张子和云∶李屏山素饮酒，一日得病，医用酒症丸热药，后目睹天地，但见红色，遂
成龙火之证，卒不能救。棠溪李济之，常病目，及居省掾，每服补肝散，以致睛胀，但见窗
槛横排，几至丧明，令涌泄五七次，继服凉剂，方始如故。丹霞朱僧人曾病三阳蓄热，常居
静室，不敢见明，明则头疼如锥，每置冰于顶上，不能解其物。询诸医，莫能辨其病，后治
之七日而愈。其用汗吐下三法而已，后用凉物清镇之，平复如故。夫人阴平阳秘，神气以宁
。盖昧者徇情纵欲，因致积热之证，非一朝一日故也，皆出于心热，甚则能伤血，故出于心
。积热者，热毒蕴积于内也，或有体气素实，一时感触热毒之气，郁积脏腑之间，或在心肺
之内，令人口苦咽干，涎唾稠粘，眼涩多泪，心气通于舌，脾气通于口，热燥相合，无所受
制，故口舌上生疮，小便秘涩，非伤寒之热，非风证之热，此乃积聚之热也。又有酒面煎爆
，雄附峻补，皆能有热，谓之积热也。何哉？一阴一阳之谓道，偏阴偏阳之谓疾。若偏者皆
致成疾。过于热者，积温成热，蕴积于内，遂成前证。经云∶偏胜则有偏害，偏害则有偏绝
，不可不察也。王安道曰∶人之所赖以生者气也。气者何？阴阳是也。夫阴与阳可以和而平
，可以乖而否，善摄与否，吉凶于是系，不能善者故偏寒偏热之病，莫逃乎乖否之余。虽然
寒也热也，粗工为之，不难设积热，良工犹弗能以为计。且以积热言之，始而凉和，次而寒
取，寒取不愈，则因热而从之。从之不愈，则技穷矣。王太仆故曰∶益火之源以消阴气，壮
水之主以制阳光。又曰∶取心者不必齐以热，取肾者不必齐以寒。吁∶千言万语之间，殆犹
和璧之在璞也，积热之病，由此来矣。人处中和， 偏阴不可以无阳，偏阳不可以无阴，惟
在冷暖得中而已。矫枉过正，识者忧焉。治法以三黄丸。凡热皆出于心，热甚则能伤血，或
以洗心散，四顺清凉饮子之类，此皆前人立率处方，后之学人，不可将阴阳虚盛之热，又有
血分气分之热，阴盛格阳之热，一例作积热证治之，反误多矣。今闻积热之方，条具于后。
张子和说：李屏山平时喜欢喝酒，有一天生病了，医生用酒症丸这种热性药物治疗，后来他出现眼前看到天地旋转、只见红色的症状，最终发展为龙火之证（指虚阳上浮、火热内盛的危重证候），抢救无效死亡。棠溪人李济之，经常患有眼病，担任省掾官职期间，每次服用补肝散，导致眼睛胀痛，看东西时只见窗框横排排列，几乎失明，经过涌吐和泻下疗法五到七次后，继服凉性药物，才恢复如初。丹霞朱僧人曾患三阳经蓄积热邪的病，常常待在安静的房间里，不敢见光，见到光就头痛如锥刺，每次把冰放在头顶上，也不能缓解痛苦。询问各位医生，没有人能辨别这是什么病，后来治疗七天痊愈。所用的方法不过是汗法、吐法、下法这三种而已，之后再用凉性物品清镇，才平复如常。人的阴气平和、阳气固秘，神气才能安宁。大概是因为无知之人顺从情欲放纵欲望，因而导致积热之证，这不是一朝一夕形成的，都源于心热，严重时能损伤血液，所以病根在于心。所谓积热，是指热毒蕴结积聚在体内。有的人体质原本强实，一时感触热毒之气，郁积在脏腑之间，或在心肺之内，使人口苦咽干，唾液稠粘，眼睛干涩多泪。心气通于舌，脾气通于口，热与燥相结合，没有制约，所以在口舌上生疮，小便短少涩滞。这不是伤寒的热证，也不是风证的热证，这是积聚而成的热证。又有饮酒、吃面食以及煎炸爆炒的食物，还有使用雄黄、附子等峻烈温补的药物，都能产生热邪，这叫做积热。为什么呢？一阴一阳交替变化叫做道，偏于阴或偏于阳叫做疾病。凡是偏颇的都会导致疾病。过于热的情况，是长期温热积累而成热，蕴积在体内，于是形成前面的那些症状。《内经》说：偏胜就会产生偏害，偏害就会导致偏绝，不可不仔细考察。王安道说：人赖以生存的是气。气是什么？就是阴阳。阴与阳可以和谐平衡，也可以乖违阻滞，善于调养与否，吉凶由此决定，不能善于调养的人，所以会有偏寒偏热的疾病，都逃不过阴阳乖违阻滞的后果。虽然说是寒证或热证，庸医容易设立“积热”的诊断，但高明的医生还不能轻易以此作为计策。且以积热来说，开始用凉性和缓的方法，其次用寒凉攻取的方法，如果寒凉攻取无效，则顺着热势而治；顺着热势而治无效，医术就穷尽了。王太仆曾说：益火之源以消除阴气，壮水之主以抑制阳光。又说：治疗心病不必一律用热药，治疗肾病不必一律用寒药。唉：千言万语之中，大概就像和氏璧藏在璞玉中一样，积热病的道理，由此而来。人处于中和状态，偏阴不可以没有阳，偏阳不可以没有阴，关键在于冷暖适中罢了。矫枉过正，有见识的人会为此担忧。治疗方法使用三黄丸。凡热邪都出于心，热甚则能损伤血液，或者使用洗心散、四顺清凉饮子之类的方剂，这些都是前人确立法则制定的处方，后来的学医者，不可将阴虚阳盛的热证、血分气分的热证、阴盛格阳的热证，一概当作积热证来治疗，否则错误就多了。现在听闻关于积热的方剂，详细列举在后面。
Zi Hezi stated: Li Pingshan used to drink alcohol frequently. One day he fell ill, and the physician treated him with Jiuzheng Wan (Alcohol Stasis Pill), a hot-natured medicine. Subsequently, he experienced visual disturbances where heaven and earth appeared to rotate, seeing only redness. This eventually developed into Longhuo Syndrome (a critical syndrome characterized by floating deficient yang and internal excess heat), for which he could not be saved and died. Li Zhizhi from Tangxi often suffered from eye diseases. While serving as a provincial clerk, every time he took Bugan San (Liver-Nourishing Powder), his eyes swelled and distended, causing him to see window frames arranged horizontally, nearly leading to blindness. After undergoing Yongxie therapy (emetic and purgative treatments) five to seven times, followed by the administration of cooling agents, his condition finally returned to normal. The monk Zhu Danxian once suffered from accumulated heat in the three Yang meridians. He stayed in quiet rooms and dared not look at light; exposure to light caused headaches like needle pricks. Placing ice on his head provided no relief. Physicians were unable to diagnose the illness. It was cured after seven days of treatment using only the Sweating, Vomiting, and Purging methods. Later, cooling substances were applied to clear and settle the condition, restoring health. When Yin is peaceful and Yang is secure, Shen Qi (Spiritual Energy) remains tranquil. Ignorant people