暑与湿为熏蒸粘腻之邪，治不中窍，暑热从阳上蒸而伤阴化燥。湿邪从阴下沉而伤阳变浊，六气伤人因人
而化
夏月盛暑气注人，令人病热生暑症。总由阴虚挟痰火，脉虚身热症可认。腹痛泄泻兼呕吐，恶心头晕冒暑
病。伤暑身热兼头痛，身如针刺躁难静。中暑寒热自汗多，咳嗽倦怠不知性。动而得之病属阳，加味香薷汤可
定。香薷麦味茯甘陈，豆朴木瓜次第寻。川连灯心姜枣服，气虚白术与参 ，寒热柴芩为要药，呕吐藿半法尤
精。泻用泽猪功最速（去麦味），渴增知粉效如神；绵绵腹痛伤水冷，干姜滑石法从心。小水不利或短赤，泽泻
山栀并滑石。搐拢加羌辨暑风，胸满枳槟消食积。自汗不止用 参，水泻木通泽有益。头痛川芎并石膏，痰闷
栝蒌及枳实（以上阳症治法）。若居凉馆喜风凉，恶寒头痛头项强。身形拘急热无汗，静而得之阴寒伤。宜用
羌活与茅术，川朴干姜及藿香。柴苏等分姜三片，水煎热服号升阳，兼食神曲滑石妙，内伤冰冷用炮姜。
陈曰∶六气伤人，因人而化，阴虚者火旺，邪归营分为多，阳虚者湿胜，邪伤气分为多。
暑伤气分上焦开郁
杏仁 通草 象贝 郁金 射于 石膏
半夏 山栀 豆豉 滑石 豆卷 橘皮 竹茹 苡仁 川朴 元参 香薷 犀角 芦根 丹皮 甘草 赤芍 连
翘竹沥 细生地 益元散 石菖蒲 西瓜翠
以上药皆可参用之。
何源长先生家制定中丸方，计十九味
陈香薷（三两） 宣木瓜（二两） 公丁香（一两） 法半夏（二两） 广木香（一两） 紫川朴（一两）
白檀香（一两） 建泽泻（二两） 广藿香（四两） 陈枳壳（一两） 紫苏叶（二两） 飞滑石（四两） 软
柴胡（一两） 茅山术（二两） 山楂肉（四两） 川羌活（一两五钱） 赤茯苓（二两） 粉甘草（二两）
生葛根（二两）
右药研末蜜丸，每丸重二钱，朱砂为衣，开水送服。孕妇及血症忌之。
暑风伤肺
石膏 连翘 竹叶 杏仁 六一散 苡仁 橘红 甘草 桑皮
暑厥中恶暑热，必先伤气分，故舌发燥，口渴身痛（陈注）
苍术白虎汤加滑石
暑热阻气，中痞不运
半夏泻心汤去干姜、甘草，加杏仁、枳实、竹心、广皮、茯苓、知母、广藿、半夏、黄芩、白芍、山桅、
川朴、麦芽、白蔻仁，生脉四君汤，清暑益气汤。
烦劳伤暑胃虚
《金匮》麦门冬汤。如脉左关大，木瓜、麦冬、沙参、乌梅、甘草。
暑入心营
鲜生地 元参 银花 川连 竹心 石菖蒲 丹参 连翘 犀角
暑病久延伤液
生脉散 三才汤 熟地 人参 天冬 茯苓 白芍 辰砂
暑热深入劫阴
阿胶 门冬 川连 生地 人参 乌梅
暑瘵寒热。舌白不渴，吐血
西瓜 翠竹芯 苡仁 鲜荷叶 杏仁 滑石
暑邪人厥阴（危症，消渴吐蛔，舌缩，肺气阻塞。若逆传腔中，必致昏厥。心之下有膈膜，与脊胁周遭相
着，所谓腔中也。暑病必挟湿。陈注）
川连 黄芩 干姜 人参 杨梅 川椒 白芍 枳实
暑兼血症
鲜生地 绿豆皮 通草 石膏 川贝
枇杷叶 白蔻仁 知母 苡仁 丹皮 连翘
郁金 桑叶 元参 竹心 杏仁 橘红 六一散 六味丸加阿胶 麦冬 沙参
陈曰∶《内经》云，病自上受者治其上，上受者以辛凉微苦，如竹叶、杏仁、连翘、薄荷。在中者以苦辛
宣通，如半夏泻心汤法。在下者以温行，寒性质重开下，如河间桂苓甘露饮之类，乃治三焦之大意。
暑病用苦辛味自能泄降也（陈注）
桂苓甘露饮（肉桂、云苓、膏、滑石、术，甘寒水泻猪芩）
张司农集诸贤论暑病，谓入肝则麻痹，入肾为消渴。瘦人之病虑涸其阴，肥人之病虑虚
其阳，胃中湿热，得燥热锢闭下痢稀水，即协热下痢。
热病之瘀热留络而为遗，毒注肠腑而为溺痢，皆属棘手。
Shu (Summerheat) and Shi (Dampness) are pathogenic factors characterized by steaming, muggy, and sticky qualities. If treatment is not apt, Shu-Heat ascends from the Yang aspect to damage Yin fluids, leading to dryness transformation; Dampness descends from the Yin aspect to damage Yang Qi, leading to turbidity transformation. The Six Qi harm humans and transform according to individual constitution.
