暑有分阳暑阴暑,如冰炭之不兼容,人莫不知之。然静而得之为中暑,动而得之为中热。阳暑者,因暑受热
之意,是阳暑即为中热也。阴暑者,因暑受寒之意,是阴暑即为中暑也。经曰∶气虚身热,得之伤暑。婴儿之患,
于长夏为尤甚,盖火土最旺于长夏,正当金木受伤,稚阳甚微,已失天和,兼之有暑即有热,阳气浮于外,生冷
戕其中,夏失长养,而欲保其生全,是不能不加意讲求伤暑之病。
膏粱之儿,日在深堂广厦之中,畏热贪凉,不谨衣被,致寒邪袭于肌表,其得病因暑而受寒也。初起头痛无汗,
恶寒身体拘急,四肢酸痛。古法主五积散(如白芷、广皮、浓朴、桔梗、枳壳、川芎、白芍、茯苓、白术、当归、
半夏、桂枝、炮姜、炙甘草,生姜、枣为引)。
〔真按〕小儿易虚易实之体,虽因暑受寒,亦不宜温散,若五积散更非所宜,但用鲜荷叶一角,扁豆皮一
钱,川浓朴八分,滑石三钱,生甘草五分,长流水煎服,即愈。盖因暑中之寒化,而暑亦随之而俱化也。
藜藿之儿,常在烈日之中,坐于热地之上,其得病因暑而受热也。初起发热头痛,烦燥大渴大汗,脉洪滑,
大便干结,小便赤痛。古法主白虎汤(如石膏、知母、甘草、粳米为引)。脉虚烦渴而少气者,主白虎加人参。
若眩晕者,主生脉散(如人参、麦冬、北五味),水煎服。
〔真按〕症属阳暑,热焰沸张,须防引动肝风,则发搐厥,治宜以清暑涤热为法。但用连翘壳、淡竹叶各
钱半,青蒿一钱,黑栀子五分,飞滑石三钱,赤芍一钱,鲜荷叶一角为引,服之。斯热解而暑无不解矣。
暑病分为阳暑和阴暑,二者性质截然不同,如同冰与炭互不相容,这是人们所共知的。然而,在静处所得的称为“中暑”,在活动劳作中所得的称为“中热”。所谓阳暑,是指因感受暑邪而受热,所以阳暑即为中热;所谓阴暑,是指因感受暑邪而受寒,所以阴暑即为中暑。《内经》说:“气虚身热,得之伤暑。”婴儿患病,在长夏季节尤为严重,因为火土之气在长夏最旺盛,此时正值金木二脏受伤,小儿阳气稚嫩微弱,已经失去阴阳调和的状态,加之有暑必有热,阳气浮越于体表,若再食用生冷食物损伤脾胃,导致夏季未能正常生长养护,想要保全其生命健康,就不能不仔细探究伤暑这一病症。
富贵人家的孩子,整天待在深宅大院之中,畏惧炎热贪图凉爽,穿衣盖被不慎,导致寒邪侵袭肌表,他们的病因是因暑天而受寒。初起时头痛无汗,怕冷身体拘紧僵硬,四肢酸痛。古法主要使用五积散(包含白芷、陈皮、厚朴、桔梗、枳壳、川芎、白芍、茯苓、白术、当归、半夏、桂枝、炮姜、炙甘草,以生姜、大枣为药引)。
〔陈守真按〕小儿体质容易虚也容易实,虽然是因为暑天受寒,也不宜使用温燥发散的方法,像五积散就更不适宜了,只需用鲜荷叶一角,扁豆皮一钱,川厚朴八分,滑石三钱,生甘草五分,用长流水煎服,即可痊愈。这是因为暑中的寒邪化解,暑邪也随之一起化解了。
贫苦人家的孩子,常在烈日下活动,坐在热地上,他们的病因是因暑天而受热。初起时发热头痛,烦躁大渴大汗,脉象洪大滑数,大便干结,小便赤痛。古法主要使用白虎汤(包含石膏、知母、甘草、粳米为引)。如果脉象虚弱、烦渴且少气,主要使用白虎加人参汤。如果有眩晕症状,主要使用生脉散(包含人参、麦冬、北五味子),水煎服。
〔陈守真按〕此症属于阳暑,热势炽盛张扬,必须防止引动肝风,从而发生抽搐厥逆,治疗应当以清暑涤热为法则。只需用连翘壳、淡竹叶各一钱半,青蒿一钱,黑栀子五分,飞滑石三钱,赤芍一钱,以鲜荷叶一角为引,服用这些药物。这样热解除了,暑邪也就没有不解的了。
Summerheat is divided into Yang summerheat and Yin summerheat; their natures are mutually exclusive, like ice and charcoal, a fact well known to all. However, that which is contracted while at rest is termed "Zhong Shu" (Heatstroke), while that which is contracted during movement or labor is termed "Zhong Re" (Heat Exhaustion). Yang summerheat refers to contracting heat due to summerheat, thus Yang summerheat is equivalent to Zhong Re. Yin summerheat refers to contracting cold due to summerheat, thus Yin summerheat is equivalent to Zhong Shu. The Classics state: "Qi deficiency with body heat results from injury by summerheat." Infants suffer particularly severely during the late summer season, as Fire and Earth Qi are most vigorous then, causing injury to Metal and Wood organs. Their Yang Qi is tender and weak, having already lost harmony between Ying and Wei (Defensive and Nutritive Qi). Furthermore, where there is summerheat, there is heat; Yang Qi floats on the exterior, and if cold and raw foods damage the interior, failing to nourish the body in accordance with the summer growth phase, preserving life requires careful study of diseases caused by summerheat injury.
