脉
暑伤于气，所以脉虚、弦、细、芤、迟，体状无余。
证
夫暑者，相火行令也。夏月人感之，自口齿而入，伤心胞络之经。其脉虚。或浮大而散，或弦细芤迟。
盖热伤气，则气消而脉虚弱。其外证头疼身热，口干烦渴，面垢自汗，倦怠少气，背寒冷热。甚者迷闷不省，
而为霍乱吐利，痰涎呕逆，发黄生斑，皆是其症。又甚者，火盛制金，不能平木，肝邪独旺，以致搐搦，不省人
事，其脉虚浮。浮者风也，虚者暑也，俗曰暑风。治宜黄连香薷饮加羌活，或只双解散加香薷。
治
大抵治暑之法，宜清心利小便为主。若自汗甚者，不可利之，以白虎汤清解之，次分表里治之。如在表，
头痛恶寒，双解散加香薷，及二香散、十味香薷饮之类。在半表半里，泄泻须渴，饮水吐逆，五苓散主之。热
甚烦渴，益元散清之。若表解里热甚，宜解毒汤、下神芎丸，酒蒸黄连等丸。或人平素虚弱，及老人冒暑，脉微
下利，渴而喜温，或厥逆不省人事，宜竹叶石膏汤加附子半个冷服。凡夏月暑证，不可服诸热燥剂。若误用
之，乃致斑毒发黄，小便不通，闷乱而死矣。
一伤暑与伤寒，俱有发热，当明辨之。盖寒伤形，暑伤气。伤暑则恶寒而脉紧，伤暑则恶热而脉虚微，
以此为异。经云∶脉盛身寒，得之伤寒。脉虚身热，得之伤暑，治宜小柴胡汤加石膏、知母，或人参白虎汤主
之。天时淫雨，湿令并行，苍术白虎汤主之。若元气素弱而伤重者，用清暑益气汤。
一行人或农夫于日中劳役得之者，名曰中热。其病必苦头痛，发燥热恶热，扪之肌肤大热，大渴引饮，
汗大泄，无气以动，乃为天热外伤肺气也，宜人参白虎汤主之。
一人避暑热于深堂大厦而得之者，名曰中热。其病必头痛恶寒，身形拘急，肢节痛而烦心，肌肤大热
无汗。为房室之阴寒所遏，使周身阳气不得伸越，宜用辛温之剂以解表散寒，五积散主之。
一外不受寒，止是内伤瓜果、冰水冷物，腹痛泄泻，或霍乱吐逆，宜缩脾饮主之。或理中
汤加神曲，麦芽、苍术、砂仁，此专治内温中消食也。
一吐泻脉沉微，不可用凉药，宜附子大顺散主之，或附子理中汤加炒白芍药。
一夏月多食冷物，及过饮茶汤水湿，致伤脾胃，吐泻霍乱，故治暑药多用温脾、消食、渗湿、利小便
之药，医者要识此意。
一发热恶寒，身体疼痛，小便涩，洒然毛耸，手足逆冷，小有
劳，身即热，口开，前板齿燥，脉弦细虚迟，表里中 也，用补中益气汤加香薷、白扁豆；热加黄芩。
方
治暑风卒倒法 凡人中暑，先触心经，一时昏迷，切不可饮冷水，并卧湿地。其法先以热汤灌，或
童便灌，及用青布蘸热汤熨脐中、气海，续续令暖气透彻脐腹，候其苏醒，然后进药。若旅途中
卒然晕倒，急扶在阴凉处，掬路中热土作窝于脐上，令人溺其内即苏。却灌以人尿，或搅地浆饮半碗，或
车轮土五钱，冷水调，澄清服，皆可。
香薷饮 治脏腑冷热不调，饮食不节，或食腥脍生冷过度，起居不时，或露卧湿地，或当风取凉，
而风冷之气，归于三焦，传于脾胃。脾胃得冷，不能克化水谷，致令真邪相干，心腹疼痛，霍乱
气逆。先心痛，则先吐，先腹痛则先利；心腹齐痛，吐利并作。或憎寒壮热，或头痛眩晕，或转筋拘急，
或四肢厥逆，烦闷昏塞，燥乱欲死，并能治之。
香薷（四钱） 浓朴（二钱，姜炒） 白扁豆（二钱）
上锉一剂，水煎冷服。
挟风搐搦不省人事，加黄连、羌活。小便涩浊，加茵陈、车前。霍乱吐利，加木瓜、薷香、姜汁。脏腑
积热便血，加枳壳、黄连、赤芍药、乌梅。小便血，加瞿麦、车前子。壮热大渴，五心烦热，加麦门冬，淡
竹叶、茅根、灯心。香港脚作痛，行步
艰辛，加羌活、独活、苍术、木瓜、枳壳、陈皮、半夏。挟痰，加南星、半夏。
二香散〔批〕（按此方祛暑和中之剂）
治四时感冒寒暑，呕吐泄泻，腹痛瘴气，饮冷当风，头疼身
热，伤食不化，及南方风土，暑月伤风、伤寒，悉以此药解表发散。
香薷（二钱） 浓朴（一钱，姜炒） 扁豆（一钱） 紫苏（一钱） 香附（二钱） 陈皮
（一钱） 苍术（一钱） 甘草（五分）
上锉一剂，葱姜煎服，加木瓜一钱更妙。
五苓散 治中暑伤寒湿热，表里未解，头疼发热，口燥咽干，
烦渴及饮水不止，小便赤涩，霍乱吐泻，心神恍惚，腹中气块，黄胆发渴等症。
猪苓（二钱五分） 泽泻（二钱五分） 白术（二钱五分） 茯苓（一钱五分） 肉桂（三分）
上锉一剂，水煎温服。或用滑石同为末，每服二钱，白沸汤调下尤妙。本方去桂，名四苓散。加茵陈，
名茵陈五苓散。加辰砂，名辰砂五苓散。一方加大黄治初利，亦治积聚、食黄、酒疸，量人虚实用之，
阳毒，加升麻、芍药，去桂。狂言妄语，加辰砂、酸枣仁。头痛目眩，加川芎、羌活。咳嗽，加桔梗，
杏仁。心气不定，加人参、麦门冬。痰多，加陈皮、半夏。喘急，加马兜铃、桑白皮。气块，加三棱、蓬
术。心热，加黄连、石莲肉。身疼拘急，加麻黄。口干嗳水，加乌梅、干葛。眼黄酒疸及五疸，加茵陈、
木通、滑石、栀子。鼻衄，加栀子、乌梅。伏暑鼻衄，加茅根，煎调百草霜末。五心热如劳，加柴
胡、桔梗。有痰有热，加桑白皮、人参、前胡。水肿，加甜葶苈、木通、滑石、木香。疝气，加吴茱萸、
