用清暑气,砂仁草果乌梅暨。甘草葛根扁豆加,吐泻烦渴温脾胃。(砂仁、草果(
乌梅、甘草(炙)各四两,扁豆(炒研)、葛根各二两。暑必兼温,而湿属脾土,故用砂仁、
草果利气温脾,扁豆解暑渗湿,葛根升阳生津,甘草补土和中,乌梅清热止渴。)古人治暑
多用温,(如香薷饮、大顺散之类。)暑为阴证此所谓。(洁古曰∶中热为阳证,为有余;中
暑为阴证,为不足。经曰∶脉虚身热,得之伤暑。)大顺(散)杏仁姜桂甘,散寒燥湿斯
为贵。(先将甘草、白砂仁,次入干姜、杏仁(炒),合肉桂为末,每服一钱。吴鹤皋曰∶此
非治暑,乃治暑月饮冷受伤之脾胃耳。)
麦味与人参,保肺清心治暑淫。气少汗多兼口渴,病危脉绝急煎斟。(人参五分
八分,五味子九粒。人参大补肺气,麦冬甘寒润肺,五味酸收敛肺,并能泻火生津。盖心主
脉,肺朝百脉,补肺清心,则气充而脉复。将死脉绝者服之,能令复生。夏月火旺烁金,尤
宜服之。)
滑石同甘草,解肌行水兼清燥。统治表里及三焦,热渴暑烦泻痢保。(滑石六两,甘草
一两,灯心汤下,亦有用姜汤下者。滑石气轻解肌,质重泻火,滑能入窍,淡能行水,故能
通治上下表里之湿热,甘草泻火和中,又以缓滑石之寒滑也。)益元(散)碧玉与鸡苏(散),
砂黛薄荷加之好。(前方加辰砂,名益元散,取其清心;加青黛,名碧玉散,取其凉肝;加
薄荷,
使用清解暑气的方剂,包含砂仁、草果、乌梅以及甘草、葛根、扁豆。这些药物共同作用,可以治疗因暑湿引起的呕吐、腹泻、心烦和口渴,并温暖脾胃。(其中砂仁、草果、乌梅、炙甘草各四两,炒研的扁豆、葛根各二两。暑邪必然兼夹温邪,而湿气归属于脾土,因此使用砂仁、草果来利气并温暖脾脏,扁豆来解除暑热并渗利湿气,葛根来提升阳气并生津液,甘草来补益中土并调和诸药,乌梅来清热并止渴。)古人在治疗暑病时多使用温性药物,(例如香薷饮、大顺散之类的方剂。)中暑被归类为阴证,这就是所说的道理。(张洁古说:感受热邪属于阳证,表现为实证;感受暑邪属于阴证,表现为虚证。《内经》记载:脉象虚弱且身体发热,是由于伤暑所致。)大顺散的组成包括杏仁、干姜、肉桂和甘草,其珍贵之处在于能够散寒燥湿。(制作时先将甘草和白砂仁放入,接着加入干姜和炒杏仁,最后混合肉桂研磨成粉末,每次服用一钱。吴鹤皋说:这个方子不是直接治疗暑邪,而是治疗在暑月因贪凉饮冷而损伤脾胃的情况。)
麦冬、五味子配合人参,能够保养肺脏、清心火以治疗暑邪侵袭。当出现气短、汗多兼有口渴的症状,甚至病情危重、脉搏微弱欲绝时,需紧急煎服此药。(人参用量五分至八分,五味子九粒。人参能大补肺气,麦冬甘寒滋润肺阴,五味子酸涩收敛肺气,并能泻火生津。因为心主血脉,肺朝会百脉,补肺清心,则气机充盛而脉搏恢复。对于濒临死亡、脉搏断绝的患者服用,能使脉搏复生。夏季月份火气旺盛灼伤肺金,尤其适宜服用此方。)
滑石与甘草同用,能够解肌表之邪、行水湿并清除燥热。它可以统管治疗表里及三焦的病症,对于热盛、口渴、暑烦、腹泻和痢疾都有保护作用。(滑石六两,甘草一两,用灯心草汤送服,也有用姜汤送服的。滑石质地轻清能解肌表之邪,质地沉重能泻火,滑利能通窍,淡味能行水,因此能通治上下表里所有的湿热之邪;甘草能泻火和中,同时缓和滑石的寒凉滑利之性。)益元散、碧玉散和鸡苏散,是在前方基础上加入辰砂、青黛和薄荷,效果更佳。(前方即六一散,加入辰砂名为益元散,取其清心火之意;加入青黛名为碧玉散,取其凉肝火之意;加入薄荷……)
To clear summerheat, use Amomum Fruit (Sharen), Tsaoko Cardamom Fruit (Caoguo), and Mume Fruit (Wumei). Add Licorice Root (Gancao), Kudzu Root (Gegen), and Lablab Bean (Baidou) to treat vomiting, diarrhea, irritability, thirst, and warm the spleen and stomach. (Sharen, Caoguo, Wumei, and roasted Gancao are each 4 liang; fried and ground Baidou and Gegen are each 2 liang. Summerheat inevitably combines with warmth, while dampness belongs to the Spleen Earth. Therefore, Sharen and Caoguo promote Qi circulation and warm the Spleen; Baidou resolves summerheat and leaches out dampness; Gegen raises Yang and generates fluids; Gancao tonifies the Middle Jiao and harmonizes; Wumei clears heat and stops thirst.) Ancients often used warm herbs to treat summerheat conditions (such as Xiangru Yin and Dashun San). Summerstroke is considered a Yin syndrome, which is what this refers to. (Jiegu stated: Zhongre [heat stroke] is a Yang syndrome, representing excess; Zhongshu [summerstroke] is a Yin