Children of affluent families, living deep within large mansions, fearing heat and seeking coolness, neglect proper clothing and bedding, leading to Cold Evil invading the muscle layer. Their etiology is contracting cold due to summerheat. Initial symptoms include headache, absence of sweating, aversion to cold, bodily stiffness and tightness, and soreness and pain in the four limbs. Ancient methods primarily prescribe Wuji San (Five Accumulations Powder) (containing Bai Zhi, Chen Pi, Hou Po, Jie Geng, Zhi Ke, Chuan Xiong, Bai Shao, Fu Ling, Bai Zhu, Dang Gui, Ban Xia, Gui Zhi, Pao Jiang, Zhi Gan Cao, with Sheng Jiang and Da Zao as guides).
[Chen Shouzhen's Note] Children have constitutions prone to both deficiency and excess. Although the cause is cold contracted during summerheat, warm and dispersing methods are not suitable, and Wuji San is especially inappropriate. Instead, use one piece of fresh He Ye (Lotus Leaf), one qian of Bian Dou Pi (Vigna Angularis Peel), eight fen of Chuan Hou Po (Magnolia Bark), three qian of Hua Shi (Talcum), and five fen of Sheng Gan Cao (Raw Licorice Root), decocted in flowing water for administration, which will result in recovery. This is because the cold within the summerheat transforms, and the summerheat transforms along with it.
Children of humble families, often exposed to scorching sun and sitting on hot ground, contract heat due to summerheat. Initial symptoms include fever, headache, irritability, excessive thirst, profuse sweating, a surging and slippery pulse, dry and bound stools, and painful, red urine. Ancient methods primarily prescribe Bai Hu Tang (White Tiger Decoction) (containing Shi Gao, Zhi Mu, Gan Cao, Jing Mi as a guide). If the pulse is deficient with irritability, thirst, and shortness of breath, Bai Hu Jia Ren Shen Tang (White Tiger Decoction plus Ginseng) is indicated. If dizziness occurs, Sheng Mai San (Generate the Pulse Powder) (containing Ren Shen, Mai Dong, Bei Wu Wei Zi) is indicated, decocted in water.
[Chen Shouzhen's Note] This syndrome belongs to Yang summerheat, with blazing heat. One must guard against stirring up Liver Wind, which could lead to convulsions and syncope. Treatment should employ clearing summerheat and purging heat. Use Lian Qiao Qiao (Forsythia Husk) and Dan Zhu Ye (Lophatherum Herb) each 1.5 qian, Qing Hao (Artemisia Annua) 1 qian, Hei Zhi Zi (Black Gardenia Fruit) 0.5 qian, Fei Hua Shi (Prepared Talcum) 3 qian, Chi Shao (Red Peony Root) 1 qian, with one piece of fresh He Ye (Lotus Leaf) as a guide. Upon ingestion, the heat resolves, and consequently, the summerheat is entirely resolved.