枳壳、小茴香、川楝子、肉桂。霍乱转筋，加藿香、木瓜。女子血，加桃仁，丹
皮。呕吐，去桂，加半夏、姜汁。
益元散（一名六一散）〔批〕（按此方祛暑利水之剂）治中暑身热呕吐，
烦躁不宁，小水赤黄，大便泄泻，善解暑毒。凡盛暑之时，虽不病，亦宜散。
白滑石（六两，水飞） 大粉草（一两，微炒）
上为细末，每服三钱，加蜜少许，热汤冷水任下。
清暑益气汤 治长夏湿热蒸人，人感之，四肢困倦，精神短少，懒于动作，胸满气促，肢节疼痛。或气
高而喘，身热而烦，心下痞闷，小便黄而数，大便溏而频，饮食不思，身汗体重，或汗少
者，血先病而气未病也。其脉中得洪缓，若湿热相搏，必加之以迟迟。病虽互换少瘥，其因不出于暑湿二
气也。宜以清燥之药治之，此汤为的。
黄 （炒，一钱） 苍术（炒，一钱半） 升麻（一钱） 人参（五分） 白术（五分）
陈皮（五分） 神曲（五分） 泽泻（五分） 甘草（炙，三分） 黄柏（酒炒，三分） 当归
（三分） 青皮（三分） 麦门冬（三分） 干葛（三分） 五味子（十粒）
上锉一剂，水煎温服。
清暑和中散（介石伯传） 治中暑诸证。
黄连（酒炒，一两） 香薷（浮穗，二两） 浓朴（一两） 白扁豆（炒，四钱） 猪苓
（一两五钱） 泽泻（一两五钱） 白术（七钱） 赤茯苓（去皮，七钱） 木通（去皮，一两）
滑石（一两五钱） 枳壳（炒，一两） 车前子（炒，一两） 陈皮（去白，七钱） 砂仁
（炒，一两） 木香（三钱） 草果仁（一两五钱） 甘草（炙，三钱） 小茴香（炒，五钱）
上为细末，每服一、二匙，随病用引。伏暑，冷水调下。腹痛，酒调下。呕吐泄泻，霍乱转筋，百
沸汤调，热服出汗。
呕吐甚而不止者，百沸汤和姜汁调下。伤寒作疟者，葱白汤调下取汗。
清暑六和汤〔批〕（按此方清暑养元气，除温热之剂） 治心脾不调，气
不升降，霍乱转筋，呕吐泄泻，寒热交作，痰喘咳嗽，胸膈痞满，头目昏痛，肢体浮肿，嗜卧倦怠，小
便赤涩，并阴阳不分，冒暑伏热。烦闷。或成痢下，中酒烦渴，畏食，妇人妊娠产后，皆可服。
砂仁（五分） 半夏（汤泡，五分） 杏仁（泡，五分） 人参（去芦，五分） 赤茯苓
（五分） 藿香（一钱） 白扁豆（姜炒，一钱） 木瓜（一钱） 香薷（二钱） 浓朴（姜炒，二
钱） 黄连（麸炒，一钱）
上锉一剂，生姜三片，枣二枚，水煎服。
生脉散 夏月服之，能生津液，通血脉，止烦渴，养元气，健脾胃，益精神。
人参（去芦） 五味子（去梗） 麦门冬（去心）
上煎汤代茶，此一盏，可当茶三盏。
千里水葫芦（秘方） 治路上行人暑热作渴，茶水不便，用此药备
之，俟渴时，即用一丸噙化。止渴生津，化痰宁嗽。
硼砂 柿霜 乌梅肉 薄荷叶 白砂糖
上等分，捣烂为丸。每用一丸噙化。
水葫芦丸〔批〕（按此方养气清热，生津止渴之剂） 治冒暑毒，解烦渴，生津液。
川百药煎（三两） 麦门冬（去心） 乌梅肉 白梅肉 干葛 甘草（各五钱） 人参（去芦，二钱）
上为细末，面糊为丸，如芡实大。每用一丸噙化。夏月出行，一丸可度一日。
脉象
暑邪损伤人体正气，因此脉象表现为虚、弦、细、芤（中空如葱管）、迟，其形态特征已无遗漏。
证候
所谓暑邪，是夏季相火当令时的气候。夏季人们感受暑邪，病邪从口鼻进入，侵犯心包络的经脉。其脉象虚弱。或者呈现浮大而散，或者弦细芤迟。
大概热邪伤气，则气耗损而脉象虚弱。其外在症状有头痛、身体发热、口干、心烦口渴、面部污垢、自然出汗、疲倦乏力、气短、背部感觉寒冷或发热。严重的出现神志昏迷不省人事，
进而发展为霍乱（上吐下泻）及呕吐腹泻，痰涎上逆，皮肤发黄生斑，这些都是暑病的症状。更严重的情况，火邪过盛克制肺金，导致不能制约肝木，肝风独旺，以致出现抽搐痉挛，神志不清，其脉象虚浮。浮代表风邪，虚代表暑邪，俗称“暑风”。治疗适宜用黄连香薷饮加羌活，或者只用双解散加香薷。
治法
大抵治疗暑病的方法，以清心火、利小便为主。如果自汗严重的，不可使用利尿药，应用白虎汤清热解表，其次再分表里进行治疗。如果在表证阶段，
头痛恶寒，用双解散加香薷，以及二香散、十味香薷饮之类。在半表半里阶段，出现泄泻且口渴，饮水后呕吐，用五苓散主治。热势严重且烦渴，用益元散清热。如果表证已解而里热甚重，宜用解毒汤、下神芎丸，或酒蒸黄连制成的丸剂。或者患者平素体虚，以及老人中暑，脉象微弱且下利，口渴但喜欢温热饮食，或者四肢厥冷不省人事，宜用竹叶石膏汤加半个附子，冷服。凡是夏季暑病，不可服用各种热燥的药物。如果误用，
会导致发斑毒黄、小便不通，因闷乱而死。
一种情况是伤暑与伤寒，都有发热症状，应当明确辨别。大概寒邪伤形，暑邪伤气。伤暑则恶寒而脉紧（注：此处原文逻辑似有误，通常伤寒脉紧，伤暑脉虚，但依原文翻译），伤暑则恶热而脉虚微，
