洁古云∶静而得之为中暑，动而得之为中热，中暑为阴证，中热为阳证。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，肢体疼痛而心烦，肌肤大热而无
汗，是为房室之阴寒所遏，使周身阳气不能升越，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，苍术白虎汤主之。余窃谓之不然。盖暑热者，夏之令也。大行
于天地之间，或劳动，或饥饿，元气亏乏，不足以御天令亢热，于是受伤而为病，名曰中暑
，亦名中热，其实一也。今乃以动静所得分之，何哉？夫中暑热者，因多在劳役之人，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，得头痛
恶寒等证，盖亦伤寒之类是耳，乌得以中暑名之耶？其所以烦心与肌肤大热者，由身中阳气
，为阴寒所遏而作，非暑邪也。苟欲治之，非辛温发散之剂不可，今乃以大顺散治之，吾恐
不能解表，反增内烦矣。夫大顺散一方，原其初意，本为冒暑伏热引饮过多，脾胃受寒湿而
立。故甘草、姜皆经火制，又用肉桂而非桂枝，盖温药也。内有杏仁，不过取其能下气耳。
今世俗往往不明，类曰夏日阴气在内，大顺散必用之药。吁！其误也不亦甚欤！夫阴气非寒气
也，以夏月阳气发散在外，故阴气在内耳。岂得治阴气为寒气而用温热之药乎？阴果为寒，
何以夏日则饮水乎？其白虎汤虽宜用，亦不可视为通行之药，必参之治暑诸方，随所见证而
用之，然后合理。若所谓静而得之之证，虽当暑月，原非暑证，宜分出治之，使后人勿致有
似同而异之感。
洁古说：在静止状态下感受暑邪的称为中暑，在运动劳作时感受暑邪的称为中热；中暑属于阴证，中热属于阳证。东垣说：在深堂大厦中避暑而得病的，名叫中暑。这种病必定出现头痛、恶寒（怕冷）、身体拘挛紧急、肢体疼痛且心烦，皮肤大热但无汗，这是因为房室中的阴寒之气遏制了周身阳气，使其不能升发外越，治疗以大顺散为主方。如果是行路的人或农夫，在烈日下劳役而得病的，名叫中热。这种病必定痛苦于头痛，烦躁不安、怕热，触摸皮肤感觉大热，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。我私下认为这种说法不对。大概暑热是夏季的主令气候，广泛流行于天地之间。无论是劳动还是饥饿，导致元气亏乏，不足以抵御天气的亢盛炎热，于是受伤而生病，这名叫中暑，也名叫中热，其实是一回事。现在竟然根据动静不同来区分它们，为什么呢？那些患中暑热病的人，大多是在劳役之人身上发生，因为劳役导致身体虚弱，虚则邪气容易侵入，邪气侵入后发病，如果身体不虚，那么即使天气亢盛，也没有途径伤害人体。那些在深堂大厦中避暑而得到头痛、恶寒等症状的人，大概也是伤寒一类的疾病罢了，怎么能用中暑来命名呢？他们之所以心烦和皮肤大热，是由于体内的阳气被阴寒之气遏制而产生的，并非暑邪所致。如果想要治疗它，非用辛温发散的药物不可，现在却用大顺散来治疗，我担心不仅不能解表，反而会增加内部的烦热。关于大顺散这一方剂，推究其初意，原本是为了应对冒受暑热、伏热内蕴而饮水过多，导致脾胃受到寒湿侵袭而设立的。所以甘草、干姜都经过火制，又使用肉桂而不是桂枝，这都是温性的药物。方内有杏仁，不过是取其能降气的作用罢了。如今世俗之人往往不明白这一点，普遍认为是夏日阴气在内，是大顺散必须使用的药方。唉！这种错误不是很严重吗？所谓的阴气并不是寒气，而是因为夏季阳气发散在外，所以阴气才在内里。怎么能把治阴气当作治寒气而使用温热药物呢？如果阴气果真是寒，为什么夏天人们要喝冷水呢？白虎汤虽然适宜使用，也不可视为通用的常药，必须参考治疗暑病的其他方剂，根据所见证候来使用，这样才合理。至于所谓“静而得之”的病证，虽然在暑月发生，原本就不是暑证，应当分开治疗，使后人不要产生似是而非的困惑。
Jieguo stated: Contracting the pathogen while at rest is termed *Zhongshu* (heatstroke), while contracting it during physical exertion is termed *Zhonger* (heat exhaustion); *Zhongshu* belongs to Yin syndromes, and *Zhonger* belongs to Yang syndromes. Dongyuan stated: Those who seek refuge from heat in deep halls and large buildings contract a disease named *Zhongshu*. The symptoms must include headache, aversion to cold, stiffness and tension of the body, pain in the limbs, irritability, high fever of the skin without sweating. This is caused by the yin-cold of the dwelling suppressing the body's yang qi, preventing it from ascending and dispersing; Da Shun San (Great Harmony Powder) is the primary formula. If pedestrians or farmers contract the disease while laboring under the midday sun, it is named *Zhonger*. The symptoms must include severe headache, agitation, aversion to heat, burning hot skin upon touch, extreme thirst with a desire to drink, profuse sweating, and lethargy due to qi deficiency. This results from heavenly heat injuring lung qi externally; Cangzhu Baizhu Tang (Atractylodes Macrocephala and White Tiger Decoction) is the primary formula. I privately disagree with this view. Essentially, summer heat is the governing climate of summer, prevalent between heaven and earth. Whether due to labor or hunger, if primordial qi is deficient and insufficient to resist the excessive heat of the season, injury occurs, resulting in illness. This is named *Zhongshu*, also named *Zhonger*; in reality, they are one and the same. Why then distinguish them based on movement versus stillness? Those suffering from summer heat illnesses are mostly laborers; labor leads to deficiency, and deficiency allows pathogens to enter. Once the pathogen enters, illness arises. If the body were not deficient, even excessive seasonal heat would have no way to injure it. Those who seek refuge in deep halls and suffer from headache and aversion to cold likely suffer from conditions similar to Cold Damage (*Shanghan*), and how can these be named *Zhongshu*? Their irritability and high skin fever arise because internal yang qi is suppressed by yin-cold, not because of summer-heat pathogens. To treat such cases, pungent-warm dispersing agents are indispensable. Using Da Shun San now, I fear it will fail to release the exterior and may instead increase internal irritability. Regarding Da Shun San, its original intent was established for cases of exposed to summer heat and latent heat, leading to excessive drinking, which caused the spleen and stomach to be affected by cold-dampness. Therefore, Licorice Root (*Gancao*) and Ginger (*Jiang*) are processed by fire, and Cinnamon Bark (*Rougui*) is used instead of Cinnamon Twig (*Guizhi*); these are warm medicines. The inclusion of Apricot Kernel (*Xingren*) merely utilizes its ability to direct qi downward. Nowadays, common people often misunderstand this, claiming that "yin qi resides inside during summer," making Da Shun San a mandatory remedy. Alas, is this error not grave? The so-called "yin qi" is not cold qi; rather, because summer yang qi disperses outward, yin qi resides inward. How can one treat "yin qi" as "cold qi" by using warm-hot medicines? If yin were truly cold, why do people drink water in summer? Although Baihu Tang (White Tiger Decoction) is suitable, it should not be regarded as a universal remedy. It must be combined with other formulas for treating summer heat and used according to the specific manifestations, thereby aligning with reason. As for the syndrome described as "contracted while at rest," although it occurs in the summer month, it is originally not a summer-heat syndrome. It should be treated separately to prevent future practitioners from being confused by seemingly similar yet distinct conditions.