凡治伤暑证,最当辨其阴阳虚实。若外中热邪、内亦烦躁而热者。此表里俱热,方是阳
症,治宜清热解暑。
若脉虚无力,或为恶寒背寒,或为吐恶,或为腹痛泄泻,或四肢鼻尖微冷,或不喜冷茶
冷水,或息促气短无力,皆阳中之阴也。凡见此类,但当专顾元气,四君子为主治,或理中
汤加白芍。若虚寒甚者,则合时令而从证,必用桂附参 等药,切不可因暑热之名,而热用
寒凉解暑,则祸不可胜言矣。
五积散 治阴暑受寒,头痛无汗,恶寒身体拘急,四肢酸疼,以此温之。
白芷 广皮 紫朴 枳壳 桔梗 川芎 白芍 茯苓 苍术 当归 法夏 桂枝 黑姜
炙草(各五分) 生姜(三片) 枣(二枚) 水煎服。
清暑益气汤 治伤暑寒热,自汗口渴,恶寒发热。
条参 箭 焦术 建曲(各一钱) 泽泻 黄柏 青皮 干葛 五味 炙草(各五分) 姜(一
片) 枣(二枚,为引)
人参白虎汤 治中暑不恶寒而发热。
沙参 石膏 知母(各一钱) 炙草(五分)
粳米一撮,水煎服。口渴加麦冬一钱,五味七粒。
调元生脉散 平肝木,益脾土,泻邪火,补元气,小儿要药。
党参 箭 麦冬(各二钱) 五味(一分) 炙草(一钱) 姜(三片) 大红枣(二枚,为引)
加味五苓散 治暑症要药。
焦术 茯苓(各二钱) 猪苓 泽泻 安桂 藿香 木瓜 西砂(各一钱) 姜(三片) 红枣(三枚) 灯芯为引。
四君子汤 治脾胃虚弱,四肢无力,咳嗽伤暑等症。
条参 焦术 茯苓(各二钱) 炙草(一钱) 姜(二片) 枣(二枚) 水煎服。
吐加西砂一钱;水泻加前仁一钱;食积加神曲、麦芽各一钱。
理中汤 治阴暑呕吐、泻利腹痛。
条参 黑姜(各一钱) 炙草(七分) 焦术(三钱) 大枣(二枚) 水煎服,为丸亦可。
生脉散 固中气,清火热,保肺金,并止口渴。
洋参(二钱) 麦冬(三钱) 五味子(五分) 水煎服。
香苓汤 治阳暑脉虚兼吐泻。
焦术 茯苓 扁豆(各二钱) 香薷 猪苓 泽泻 安桂 紫朴 甘草(各一钱) 大枣(二枚)
生姜(三片) 灯芯(十茎,为引) 水煎服。
凡是治疗伤暑证,最应当辨别其阴阳虚实。如果外感热邪、内部也烦躁且发热,这是表里俱热,属于阳症,治疗适宜清热解暑。
如果脉象虚弱无力,或者出现怕冷背部发凉,或者恶心呕吐,或者腹痛腹泻,或者四肢和鼻尖微微发冷,或者不喜欢喝冷茶冷水,或者呼吸急促气短无力,这些都是阳症中的阴证(即真寒假热或阳气虚衰)。凡见到这类情况,只应当专门顾护元气,以四君子汤为主治方剂,或者使用理中汤加白芍。如果虚寒症状严重,则需结合时令和具体证候,必须使用桂枝、附子、人参等药物,切不可因为“暑热”的名字,就错误地使用寒凉药物来解暑,那样造成的祸害不可胜言。
五积散 治疗阴暑受寒,头痛无汗,怕冷身体拘急僵硬,四肢酸痛,用此方温散寒邪。
白芷、广陈皮、紫厚朴、枳壳、桔梗、川芎、白芍、茯苓、苍术、当归、法半夏、桂枝、黑姜、炙甘草(各五分),生姜(三片),大枣(二枚),水煎服。
清暑益气汤 治疗伤暑引起的寒热往来,自汗口渴,恶寒发热。
党参、炒白术、建神曲(各一钱),泽泻、黄柏、青皮、干葛根、五味子、炙甘草(各五分),生姜(一片),大枣(二枚,作为药引)。
人参白虎汤 治疗中暑后不恶寒而发热。
南沙参、石膏、知母(各一钱),炙甘草(五分),粳米一撮,水煎服。口渴者加麦冬一钱,五味子七粒。
调元生脉散 平抑肝木,补益脾土,泻除邪火,补益元气,是小儿的重要药物。
党参、麦冬(各二钱),五味子(一分),炙甘草(一钱),生姜(三片),大红枣(二枚,作为药引)。
加味五苓散 治疗暑症的要药。
炒白术、茯苓(各二钱),猪苓、泽泻、安桂(肉桂)、藿香、木瓜、西砂仁(各一钱),生姜(三片),红枣(三枚),灯芯草作为药引。
四君子汤 治疗脾胃虚弱,四肢无力,咳嗽伤暑等症状。
党参、炒白术、茯苓(各二钱),炙甘草(一钱),生姜(二片),大枣(二枚),水煎服。
呕吐者加西砂仁一钱;水样腹泻者加车前子一钱;食积者加神曲、麦芽各一钱。
理中汤 治疗阴暑引起的呕吐、腹泻腹痛。
党参、黑姜(各一钱),炙甘草(七分),炒白术(三钱),大枣(二枚),水煎服,也可制成丸药服用。
生脉散 固护中气,清除火热,保润肺金,并止口渴。
西洋参(二钱),麦冬(三钱),五味子(五分),水煎服。
香苓汤 治疗阳暑脉象虚弱兼有呕吐腹泻。
炒白术、茯苓、扁豆(各二钱),香薷、猪苓、泽泻、安桂(肉桂)、紫厚朴、甘草(各一钱),大枣(二枚),生姜(三片),灯芯草(十茎,作为药引),水煎服。
In the treatment of heatstroke (Shangshu), it is most crucial to differentiate between Yin and Yang, as well as deficiency and excess. If external pathogenic heat invades and internal restlessness with fever occurs, this indicates heat in both the exterior and interior, constituting a Yang syndrome. The treatment should focus on clearing heat and resolving summerheat.
