吴 脉虚伤暑，得汗身凉，头眩神疲，懈言不食，溺少而痛，
生脉散合六一散主之。潞参（五钱）、麦冬（三钱）、五味（五分）、赤苓（二钱）、滑石、甘草（各六分）
荷叶（一张）、灯心（三分）、玉竹（钱半）。二服效。
族某 感暑头晕，微热额汗，左胁痞硬，汤饮格拒不下，脉濡涩，此中焦气阻湿聚。用香薷饮加减，香薷、
浓朴、杏仁、枳壳、栝蒌、橘白、半夏（姜制）、薄荷梗。二服痞硬除，热眩减。去朴、枳、蒌、夏，加栀子、
丹皮、苓、薏米、灯心，再剂而瘳。
厉氏 暑热伤气，劳倦食少，烦满口干，下部骨蒸，足心如烙，仿清暑益气汤加减。潞参、麦冬、五味、
陈皮、神曲、当归、生地、沙参、地骨皮，数服效。
李 暑症，用伤寒六经治法，致壮热烦冤，头目重胀，喉梗气窒，呼吸不利，舌白不饥。夫暑 所伤，
必脉虚少气，自汗面垢，纵有兼症，大异伤寒浮紧脉象，岂堪例治。迨失治而症加重，本症尚自显然。何者？
暑入心，故烦冤；暑挟湿，故重胀；暑犯肺，故气窒不利。叶氏所谓暑由鼻吸，必伤上焦气分，每引经义云∶
自上受者治其上，法宜辛凉微苦，廓清上焦气分，自愈。黄芩（酒炒八分）、黑山栀、橘白、郁金（磨汁。
各一钱）、栝蒌仁（麸炒）、赤苓（各二钱）、薄荷梗（八分）、沙参、薏仁（各三钱）、新荷梗（五钱）。
二服头清咽爽，烦热大减。去黄芩、郁金，加麦冬、鲜藕，渴热退而思食矣。
族某 有年，力农中 ，恶热无汗，腹痛自利，唇干肌槁，舌焦而燥，脉小数，乃热烁肌消，阳津阴液
俱涸也。经曰∶热淫于内，治以咸寒，佐以苦甘。用花粉、麦冬，沙参、黄芩（酒炒）、枳壳、白芍、丹皮、
鲜石斛、甘草，三服舌润利稀，腹不痛，身热减。去沙参、黄芩、枳壳，加青蒿、知母（酒炒）、滑石、赤苓、
生地、车前子、灯心。数服热退利止，呃逆间作，少寐，此胃虚有痰。用淡竹茹、杏仁、潞参、茯神、当归、
白芍、柿蒂、橘红、枣仁，二服呃止熟寐，又调补乃平。
族某 禀赋素弱，中年暑热伤气，神倦嗜卧，食少肢麻，闻腥欲呕，脉右虚左促。按东垣论长夏湿热损伤元
气，肢倦神少，足痿软，早晚发寒厥，日午热如火，乃阴阳气血俱不足也。此症虽未至甚，然热伤元气，
久则水不胜火，发为骨痿。先服清暑益气汤，苍术改生白术，去泽泻、升麻、干葛，加归、芍、半夏、
石斛、茯神。后服生脉散，又服大补元煎，加橘络、桑枝膏，丸服而安。
张 暑热作劳，汗泄面垢，初起吐蛔，厥阴受病，已非浅恙。消导表散，延至谵妄神昏，舌心灰而尖绛，
齿燥鼻煤，津液告涸，脉虚细涩数，邪陷营络。治者徒知下焦火亢，用黄柏、知母，苦寒直降，与心包袭入
暑邪全不相涉。更医，用羚羊角、陈海 ，泄胆热而降肺火。究竟治不中病，使热邪漫布，神明渐昏。昔人
治邪入心包，每用芳香宣窍逐秽，如至宝丹之类。若得痰热净扫，如清风卷雾，神识稍开，方不至内闭外脱。
然症险难挽，姑据理论治而已。犀角尖（磨汁冲）、连翘心、赤芍、丹皮、佩兰叶、琥珀、石菖蒲（捣汁冲）、
鲜荷梗煎服。明晨颇觉神气清爽，更酌加梨皮、灯心、麦冬、银花。煎送至宝丹，乃穷乡一时竟同返魂香，
无觅处矣。
王 脉不鼓指，渴不多饮，舌尖绛，身热语谵，肢冷溺浑赤，伏暑晚发，热深厥深之象。川连（酒制三分）、
元参、连翘、山栀、麦冬（各钱半）、石斛、梨肉、赤苓（各二钱）、灯心、滑石（各四分）。一服而手足
温，谵语息。去川连加生地，再服再汗而解。
幼儿 伏暑秋发，头痛壮热，燥渴引饮，自汗，手足心如烙，脉洪而疾，溺赤而浊。由素禀阴虚，伏邪内烁，
仲景所谓阴气先伤，阳气独发，不寒痹热，令人肌肉消烁者也。宜甘寒生津，以解热烦。用生地、知母、麦冬、
石斛、丹皮、花粉、甘草、鲜芦根、鲜荷梗，一服汗彻身凉。越日再发，觉热气由腹背上蒸，顷刻如焚，一
日夜渴饮唇干。前方去丹皮、荷梗，加石膏，一服热退。越日又发，一日两夜汗出热不解。去石膏，加鲜地黄、
绿豆皮、车前穗，又服又退。越二日，夜分又发热，势较轻，原方再加通草、滑石、青蒿，半夜热退，调理
而安。（暑必挟湿，此症历四五发，于清暑中必兼利湿，方得热退凉解。）按暑湿伤人，随发者浅，迟至秋
后为伏气，晚发者深，其候脉色必滞，口舌必腻，或微寒，或单热，头重脘痞，渴烦溺浊，午则甚，暮尤剧。
一次汗则邪一次散，比伤寒势较缓，比疟疾发无时，秋来此症最多，名曰伏暑晚发，不似风寒之邪，一汗辄解。
温热之症，投凉即安。以暑湿为熏蒸粘腻之邪，故难骤 耳。
汤氏 灼热无汗，下泻后重，舌干少润，脉缓大，乃湿热交蒸。用六一散加薄荷、青蒿、麦冬、藿香、
赤苓、石斛、绿豆皮、车前穗、灯心。一啜热退，去首四味，加猪苓、枳壳，泻止。
