（第一卷内备用治暑方，并入于此，以便观览。）
夏至日后病热为暑，暑者相火行令也。夏月人
感之，自口齿而入，伤心包络之经，其脉虚，或浮大而散，或弦细芤迟。盖热伤气则气消，而脉虚弱，
其为症，汗，烦则喘喝，静则多言，身热而烦，心痛，大渴引饮，头疼，自汗，倦怠少气，或下血，发
黄，生斑，甚者火热致金不能平木，搐搦，不省人事。治暑之法，清心、利小便最好。暑伤气，宜补真
气为要。又有恶寒，或四肢逆冷，甚者迷闷不省，而为霍乱吐利，痰滞呕逆，腹痛泻痢。此则非暑伤人，
乃因暑而自致之病也。以其因暑而得，故亦谓之暑病，治法不同。
若行人或农夫，于日中劳役得之者，是动而得之，阳症也。其病必苦头痛，发燥热，恶热，扪之肌肤大
热，必大渴引饮，汗泄，无气以动，乃天热外伤元气也。宜清暑益气，用香薷、黄连、扁豆、人参、黄 、
五味、知母、石膏之类。
暑热发渴，脉虚，宜用人参白虎汤。人参一钱五分，知母二钱，石膏五钱，甘草二钱。竹叶石膏汤亦
好。石膏一两，半夏二钱五分，甘草二钱，人参二钱，麦门冬五钱，入竹叶，水煎。
东垣清暑益气汤，治长夏湿热蒸人，人感之，四肢困倦，精神短少，胸满气促，肢节作痛，或气高而
喘，身热而烦，心下痞闷，小便黄数，大便溏而频，
或痢，或渴，不思饮食，自汗，体重。黄 、升麻、苍术各一钱，人参、白术、神曲、陈皮各五分，甘
草（炙）、黄柏、麦门冬、当归各三分，葛根、泽泻、青皮、五味各二分。
若暑热之时，无病之人，或避暑热，纳凉于深堂大厦，凉台冷馆、大扇风车得之者，是静而得之，阴
证也。其病必头痛，恶寒，身形拘急，肢节疼痛而烦心，肌肤大热，无汗。此为阴寒所遏，使周身阳气不
得伸越，宜用辛温之剂以解表散寒，用浓朴、紫苏、干葛、藿香、羌活、苍术之类。若外既受寒，内复伤
冰水生冷瓜果之类，前药再加干姜、缩砂、神曲之类。此非治暑也，治因暑而致之病也。若外不受寒，
止是内伤冰水冷物，腹痛泄泻，或霍乱吐逆，宜缩脾饮，砂仁、草果、甘草、扁豆、干姜、乌梅，或理中汤
加神曲、麦芽、缩砂、苍术。此专治内，温中消食也。
若吐泻，脉沉微甚者，不可用凉药，可用附子大顺散∶熟附子、甘草、干姜、杏仁、桂，或附子理中
汤加芍药。
夏月多食冷物及过饮茶水，致伤脾胃，吐泻霍乱。故治暑药多用温脾消食、治湿利小便。医者要识
此意。
若既伤暑热，复伤生冷，外热内寒，宜先治其内，温中消食，次治其外，清暑补气，而以理脾为主，于
前阴阳二条内相兼取用。东垣清暑益气汤，已兼此意。其用黄 、升麻、人参、白术、甘草、麦门冬、
当归、五味、黄柏、葛根，是清暑补气也；苍术、神曲、陈皮、泽泻、青皮，是治内补脾也。
愚按前症又当分别中暑中 、脉虚脉沉、无汗有汗、发热不热、作渴不渴、或泻不泻、饮寒饮热，辨
其阴阳虚实，不可泛投寒凉之剂。盖为夏月伏阴在内，古人用附子大顺散之类温补阳气，厥有旨哉！何
今之老弱，至夏月患食少，体倦，发热作渴，或吐泻，腹痛，头痛诸症，反服香薷饮，复伤元气，无不招引
暑症，以致不起。至若清暑益气汤内用猪苓、泽泻之类，必审其果有湿热壅滞，方可用之，否则亏损其阴，
而伤其目矣。用当审察！
仪部李北川，仲夏患腹痛吐泻，两手足扪之则热，按之则冷，其脉轻诊则浮大，重诊则微细。余
曰∶此阴寒之症也。急服附子理中汤，不应仍服，至四剂而愈。
注夏病属阴虚元气不足，宜补中益气汤去柴胡，升麻，加黄柏（炒）、白芍药。挟痰者，加半夏、陈皮。
愚按丹溪先生云∶天地以五行更迭衰旺而成四时，人之五脏六腑亦应之而衰旺。四月属巳，五月属
午，为火太旺，火为肺金之夫，火旺则金衰；六月属
未，土大旺，土为水之夫，土旺则水衰，况肾水尝藉肺金为母，以补其不足。古人于夏月必独宿而淡味，
保养金、水二脏。经曰冬藏精者，春不病温。十月属亥，十一月属子，正火气潜藏，必养其本然之真，而
为来春发生之本。若于此时不恣欲以自戕，至春升之际，根本壮实，何病之可言哉？
文选姚海山，仲夏头痛，发热，气高而喘，肢体倦怠，两手麻木。余谓热伤元气，用人参益气汤顿安，
又用补中益气汤加麦门、五味而痊。
若夏月伤暑，发热，汗大泄，无气力，脉虚细而迟。此暑伤元气也，服后方∶
人参 黄 （蜜炙） 麦门冬（去心） 白芍药 陈皮 白茯苓（各一钱） 黄连（炒） 甘草（炙，各
