伤暑热久，杳不知饥，舌干或赤或黑，而无苔
腻，此镜面舌也。以热劫胃津，气不化液。宜用西洋
参、麦冬、霍山斛、知母、白芍、木爪、建莲肉、鲜
谷芽、甘草等味，甘酸化阴也。
凡热病之后，舌干赤而光洁无苔者，此名镱面舌，无论
病祥如何，总宜滋阴为主。若黑而干赤无苔，此为无地之
黑，乃阴伤液涸，急宜甘凉补阴。故用洋参、甘草、麦冬、
谷芽，合白芍、木爪甘酸化阴，即甲己化土之义也;若见焦
黑，热势尤甚，宜加生地、知母柔阴和阳。法虽如斯，而神
机变化，则存乎其人焉。
伤暑日多，身无大热，脉软神疲，默默如寐，唤
之略应，并不烦躁，此邪正混淆，湿浊蒙蔽，清补两
难。惟用鲜藿香叶、鲜稻叶、鲜荷叶，鲜佩兰叶，鲜
菖蒲，白蔻仁、益元散等味，辛凉清解，以化余邪
也。
身不大热，脉软神疲，乃病退之象。但默默欲寐，唤亦
不苏，与饮则饮，不与不索，此余邪蒙绕三焦，清阳不得舒
转。清之则损其阳，补之则助其湿，最为两难。惟宜藿香
叶、稻叶、枫兰叶、荷叶、菖蒲，俱用鲜者，取其质轻气
薄，芳香驱浊，更加白寇仁、益元散，通阳宜气，俾正不伤
而湿可祛也。
伤暑汗多身热，经旬不解，胸腹发出白瘖，状如
水晶粒，此湿邪化热，气液外泄。急宜洋参、连翘、
甜杏、花粉，骨皮、银花、麦冬、绿豆壳、鲜荷叶等
味，清养气液也。
身热汗多，而病不肯解，正气已虚，又见白瘖，是气液
外泄，不可再用疏散，以伤其气。惟宜洋参、麦冬、银花、
绿豆壳，清养气液而又兼化邪也。若舌红少津，而食不甘
味，即以复脉汤去姜桂，养阴益气。更有舌淡少苔，而胃不
加纳，当以六君子汤加牡蛎、白芍扶胃敛阴，勿因见瘖而踌
躇莫进。近时医辈，都以治痧之法治瘖。不知痧为太阴风
热，斑为阳明火毒，其初见隐隐，固宜清之透之，若已见点
粒，即宜解之化之，尚不敢恣意透泄，以虚其内，而恐邪陷
莫救也。至白瘖乃气液外泄之候，若既现而再行疏泄透汗，
其不致气悦而毙者几希矣。予见知医之辈，不惟青年浅见者
蹈此流弊，即皓首老成者，尚难观觑破此关，故并及之，以质
诸高明，为是否耶?
