【歌】暑伤气分汗如倾，身热头疼躁不宁。所感必须分动静，阴阳二证自然明。
【论】东垣云∶静而得之曰伤暑，动而得之曰中热。富贵人避暑于凉亭广厦，为房室阴寒所遏，暑火不伸，
故曰静而得之。辛苦人负重作劳，勤耕力役，大暑行途者，此动而得之。王安道以静得者即是阴证，非暑也。
然大暑炎热流行，无所不至，虽外以风扇寒凉抑之，终非凛冽之寒邪。但
外寒遏，暑火不伸，此寒为标，热为本，故先以辛温治其标寒，继以清凉治其本热，无不愈者。若便作阴证名
之，用辛热剂可乎？学人宜临时参究脉证可也。
【脉】暑伤于气，所以脉虚。弦细芤豁，体状无余。
动而得之
冒暑作劳，身热头疼，自汗烦渴，面垢唇焦，或身如针刺，此热伤分肉也，人参白虎汤主之。素有痰火，
复冒暑气而恶心，眩晕吐呕者，黄连香薷饮主之，有痰加胆星、半夏，虚加人参。内外挟火相灼，卒倒不知人
事者，名曰暑风，此暑气入而鼓激痰火，塞碍心窍故也，治宜吐之。
人参白虎汤
治伏暑发渴，舌燥生芒刺，身热，脉虚，自汗等证。
人参（一钱半） 知母（二钱） 石膏（五钱） 甘草（炙，一钱）
上方入粳米一撮，水一钟，煎八分，不拘时服。
若腹痛吐泻饱闷者，石膏切不可用。热极，小便遗尿不止，加炒黄柏。烦躁加辰砂末、酸枣仁。
黄连香薷饮
治伏暑引饮，口燥咽干，或吐或泻。
黄连（姜炒，四两） 浓朴（姜炒，六两） 扁豆（微炒，半斤） 香薷（去土，一斤）
每服三钱，水一钟，酒少许，煎七分，沉冷，不拘时服。
若卒中昏冒僵仆，角弓反张，不省人事，手足或发搐搦，此为暑风，不可作风治，本方加羌活主之。泻利
加白术、茯苓。脉虚弱加人参、五味、麦冬。虚汗不止加黄 、白术。心烦加栀子、辰砂末。渴加干葛、天花
粉。胸满加枳壳、桔梗。小便不利加赤茯苓、滑石。呕吐加藿香、陈皮、姜汁。
十味香薷饮
消暑气，和脾胃。
香薷（一两） 人参 陈皮（炒） 白术（土炒） 黄 （蜜炙） 扁豆（炒，去壳） 甘草（炙） 浓朴
（姜炒） 木瓜 白茯（去皮，各半两） 脉虚，加麦冬、五味
上为末，每服二钱，热汤、冷水任调下。
静而得之
避暑于深堂大厦，为阴寒所遏，暑不得越，手足厥逆者，大顺散。霍乱者，六和汤、桂苓甘露饮。
大顺散
干姜（一钱，炒） 甘草（八分，蜜炒） 肉桂（去皮） 杏仁（去皮尖，各六分）
上为粗末，水煎温服，如烦躁，井花水调下。
按∶本方治夏月引饮过多，脾胃受湿，清浊相干，阴阳气逆，霍乱吐泻，腹痛脉迟者主之。用干姜、肉桂，
温胃而建中。甘草、杏仁，调脾而利气。非治暑之药，乃治饮冷受伤之剂也，若非饮冷，切勿执方。
六和汤
桂苓甘露饮（二方并见霍乱。）
达按∶暑与热，同义而异名。中暑，即中热也，何分之有？历代医家，乃有中暑、中热之分，吾不知其所
谓。假如道中行人，酷日趱程；野中农夫，暄天劳力，津竭汗尽，咽喉如烧，饥未得食，渴未得饮，劳未得息，
卒然昏冒，不省人事，身体发热，名为中热，虽谓之中暑，亦可也。至于素享富贵之人，其性不耐寒暄，每至
暑月，即池亭水阁以安其身，浮瓜沉李以供其口，环冰挥扇，以祛其热，藤箪竹床以取其凉，炎蒸不来，清风
满座，内有伏阴，外受凉气，汗不
流而肌理密，阴愈侵而阳不发，卒然昏眩，寒热交作，呕吐腹痛，乃为夏月感寒，非中暑也。法当温以理其中，
辛以散其表，不可执中暑之说，而用治暑之剂也。宜以生姜、葱白、木香、陈皮、羌活、紫苏之类。
【歌诀】暑邪损伤气分，导致汗出如注；身体发热、头痛、烦躁不安。感受暑邪必须区分静得与动得两种情况，阴证与阳证的界限自然清晰。
【论述】李东垣说：静处时感受暑邪称为“伤暑”，活动时感受暑邪称为“中热”。富贵之人避暑于凉亭和宽敞的房屋中，被房室内的阴寒之气所遏制，导致暑火之气无法舒展，所以称为“静而得之”。辛苦劳作之人背负重物从事劳动，辛勤耕种或服劳役，或在酷暑天气下赶路，这属于“动而得之”。王安道认为静处所得的即是阴证，并非暑病。然而，大暑时节炎热之气流行，无处不在，虽然外界有风扇和寒凉之气抑制它，但这终究不是凛冽的寒邪。只是外部的寒邪遏制了体内的暑火，使其不能发散，这种寒邪是标象，内热才是根本，所以先用辛温药物治疗其标寒，继用清凉药物治疗其本热，没有不痊愈的。如果直接将其命名为阴证，使用辛热剂可以吗？学者应当根据临证时的脉象和症状进行参详研究。