五分） 黄柏（三分） 白术（一钱五分） 香薷 知母（各七分）
上姜、水煎，食前温服。
愚按前症有热伤元气而汗出者，有劳伤元气而汗出者，有因元气素虚腠理不密而汗出者。治法∶暑
伤元气者，清暑益气汤；劳伤元气者，补中益气汤；元气素虚而自汗者，十全大补汤。如兼盗汗，佐以六
味丸加五味子。前云大汗，无力，脉虚细迟，属阳气虚弱，纳黄柏、知母恐复损阳气，芍药、茯苓恐导损
阴气也。治者审之！
若夏秋暑热，因过用冷物茶水伤其内，又过取凉
风伤其外，以致恶寒发热，胸膈饱闷，饮食不进，或兼呕吐、泄泻，此内外俱伤寒冷也。
人参 干姜（炒紫色） 浓朴（姜水炒） 陈皮 羌活 枳实 白茯苓（各一钱） 白术（一钱五分）
甘草（炙，五分）
上姜，水煎，食前温服。
愚按前症宜用此方，如未应，宜用藿香正气散。若内外已解，寒热未退，或饮食不进，宜用六君子。
《保命集》云∶霍乱属阳明症，宜用和中、平胃、建中汤辈，或四君子汤。脉浮，自汗，四君子加桂枝主
之；脉浮，无汗，四君子加麻黄。吐利转筋，胁下痛，脉弦者，木克土也，用平胃散加木瓜，或建中加柴
胡、木瓜；吐利转筋，腹痛，体重，脉沉而细，四君子加白芍药、良姜。吐利，四肢拘急，脉沉而迟，属
少阴，四君加姜、附、浓朴；吐利，四肢厥冷，脉微缓，属厥阴，建中加归、附。吐利，头痛而身热，热
多欲饮水者，五苓散；寒多不欲水者，理中丸主之。元戎云∶太阴症霍乱者，理中加橘红；下腹痛，手足
逆冷，理中加熟附子；吐利后转筋者，理中加火 石膏一两。
上舍徐民则，夏月入房及食冰果面食，而患腹痛。余曰∶此阴寒之症也，急用附子理中汤以回阳。不
信，别用二陈、枳实、黄连香薷饮之类而死。
进士刘华甫，夏月食生冷果品，患前症，余用附
子理中汤一钟顿安。（凡方内用木瓜者，俱用砂器煎炒，恶铁故也。余方仿此。）
若夏暑在途中，常服以壮元气、清热驱暑。服之免中暑、霍乱、泄泻、痢疾等症。
人参（一钱二分） 白术（一钱五分） 五味子（十粒，杵碎） 麦门冬（去心）
白芍药（炒） 白茯苓（各一钱） 知母（炒） 陈皮 香薷（各七分） 黄芩（炒，三分）
甘草（炙，五分）
上姜、水煎，食前温服。
愚按前症若人元气虚弱，宜用补中益气去柴胡、升麻，加麦门、五味，或少加炒黑黄柏。人参益气汤
亦可用。
若遇劳倦辛苦，用力过多，即服后方二、三服，免生内伤发热之病。此方主于补气。
黄 （一钱半，蜜炙） 人参 麦门冬（去心） 陈皮（各一钱） 白术（一钱） 甘草（炙，七分）
上姜、枣、水煎，食前温服。劳倦甚，加熟附子四五分。
愚按前论开世俗之蒙 ，济无穷之夭枉。纳附子若素畏寒饮食者，尤宜用。若素喜寒饮食者，以肉桂
或炮姜代之亦可。若因暑热伤气，而四肢困倦，或手足麻木者，先用人参益气汤，后用补中益气汤。
若人过劳心思虑，损伤精神，头眩目昏，心虚气短，即服后方补血为主。
人参（一钱） 五味子（十五粒，杵） 当归（一钱，酒洗） 麦门冬（去心，五分） 白
芍药（炒，一钱） 山栀子（炒，五分） 茯神（去心，一钱） 酸枣仁（炒，一钱） 生地黄（酒洗，五分）
甘草 陈皮 川芎（各五分）
上水煎服。
愚按前症宜用此方，不宜多服。其麦门冬、芍药、山栀、生地苦寒，恐复损脾气。若脾胃素虚热而患前
证，但以补中益气汤加麦门、五味亦可。若因饥渴劳役，或因误行攻伐，以致气高而喘，身热而烦，或自
汗，此为阳气内伤，宜用补中益气汤。若因饥饱劳役，或因误出汗，以致肌热，大渴引饮，目赤面红，脉
洪大，按之如无，此为血脱烦躁，宜用当归补血汤。
（第一卷中备用的治疗暑病的方剂，一并收录于此，以便查阅。）
夏至日后出现发热症状的称为暑病，暑属于相火当令的时节。夏季人们感受暑邪，邪气从口鼻进入，损伤心包络的经脉，其脉象多虚，或浮大而散，或弦细芤迟。因为热邪耗伤元气导致气虚，所以脉象虚弱。其症状表现为：出汗，心烦则气喘喝喝，安静时多言语，身体发热且烦躁，心痛，极度口渴想喝水，头痛，自汗，疲倦少气，或者便血，发黄，生斑疹，严重时火热之邪克制肺金不能平抑肝木，导致抽搐痉挛，不省人事。治疗暑病的方法，以清心火、利小便为最好。暑邪耗伤元气，应当以补益真气为关键。又有恶寒，或者四肢逆冷，严重时昏迷不省人事，以及霍乱吐泻，痰滞呕逆，腹痛腹泻痢疾等症状。这并非暑邪直接伤人，而是因暑天贪凉饮冷等自身行为导致的疾病。虽然是因为暑天引起的，所以也称为暑病，但治疗方法不同。