In midsummer, intense Summerheat Qi invades the human body, causing heat disease and Shu symptoms. This generally stems from Yin deficiency combined with Phlegm-Fire. The pulse is deficient, and the body is feverish; these symptoms can be identified. Abdominal pain, diarrhea accompanied by vomiting, nausea, and dizziness indicate Shu-stroke (Maoshu Bing). Shangshu (injury by summerheat) presents with fever and headache, a sensation of needle-like pricking in the body, restlessness, and inability to remain calm. Zhongshu (heatstroke) presents with alternating chills and fever, profuse spontaneous sweating, coughing, fatigue, and confusion. Diseases acquired through movement belong to the Yang syndrome; Jiawei Xiangru Tang (Modified Elsholtzia Decoction) can determine the treatment. The formula includes Xiangru (Elsholtiae Herba), Maidong (Ophiopogonis Radix), Wuweizi (Schisandrae Fructus), Fuling (Poria), Gancao (Glycyrrhizae Radix et Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Dougong (Sojae Semen Praeparatum), Houpo (Magnoliae Officinalis Cortex), Mugua (Chaenomelis Fructus), selected sequentially. Add Chuanlian (Coptidis Rhizoma), Dengxincao (Junci Medulla), Shengjiang (Zingiberis Rhizoma Recens), and Dazao (Jujubae Fructus) for administration; for Qi deficiency, add Baizhu (Atractylodis Macrocephalae Rhizoma) and Renshen (Ginseng Radix et Rhizoma); for alternating chills and fever, Chaihu (Bupleuri Radix) and Huangqin (Scutellariae Radix) are essential; for vomiting, Huoxiang (Agastaches Herba) and Banxia (Pinelliae Rhizoma) are used, with particularly refined methodology. For diarrhea, Zexie (Alismatis Rhizoma) and Zhuling (Polyporus) act most rapidly (remove Maidong and Wuweizi at this time); for thirst, add Zhimu (Anemarrhenae Rhizoma) and Gafen (Starch powder, likely referring to Gypsum or similar drying agent, contextually implies cooling/drying), effective as if divine; for continuous abdominal pain due to cold water injury, Ganjiang (Zingiberis Rhizoma) and Huashi (Talcum) require careful application. For difficult urination or short, red urine, use Zexie, Shanzhi (Gardeniae Fructus), and Huashi. For spasms and convulsions, add Qianghuo (Notopterygii Rhizoma et Radix) to distinguish Shu-Feng (Summerheat-Wind); for chest fullness, use Zhishi (Aurantii Fructus Immaturus) and Binglang (Arecae Semen) to eliminate food stagnation. For unceasing spontaneous sweating, use Renshen; for watery diarrhea, Mutong (Akebiae Caulis) and Zexie are beneficial. For headache, use Chuanxiong (Ligustici Chuanxiong Rhizoma) and Shigao (Gypsum Fibrosum); for phlegm oppression, use Gualou (Trichosanthis Fructus) and Zhishi (above methods treat Yang syndromes).
If one resides in a cool pavilion and prefers wind and coolness, presenting with aversion to cold, headache, and stiffness of the head and neck, with body rigidity, fever, and no sweat, this is Yin-Cold injury acquired through stillness (Jing Er De Zhi). Use Qianghuo (Notopterygii Rhizoma et Radix) and Maoyuzhu (Atractylodis Rhizoma), Chuanpu (Magnoliae Officinalis Cortex), Ganjiang (Zingiberis Rhizoma), and Huoxiang (Agastaches Herba). Equal parts of Chaihu (Bupleuri Radix) and Zisu Ye (Perillae Folium), with three slices of Shengjiang (Zingiberis Rhizoma Recens), decocted in water and taken hot, is called Shengyang Sanxie Tang (Yang-Raising and Pathogen-Dispersing Decoction); for concurrent food stagnation, add Shenqu (Meditationis Mass) and Huashi (Talcum) for efficacy; for internal injury with cold sensations, use Paojiang (Prepared Zingiberis Rhizoma).
Chen states: The Six Qi harm humans and transform according to the individual. Those with Yin deficiency have vigorous Fire, so pathogens tend to enter the Ying (Nutritive) and Xue (Blood) levels; those with Yang deficiency have excess Dampness, so pathogens tend to damage the Qi level.
