伤暑发热，是火邪伤心，元气耗散，而邪热入客于中，故发为热，汗大泄，无气以动，其脉虚迟而
无力，是外之热邪伤荣也。治主内。
愚按夏月阳气浮于外，阴气伏于内，法当调补阳气为主，而佐以解暑，此推《内经》舍时从症之良法
也。故前症当究其所因而治之，不可泛用香薷饮之类，走散阳气，导损真阴，而益其病也。又有夏间用
薄荷煎汤以代茶，殊不知散人之真气，即久用川芎汤，令人暴死之类也。（详见后。）
病有感，有伤，有中。感者，在皮毛，为轻；伤者，兼肌肉，稍重；中者，属脏腑，最重。寒有感寒、
伤寒、中寒，风有感风、伤风、中风，暑有感暑、伤暑、中暑，当分轻重表里，治各不同。又如
中湿、中气、中毒，皆云中。中者，中也，谓邪直入于中也，故为重病。
凡治心腹疼痛，但是新病，须问曾何饮食？因何伤感？有无积滞？便与和中消导之药。若日数已多，曾
多服过辛温燥热之药，呕吐不纳，胸膈饱闷，口舌干燥，大小便涩，虽则内有郁热，或原有旧病，因感而
发，绵延日久，见证如前者，俱用开郁行气、降火润燥之药，如川芎、香附、炒山栀、黄连、姜汁之类，
甚者再加芒硝。但治心腹久痛，须于温散药内加苦寒咸寒之药，温治其标，寒治其本也。
愚按腹痛，若脾胃虚弱，饮食不化，或兼腹中作痛，用六君子汤；若饮食过多，停滞未化，或兼腹
痛，用人参养胃汤；若饮食既化，脾胃受伤，或兼腹中作痛，用六君子加当归；若胃中有热，心腹中脘作痛，
呕吐，用二陈汤加黄连、山栀；若脾胃虚弱，少食，心腹作痛，用六君子汤。脾胃虚寒，亦用前汤加
炮姜。大凡腹满痛，按之不痛为虚，痛者为实，余当临症制宜。
副郎李孟卿，常患腹痛，每治以补中益气加山栀即愈。一日因怒，腹痛，脉弦紧，以前汤吞左金丸三
十粒而愈。
一妇人，心腹痛，诸药不应。余用炒黑山栀、桔梗治之而愈。
儒者沈HT 文，内停饮食，外感风寒，头痛发
热，恶心腹痛，用人参养胃汤加芎、芷、曲、 、香附、桔梗，一剂诸症悉退，次日腹痛甚可畏，喜手
按，痛即止。此脾气虚弱，客寒乘之而作，是内虚寒而外假热也。用香砂六君子加木香、炮姜，服之痛减六
七，又以前药去二香，一钟而愈。
府庠徐道夫母，胃脘当心痛剧，右寸关俱无，左虽有微而似绝，手足厥冷，病势危笃。察其色，眼
胞上下青黯，此脾虚肝木所胜。用参、术、茯苓、陈皮、甘草补其中气，用木香和胃气以行肝气，用吴茱
萸散脾胃之寒，止心腹之痛。急与一剂，俟滚先服，煎熟再进，诸病悉愈。
伤暑发热，是火邪损伤心脏，元气耗散，而邪热侵入体内，因此发生发热，大汗淋漓，气短无力，脉象虚迟且无力，这是外部的热邪损伤营气。治疗以内治为主。
我按语：夏季阳气浮越于体表，阴气潜伏于体内，治疗方法应当以调补阳气为主，辅以解暑，这是遵循《内经》“舍时从症”原则的良好方法。所以前述症状应当探究其病因进行治疗，不可泛用香薷饮之类的方剂，以免耗散阳气，损伤真阴，从而加重病情。又有在夏季用薄荷煎汤代替茶饮的，殊不知这会耗散人的真气，就像长期服用川芎汤导致人突然死亡一样。（详见后文。）
病有感、有伤、有中。感邪轻浅，仅在皮毛，病情较轻；伤邪稍深，兼及肌肉，病情稍重；中邪最深，涉及脏腑，病情最重。寒邪有感寒、伤寒、中寒之分，风邪有感风、伤风、中风之分，暑邪有感暑、伤暑、中暑之分，应当区分轻重表里，治疗方法各不相同。又如中湿、中气、中毒，都称为“中”。所谓“中”，即中道，指邪气直接侵入内部，所以属于重病。
凡是治疗心腹疼痛，只要是新发病，必须询问曾吃过什么饮食？因何感受外邪？有无积滞？随即给予调和脾胃、消食导滞的药物。如果病程已长，曾多次服用辛温燥热的药物，出现呕吐不纳、胸膈饱闷、口舌干燥、大小便涩滞等症状，虽然体内有郁热，或者原有旧病，因感受外邪而发作，绵延日久，见证如前所述者，均使用开郁行气、降火润燥的药物，如川芎、香附、炒山栀、黄连、姜汁之类，严重的再加芒硝。但治疗心腹久痛，必须在温散药中加入苦寒、咸寒的药物，以温法治其标，以寒法治其本。
我按语：腹痛，若因脾胃虚弱，饮食不化，或兼腹中作痛，使用六君子汤；若因饮食过多，停滞未化，或兼腹痛，使用人参养胃汤；若饮食已化，但脾胃受伤，或兼腹中作痛，使用六君子汤加当归；若胃中有热，心腹中脘作痛，呕吐，使用二陈汤加黄连、山栀；若脾胃虚弱，少食，心腹作痛，使用六君子汤。脾胃虚寒，也使用前汤加炮姜。大凡腹部胀满疼痛，按压不痛的为虚证，痛的为实证，其余情况应当临症灵活制宜。
副郎李孟卿，常患腹痛，每次用补中益气汤加山栀即可痊愈。一日因发怒，腹痛，脉弦紧，用前汤吞服左金丸三十粒而愈。
一位妇人，心腹痛，各种药物无效。我用炒黑山栀、桔梗治疗而愈。
儒者沈HT文，内停饮食，外感风寒，头痛发热，恶心腹痛，用人参养胃汤加川芎、白芷、神曲、（此处原文缺字，推测为半夏或其他）、香附、桔梗，一剂后诸症悉退，次日腹痛剧烈可畏，喜欢用手按压，按压则痛止。这是脾气虚弱，客寒乘虚而入所致，是内虚寒而外假热。用香砂六君子汤加木香、炮姜，服用后疼痛减轻六七成，又以前药去掉二香（木香、砂仁），一钟量即愈。
府庠徐道夫的母亲，胃脘当心部位疼痛剧烈，右寸关脉均无，左脉虽有微弱但似绝，手足厥冷，病势危笃。观察其面色，眼胞上下青黯，这是脾虚肝木所胜。用人参、白术、茯苓、陈皮、甘草补其中气，用木香和胃气以行肝气，用吴茱萸散脾胃之寒，止心腹之痛。急予一剂，待煮沸先服，煎熟再进，诸病悉愈。