如果是行路人或农夫，在烈日下劳作得病的，是“动而得之”，属于阳证。其病症必定苦于头痛，燥热，怕热，摸皮肤很热，必定大渴引饮，出汗，没有力气活动，这是天气炎热外伤元气所致。宜用清暑益气法，使用香薷、黄连、扁豆、人参、黄芪、五味子、知母、石膏等药物。
暑热导致口渴，脉象虚，宜用人参白虎汤。人参一钱五分，知母二钱，石膏五钱，甘草二钱。竹叶石膏汤也很好。石膏一两，半夏二钱五分，甘草二钱，人参二钱，麦门冬五钱，加入竹叶，水煎服。
李东垣的清暑益气汤，治疗长夏季节湿热蒸腾，人感受后，四肢困倦，精神不足，胸满气促，肢节疼痛，或者气短而喘，身体发热且烦躁，胃脘痞闷，小便黄而频数，大便溏薄而次数多，或者痢疾，或者口渴，不想饮食，自汗，身体沉重。黄芪、升麻、苍术各一钱，人参、白术、神曲、陈皮各五分，甘草（炙）、黄柏、麦门冬、当归各三分，葛根、泽泻、青皮、五味子各二分。
如果在暑热之时，原本没病的人，为了避暑热，在深堂大厦、凉台冷馆，或用大扇风车纳凉而得病的，是“静而得之”，属于阴证。其病症必定头痛，恶寒，身体拘急不舒，肢节疼痛且心烦，皮肤很热，无汗。这是因为阴寒之气遏制，使周身阳气不得舒展，宜用辛温的药物来解表散寒，使用厚朴、紫苏、干葛、藿香、羌活、苍术等药物。如果外感寒邪，内又损伤冰水生冷瓜果，前面的药再加干姜、缩砂仁、神曲等。这不是治疗暑病，而是治疗因暑天贪凉导致的疾病。如果外不受寒，只是内伤冰水冷物，腹痛泄泻，或者霍乱吐逆，宜用缩脾饮，砂仁、草果、甘草、扁豆、干姜、乌梅，或者理中汤加神曲、麦芽、缩砂仁、苍术。这是专门治内，温中消食。
如果出现吐泻，脉象沉微严重的，不可用凉药，可用附子大顺散：熟附子、甘草、干姜、杏仁、桂枝，或者附子理中汤加芍药。
夏天多吃冷物及过量饮茶酒水，导致脾胃受伤，出现吐泻霍乱。所以治疗暑病的药多用温脾消食、治湿利小便的药物。医生要明白这个意思。
如果既伤了暑热，又伤了生冷，外热内寒，宜先治其内，温中消食，再治其外，清暑补气，而以调理脾胃为主，在前文阴阳两条内兼取使用。东垣的清暑益气汤，已经兼顾了这个意思。其中用黄芪、升麻、人参、白术、甘草、麦门冬、当归、五味子、黄柏、葛根，是清暑补气；苍术、神曲、陈皮、泽泻、青皮，是治内补脾。
我按语：前述病症还应当分别中暑与中寒、脉虚与脉沉、无汗与有汗、发热与不发热、作渴与不作渴、或泻或不泻、饮寒与饮热，辨别其阴阳虚实，不可泛泛投用寒凉药剂。因为夏天体内潜伏阴气，古人使用附子大顺散之类温补阳气，很有深意啊！为什么现在的老弱之人，到了夏天患食欲不振，身体疲倦，发热作渴，或者吐泻，腹痛，头痛等症状，反而服用香薷饮，再次损伤元气，无不招致暑症，以致无法挽救。至于清暑益气汤内用猪苓、泽泻等药，必须仔细审查确实有湿热壅滞，方可使用，否则亏损其阴气，而伤害眼睛。用药应当审察！
仪部郎中李北川，仲夏患腹痛吐泻，两手脚摸起来热，按压则冷，轻诊脉象浮大，重诊脉象微细。我说：这是阴寒的病症。急服附子理中汤，未见效仍继续服用，至四剂而痊愈。
注夏病属于阴虚元气不足，宜用补中益气汤去掉柴胡、升麻，加黄柏（炒）、白芍药。挟痰者，加半夏、陈皮。
我按语：丹溪先生曾说：天地以五行更迭衰旺而成四季，人的五脏六腑也相应地衰旺。四月属巳，五月属午，为火太旺，火是肺金的夫（克星），火旺则金衰；六月属未，土大旺，土是水的夫（克星），土旺则水衰，何况肾水常常借助肺金为母，以补充其不足。古人在夏天一定独居并清淡饮食，保养肺金、肾水两脏。经书说冬天藏精的人，春天不患温病。十月属亥，十一月属子，正是火气潜藏的时候，必须保养其本然的真气，作为来年春天生发的根本。如果在这个时候不纵欲自残，到春天升发之际，根本壮实，有什么病可说呢？
文选姚海山，仲夏头痛，发热，气短而喘，肢体倦怠，两手麻木。我说热伤元气，用人参益气汤顿然安适，又用补中益气汤加麦门冬、五味子而痊愈。
如果夏天伤暑，发热，大汗出，没有力气，脉象虚细而迟。这是暑伤元气，服用后方：