以此作为区别。经书说：脉象盛大而身体寒冷，得自于伤寒。脉象虚弱而身体发热，得自于伤暑，治疗适宜用小柴胡汤加石膏、知母，或者人参白虎汤主治。如果天时阴雨连绵，湿气与暑令并行，用苍术白虎汤主治。如果元气素来虚弱且病情严重者，用清暑益气汤。
另一种情况是有人或农夫在烈日下劳作得病，名叫中热。其病症必定痛苦头痛，烦躁发热且怕热，触摸肌肤非常热，极度口渴想喝水，
大汗淋漓，没有力气活动，这是天热外伤肺气所致，宜用人参白虎汤主治。
还有一种情况是人避暑热而在深堂大厦中得病，也名叫中热。其病症必定头痛恶寒，身体拘急僵硬，肢节疼痛且心烦，肌肤非常热
但无汗。这是因为房屋室内的阴寒之气遏制了阳气，使周身阳气不得舒展发散，宜用辛温药物解表散寒，用五积散主治。
一种情况是外不受寒，只是内伤瓜果、冰水冷物，导致腹痛泄泻，或者霍乱呕吐，宜用缩脾饮主治。或者理中汤加神曲、麦芽、苍术、砂仁，这专门治疗内伤温中消食。
一种情况是呕吐泄泻脉象沉微，不可用凉药，宜用附子大顺散主治，或者附子理中汤加炒白芍药。
一种情况是夏季多吃冷物，以及过量饮茶酒水湿，导致脾胃受伤，呕吐泄泻霍乱，所以治疗暑病的药物多用温脾、消食、渗湿、利小便的药物，医者要明白这个意思。
一种情况是发热恶寒，身体疼痛，小便涩滞，洒然毛耸（毛孔竖起），手足逆冷，稍微有点
劳累，身体立即发热，张口呼吸，前板齿干燥，脉象弦细虚迟，这是表里同病，用补中益气汤加香薷、白扁豆；热重加黄芩。
方剂
治疗暑风突然昏倒的方法 凡人中暑，先触动心经，一时昏迷，切不可喝冷水，并躺在潮湿地上。其方法先用热汤灌服，或者
童便（儿童尿液）灌服，以及用青布蘸热汤熨烫脐中、气海穴，连续让暖气透彻脐腹，等到其苏醒，然后进药。如果在旅途中
突然晕倒，急忙扶到阴凉处，捧路中的热土做成窝状放在脐上，让人尿在里面即苏醒。却灌入人尿，或者搅地浆喝半碗，或者
车轮土五钱，冷水调匀澄清后服用，都可以。
香薷饮 治疗脏腑冷热不调，饮食不节制，或者吃腥脍生冷过度，起居不时，或者露天睡在湿地，或者对着风取凉，
而风冷之气，归于三焦，传于脾胃。脾胃受冷，不能消化水谷，导致真邪相干，心腹疼痛，霍乱
气逆。先心痛，则先呕吐，先腹痛则先腹泻；心腹同时痛，吐利并作。或者憎寒壮热，或者头痛眩晕，或者转筋拘急，
或者四肢厥冷，烦闷昏塞，燥乱欲死，都能治疗。
香薷（四钱） 浓朴（二钱，姜炒） 白扁豆（二钱）
以上锉成一剂，水煎冷服。
挟风搐搦不省人事，加黄连、羌活。小便涩浊，加茵陈、车前。霍乱吐利，加木瓜、香薷、姜汁。脏腑
积热便血，加枳壳、黄连、赤芍药、乌梅。小便血，加瞿麦、车前子。壮热大渴，五心烦热，加麦门冬、淡
竹叶、茅根、灯心草。香港脚作痛，行走
艰辛，加羌活、独活、苍术、木瓜、枳壳、陈皮、半夏。挟痰，加南星、半夏。
二香散〔批注〕（按此方为祛暑和中之剂）
治疗四季感冒寒暑，呕吐泄泻，腹痛瘴气，饮冷当风，头疼身
热，伤食不化，以及南方风土，暑月伤风、伤寒，都用此药解表发散。
香薷（二钱） 浓朴（一钱，姜炒） 扁豆（一钱） 紫苏（一钱） 香附（二钱） 陈皮
（一钱） 苍术（一钱） 甘草（五分）
以上锉成一剂，葱姜煎服，加木瓜一钱更好。
五苓散 治疗中暑伤寒湿热，表里未解，头疼发热，口燥咽干，
烦渴及饮水不止，小便赤涩，霍乱吐泻，心神恍惚，腹中气块，黄疸发渴等症状。
猪苓（二钱五分） 泽泻（二钱五分） 白术（二钱五分） 茯苓（一钱五分） 肉桂（三分）
以上锉成一剂，水煎温服。或用滑石同为末，每服二钱，用白沸汤调下尤其好。本方去掉桂枝，名叫四苓散。加茵陈，
名叫茵陈五苓散。加辰砂，名叫辰砂五苓散。一方加大黄治疗初起腹泻，也治疗积聚、食黄、酒疸，根据人体虚实使用，
阳毒，加升麻、芍药，去桂枝。狂言妄语，加辰砂、酸枣仁。头痛目眩，加川芎、羌活。咳嗽，加桔梗，
杏仁。心气不定，加人参、麦门冬。痰多，加陈皮、半夏。喘急，加马兜铃、桑白皮。气块，加三棱、蓬
术。心热，加黄连、石莲肉。身疼拘急，加麻黄。口干嗳水，加乌梅、干葛。眼黄酒疸及五疸，加茵陈、木通、滑石、栀子。鼻衄，加栀子、乌梅。伏暑鼻衄，加茅根，煎调百草霜末。五心热如劳，加柴
胡、桔梗。有痰有热，加桑白皮、人参、前胡。水肿，加甜葶苈、木通、滑石、木香。疝气，加吴茱萸、
枳壳、小茴香、川楝子、肉桂。霍乱转筋，加藿香、木瓜。女子血证，加桃仁，丹
皮。呕吐，去桂枝，加半夏、姜汁。
益元散（一名六一散）〔批注〕（按此方为祛暑利水之剂）治疗中暑身热呕吐，
烦躁不宁，小便赤黄，大便泄泻，善于解除暑毒。凡盛夏之时，即使没生病，也适宜服用。
白滑石（六两，水飞） 大粉草（一两，微炒）
以上为细末，每服三钱，加少许蜜，热汤或冷水任下。
清暑益气汤 治疗长夏湿热蒸人，人感受它，四肢困倦，精神短少，懒于动作，胸满气促，肢节疼痛。或气
高而喘，身热而烦，心下痞闷，小便黄而数，大便溏而频，饮食不思，身汗体重，或汗少
者，这是血先病而气未病。其脉象中得洪缓，若湿热相搏，必加上迟缓。病虽然互换稍有好转，其病因不出于暑湿二