Heat caused by summerheat injury involves the fire pathogen damaging the Heart, with the primordial Qi dissipating and the pathogenic heat invading the interior, thus causing fever. There is profuse sweating, inability to move due to Qi deficiency, and a pulse that is deficient, slow, and forceless; this indicates that external heat pathogens have damaged the Ying (Nutritive) Qi. Treatment should focus on internal regulation.
My commentary: In summer, Yang Qi floats externally while Yin Qi remains latent internally. The treatment method should primarily regulate and tonify Yang Qi, assisted by resolving summerheat. This is an excellent application of the principle from the *Nei Jing* (Inner Canon) of "abandoning the season to follow the symptoms." Therefore, for the aforementioned symptoms, one must investigate the etiology to treat accordingly. One should not indiscriminately use formulas like Xiangru Yin (Mosla Decoction), which scatter Yang Qi and damage True Yin, thereby exacerbating the condition. Furthermore, using mint decoction as tea during summer is unknown to many; it inadvertently scatters the body's True Qi, similar to how prolonged use of Chuanxiong Tang (Sichuan Lovage Decoction) can lead to sudden death. (See later sections for details.)
Diseases are categorized into Gan (Infection/Contact), Shang (Injury), and Zhong (Strike). Gan affects the skin and hair, being mild; Shang extends to muscles, being slightly severe; Zhong involves the Zang-Fu organs, being the most severe. Cold pathogens include Gan Han (Cold Contact), Shang Han (Cold Injury), and Zhong Han (Cold Strike). Wind pathogens include Gan Feng (Wind Contact), Shang Feng (Wind Injury), and Zhong Feng (Wind Strike). Summerheat pathogens include Gan Shu (Summerheat Contact), Shang Shu (Summerheat Injury), and Zhong Shu (Summerheat Strike). These must be differentiated by severity and exterior-interior status, with distinct treatments. Similarly, Zhong Shi (Dampness Strike), Zhong Qi (Qi Strike), and Zhong Du (Toxin Strike) are all termed "Zhong." "Zhong" means center, indicating that the pathogen directly enters the interior, hence constituting a severe disease.