人参、黄芪（蜜炙）、麦门冬（去心）、白芍药、陈皮、白茯苓（各一钱）、黄连（炒）、甘草（炙，各五分）、黄柏（三分）、白术（一钱五分）、香薷、知母（各七分）。
上药加生姜、水煎，饭前温服。
我按语：前述病症有热伤元气而出汗的，有劳伤元气而出汗的，有因元气素虚腠理不密而出汗的。治疗方法：暑伤元气者，用清暑益气汤；劳伤元气者，用补中益气汤；元气素虚而自汗者，用十全大补汤。如兼盗汗，佐以六味丸加五味子。前文说大汗，无力，脉虚细迟，属于阳气虚弱，纳入黄柏、知母恐怕再次损伤阳气，芍药、茯苓恐怕引导损耗阴气。医者审察！
如果夏秋暑热，因过用冷物茶水伤其内，又过受凉风伤其外，以致恶寒发热，胸膈饱闷，饮食不进，或兼呕吐、泄泻，这是内外俱伤寒冷。
人参、干姜（炒紫色）、厚朴（姜水炒）、陈皮、羌活、枳实、白茯苓（各一钱）、白术（一钱五分）、甘草（炙，五分）。
上药加生姜，水煎，饭前温服。
我按语：前述病症宜用此方，如果未见效，宜用藿香正气散。如果内外已解，寒热未退，或饮食不进，宜用六君子汤。
《保命集》说：霍乱属于阳明症，宜用和中、平胃、建中汤类，或四君子汤。脉浮，自汗，四君子汤加桂枝主治；脉浮，无汗，四君子汤加麻黄。吐利转筋，胁下痛，脉弦者，是木克土，用平胃散加木瓜，或建中汤加柴胡、木瓜；吐利转筋，腹痛，体重，脉沉而细，四君子汤加白芍药、良姜。吐利，四肢拘急，脉沉而迟，属于少阴，四君子汤加姜、附、厚朴；吐利，四肢厥冷，脉微缓，属于厥阴，建中汤加当归、附子。吐利，头痛而身热，热多欲饮水者，五苓散；寒多不欲水者，理中丸主治。元戎说：太阴症霍乱者，理中汤加橘红；下腹痛，手足逆冷，理中汤加熟附子；吐利后转筋者，理中汤加火硝石膏一两。
上舍徐民则，夏天入房事及吃冰果面食，而患腹痛。我说：这是阴寒的病症，急用附子理中汤以回阳。他不信，另用二陈汤、枳实、黄连香薷饮之类而死。
进士刘华甫，夏天吃生冷果品，患前述病症，我用附子理中汤一钟顿然安适。（凡是方剂内用木瓜的，都用砂器煎炒，因为厌恶铁故也。我的方剂仿照此例。）
如果在夏天暑热途中，常服用以壮元气、清热驱暑。服用可避免中暑、霍乱、泄泻、痢疾等症。
人参（一钱二分）、白术（一钱五分）、五味子（十粒，捣碎）、麦门冬（去心）、白芍药（炒）、白茯苓（各一钱）、知母（炒）、陈皮、香薷（各七分）、黄芩（炒，三分）、甘草（炙，五分）。
上药加生姜、水煎，饭前温服。
我按语：前述病症如果人元气虚弱，宜用补中益气汤去掉柴胡、升麻，加麦门冬、五味子，或少加炒黑黄柏。人参益气汤也可用。
如果遇到劳倦辛苦，用力过多，即服后方二、三服，避免产生内伤发热的病。此方主要在于补气。
黄芪（一钱半，蜜炙）、人参、麦门冬（去心）、陈皮（各一钱）、白术（一钱）、甘草（炙，七分）。
上药加生姜、大枣、水煎，饭前温服。劳倦严重，加熟附子四五分。
我按语：前述论述开启世俗之蒙昧，救济无穷的夭折枉死。纳入附子若平时畏寒饮食者，尤其适宜使用。如果平时喜寒饮食者，用肉桂或炮姜代替也可以。如果因暑热伤气，而四肢困倦，或手足麻木者，先用真人参益气汤，后用补中益气汤。
如果人过度劳心思虑，损伤精神，头眩目昏，心虚气短，即服后方以补血为主。
人参（一钱）、五味子（十五粒，捣）、当归（一钱，酒洗）、麦门冬（去心，五分）、白芍药（炒，一钱）、山栀子（炒，五分）、茯神（去心，一钱）、酸枣仁（炒，一钱）、生地黄（酒洗，五分）、甘草、陈皮、川芎（各五分）。
上药水煎服。
我按语：前述病症宜用此方，不宜多服。其麦门冬、芍药、山栀、生地苦寒，恐怕再次损伤脾气。如果脾胃素虚热而患前述证，但以补中益气汤加麦门冬、五味子也可以。如果因饥渴劳役，或因误行攻伐，以致气短而喘，身体发热且烦躁，或自汗，此为阳气内伤，宜用补中益气汤。如果因饥饱劳役，或因误出汗，以致肌热，大渴引饮，目赤面红，脉洪大，按之如无，此为血脱烦躁，宜用当归补血汤。
(The formulas for treating summerheat prepared in Volume I are included here for easy reference.)
