夏日炎炎，耗伤元气。故病必体倦脉弱，身热自汗，烦躁，面垢唇青。李东垣以动而得
之为中热，静而得之为伤暑，热阳而暑阴也。其实未确。盖以暑字从日，暑即热也，何必分
名。但动静二字，是阴阳分别。兹仍分动以得之、静以得之，以为此症提纲。
何谓动以得之？长途赤日，荷重作劳，因而致病。如大热（伤暑而发热头痛与伤寒症同，
但伤寒脉浮而紧，伤暑脉洪而虚，以此为辨。香薷是解表却暑之药，夏日之用香薷与冬日之
用麻黄同义也。）大渴，脉浮自汗，以白虎人参汤主之。更加身体重着，是暑而挟湿，宜苍
术白虎汤主之。若有吐泻腹痛，此方不可轻用也。若前症发热身疼，口燥咽干，或吐或泻，
宜黄连香薷饮主之。又有暑风症，因暑气鼓激痰火，塞碍心窍，以致卒倒不省人事，宜吐之
，或以《千金》消暑丸灌之。
白虎汤（见《伤寒》）
一加人参二钱，名白虎人参汤。治汗出恶热、身热大渴等症；
一加苍术二钱，名苍术白虎汤，治汗出身热足冷等症。
黄连香薷饮（方见《时方》）
去黄连，名香薷饮。治同。
暑风发搐，加羌活、秦艽各一钱；泻利，加白术、茯苓各一钱五分；虚汗不止，加白术
一钱五分、炙黄 三钱；心烦，加栀子、朱砂各一钱；呕吐，加半夏二钱，藿香、陈皮各八
分，姜汁少许。
何谓静以得之？避暑于深堂大厦，为阴寒所遏，暑不得越。手足厥逆者，大顺散主之；
霍乱吐泻口渴者，五苓散主之；不渴者，理中汤主之。亦有以二汤送下六一散三钱者，巧法
不可言传也。
大顺散
干姜（一钱，炒） 甘草（八分，炒） 杏仁（六分，去皮尖，炒） 肉桂（六分）
共为末，每服五钱。水一盅，煎七分服。如烦躁，井花水调下三四五钱。
又有遇夏即病，秋后即愈，是暑伤元气。如草木遇盛日则痿，得雨露则挺，名曰疰夏症
。宜补中益气汤，照《薛氏医案》，去升麻、柴胡，加麦冬一钱五分，五味、黄柏各五分，炮姜
三分，服三四剂。
又生脉散、清暑益气汤、六一散，皆却暑之良方。一切暑病，不可须臾离之。学人当于
三方求其奥旨，难以缕陈。
夏日天气炎热，会耗伤人体的元气。因此患病后必然出现身体疲倦、脉象微弱、身体发热、自然出汗、烦躁不安、面色污浊、嘴唇发青等症状。李东垣认为，因活动而得病的是“中热”，因静处而得病的是“伤暑”，认为热属阳而暑属阴。这其实并不准确。因为“暑”字从“日”部，暑就是热，何必非要区分名称。但“动”与“静”二字，确实是阴阳的分别依据。这里仍然分为“动而得之”和“静而得之”，作为本症的提纲。
什么叫“动而得之”？指在烈日当空的长途跋涉中，挑重担从事劳作，因而致病。表现为大热（伤暑引起的发热头痛与伤寒症状相同，但伤寒脉象浮紧，伤暑脉象洪大而虚，以此作为鉴别。香薷是解表祛暑的药物，夏天使用香薷与冬天使用麻黄意义相同）、大渴、脉浮、自然出汗，用白虎人参汤主治。如果再加上身体沉重困着，这是暑邪夹带湿邪，宜用苍术白虎汤主治。如果有呕吐、腹泻、腹痛的症状，这个方子不可轻易使用。如果前述症状伴有发热身痛、口燥咽干，或者呕吐或腹泻，宜用黄连香薷饮主治。又有暑风症，因暑气鼓动激惹痰火，堵塞心窍，导致突然昏倒、不省人事，宜采用催吐法，或者灌服《千金》消暑丸。
白虎汤（见《伤寒论》）
加人参二钱，名为白虎人参汤。治疗汗出怕热、身体发热、大渴等症状；
加苍术二钱，名为苍术白虎汤，治疗汗出、身体发热、脚冷等症状。
黄连香薷饮（方剂见《时方妙用》）
去掉黄连，名为香薷饮。主治相同。
暑风引起抽搐，加羌活、秦艽各一钱；腹泻，加白术、茯苓各一钱五分；虚汗不止，加白术一钱五分、炙黄芪三钱；心烦，加栀子、朱砂各一钱；呕吐，加半夏二钱、藿香、陈皮各八分，少许姜汁。
什么叫“静而得之”？指在深堂大厦中避暑，被阴寒之气遏制，暑热不得发散。出现手脚厥冷的，用大顺散主治；霍乱、呕吐、腹泻且口渴的，用五苓散主治；不口渴的，用理中汤主治。也有用这两种汤药送服六一散三钱的，这种巧妙的用法难以言传。
大顺散
干姜（一钱，炒制） 甘草（八分，炒制） 杏仁（六分，去皮尖，炒制） 肉桂（六分）
共研为末，每次服用五钱。用水一盅，煎至七分服用。如果出现烦躁，用井花水调服三四五钱。
又有每到夏天就发病，秋天后就痊愈的情况，这是暑邪伤了元气。就像草木遇到烈日就会枯萎，得到雨露就能挺立，这种情况名叫疰夏症。宜用补中益气汤，参照《薛氏医案》，去掉升麻、柴胡，加麦冬一钱五分、五味子、黄柏各五分、炮姜三分，服用三四剂。
另外生脉散、清暑益气汤、六一散，都是祛暑的良好方剂。所有的暑病，一刻也不能离开这些方子。学者应当从这三个方剂中探求其奥妙宗旨，难以一一陈述。