Wu: The pulse is deficient, indicating summerheat injury. After sweating, the body cools, but dizziness and mental fatigue persist, with reluctance to speak or eat. Urine is scanty and painful. Treatment is primarily Shengmai San (Life-Preserving Pulse Decoction) combined with Liuyi San (Six-to-One Powder). Ingredients: Radix Codonopsis Pilosae (Luparenshen, 潞参) 5 qian, Fructus Schisandrae Chinensis (Wuweizi, 五味) 5 fen, Radix Ophiopogonis Japonici (Maidong, 麦冬) 3 qian, Poria Cocos (Fuling, 茯苓) 2 qian, Talcum (Huashi, 滑石), Radix Glycyrrhizae Uralensis (Gancao, 甘草) 6 fen each, Lotus Leaf (Heye, 荷叶) 1 piece, Juncus Effusus (Dengxin, 灯心) 3 fen, Rhizoma Polygonati Odorati (Yuzhu, 玉竹) 1.5 qian. Two doses yielded results.
Relative: Summerheat sensation caused dizziness, slight fever, and sweating on the forehead. There was fullness and hardness in the left hypochondrium, with rejection of food and drink. The pulse was soggy and choppy. This indicates obstruction of Qi and accumulation of dampness in the Middle Jiao. Treatment used Xiangru Yin (Elsholtzia Decoction) modified. Ingredients: Herba Elsholtziae (Xiangru, 香薷), Cortex Magnolia Officinalis (Houpo, 浓朴), Semen Pruni Armeniacae (Xingren, 杏仁), Pericarpium Aurantii (Zhike, 枳壳), Fructus Trichosanthis (Gualou, 栝蒌), Pericarpium Citri Reticulatae (Jubai, 橘白), Rhizoma Pinelliae Ternatae (Banxia, 半夏), Caulis Menthae Haplocalycis (Boheteng, 薄荷梗). Two doses resolved the fullness and hardness, reducing fever and dizziness. Houpo, Zhike, Gualou, and Banxia were removed; Fructus Gardeniae Jasminoidis (Zhizi, 栀子), Cortex Moutan (Danpi, 丹皮), Poria Cocos (Ling, 苓), Semen Coicis (Yimi, 薏米), and Juncus Effusus (Dengxin, 灯心) were added. One more dose led to recovery.
Li family member: Summerheat damaged Qi, accompanied by fatigue, poor appetite, irritability, fullness, dry mouth, bone-steaming heat in the lower body, and burning soles. Modeled after Qingshu Yiqi Tang (Clear Summerheat and Boost Qi Decoction) modified. Ingredients: Radix Codonopsis Pilosae (Luparenshen, 潞参), Fructus Schisandrae Chinensis (Wuweizi, 五味), Radix Ophiopogonis Japonici (Maidong, 麦冬), Pericarpium Citri Reticulatae (Chenpi, 陈皮), Massae Fermentatae Medicinales (Shenqu, 神曲), Radix Angelicae Sinensis (Danggui, 当归), Radix Rehmanniae Preparata (Shengdi, 生地), Radix Glehniae (Shashen, 沙参), Cortex Lycii (Digupi, 地骨皮). Several doses yielded results.
