夏月头疼妄言。自汗。身不甚热。两胫逆冷。四肢沉重。胸腹多汗而满。其人先伤于
湿。因而中暑。其脉阳涩或弱。阴小而急。不可发汗。汗之名重 。必死。汗多者。白虎
汤加桂枝。汗少者。白虎汤加苍术。或概用苍术白虎汤。（述古）
按湿温症。因长夏每多阴雨。得日气煦照。则潮湿上蒸。袭人肌表。着于经络。则发
热头胀。身痛。足胫痛。舌苔腻白等症。重者。兼感时邪不正之气。即为湿温疫症。
邪入气分 暑湿之邪。阻于肺。必咽痛、发热、身痛。舌苔黄浓粘腻。烦渴不解。当清
上焦。如连翘、桔梗、滑石、射干、米仁、马勃、通草、淡竹叶、银花、芦根之类。如见身发
疹。舌黄燥浓。当凉膈疏 。如连翘、薄荷、生栀、石膏、牛蒡、杏仁、枳实、黄芩之类。
邪乘包络 湿温之邪。乘于包络。则神识昏呆。发热身痛。四肢不暖。舌苔鲜红燥
刺者。宜解手厥阴之邪。如犀角尖、连翘、石菖蒲、川郁金、元参、赤小豆、西黄之属主之。
邪入营分 如湿温之邪。入于血络。舌苔中黄边赤。发为赤 丹疹。神昏谵语。宜
清疏血分以透 。佐芳香逐秽以开闭。犀角、连翘、赤芍、银花、牛蒡、菖蒲、郁金、元参、
薄荷、人中黄之类。
邪阻上焦 病起发热头胀。渐至耳聋。喉痛欲闭。鼻中衄血。此邪混气之象。邪在
上焦空虚之所。非苦寒直达胃中之药可以治。病不能即解。即有昏痉之变。宜轻清理上为治。如
连翘、马勃、牛蒡、银花、射干、白金汁。如见呃忒。加枇杷叶、竹茹。（以上参叶案）
In summer, headache and delirious speech occur. There is spontaneous sweating, the body is not significantly hot, the lower legs are cold in reverse, the four limbs feel heavy, and there is excessive sweating and fullness in the chest and abdomen. The person was first injured by dampness, and subsequently contracted summerheat. The pulse is coarse or weak at the yang position (cun), and small and rapid at the yin position (chi). Sweating methods must not be used; if sweating is induced, it is called "Zhong" (severe error/mismanagement), which will inevitably lead to death. If sweating is excessive, use Baihu Tang (White Tiger Decoction) with Guizhi (Cinnamon Twig). If sweating is slight, use Baihu Tang (White Tiger Decoction) with Cangzhu (Atractylodis Rhizoma). Alternatively, Cangzhu Baihu Tang (Atractylodes and White Tiger Decoction) may be used generally. (Quoted from Shugu)
Note: Shiwen syndrome (Damp-Heat Febrile Disease) often occurs during late summer due to frequent rainy days. When warmed by sunlight, dampness steams upward, attacking the muscle surface and lodging in the meridians, causing symptoms such as fever, head distension, body pain, leg pain, and a greasy white tongue coating. In severe cases, concurrent infection with pathogenic factors of the time results in Shiwen epidemic disease.
Pathogen entering Qi Level: Summerheat-dampness pathogens obstructing the Lung will necessarily cause sore throat, fever, body pain, a thick yellow sticky tongue coating, restlessness, and unquenchable thirst. One should clear the Upper Jiao, using herbs such as Qiaofeng (Forsythiae Flos), Jiegeng (Platycodonis Radix), Huashi (Talcum), Shegan (Belamcandae Rhizoma), Yiyiren (Coicis Semen), Mabo (Bletillae Rhizoma), Tongcao (Tetrapanacis Medulla), Danzhuye (Lophatheri Herba), Yinhua (Lonicerae Japonicae Flos), and Lugen (Phragmitis Rhizoma). If rashes appear on the body and the tongue coating is yellow, dry, and thick, one should cool the Diaphragm and disperse wind, using herbs such as Qiaofeng (Forsythiae Flos), Bohe (Menthae Haplocalycis Herba), Shengzhi (Gardeniae Fructus), Shigao (Gypsum Fibrosum), Niubang (Arctii Fructus), Xingren (Armeniacae Semen Amarum), Zhishi (Aurantii Fructus Immaturus), and Huangqin (Scutellariae Radix).
Pathogen affecting Pericardium: When damp-heat pathogens affect the Pericardium, mental confusion and dullness occur, accompanied by fever, body pain, and cold extremities. If the tongue coating is bright red, dry, and prickly, one should resolve pathogens of the Hand-Jueyin Meridian, primarily using herbs such as Xijiao (Rhinocerotis Cornu - note: substitute with water buffalo horn in practice), Qiaofeng (Forsythiae Flos), Shichangpu (Acori Tatarinowii Rhizoma), Chuan Yujin (Curcumae Radix), Xuanshen (Scrophulariae Radix), Chixiaodou (Vigna Semen Rubrum), and Xi Huang (Moschus).
Pathogen entering Ying Level: When damp-heat pathogens enter the blood collaterals, the tongue coating is yellow in the center and red at the edges, manifesting as red macules and papules. With coma and delirious speech, one should clear and disperse the Blood level to vent pathogens, assisted by aromatic herbs to dispel turbidity and open the orifices. Herbs include Xijiao (Rhinocerotis Cornu), Qiaofeng (Forsythiae Flos), Chishao (Paeoniae Radix Rubra), Yinhua (Lonicerae Japonicae Flos), Niubang (Arctii Fructus), Changpu (Acori Tatarinowii Rhizoma), Yujin (Curcumae Radix), Xuanshen (Scrophulariae Radix), Bohe (Menthae Haplocalycis Herba), and Renzhonghuang (Hominis Excrementum Treatum).
Pathogen obstructing Upper Jiao: The disease begins with fever and head distension, gradually progressing to deafness, sore throat threatening closure, and epistaxis. This indicates pathogens mixed within the Qi. The pathogen resides in the empty spaces of the Upper Jiao; bitter-cold herbs that directly reach the Stomach cannot treat this. The illness will not resolve immediately, and complications such as coma and convulsions may arise. Treatment should involve light clearing and resolving of the Upper Jiao, using herbs such as Qiaofeng (Forsythiae Flos), Mabo (Bletillae Rhizoma), Niubang (Arctii Fructus), Yinhua (Lonicerae Japonicae Flos), Shegan (Belamcandae Rhizoma), and Baijin Zhi (Platinum Water Juice). If hiccups are present, add Pipaye (Eriobotryae Folium) and Zhuru (Bambusae Caulis in Taenia). (Referencing Ye Tianshi's medical cases above)