Summer heat is scorching and consumes the primordial Qi (Vital Energy). Therefore, illness inevitably presents with fatigue, weak pulse, fever, spontaneous sweating, irritability, a dirty complexion, and cyanotic lips. Li Dongyuan considered that contracting disease through activity is "Zhongre" (Heatstroke), while contracting it through stillness is "Shangshu" (Summerheat Injury), asserting that Heat is Yang and Summerheat is Yin. This is actually inaccurate. Since the character "Shu" (Summerheat) contains the radical for "Sun," Shu is essentially Heat; why must names be distinguished? However, the terms "Activity" and "Stillness" do serve as distinctions of Yin and Yang. Here, we still divide them into "obtained through activity" and "obtained through stillness" to serve as the outline for this syndrome.
What is meant by "obtained through activity"? It refers to illness caused by long journeys under the blazing sun or carrying heavy loads while working. Symptoms include high fever (Fever and headache caused by Summerheat injury are identical to those of Cold Damage [Shanghan]; however, Cold Damage presents with a floating and tight pulse, whereas Summerheat presents with a surging and empty pulse, which serves as the differentiation. Xiangru [Moslae Herba] is an herb that releases the exterior and dispels summerheat; using Xiangru in summer is analogous to using Mahuang [Ephedrae Herba] in winter), extreme thirst, floating pulse, and spontaneous sweating. Baihu Renshen Tang (White Tiger with Ginseng Decoction) is indicated. If accompanied by a heavy and oppressive sensation in the body, this indicates Summerheat complicated by Dampness, and Cangzhu Baihu Tang (Atractylodes White Tiger Decoction) is indicated. If vomiting, diarrhea, and abdominal pain are present, this formula should not be used lightly. If the aforementioned symptoms include fever, body ache, dry mouth and throat, or vomiting and diarrhea, Huanglian Xiangru Yin (Coptis and Mosla Decoction) is indicated. There is also a condition called "Summerwind Syndrome," where Summerheat agitates Phlegm-Fire, blocking the Heart orifices, leading to sudden collapse and loss of consciousness. Induced vomiting is indicated, or one may administer Qianjin Xiaoshu Wan (Million Gold Summerheat-Dispelling Pill) from *Qianjin Fang*.
