脉虚微细弦芤迟。皆属于中暑。不可汗下。但解热利小便为要。
夫暑者。乃长夏盛热之令也。人当避酷热之亢。相安于燔炙之宜。毋冒灼灼。毋致怆怆
其
知道者。夏以养阴扶阳。顺之则祥。逆之则殃。故三伏炎炎。三暑蒸蒸。腠理开泄。真气不
藏。孙思邈云。长夏宜服五味子、人参、麦门冬。以固耗散之金。真气不足者。倍加人参。
其不善养者。坐卧于风凉之处。扇不息于寝寐之时。或拭以冷布。或浴以凉泉。则腠理寒侵
逆其时令。即病曰伤暑矣。其藏于肌表之间。至秋收敛阳回。邪正交争。故寒热兢兢作病
名曰疟者也。其有过食瓜果。好饮梅浆冷水。吞泉噙水。及爱食凉汤生蔬。此伤暑于肠胃
或为霍乱等症。遗于秋病发。曰痢疾脾寒等症。此有人伤于暑者也。饥渴于道途。及乘虚
而冒暑。或运气之兼胜而病。曰暑病。感之深者曰中暑。皆作头疼昏愦发热。伤寒则身热而
脉大。惟伤暑则身热而脉小。又有暑风者。神昏身体拘急。类若中风 病相似。此为极重之
候。盖必其人元气素弱。真阴不足。感于金消水涸之时。则内外两虚。法当清补。倍加生脉
散。缘夏乃阳外阴内。表里不实。清暑益气汤。最为精确。以香藿饮为却暑之药。
一论暑者。天地炎热之气。中之多成吐泻。身热头痛烦渴。甚则昏迷不知人事。如遇是
病。
切不可饮以冷水。令卧湿地。当以热汤灌之。俟其苏醒。投之以药可也。盛暑切戒劳苦淫欲
之事。谚云。六月莫入房。胜似灸膏肓。诚哉是言也。虚弱之人。尤宜谨焉。
一论凡行人。或农夫。于日中劳役得之者。名曰中热。其病必苦头痛。发燥热。恶热。
扪
之肌肤大热。必大渴引饮。汗大泄。无气以动。乃为天热外伤肺气也。宜人参白虎汤主之。
（方见伤寒）
一论凡人之暑。于深堂大厦而得病者。名曰中暑。其病必头痛恶寒。身战而急。肢节痛
而心
烦。肌肤大热无汗。为房室之阴寒所遏。使周身阳气不得伸越。宜辛温之剂。以解表散寒。
五积散主之。（方见中寒）
一论伤暑。则脉虚而身热。口燥咽干。或吐或泻。或背恶寒者。盖暑伤心。心不受邪。
则包络受之。包络相火。以火助火。则热盛而昏不醒也。大抵清心利小便为主。
黄连香薷饮
川浓朴（去皮姜汁浸炒五钱） 白扁豆（微炒五钱） 香薷（去土五钱） 加黄连姜汁炒。名
黄连香薷散。
上锉一剂。水煎。入酒一分。澄冷。不拘时服。热则作泻。心烦热多。或吐逆。加姜汁
炒黄连。手足搐搦。不省人事。加黄连、羌活。小便不利。加滑石、赤茯苓。吐。
加藿香、陈皮。少加姜汁。呕。加生姜、半夏。口渴。加干葛、天花粉。泻痢。加
白术、茯苓。脉虚弱。加人参、五味、麦门冬。虚汗不止。加黄 、白术。心烦躁
加栀子、姜炒黄连。调辰砂末服之。胸膈饱闷。加枳壳、桔梗。
一论伤暑饮冷。当风取凉。呕吐不止。用二陈汤合香薷饮。加生姜、乌梅。煎服。
一论一切外感风寒暑湿之病。内伤饮食生冷之症。悉宜此方。
二香散
香薷（一钱二分） 扁豆（炒） 浓朴（姜汁拌炒） 黄连（姜汁炒） 藿香 半夏（姜汁炒）
陈
皮大腹皮 桔梗（去芦） 紫苏 白茯苓（去皮） 苍术（米泔浸） 白芷（各一钱） 甘草（二
分）
上锉一剂。姜、枣煎服。
一论夏月中暑危笃。而大便下血者。
香薷解毒汤
旧香薷（三钱） 浓朴（姜炒） 白扁豆（炒） 山栀（炒） 黄连 黄柏（炒） 黄芩（炒各一
钱）
上锉。水煎服。
一论伤暑身热。烦渴引饮。小便不利者。此胃脘积热也。
益元散 （一名天水散。一名六一散）
白滑石（水飞六两） 粉草（微炒一两）
上为细末。每服二三钱。加蜜少许。热汤冷水任下。如欲发汗。以葱白豆豉汤调下。或
用生蜜和为丸。如弹子大。每服一丸。凉水研化服亦可。
一论伤暑身热。口干烦渴。心神恍惚。小便赤涩。大便泄泻者。此脾胃虚而阴阳不分也
宜服。
五苓散
猪苓（二钱） 泽泻（二钱） 白术（一钱五分） 白茯苓（三钱） 肉桂（五分）
上锉散。白水煎服。本方去桂。名四苓散。加茵陈。名茵陈五苓散。加辰砂。名辰砂
五苓散。一方。加大黄。治初痢。亦治积聚食黄。并酒疽。量人虚实。多则三钱。少则二
钱。须煎药八分熟。然后入之。阳毒。加芍药、升麻。去肉桂。狂言乱语。加辰砂、酸枣
仁。头痛目眩。加川芎、羌活。咳嗽。加五味、桔梗。心气不定。加人参、麦门冬。
痰多加半夏、陈皮。喘急加马兜铃、桑白皮。大便不通。加大黄、芒硝。气块。加
三棱、莪术。心热。加黄连、石莲肉。身痛拘急。加麻黄。口干嗳水。加干葛、乌梅
眼黄酒疽及五疽。加茵陈、木通、滑石。鼻衄。加栀子、乌梅。伏暑鼻衄。加茅根
煎。调百草霜末。五心热如劳。加桔梗、柴胡。有痰有热。加桑白皮、人参、前胡。
水肿。加甜葶苈、木通、滑石、木香。
吊肾气。加吴茱萸、枳壳。小肠气痛。加小茴、木通。霍乱转筋。加藿香、木瓜。小
便不利。加木通、滑石、车前子。喘咳心烦不得眠。加阿胶炒。疝气。加小茴香、川楝
子、槟榔、官桂、姜、葱。入盐一捻同服。女子红汗。加桃仁、牡丹皮。呕吐。去桂。加半
夏、生姜。
一论伏暑作寒热未解。宜五苓散合白虎汤主之。伏热后。或冷水沐浴。或吃冷物。清气
在脾。令日作寒栗壮热。浑身洒淅。更加桂出汗。便解。
一论伤暑烦渴。小便不利。大便泄泻者。宜用香薷散合四苓散。名薷苓汤。加木通二钱
滑石三钱。内热心烦。加姜炒黄连八分。山栀三钱。调辰砂末。虚。倍加人参三钱。
一论伏暑身体倦怠。神昏头重。吐利。宜服。
十味香薷饮
黄 （二钱） 人参（三钱） 白术（二钱） 白茯苓（二钱） 陈皮（二钱） 浓朴（一钱） 木
瓜（二钱） 香薷（二钱） 扁豆（三钱） 甘草（一钱）
上锉。水煎。温服之。
一论长夏湿热蒸人。人感之。四肢困倦。精神短少。懒于动作。胸满气促。肢节痛。或
气高
而喘。身热而烦。心下痞闷。小便黄而数。大便溏而频。或利或渴。不思饮食。自汗体重。
或汗少者。血先病而气未病也。其脉中得洪缓。若湿热未消。必加以迟迟。病虽互换少瘥。
其脉暑湿合则一也。宜清燥之药治之。用
清暑益气汤
黄 （蜜炙一钱） 苍术（米泔浸一钱半） 升麻（一钱） 人参 白术（去芦） 陈皮 神曲（炒
）泽泻（各五分） 甘草（炙） 黄柏（酒炒） 当归（酒洗） 青皮（去穣） 麦门冬（去心）
