王节斋曰∶夏至后病热者为暑。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，
或浮而大散，或弦细芤迟，盖热伤气则气消而脉虚弱。其为证，烦则喘渴，静则多言，身热而烦，心痛，
大渴引饮，头痛自汗，倦怠少气，或下血、发黄、生斑，甚者火热制金，不能平木，搐搦不省人事。治暑
之法，清心利小便最好。暑伤气，宜补其气为要。又有恶寒，或四肢逆冷，甚者迷闷不省，而为藿乱吐
利，痰滞呕逆，腹痛泻利，此则非暑伤人，乃因暑而自致之病也。以其因暑而得，故亦谓之暑病，然治法
不同也。
若行人或农夫于日中劳役得之者，是动而得之，阳症也。其病必苦头痛，发躁热，恶热，扪之肌肤火热，
必大渴引饮，汗大泄，无气以动，乃天热外伤元气也。宜清暑益气，用香薷、黄连、扁豆、人参、黄 、
五味、知母、石膏之类。
暑热发渴、脉虚，用人参白虎汤，或竹叶石膏汤。
若暑热之时，无病之人，或避暑热，纳凉于深堂大厦、凉台水阁，大扇风车，是静而得之，阴症也。其
人必头痛恶寒，
身形拘急，肢节疼痛而烦心，肌肤大热，无汗，此为阴寒所遏，使周身阳气不得伸越。宜用辛温之剂以
解表散寒，用浓朴、紫苏、葛根、藿香、羌活、苍术之类。
若外既受寒，内复伤生冷瓜果之类，前药再加干姜、砂仁、神曲之类。此非治暑也，治因暑而致之
病也。
若外不受寒，止是内伤冰水冷物，腹痛泄泻，或霍乱吐逆，宜缩脾饮，或理中汤加神曲、麦芽、砂仁、
苍术，温中消食也。
若吐泻脉沉微者，不可用凉药，宜用大顺散加熟附等分，或附子理中汤加炒白芍。
若既伤暑热，复伤生冷，外热内寒，宜先治其内，温中消食，次治其外，清暑益气，而以理脾为主。
东垣立方，已兼此意。其用黄 、升麻、人参、白术、甘草、麦冬、当归、五味、黄柏，葛根，是清暑
补气也；苍术、神曲、青皮、陈皮、泽泻、是补脾也。
朱丹溪曰∶暑病之外，又有注夏，属阴虚元气不足。夏初春末，头疼脚软，食少体热者，宜补中益
气汤去升柴，加炒黄柏、白芍。挟痰加半夏、橘红，或用生脉汤。
喻嘉言曰∶暑症，日中劳役而触冒其暑，此宜清凉，解其暑毒。若深居广厦，袭风凉，餐生冷，遏
抑其阳而病者，一切清凉之方，即不得径情直施。如无汗，仍须透表，以宣其阳。如吐利，急须和解，以
安其中，甚者少用温药以从治之。故冒暑之霍乱吐泻，以治暑为主；避暑之霍乱吐泻，以和中
温中为主，不可不辨也。
元丰朝立和剂局，萃聚医家经验之方，于中暑一门独详。夏月暑症，五方历试，见闻广耳。其取小
半夏茯苓汤，不治其暑，专治其湿。又以半夏、茯苓，少加甘草，名消暑丸，见
消暑在消其湿，名正言顺矣。其香薷饮，用香薷、扁豆、浓朴为主方。如热盛则去扁豆，加黄连为君，
治其心火。湿盛则去黄连，加茯苓、甘草，治其脾湿。其缩脾饮，则以脾为湿所浸淫而重滞，于扁豆、葛
根、甘草中，佐以乌梅、砂仁、草果，以快脾而去脾所恶之湿。甚则用大顺散、来复丹，以治暑症之多
泄利者，又即缩脾之意而推之也。医者于热湿虚寒，浅深缓急间酌而用之，其利溥矣。
而后来诸贤，以益虚继之。河间之桂苓甘露饮、五苓三石，意在生津液以益胃之虚。子和之桂苓甘
露饮，用人参、葛根、甘草、藿香、木香，益虚之中又兼去浊。或用十味香薷饮，于局方五味中增参、
、术、陈、木瓜，益虚以去湿热。
乃至东垣之清暑益气汤、人参黄 汤，又补中实卫以去其湿热。肥白内虚之人，勿论中暑与否，所宜频
服也。中暑必显躁烦热闷，东垣仿仲景竹叶石膏汤之制，方名清燥汤，仍以去湿为首务。夫燥与湿相反者
也，而清燥亦务除湿，非东垣具过人之识，不及此矣。
又如益元散之去湿而加辰砂，则并去其热；五苓散之去湿而加人参以补其虚，加辰砂减桂以去热；白
虎汤加人参以益虚，加苍术以胜湿。合之局方，则大备矣，然尚有未备者焉。
暑风一症，为心火暴甚，煎熬阴血，其卒倒类乎中风，而不可从风门索治。《百一选方》虽有大黄龙
丸，初不为暑风立法，然有中 昏死，以此方灌之立苏。但其人阴血素亏，暑毒深入血分，此方慎不可用。
《良方》复有地榆散，治中暑昏迷不省人事而欲死者，但用平常凉血之药，清解深入血分之暑风，良莫良于
此矣。
中暑卒倒无知，名曰暑风。大率有虚实两途∶实者痰之
实也，平素积痰，充满经络，一旦感召盛暑，痰阻其气，卒倒流涎，此湿 合病之最剧者也，宜先吐其痰，
后清其暑，犹易为也；虚者阳之虚也，平素阳气衰微不振，阴寒久已用事，一旦感召盛暑，邪凑其虚，此湿
病之得自虚寒者也，宜回阳药中兼清其暑，最难为也。