Febrile diseases occurring after the Summer Solstice are termed summerheat (Shu Bing, 暑病), which is governed by the ministerial fire (Xiang Huo, 相火). When people contract this pathogen in summer, it enters through the mouth and nose, damaging the Pericardium Collateral (Xin Bao Luo, 心包络) meridian. The pulse may be deficient (Xu Mai, 虚脉), or floating, large, and scattered (Fu Da Er San, 浮大而散), or wiry, fine, hollow, and slow (Xian Xi Kou Chi, 弦细芤迟). Since heat consumes Qi, Qi becomes depleted, resulting in a weak pulse. Symptoms include sweating; if vexed, there is panting and loud breathing; if quiet, there is excessive talking; body heat with vexation; heart pain; extreme thirst with desire to drink; headache; spontaneous sweating; fatigue and shortness of breath; or bleeding from the lower orifices; jaundice; eruption of macules. In severe cases, excessive fire fails to allow Metal (Lung) to control Wood (Liver), leading to spasms and convulsions, and loss of consciousness. The treatment principle for summerheat is best achieved by clearing Heart Fire and promoting urination. Since summerheat damages Qi, tonifying True Qi (Zhen Qi, 真气) is essential. There are also cases of aversion to cold, or cold limbs, and in severe instances, coma and loss of consciousness, as well as cholera-like vomiting and diarrhea, phlegm obstruction with retching, abdominal pain, and dysentery. These are not directly caused by summerheat invading the body, but are self-inflicted illnesses due to behaviors during summer. Although arising in summer, they are called summerheat diseases, yet their treatment differs.
If travelers or farmers contract the disease while laboring under the sun, it is "obtained through movement" (Dong De Zhi, 动而得之), representing a Yang pattern (Yang Zheng, 阳证). Symptoms must include severe headache, dryness and heat, aversion to heat, skin feeling very hot to the touch, extreme thirst with desire to drink, sweating, and inability to move due to lack of Qi. This is external damage to Original Qi (Yuan Qi, 元气) by heavenly heat. Treatment should clear summerheat and benefit Qi, using herbs such as Moslae Herba (Xiang Ru, 香薷), Coptidis Rhizoma (Huang Lian, 黄连), Dolichos Semen (Bian Dou, 扁豆), Ginseng Radix et Rhizoma (Ren Shen, 人参), Astragali Radix (Huang Qi, 黄 ), Schisandrae Fructus (Wu Wei Zi, 五味子), Anemarrhenae Rhizoma (Zhi Mu, 知母), and Gypsum Fibrosum (Shi Gao, 石膏).
For summerheat causing thirst with a deficient pulse, Ren Shen Bai Hu Tang (Ginseng White Tiger Decoction) is indicated: Ginseng Radix et Rhizoma (Ren Shen, 人参) 1.5 qian, Anemarrhenae Rhizoma (Zhi Mu, 知母) 2 qian, Gypsum Fibrosum (Shi Gao, 石膏) 5 qian, Glycyrrhizae Radix et Rhizoma (Gan Cao, 甘草) 2 qian. Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) is also effective: Gypsum Fibrosum (Shi Gao, 石膏) 1 liang, Pinelliae Rhizoma (Ban Xia, 半夏) 2.5 qian, Glycyrrhizae Radix et Rhizoma (Gan Cao, 甘草) 2 qian, Ginseng Radix et Rhizoma (Ren Shen, 人参) 2 qian, Ophiopogonis Tuber (Mai Men Dong, 麦门冬) 5 qian, add Bamboo Leaves (Zhu Ye, 竹叶), decoct in water.
Li Dongyuan's Qing Shu Yi Qi Tang (Clear Summerheat Benefit Qi Decoction) treats damp-heat steaming during the late summer season. Upon contraction, symptoms include limb fatigue, diminished spirit, chest fullness and shortness of breath, joint pain, or rapid breathing with panting, body heat with vexation, epigastric stuffiness, yellow and frequent urine, loose and frequent stools, or dysentery, thirst, anorexia, spontaneous sweating, and heavy body. Astragali Radix (Huang Qi, 黄 ), Cimicifugae Rhizoma (Sheng Ma, 升麻), Atractylodis Rhizoma (Cang Zhu, 苍术) each 1 qian; Ginseng Radix et Rhizoma (Ren Shen, 人参), Atractylodis Macrocephalae Rhizoma (Bai Zhu, 白术), Massae Fermentatae Medicinalis (Shen Qu, 神曲), Tangerine Peel (Chen Pi, 陈皮) each 0.5 qian; Glycyrrhizae Radix et Rhizoma (Gan Cao, 甘草, honey-fried), Phellodendri Cortex (Huang Bo, 黄柏), Ophiopogonis Tuber (Mai Men Dong, 麦门冬), Angelicae Sinensis Radix (Dang Gui, 当归) each 0.3 qian; Puerariae Radix (Ge Gen, 葛根), Alismatis Rhizoma (Ze Xie, 泽泻), Tangerine Peel (Qing Pi, 青皮), Schisandrae Fructus (Wu Wei Zi, 五味) each 0.2 qian.