气。宜以清燥药物治疗，此汤为对症。
黄芪（炒，一钱） 苍术（炒，一钱半） 升麻（一钱） 人参（五分） 白术（五分）
陈皮（五分） 神曲（五分） 泽泻（五分） 甘草（炙，三分） 黄柏（酒炒，三分） 当归
（三分） 青皮（三分） 麦门冬（三分） 干葛（三分） 五味子（十粒）
以上锉成一剂，水煎温服。
清暑和中散（介石伯传） 治疗中暑诸证。
黄连（酒炒，一两） 香薷（浮穗，二两） 浓朴（一两） 白扁豆（炒，四钱） 猪苓
（一两五钱） 泽泻（一两五钱） 白术（七钱） 赤茯苓（去皮，七钱） 木通（去皮，一两）
滑石（一两五钱） 枳壳（炒，一两） 车前子（炒，一两） 陈皮（去白，七钱） 砂仁
（炒，一两） 木香（三钱） 草果仁（一两五钱） 甘草（炙，三钱） 小茴香（炒，五钱）
以上为细末，每服一、二匙，随病用引药。伏暑，冷水调下。腹痛，酒调下。呕吐泄泻，霍乱转筋，百
沸汤调，热服出汗。
呕吐甚而不止者，百沸汤和姜汁调下。伤寒作疟者，葱白汤调下取汗。
清暑六和汤〔批注〕（按此方为清暑养元气，除温热之剂） 治疗心脾不调，气
不升降，霍乱转筋，呕吐泄泻，寒热交作，痰喘咳嗽，胸膈痞满，头目昏痛，肢体浮肿，嗜卧倦怠，小
便赤涩，并阴阳不分，冒暑伏热。烦闷。或成痢下，中酒烦渴，畏食，妇人妊娠产后，皆可服。
砂仁（五分） 半夏（汤泡，五分） 杏仁（泡，五分） 人参（去芦，五分） 赤茯苓
（五分） 藿香（一钱） 白扁豆（姜炒，一钱） 木瓜（一钱） 香薷（二钱） 浓朴（姜炒，二
钱） 黄连（麸炒，一钱）
以上锉成一剂，生姜三片，枣二枚，水煎服。
生脉散 夏季服用，能生津液，通血脉，止烦渴，养元气，健脾胃，益精神。
人参（去芦） 五味子（去梗） 麦门冬（去心）
以上煎汤代茶，这一盏，可当茶三盏。
千里水葫芦（秘方） 治疗路上行人暑热作渴，茶水不便，用此药备
之，等渴时，即用一丸噙化。止渴生津，化痰宁嗽。
硼砂 柿霜 乌梅肉 薄荷叶 白砂糖
以上等分，捣烂为丸。每用一丸噙化。
水葫芦丸〔批注〕（按此方为养气清热，生津止渴之剂） 治疗冒暑毒，解烦渴，生津液。
川百药煎（三两） 麦门冬（去心） 乌梅肉 白梅肉 干葛 甘草（各五钱） 人参（去芦，二钱）
以上为细末，面糊为丸，如芡实大。每用一丸噙化。夏季出行，一丸可度一日。
Pulse
Summerheat injures Qi, therefore the pulse presents as Empty (Xu), Wiry (Xian), Thin (Xi), Kou (Kou - hollow like a scallion stem), or Slow (Chi), with its morphological characteristics fully described.
Symptoms
Summerheat is the climate when Ministerial Fire (Xianghuo) rules in summer. When people are affected by it in summer, the pathogen enters through the mouth and nose, invading the Pericardium Collateral (Xinbaoluojing) meridians. The pulse is Empty (Xu). It may present as Floating and Large but Scattered (Fuda San), or Wiry, Thin, Kou, and Slow.
Generally, Heat injures Qi, causing Qi depletion and an Empty (Xu) and Weak pulse. External symptoms include headache, body fever, dry mouth, vexation and thirst, facial grime, spontaneous sweating, fatigue, shortness of breath, and a sensation of cold or heat on the back. In severe cases, there is confusion and unconsciousness,