Li: Summerheat syndrome was treated incorrectly using the Six Meridians approach for Cold Damage, resulting in high fever, irritability, heavy and distended head and eyes, throat obstruction, difficulty breathing, white tongue coating, and loss of appetite. Summerheat injury typically presents with a deficient pulse, shortness of breath, spontaneous sweating, and a greasy face. Even with concurrent symptoms, it differs significantly from the floating-tight pulse of Cold Damage. Neglecting proper treatment worsened the condition, though the primary symptoms remained clear. Why? Summerheat entering the Heart causes irritability; summerheat carrying dampness causes heaviness and distension; summerheat invading the Lung causes Qi obstruction and breathing difficulty. As Ye Tianshi stated, summerheat enters via the nose and damages the Qi aspect of the Upper Jiao. The principle is "treat the upper if affected from above," using acrid-cool and slightly bitter methods to clear the Upper Jiao Qi aspect. Prescription: Radix Scutellariae Baicalensis (Huangqin, 黄芩), Fructus Gardeniae Jasminoidis (Heishanzhi, 黑山栀), Pericarpium Citri Reticulatae (Jubai, 橘白), Radix Curcumae Longae (Yujin, 郁金), Semen Trichosanthis (Gualouren, 栝蒌仁), Poria Cocos (Chiling, 赤苓), Caulis Menthae Haplocalycis (Boheteng, 薄荷梗), Radix Glehniae (Shashen, 沙参), Semen Coicis (Yiren, 薏仁), Caulis Nelumbinis Speciosi (Xinhegeng, 新荷梗). Two doses cleared the head and throat, greatly reducing irritability and heat. Huangqin and Yujin were removed; Maidong and fresh lotus root were added. Thirst and heat subsided, and appetite returned.
Elderly Relative: An elderly farmer suffered summerheat while working, experiencing aversion to heat, anhidrosis, abdominal pain, diarrhea, dry lips, emaciation, scorched and dry tongue, and a fine-rapid pulse. This indicates heat consuming muscle and fluid, exhausting both Yang fluids and Yin essence. Following the classic principle "for excessive heat within, treat with salty-cold, assisted by bitter-sweet," the prescription included Radix Trichosanthis (Huafen, 花粉), Radix Ophiopogonis Japonici (Maidong, 麦冬), Radix Glehniae (Shashen, 沙参), Radix Scutellariae Baicalensis (Huangqin, 黄芩), Pericarpium Aurantii (Zhike, 枳壳), Radix Paeoniae Alba (Baishao, 白芍), Cortex Moutan (Danpi, 丹皮), Rhizoma Dendrobii Nobile (Xianshihu, 鲜石斛), Radix Glycyrrhizae Uralensis (Gancao, 甘草). Three doses moistened the tongue, regulated stool, stopped abdominal pain, and reduced fever. Shashen, Huangqin, and Zhike were removed; Herba Artemisiae Annuae (Qinghao, 青蒿), Radix Anemarrhenae Asphodeloides (Zhimu, 知母), Talcum (Huashi, 滑石), Poria Cocos (Chiling, 赤苓), Radix Rehmanniae Preparata (Shengdi, 生地), Semen Plantaginis (Cheqianzi, 车前子), and Juncus Effusus (Dengxin, 灯心) were added. Several doses stopped fever and diarrhea, but hiccups and insomnia appeared, indicating Stomach deficiency with phlegm. Treatment used Bamboo Shavings (Zhuru, 竹茹), Semen Pruni Armeniacae (Xingren, 杏仁), Radix Codonopsis Pilosae (Luparenshen, 潞参), Poria Cocos Cum Lignum (Fushen, 茯神), Radix Angelicae Sinensis (Danggui, 当归), Radix Paeoniae Alba (Baishao, 白芍), Persimmon Calyx (Shidi, 柿蒂), Pericarpium Citri Reticulatae (Juhong, 橘红), Semen Ziziphi Spinosae (Zaoren, 枣仁). Two doses stopped hiccups and restored sleep; further tonification led to stability.
Relative: Constitutionally weak, this middle-aged patient suffered summerheat damaging Qi, causing mental fatigue, lethargy, poor appetite, limb numbness, and nausea at the smell of fish. The right pulse was deficient, the left rapid. According to Li Dongyuan, damp-heat in late summer damages Yuan Qi, causing limb fatigue, weakness, cold extremities in morning/evening, and intense heat at noon, indicating deficiency of Yin-Yang and Qi-Blood. Although not severe, prolonged heat damage to Yuan Qi can lead to Water failing to control Fire, resulting in bone痿 (Guwei, 骨痿). First, Qingshu Yiqi Tang was given, replacing Cangzhu with Baizhu, removing Ze Xie, Shengma, and Gegen, adding Danggui, Baishao, Banxia, Shihu, and Fushen. Subsequently, Shengmai San and Dabu Yuanyin Jian were taken, plus Juluo and Sangzhigao, prepared as pills for safety.