syndrome, representing deficiency. The Classic states: weak pulse and body heat result from injury by summerheat.) Dashun San contains Apricot Kernels (Xingren), Dried Ginger (Ganjiang), Cinnamon Twig (Rougui), and Licorice Root (Gancao); its value lies in dispelling cold and drying dampness. (First add Gancao and white Sharen, then add Ganjiang and fried Xingren, mix with Rougui into powder, take 1 qian per dose. Wu Hegao said: This is not treating summerheat itself, but rather the spleen and stomach injured by drinking cold beverages during summer months.)
Ophiopogon Tuber (Maidong), Schisandra Berry (Wuweizi), and Ginseng Root (Renshen) preserve the Lungs, clear the Heart, and treat summerheat invasion. When there is shortness of breath, profuse sweating, and thirst, or when the condition is critical with a faint or absent pulse, decoct and administer urgently. (Renshen 5-8 fen, Wuweizi 9 grains. Renshen greatly tonifies Lung Qi; Maidong is sweet and cold, moistening the Lungs; Wuweizi is sour and astringent, consolidating Lung Qi, and can drain fire and generate fluids. Since the Heart governs the vessels and the Lungs convene all vessels, tonifying the Lungs and clearing the Heart replenishes Qi and restores the pulse. Administered to those near death with absent pulses, it can restore life. In summer months when Fire is prosperous and scorches Metal [Lungs], this is especially suitable.)
Talcum (Huashi) combined with Licorice Root (Gancao) releases the muscle layer, promotes water metabolism, and clears dryness and heat. It treats disorders of the exterior and interior, as well as the Triple Burner, protecting against heat, thirst, summerheat irritability, diarrhea, and dysentery. (Huashi 6 liang, Gancao 1 liang, taken with Dengxin Cao [Juncus Decoction], sometimes with Jiang Tang [Ginger Decoction]. Huashi is light to release the muscle layer, heavy to drain fire, slippery to enter orifices, and bland to move water; thus it treats damp-heat in the upper/lower, exterior/interior. Gancao drains fire and harmonizes the Middle, moderating the cold and slippery nature of Huashi.) Yi Yuan San, Bi Yu San, and Ji Su San are improved by adding Cinnabar (Chensha), Indigo Naturalis (Qingdai), and Mint Leaves (Bohe). (The previous formula [Liuyi San] plus Chensha is named Yi Yuan San, for its heart-clearing property; plus Qingdai is named Bi Yu San, for its liver-cooling property; plus Bohe...)