If the pulse is weak and forceless, or if there is aversion to cold with a cold back, nausea and vomiting, abdominal pain with diarrhea, slight coldness in the four limbs and nasal tip, aversion to drinking cold tea or water, or rapid breathing with shortness of breath and weakness, these are all "Yin within Yang" (indicating true cold/false heat or depletion of Yang Qi). In such cases, one must exclusively protect the Yuan Qi (Original Qi). The primary formula is Sijunzi Tang (Four Gentlemen Decoction), or Lizhong Tang (Regulate the Middle Decoction) modified with Baishao (White Peony Root). If deficiency-cold is severe, treatment must align with the season and specific syndrome, requiring herbs such as Guizhi (Cinnamon Twig), Fuzi (Prepared Aconite Root), and Renshen (Ginseng Root). One must absolutely not use cold-natured herbs to resolve summerheat merely because of the name "summerheat," as doing so would lead to disastrous consequences.
Wuji San (Five Accumulations Powder) treats cold contracted from Yin Summerheat, presenting with headache, absence of sweating, aversion to cold, bodily stiffness, and soreness/pain in the four limbs. It is used to warm and dispel cold.
Ingredients: Bai Zhi (Angelicae Dahuricae Radix), Guang Pi (Tangerine Peel), Zi Hou Po (Magnolia Bark), Zhi Ke (Aurantium Fructus Immaturus), Jie Geng (Platycodon Root), Chuan Xiong (Ligusticum Rhizome), Bai Shao (Paeoniae Radix Alba), Fu Ling (Poria), Cang Zhu (Atractylodis Rhizoma), Dang Gui (Angelicae Sinensis Radix), Fa Ban Xia (Pinellia Rhizoma Prepared), Gui Zhi (Cinnamomi Ramulus), Hei Jiang (Scorched Ginger), Zhi Gan Cao (Honey-fried Licorice Root) (each 0.5 fen); Sheng Jiang (Fresh Ginger) (3 slices); Da Zao (Jujube) (2 pieces). Decoct in water and take orally.
Qingshu Yiqi Tang (Clear Summerheat and Boost Qi Decoction) treats heatstroke with alternating chills and fever, spontaneous sweating, thirst, aversion to cold, and fever.
Ingredients: Tiao Shen (Codonopsis Root), Jian Qu (Medicated Leaven) (each 1 qian); Ze Xie (Alismatis Rhizoma), Huang Bo (Phellodendri Cortex), Qing Pi (Aurantii Fructus Pericarpium), Gan Ge (Puerariae Radix), Wu Wei Zi (Schisandrae Fructus), Zhi Gan Cao (Honey-fried Licorice Root) (each 0.5 fen); Sheng Jiang (Fresh Ginger) (1 slice); Da Zao (Jujube) (2 pieces, as an enabler/guide).
