【歌】暑伤气分汗如倾，身热头疼躁不宁。所感必须分动静，阴阳二证自然明。
【论】东垣云∶静而得之曰伤暑，动而得之曰中热。富贵人避暑于凉亭广厦，为房室阴寒所遏，暑火不伸，
故曰静而得之。辛苦人负重作劳，勤耕力役，大暑行途者，此动而得之。王安道以静得者即是阴证，非暑也。
然大暑炎热流行，无所不至，虽外以风扇寒凉抑之，终非凛冽之寒邪。但
外寒遏，暑火不伸，此寒为标，热为本，故先以辛温治其标寒，继以清凉治其本热，无不愈者。若便作阴证名
之，用辛热剂可乎？学人宜临时参究脉证可也。
【脉】暑伤于气，所以脉虚。弦细芤豁，体状无余。
动而得之
冒暑作劳，身热头疼，自汗烦渴，面垢唇焦，或身如针刺，此热伤分肉也，人参白虎汤主之。素有痰火，
复冒暑气而恶心，眩晕吐呕者，黄连香薷饮主之，有痰加胆星、半夏，虚加人参。内外挟火相灼，卒倒不知人
事者，名曰暑风，此暑气入而鼓激痰火，塞碍心窍故也，治宜吐之。
人参白虎汤
治伏暑发渴，舌燥生芒刺，身热，脉虚，自汗等证。
人参（一钱半） 知母（二钱） 石膏（五钱） 甘草（炙，一钱）
上方入粳米一撮，水一钟，煎八分，不拘时服。
若腹痛吐泻饱闷者，石膏切不可用。热极，小便遗尿不止，加炒黄柏。烦躁加辰砂末、酸枣仁。
黄连香薷饮
治伏暑引饮，口燥咽干，或吐或泻。
黄连（姜炒，四两） 浓朴（姜炒，六两） 扁豆（微炒，半斤） 香薷（去土，一斤）
每服三钱，水一钟，酒少许，煎七分，沉冷，不拘时服。
若卒中昏冒僵仆，角弓反张，不省人事，手足或发搐搦，此为暑风，不可作风治，本方加羌活主之。泻利
加白术、茯苓。脉虚弱加人参、五味、麦冬。虚汗不止加黄 、白术。心烦加栀子、辰砂末。渴加干葛、天花
粉。胸满加枳壳、桔梗。小便不利加赤茯苓、滑石。呕吐加藿香、陈皮、姜汁。
十味香薷饮
消暑气，和脾胃。
香薷（一两） 人参 陈皮（炒） 白术（土炒） 黄 （蜜炙） 扁豆（炒，去壳） 甘草（炙） 浓朴
（姜炒） 木瓜 白茯（去皮，各半两） 脉虚，加麦冬、五味
上为末，每服二钱，热汤、冷水任调下。
静而得之
避暑于深堂大厦，为阴寒所遏，暑不得越，手足厥逆者，大顺散。霍乱者，六和汤、桂苓甘露饮。
大顺散
干姜（一钱，炒） 甘草（八分，蜜炒） 肉桂（去皮） 杏仁（去皮尖，各六分）
上为粗末，水煎温服，如烦躁，井花水调下。
按∶本方治夏月引饮过多，脾胃受湿，清浊相干，阴阳气逆，霍乱吐泻，腹痛脉迟者主之。用干姜、肉桂，
温胃而建中。甘草、杏仁，调脾而利气。非治暑之药，乃治饮冷受伤之剂也，若非饮冷，切勿执方。
六和汤
桂苓甘露饮（二方并见霍乱。）
达按∶暑与热，同义而异名。中暑，即中热也，何分之有？历代医家，乃有中暑、中热之分，吾不知其所
谓。假如道中行人，酷日趱程；野中农夫，暄天劳力，津竭汗尽，咽喉如烧，饥未得食，渴未得饮，劳未得息，
卒然昏冒，不省人事，身体发热，名为中热，虽谓之中暑，亦可也。至于素享富贵之人，其性不耐寒暄，每至
暑月，即池亭水阁以安其身，浮瓜沉李以供其口，环冰挥扇，以祛其热，藤箪竹床以取其凉，炎蒸不来，清风
满座，内有伏阴，外受凉气，汗不
流而肌理密，阴愈侵而阳不发，卒然昏眩，寒热交作，呕吐腹痛，乃为夏月感寒，非中暑也。法当温以理其中，
辛以散其表，不可执中暑之说，而用治暑之剂也。宜以生姜、葱白、木香、陈皮、羌活、紫苏之类。
[Song] Summerheat injuring the Qi level causes sweating profusely like pouring; body heat, headache, and restlessness. One must distinguish between "static" and "dynamic" acquisition of summerheat, making the distinction between Yin and Yang syndromes clear.