progressing to Huoluan (acute vomiting and diarrhea), phlegm-saliva regurgitation, jaundice, and macules. These are all symptoms of summerheat disease. Even more severely, excessive Fire controls Metal (Lung), failing to restrain Wood (Liver), leading to independent hyperactivity of Liver Wind, resulting in convulsions and spasms, and loss of consciousness. The pulse is Empty and Floating. Floating indicates Wind, Empty indicates Summerheat; commonly known as "Summerheat Wind" (Shufeng). Treatment should preferably use Huanglian Xiangru Yin (Coptis and Mosla Decoction) plus Qianghuo, or only Shuangjie San (Double Release Powder) plus Xiangru.
Treatment
Generally, the method for treating summerheat focuses on clearing Heart fire and promoting urination. If spontaneous sweating is severe, diuretics should not be used; instead, Baihu Tang (White Tiger Decoction) should be used to clear and resolve heat, followed by treatment based on exterior or interior differentiation. If the pathogen is in the Exterior stage,
with headache and aversion to cold, use Shuangjie San (Double Release Powder) plus Xiangru, as well as Erxiang San (Two Fragrances Powder) or Shiwei Xiangru Yin (Ten-Ingredient Mosla Decoction). If in the Half-Exterior Half-Interior stage, with diarrhea and thirst, drinking water leads to vomiting, use Wuling San (Five-Ingredient Powder with Poria) as the main formula. If heat is severe with vexation and thirst, use Yiyuan San (Benefit Origin Powder) to clear heat. If the exterior is resolved but interior heat is severe, use Jiedu Tang (Detoxification Decoction), Xiashenxiong Wan (Lower Spirit and Ligusticum Pill), or wine-steamed Huanglian pills. Or if the patient is constitutionally weak, or an elderly person suffers from summerheat, with a faint pulse and diarrhea, thirst but preference for warmth, or cold limbs and unconsciousness, use Zhuyeshigu Tang (Bamboo Leaf and Gypsum Decoction) plus half a Fuzi (Aconite Root), taken cold. In summer, summerheat conditions must not be treated with hot and drying agents. If mistakenly used,
it can lead to toxic macules, jaundice, urinary retention, and death due to stifling confusion.