干葛（各三分） 五味子（九粒）
上锉一剂。水煎服。
一论发热恶寒。身重疼痛。小便涩。洒然毛耸。手足逆冷。小有劳。身即热。口开。前
板齿
燥。脉弦细虚迟。表里中 也。补中益气汤。（方见内伤）根据本方加香薷、扁豆。有热。加黄
芩。
一论外不受寒。止是内伤冰水冷物。腹痛泄泻。或霍乱吐逆者。宜理中汤。加神曲、麦
芽、苍术、砂仁。此专治内。温中消食也。
一论注夏者。属阴血虚。元气不足也。夏初春末。头疼眼花。腿酸脚软。食少体弱。五
心烦
热。口苦舌干。精神困倦。无力好睡。胸膈不利。形如虚瘠。脉数无力。是名注夏。宜服
参归益元汤
人参（去芦五分） 当归（酒洗） 白芍（酒炒） 怀熟地黄 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（三分）
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、益智仁、砂仁、莲肉。去熟地黄、黄柏、知母。腰痛。加杜仲、破
故纸、小茴香。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 、酸枣仁、白术。梦遗。加牡蛎、山药、辰砂、椿根皮。虚惊烦热。加辰
砂、酸枣仁、竹茹。口苦舌干。加山栀、乌梅、葛根。
一论夏月最难调理。而途中尤甚。故附方预却暑毒。清热解烦。可免中暑霍乱泄泻痢疾
等症。
驱暑益元汤
人参（一钱二分） 白术（去芦一钱五分） 五味子（十粒） 白芍（酒炒） 麦门冬（去心）
甘草（炙五分） 陈皮 知母（酒炒） 香薷（各七分） 黄芩（炒三分） 白茯神（去皮木
一钱）
上锉。生姜煎服。
一论途中伤暑而作水泻。腹痛烦渴者。行人不服水土。夏秋月宜随身备此丸以防之。
胃苓丸
苍术（米泔浸炒一两） 陈皮（一两） 浓朴（姜汁炒
一两） 白术（去芦土炒一两） 白茯苓（去皮二两） 肉桂（五钱） 猪苓（一两） 泽泻（
一两） 人参（五钱） 黄连（姜汁炒一两） 白芍（炒一两） 甘草（炙五钱）
上为末。炼蜜为丸。如梧子大。每服五六十丸。清米汤下。一论此方清上焦热。润肺
生津止渴。
清上梅苏丸
乌梅（不拘多少清水洗净取肉半斤） 白砂糖（半斤）
上为细末。入南薄荷头末半斤。共捣成膏。丸如弹子大。每用一丸。口中噙化。行路
备之。解渴最妙。
千里梅花丸（长途备用）
枇杷叶 干葛末 百药煎 乌梅肉 蜡梅花 甘草（各一钱）
上俱为末。用蜡五两。先溶蜡开。投蜜一两。和药末捣二三百下。丸如鸡头实大。夏月
长途。噙化一丸。津液顿生。寒香满腹。妙不可言。
一夏末秋初。热气酷烈。不可于中庭脱露身背。受风取凉。五脏俞穴。并会于背。或令
人扇
风。或袒露手足。此中风之原。若染诸疾。便服八味丸。补理腑脏。御邪气。仍忌三白。恐
冲克药性。
一人盛暑发热。胸背作痛。饮汤自汗。用发表之药。昏 谵语。大便不实。吐痰甚多。
用十全大补一剂顿退。又用补中益气加炮姜二剂全愈。
一人夏月入房。食水果腹痛。余用附子理中汤而愈。有同患此者不信。别用二陈芩连之
类而死。
一人虽盛暑。喜燃火。四肢常欲沸汤渍之。面赤吐痰。一似实火。吐甚。宿食亦出。惟
食椒
姜之物方快。余谓食入反出。乃脾胃虚寒。用八味丸及十全大补。加炮姜。全愈。不月平复
一伤暑与伤寒俱有发热。若误作伤寒治之。则不可也。盖寒伤形。热伤气。伤寒则外恶
寒而脉
浮紧。伤暑则不恶寒而脉虚。此为异耳。经云。脉盛身寒。得之伤寒。脉虚身热。得之伤暑
治宜小柴胡汤。渴。加知母、石膏。或人参白虎汤。天久霪雨湿令大行。苍术白虎汤。若
元气素弱。而伤之重者。清暑益气汤治之。
八味丸（见补益） 补中益气汤（见内伤） 十全大补汤（见补益） 附子理中汤（见中寒）
六味丸（见补益） 小柴胡汤 白虎汤（俱见伤寒）
Pulse that is empty (Xu), faint (Wei), fine (Xi), string-taut (Xian), knifelike (Kou), or slow (Chi) all belong to heatstroke (Zhongshu). Sweating-inducing (Han) and purgative (Xia) methods must not be used. The key lies in clearing heat (Qingre) and promoting urination (Lipainiao).
Shu (Summerheat) is the climate of intense heat during late summer. One should avoid the excessive intensity of extreme heat, adapting appropriately to the scorching environment, without exposing oneself to the blazing sun, nor causing distress to body and mind.
Those who understand the way of health preservation nourish Yin (Yin) and support Yang (Yang) in summer. Following this brings auspiciousness; opposing it brings disaster. Therefore, during the three Fu days with scorching sun and the three Shu days with steaming heat, the interstices (Couli - skin pores) open and leak, and the True Qi (Zhenqi) does not remain stored. Sun Simiao said: During late summer, it is suitable to take Schisandrae Fructus (Wuweizi), Ginseng Radix et Rhizoma (Renshen), and Ophiopogonis Radix (Maidong) to consolidate the dissipating Lung Metal (Jin). For those with insufficient True Qi, double the dosage of Ginseng Radix et Rhizoma (Renshen).