If healthy individuals, seeking relief from summerheat, stay in deep halls, cool pavilions, or use large fans, contracting the disease through stillness, it is "obtained through stillness" (Jing De Zhi, 静而得之), representing a Yin pattern (Yin Zheng, 阴证). Symptoms must include headache, aversion to cold, bodily stiffness, joint pain with vexation, hot skin, and absence of sweat. This is caused by Yin-cold constraining the body's Yang Qi, preventing its extension. Treatment should use acrid-warm agents to release the exterior and disperse cold, using Magnoliae Officinalis Cortex (Hou Po, 浓朴), Perillae Folium (Zi Su, 紫苏), Puerariae Radix (Gan Ge, 干葛), Agastache Herba (Huo Xiang, 藿香), Notopterygii Rhizoma et Radix (Qiang Huo, 羌活), Atractylodis Rhizoma (Cang Zhu, 苍术), etc. If externally affected by cold and internally injured by ice water and raw fruits, add Zingiberis Rhizoma (Gan Jiang, 干姜), Amomi Fructus Rotundus (Suo Sha, 缩砂), and Massae Fermentatae Medicinalis (Shen Qu, 神曲) to the previous formula. This does not treat summerheat itself, but treats diseases caused by summer-related cooling behaviors. If there is no external cold, only internal injury from ice/cold foods causing abdominal pain and diarrhea, or cholera-like vomiting, use Suo Pi Yin (Spleen-Constricting Drink): Amomi Fructus (Sha Ren, 砂仁), Tsaoko Fructus (Cao Guo, 草果), Glycyrrhizae Radix et Rhizoma (Gan Cao, 甘草), Dolichos Semen (Bian Dou, 扁豆), Zingiberis Rhizoma (Gan Jiang, 干姜), Mume Fructus (Wu Mei, 乌梅); or Li Zhong Tang (Regulate the Middle Decoction) added with Massae Fermentatae Medicinalis (Shen Qu, 神曲), Malto (Mai Ya, 麦芽), Amomi Fructus Rotundus (Suo Sha, 缩砂), Atractylodis Rhizoma (Cang Zhu, 苍术). This specifically treats the interior, warming the middle and digesting food.
In cases of vomiting and diarrhea with a deep and faint pulse, cool medicines should not be used. Instead, Fu Zi Da Shun San (Aconite Great Smooth Powder) can be used: Prepared Aconite Root (Shu Fu Zi, 熟附子), Glycyrrhizae Radix et Rhizoma (Gan Cao, 甘草), Zingiberis Rhizoma (Gan Jiang, 干姜), Prunus Armeniaca Seed (Xing Ren, 杏仁), Cinnamon Twig (Gui Zhi, 桂); or Fu Zi Li Zhong Tang (Aconite Regulate the Middle Decoction) added with Paeoniae Radix Alba (Bai Shao, 芍药).
Summer consumption of cold foods and excessive tea/wine injures the Spleen and Stomach, causing vomiting, diarrhea, and cholera. Therefore, summerheat treatments often use herbs that warm the Spleen, aid digestion, resolve dampness, and promote urination. Physicians must understand this principle.
If both summerheat and cold/raw foods are injured, presenting with external heat and internal cold, treat the interior first by warming the middle and aiding digestion, then treat the exterior by clearing summerheat and benefiting Qi, focusing on regulating the Spleen. Combine methods from the preceding Yin and Yang sections. Li Dongyuan's Qing Shu Yi Qi Tang already incorporates this principle: Astragali Radix (Huang Qi, 黄 ), Cimicifugae Rhizoma (Sheng Ma, 升麻), Ginseng Radix et Rhizoma (Ren Shen, 人参), Atractylodis Macrocephalae Rhizoma (Bai Zhu, 白术), Glycyrrhizae Radix et Rhizoma (Gan Cao, 甘草), Ophiopogonis Tuber (Mai Men Dong, 麦门冬), Angelicae Sinensis Radix (Dang Gui, 当归), Schisandrae Fructus (Wu Wei Zi, 五味), Phellodendri Cortex (Huang Bo, 黄柏), Puerariae Radix (Ge Gen, 葛根) clear summerheat and benefit Qi; Atractylodis Rhizoma (Cang Zhu, 苍术), Massae Fermentatae Medicinalis (Shen Qu, 神曲), Tangerine Peel (Chen Pi, 陈皮), Alismatis Rhizoma (Ze Xie, 泽泻), Tangerine Peel (Qing Pi, 青皮) treat the interior and tonify the Spleen.
My commentary: The aforementioned symptoms require differentiation between summerheat and cold, deficient vs. deep pulse, absence vs. presence of sweat, fever vs. no fever, thirst vs. no thirst, diarrhea vs. no diarrhea, preference for cold vs. hot drinks, to distinguish Yin/Yang and Deficiency/Excess. Do not indiscriminately administer cold-cooling agents. Since Yin is latent inside during summer, ancients used Fu Zi Da Shun San to warm and tonify Yang Qi, which is profound. Why do modern frail elderly, suffering from poor appetite, fatigue, fever, thirst, vomiting/diarrhea, abdominal pain, and headache in summer, instead take Xiang Ru Yin, further damaging Original Qi, inevitably inviting summerheat pathogens, leading to death? Regarding Zhu Ling and Ze Xie in Qing Shu Yi Qi Tang, one must verify damp-heat stagnation before use; otherwise, Yin is damaged, harming the eyes. Use with caution!
Li Beichuan, a Secretary, suffered abdominal pain, vomiting, and diarrhea in mid-summer. His hands and feet felt hot to the touch but cold upon pressure. Light palpation revealed a floating-large pulse; heavy palpation revealed a micro-fine pulse. I said: This is a Yin-cold pattern. Urgently administer Fu Zi Li Zhong Tang. After no improvement, continued administration cured him in four doses.
Zhu Xia (Summer Complaint) belongs to Yin deficiency and insufficient Original Qi. Use Bu Zhong Yi Qi Tang removing Chai Hu and Sheng Ma, adding Huang Bo (fried) and Bai Shao Yao. If accompanied by phlegm, add Ban Xia and Chen Pi.
