（即地榆散） 治中暑昏迷，不省人事欲死者。并治伤暑烦躁，口苦舌干，头痛恶心，
不思饮食，及血痢。
地榆 赤芍药 黄连 青皮（去白等分） 每服三钱，浆水调服。若血痢，水煎服。
喻嘉言曰∶元丰朝，立和剂局，萃集医家经验之方，于中暑一门独详。以夏
方历试，见闻广尔。其取用小半夏茯苓汤，不治其暑，专治其湿。又以半夏茯苓
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
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
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
用大顺散来复丹，以治暑证之多泻利者，又即缩脾之意而推之也。其枇杷叶散
所窃据而浊秽，故用香薷枇杷叶丁香白茅根之辛香，以安胃而去胃所恶之臭。
子，以治暑证之多呕吐者，又即枇杷叶散而推之也。医者于热湿虚寒浅深缓急
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
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
饮，于局方五味中，增人参黄 白术陈皮木瓜，益虚以去湿热。乃至东垣之
黄汤，又补中实卫以去其湿热，肥白内虚之人，所宜服者也。中暑必兼躁
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
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
湿，而加人参则益虚，加辰砂减桂则去热。白虎汤加人参则益虚，加苍术则
则大备矣，然尚有未备焉。尝观暑风一证，其卒倒头乎中风，而不可从风
虽有大黄龙丸，初不为暑风立法。管见从而赞之曰∶有中 昏死，灌之
暑风之一斑矣。倘其人阴血素亏，暑毒深入血分，进以此丸，宁不立至
榆散，治中暑昏迷不醒人事而欲死者，但用平常凉血之药，清解深入血
此矣。后有用之屡效，而美其名为泼火散者，知言哉。夫中天火运，流
益见暑风为心火暴甚，煎熬阴血，舍清心凉血之外，无可扑灭尔。综
故益加详焉。
（即地榆散）治疗中暑导致昏迷、不省人事、濒临死亡的情况。同时也治疗伤暑引起的烦躁、口苦舌干、头痛恶心、不想饮食，以及血痢。
地榆、赤芍药、黄连、青皮（去白，各等分）。每次服用三钱，用浆水调服。如果是血痢，用水煎服。
喻嘉言说：元丰年间，设立和剂局，汇集医家的经验方剂，对于中暑这一门类记载得特别详细。因为夏季的方剂经过广泛试用，见闻广博。其中取用小半夏茯苓汤，不直接治疗暑邪，而是专门治疗湿邪。又把半夏茯苓命名为消暑丸，可见消暑的关键在于消除湿气，名称正当且理由充分。至于香薷饮，以香薷、扁豆、浓朴为主方；若加入黄连为君药，则是为了治疗心火。如果湿气重，则去掉黄连，加入茯苓、甘草，以治疗脾湿。暑邪被湿气浸淫而变得沉重滞涩，所以在扁豆、葛根、甘草中，辅助使用乌梅、砂仁、草果来舒畅脾气；而去掉大顺散、来复丹，用来治疗暑证中多伴有腹泻的情况，这又是从缩脾散的意思推导出来的。枇杷叶散所针对的是因暑热导致的浊秽之气，所以使用香薷、枇杷叶、丁香、白茅根的辛香之性，来安抚胃气并去除胃所厌恶的臭秽。这是治疗暑证中多伴有呕吐的情况，又是从枇杷叶散推导出来的。医生们对于热、湿、虚、寒的浅深缓急，其利益广大了。而后来的各位贤人，又在补益虚弱方面加以补充。河间刘完素的桂苓甘露饮，以及五苓散加三石，意在补益人体的虚弱。张子和的桂苓甘露饮，用人参、葛根、甘草、藿香、木香，在补益虚弱的同时，又兼有清除浊邪的作用。局方五味子散中，增加人参、黄芩、白术、陈皮、木瓜，通过补益虚弱来清除湿热。乃至东垣李杲的黄连解毒汤（注：原文“黄汤”结合语境及东垣学术思想，此处疑指代其清热补中或相关方义，但依字面及常见误读，结合后文“补中实卫”，可能指补中益气汤类或清暑益气汤之意，然原文仅二字“黄汤”，暂按字面或通假理解，此处根据上下文“补中实卫”推测可能指代具有补中作用的方剂，但严格忠实原文提取实体），又通过补中气、充实卫气来清除湿热，这是适合形体肥胖、内部虚弱的人服用的。中暑必然兼有躁动不安。仲景竹叶石膏汤的制法，方名清燥汤，仍然以祛湿为首要任务。燥与湿，是相反的两个概念。非东垣具有过人的见识，达不到这种认识程度。又如益元散用于祛湿，如果加入辰砂，则并去其热；如果加入人参，则补益虚弱；如果加入辰砂并减少桂枝，则清除热邪。白虎汤加入人参则补益虚弱，加入苍术则……（原文此处似有缺漏或语意未完，但根据前文逻辑推断，意为增强祛湿或调整配伍），这样就非常完备了，然而还有不完备的地方。曾经观察到暑风这一病症，其突然昏倒是类似中风，但不能按照中风来治。虽然有大黄龙丸，但最初并不是为暑风立法的。我根据自己的见解加以赞同说：遇到中暑昏死的情况，灌服此药，算是看到了暑风的一个方面罢了。假如这个人阴血素来亏损，暑毒深入血分，进服这个丸药，岂不是立刻导致死亡？地榆散，治疗中暑昏迷不醒人事、濒临死亡的，只使用平常的凉血药物，清解深入血分的暑毒，这才是正确的。后来有人多次使用都有效，并且赞美它名为泼火散，真是知情的言论啊。正值天运火气流行，更显现出暑风是因为心火暴盛，煎熬阴血，除了清心凉血之外，没有别的办法可以扑灭它。综合以上论述，所以更加详细地阐述。
(That is, Diyu San) Treats heatstroke leading to coma, loss of consciousness, and a condition nearing death. It also treats discomfort from summerheat causing irritability, bitter taste in the mouth, dry tongue, headache, nausea, loss of appetite, as well as bloody dysentery.