Those who are not good at health preservation sit and lie in cool, breezy places, fan themselves continuously while sleeping, wipe their bodies with cold cloths, or bathe in cool springs. Thus, cold invades the interstices, violating the seasonal timing, which is called "Injury by Summerheat" (Shangshu). When pathogenic factors hide between the muscle layer, and autumn arrives to converge Yang and return it inward, pathogen and healthy Qi struggle, causing chills and high fever. This disease is named Malaria (Nue). Some people suffer from overeating melons and fruits, liking to drink plum syrup and cold water, swallowing spring water, or loving cold soups and raw vegetables. This injures the intestines and stomach with summerheat, potentially leading to Cholera-like symptoms (Huoluan), which may linger and manifest in autumn as Dysentery (Liji) or Spleen Cold (Pi Han). These are cases where one is injured by summerheat. If one suffers from hunger and thirst on the road, or exposes oneself to summerheat when deficient, or falls ill due to climatic factors combining and overpowering, it is called "Summerheat Disease" (Shubing); deep infection is called "Heatstroke" (Zhongshu). Both present with headache, dizziness/confusion, and fever. In Cold Damage (Shanghan), there is body heat with a large pulse; only in Injury by Summerheat is there body heat with a small pulse. There is also "Summerwind" (Shufeng), characterized by coma and body stiffness/spasms, resembling Stroke (Zhongfeng). This is an extremely critical condition, likely because the person's Original Qi (Yuanqi) has always been weak and True Yin (Zhenyin) insufficient. Contracting pathogens during the time when Metal declines and Water dries leads to both internal and external deficiency. The treatment method should be clearing and tonifying, doubling the dosage of Shengmai San (Generate the Pulse Powder). Since summer is externally Yang and internally Yin, with exterior and interior lacking solidity, Qingshu Yiqi Tang (Clear Summerheat and Boost Qi Decoction) is most precise, and Xianghuo Yin (Aromatic Refreshment Drink) serves as a drug to dispel summerheat.