【脉象】暑邪损伤气分，所以脉象呈现虚象。弦、细、芤、豁等脉象，其特征表现无遗。
动而得之（指动而受暑）
冒暑劳作，身体发热、头痛，自汗、心烦口渴，面色污垢、嘴唇焦裂，或者身体感觉像针刺一样疼痛，这是热邪损伤了分肉（肌肉间隙），用人参白虎汤主治。素来有痰火体质的人，又冒受暑气导致恶心、眩晕、呕吐者，用黄连香薷饮主治，有痰者加胆南星、半夏，体虚者加人参。内外火热相互灼烧，突然昏倒不知人事的，称为“暑风”，这是因为暑气侵入并鼓动激惹痰火，堵塞心窍所致，治疗宜采用催吐法。
人参白虎汤
治疗伏暑引发口渴，舌燥生芒刺，身体发热，脉虚，自汗等症状。
人参（一钱半） 知母（二钱） 石膏（五钱） 甘草（炙，一钱）
上方加入粳米一撮，水一碗，煎至八分满，不拘时候服用。
如果出现腹痛、呕吐、腹泻、饱闷的症状，石膏切不可使用。若热极严重，小便失禁不止，加炒黄柏。烦躁不安加辰砂末、酸枣仁。
黄连香薷饮
治疗伏暑引致饮水过多，口燥咽干，或者呕吐或者腹泻。
黄连（姜炒，四两） 厚朴（姜炒，六两） 扁豆（微炒，半斤） 香薷（去土，一斤）
每次服用三钱，水一碗，少许酒，煎至七分满，放冷后，不拘时候服用。
如果突然中暑昏倒僵仆，角弓反张，不省人事，手足抽搐，这是暑风，不可当作风病治疗，在本方基础上加羌活主治。腹泻加白术、茯苓。脉虚弱加人参、五味子、麦冬。虚汗不止加黄芪、白术。心烦加栀子、辰砂末。口渴加葛根、天花粉。胸满加枳壳、桔梗。小便不利加赤茯苓、滑石。呕吐加藿香、陈皮、姜汁。
十味香薷饮
消暑气，调和脾胃。
香薷（一两） 人参 陈皮（炒） 白术（土炒） 黄芪（蜜炙） 扁豆（炒，去壳） 甘草（炙） 厚朴（姜炒） 木瓜 白茯苓（去皮，各半两） 脉虚者，加麦冬、五味子
以上药物研为末，每次服用二钱，用热汤或冷水调服均可。
静而得之（指静处受寒）
避暑于深堂大厦，被阴寒之气所遏制，暑气不得发散，手足厥冷的，用大顺散。霍乱的，用六和汤、桂苓甘露饮。
大顺散
干姜（一钱，炒） 甘草（八分，蜜炒） 肉桂（去皮） 杏仁（去皮尖，各六分）
以上药物捣成粗末，水煎温服，如果烦躁，用井花水调服。
按语：本方治疗夏季因饮水过多，脾胃受湿，清浊之气相干扰，阴阳之气逆乱，导致霍乱吐泻、腹痛脉迟的情况。使用干姜、肉桂，温暖胃腑并建立中气。甘草、杏仁，调理脾脏并利气。这不是治疗暑病的药，而是治疗因饮冷受伤的药方，如果不是因为饮冷，切勿拘泥于此方。
达按：暑与热，意义相同但名称不同。中暑，就是中热，有什么可区分的呢？历代医家，却将中暑和中热分开，我不明白他们所谓的区别在哪里。假如道路上的行人，在酷日下赶路；田野中的农夫，在烈日下劳作，津液枯竭，汗水流尽，咽喉如火烧，饥饿未得进食，口渴未得饮水，劳累未得休息，突然昏倒，不省人事，身体发热，名为中热，即使称之为中暑，也是可以的。至于向来享受富贵生活的人，他们的性格不耐寒暑变化，每到暑月，就住在池亭水阁中以安顿身体，吃浮瓜沉李以供养口腹，环绕冰块挥动扇子以祛除热气，躺在藤席竹床上以获取凉意，炎蒸之气不来，清风满座，体内潜伏着阴寒，外部受凉气侵袭，汗液不流通而肌理紧密，阴气日益侵扰而阳气无法发越，突然昏眩，寒热交替发作，呕吐腹痛，这才是夏季感受寒邪，并非中暑。治疗方法应当用温里药调理其中，用辛散药解散表邪，不可执着于中暑的说法，而使用治疗暑病的药剂。适宜使用生姜、葱白、木香、陈皮、羌活、紫苏之类的药物。
[Song] Summerheat injuring the Qi level causes sweating profusely like pouring; body heat, headache, and restlessness. One must distinguish between "static" and "dynamic" acquisition of summerheat, making the distinction between Yin and Yang syndromes clear.
