洁古云。静而得之为中暑。动而得之为中热。中暑者阴证。中热者阳证。东垣云。避暑热于
深堂大厦得之者。名曰中暑。其病必头痛。恶寒。身形拘急。肢节疼痛。而烦心。肌肤火热
。无汗。为房室之阴寒所遏。使周身阳气不得伸越。大顺散主之。若行人。或农夫。于日中
劳役得之者。名曰中热。其病必苦头痛。发躁热。恶热。扪之肌肤。大热。必大渴引饮。汗
大泄。无气以动。乃为天热外伤肺气。苍术白虎汤主之。窃谓暑热者。夏之令也。大行于天
地之间。人或劳动。或饥饿。元气亏乏。不足以御天令亢极。于是受伤而为病。名曰中暑。亦
名曰中热。其实一也。今乃以动静所得分之何哉。夫中暑热者。固多在劳役之人。劳役则虚
。虚则邪入。邪入则病。不虚则天令虽亢。亦无由以伤之。彼避暑于深堂大厦。得头疼恶寒
等证者。盖亦伤寒之类耳。不可以中暑名之。其所以烦心。与肌肤火热者。非暑邪也。身中
阳气受阴寒所遏而作也。既非暑邪。其可以中暑名乎。苟欲治之。则辛温轻扬之剂。发散可
也。夫大顺散一方。甘草最多。干姜杏仁肉桂次之。除肉桂外。其三物皆炒者。原其初意。
本为冒暑伏热。引饮过多。脾胃受湿。呕吐。水谷不分。脏腑不调所立。故甘草干姜皆经火
炒熟。又肉桂而非桂枝。盖温中药也。内有杏仁。不过取其能下气耳。若以此药。治静而
得之之证。吾恐不能解。反增内烦矣。今之世俗。往往不明。类曰。夏月阴气在内。大顺散
为
必用之药。吁。其误也。不亦甚欤。夫阴气非寒气也。盖夏月阳气发散于外。而阴气则在
内耳。岂空视阴气为寒气。而用温热之药乎。阴果为寒
。何以夏则饮水乎。其苍术白虎汤虽宜用。然亦岂可视为通行之药。必参之治暑诸方。随所
见之证而用之。然后合理。若夫所谓静而得之之证。虽当暑月。即非暑病。宜分出之。勿使
后人。有似同而异之惑。
洁古说：在安静状态下感受暑邪而发病的，称为中暑；在活动时感受暑邪而发病的，称为中热。中暑属于阴证，中热属于阳证。
东垣说：在深堂大厦等阴凉处避暑而得病的，名叫中暑。这种病必然出现头痛、怕冷、身体拘紧急迫、四肢关节疼痛，并且心中烦闷、肌肤感觉火热、无汗等症状。这是因为被房屋室内的阴寒之气所遏制，导致周身阳气不能舒展发散。治疗以大顺散为主方。如果是行人或农夫，在烈日下劳作而得病的，名叫中热。这种病必然痛苦于头痛、烦躁发热、怕热、触摸肌肤感觉大热、必定极度口渴想喝水、大汗淋漓、气短无力不想活动。这是天热外伤肺气所致，治疗以苍术白虎汤为主方。
我私下认为，“暑”和“热”是夏季的气候特征，广泛流行于天地之间。人如果因为劳动或饥饿，导致元气亏虚，不足以抵御天气的极度亢盛，于是受伤而生病，这名叫中暑，也名叫中热。其实二者是一样的。现在为什么要根据动静来区分它们呢？
那些中暑热的人，确实多在从事体力劳动的人身上发生。劳动会导致身体虚弱，虚弱则邪气容易侵入，邪气侵入就会生病；如果不虚弱，即使天气亢盛，也没有途径伤害人体。那些在深堂大厦避暑，出现头痛、怕冷等症状的人，大概也是伤寒一类的疾病罢了，不可以称之为中暑。他们之所以心中烦闷、肌肤感觉火热，并不是暑邪造成的，而是体内阳气受到阴寒之气的遏制而产生的。既然不是暑邪，怎么可以称之为中暑呢？如果要治疗这些症状，使用辛温轻扬的药剂进行发散就可以了。
大顺散这一方剂，甘草用量最多，干姜、杏仁、肉桂次之。除了肉桂之外，其他三味药都是炒过的。推究其最初的本意，原本是为了治疗因冒受暑热伏邪，饮水过多，导致脾胃受湿，出现呕吐、水谷不分、脏腑不调等情况而设立的。所以甘草、干姜都经过火炒熟，而且用的是肉桂而不是桂枝，因为它们是温中药。方中含有杏仁，不过是取其能够下气的作用罢了。如果用这个药去治疗“静而得之”的病证，我担心不仅不能解除病症，反而会增加内部的烦热。
现在的世俗之人，往往不明白这个道理，一概说道：夏季阴气在内，大顺散是必用的药物。唉，这也太错误了，难道不严重吗？所谓的“阴气”并不是“寒气”。大概是夏季阳气发散于体表，而阴气则在体内而已。怎么能空泛地把阴气看作寒气，从而使用温热性质的药物呢？如果阴气真的是寒气，为什么夏天人们要喝水解渴呢？
苍术白虎汤虽然适宜使用，但也不能把它视为通用的药物，必须参考治疗暑病的各种方剂，根据所见到的具体证候来选用，这样才合理。至于所谓“静而得之”的病证，即使在暑月，也不是暑病，应当将其区分出来，不要让后人产生似是而非的困惑。
Jieguo stated: Contracting heatstroke while at rest is termed *Zhongshu* (Summerheat Stroke); contracting it during physical exertion is termed *Zhongre* (Summerheat Heat). *Zhongshu* belongs to Yin patterns, whereas *Zhongre* belongs to Yang patterns.
