立夏以后，暑热盛行，时人有头疼恶心，身热恶寒，手足厥冷，肢节沉痛，不思饮食，或气高而喘，或气短而促，
甚者
用手扪之，如火燎皮肤，或腹肠绞疼，或口鼻流血，病候与伤寒相似。不知者误认伤寒，用风热发汗药，或
加衣出汗，则元气益虚，终不知悟。盖此证乃夏属阴虚，元气不足，湿热蒸人，暴伤元气，人初感之，即骨乏腿软
，精神倦怠，昏睡懒语，其形如醉梦间，或无汗或微汗不断，或大汗不止，烦渴饮水，胸膈痞闷，小便黄而少，大
便溏而频，或呕或泻或结，或霍乱不止。此等证与伤寒大异，按时而施治，据证而急疗，无不应手者。语曰勿伐天
和，正因时之道也。亦有不头痛身痛恶寒者，治法皆同，治法轻者以五苓散，以利小便，导火下泻而暑自解，或香
薷饮辛散以驱暑毒，木瓜制暑之要药也。或藿香正气散、十味香薷饮之类，重者人参败毒散、桂苓甘露饮、竹叶石
膏汤、白虎汤之类，弱者用生脉散、清暑益气汤、补中益气汤等。若不分内外，不论轻重强弱，一概以和解，百发
百中，随试随应，则无如六和汤最良矣。方书名家，古今甚众，其中多所发挥，明切精密者，惟朱丹溪为最详且要。
近世著作，王宇泰先生，有《证治准绳》、《证治类方》诸帙，独得其解，批 中窍，转丸游刃之技，力追古名流
已，工医者所当时披诵而潜玩者也，治方见后。
霖按∶暑证论治，此篇要言不烦，可作《医门棒喝》，然未若仲景治 精简也。第一节言暑证总纲论曰∶太阳
中，发热恶寒，身重而疼痛，其脉弦细芤迟，小便已洒洒然毛耸，手足逆冷，小有劳，身即热，口开前板齿燥，若
发其汗，则恶寒甚，加温针，则发热甚，数下之，则淋甚。夫暑为天日之阳邪，由口鼻皮毛袭入者多，先见寒热，其
身重疼痛，脉弦细芤迟者，暑多兼湿，盖弦细芤迟中，寓濡象挟湿故也。太阴主表，膀胱亦主表，热邪伤气，故小便
已洒洒然毛耸也。手足冷者，阳气内郁而不能外达也。热湿盛于内，气淫于外，故气出身热，口开齿燥也。若发汗则
更伤其表气，温针则益其燥热，下之则热邪内陷，此示人以暑病之脉证禁忌，而不出方也。第二节论曰∶太阳中热者，
是也。汗出恶寒，身热而渴，白虎加人参汤主之。此言热甚者，宜清热生阴也。第三节论曰∶太阳中 ，身热疼重，
而脉微弱，此以夏月伤冷水，水行皮中所致也。一物瓜蒂汤主之，此言湿甚热微者，以瓜蒂去身面四肢水气，水去暑
无所根据则自解。观其三法鼎峙，由此类推，其热湿微甚，治暑已无余蕴，谁谓长沙知治寒而不知治暑哉！
立夏之后，暑热之气盛行。此时人们常出现头痛、恶心，身体发热却怕冷，手足冰冷，肢体关节沉重疼痛，不想进食；或者呼吸急促而喘，或者气短而急促。病情严重的，用手触摸皮肤，感觉像火烧一样烫手；或者腹部和肠道绞痛，或者口鼻出血。这些病候与伤寒相似。不了解的人误认为是伤寒，使用发散风热的发汗药，或者通过加衣被来逼出汗，这样会导致元气更加虚弱，却始终不知醒悟。
这是因为此证属于夏季阴虚，元气不足，湿热蒸腾人体，突然损伤了元气。人刚感受邪气时，就会感到骨节酸软、腿部无力，精神倦怠，昏睡懒言，身形如同醉梦之中；或者无汗，或者微汗不止，或者大汗淋漓不止；烦渴想喝水，胸膈部痞塞闷胀，小便黄而量少，大便稀溏且次数频繁；或者呕吐，或者腹泻，或者便秘；或者霍乱不止。这些证候与伤寒大不相同。按时令施治，依据症状紧急治疗，没有不立刻见效的。俗话说不要违背“天和”（自然规律），正是顺应时令的道理。
也有不出现头痛、身痛、恶寒的情况，治疗方法都相同。轻症用五苓散，通过利小便，引导火邪向下排泄，暑气自然解除；或者用香薷饮辛温发散以驱除暑毒，木瓜是制约暑邪的要药。或者用藿香正气散、十味香薷饮之类；重症用人参败毒散、桂苓甘露饮、竹叶石膏汤、白虎汤之类；体弱者用生脉散、清暑益气汤、补中益气汤等。如果不分内外、不论轻重强弱，一概采用和解法，百发百中，随试随应，那么没有比六和汤更好的了。方书名家古今很多，其中多有发挥，阐述得明白确切、精密详尽的，只有朱丹溪最为详细重要。近世的著作中，王宇泰先生有《证治准绳》、《证治类方》等书，独得其解，切中要害，具有游刃有余的技巧，功力直追古代名医，这是医生当时应当诵读并潜心玩味的，治方见后文。