[Discussion] Li Dongyuan stated: Acquired while resting is called "Shangshu" (Injury by Summerheat); acquired during activity is called "Zhongre" (Heatstroke). Wealthy individuals seeking coolness in pavilions or spacious halls are constrained by the yin-cold of their dwellings, preventing summerfire from dispersing; this is termed "acquired statically." Laborers carrying heavy loads, farming diligently, or walking in extreme heat acquire it through movement; this is termed "acquired dynamically." Wang Andao argued that what is acquired statically is a Yin syndrome, not summerheat. However, during peak summer, heat qi circulates everywhere. Although external wind and cold may suppress it, it is ultimately not biting cold pathogen. The external cold constrains the internal summerfire, causing it to stagnate; here, cold is the branch (manifestation), and heat is the root. Therefore, one should first treat the branch cold with acrid-warm herbs, then treat the root heat with cooling herbs, leading to recovery. If one were to label it simply as a Yin syndrome and use acrid-hot formulas, would that be appropriate? Scholars should investigate pulse and symptoms at the time of treatment.
[Pulse] Summerheat injures Qi, resulting in a deficient pulse. Characteristics include wiry, fine, hollow, or wide pulses, fully describing its nature.
Acquired Dynamically (Activity-induced)
Exposure to summerheat during labor leads to body heat, headache, spontaneous sweating, irritability, thirst, dirty complexion, cracked lips, or body pain like needle pricks. This indicates heat damaging the muscle layers; Ren Shen Bai Hu Tang (Ginseng White Tiger Decoction) is indicated. For those with pre-existing phlegm-fire who develop nausea, vertigo, and vomiting upon exposure to summerheat, Huang Lian Xiang Ru Yin (Coptis and Mosla Decoction) is indicated. Add Dan Nan Xing (Arisaema cum Bile) and Ban Xia (Pinellia Tuber) for phlegm; add Ren Shen (Ginseng Root) for deficiency. When internal and external fire scorch each other, causing sudden collapse and unconsciousness, it is named "Summerwind" (Shufeng). This occurs when summerheat enters and agitates phlegm-fire, obstructing the Heart orifice. Treatment should induce vomiting.
Ren Shen Bai Hu Tang (Ginseng White Tiger Decoction)
Treats latent summerheat causing thirst, dry tongue with prickles, body heat, deficient pulse, and spontaneous sweating.
Ren Shen (Ginseng Root, 1.5 qian) Zhi Mu (Anemarrhenae Rhizoma, 2 qian) Shi Gao (Gypsum Fibrosum, 5 qian) Gan Cao (Licorice Root, processed with honey, 1 qian)
Add a pinch of Jing Mi (Oryza Sativa Var. Glutinosa, Rice Grain) to one bowl of water, decoct to 80%, take at any time.
If abdominal pain, vomiting, diarrhea, or fullness occur, avoid Shi Gao. For extreme heat with involuntary urination, add Chao Huang Bo (Phellodendri Cortex, fried). For irritability, add Chen Sha (Cinnabar powder) and Suan Zao Ren (Ziziphi Spinosomi Semen).
Huang Lian Xiang Ru Yin (Coptis and Mosla Decoction)
Treats latent summerheat leading to excessive drinking, dry mouth/throat, vomiting, or diarrhea.
Huang Lian (Coptidis Rhizoma, ginger-fried, 4 liang) Hou Po (Magnoliae Officinalis Cortex, ginger-fried, 6 liang) Bian Dou (Dolichoris Semen, lightly fried, 0.5 jin) Xiang Ru (Elsholtziae Herba, cleaned, 1 jin)
Take 3 qian per dose with one bowl of water and a little wine, decoct to 70%, let cool, take at any time.