Shu injuring the Qi level and Upper Jiao requires opening depression. Medicinals include Xingren (Armeniacae Semen Amarum), Tongcao (Tetrapanacis Medulla), Xiangbei (Fritillariae Thunbergii Bulbus), Yujin (Curcumae Longae Radix), Shegan (Belamcandae Rhizoma), Shigao (Gypsum Fibrosum), Banxia (Pinelliae Rhizoma), Shanzhi (Gardeniae Fructus), Douchi (Sojae Semen Preparatum), Huashi (Talcum), Doujuan (Sojae Germinatus), Juapi (Citri Reticulatae Pericarpium), Zhuru (Bambusae Caulis in Taenia), Yiren (Coicis Semen), Chuanpu (Magnoliae Officinalis Cortex), Yuanshen (Scrophulariae Radix), Xiangru (Elsholtiae Herba), Xijiao (Rhinocerotis Cornu), Lugen (Phragmitis Rhizoma), Danpi (Moutan Cortex), Chishao (Paeoniae Radix Rubra), Lianqiao (Forsythiae Fructus), Zhuli (Bambusae Sap), Xi Shengdi (Rehmanniae Radix Preparata), Yi Yuan San (Benefit Origin Powder), Shichangpu (Acori Tatarinowii Rhizoma), and Xigua Cui (Citrulli Exocarpium). All above medicinals may be referenced for use.
Mr. He Yuanchang's family formulated the Zhong Wan Formula, consisting of nineteen ingredients: Chen Xiangru (3 liang), Xuan Mugua (2 liang), Gong Dingxiang (1 liang), Fa Banxia (2 liang), Guang Muxiang (1 liang), Zi Chuanpu (1 liang), Bai Tanxiang (1 liang), Jian Zexie (2 liang), Guang Huoxiang (4 liang), Chen Zhike (1 liang), Zi Su Ye (2 liang), Fei Huashi (4 liang), Ruan Chaihu (1 liang), Maoshan Zhu (2 liang), Shanzha Rou (4 liang), Chuan Qianghuo (1.5 liang), Chi Fuling (2 liang), Fen Gancao (2 liang), Sheng Gegen (2 liang).
The above medicinals are ground into powder, made into pills with honey, each pill weighing 2 qian, coated with Zhusha (Cinnabaris), and taken with boiled water. Contraindicated for pregnant women and those with blood disorders.
Shu-Feng injuring the Lung: Shigao (Gypsum Fibrosum), Lianqiao (Forsythiae Fructus), Zhuye (Bambusae Folium), Xingren (Armeniacae Semen Amarum), Liuyi San (Six-to-One Powder), Yiren (Coicis Semen), Juhong (Citri Reticulatae Pericarpium Album), Gancao (Glycyrrhizae Radix et Rhizoma), Sangpi (Mori Cortex).
Shu-Jue (Summerheat Syncope) and Zhong'e (Sudden Evil Attack by Summerheat): Must first injure the Qi level, hence the tongue becomes dry, thirst occurs, and the body aches (Chen's note).
Cangzhu Baihu Tang (Atractylodes White Tiger Decoction) plus Huashi (Talcum).
Shu-Heat obstructing Qi, causing Middle Jiao痞 (fullness/stagnation) and poor transport: Banxia Xiexin Tang (Pinellia Heart-Draining Decoction) remove Ganjiang (Zingiberis Rhizoma) and Gancao (Glycyrrhizae Radix et Rhizoma), add Xingren (Armeniacae Semen Amarum), Zhishi (Aurantii Fructus Immaturus), Zhuxin (Bambusae Medulla), Guangpi (Citri Reticulatae Pericarpium), Fuling (Poria), Zhimu (Anemarrhenae Rhizoma), Guang Huoxiang (Agastaches Herba), Banxia (Pinelliae Rhizoma), Huangqin (Scutellariae Radix), Baishao (Paeoniae Radix Alba), Shanzhi (Gardeniae Fructus), Chuanpu (Magnoliae Officinalis Cortex), Maiya (Hordei Fructus Germinatus), Baokou Ren (Amomi Rotundus Fructus); or Shengmai Sijun Tang (Generate Pulse Four Gentlemen Decoction), Qingshu Yiqi Tang (Clear Summerheat Benefit Qi Decoction).
Fatigue injuring Summerheat causing Stomach deficiency: Jin Gui Maimendong Tang (Golden Chamber Ophiopogon Decoction). If the left Guan pulse is large, add Mugua (Chaenomelis Fructus), Maidong (Ophiopogonis Radix), Shashen (Glehniae Radix), Wumei (Mume Fructus), Gancao (Glycyrrhizae Radix et Rhizoma).