Discussion 1: Summerheat is the hot and dry Qi of heaven and earth. Those struck by it often experience vomiting and diarrhea, body heat, headache, irritability, and thirst. Severe cases lead to coma and loss of consciousness. If encountering such illness, one must absolutely not drink cold water or lie on damp ground. Instead, pour hot water into the mouth, wait for recovery of consciousness, and then administer medicine. In midsummer, labor and sexual indulgence must be strictly avoided. The proverb says, "Do not engage in intercourse in the sixth lunar month; it is better than moxibustion on Gao Huang." This statement is indeed true. Weak individuals should be especially cautious.
Discussion 2: Any traveler or farmer who contracts illness from working under the sun is named "Zhongre" (Middle Heat). The illness necessarily involves painful headache,燥热 (dry-heat), aversion to heat, great heat upon touching the skin, extreme thirst with desire to drink, profuse sweating, and inability to move due to lack of Qi. This is caused by heavenly heat injuring Lung Qi (Feiqi) externally. Ren Shen Bai Hu Tang (Ginseng White Tiger Decoction) should be used as the main treatment. (Formula see Shanghan chapter).
Discussion 3: Anyone contracting illness in deep halls and large buildings is named "Zhongshu" (Heatstroke). The illness necessarily involves headache, aversion to cold, body trembling and stiffness, joint pain, and heart vexation. The skin is very hot with no sweat. This is because the Yin-cold of the house suppresses the body's Yang Qi, preventing it from extending and rising. Acrid-warm agents should be used to release the exterior and scatter cold. Wu Ji San (Five Accumulations Powder) should be used as the main treatment. (Formula see Zhonghan chapter).
Discussion 4: Injury by Summerheat presents with an empty pulse and body heat, dry mouth and throat, possibly vomiting or diarrhea, or aversion to cold on the back. Generally, Summerheat injures the Heart (Xin). Since the Heart does not accept pathogens, the Pericardium (Baoluo) accepts them instead. The Ministerial Fire (Xianghuo) of the Pericardium, assisting fire with fire, leads to excess heat and coma/unconsciousness. Broadly, the principle is to clear the Heart and promote urination.
Huanglian Xiangru Yin (Coptis and Elsholtzia Decoction)
Chuan Houpo (Magnolia Bark, peeled, soaked in ginger juice and stir-fried, 5 qian), Bai Biandou (White Hyacinth Bean, lightly stir-fried, 5 qian), Xiangru (Elsholtzia Herb, cleaned, 5 qian). Add Huanglian (Coptis Rhizome), stir-fried with ginger juice, named Huanglian Xiangru San (Coptis and Elsholtzia Powder).
Grind the above into pieces for one dose. Decoct in water, add one fen of wine, clarify and cool. Take at any time. If heat causes diarrhea, severe heart vexation/heat, or vomiting/reversal, add Huanglian stir-fried with ginger juice. If hands and feet spasm and unconsciousness occurs, add Huanglian and Qianghuo (Notopterygium Rhizome). If urination is difficult, add Huashi (Talcum) and Chi Fuling (Red Poria). For vomiting, add Huoxiang (Patchouli) and Chenpi (Aged Tangerine Peel), with a little ginger juice. For retching, add Shengjiang (Fresh Ginger) and Banxia (Pinellia Tuber). For thirst, add Genge (Kudzu Root) and Tianhuafen (Trichosanthes Root). For dysentery/diarrhea, add Baizhu (Atractylodes Macrocephala Rhizome) and Fuling (Poria). For weak pulse, add Renshen (Ginseng), Wuweizi (Schisandra), and Maidong (Ophiopogon). For continuous deficiency sweating, add Huangqi (Astragalus) and Baizhu. For heart vexation/restlessness, add Zhizi (Gardenia) and Huanglian stir-fried with ginger, mixed with Chen Sha (Cinnabar powder). For fullness/stuffiness in chest and diaphragm, add Zhiqiao (Bitter Orange) and Jiegeng (Platycodon Root).
Discussion 5: Injury by summerheat due to drinking cold water and seeking coolness in the wind, resulting in incessant vomiting, is treated with Er Chen Tang (Two-Cured Decoction) combined with Xiangru Yin, adding Shengjiang (Fresh Ginger) and Wumei (Dark Plum), decocted and taken.
Discussion 6: All diseases of external contraction of Wind-Cold, Summerheat, and Dampness, and internal injuries from diet of raw/cold foods, are suitable for this formula.