东垣曰∶夫脾胃虚弱，至六七月间，人汗沾衣，身重短气，甚则四肢痿软，行走不正，脚欹眼花，黑欲
倒者，此肾也膀胱俱竭之状也。当急救之，滋肺气以补水之上源。又汗多则津液伤，筋骨失养则痛或渴，
不可作暑热治。
王节斋说：夏至之后发生的发热性疾病称为暑病。暑是相火当令的时节，夏季人体感受暑邪，病邪从口鼻进入，损伤心包络的经脉。其脉象虚软，或浮大而散乱，或弦细、芤大、迟滞，这是因为热邪耗伤元气导致气虚而脉象虚弱。其临床表现，烦躁时气喘口渴，安静时多言妄语，身体发热且心烦，心痛，极度口渴想喝水，头痛自汗，疲倦乏力少气，或者出现便血、发黄、生斑疹，严重时火热克制肺金（金），不能制约肝木（木），出现抽搐痉挛、不省人事。治疗暑病的方法，清心火并通利小便最好。暑邪耗伤元气，应当以补气为关键。又有恶寒，或四肢逆冷，严重时神志昏迷不省人事，以及霍乱吐泻，痰滞呕逆，腹痛腹泻，这些并非暑邪直接伤人所致，而是因为贪凉受寒等自身原因导致的疾病。因为是在暑季因避暑不当而得的，所以也称为暑病，但治疗方法不同。
如果是行路之人或农夫在烈日下劳作得病的，属于“动而得之”，是阳证。其病症必定剧烈头痛，烦躁发热，怕热，触摸肌肤感觉火热，必定极度口渴想喝水，大汗淋漓，无力活动，这是天热外伤元气所致。宜用清暑益气法，使用香薷、黄连、扁豆、人参、黄芪、五味子、知母、石膏等药物。
如果在暑热季节，原本健康的人，为了躲避暑热，居住在深堂大厦、凉台水阁，使用大扇子或风车纳凉，这属于“静而得之”，是阴证。其人必定头痛恶寒，身体拘急僵硬，肢节疼痛且心烦，肌肤大热但无汗，这是因为阴寒之气遏制了周身阳气，使其不得舒展发散。宜用辛温解表散寒的药物，使用厚朴、紫苏、葛根、藿香、羌活、苍术等。
如果外感寒邪，内又损伤生冷瓜果等食物，在前述解表药基础上再加干姜、砂仁、神曲等。这不是治疗暑病，而是治疗因避暑不当导致的疾病。
如果外不受寒，只是内伤冰水冷物，出现腹痛泄泻，或霍乱吐逆，宜用缩脾饮，或理中汤加神曲、麦芽、砂仁、苍术，以温中消食。
如果吐泻且脉象沉微的，不可用凉药，宜用大顺散加熟附子等量，或附子理中汤加炒白芍。
如果既伤暑热，又伤生冷，表现为外热内寒，宜先治其内，温中消食，再治其外，清暑益气，并以调理脾胃为主。李东垣制定的方剂，已经兼顾了这一意思。他使用黄芪、升麻、人参、白术、甘草、麦冬、当归、五味子、黄柏、葛根，这是清暑补气；使用苍术、神曲、青皮、陈皮、泽泻，这是补脾。
朱丹溪说：除了暑病之外，还有“注夏”（季节性虚弱症），属于阴虚元气不足。夏初春末，出现头疼脚软，食欲不振，身体发热的，宜用补中益气汤去掉升麻、柴胡，加炒黄柏、白芍。挟带痰湿的加半夏、橘红，或用生脉汤。
喻嘉言说：暑症，是在烈日下劳作触冒暑气所致，这宜用清凉之法，解除暑毒。如果深居广厦，吹着凉风，吃生冷食物，遏制阳气而发病的，一切清凉方剂，就不能直接施用。如无汗，仍须透表，以宣发阳气。如出现吐利，急须和解，以安和中焦，严重的少量使用温药以顺从其病势（从治）。所以，冒暑引起的霍乱吐泻，以治暑为主；避暑引起的霍乱吐泻，以和中温中为主，不可不辨别清楚。
元丰年间设立和剂局，聚集医家经验方剂，在中暑一门特别详细。夏季暑症，在各地经过广泛试用，见闻广博。他们取用小半夏茯苓汤，不直接治暑，专门治湿。又以半夏、茯苓，少加甘草，名为消暑丸，可见消暑在于消除湿气，名正言顺。他们的香薷饮，以香薷、扁豆、厚朴为主方。如果热盛则去掉扁豆，加黄连为君药，治疗心火。湿盛则去掉黄连，加茯苓、甘草，治疗脾湿。他们的缩脾饮，则是认为脾被湿气浸淫而沉重滞涩，在扁豆、葛根、甘草中，佐以乌梅、砂仁、草果，以畅达脾气并去除脾所厌恶的湿气。严重的用大顺散、来复丹，治疗暑症多伴有泄利的情况，这也是由缩脾饮的意思推演而来。医生在热、湿、虚、寒之间，根据病情的浅深缓急斟酌用药，利益就很大了。
后来的各位贤者，在此基础上进一步补充了益虚的内容。刘河间的桂苓甘露饮、五苓散加三石（滑石、寒水石、赤石脂），意在生津液以补益胃之虚。张子和的桂苓甘露饮，用人参、葛根、甘草、藿香、木香，在益虚的同时兼去浊邪。或者用十味香薷饮，在和剂局的五味香薷饮中增加人参、黄芪、白术、陈皮、木瓜，在益虚的同时去除湿热。
乃至李东垣的清暑益气汤、人参黄芪汤，又是通过补中实卫来去除湿热。对于肥胖白色、体内虚弱的人，不论是否中暑，都适宜频繁服用。中暑必定显现躁烦热闷，李东垣模仿张仲景竹叶石膏汤的体制，方名清燥汤，仍然以祛湿为首要任务。燥与湿是相反的，但清燥也致力于除湿，如果不是李东垣具有过人的见识，达不到这种境界。