霖按：关于暑证的论治，这篇文字简明扼要，可以作为《医门棒喝》，然而不如张仲景的治疗精简。第一节论述暑证总纲说：太阳中暍（中暑），发热恶寒，身体沉重而疼痛，脉象弦细芤迟，小便后感觉洒洒然毛发耸立，手足逆冷，稍微劳作，身体就发热，张口呼吸前板齿干燥。如果发汗，则恶寒更甚；加温针，则发热更甚；多次攻下，则淋证更重。夫暑是天日之阳邪，多由口鼻皮毛侵入，先出现寒热，身体沉重疼痛，脉象弦细芤迟，是因为暑多兼湿，盖因弦细芤迟中，蕴含濡象挟湿的缘故。太阴主表，膀胱也主表，热邪伤气，所以小便后洒洒然毛发耸立。手足冷，是因为阳气内郁而不能外达。热湿盛于内，气淫于外，所以气出身体发热，张口齿燥。如果发汗则更伤表气，温针则增加燥热，攻下则热邪内陷。这是向人展示暑病的脉证禁忌，而不给出方剂。第二节论述说：太阳中热者，即中暍。汗出恶寒，身体发热而口渴，用白虎加人参汤主治。这是说热势重的，宜清热生津。第三节论述说：太阳中暍，身体发热疼痛沉重，而脉微弱，这是因为夏天伤了冷水，水气行于皮中所致。用一物瓜蒂汤主治，这是说湿重热轻者，用瓜蒂去除身面四肢的水气，水去暑邪无所依附则自然解除。看这三种方法鼎足而立，由此类推，对于暑病的热湿轻重，治疗已无遗漏，谁说长沙（指张仲景）只知道治寒却不知道治暑呢！
After the Beginning of Summer (Lixia), summer heat prevails. At this time, people often experience headache, nausea, fever with aversion to cold, cold hands and feet, heavy and painful limbs and joints, loss of appetite; or rapid breathing with panting, or shortness of breath. In severe cases, touching the skin feels like burning fire; or there is colicky pain in the abdomen and intestines, or bleeding from the mouth and nose. These symptoms resemble Taiyang disease (diseases affecting the Taiyang channel). Those who do not understand may mistakenly diagnose it as Taiyang disease and use diaphoretic herbs for wind-heat, or induce sweating by adding clothing, which further depletes Yuan Qi (Primordial Qi) without realization.
This condition belongs to Yin deficiency in summer, with insufficient Yuan Qi, where damp-heat steams the body, suddenly damaging Yuan Qi. Upon initial contraction, one feels bone soreness and leg weakness, mental fatigue, drowsiness, reluctance to speak, resembling a drunken dream state; or no sweat, or continuous slight sweating, or profuse uncontrollable sweating; irritability and thirst desiring water, chest and epigastrium fullness and oppression, yellow and scanty urine, loose and frequent stools; or vomiting, diarrhea, or constipation; or cholera-like disorder unceasing. These syndromes are vastly different from Taiyang disease. Treating according to the season and urgently addressing the symptoms yields immediate results. As the saying goes, "Do not violate Tian He (Heavenly Harmony/Natural Order)," which is precisely following the way of the seasons.