[Discussion] Li Dongyuan stated: Acquired while resting is called "Shangshu" (Injury by Summerheat); acquired during activity is called "Zhongre" (Heatstroke). Wealthy individuals seeking coolness in pavilions or spacious halls are constrained by the yin-cold of their dwellings, preventing summerfire from dispersing; this is termed "acquired statically." Laborers carrying heavy loads, farming diligently, or walking in extreme heat acquire it through movement; this is termed "acquired dynamically." Wang Andao argued that what is acquired statically is a Yin syndrome, not summerheat. However, during peak summer, heat qi circulates everywhere. Although external wind and cold may suppress it, it is ultimately not biting cold pathogen. The external cold constrains the internal summerfire, causing it to stagnate; here, cold is the branch (manifestation), and heat is the root. Therefore, one should first treat the branch cold with acrid-warm herbs, then treat the root heat with cooling herbs, leading to recovery. If one were to label it simply as a Yin syndrome and use acrid-hot formulas, would that be appropriate? Scholars should investigate pulse and symptoms at the time of treatment.
[Pulse] Summerheat injures Qi, resulting in a deficient pulse. Characteristics include wiry, fine, hollow, or wide pulses, fully describing its nature.
Acquired Dynamically (Activity-induced)
Exposure to summerheat during labor leads to body heat, headache, spontaneous sweating, irritability, thirst, dirty complexion, cracked lips, or body pain like needle pricks. This indicates heat damaging the muscle layers; Ren Shen Bai Hu Tang (Ginseng White Tiger Decoction) is indicated. For those with pre-existing phlegm-fire who develop nausea, vertigo, and vomiting upon exposure to summerheat, Huang Lian Xiang Ru Yin (Coptis and Mosla Decoction) is indicated. Add Dan Nan Xing (Arisaema cum Bile) and Ban Xia (Pinellia Tuber) for phlegm; add Ren Shen (Ginseng Root) for deficiency. When internal and external fire scorch each other, causing sudden collapse and unconsciousness, it is named "Summerwind" (Shufeng). This occurs when summerheat enters and agitates phlegm-fire, obstructing the Heart orifice. Treatment should induce vomiting.
Ren Shen Bai Hu Tang (Ginseng White Tiger Decoction)
Treats latent summerheat causing thirst, dry tongue with prickles, body heat, deficient pulse, and spontaneous sweating.
Ren Shen (Ginseng Root, 1.5 qian) Zhi Mu (Anemarrhenae Rhizoma, 2 qian) Shi Gao (Gypsum Fibrosum, 5 qian) Gan Cao (Licorice Root, processed with honey, 1 qian)
Add a pinch of Jing Mi (Oryza Sativa Var. Glutinosa, Rice Grain) to one bowl of water, decoct to 80%, take at any time.
If abdominal pain, vomiting, diarrhea, or fullness occur, avoid Shi Gao. For extreme heat with involuntary urination, add Chao Huang Bo (Phellodendri Cortex, fried). For irritability, add Chen Sha (Cinnabar powder) and Suan Zao Ren (Ziziphi Spinosomi Semen).
Huang Lian Xiang Ru Yin (Coptis and Mosla Decoction)
Treats latent summerheat leading to excessive drinking, dry mouth/throat, vomiting, or diarrhea.
Huang Lian (Coptidis Rhizoma, ginger-fried, 4 liang) Hou Po (Magnoliae Officinalis Cortex, ginger-fried, 6 liang) Bian Dou (Dolichoris Semen, lightly fried, 0.5 jin) Xiang Ru (Elsholtziae Herba, cleaned, 1 jin)
Take 3 qian per dose with one bowl of water and a little wine, decoct to 70%, let cool, take at any time.