又如益元散去湿而加辰砂，则是同时去除热邪；五苓散去湿而加人参以补虚，加辰砂减桂枝以去热；白虎汤加人参以益虚，加苍术以胜湿。合起来看和剂局的方剂，就非常完备了，然而还有不完备的地方。
暑风一症，是由于心火暴甚，煎熬阴血，突然昏倒类似中风，但不能从风门角度去治疗。《百一选方》虽然有大黄龙丸，起初并不是为暑风立法的，但有中暑昏迷死亡的，用此方灌服立刻苏醒。但是这种人阴血素来亏损，暑毒深入血分，此方慎用不可用。《良方》又有地榆散，治疗中暑昏迷不省人事快要死的，只用平常凉血的药物，清解深入血分的暑风，没有比这更好的了。
中暑突然昏倒无知，名叫暑风。大体有虚实两条途径：实者是痰之实，平素积痰，充满经络，一旦感召盛暑，痰阻气机，突然昏倒流涎，这是湿痰合病中最剧烈的，宜先用吐法祛除痰涎，后清暑热，还比较容易治疗；虚者是阳之虚，平素阳气衰微不振，阴寒久已占据主导，一旦感召盛暑，邪气凑其虚处，这是湿病源于虚寒的，宜在回阳药中兼清暑热，最难治疗。
李东垣说：脾胃虚弱，到了六七月间，人出汗沾衣，身体沉重短气，甚至四肢痿软，行走不正，脚歪眼花，面色黑晦想要倒下，这是肾与膀胱俱竭的状态。应当急救，滋肺气以补水之上源。另外汗多则津液受伤，筋骨失养则痛或渴，不可当作暑热治疗。
Wang Jiezhai stated: Febrile diseases occurring after the Summer Solstice are termed Shu (Summerheat). Shu is the season when Ministerial Fire (Xianghuo) governs. When humans contract this pathogen in summer, it enters through the mouth and nose, damaging the Pericardium Collateral meridian (Pericardium Channel). The pulse is deficient, or floating and large and scattered, or wiry, thin, hollow, or slow; this is because heat damages Qi, leading to Qi consumption and a weak pulse. The manifestations include panting and thirst when restless, excessive talking when quiet, fever with irritability, heart pain, extreme thirst with desire to drink, headache with spontaneous sweating, fatigue with shortness of breath, or bleeding from the lower orifices, jaundice, and macules. In severe cases, Fire controls Metal (Lung), failing to restrain Wood (Liver), leading to spasms, convulsions, and loss of consciousness. The treatment for Shu is best achieved by clearing Heart fire and promoting urination. Since Shu damages Qi, tonifying Qi is essential. There are also cases of aversion to cold, cold limbs, severe confusion and loss of consciousness, Huoluan (cholera-like vomiting and diarrhea), phlegm obstruction with retching, abdominal pain, and diarrhea. These are not caused directly by Shu invading the body, but are self-induced illnesses due to summer conditions. Because they arise in summer, they are also called Shu diseases, but the treatment methods differ.