For sudden collapse, opisthotonos, unconsciousness, or convulsions of limbs (Summerwind), do not treat as Wind disease; add Qiang Huo (Notopterygii Rhizoma et Radix) to this formula. For diarrhea, add Bai Zhu (Atractylodis Macrocephalae Rhizoma) and Fu Ling (Poria). For weak pulse, add Ren Shen, Wu Wei Zi (Schisandrae Fructus), and Mai Dong (Ophiopogonis Radix). For continuous deficiency sweating, add Huang Qi (Astragali Radix) and Bai Zhu. For mental distress, add Zhi Zi (Gardeniae Fructus) and Chen Sha. For thirst, add Ge Gen (Puerariae Lobatae Radix) and Tian Hua Fen (Trichosanthis Radix). For chest fullness, add Zhi Ke (Aurantii Fructus Immaturus) and Jie Geng (Platycodonis Radix). For difficult urination, add Chi Fu Ling (Poria with Red Skin) and Hua Shi (Talcum). For vomiting, add Huo Xiang (Agastaches Herba), Chen Pi (Citri Reticulatae Pericarpium), and Jiang Zhi (Zingiberis Rhizoma Recens Juice).
Shi Wei Xiang Ru Yin (Ten-Ingredient Mosla Decoction)
Resolves summerheat, harmonizes Spleen and Stomach.
Xiang Ru (Elsholtziae Herba, 1 liang) Ren Shen (Ginseng Root) Chen Pi (Citri Reticulatae Pericarpium, fried) Bai Zhu (Atractylodis Macrocephalae Rhizoma, earth-fried) Huang Qi (Astragali Radix, honey-fried) Bian Dou (Dolichoris Semen, fried, shelled) Gan Cao (Licorice Root, processed) Hou Po (Magnoliae Officinalis Cortex, ginger-fried) Mu Gua (Chaenomelis Fructus) Bai Fu Ling (Poria, peeled, each 0.5 liang) For deficient pulse, add Mai Dong and Wu Wei Zi.
Grind into powder. Take 2 qian per dose, mixed with hot or cold water as preferred.
Acquired Statistically (Rest-induced)
Seeking coolness in deep halls, constrained by yin-cold so summerheat cannot disperse, leading to cold extremities: Da Shun San (Great Harmony Powder). For Huoluan (Cholera-like disorder): Liu He Tang (Six-Harmony Decoction) or Gui Ling Gan Lu Yin (Cassia, Poria, and Sweet Dew Decoction).
Da Shun San (Great Harmony Powder)
Gan Jiang (Zingiberis Rhizoma, fried, 1 qian) Gan Cao (Licorice Root, honey-fried, 0.8 qian) Rou Gui (Cinnamomi Cortex, bark removed) Xing Ren (Armeniacae Semen Amarum, skin and tip removed, each 0.6 qian)
Grind into coarse powder. Decoct in water, take warm. If irritable, mix well water (Jinghua Shui) and take.
Note: This formula treats cases where excessive drinking in summer damages the Spleen/Stomach with dampness, causing turbid and clear qi to interfere, Yin/Yang reversal, leading to Huoluan, vomiting/diarrhea, abdominal pain, and slow pulse. Gan Jiang and Rou Gui warm the Stomach and support Middle Jiao. Gan Cao and Xing Ren regulate Spleen and move Qi. This is not a summerheat-resolving formula but a remedy for injury from cold drinks. Do not use rigidly unless caused by cold drinks.
Liu He Tang (Six-Harmony Decoction)
Gui Ling Gan Lu Yin (See Cholera section for both formulas.)
Commentary: Summerheat and Heat share the same meaning but different names. Zhongshu (Heatstroke) is Zhongre (Heatstroke); why distinguish them? I do not understand the distinction made by past physicians. Consider a traveler rushing under the scorching sun or a farmer laboring in the heat: fluids exhausted, sweat dried, throat burning, hungry and thirsty, unable to rest, suddenly collapsing unconscious with fever. This is Zhongre, yet calling it Zhongshu is also acceptable. Conversely, wealthy individuals intolerant of temperature changes retreat to pavilions, eat chilled fruits, fan themselves near ice, and sleep on bamboo mats. External coolness prevents heat entry, but internal Yin accumulates while Yang fails to vent. Sweat does not flow, pores close, Yin invades, Yang stagnates, leading to sudden vertigo, alternating chills/fever, vomiting, and abdominal pain. This is Winter Cold contracted in summer, not true Zhongshu. Treatment requires warming the interior and releasing the exterior with acrid herbs, such as Sheng Jiang (Zingiberis Rhizoma), Cong Bai (Allii Fistulosi Bulbus), Mu Xiang (Aucklandiae Radix), Chen Pi, Qiang Huo, and Zi Su Ye (Perillae Folium). Do not cling to the "Zhongshu" diagnosis and use summerheat-resolving agents.