Er Xiang San (Two Aromatics Powder)
Xiangru (Elsholtzia Herb, 1.2 qian), Biandou (Hyacinth Bean, stir-fried), Houpo (Magnolia Bark, stir-fried with ginger juice), Huanglian (Coptis Rhizome, stir-fried with ginger juice), Huoxiang (Patchouli), Banxia (Pinellia Tuber, stir-fried with ginger juice), Chenpi (Aged Tangerine Peel), Dafupi (Areca Peel), Jiegeng (Platycodon Root, de-rhizomed), Zisu (Perilla Leaf), Baifuling (White Poria, peeled), Cangzhu (Atractylodes Lancea Rhizome, soaked in rice wash water), Baizhi (Angelica Dahurica Root, each 1 qian), Gancao (Licorice Root, 0.2 qian).
Grind the above into pieces for one dose. Decoct with Shengjiang (Fresh Ginger) and Zao (Jujube).
Discussion 7: Critical summerheat in summer with blood in stool.
Xiangru Jiedu Tang (Elsholtzia Detoxification Decoction)
Jiu Xiangru (Old Elsholtzia Herb, 3 qian), Houpo (Magnolia Bark, stir-fried with ginger), Bai Biandou (White Hyacinth Bean, stir-fried), Shanzhi (Gardenia Fruit, stir-fried), Huanglian (Coptis Rhizome), Huangbai (Phellodendron Bark, stir-fried), Huangqin (Scutellaria Root, stir-fried, each 1 qian).
Grind the above. Decoct in water and take.
Discussion 8: Injury by summerheat with body heat, extreme thirst with desire to drink, and difficulty urinating indicates accumulated heat in the Stomach cavity (Weiwuan).
Yiyuan San (Benefit Origin Powder) (Also known as Tianshui San or Liuyi San)
Bai Huashi (White Talcum, water-ground, 6 liang), Fengan (Licorice Root, lightly stir-fried, 1 liang).
Grind into fine powder. Take 2-3 qian per dose, add a little honey, and swallow with hot water or cold water as preferred. To induce sweating, mix with Congbai Douchi Tang (Green Onion and Fermented Soybean Decoction). Alternatively, mix with raw honey to form pills the size of a bullet. Take one pill per dose, dissolved in cold water.
Discussion 9: Injury by summerheat with body heat, dry mouth, extreme thirst, mental confusion, red/scanty urine, and diarrhea indicates deficiency of Spleen and Stomach with failure of Yin-Yang differentiation. It is suitable to take:
Wuling San (Five-Ling Powder)
Zhuling (Polyporus, 2 qian), Zexie (Alisma Rhizome, 2 qian), Baizhu (Atractylodes Macrocephala Rhizome, 1.5 qian), Baifuling (White Poria, 3 qian), Rougui (Cinnamon Bark, 0.5 qian).
Grind into powder. Decoct in plain water and take. Removing Rougui from this formula names Siling San (Four-Ling Powder). Adding Yinchen (Artemisia Capillaris) names Yinchen Wuling San. Adding Chen Sha (Cinnabar) names Chensha Wuling San. Another variation adds Dahuang (Rhubarb) to treat initial dysentery, also treating accumulation/growths, food stagnation yellow, and alcohol jaundice. Dosage depends on deficiency/excess: 3 qian for more, 2 qian for less. Must decoct until 80% cooked, then add Dahuang. For Yang Du (Toxic Heat), add Shaoyao (Peony Root) and Shengma (Cimicifuga Rhizome), remove Rougui. For delirious speech, add Chen Sha (Cinnabar) and Suanzaoren (Ziziphus Seed). For headache and dizzy eyes, add Chuanxiong (Szechwan Lovage Rhizome) and Qianghuo (Notopterygium Rhizome). For cough, add Wuweizi (Schisandra) and Jiegeng (Platycodon Root). For unsettled Heart Qi, add Renshen (Ginseng) and Maidong (Ophiopogon). For excess phlegm, add Banxia (Pinellia) and Chenpi (Aged Tangerine Peel). For panting urgency, add Madouliao (Aristolochia Stem) and Sangbaipi (Mulberry Root Bark). For constipation, add Dahuang (Rhubarb) and Mangxiao (Mirabilite). For Qi masses, add Sanleng (Sparganium Tuber) and Ezhu (Curcuma Rhizome). For Heart heat, add Huanglian (Coptis) and Shilianrou (Lotus Seed Embryo). For body pain and stiffness, add Mahuang (Ephedra). For dry mouth and belching water, add Gange (Kudzu Root) and Wumei (Dark Plum). For eye yellow/alcohol jaundice and five jaundices, add Yinchen (Artemisia Capillaris), Mutong (Akebia Stem), and Huashi (Talcum). For epistaxis, add Zhizi (Gardenia) and Wumei (Dark Plum). For latent summerheat epistaxis, add Maogen (Imperata Rhizome) decoction, mixed with Baicaoshuang (Charred Grass Ash) powder. For five-palm heat like consumption, add Jiegeng (Platycodon) and Chaihu (Bupleurum Root). For phlegm and heat, add Sangbaipi (Mulberry Root Bark), Renshen (Ginseng), and Qianhu (Peucedanum Root). For edema, add Tiantingli (Descurainia Seed), Mutong (Akebia Stem), Huashi (Talcum), and Muxiang (Vladimiria Root). For hanging Kidney Qi, add Wuzhuyu (Evodia Fruit) and Zhiqiao (Bitter Orange). For Small Intestine Qi pain, add Xiaohui (Fennel Fruit) and Mutong (Akebia Stem). For cholera with tendon spasms, add Huoxiang (Patchouli) and Mugua (Chaenomeles Fruit). For difficult urination, add Mutong (Akebia Stem), Huashi (Talcum), and Cheqianzi (Plantago Seed). For panting, cough, heart vexation, and insomnia, add Ejiao (Donkey-Hide Gelatin), stir-fried. For hernia, add Xiaohuixiang (Fennel), Chuanlianzi (Szechwan Chinaberry Seed), Binglang (Areca Nut), Guangui (Cinnamon Twig), Jiang (Ginger), and Cong (Scallion). Take with a pinch of salt. For women's red sweat, add Taoren (Peach Kernel) and Mudanpi (Tree Peony Bark). For vomiting, remove Gui (Cinnamon), add Banxia (Pinellia) and Shengjiang (Fresh Ginger).
