暑风之病,良由暑热极盛,金被火刑,木无所畏,则风从内而生,此与外感风邪之治法,相悬霄壤,若
误汗之,变证百出矣。夫木既化乎风,而脾土未尝不受其所制者,是以卒然昏倒,四肢搐搦,内扰神舍,志
识不清,脉多弦劲或洪大,或滑数。总当去时令之火,火去则金自清,而木自平,兼开郁闷之痰,痰
开则神自安,而气自宁也,拟用清离定巽法佐以郁金、川贝治之。倘有角弓反张,牙关紧闭者,宜加犀角、
羚羊;痰塞喉间有声者,宜加胆星、天竺;服药之后,依然昏愦者,宜加远志、菖
蒲。然而证候至此,亦难治矣。
考暑温之证,较阳暑略为轻可。吴淮阴曰∶温者热之渐,
热乃温之极也。其名暑温,比暑热为轻者,不待言矣。在医者务宜留心慎药,弗使温盛成热耳。夫暑温之初
病也,右脉胜于左部,或洪或数,舌苔微白,或黄而润,身热有汗,或口渴,或咳嗽,此邪在上焦气分,当
用清凉涤暑法加杏仁、蒌壳治之。倘汗少而有微寒,或有头痛者,宜透肌肤之冒,于本法内去扁豆、
瓜翠,加藿香、香薷治之。如口不渴者,乃兼湿也,加米仁、半夏治之。如舌苔黄燥,渴欲喜饮,宜清胃家
之热,用凉解里热法治之。如舌苔光绛,伤于阴也,宜用清热保津法加西洋参、北沙参、元参治之。总当细
究其因,或夹冒,或夹湿,或胃热,或阴伤,按证而分治之,未有不向愈者。
暑风病,确实是由于暑热极度旺盛,火克金(肺),导致金不能制约木(肝),木气无所畏惧,从而风气从体内产生。这与外感风邪的治疗方法截然不同,如果误用发汗法,会导致各种变证出现。既然木气化为风,而脾土未曾不受其克制,所以患者会突然昏倒,四肢抽搐,内扰心神,意识不清,脉象多呈弦劲或洪大,或滑数。治疗总原则应当去除时令之火,火去则金自清,木自平;兼开郁闷之痰,痰开则神自安,气自宁。拟用清离定巽法,佐以郁金、川贝母治疗。如果有角弓反张、牙关紧闭的症状,宜加用水牛角、羚羊角;痰阻塞喉间有声音的,宜加入胆南星、天竺黄;服药之后,依然昏迷不醒的,宜加入远志、石菖蒲。然而病情发展到这种地步,也难以治疗了。
考察暑温病证,比阳暑略为轻浅。吴淮阴说:温是热的渐进过程,热是温的极致。名为暑温,比暑热要轻,是不言而喻的。作为医生务必留心谨慎用药,不让温盛发展为热罢了。暑温初起时,右脉胜于左部,脉象或洪大或数,舌苔微白,或黄而润,身体发热有汗,或口渴,或咳嗽,这是邪气在上焦气分,应当用清凉涤暑法加杏仁、瓜蒌壳治疗。如果汗少而有轻微恶寒,或有头痛的,宜透达肌肤之邪,于本法中去掉扁豆、西瓜翠衣,加入藿香、香薷治疗。如口不渴的,是兼夹湿邪,加入薏苡仁、半夏治疗。如舌苔黄燥,口渴想喝水,宜清胃中之热,用凉解里热法治之。如舌苔光绛,是伤及阴液,宜用清热保津法加西洋参、北沙参、玄参治疗。总之应当仔细探究病因,或夹冒邪,或夹湿邪,或胃热,或阴伤,按证候分别治疗,没有不向愈的。
The disease of Summer-Wind (Shu Feng) is indeed caused by extreme abundance of summer-heat, where Fire overacts on Metal (Lung), causing Metal to fail in controlling Wood (Liver). Consequently, Wood becomes unrestrained, and Wind arises from within. This differs vastly from the treatment of exogenous Wind pathogen; if sweating methods are mistakenly applied, myriad complications will arise. Since Wood transforms into Wind, and Spleen Earth has not been exempt from its constraint, patients may suddenly faint, experience convulsions of the four limbs, have their Spirit residence disturbed internally, and suffer from unclear consciousness. The pulse is often wiry and forceful, or surging and large, or slippery and rapid. The general principle should be to eliminate the seasonal Fire; once Fire is gone, Metal clears naturally, and Wood calms down. Simultaneously, one must open up stagnant Phlegm; once Phlegm is resolved, the Spirit settles naturally, and Qi becomes tranquil. It is proposed to use Qing Li Ding Xuan Method (Clearing the Heart and Stabilizing the Liver Method), assisted by Curcumae Radix (Yujin) and Fritillariae Thunbergii Bulbus (Chuanbei). If there is opisthotonos (rigid arching of the back) and lockjaw, Rhinocerotis Cornu (Xijiao) and Antilopis Cornu (Lingyangjiao) should be added. If Phlegm obstructs the throat with audible sounds, Arisaematis Cum Bile (Danning) and Tectona Grandis Seed (Tianzhuru) should be added. If the patient remains comatose after taking medicine, Polygalae Radix (Yuanzhi) and Acori Tatarinowii Rhizoma (Changpu) should be added. However, when the condition reaches this stage, it is difficult to treat.
Examining the syndrome of Summer-Warmth (Shu Wen), it is slightly milder than Yang-Summer-Heat. Wu Huaiyin stated: "Warmth is the gradual onset of Heat, and Heat is the extreme of Warmth." Its name, Summer-Warmth, being lighter than Summer-Heat, goes without saying. Physicians must pay close attention and prescribe cautiously, preventing Warmth from intensifying into Heat. In the initial stage of Summer-Warmth, the right pulse is stronger than the left, appearing either surging or rapid. The tongue coating is slightly white, or yellow and moist. There is fever with sweat, thirst, or cough. This indicates the pathogen is in the Qi level of the Upper Jiao. One should use Liang Qing Di Shu Method (Cooling and Clearing Summer-Heat Method) with Apricot Seed (Xingren) and Benincasae Fructus Pericarpium (Louqiao). If there is scanty sweat accompanied by slight aversion to cold, or headache, one should release the exterior pathogens from the skin and muscles. Remove Coix Seed (Bian Dou) and Watermelon Rind (Gua Cui) from the base formula, and add Pogostemonis Herba (Huoxiang) and Moslae Herba (Xiangru). If there is no thirst, it implies a combination with Dampness; add Coix Seed (Miren) and Pinelliae Rhizoma (Banxia). If the tongue coating is yellow and dry, with thirst and desire to drink, one should clear Stomach Heat using Liang Jie Li Re Method (Cooling and Resolving Interior Heat Method). If the tongue coating is glossy and crimson, indicating Yin injury, use Qing Re Bao Jin Method (Clearing Heat and Protecting Fluids Method) with Panax Quinquefolii Radix (Yangshengshen), Glehniae Radix (Beishashen), and Scrophulariae Radix (Yuanshen). Generally, one must carefully investigate the cause: whether it involves exterior contraction, dampness, Stomach heat, or Yin injury, and treat according to the specific syndrome. There will be no case that does not recover.