Dongyuan stated: Those who contract illness by seeking coolness in deep halls and large mansions are named as having *Zhongshu*. Their symptoms must include headache, aversion to cold, bodily stiffness and urgency, pain in the limbs and joints, mental vexation, a sensation of fire on the skin, and anhidrosis (absence of sweating). This occurs because the yin-cold of the dwelling suppresses the body's yang qi, preventing its free expansion and diffusion. The primary formula for treatment is Dashun San (Greatly Smooth Powder). Conversely, those who contract illness through labor under the midday sun, such as travelers or farmers, are named as having *Zhongre*. Their symptoms must include severe headache, agitation and fever, aversion to heat, burning hot skin upon touch, intense thirst with excessive drinking, profuse sweating, and lethargy with lack of energy to move. This results from heavenly heat injuring Lung Qi externally. The primary formula for treatment is Cangzhu Baizhu Tang (Atractylodes and White Tiger Decoction) — *Note: Text says Cangzhu Baihu Tang*.
I privately hold that "Summerheat" and "Heat" are the climatic commands of summer, prevalent throughout heaven and earth. If a person engages in labor or suffers from hunger, causing their Yuan Qi (Original Qi) to become deficient and insufficient to resist the extreme exuberance of the heavenly climate, they will be injured and fall ill. This is named *Zhongshu*, also named *Zhongre*. In reality, they are one and the same. Why, then, do we now distinguish them based on movement versus stillness?
Those who contract Summerheat-Heat indeed mostly occur among those engaged in labor. Labor leads to deficiency; deficiency allows pathogenic factors to enter; entry of pathogenic factors leads to disease. If there is no deficiency, even if the heavenly climate is exuberant, there is no pathway for it to cause injury. Those who seek coolness in deep halls and large mansions and present with symptoms such as headache and aversion to cold are likely suffering from conditions similar to Cold Damage (Shanghan). They should not be named *Zhongshu*. The reason for their mental vexation and sensation of fire on the skin is not due to Summerheat pathogenic factors, but rather due to the body's internal Yang Qi being suppressed by yin-cold. Since it is not a Summerheat pathogen, how can it be called *Zhongshu*? If one wishes to treat this, dispersal using pungent-warm and light-yang agents would suffice.
Regarding the formula Dashun San, Licorice Root (Gancao) is used in the largest quantity, followed by Dried Ginger (Ganjiang), Apricot Kernel (Xingren), and Cinnamon Bark (Rougui). Except for Cinnamon Bark, the other three ingredients are stir-fried. Investigating its original intent, it was established primarily for cases where one had been exposed to latent Summerheat, drank excessively, leading to dampness affecting the Spleen and Stomach, vomiting, indistinguishable food and water, and disharmony of the Zang-Fu organs. Therefore, both Licorice Root and Dried Ginger were roasted over fire. Furthermore, Cinnamon Bark (Rougui) was used instead of Cinnamon Twig (Guizhi), as they are warming middle-jiao herbs. The inclusion of Apricot Kernel merely utilizes its ability to direct Qi downward. If this medicine is used to treat the condition contracted through stillness, I fear it will fail to resolve the issue and may instead increase internal vexation.
Modern secular practitioners often fail to understand this, generally stating: "In summer, Yin Qi resides internally; therefore, Dashun San is an essential medication." Alas, this is a grave error. Is it not too serious? The so-called "Yin Qi" is not "Cold Qi." It is simply that in summer, Yang Qi diffuses outward, while Yin Qi remains inward. How can one superficially view Yin Qi as Cold Qi and thus employ warm-hot medications? If Yin were truly Cold, why would people drink water in summer?
Although Cangzhu Baihu Tang (Atractylodes and White Tiger Decoction) is suitable for use, it cannot be regarded as a universal remedy. One must refer to various formulas for treating Summerheat and apply them according to the specific manifestations observed, which aligns with principle. As for the so-called condition contracted through stillness, even if it occurs during the summer months, it is not a Summerheat disease. It should be differentiated clearly to prevent later generations from being confused by apparent similarities and underlying differences.