Discussion 10: Latent summerheat causing alternating chills and fever unresolved. Use Wuling San combined with Baihu Tang (White Tiger Decoction) as main treatment. After latent heat, if bathing in cold water or eating cold things, clear Qi remains in the Spleen, causing daily chills and high fever, shivering all over. Adding Rougui (Cinnamon Bark) to induce sweating resolves it.
Discussion 11: Injury by summerheat with heart vexation/thirst, difficult urination, and diarrhea. Use Xiangru San combined with Siling San, named Ruling Tang. Add Mutong (Akebia Stem) 2 qian, Huashi (Talcum) 3 qian. For internal heat and heart vexation, add Huanglian stir-fried with ginger 0.8 fen, Zhizi (Gardenia) 3 qian, mixed with Chen Sha (Cinnabar) powder. For deficiency, double Renshen (Ginseng) to 3 qian.
Discussion 12: Latent summerheat with body fatigue, mental confusion, heavy head, vomiting, and diarrhea. Suitable to take:
Shiwei Xiangru Yin (Ten-Ingredient Elsholtzia Decoction)
Huangqi (Astragalus Root, 2 qian), Renshen (Ginseng Root, 3 qian), Baizhu (Atractylodes Macrocephala Rhizome, 2 qian), Baifuling (White Poria, 2 qian), Chenpi (Aged Tangerine Peel, 2 qian), Houpo (Magnolia Bark, 1 qian), Mugua (Chaenomeles Fruit, 2 qian), Xiangru (Elsholtzia Herb, 2 qian), Biandou (Hyacinth Bean, 3 qian), Gancao (Licorice Root, 1 qian).
Grind the above. Decoct in water and take warm.
Discussion 13: Late summer damp-heat steams people. Those affected experience limb fatigue, shortness of spirit, reluctance to move, chest fullness and shortness of breath, joint pain, or high Qi with panting, body heat with vexation, subcardiac stuffiness, yellow and frequent urination, loose and frequent stools or diarrhea/thirst, loss of appetite, spontaneous sweating with heaviness, or scanty sweating. This indicates Blood is diseased first while Qi is not yet diseased. The pulse is Hong (Surging) and Huan (Relaxed). If damp-heat is not eliminated, it lingers. Although symptoms may interchange slightly, the pulse reflects combined Summerheat-Dampness. Treat with drying-clearing medicines. Use:
Qingshu Yiqi Tang (Clear Summerheat and Boost Qi Decoction)
Huangqi (Astragalus Root, honey-roasted 1 qian), Cangzhu (Atractylodes Lancea Rhizome, soaked in rice wash water 1.5 qian), Shengma (Cimicifuga Rhizome, 1 qian), Renshen (Ginseng Root), Baizhu (Atractylodes Macrocephala Rhizome, de-rhizomed), Chenpi (Aged Tangerine Peel), Shenqu (Medicated Leaven, stir-fried), Zexie (Alisma Rhizome, each 0.5 qian), Gancao (Licorice Root, roasted), Huangbai (Phellodendron Bark, wine-stir-fried), Danggui (Angelica Sinensis Root, wine-rinsed), Qingpi (Green Tangerine Peel, de-albedo), Maidong (Ophiopogon Root, de-heart), Gange (Kudzu Root, each 0.3 qian), Wuweizi (Schisandra Fruit, 9 grains).
Grind into pieces for one dose. Decoct in water and take.
Discussion 14: Fever with aversion to cold, body heaviness and pain, scanty/difficult urination, shivering with hair standing on end, cold extremities, slight exertion causes immediate heat, open mouth, dry front teeth, pulse Xian (String-taut), Xi (Fine), Xu (Empty), Chi (Slow), indicating exterior-interior middle [pathogen]. Buyi Yiqi Tang (Tonify the Middle and Boost Qi Decoction). (Formula see Neishang chapter). Based on this formula, add Xiangru (Elsholtzia) and Biandou (Hyacinth Bean). If heat, add Huangqin (Scutellaria Root).
Discussion 15: No external cold contraction, only internal injury from ice/cold water, abdominal pain and diarrhea, or cholera with vomiting/reversal. Use Lizhong Tang (Regulate the Middle Decoction), adding Shenqu (Medicated Leaven), Maiya (Barley Sprout), Cangzhu (Atractylodes Lancea Rhizome), and Sharen (Amomum Fruit). This specifically treats the interior, warming the middle and digesting food.