When treating abdominal pain, if it is a new onset, one must inquire about dietary intake, exposure to pathogens, and presence of food stagnation. Immediately administer herbs that harmonize the Middle Jiao and promote digestion. If the duration is long, and the patient has taken many acrid-warm drying-hot drugs, resulting in vomiting, inability to retain food, chest and diaphragm fullness, dry mouth and tongue, and difficult urination and defecation, despite internal stagnant heat or pre-existing chronic conditions exacerbated by pathogenic invasion, use herbs that open depression, move Qi, descend fire, and moisten dryness, such as Chuanxiong Rhizoma (Chuanxiong), Cyperi Rhizoma (Xiangfu), Gardeniae Fructus stir-fried (Chao Shanzhi), Coptidis Rhizoma (Huanglian), and Ginger Juice (Jiangzhi). For severe cases, add Natrii Sulfas (Mangxiao). However, when treating chronic abdominal pain, bitter-cold and salty-cold herbs must be added to warm-dispersing formulas. Warm methods treat the branch (symptoms), while cold methods treat the root (etiology).
My commentary: For abdominal pain due to Spleen-Stomach deficiency and undigested food, or accompanied by abdominal pain, use Liujunzi Tang (Six Gentlemen Decoction). For excessive food intake leading to stagnation without digestion, or accompanied by abdominal pain, use Renshen Yangwei Tang (Ginseng Stomach-Nourishing Decoction). If food is digested but the Spleen-Stomach is injured, or accompanied by abdominal pain, use Liujunzi Tang plus Danggui Radix (Danggui). If there is heat in the Stomach causing pain in the epigastrium and abdomen with vomiting, use Erchen Tang (Two Aged Herbs Decoction) plus Huanglian and Shanzhi. If Spleen-Stomach deficiency causes reduced appetite and abdominal pain, use Liujunzi Tang. For Spleen-Stomach deficiency-cold, use the previous formula plus Paojiang (Prepared Ginger). Generally, abdominal distension and pain that do not hurt upon pressure indicate deficiency, while pain upon pressure indicates excess. Remaining cases require clinical discretion.
Li Mengqing, Vice Director, frequently suffered from abdominal pain, which resolved each time he took Buzhong Yiqi Tang (Middle-Boosting Qi-Supplementing Decoction) plus Shanzhi. One day, after anger-induced abdominal pain with a wiry-tight pulse, he took thirty pills of Zuojin Wan (Left Metal Pill) swallowed with the previous decoction and recovered.
A woman suffered from heart and abdominal pain unresponsive to various medicines. I treated her with stir-fried black Shanzhi and Jiegeng Platycodon Root, resulting in recovery.
Scholar Shen HTwen had internal food retention and external wind-cold invasion, presenting with headache, fever, nausea, and abdominal pain. He was given Renshen Yangwei Tang plus Chuanxiong, Baizhi, Shenqu, [missing character], Xiangfu, and Jiegeng. After one dose, all symptoms subsided. The next day, abdominal pain became severe and frightening, but was relieved by manual pressure. This indicated Spleen Qi deficiency allowing guest cold to invade, representing internal deficiency-cold with external false-heat. He was treated with Xiangsha Liujunzi Tang plus Muxiang and Paojiang. Pain decreased by 60-70%. Subsequently, taking the same formula minus Muxiang and Sharen (one cup) led to complete recovery.
The mother of Xu Daofu, a government student, suffered severe pain in the epigastrium corresponding to the heart. The Right Cun and Guan pulses were absent; the Left pulse was faint and nearly imperceptible. Extremities were cold, and the condition was critical. Observation revealed dark bluish discoloration around the eyelids, indicating Spleen deficiency with Liver Wood overacting. She was administered Renshen, Baizhu, Fuling, Chenpi, and Gancao to tonify Middle Qi; Muxiang to harmonize Stomach Qi and move Liver Qi; and Wuzhuyu to disperse cold in the Spleen-Stomach and stop abdominal pain. An urgent dose was prepared, taken boiling hot first, followed by the remainder after brewing. All ailments were cured.