One distinction is between Shangshu (summerheat injury) and Shanghan (cold injury); both have fever, so they must be clearly differentiated. Generally, Cold injures the Form (body structures), while Summerheat injures Qi. Injury from summerheat causes aversion to cold and a tight pulse (Note: Textual logic here contrasts with standard theory where summerheat typically causes aversion to heat and empty pulse, but translating strictly per source), while injury from summerheat causes aversion to heat and a faint, weak pulse,
using this as the difference. The Classics state: A full pulse with body cold comes from Shanghan. An empty pulse with body heat comes from Shangshu. Treatment should preferably use Xiaochaihu Tang (Minor Bupleurum Decoction) plus Shigao (Gypsum) and Zhimu (Anemarrhena), or Renshen Baihu Tang (Ginseng White Tiger Decoction). If weather involves continuous rain with dampness and summerheat commands acting together, use Cangzhu Baihu Tang (Atractylodes White Tiger Decoction). If Yuanqi (Original Qi) is constitutionally weak and the injury is severe, use Qingshu Yiqi Tang (Clear Summerheat and Benefit Qi Decoction).
Another case refers to laborers or farmers who contract illness from working under the sun, named Rezhong (Heat Stroke). The illness necessarily involves painful headache, irritability, fever, aversion to heat, skin feeling very hot to touch, extreme thirst with desire to drink,
profuse sweating, lack of energy to move. This is caused by heavenly heat externally injuring Lung Qi; Ren Shen Baihu Tang (Ginseng White Tiger Decoction) is indicated.
Another case refers to those who contract illness by avoiding heat in deep halls and large buildings, also named Rezhong. The illness necessarily involves headache, aversion to cold, bodily stiffness and urgency, joint pain, and vexation, with skin feeling very hot
but no sweat. This is because the Yin-cold of the rooms suppresses Yang Qi, preventing the周身 (whole-body) Yang Qi from extending and diffusing. Acrid-warm agents should be used to release the exterior and disperse cold; Wuji San (Five Accumulations Powder) is indicated.
One condition is external cold not received, but internal injury from melons, fruits, ice, and cold drinks, causing abdominal pain and diarrhea, or Huoluan (vomiting and diarrhea). Suopi Yin (Spleen-Constricting Decoction) is indicated. Or Lizhong Tang (Regulate the Middle Decoction) plus Shenqu (Medicated Leaven), Maiya (Malt), Cangzhu (Atractylodes), and Sharen (Amomum), which specifically treats internal warmth, warming the middle and digesting food.
One condition is vomiting and diarrhea with a sinking and faint pulse; cool medicines should not be used. Fuzi Dashun San (Aconite Great Smoothness Powder) is indicated, or Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction) plus stir-fried Baishao (White Peony Root).
One condition is eating too many cold foods in summer, and overdrinking tea, alcohol, and water-dampness, injuring the Spleen and Stomach, causing vomiting, diarrhea, and Huoluan. Therefore, summerheat remedies often use herbs that warm the Spleen, aid digestion, leach out dampness, and promote urination. Physicians must understand this principle.
One condition is fever, aversion to cold, body pain, astringent urination, chills with piloerection, cold limbs, slight exertion immediately causing body heat, open mouth, dry anterior teeth, and a wiry, thin, empty, and slow pulse. This is simultaneous exterior and interior pathology. Buyi Yiqi Tang (Tonify the Middle and Boost Qi Decoction) plus Xiangru and Baibian Dou is used; add Huangqin (Scutellaria) if heat is significant.
Formulas
Method for treating sudden collapse from Summerheat Wind: When a person suffers summerheat, the Heart Meridian is first affected, causing temporary coma. One must absolutely avoid drinking cold water or lying on wet ground. The method is to first pour hot water into the mouth, or pour child's urine, and use green cloth dipped in hot water to compress the navel (Shenzhong) and Qihai acupoints, continuously allowing warm energy to penetrate the abdomen until the patient revives, then administer medicine. If suddenly fainting on a journey, urgently support them to a shady place, scoop up hot earth from the road to make a nest above the navel, and have someone urinate into it to revive. Then pour human urine, or stir mud-water and drink half a bowl, or five qian of wheel-earth, mixed with cold water and clarified before taking; all are acceptable.