My commentary: Mr. Danxi stated: Heaven and Earth form the four seasons through the alternating decline and rise of the Five Elements; human Zang-Fu organs correspondingly wax and wane. The fourth month is Si, the fifth is Wu, indicating excessive Fire. Fire controls Lung Metal; when Fire is excessive, Metal declines. The sixth month is Wei, indicating excessive Earth. Earth controls Water; when Earth is excessive, Water declines. Moreover, Kidney Water relies on Lung Metal as its mother to supplement deficiencies. Ancients practiced celibacy and bland diets in summer to nourish Lung Metal and Kidney Water. The Classic states: Those who store Essence in winter will not suffer Warm diseases in spring. The tenth month is Hai, the eleventh is Zi, when Fire Qi is hidden. One must preserve innate True Qi as the root for spring generation. If one does not indulge desires and harm oneself at this time, the root will be strong during spring ascent; what illness could arise?
Yao Haishan, a Literary Selection official, suffered headache, fever, shortness of breath with panting, limb fatigue, and numbness in both hands in mid-summer. I attributed this to Heat injuring Original Qi, administered Ren Shen Yi Qi Tang for immediate relief, followed by Bu Zhong Yi Qi Tang added with Mai Men Dong and Wu Wei Zi for recovery.
If summerheat injury causes fever, profuse sweating, weakness, and a deficient, fine, slow pulse, this is summerheat damaging Original Qi. Take the following formula:
Ginseng Radix et Rhizoma (Ren Shen, 人参), Astragali Radix (Huang Qi, 黄, honey-fried), Ophiopogonis Tuber (Mai Men Dong, 麦门冬, core removed), Paeoniae Radix Alba (Bai Shao, 白芍), Tangerine Peel (Chen Pi, 陈皮), Poria (Bai Fu Ling, 白茯苓) each 1 qian; Coptidis Rhizoma (Huang Lian, 黄连, fried), Glycyrrhizae Radix et Rhizoma (Gan Cao, 甘草, fried) each 0.5 qian; Phellodendri Cortex (Huang Bo, 黄柏) 0.3 qian; Atractylodis Macrocephalae Rhizoma (Bai Zhu, 白术) 1.5 qian; Moslae Herba (Xiang Ru, 香薷), Anemarrhenae Rhizoma (Zhi Mu, 知母) each 0.7 qian.
Decoct with Ginger and Water, take warm before meals.
My commentary: The aforementioned sweating conditions include those where Heat injures Original Qi, those where Labor injures Original Qi, and those where inherent Original Qi deficiency leads to loose pores. Treatments: For summerheat injuring Original Qi, use Qing Shu Yi Qi Tang; for Labor injuring Original Qi, use Bu Zhong Yi Qi Tang; for inherent Original Qi deficiency with spontaneous sweating, use Shi Quan Da Bu Tang. If accompanied by night sweats, assist with Liu Wei Di Huang Wan added with Wu Wei Zi. The previous text mentions profuse sweating, weakness, and deficient/fine/slow pulse belonging to Yang Qi deficiency. Adding Huang Bo and Zhi Mu may further damage Yang Qi; Bai Shao and Fu Ling may drain Yin Qi. Physicians should examine carefully!
If summer/autumn summerheat is compounded by internal injury from excessive cold foods/tea and external injury from excessive cool wind, causing aversion to cold, fever, chest fullness, anorexia, or vomiting/diarrhea, this is dual injury from cold.
Ginseng Radix et Rhizoma (Ren Shen, 人参), Zingiberis Rhizoma (Gan Jiang, 干姜, fried purple), Magnoliae Officinalis Cortex (Hou Po, 浓朴, ginger-water fried), Tangerine Peel (Chen Pi, 陈皮), Notopterygii Rhizoma et Radix (Qiang Huo, 羌活), Immature Bitter Orange (Zhi Shi, 枳实), Poria (Bai Fu Ling, 白茯苓) each 1 qian; Atractylodis Macrocephalae Rhizoma (Bai Zhu, 白术) 1.5 qian; Glycyrrhizae Radix et Rhizoma (Gan Cao, 甘草, fried) 0.5 qian.
Decoct with Ginger and Water, take warm before meals.
My commentary: Use this formula for the aforementioned symptoms. If ineffective, use Huo Xiang Zheng Qi San. If exterior/interior resolved but chills/fever persist, or anorexia remains, use Liu Jun Zi Tang.
The *Bao Ming Ji* states: Cholera belongs to Yangming patterns. Use He Zhong, Ping Wei, Jian Zhong formulas, or Si Jun Zi Tang. With floating pulse and spontaneous sweating, Si Jun Zi Tang plus Gui Zhi; with floating pulse and no sweat, Si Jun Zi Tang plus Ma Huang. With vomiting/diarrhea, muscle cramps, hypochondriac pain, and wiry pulse (Wood overacting on Earth), use Ping Wei San plus Chaenomelis Fructus, or Jian Zhong Tang plus Chai Hu and Chaenomelis Fructus. With vomiting/diarrhea, muscle cramps, abdominal pain, heaviness, and deep-fine pulse, Si Jun Zi Tang plus Bai Shao and Galangal Rhizome (Liang Jiang, 良姜). With vomiting/diarrhea, limb stiffness, and deep-slow pulse (Shaoyin pattern), Si Jun Zi Tang plus Ginger, Aconite, and Hou Po. With vomiting/diarrhea, cold limbs, and micro-slow pulse (Jueyin pattern), Jian Zhong Tang plus Dang Gui and Aconite. With vomiting/diarrhea, headache, fever, and desire to drink water (excess heat), use Wu Ling San; with excess cold and no desire for water, use Li Zhong Wan. Yuan Rong states: For Taiyin pattern cholera, Li Zhong Tang plus Ju Hong; for lower abdominal pain and cold limbs, Li Zhong Tang plus Shu Fu Zi; for cramps after vomiting/diarrhea, Li Zhong Tang plus Fire Calcined Gypsum (Huo Shi Gao, 火石膏) 1 liang.