If walkers or farmers contract it while laboring under the sun, it is "obtained through movement," which is a Yang syndrome. Symptoms must include severe headache, restlessness and fever, aversion to heat, hot skin upon touch, extreme thirst with desire to drink, profuse sweating, and inability to move due to lack of Qi. This is external damage to Yuan Qi (Primal Qi) by heavenly heat. One should clear Summerheat and tonify Qi, using herbs such as Moslae Herba (Xiangru), Coptidis Rhizoma (Huanglian), Dolichoris Semen (Biandou), Ginseng Radix et Rhizoma (Renshen), Astragali Radix (Huangqi), Schisandrae Fructus (Wuweizi), Anemarrhenae Rhizoma (Zhimu), and Gypsum Fibrosum (Shigao).
For Summerheat causing thirst and a deficient pulse, use Renshen Baihu Tang (Ginseng White Tiger Decoction) or Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction).
If healthy individuals, during the hot summer, seek coolness in deep halls, pavilions, or water towers, using large fans or wind machines, this is "obtained through stillness," which is a Yin syndrome. Such patients suffer from headache, aversion to cold, stiff and rigid body, painful joints with irritability, high fever on the skin but no sweat. This is caused by Yin-Cold restraining the body's Yang Qi, preventing its expansion and diffusion. One should use acrid-warm formulas to release the exterior and disperse cold, using herbs such as Magnoliae Officinalis Cortex (Houpo), Perillae Folium (Zisu), Puerariae Radix (Gegen), Agastachis Herba (Huoxiang), Notopterygii Rhizoma et Radix (Qianghuo), and Atractylodis Rhizoma (Cangzhu).