Xiangru Yin (Mosla Decoction): Treats disharmony of cold and heat in the Zang-Fu organs, irregular diet, or excessive consumption of raw/cold/fishy foods, irregular lifestyle, sleeping outdoors on damp ground, or cooling off facing the wind. The wind-cold qi returns to the Sanjiao (Triple Burner) and transmits to the Spleen and Stomach. The Spleen and Stomach get cold and cannot transform food and water, causing true and pathogenic factors to interfere, leading to heart and abdominal pain, Huoluan, and rebellious Qi. If heart pain occurs first, vomiting occurs first; if abdominal pain occurs first, diarrhea occurs first; if heart and abdomen hurt simultaneously, vomiting and diarrhea occur together. It also treats aversion to cold with high fever, headache and vertigo, muscle twitching and stiffness, cold limbs, stifling and coma, restlessness and despair.
Xiangru (4 qian) Nongpu (2 qian, stir-fried with ginger) Baibian Dou (2 qian)
Cut into one dose, decoct in water, take cold.
For accompanying wind with convulsions and unconsciousness, add Huanglian and Qianghuo. For astringent and turbid urination, add Yinchen and Cheqian. For Huoluan with vomiting and diarrhea, add Mugua, Xiangru, and Jiangzhi (Ginger Juice). For Zang-Fu accumulated heat with bloody stool, add Zhike, Huanglian, Chishao, and Wumei. For blood in urine, add Qumai and Cheqianzi. For high fever and extreme thirst, five-palm heat, add Maidong, Danzhuye, Maogen, and Dengxincao. For podagra pain and difficult walking, add Qianghuo, Duhuo, Cangzhu, Mugua, Zhike, Chenpi, and Banxia. For accompanying phlegm, add Nanting and Banxia.
Erxiang San (Two Fragrances Powder) [Commentary: This formula harmonizes the middle and dispels summerheat.]
Treats cold and summerheat common colds in all four seasons, vomiting and diarrhea, abdominal pain and miasma, drinking cold while facing wind, headache and body heat, food stagnation not digesting, and southern climates. For wind-cold and cold-injury in summer months, all can be resolved with this formula to release the exterior and diffuse.
Xiangru (2 qian) Nongpu (1 qian, stir-fried with ginger) Bian Dou (1 qian) Zisu (1 qian) Xiangfu (2 qian) Chenpi (1 qian) Cangzhu (1 qian) Gancao (0.5 qian)
Cut into one dose, decoct with ginger and scallion. Adding Mugua (1 qian) is even better.
Wuling San (Five-Ingredient Powder with Poria): Treats summerheat, cold-injury, and damp-heat where exterior and interior are unresolved. Symptoms include headache, fever, dry mouth and throat, vexation and thirst with incessant drinking, red and astringent urination, Huoluan with vomiting and diarrhea, mental confusion, abdominal gas masses, jaundice with thirst, etc.
Zhuling (2.5 qian) Zexie (2.5 qian) Baizhu (2.5 qian) Fuling (1.5 qian) Rougui (0.3 qian)
Cut into one dose, decoct in water, take warm. Alternatively, mix Huashi (Talc) into powder, take 2 qian each time, mixed with boiling water; this is excellent. Removing Rougui from this formula names Siling San (Four-Ingredient Powder with Poria). Adding Yinchen names Yinchchen Wuling San (Yinchen Five-Ingredient Powder). Adding Chensha (Cinnabar) names Chensha Wuling San. Another variation adds Dahuang to treat initial diarrhea, also treating accumulations, food jaundice, and wine jaundice, used according to deficiency or excess. For Yang Du (Yang Toxin), add Shengma and Shaoyao, remove Rougui. For delirious speech, add Chensha and Suanzaoren. For headache and dizziness, add Chuanxiong and Qianghuo. For cough, add Jiegeng and Xingren. For unsettled Heart Qi, add Renshen and Maidong. For much phlegm, add Chenpi and Banxia. For panting and urgency, add Madouling and Sangbaipi. For gas masses, add Sanleng and Pengze. For Heart heat, add Huanglian and Shilianrou. For body pain and stiffness, add Mahuang. For dry mouth and belching water, add Wumei and Gange. For eye yellow, wine jaundice, and five types of jaundice, add Yinchen, Mutong, Huashi, and Zhizi. For epistaxis, add Zhizi and Wumei. For latent summerheat with epistaxis, add Maogen, decocted with Baicaoshuang powder. For five-palm heat resembling consumptive fever, add Chaihu and Jiegeng. For phlegm and heat, add Sangbaipi, Renshen, and Qianhu. For edema, add Tiantingli, Mutong, Huashi, and Muxiang. For hernia, add Wuzhuyu, Zhike, Xiaohuixiang, Chuanlianzi, and Rougui. For Huoluan with muscle twitching, add Huoxiang and Mugua. For women's blood disorders, add Taoren and Danpi. For vomiting, remove Rougui, add Banxia and Jiangzhi.
Yiyuan San (Benefit Origin Powder) [Also known as Liuyi San] [Commentary: This formula dispels summerheat and promotes urination.] Treats summerheat with body heat, vomiting, restlessness, red-yellow urine, and diarrhea. It effectively resolves summerheat toxins. During peak summer, even if not ill, it is advisable to take it.
Baishi (6 liang, water-flown) Dafengcao (1 liang, slightly stir-fried)
Grind into fine powder. Take 3 qian each time, with a little honey, taken with hot or cold water as desired.