Discussion 16: Zhu Xia (Summer Note/Attendant Summer) belongs to Yin-Blood deficiency and insufficiency of Original Qi. In early summer/late spring, headache and blurry eyes, sore legs and soft feet, poor appetite and weak body, five-center heat, bitter taste and dry tongue, mental fatigue, weakness and desire to sleep, chest/diaphragm discomfort, appearance like consumptive emaciation, rapid but weak pulse. This is named Zhu Xia. Suitable to take:
Shen Gui Yiyuan Tang (Ginseng and Angelica Benefit Origin Decoction)
Renshen (Ginseng Root, de-rhizomed 0.5 qian), Danggui (Angelica Sinensis Root, wine-rinsed), Baishao (White Peony Root, wine-stir-fried), Huaishu Dihuang (Rehmannia Glutinosa Root, prepared), Baifuling (White Poria, peeled), Maidong (Ophiopogon Root, de-heart, each 1 qian), Wuweizi (Schisandra Fruit, 10 grains), Chenpi (Aged Tangerine Peel), Huangbai (Phellodendron Bark, wine-stir-fried), Zhimu (Anemarrhena Rhizome, wine-stir-fried, each 0.7 qian), Gancao (Licorice Root, 0.3 qian).
Grind into pieces for one dose. With one Jujube, one Dark Plum, and a pinch of stir-fried rice, decoct in water and take. For fullness, add Sharen (Amomum) and Baudoukou (Cardamom). For nausea, add Wumei (Dark Plum), Lianrou (Lotus Seed Flesh), and stir-fried rice. For hiccups, add Zhuru (Bamboo Shavings). For vexation/restlessness, add Chen Sha (Cinnabar), Suanzaoren (Ziziphus Seed), and Zhuru (Bamboo Shavings). For diarrhea, add Baizhu (Atractylodes), Shanyao (Dioscorea Rhizome), Sharen (Amomum), and Wumei (Dark Plum). Remove Shudi (Prepared Rehmannia), Zhimu (Anemarrhena), and Huangbai (Phellodendron). For short/red urine, add Mutong (Akebia Stem) and Zhizi (Gardenia). For Stomach cavity blockage and no desire to eat, add Houpo (Magnolia Bark), Baudoukou (Cardamom), Yizhiren (Alpinia Oxyphylla Fruit), Sharen (Amomum), and Lianrou (Lotus Seed Flesh). Remove Shudi (Prepared Rehmannia), Huangbai (Phellodendron), and Zhimu (Anemarrhena). For lower back pain, add Duzhong (Eucommia Bark), Poguzhi (Psoralea Fruit), and Xiaohuixiang (Fennel Fruit). For sore/weak legs, add Niuxi (Achyranthes Root) and Duzhong (Eucommia Bark). For scorched skin, add Digupi (Dogwood Root Bark). For dizzy head/eyes, add Chuanxiong (Szechwan Lovage Rhizome). For deficiency sweating, add Huangqi (Astragalus), Suanzaoren (Ziziphus Seed), and Baizhu (Atractylodes). For nocturnal emission, add Muli (Oyster Shell), Shanyao (Dioscorea Rhizome), Chen Sha (Cinnabar), and Chun Gen Pi (Toona Root Bark). For deficiency fright/vexation/heat, add Chen Sha (Cinnabar), Suanzaoren (Ziziphus Seed), and Zhuru (Bamboo Shavings). For bitter taste/dry tongue, add Zhizi (Gardenia), Wumei (Dark Plum), and Gegen (Kudzu Root).
Discussion 17: Summer months are hardest to regulate, especially on journeys. Therefore, formulas are attached to prevent summerheat toxicity, clear heat, relieve vexation, and avoid heatstroke, cholera, diarrhea, dysentery, etc.
Qushu Yiyuan Tang (Dispel Summerheat and Benefit Origin Decoction)
Renshen (Ginseng Root, 1.2 qian), Baizhu (Atractylodes Macrocephala Rhizome, de-rhizomed 1.5 qian), Wuweizi (Schisandra Fruit, 10 grains), Baishao (White Peony Root, wine-stir-fried), Maidong (Ophiopogon Root, de-heart), Gancao (Licorice Root, roasted 0.5 qian), Chenpi (Aged Tangerine Peel), Zhimu (Anemarrhena Rhizome, wine-stir-fried), Xiangru (Elsholtzia Herb, each 0.7 qian), Huangqin (Scutellaria Root, stir-fried 0.3 qian), Baifushen (White Poria Spirit, de-woody core 1 qian).
Grind the above. Decoct with Shengjiang (Fresh Ginger) and take.
Discussion 18: Injury by summerheat on journey causing watery diarrhea, abdominal pain, and extreme thirst. Travelers unaccustomed to local conditions should carry these pills in summer/autumn to prevent it.