伤暑热日久，完全不知道饥饿，舌面干燥，颜色或红或黑，但没有腻苔，这就是镜面舌。这是因为热邪劫夺了胃中的津液，导致气无法化生为津液。适宜使用西洋参、麦冬、霍山石斛、知母、白芍、木瓜、建莲肉、鲜谷芽、甘草等药物，这是利用甘味与酸味化合以滋生阴液的方法。
凡是热病之后，舌面干燥、发红且光洁无苔的，这叫镜面舌，无论病情如何，总宜以滋阴为主。如果舌色黑而干赤无苔，这称为“无地之黑”，是阴伤液竭的表现，急需使用甘凉药物来补阴。所以用西洋参、甘草、麦冬、谷芽，配合白芍、木瓜，通过甘酸化阴的方法，即体现了甲己化土（脾土）的道理；如果见到焦黑色，热势更加严重，适宜加入生地、知母来柔润阴液、调和阴阳。方法虽然如此，但神机的变化运用，则取决于医生个人的悟性与能力。
患伤暑多日，身体没有大热，脉象软弱，精神疲倦，沉默寡言如同睡眠，叫醒后稍微应答，并不烦躁，这是邪气与正气混淆，湿浊之气蒙蔽清窍，清热与补益都难以施治。只有使用鲜藿香叶、鲜稻叶、鲜荷叶、鲜佩兰叶、鲜石菖蒲、白蔻仁、益元散等药物，采用辛凉清解的方法，以化解残留的邪气。
身体不大热，脉象软弱精神疲倦，这是病邪退去的迹象。但是沉默想要睡觉，叫醒也不能清醒，给喝水就喝，不给也不索要，这是残留的邪气缠绕三焦，清阳之气不能舒展运转。清热则会损伤阳气，补益则会助长湿气，最为两难。只适宜使用藿香叶、稻叶、枫兰叶、荷叶、石菖蒲，都要用新鲜的，取它们质地轻、气味薄的特点，芳香以驱除浊气，再加上白蔻仁、益元散，通利阳气、宣畅气机，使得正气不受伤而湿气可被祛除。
伤暑出汗多且身体发热，经过十天仍不解除，胸腹部出现白瘖，形状像水晶颗粒，这是湿邪化为热邪，气与津液外泄。急需使用西洋参、连翘、甜杏仁、天花粉、地骨皮、金银花、麦冬、绿豆壳、鲜荷叶等药物，以清养气与津液。
身体发热出汗多，而病不肯好，正气已经虚弱，又出现白瘖，这是气与津液外泄，不可再用疏散发汗的方法，以免进一步损伤正气。只适宜用西洋参、麦冬、金银花、绿豆壳，清养气津而又兼能化解邪气。如果舌红少津，吃东西觉得无味，就用复脉汤去掉生姜、桂枝，以养阴益气。更有舌淡少苔，而胃不能受纳饮食的，应当用六君子汤加牡蛎、白芍来扶助胃气、收敛阴液，不要因为看到白瘖就犹豫不前。近时的医生，都用治疗痧证的方法来治疗白瘖。不知道痧证是太阴风热，斑疹是阳明火毒，初起时隐约可见，固然适宜清热透发；如果已经出现点粒，就适宜解毒化解，尚且不敢肆意透泄，以免使内部空虚，恐怕邪气内陷无法救治。至于白瘖，是气液外泄的征候，如果已经显现再行疏泄透汗，那不至于因气绝而死的情况是很少见的。我见过懂医的人，不仅是年轻见识浅的人犯这种弊端，就是头发花白的老成医生，也难以看破这一关，所以一并提及，以此请教高明之士，不知是否如此？
After prolonged heat from summerheat, one feels no hunger at all; the tongue is dry, appearing red or black, yet lacks a greasy coating. This is known as a "mirror tongue." It results from heat devouring stomach fluids, causing Qi to fail in transforming into fluids. It is appropriate to use American ginseng (Radix Panacis Quinquefolii), Ophiopogon tuber (Ophiopogonis Radix), Huoshan Dendrobium (Dendrobii Officinalis Caulis), Anemarrhena rhizome (Anemarrhenae Rhizoma), White peony root (Paeoniae Radix Alba), Quince fruit (Chaenomelis Fructus), Jian lotus seed flesh (Nelumbinis Semen), fresh rice sprout (Hordei Fructus Germinatus), and licorice root (Glycyrrhizae Radix et Rhizoma). This employs the method of combining sweet and sour flavors to generate Yin.
Following any febrile disease, if the tongue is dry, red, smooth, and devoid of coating, it is termed a mirror tongue. Regardless of the specific condition, nourishing Yin should always be the primary approach. If the tongue is black, dry, and red without coating, this is called "blackness without ground," indicating severe Yin injury and fluid exhaustion. Urgent treatment with sweet-cool Yin-nourishing herbs is required. Thus, American ginseng, licorice, Ophiopogon, and rice sprouts are combined with White peony and Quince to generate Yin via the sweet-sour method, embodying the principle of Jia-Ji transforming into Earth (Spleen-Stomach). If scorched-black color appears with even more intense heat, Rehmannia root (Rehmanniae Radix) and Anemarrhena should be added to moisten Yin and harmonize Yang. Although the methods are thus defined, the subtle application depends entirely on the practitioner's insight.