Qingshu Yiqi Tang (Clear Summerheat and Benefit Qi Decoction): Treats long summer damp-heat steaming people. People affected feel tired limbs, shortness of spirit, reluctance to move, chest fullness and shortness of breath, joint pain. Or high breathing and panting, body heat and vexation, epigastric stuffiness, yellow and frequent urination, loose and frequent stools, loss of appetite, sweating with heavy body, or little sweating. This indicates Blood is diseased first while Qi is not yet diseased. The pulse is Hong-Huan (Surging-Slow); if damp-heat intertwines, it becomes Chi-Chi (Slow). Although the illness may interchange and slightly improve, the cause lies in summerheat and dampness. Clear-drying medicines should be used; this decoction is appropriate.
Huangqi (stir-fried, 1 qian) Cangzhu (stir-fried, 1.5 qian) Shengma (1 qian) Renshen (0.5 qian) Baizhu (0.5 qian)
Chenpi (0.5 qian) Shenqu (0.5 qian) Zexie (0.5 qian) Gancao (roasted, 0.3 qian) Huangbai (wine-stir-fried, 0.3 qian) Danggui (0.3 qian) Qingpi (0.3 qian) Maidong (0.3 qian) Gange (0.3 qian) Wuweizi (10 grains)
Cut into one dose, decoct in water, take warm.
Qingshu Zhonghe San (Clear Summerheat and Harmonize Middle Powder) (Transmitted by Jieshibo): Treats various summerheat syndromes.
Huanglian (wine-stir-fried, 1 liang) Xiangru (floating spikes, 2 liang) Nongpu (1 liang) Baibian Dou (stir-fried, 4 qian) Zhuling (1.5 liang) Zexie (1.5 liang) Baizhu (7 qian) Chifuling (peeled, 7 qian) Mutong (peeled, 1 liang)
Huashi (1.5 liang) Zhike (stir-fried, 1 liang) Cheqianzi (stir-fried, 1 liang) Chenpi (peeled, 7 qian) Sharen (stir-fried, 1 liang) Muxiang (3 qian) Caoguoren (1.5 liang) Gancao (roasted, 3 qian) Xiaohuixiang (stir-fried, 5 qian)
Grind into fine powder. Take 1-2 spoons each time, using appropriate guiding substances for the condition. For latent summerheat, mix with cold water. For abdominal pain, mix with wine. For vomiting, diarrhea, Huoluan, and muscle twitching, mix with boiling water, take warm to induce sweating.
For severe and incessant vomiting, mix with boiling water and ginger juice. For cold-injury becoming malaria, mix with scallion white decoction to induce sweating.
Qingshu Liuhe Tang (Clear Summerheat Six-Harmonies Decoction) [Commentary: This formula clears summerheat, nourishes Original Qi, and removes warm-heat.] Treats Heart-Spleen disharmony, ascending-descending Qi dysfunction, Huoluan with muscle twitching, vomiting and diarrhea, alternating chills and fever, phlegm-panting and cough, chest-diaphragm stuffiness, head-eye dizziness and pain, limb edema, lethargy and fatigue, red-astringent urination, yin-yang indistinction, exposure to summerheat and latent heat. Vexation. Or dysentery, wine-induced thirst and vexation, aversion to food. Women during pregnancy or postpartum can also take it.
Sharen (0.5 qian) Banxia (soaked in boiling water, 0.5 qian) Xingren (soaked, 0.5 qian) Renshen (de-rhizome, 0.5 qian) Chifuling (0.5 qian) Huoxiang (1 qian) Baibian Dou (stir-fried with ginger, 1 qian) Mugua (1 qian) Xiangru (2 qian) Nongpu (stir-fried with ginger, 2 qian) Huanglian (bran-stir-fried, 1 qian)
Cut into one dose, with 3 slices of fresh ginger and 2 jujubes, decoct in water and take.
Shengmai San (Generate Pulse Powder): Taken in summer, it generates fluids, unblocks vessels, stops vexation and thirst, nourishes Original Qi, strengthens Spleen and Stomach, and benefits spirit.
Renshen (de-rhizome) Wuweizi (de-stem) Maidong (de-heart)
Decoct in water to replace tea. One cup is equivalent to three cups of tea.
Qianli Shuihulu (Thousand-Mile Water Gourd) (Secret Recipe): Treats travelers suffering from summerheat thirst when tea/water is inconvenient. Prepare this medicine; when thirsty, dissolve one pill in the mouth. Stops thirst, generates fluids, transforms phlegm, and calms cough.
Pengsha Persimmon Frost Wumei Meat Bohe Ye White Sugar
Equal parts, pound into paste and form pills. Dissolve one pill in the mouth each time.
Shuihulu Wan (Water Gourd Pill) [Commentary: This formula nourishes Qi, clears heat, generates fluids, and stops thirst.] Treats exposure to summerheat toxin, resolves vexation and thirst, generates fluids.
Chuan Baiyaojian (3 liang) Maidong (de-heart) Wumei Meat Plum Meat Gange Gancao (each 5 qian) Renshen (de-rhizome, 2 qian)
Grind into fine powder, bind with wheat paste into pills the size of Euryale seeds. Dissolve one pill in the mouth each time. In summer travel, one pill lasts a day.