Shu entering the Heart Ying (Nutritive) Level: Xian Shengdi (Rehmanniae Radix Recens), Yuanshen (Scrophulariae Radix), Yinhua (Lonicerae Japonicae Flos), Chuanlian (Coptidis Rhizoma), Zhuxin (Bambusae Medulla), Shichangpu (Acori Tatarinowii Rhizoma), Danshen (Salviae Miltiorrhizae Radix et Rhizoma), Lianqiao (Forsythiae Fructus), Xijiao (Rhinocerotis Cornu).
Shu disease prolonged damaging fluids: Shengmai San (Generate Pulse Powder), Santang Tang (Three Talents Decoction), Shudi (Rehmanniae Radix Preparata), Renshen (Ginseng Radix et Rhizoma), Tiandong (Asparagi Radix), Fuling (Poria), Baishao (Paeoniae Radix Alba), Chensha (Cinnabaris).
Shu-Heat deeply penetrating and robbing Yin: Ejiao (Colla Corii Asini), Mendong (Asparagi Radix), Chuanlian (Coptidis Rhizoma), Shengdi (Rehmanniae Radix Preparata), Renshen (Ginseng Radix et Rhizoma), Wumei (Mume Fructus).
Shu Zhai (Summerheat Consumption) with chills and fever, white tongue, no thirst, hematemesis: Xigua Cuipi (Citrulli Exocarpium), Zhuxin (Bambusae Medulla), Yiren (Coicis Semen), Xian Heye (Nelumbinis Folium), Xingren (Armeniacae Semen Amarum), Huashi (Talcum).
Shu pathogen entering Jueyin (Critical condition: polydipsia, vomiting roundworms, retracted tongue, lung Qi obstruction. If transmitting reversely to Qiangzhong [Pericardium/Heart area], it will cause coma. Below the heart is the diaphragm membrane, connecting around the spine and ribs, referred to as Qiangzhong. Shu disease must carry Dampness. Chen's note): Chuanlian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Ganjiang (Zingiberis Rhizoma), Renshen (Ginseng Radix et Rhizoma), Yangmei (Myrti Fructus), Chuanjiao (Zanthoxyli Pericarpium), Baishao (Paeoniae Radix Alba), Zhishi (Aurantii Fructus Immaturus).
Shu combined with Blood Disorders: Xian Shengdi (Rehmanniae Radix Recens), Lüdoupi (Phaseoli Radiati Testa), Tongcao (Tetrapanacis Medulla), Shigao (Gypsum Fibrosum), Chuanbei (Fritillariae Thunbergii Bulbus), Pipaye (Loquasi Folium), Baokou Ren (Amomi Rotundus Fructus), Zhimu (Anemarrhenae Rhizoma), Yiren (Coicis Semen), Danpi (Moutan Cortex), Lianqiao (Forsythiae Fructus), Yujin (Curcumae Longae Radix), Sangye (Mori Folium), Yuanshen (Scrophulariae Radix), Zhuxin (Bambusae Medulla), Xingren (Armeniacae Semen Amarum), Juhong (Citri Reticulatae Pericarpium Album), Liuyi San (Six-to-One Powder), Liuwei Wan (Six-Ingredient Pill) plus Ejiao (Colla Corii Asini), Maidong (Ophiopogonis Radix), Shashen (Glehniae Radix).
Chen states: The Nei Jing says, diseases received from above should be treated in the upper part; received from above, use pungent-cool and slightly bitter herbs, such as Zhuye (Bambusae Folium), Xingren (Armeniacae Semen Amarum), Lianqiao (Forsythiae Fructus), Bohe (Menthae Haplocalycis Herba). In the middle, use bitter-pungent to promote circulation, such as the method of Banxia Xiexin Tang (Pinellia Heart-Draining Decoction). In the lower part, use warm-moving methods; cold-nature heavy substances open downward, such as Hejian Guiling Ganlu Yin (Guiling Sweet Dew Decoction). This is the general principle for treating the Three Jiao.
Using bitter and pungent flavors for Shu disease naturally leads to draining and descending (Chen's note).
Guiling Ganlu Yin (Guijiang [Cinnamomi Ramulus], Yunling [Poria], Shigao [Gypsum Fibrosum], Huashi [Talcum], Zhu [Atractylodis Rhizoma]; sweet-cold promoting urination, Zhuling [Polyporus] and Fuling [Poria] used together).
Zhang Sinong collected discussions on Shu disease from sages, stating that entering the Liver causes numbness and paralysis, entering the Kidney causes Xiao Ke (Wasting-Thirst). For thin people, worry about drying up their Yin; for fat people, worry about emptying their Yang. Damp-Heat in the Stomach, when bound by Dry-Heat, results in dysentery with watery stool, known as Xiere Xieli (Dysentery with Heat).
Stasis-Heat remaining in collaterals from heat disease causes nocturnal emission; toxins pouring into the Intestines and Bowels cause urinary dysentery. Both are thorny and difficult to treat.