If there is external cold contraction combined with internal injury from raw/cold fruits and vegetables, add Dried Ginger (Ganjiang), Amomi Fructus (Sharen), and Medicated Leaven (Shenqu) to the previous formula. This does not treat Shu, but treats the illness caused by avoiding Shu improperly.
If there is no external cold, only internal injury from ice-cold drinks, causing abdominal pain and diarrhea, or Huoluan with vomiting and retching, use Suopi Yin (Spleen-Constricting Decoction) or Lizhong Tang (Regulate the Middle Decoction) added with Shenqu, Maltae Fructus (Maiya), Sharen, and Cangzhu, to warm the middle and digest food.
If vomiting and diarrhea present with a deep and faint pulse, cooling medicines must not be used. Instead, use Dashun San (Great Smooth Powder) added with equal parts of Prepared Aconite Root (Fuzi), or Fuzi Lizhong Tang added with stir-fried White Peony Root (Baishao).
If one is injured by both Summerheat and raw/cold foods, presenting with external heat and internal cold, one should first treat the interior by warming the middle and digesting food, then treat the exterior by clearing Summerheat and tonifying Qi, focusing primarily on regulating the Spleen. Li Dongyuan’s prescriptions already incorporate this idea. His use of Huangqi, Shengma, Renshen, Baizhu, Gancao, Maidong, Danggui, Wuweizi, Huangbai, and Gegen clears Summerheat and tonifies Qi; Cangzhu, Shenqu, Qingpi, Chenpi, and Zexie tonify the Spleen.
Zhu Danxi stated: Besides Shu disease, there is "Zhuxia" (Seasonal Weakness), belonging to Yin deficiency and insufficient Yuan Qi. In early summer and late spring, if one suffers from headache, weak legs, poor appetite, and low-grade fever, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) removing Shengma and Chaihu, adding stir-fried Huangbai and Baishao. If accompanied by phlegm, add Banxia and Juhong, or use Shengmai Tang (Generate the Pulse Decoction).
Yu Jiayan stated: For Shu symptoms contracted by laboring in the sun and being exposed to Summerheat, cooling methods should be used to resolve Summerheat toxicity. However, for those who live in deep mansions, enjoy cool breezes, eat raw/cold foods, and suppress their Yang Qi leading to illness, all cooling formulas should not be applied directly. If there is no sweat, one must still vent the exterior to diffuse Yang. If there is vomiting and diarrhea, one must urgently harmonize to calm the Middle Jiao; in severe cases, use small amounts of warming medicines to follow the disease trend (Congzhi). Therefore, for Huoluan vomiting and diarrhea caused by exposure to Summerheat, treating Shu is primary; for that caused by avoiding Summerheat, harmonizing and warming the Middle is primary. This distinction must not be overlooked.
During the Yuanfeng era, the Heji Bureau was established, compiling experienced formulas from physicians, with particular detail on Zhongshu (Heatstroke). Summer Shu symptoms were tested widely across regions. They utilized Xiao Banxia Fuling Tang (Minor Pinellia and Poria Decoction), not to treat Shu directly, but specifically to treat Dampness. By adding Banxia and Fuling with a little Gancao, named Xiaoshu Wan (Summerheat-Relieving Pill), it shows that relieving Summerheat lies in eliminating Dampness, making the name appropriate. Their Xiangru Yin uses Xiangru, Biandou, and Houpo as the main formula. If Heat is prevalent, remove Biandou and add Huanglian as the sovereign herb to treat Heart Fire. If Dampness is prevalent, remove Huanglian and add Fuling and Gancao to treat Spleen Dampness. Their Suopi Yin addresses the Spleen being soaked by Dampness and becoming heavy and stagnant; it adds Wumei, Sharen, and Caoguo to Bian Dou, Gegen, and Gancao to invigorate the Spleen and eliminate the Dampness the Spleen dislikes. In severe cases, Dashun San and Laifu Dan are used to treat Shu symptoms with frequent diarrhea, extending the logic of Suopi Yin. Physicians should weigh Heat, Dampness, Deficiency, and Cold, considering depth and urgency, to maximize benefit.
