论注夏
天师曰∶坚治者，怠惰不振，用坚药以坚其气，或坚其骨也。坚气者，如人夏月无阴，到三伏之
时，全无气力，悠悠忽忽，惟思睡眠，一睡不足再睡，再睡不足，则懒于语言，或梦遗不已，或夜热不
休者是也。此皆肾水泄于冬天，夏月阳胜，阴无以敌，所以如此。必须峻补其肾水，水足而骨髓充满，
则骨始有力，而气不下陷矣。方用熟地一两，山茱萸四钱，北五味一钱，麦门冬三钱，白芍三钱，当归二
钱，白术三钱，茯苓一钱，陈皮一钱，生枣仁二钱，芡实三钱，水煎服。方名软坚汤。得此方妙在纯是补
阴，而全无坚治之法，然坚之意已寓于中矣。盖骨空则软，补其骨中之髓，则骨不坚而坚也。此方之妙，
可以治以上之气软骨软，无不全愈，终不必再立坚骨之法也。
此亦有凡小儿十岁以上，十岁以下，天癸水未至，亦有患前症者，岂皆冬不藏精之故耶？而非然也。
盖小儿最不忌口，一见瓜果凉热之物，尽意饱啖；久则胃气弱矣，再则脾气坏矣，又肾气寒矣，遂至肾水
耗去，亦如冬不藏精之症。方又不可全用前方，当以补胃补脾补肾三经为主，不可纯用补肾一经之味也。
方用白术一钱，茯苓一钱，熟地三钱，北五味五分，麦冬一钱，当归一钱，白芍二钱，陈皮三分，山
楂三粒，枳壳二分，人参五分。水煎服。（〔批〕健脾生水汤。）一剂立愈，不必再服也。此方脾肺肾
俱为统治，而又平肝木，肝既得养，则心亦泰然。此五脏皆用补剂，而小儿纯阳，尤易奏功，不若大人
之必须多服也，夏天小儿最宜服一二剂，再无注夏之病。此又坚治之一法，留心儿科者，幸察之。
张公曰∶坚治法妙。
华君曰∶君多小儿症治。
[Commentary: Zhu Xia (Summer Lethargy)]
The Heavenly Master said: The so-called "Jian Zhi Fa" (Method of Strengthening) is used for symptoms of lethargy and lack of vigor. It employs herbs with "strengthening" properties to consolidate the Zheng Qi (Upright Qi) or strengthen the bones. Regarding "consolidating Qi," it refers to situations where, in summer lacking Yin essence, during the San Fu days (the hottest period of the year), one feels completely devoid of strength, spiritless and vague, desiring only sleep. One sleep is insufficient, followed by another, yet still not relieved, leading to reluctance to speak, frequent nocturnal emissions, or persistent night fever. These conditions arise because the Kidney Water (Kidney Yin) was depleted in winter; thus, in summer when Yang is excessive, there is insufficient Yin to counteract it. Therefore, one must vigorously tonify the Kidney Water. Once the water is sufficient, the bone marrow becomes full, the bones gain strength, and the Qi no longer sinks. The prescription consists of Shu Di Huang (Prepared Rehmannia Root) 1 liang, Shan Zhu Yu (Cornus Fruit) 4 qian, Bei Wu Wei Zi (Schisandra Berry) 1 qian, Mai Men Dong (Ophiopogon Tuber) 3 qian, Bai Shao (White Peony Root) 3 qian, Dang Gui (Angelica Sinensis) 2 qian, Bai Zhu (Atractylodes Rhizome) 3 qian, Fu Ling (Poria) 1 qian, Chen Pi (Tangerine Peel) 1 qian, Sheng Suan Zao Ren (Ziziphus Seed) 2 qian, and Qian Shi (Euryale Seed) 3 qian. Decoct in water and take orally. This formula is named Ruan Jian Tang (Softening and Strengthening Decoction). The brilliance of this formula lies in its pure Yin-tonifying nature, without explicitly employing a "strengthening" method; however, the intent of strengthening is embedded within it. When bones are empty, they appear soft; by replenishing the marrow within the bones, the bones become strong despite appearing soft. The efficacy of this formula can cure all aforementioned conditions related to Qi deficiency and bone softness, ensuring complete recovery, thereby eliminating the need to establish separate methods for strengthening bones.
This condition also occurs in children aged ten and above or ten and below, whose Tian Gui (Reproductive Essence/Menstruation) has not yet arrived, yet they suffer from the aforementioned symptoms. Is this solely due to failing to store essence in winter? Not necessarily. Generally, children do not observe dietary restrictions; upon seeing fruits and melons or other cold/hot foods, they eat to satiety. Over time, the Stomach Qi weakens, then the Spleen Qi deteriorates, and subsequently the Kidney Qi becomes cold, leading to the depletion of Kidney Water, mimicking the syndrome caused by failing to store essence in winter. In such cases, the previous formula cannot be used entirely. The treatment should focus on tonifying the Stomach, Spleen, and Kidney meridians, rather than using only Kidney-tonifying herbs exclusively. The prescription consists of Bai Zhu (Atractylodes Rhizome) 1 qian, Fu Ling (Poria) 1 qian, Shu Di Huang (Prepared Rehmannia Root) 3 qian, Bei Wu Wei Zi (Schisandra Berry) 5 fen, Mai Dong (Ophiopogon Tuber) 1 qian, Dang Gui (Angelica Sinensis) 1 qian, Bai Shao (White Peony Root) 2 qian, Chen Pi (Tangerine Peel) 3 fen, Shan Zha (Hawthorn Fruit) 3 pieces, and Zhi Ke (Bitter Orange Fruit) 2 fen. Decoct in water and take orally. [Commentary: Jian Pi Sheng Shui Tang (Spleen-Strengthening and Water-Generating Decoction)]. One dose brings immediate cure, and further doses are unnecessary. This formula simultaneously regulates the Spleen, Lung, and Kidney, while also pacifying the Liver Wood. Once the Liver is nourished, the Heart becomes tranquil. Although this formula uses tonics for all five Zang organs, children possess a "Pure Yang" constitution, making them more responsive to treatment compared to adults who require prolonged administration. For children in summer, taking one or two doses prevents "Zhu Xia" disease. This represents another aspect of the Jian Zhi (Strengthening) method. Pediatric practitioners should pay close attention to this.
Master Zhang said: The Jian Zhi Fa (Method of Strengthening) is excellent.
Lord Hua said: You have treated many pediatric cases.