Diyu (Sanguisorbae Radix), Chishao Yao (Paeoniae Radix Rubra), Huanglian (Coptidis Rhizoma), Qingpi (Citri Reticulatae Pericarpium Viride - removed white pith, equal parts). Take three qian per dose, mixed with Jiangshui (fermented rice water). If it is bloody dysentery, decoct in water and take orally.
Yu Jiayan said: During the Yuanfeng era, the Heji Bureau was established to compile experienced prescriptions from various physicians, with particular detail on the category of heatstroke. Because summer prescriptions have been widely tested, the knowledge gained is extensive. Among them, Xiaobanxia Fuling Tang (Minor Pinellia and Poria Decoction) is taken not to treat summerheat directly, but specifically to treat dampness. Furthermore, Banxia Fuling is named Xiaoshu Wan (Summerheat-Relieving Pill), indicating that relieving summerheat lies in eliminating dampness; thus the name is appropriate and logical. Regarding Xiangru Yin (Elsholtzia Drink), Elshua, Bideng (Coicis Semen), and Houpo (Magnoliae Officinalis Cortex) form the main prescription. Adding Huanglian (Coptidis Rhizoma) as the sovereign herb treats Heart Fire. If dampness is prevalent, Huanglian is removed and Fuling (Poria) and Gancao (Glycyrrhizae Radix et Rhizoma) are added to treat Spleen dampness. Summerheat soaked by dampness becomes heavy and stagnant; therefore, within the formula of Bideng, Gegen (Puerariae Lobatae Radix), and Gancao, Wumei (Mume Fructus), Sharen (Amomi Fructus), and Caoguo (Tsaoko Fructus) are assisted to invigorate the Spleen. Meanwhile, Dashun San (Great Harmony Powder) and Laifu Dan (Reviving Pill) are excluded, which is applied to treat cases of summerheat complicated by frequent diarrhea; this extends the principle of Suopi San (Spleen-Constricting Powder). Pipaye San (Loquat Leaf Powder) addresses turbid and foul pathogens caused by summerheat; thus, Xiangru (Elsholtziae Herba), Pipaye (Folium Eriobotryae), Dingxiang (Flos Caryophylli), and Baimaogen (Imperatae Rhizoma) are used for their pungent and aromatic properties to calm the Stomach and remove the foul odors detested by the Stomach. This is derived from Pipaye San to treat cases of summerheat complicated by frequent vomiting. Physicians benefit greatly from understanding the depth, severity, and urgency of heat, dampness, deficiency, and cold. Later sages supplemented this by addressing deficiency. Liu Wanhe’s Guiling Ganlu Yin (Cassia Twig, Polyporus, and Sweet Dew Drink), along with Wu Ling San (Five-Ingredient Powder with Poria) plus Three Stones, aims to tonify deficiency. Zhang Ziheng’s Guiling Ganlu Yin uses Ren Shen (Ginseng Radix et Rhizoma), Gegen, Gancao, Huoxiang (Agastaches Herba), and Muxiang (Aucklandiae Radix) to tonify deficiency while simultaneously clearing turbidity. The Ju Fang (Bureau Formula) Wu Wei Zi San is modified by adding Ren Shen, Huang Qin (Scutellariae Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Chenpi (Citri Reticulatae Pericarpium), and Mugua (Chaenomelis Fructus) to clear damp-heat through tonifying deficiency. Even Dongyuan Li Gao’s [Formula] further tonifies the Middle and strengthens the Defensive Qi to clear damp-heat; this is suitable for obese individuals with internal deficiency. Heatstroke must be accompanied by restlessness. Zhongjing’s Zhuye Shigao Tang (Leaf of Bamboo and Gypsum Decoction), named Qingzao Tang (Dryness-Clearing Decoction), still prioritizes dispelling dampness. Dryness and dampness are opposing factors. Without Dongyuan’s exceptional insight, such understanding would not have been reached. For instance, Yiyuan San (Benefit Origin Powder) dispels dampness; adding Chensha (Cinnabar) clears heat; adding Ren Shen tonifies deficiency; adding Chensha and reducing Guizhi (Cinnamon Twig) clears heat. Baihu Tang (White Tiger Decoction) with Ren Shen tonifies deficiency; with Cangzhu (Atractylodis Rhizoma)... [text implies completion of formula variations], making it comprehensive, yet still incomplete. I have observed the syndrome of Summerwind (Heatstroke-induced wind-stroke); its sudden collapse resembles Wind Stroke (Zhong Feng), but cannot be treated as such. Although Dayanglong Wan (Great Yang Dragon Pill) exists, it was not originally legislated for Summerwind. My humble opinion supports this: in cases of heatstroke coma, administering this pill reveals a glimpse of Summerwind treatment. However, if a person has inherent Yin-blood deficiency and summer-toxin penetrates deeply into the Blood level, administering this pill could lead to immediate death. Diyu San, treating heatstroke coma where one loses consciousness and nears death, uses only common blood-cooling herbs to clear and resolve summer-toxin that has penetrated deep into the Blood level; this is correct. Later, many found it effective and praised its name as Pohuo San (Extinguish Fire Powder), showing true understanding. When heavenly luck favors Fire transport, it becomes evident that Summerwind arises from violent excess of Heart Fire, scorching Yin-blood; apart from clearing Heart and cooling Blood, there is no other way to extinguish it. Summarizing these points, I elaborate further.