Baihu Tang (See *Shanghan Lun*)
Add 2 qian of Renshen [Panacis Ginseng Radix], named Baihu Renshen Tang. Treats symptoms such as sweating with aversion to heat, fever, and extreme thirst.
Add 2 qian of Cangzhu [Atractodis Rhizoma], named Cangzhu Baihu Tang. Treats symptoms such as sweating, fever, and cold feet.
Huanglian Xiangru Yin (Formula see *Shifang Miaoyong*)
Remove Huanglian [Coptidis Rhizoma], named Xiangru Yin (Mosla Decoction). The indications remain the same.
For Summerwind-induced convulsions, add 1 qian each of Qianghuo [Notopterygii Rhizoma et Radix] and Qinjiao [Gentianae Macrophyllae Radix]; for diarrhea, add 1.5 qian each of Baizhu [Atractodis Macrocephalae Rhizoma] and Fuling [Poria]; for unremitting deficiency sweating, add 1.5 qian of Baizhu and 3 qian of Zhi Huangqi [Astragali Radix]; for mental restlessness, add 1 qian each of Zhizi [Gardeniae Fructus] and Zhusha [Cinnabaris]; for vomiting, add 2 qian of Banxia [Pinelliae Rhizoma], 0.8 fen each of Huoxiang [Agastaches Herba] and Chenpi [Citri Reticulatae Pericarpium], and a small amount of Jiangzhi [Zingiberis Recens Juice].
What is meant by "obtained through stillness"? It refers to seeking coolness in deep halls and large buildings, where Yin-Cold obstructs the body, preventing the dispersion of Summerheat. For cases with cold extremities (Jue-ni), Dashun San (Great Harmony Powder) is indicated. For cholera-like vomiting, diarrhea, and thirst, Wuling San (Five-Ingredient Powder with Poria) is indicated. For those without thirst, Lizhong Tang (Regulate the Middle Decoction) is indicated. Some clever practitioners use these two decoctions to deliver 3 qian of Liuyi San (Six-to-One Powder); such ingenious methods are hard to convey in words.
Dashun San
Ganjiang [Zingiberis Rhizoma] (1 qian, stir-fried) Gancao [Glycyrrhizae Radix et Rhizoma] (0.8 fen, stir-fried) Xingren [Armeniacae Semen Amarum] (0.6 fen, skin and tip removed, stir-fried) Rougui [Cinnamomi Cortex] (0.6 fen)
Grind all into powder. Take 5 qian per dose. Boil in one cup of water until reduced to 0.7 cup, then take. If irritability occurs, mix with well-water (Jinghua Shui) and take 3–5 qian.
There are also cases where illness occurs only in summer and resolves after autumn; this is Summerheat injuring the Primordial Qi. It is like vegetation that withers under the intense sun but recovers with rain and dew; this condition is called "Zhu-xia Syndrome" (Stuck-summer Syndrome). Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) is indicated. Following *Xue Shi Yi An* (Cases of Master Xue), remove Shengma [ Cimicifugae Rhizoma] and Chaihu [Bupleuri Radix], add 1.5 qian of Maidong [Ophiopogonis Tuber], 0.5 fen each of Wuweizi [Schisandrae Fructus] and Huangbai [Phellodendri Cortex], and 0.3 fen of Paojiang [Zingiberis Rhizoma Preparatum]. Take for 3–4 doses.
Additionally, Shaomsan (Generate the Pulse Powder), Qingshu Yiqi Tang (Clear Summerheat and Augment Qi Decoction), and Liuyi San (Six-to-One Powder) are excellent formulas for dispelling summerheat. One cannot be without them for a moment in treating all summerheat diseases. Scholars should seek their profound principles within these three formulas; they cannot be exhaustively detailed here.