indulge their desires and emotions, leading to Accumulated Heat Syndromes, which do not arise overnight but stem from Heart Heat. Severe Heat can damage Blood, hence the pathology originates in the Heart. Accumulated Heat refers to Heat-Toxin accumulating internally. Some individuals have robust constitutions but are temporarily affected by Heat-Toxin qi, which stagnates within the Zang-Fu organs or inside the Heart and Lungs. This manifests as bitter taste in the mouth, dry throat, thick and sticky saliva, dry itchy eyes with excessive tearing. Heart Qi connects to the tongue, and Spleen Qi connects to the mouth. When Heat and Dryness combine without restraint, sores appear on the mouth and tongue, and urination becomes scanty and difficult. This is not the Heat of Cold Damage (Shanghan) nor the Heat of Wind Syndromes, but rather Heat formed through accumulation. Consumption of alcohol, wheat products, fried foods, as well as the use of strong warming tonics like Xionghuang (Realgar) and Fuzi (Prepared Aconite Root) can all generate Heat, termed Accumulated Heat. Why? The alternation of one Yin and one Yang constitutes the Dao; deviation toward Yin or Yang constitutes disease. Any deviation leads to illness. Excessive heat results from long-term warmth accumulating into Heat, storing internally, thus forming the aforementioned symptoms. The Classic states: "Excess leads to harm, harm leads to severance." This must be carefully observed. Wang Andao said: What sustains human life is Qi. What is Qi? It is Yin and Yang. Yin and Yang can harmonize and balance, or they can deviate and obstruct. Whether one manages them well determines auspiciousness or misfortune. Those who fail to manage them well suffer from cold or heat deviations, escaping neither the consequences of deviation nor obstruction. Although distinguishing between cold and heat syndromes seems simple, crude physicians readily diagnose "Accumulated Heat," whereas skilled physicians hesitate to rely solely on this concept. Regarding Accumulated Heat: initially, mild cooling and harmonizing methods are used; subsequently, cold-purging methods are employed. If cold-purging fails, treatment follows the heat path. If following the heat path also fails, the physician's skills are exhausted. Wang Taipu stated: "Enrich the source of Fire to eliminate Yin Qi; strengthen the master of Water to control Solar Yang." He also said: "Treating Heart disorders does not require uniform use of hot herbs; treating Kidney disorders does not require uniform use of cold herbs." Alas! Among thousands of words, the truth lies hidden like the Hebi jade in its rough stone. The principles of Accumulated Heat derive from here. Humans exist in a state of neutrality; Yin cannot exist without Yang, and Yang cannot exist without Yin. The key lies in maintaining moderation in temperature and nature. Overcorrection causes concern among the wise. The treatment method involves Sanhuang Wan (Three-Yellow Pill). All Heat originates from the Heart; severe Heat damages Blood. Formulas such as Xixin San (Heart-Washing Powder) or Sishun Qingliang Yinzi (Four-Compliant Cooling Decoction) may be used. These are prescriptions established by predecessors. Later students must not treat Yin-deficiency with Yang-excess Heat, Blood-level Heat, Qi-level Heat, or Yin-rejection-of-Yang Heat simply as Accumulated Heat, lest errors abound. The formulas for treating Accumulated Heat are detailed below.