Later sages added methods to tonify deficiency. Liu Hejian’s Guiling Ganlu Yin (Cassia Twig, Poria, and Dew-Dripping Decoction) and Wuling San plus Three Stones (Huashi, Hanshuishi, Chishishi) aim to generate fluids to tonify Stomach deficiency. Zhang Hezi’s Guiling Ganlu Yin uses Renshen, Gegen, Gancao, Huoxiang, and Muxiang to tonify deficiency while clearing turbidity. Alternatively, Shiwei Xiangru Yin (Ten-Ingredient Mosla Decoction) adds Renshen, Huangqi, Baizhu, Chenpi, and Chaomugua to the Bureau’s Five-Ingredient Xiangru Yin to tonify deficiency while clearing Damp-Heat.
Li Dongyuan’s Qingshu Yiqi Tang (Clear Summerheat and Tonify Qi Decoction) and Renshen Huangqi Tang further tonify the Middle and solidify the Defensive Qi to remove Damp-Heat. For obese, pale individuals with internal deficiency, these are suitable for frequent use regardless of whether Zhongshu is present. Zhongshu typically manifests as restlessness, irritability, heat, and stifling sensation. Li Dongyuan, imitating Zhang Zhongjing’s Zhuye Shigao Tang, created Qingzao Tang (Clear Dryness Decoction), prioritizing dampness removal. Although Dryness and Dampness are opposites, clearing dryness also involves removing dampness; this profound insight belongs uniquely to Li Dongyuan.
Furthermore, Yi Yuan San (Benefit Primordial Powder) removes dampness and adds Chen Sha (Cinnabar) to also clear Heat; Wuling San removes dampness and adds Renshen to tonify deficiency, or adds Chen Sha and reduces Guizhi to clear Heat; Baihu Tang adds Renshen to tonify deficiency and Cangzhu to overcome dampness. Combined with the Bureau’s formulas, they are comprehensive, yet some aspects remain incomplete.
Shu Feng (Summerwind) is a condition where Heart Fire becomes violently excessive, scorching Yin Blood. Sudden collapse resembles Stroke (Zhongfeng), but it should not be treated via the Wind channel. Although *Baiyi Xuanfang* contains Da Huanglong Wan (Great Yellow Dragon Pill), it was not originally legislated for Shu Feng. However, for sudden death from Shu coma, administering this pill can restore consciousness immediately. But caution is needed: if the patient has chronic Yin Blood deficiency and Summerheat toxin has deeply entered the Blood level, this formula must not be used. *Liangfang* offers Duyu San (Sanguisorba Powder) to treat Shu coma and near-death states; using ordinary blood-cooling herbs to clear Summerheat wind deeply entrenched in the Blood level, nothing is better than this.
Sudden collapse and unconsciousness from Zhongshu is named Shu Feng. Generally, there are two pathways: Excess and Deficiency. Excess is Phlegm Excess. Normally accumulating phlegm fills the collaterals; once contracting intense Summerheat, phlegm obstructs Qi, causing sudden collapse and salivation. This is the most severe combination of Dampness and Phlegm. One should first induce vomiting to expel phlegm, then clear Summerheat; this is relatively easy. Deficiency is Yang Deficiency. Normally, Yang Qi is weak and Yin-Cold dominates. Once contracting intense Summerheat, pathogens attack the deficiency. This is a Damp disease originating from Cold-Deficiency. One must combine Yang-restoring drugs with Summerheat-clearing agents; this is the most difficult to treat.
Li Dongyuan stated: When Spleen and Stomach are weak, around June and July, people sweat soaking clothes, feel heavy and short of breath, and even suffer flaccid paralysis of limbs, unsteady gait, tilted feet, blurred vision, and dark complexion suggesting imminent collapse. This indicates exhaustion of Kidney and Bladder. Immediate rescue is required by nourishing Lung Qi to supplement the upper source of Water. Furthermore, excessive sweating injures Body Fluids; if tendons and bones lose nourishment, pain or thirst occurs. This should not be treated as Summerheat.