For sudden collapse, opisthotonos, unconsciousness, or convulsions of limbs (Summerwind), do not treat as Wind disease; add Qiang Huo (Notopterygii Rhizoma et Radix) to this formula. For diarrhea, add Bai Zhu (Atractylodis Macrocephalae Rhizoma) and Fu Ling (Poria). For weak pulse, add Ren Shen, Wu Wei Zi (Schisandrae Fructus), and Mai Dong (Ophiopogonis Radix). For continuous deficiency sweating, add Huang Qi (Astragali Radix) and Bai Zhu. For mental distress, add Zhi Zi (Gardeniae Fructus) and Chen Sha. For thirst, add Ge Gen (Puerariae Lobatae Radix) and Tian Hua Fen (Trichosanthis Radix). For chest fullness, add Zhi Ke (Aurantii Fructus Immaturus) and Jie Geng (Platycodonis Radix). For difficult urination, add Chi Fu Ling (Poria with Red Skin) and Hua Shi (Talcum). For vomiting, add Huo Xiang (Agastaches Herba), Chen Pi (Citri Reticulatae Pericarpium), and Jiang Zhi (Zingiberis Rhizoma Recens Juice).
Shi Wei Xiang Ru Yin (Ten-Ingredient Mosla Decoction)
Resolves summerheat, harmonizes Spleen and Stomach.
Xiang Ru (Elsholtziae Herba, 1 liang) Ren Shen (Ginseng Root) Chen Pi (Citri Reticulatae Pericarpium, fried) Bai Zhu (Atractylodis Macrocephalae Rhizoma, earth-fried) Huang Qi (Astragali Radix, honey-fried) Bian Dou (Dolichoris Semen, fried, shelled) Gan Cao (Licorice Root, processed) Hou Po (Magnoliae Officinalis Cortex, ginger-fried) Mu Gua (Chaenomelis Fructus) Bai Fu Ling (Poria, peeled, each 0.5 liang) For deficient pulse, add Mai Dong and Wu Wei Zi.
Grind into powder. Take 2 qian per dose, mixed with hot or cold water as preferred.
Acquired Statistically (Rest-induced)
Seeking coolness in deep halls, constrained by yin-cold so summerheat cannot disperse, leading to cold extremities: Da Shun San (Great Harmony Powder). For Huoluan (Cholera-like disorder): Liu He Tang (Six-Harmony Decoction) or Gui Ling Gan Lu Yin (Cassia, Poria, and Sweet Dew Decoction).
Da Shun San (Great Harmony Powder)
Gan Jiang (Zingiberis Rhizoma, fried, 1 qian) Gan Cao (Licorice Root, honey-fried, 0.8 qian) Rou Gui (Cinnamomi Cortex, bark removed) Xing Ren (Armeniacae Semen Amarum, skin and tip removed, each 0.6 qian)
Grind into coarse powder. Decoct in water, take warm. If irritable, mix well water (Jinghua Shui) and take.
Note: This formula treats cases where excessive drinking in summer damages the Spleen/Stomach with dampness, causing turbid and clear qi to interfere, Yin/Yang reversal, leading to Huoluan, vomiting/diarrhea, abdominal pain, and slow pulse. Gan Jiang and Rou Gui warm the Stomach and support Middle Jiao. Gan Cao and Xing Ren regulate Spleen and move Qi. This is not a summerheat-resolving formula but a remedy for injury from cold drinks. Do not use rigidly unless caused by cold drinks.
Liu He Tang (Six-Harmony Decoction)
Gui Ling Gan Lu Yin (See Cholera section for both formulas.)
Commentary: Summerheat and Heat share the same meaning but different names. Zhongshu (Heatstroke) is Zhongre (Heatstroke); why distinguish them? I do not understand the distinction made by past physicians. Consider a traveler rushing under the scorching sun or a farmer laboring in the heat: fluids exhausted, sweat dried, throat burning, hungry and thirsty, unable to rest, suddenly collapsing unconscious with fever. This is Zhongre, yet calling it Zhongshu is also acceptable. Conversely, wealthy individuals intolerant of temperature changes retreat to pavilions, eat chilled fruits, fan themselves near ice, and sleep on bamboo mats. External coolness prevents heat entry, but internal Yin accumulates while Yang fails to vent. Sweat does not flow, pores close, Yin invades, Yang stagnates, leading to sudden vertigo, alternating chills/fever, vomiting, and abdominal pain. This is Winter Cold contracted in summer, not true Zhongshu. Treatment requires warming the interior and releasing the exterior with acrid herbs, such as Sheng Jiang (Zingiberis Rhizoma), Cong Bai (Allii Fistulosi Bulbus), Mu Xiang (Aucklandiae Radix), Chen Pi, Qiang Huo, and Zi Su Ye (Perillae Folium). Do not cling to the "Zhongshu" diagnosis and use summerheat-resolving agents.