Weiling Wan (Stomach-Ling Pill)
Cangzhu (Atractylodes Lancea Rhizome, soaked in rice wash water and stir-fried, 1 liang), Chenpi (Aged Tangerine Peel, 1 liang), Houpo (Magnolia Bark, stir-fried with ginger juice, 1 liang), Baizhu (Atractylodes Macrocephala Rhizome, de-rhizomed and earth-stir-fried, 1 liang), Baifuling (White Poria, peeled, 2 liang), Rougui (Cinnamon Bark, 5 qian), Zhuling (Polyporus, 1 liang), Zexie (Alisma Rhizome, 1 liang), Renshen (Ginseng Root, 5 qian), Huanglian (Coptis Rhizome, stir-fried with ginger juice, 1 liang), Baishao (White Peony Root, stir-fried, 1 liang), Gancao (Licorice Root, roasted, 5 qian).
Grind into powder. Make pills with refined honey, size of Sophora seeds. Take 50-60 pills per dose, washed down with clear rice soup.
Discussion 19: This formula clears Upper Jiao heat, moistens Lungs, generates fluids, and stops thirst.
Qingshang Meisu Wan (Clear Upper Mei-Su Pill)
Wumei (Dark Plum, any amount, washed clean in water, flesh half jin), Baishatang (White Sugar, half jin).
Grind into fine powder. Add Nan Bohe Tou Mo (Southern Mint Head Powder, half jin). Pound together into paste. Form pills the size of bullets. Use one pill per time, hold in mouth to dissolve. Prepare for travel; best for quenching thirst.
Qianli Meihua Wan (Thousand-Mile Plum Blossom Pill) (For long journeys)
Pipaye (Loquat Leaf), Ganye Mo (Kudzu Root Powder), Baiyaojian (Fermented Tea Brick), Wumei Rou (Dark Plum Flesh), Lamiehua (Wintersweet Flower), Gancao (Licorice Root, each 1 qian).
Grind all into powder. Use 5 liang of wax, melt wax first, add 1 liang of honey, mix with powder, pound 200-300 times. Form pills the size of chestnut. In summer long journeys, hold one pill in mouth. Saliva instantly generated, cold fragrance fills abdomen, wonderful beyond words.
One: Late summer/early autumn, heat is fierce. Do not expose back in courtyard to catch wind/coolness. Five Zang Shu points converge on the back. Having someone fan you, or exposing hands/feet, is the origin of Wind Stroke. If infected with various diseases, immediately take Bawei Wan (Eight-Ingredient Pill) to tonify/regulate viscera and resist pathogens. Still avoid "Three Whites" (likely salt, sugar, or specific white foods depending on context, here implying substances that might clash with medicine properties).
Case 1: A person had fever in midsummer, chest/back pain, sweating after drinking hot water. Used exterior-releasing drugs, leading to coma/delirium, loose stools, much phlegm. Used Shiquan Dabu Tang (Perfect Ten Tonification Decoction) for one dose, symptoms receded suddenly. Then used Buyi Yiqi Tang (Tonify Middle and Boost Qi Decoction) plus Paoyang (Roasted Ginger) for two doses, fully recovered.
Case 2: A person engaged in intercourse in summer, ate fruit, had abdominal pain. I used Fuzi Lizhong Tang (Aconite Regulate Middle Decoction) and cured him. Others with same complaint did not believe, used Er Chen Tang (Two-Cured Decoction) with Qinlian (Scutellia/Coptis) class, and died.
Case 3: A person, though in midsummer, liked burning fire, wanted to soak limbs in boiling water, red face, vomiting phlegm, seeming like Excess Heat. Vomiting was severe, old food also came out. Only felt comfortable eating pepper/ginger. I said "food enters then comes out" indicates Spleen/Stomach Deficiency-Cold. Used Bawei Wan (Eight-Ingredient Pill) and Shiquan Dabu Tang (Perfect Ten Tonification Decoction), plus Paoyang (Roasted Ginger), fully recovered. Recovered within a month.
One: Injury by Summerheat and Cold Damage both have fever. If mistakenly treated as Cold Damage, it is incorrect. Cold injures Form (Xing), Heat injairs Qi (Qi). Cold Damage has external aversion to cold and floating-tight pulse; Injury by Summerheat has no aversion to cold and empty pulse. This is the difference. Classics say: Pulse strong, body cold, acquired from Cold Damage; Pulse empty, body hot, acquired from Injury by Summerheat. Treatment should use Xiaochaihu Tang (Minor Bupleurum Decoction). If thirsty, add Zhimu (Anemarrhena) and Shigao (Gypsum). Or Renshen Baihu Tang (Ginseng White Tiger Decoction). If long rainy season with heavy dampness, Cangzhu Baihu Tang (Atractylodes White Tiger Decoction). If Original Qi is inherently weak and injury is severe, Qingshu Yiqi Tang (Clear Summerheat and Boost Qi Decoction) treats it.
Bawei Wan (Eight-Ingredient Pill) (See Tonification), Buyi Yiqi Tang (Tonify Middle and Boost Qi Decoction) (See Internal Injury), Shiquan Dabu Tang (Perfect Ten Tonification Decoction) (See Tonification), Fuzi Lizhong Tang (Aconite Regulate Middle Decoction) (See Middle Cold), Liuwei Wan (Six-Ingredient Pill) (See Tonification), Xiaochaihu Tang (Minor Bupleurum Decoction), Baihu Tang (White Tiger Decoction) (All see Shanghan chapter).