Zhang: Summerheat exertion caused sweating and a greasy face. Initial vomiting of roundworms indicated Jueyin involvement, a serious condition. Digestive resolving and exterior-releasing treatments delayed care, leading to delirium, coma, gray tongue center, crimson tip, dry teeth, black nostrils, exhausted fluids, and a deficient-thin-choppy-rapid pulse, indicating pathogen sinking into Ying and Collaterals. Physicians mistakenly focused on Lower Jiao fire, using bitter-cold herbs like Huangbai and Zhimu, irrelevant to Summerheat invading the Pericardium. Another physician used Antelope Horn and Sepia Shell to drain Gallbladder heat and descend Lung fire, failing to address the core issue, allowing heat to spread and consciousness to fade. Ancient texts recommend aromatic orifices-opening agents like Zhibao Dan for pathogen entering the Pericardium. If phlegm-heat is cleared, consciousness may return. However, the case was critical. Prescription: Rhinoceros Horn Tip (Xijiaojian, 犀角尖), Forsythia Fruit (Lianqiaoxin, 连翘心), Red Peony Root (Chishao, 赤芍), Cortex Moutan (Danpi, 丹皮), Herba Eupatorii Fortunei (Peilan, 佩兰), Succinum (Hupo, 琥珀), Rhizoma Acori Tatarinowii (Shichangpu, 石菖蒲), Caulis Nelumbinis Speciosi (Xinhegeng, 鲜荷梗). Next morning, spirit refreshed. Pear skin, Dengxin, Maidong, and Jinnyinhua were added. Zhibao Dan was administered but unavailable.
Wang: Pulse did not beat strongly against fingers, thirst with little desire to drink, crimson tongue tip, fever, delirium, cold limbs, turbid red urine. This is latent summerheat manifesting in the evening, indicating deep heat with deep cold extremities. Prescription: Radix Coptidis Chinensis (Chuanlian, 川连), Radix Scrophulariae Ningpoensis (Yuanshen, 元参), Forsythia Fruit (Lianqiao, 连翘), Fructus Gardeniae Jasminoidis (Shanzhi, 山栀), Radix Ophiopogonis Japonici (Maidong, 麦冬), Rhizoma Dendrobii Nobile (Shihu, 石斛), Pear Flesh (Lirou, 梨肉), Poria Cocos (Chiling, 赤苓), Juncus Effusus (Dengxin, 灯心), Talcum (Huashi, 滑石). One dose warmed limbs and stopped delirium. Chuanlian was removed, Shengdi added. Second dose induced sweating and resolution.
Toddler: Latent summerheat manifested in autumn with headache, high fever, dry thirst, spontaneous sweating, burning soles/palms, and rapid-large pulse with turbid red urine. Due to innate Yin deficiency, latent pathogen scorched internally. As Zhang Zhongjing stated, Yin is injured first, Yang acts alone, causing non-chill bi-heat and muscle wasting. Sweet-cold methods to generate fluids were used. Prescription: Radix Rehmanniae Preparata (Shengdi, 生地), Radix Anemarrhenae Asphodeloides (Zhimu, 知母), Radix Ophiopogonis Japonici (Maidong, 麦冬), Rhizoma Dendrobii Nobile (Shihu, 石斛), Cortex Moutan (Danpi, 丹皮), Radix Trichosanthis (Huafen, 花粉), Radix Glycyrrhizae Uralensis (Gancao, 甘草), Fresh Reed Rhizome (Xianlugen, 鲜芦根), Caulis Nelumbinis Speciosi (Xianhegeng, 鲜荷梗). One dose stopped fever with sweat. Recurrence next day with steaming heat from abdomen/back. Gypsum was added to the formula, stopping fever. Further recurrences required adjustments with fresh Rehmannia, mung bean peel, and plantago spikes. Finally, Tongcao, Huashi, and Qinghao were added, resolving fever by midnight. Note: Summerheat always carries dampness; clearing summerheat must include draining dampness. Summer-damp pathogens are sticky and hard to resolve quickly compared to wind-cold.
Tang family member: Burning heat without sweat, dysentery with tenesmus, dry tongue, slow-large pulse. This is damp-heat steaming. Prescription: Liuyi San (Six-to-One Powder) with Mint, Qinghao, Maidong, Huoxiang, Chiling, Shihu, mung bean peel, Cheqiansui, and Dengxin. One dose stopped fever. First four herbs removed; Zhu Ling and Zhike added to stop diarrhea.