There are also cases without headache, body pain, or aversion to cold; the treatment methods remain the same. For mild cases, Wu Ling San (Five-Ingredient Powder with Poria) is used to promote urination, guiding Fire downward so that summer heat resolves naturally; or Xiang Ru Yin (Elsholtzia Decoction) is used for acrid-warm dispersion to expel summer heat toxin, with Papaya (Mugua, Fructus Chaenomelis) being a key herb to restrain summer heat. Or Huo Xiang Zheng Qi San (Agarwood and Patchouli Powder to Rectify the Qi), Shi Wei Xiang Ru Yin (Ten-Ingredient Elsholtzia Decoction), etc. For severe cases, Ren Shen Bai Du San (Ginseng Powder to Overcome Toxins), Gui Ling Gan Lu Yin (Cinnamon Twig, Atractylodes Macrocephala, Talcum, and Other Herbs Sweet Dew Decoction), Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction), Bai Hu Tang (White Tiger Decoction), etc., are used. For weak constitutions, Sheng Mai San (Generate the Pulse Powder), Qing Shu Yi Qi Tang (Clear Summer Heat and Benefit Qi Decoction), Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), etc., are employed. If internal and external factors are not distinguished, and severity and strength are ignored, and all cases are treated generally with harmonizing methods, achieving 100% efficacy and immediate response, then Liu He Tang (Six-Harmonies Decoction) is the best. There are many famous authors of medical formularies throughout history who have elaborated on this; among them, Zhu Danxi is the most detailed and essential. In recent times, Mr. Wang Yutai has works such as *Zheng Zhi Zhun Sheng* (Standardized Diagnosis and Treatment) and *Zheng Zhi Lei Fang* (Classified Formulas for Diagnosis and Treatment), uniquely grasping the essence, hitting the critical points, demonstrating skillful mastery comparable to ancient masters. These are texts physicians should read and ponder deeply; the formulas follow below.
Lin's Note: The discussion on the treatment of summer heat syndromes in this section is concise and to the point, serving as a wake-up call (*Yi Men Bang He*), yet it is not as streamlined as Zhang Zhongjing's approach. Section One discusses the general outline of summer heat syndromes: In Taiyang Zhong Yue (Summer Heat Strike), there is fever and aversion to cold, heaviness and pain in the body, with a pulse that is wiry, fine, hollow, and slow. After urination, there is a shivering sensation with hair standing on end, and cold extremities. Slight exertion causes fever, open-mouth breathing, and dryness of the anterior teeth. If diaphoresis is induced, aversion to cold worsens; if moxibustion/heat needle is applied, fever worsens; if purgatives are used repeatedly, strangury worsens. Summer heat is a Yang pathogen from the sun, mostly entering via the mouth, nose, skin, and hair, initially presenting with chills and fever. The heaviness, pain, and wiry/fine/hollow/slow pulse indicate that summer heat often combines with dampness; the wiry/fine/hollow/slow pulse contains a soggy quality indicating dampness. Taiyin governs the exterior, and the Bladder also governs the exterior. Heat pathogen damages Qi, hence the shivering after urination. Cold extremities occur because Yang Qi is internally constrained and cannot reach the exterior. Heat and dampness prevail internally, while Qi floats externally, causing hot breath, fever, and dry teeth. Diaphoresis further damages exterior Qi; heat needles increase dryness and heat; purgation causes heat pathogen to sink inward. This illustrates the contraindications for pulse and symptoms in summer heat disease without providing a formula. Section Two states: In Taiyang Zhong Re (Summer Heat Heat), characterized by sweating, aversion to cold, fever, and thirst, Bai Hu Jia Ren Shen Tang (White Tiger Decoction plus Ginseng) is the primary treatment. This indicates that for severe heat, clearing heat and generating fluids is appropriate. Section Three states: In Taiyang Zhong Yue, with fever, pain, heaviness, and a weak pulse, this is caused by injuring cold water in summer, with water qi circulating in the skin. Yi Wu Gua Di Tang (Single-Ingredient Momordica Seed Decoction) is the primary treatment. This addresses cases where dampness is severe and heat is mild, using Momordica seed to remove water qi from the body, face, and limbs; once water is removed, summer heat has no basis and resolves naturally. Observing these three methods standing together, one can infer by analogy. Regarding the severity of heat and dampness in summer heat, treatment leaves nothing to be desired. Who says Changsha (Zhang Zhongjing) only knows how to treat cold and not summer heat!