonged uncleared, risk of malaria/dysentery. Physicians ignorant of Three Jiao treatment, indiscriminately using exterior-releasing and digestive herbs, hence ineffective. (Summerheat-Damp pervading Three Jiaos)
Prescription: Xing Ren, Xiang Chi, Ju Hong, Hei Shan Zhi, Ban Xia, Hou Po, Hua Shi, Huang Qin.
Zhang: White tongue coated grey-black, chest/epigastric stuffiness, tidal fever, vomiting/nausea, irritability/thirst/sweating, spontaneous diarrhea. Latent Summerheat internally emerges, affecting all Three Jiaos. However, clearing Upper/Middle is key.
Prescription: Xing Ren, Hua Shi, Huang Qin, Ban Xia, Hou Po, Ju Hong, Huang Lian (Coptis), Yu Jin, Tong Cao.
Certain Patient (26 years old): Summerheat depression/stagnation, head distension/epigastric pain, thirst/scanty urine. Should clear Three Jiaos.
Prescription: Si Gua Ye, Fei Hua Shi, Dan Zhu Ye, Fu Ling Pi, Hou Po, Huo Xiang, Guang Pi, Tong Cao.
He: Summerheat and Dampness are guest pathogens, originally substance-less. Initial head distension/chest fullness only damages Upper Jiao Qi. Wine drinkers have little grain intake, weak Stomach Qi inherently. A series of digestive herbs mixed with pungent-dispersing and bitter-cold drugs further injures the Stomach. Upper Jiao Damp-Heat extends to Middle/Lower, causing heat-coupled spontaneous diarrhea. Three Jiao pathogens steam, Qi rushes filling chest, restlessness.