Xu Minze, a Scholar, suffered abdominal pain in summer after intercourse and consuming ice fruits/noodles. I said: This is a Yin-cold pattern. Urgently use Fu Zi Li Zhong Tang to restore Yang. He did not believe me, used Er Chen Tang, Zhi Shi, and Huang Lian Xiang Ru Yin instead, and died.
Liu Huaifu, a Jinshi, suffered the aforementioned symptoms in summer after eating raw/cold fruits. I administered one dose of Fu Zi Li Zhong Tang for immediate relief. (Note: Whenever Mu Gua is used in formulas, decoct in clay pots because it reacts negatively with iron. My formulas follow this practice.)
For travel during summer heat, regular consumption strengthens Original Qi, clears heat, and expels summerheat, preventing summerheat stroke, cholera, diarrhea, and dysentery.
Ginseng Radix et Rhizoma (Ren Shen, 人参) 1.2 qian, Atractylodis Macrocephalae Rhizoma (Bai Zhu, 白术) 1.5 qian, Schisandrae Fructus (Wu Wei Zi, 五味子) 10 grains (crushed), Ophiopogonis Tuber (Mai Men Dong, 麦门冬, core removed), Paeoniae Radix Alba (Bai Shao, 白芍, fried), Poria (Bai Fu Ling, 白茯苓) each 1 qian, Anemarrhenae Rhizoma (Zhi Mu, 知母, fried), Tangerine Peel (Chen Pi, 陈皮), Moslae Herba (Xiang Ru, 香薷) each 0.7 qian, Scutellariae Radix (Huang Qin, 黄芩, fried) 0.3 qian, Glycyrrhizae Radix et Rhizoma (Gan Cao, 甘草, fried) 0.5 qian.
Decoct with Ginger and Water, take warm before meals.
My commentary: For the aforementioned symptoms in persons with weak Original Qi, use Bu Zhong Yi Qi Tang removing Chai Hu and Sheng Ma, adding Mai Men Dong and Wu Wei Zi, or a small amount of fried-black Huang Bo. Ren Shen Yi Qi Tang is also applicable.
After strenuous labor or excessive effort, taking two to three doses of the following formula prevents internal injury fever. This formula primarily benefits Qi.
Astragali Radix (Huang Qi, 黄, 1.5 qian, honey-fried), Ginseng Radix et Rhizoma (Ren Shen, 人参), Ophiopogonis Tuber (Mai Men Dong, 麦门冬, core removed), Tangerine Peel (Chen Pi, 陈皮) each 1 qian, Atractylodis Macrocephalae Rhizoma (Bai Zhu, 白术) 1 qian, Glycyrrhizae Radix et Rhizoma (Gan Cao, 甘草, fried) 0.7 qian.
Decoct with Ginger, Jujube, and Water, take warm before meals. For severe fatigue, add Prepared Aconite Root (Shu Fu Zi, 熟附子) 0.4-0.5 qian.
My commentary: The preceding discussion dispels worldly ignorance and saves countless premature deaths. Using Fu Zi is especially suitable for those who fear cold and prefer warm foods/drinks. For those preferring cold foods/drinks, Rou Gui or Pao Jiang may substitute. For summerheat injuring Qi causing limb fatigue or hand/foot numbness, first use Ren Shen Yi Qi Tang, then Bu Zhong Yi Qi Tang.
For those overworking mind/thoughts, damaging Spirit, causing dizziness, blurred vision, Heart deficiency, and shortness of breath, take the following Blood-tonifying formula.
Ginseng Radix et Rhizoma (Ren Shen, 人参) 1 qian, Schisandrae Fructus (Wu Wei Zi, 五味子) 15 grains (crushed), Angelicae Sinensis Radix (Dang Gui, 当归) 1 qian (wine-washed), Ophiopogonis Tuber (Mai Men Dong, 麦门冬, core removed) 0.5 qian, Paeoniae Radix Alba (Bai Shao, 白芍, fried) 1 qian, Gardeniae Fructus (Shan Zhi Zi, 山栀子, fried) 0.5 qian, Poria Cum Wood (Fu Shen, 茯神, core removed) 1 qian, Ziziphi Spinosae Semen (Suan Zao Ren, 酸枣仁, fried) 1 qian, Rehmanniae Radix Preparata (Sheng Di Huang, 生地黄, wine-washed) 0.5 qian, Glycyrrhizae Radix et Rhizoma (Gan Cao, 甘草), Tangerine Peel (Chen Pi, 陈皮), Ligusticum Chuanxiong Rhizome (Chuan Xiong, 川芎) each 0.5 qian.
Decoct in Water and take.
My commentary: Use this formula for the aforementioned symptoms, but do not take excessively. Mai Men Dong, Bai Shao, Shan Zhi Zi, and Sheng Di Huang are bitter-cold and may damage Spleen Qi. For Spleen/Stomach deficiency-heat with these symptoms, Bu Zhong Yi Qi Tang added with Mai Men Dong and Wu Wei Zi is sufficient. For Qi deficiency with panting, fever, vexation, or sweating due to hunger/thirst/labor or mistaken purging, use Bu Zhong Yi Qi Tang. For blood depletion with restlessness, muscle heat, extreme thirst, red eyes/face, and large-empty pulse due to hunger/fullness/labor or mistaken sweating, use Dang Gui Bu Xue Tang.