After many days of summerheat illness, there is no significant fever, the pulse is soft, and spirit is fatigued. The patient remains silent and lethargic, resembling sleep, responding only slightly when called, without irritability. This indicates confusion between pathogenic factors and healthy Qi, with damp-turbidity obscuring the clear orifices, making both clearing and tonifying difficult. One should exclusively use fresh Agastache leaf (Agastaches Herba), fresh rice leaf (Oryzae Sativa Folium), fresh lotus leaf (Nelumbinis Folium), fresh Eupatorium leaf (Eupatorii Herba), fresh Acorus rhizome (Acori Tatarinowii Rhizoma), white cardamom seed (Cardamomi Fructus), and Yiyuan San (Benefit Origin Powder). These employ acrid-cool clearing and resolving methods to transform residual pathogens.
Absence of high fever, soft pulse, and fatigue indicate that the disease is receding. However, silence and desire to sleep, inability to fully awaken upon calling, drinking only when offered but not seeking water otherwise, suggest residual pathogens lingering in the Triple Burner, preventing the free movement of Clear Yang. Clearing would damage Yang, while tonifying would aid dampness, presenting a dilemma. It is best to use fresh Agastache, rice leaves, Eupatorium, lotus leaves, and Acorus, utilizing their light texture and thin aroma to drive out turbidity. Combined with white cardamom and Yiyuan San, they unblock Yang and promote Qi circulation, ensuring healthy Qi is not harmed while dampness is dispelled.
With summerheat, excessive sweating, and persistent fever for over ten days, white miliary pruritus (Bai Fan) appears on the chest and abdomen, resembling crystal grains. This indicates damp-heat transforming and the leakage of Qi and fluids. Urgent treatment requires American ginseng, Forsythia fruit (Forsythiae Fructus), sweet apricot kernel (Armeniacae Semen Amarum), Trichosanthes root (Trichosanthis Radix), wolfberry bark (Lycii Cortex), honeysuckle flower (Lonicerae Japonicae Flos), Ophiopogon, mung bean shell (Phaseoli Radiati Testa), and fresh lotus leaf to clear and nourish Qi and fluids.
Persistent fever and sweating with failure to recover indicate depleted healthy Qi. The appearance of Bai Fan signifies leakage of Qi and fluids; dispersing methods must not be used further to avoid damaging Qi. Instead, American ginseng, Ophiopogon, honeysuckle, and mung bean shell should be used to clear and nourish Qi/fluids while resolving pathogens. If the tongue is red with scanty fluids and food tastes bland, use Fu Mai Tang (Pulse-Recovering Decoction) minus Ginger and Cinnamon Twig to nourish Yin and benefit Qi. If the tongue is pale with scanty coating and the Stomach fails to accept food, use Liu Jun Zi Tang (Six Gentlemen Decoction) plus Oyster shell (Concha Ostreae) and White Peony to support Stomach Qi and astringe Yin. Do not hesitate due to the presence of Bai Fan. Contemporary physicians often treat Bai Fan using methods for Sha syndrome (sand/heat stroke rash). They fail to recognize that Sha syndrome involves Wind-Heat of the Taiyin, while macules/petechiae involve Fire-Toxin of the Yangming. Early faint appearances warrant clearing and venting; once distinct spots appear, resolution and transformation are needed. Even then, aggressive venting is avoided to prevent internal emptiness and pathogen collapse. Bai Fan, however, is a sign of Qi and fluid leakage. Applying dispersing and diaphoretic methods after its appearance risks fatal Qi exhaustion. I have observed that not only young, inexperienced practitioners fall into this error, but even seasoned elderly doctors struggle to discern this distinction. I mention this to seek the opinion of experts.