Renshen Baihu Tang (Ginseng White Tiger Decoction) treats Zhongshu (Heatstroke) characterized by fever without aversion to cold.
Ingredients: Sha Shen (Glehniae Radix or Adenophorae Radix), Shi Gao (Gypsum Fibrosum), Zhi Mu (Anemarrhenae Rhizoma) (each 1 qian); Zhi Gan Cao (Honey-fried Licorice Root) (0.5 fen); Jing Mi (Oryza Sativa Germ) (a pinch). Decoct in water and take orally. For thirst, add Mai Dong (Ophiopogonis Radix) 1 qian and Wu Wei Zi (Schisandrae Fructus) 7 grains.
Tianyuan Shengmai San (Origin-Regulating Pulse-Nourishing Powder) soothes Liver Wood, tonifies Spleen Earth, drains pathogenic fire, and supplements Yuan Qi. It is an essential medicine for children.
Ingredients: Dang Shen (Codonopsis Radix), Mai Dong (Ophiopogonis Radix) (each 2 qian); Wu Wei Zi (Schisandrae Fructus) (1 fen); Zhi Gan Cao (Honey-fried Licorice Root) (1 qian); Sheng Jiang (Fresh Ginger) (3 slices); Da Hong Zao (Large Jujube) (2 pieces, as an enabler/guide).
Jiawei Wuling San (Modified Five-Ling Powder) is a key remedy for summerheat syndromes.
Ingredients: Jiao Zhu (Stir-fried Atractylodis Rhizoma), Fu Ling (Poria) (each 2 qian); Zhu Ling (Polyporus), Ze Xie (Alismatis Rhizoma), An Gui (Cinnamomi Cortex), Huo Xiang (Agastaches Herba), Mu Gua (Chaenomelis Fructus), Xi Sha Ren (Amomi Fructus Rotundus) (each 1 qian); Sheng Jiang (Fresh Ginger) (3 slices); Hong Zao (Jujube) (3 pieces); Deng Xin Cao (Junci Medulla) as an enabler/guide.
Sijunzi Tang (Four Gentlemen Decoction) treats Spleen and Stomach deficiency, weakness in the four limbs, cough due to summerheat, etc.
Ingredients: Tiao Shen (Codonopsis Root), Jiao Zhu (Stir-fried Atractylodis Rhizoma), Fu Ling (Poria) (each 2 qian); Zhi Gan Cao (Honey-fried Licorice Root) (1 qian); Sheng Jiang (Fresh Ginger) (2 slices); Da Zao (Jujube) (2 pieces). Decoct in water and take orally.
For vomiting, add Xi Sha Ren (Amomi Fructus Rotundus) 1 qian; for watery diarrhea, add Qian Ren (Plantaginis Semen) 1 qian; for food stagnation, add Shen Qu (Massa Medicata Fermentata) and Mai Ya (Hordei Fructus Germinatus) each 1 qian.
Lizhong Tang (Regulate the Middle Decoction) treats Yin Summerheat with vomiting, diarrhea, and abdominal pain.
Ingredients: Tiao Shen (Codonopsis Root), Hei Jiang (Scorched Ginger) (each 1 qian); Zhi Gan Cao (Honey-fried Licorice Root) (0.7 fen); Jiao Zhu (Stir-fried Atractylodis Rhizoma) (3 qian); Da Zao (Jujube) (2 pieces). Decoct in water and take orally; can also be made into pills.
Shengmai San (Pulse-Nourishing Powder) consolidates Middle Qi, clears heat/fire, protects Lung Metal, and stops thirst.
Ingredients: Yang Shen (American Ginseng Radix) (2 qian); Mai Dong (Ophiopogonis Radix) (3 qian); Wu Wei Zi (Schisandrae Fructus) (0.5 fen). Decoct in water and take orally.
Xiangling Tang (Elsholtzia and Poria Decoction) treats Yang Summerheat with a weak pulse accompanied by vomiting and diarrhea.
Ingredients: Jiao Zhu (Stir-fried Atractylodis Rhizoma), Fu Ling (Poria), Bian Dou (Dolichos Lablab Seed) (each 2 qian); Xiang Ru (Elsholtziae Herba), Zhu Ling (Polyporus), Ze Xie (Alismatis Rhizoma), An Gui (Cinnamomi Cortex), Zi Hou Po (Magnolia Bark), Gan Cao (Licorice Root) (each 1 qian); Da Zao (Jujube) (2 pieces); Sheng Jiang (Fresh Ginger) (3 slices); Deng Xin Cao (Junci Medulla) (10 stems, as an enabler/guide). Decoct in water and take orally.