伤暑胸间痹痛，气逆如阻，此结胸也。宜用小陷
胸汤，加枳壳、桔梗、甘遂、郁金等味，涤痰开结
也。
凡结胸之症，必因其人中气素虚，浊痰复盛，又感暑
浊，交相互结，胸间因而作痛。宜用甘遂，半夏，瓜蒌以涤
浊痰，佐入黄连，枳，桔，泄热开胸。
伤暑瘀热不解、胸肋板痛，此血结胸也。宜用桂
枝、红花、瓜蒌，郁金、桃仁、赤芍、海蛤等味，消
而且散。若少腹硬痛，小便自利，大便黑色，此蓄血
也。宜用桃仁承气汤祛瘀逐邪也。
前二条痞与结胸，皆言热结在气。此条结胸与蓄血，皆
言热结在血。其结在胸者，仿海藏桂枝红花汤加瓜蒌，桃
仁、海蛤，为表里并消，若结在少腹者，用桃仁承气汤，为
上下分消。仲景谓蓄血者，必小便自利，大便黑色：若小便
不利者，乃热结膀胱，非血结也。以此辨诸，最为明验，学
者详之。
伤暑热久不解，神迷如寐，舌红少津，饥不欲
食，脉数无神，此热伤胃阴，津不肯复。宜用复脉汤
去姜桂，加地骨皮、鲜石斛、鲜谷芽等味，养胃和
阴，以待一阴来复也。
此言热久伤阴，胃津大损，故舌于干红，而神疲多寐。余
热消烁则易饥，胃阴被伤则不饮食。用复脉汤养阴，石斛、
谷芽养胃，俾热去津还，而胃纳自旺也。
Heat-stroke causing bi-syndrome and pain in the chest, with rebellious Qi obstructed as if blocked, this is Jie-Xiong (Chest Binding Syndrome). It is appropriate to use Xiao Xian Xiong Tang (Minor Inverted Chest Decoction), adding Zhi Qiao (Bitter Orange Fruit), Jie Geng (Platycodon Root), Gan Sui (Kansui Root), Yu Jin (Curcuma Aromatica Rhizome) and other ingredients, to cleanse phlegm and open the binding.
In all cases of Jie-Xiong syndrome, it is necessarily because the patient's Middle Qi has been deficient since long ago, turbid phlegm is abundant, and they have contracted summer-heat turbid pathogen; these factors interact and bind together, causing pain in the chest. It is appropriate to use Gan Sui, Ban Xia (Pinellia Tuber), Gua Lou (Trichosanthes Fruit) to cleanse turbid phlegm, assisted by Huang Lian (Coptis Rhizome), Zhi Shi (Immature Bitter Orange), Jie Geng to drain heat and open the chest.
After heat-stroke, if stasis-heat does not resolve, accompanied by board-like pain in the chest and hypochondrium, this is Blood Jie-Xiong (Blood Chest Binding Syndrome). It is appropriate to use Gui Zhi (Cinnamon Twig), Hong Hua (Carthamus Flower), Gua Lou, Yu Jin, Tao Ren (Peach Kernel), Chi Shao (Red Peony Root), Hai Ge Ke (Clam Shell) and other ingredients to dissipate and scatter. If there is hardness and pain in the lower abdomen, free urination, and black stool, this is Xu-Xue (Blood Accumulation Syndrome). It is appropriate to use Tao Ren Cheng Qi Tang (Peach Kernel Decoction to Order the Qi) to dispel stasis and drive out pathogens.
The previous two paragraphs discussing Pi (Stagnation) and Jie-Xiong both refer to heat binding in the Qi level. This paragraph discussing Jie-Xiong and Xu-Xue both refer to heat binding in the Blood level. For binding in the chest, imitate Hai Zang's Gui Zhi Hong Hua Tang (Cinnamon Twig and Carthamus Decoction) adding Gua Lou, Tao Ren, Hai Ge Ke, for simultaneous resolution from interior and exterior; for binding in the lower abdomen, use Tao Ren Cheng Qi Tang, for simultaneous resolution from upper and lower. Zhang Zhongjing stated that for Xu-Xue, there must be free urination and black stool: if urination is difficult, it is heat binding in the Bladder, not blood binding. By distinguishing thus, it is most clearly verified; scholars should study this in detail.
If heat from heat-stroke persists unresolved for a long time, with spirit confused as if sleeping, red tongue with little fluid, sensation of hunger but no desire to eat, rapid pulse lacking spirit, this is heat damaging Stomach Yin, with fluids unable to recover. It is appropriate to use Fu Mai Tang (Pulse-Recovering Decoction), removing Jiang (Ginger) and Gui (Cinnamon Twig), adding Di Gu Pi (Lycium Bark), Xian Shi Hu (Fresh Dendrobium Stem), Xian Gu Ya (Fresh Sprouted Grain) and other ingredients, to nourish the Stomach and harmonize Yin, awaiting the return of one Yin.
This refers to prolonged heat damaging Yin, with great loss of Stomach fluids, hence the dry, red tongue and mental fatigue with excessive sleepiness. Residual heat consuming fluids causes easy hunger, while damaged Stomach Yin causes lack of appetite. Using Fu Mai Tang to nourish Yin, Shi Hu and Gu Ya to nourish the Stomach, so that heat leaves and fluids return, and Stomach reception naturally prospers.