苦暑之时。无病之人。或避暑热。纳凉于深堂大厦。凉亭冷馆。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。肢节疼痛而心烦。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者。前药再加干姜、
缩砂、神曲之类。此皆非治暑也。治因暑而致之病也。
按静得动得。分中暑伤暑。此论出自张洁古。后皆因之。夫盛暑之时。炎火若炙。无
之非是。故古人闻避暑而未闻避寒。深堂广厦。正以避暑。安得入而中之。且房室
阴凉。正可护卫阳气。又安得而遏伤之乎。即膏粱深处。必不能无。冒暑应接。其伤
暑者。亦于动中得之耳。老子曰。人能常清静。天地悉皆归一。静即可祛暑。何从而
中也。至于冰水瓜果等寒物。多食自伤脾胃。亦生杂证。谓泻利诸证。内有此物积
聚则可。谓专以此致暑病则不可。若执口得寒物。身犯寒气。同冬时寒病治之。则谬以千里矣。
寒则伤形。热则伤气。何以言之。人与天地同一橐 。夏月天之气浮于地表。则人
之气浮于肌表。况被盛暑所伤。肤腠疏豁。气液为汗。发泄于外。是表里之气俱虚
矣。不善摄生者。暑热伤于外。生冷戕于中。若之何而能运化也。是以水谷停积。而
为湿热。发为呕吐。为泄泻。甚则吐泻俱作。而挥霍闷乱也。若不即病。湿热拂郁于
内。他日为疟为利之所由矣。今大顺散非治暑热之药。乃治暑月饮凉过多为病之剂也欤。
在苦热暑天,没有生病的人,如果为了躲避暑热,在深堂大厦、凉亭冷馆等阴凉处纳凉,或者使用大扇子、风车吹风而致病,这属于“静而得之”的阴证。这种病症必然出现头痛、怕冷、身体拘紧不舒、四肢关节疼痛且心中烦闷、皮肤肌肉高热但无汗等症状。这是因为阴寒之气遏制了人体,使得周身阳气不能舒展升发。适宜使用辛温性质的药物,来解表散寒。可选用浓朴、紫苏、干葛(葛根)、藿香、羌活、苍术这类药材。如果外部既受了寒邪,内部又因食用冰水及生冷瓜果而受伤,在上述药物基础上再加干姜、缩砂仁、神曲之类。这些都不是治疗暑邪本身的方法,而是治疗因暑天环境导致的疾病。
按语:将“静得”与“动得”区分开来,分别对应中暑和伤暑,这一论点出自张洁古,后人皆沿袭此说。然而,在盛夏时节,烈日如火烤,无处不热。所以古人只听说避暑,没听说过避寒。深堂广厦正是用来避暑的,怎么能进入其中反而被寒气所伤呢?况且房屋室内阴凉,正可以护卫阳气,又怎么会遏制伤害它呢?即使在富贵人家深处,也难免有外出冒暑应酬的情况,那些伤暑的人,也是在活动中得的。老子说:“人能常清静,天地悉皆归一。”保持清静就可以祛除暑热,怎么会从中暑邪呢?至于冰水瓜果等寒凉之物,多吃自然会损伤脾胃,也会产生各种杂症,比如导致泄泻痢疾等病症,可以说体内有这些食物积聚会导致此类问题;但如果说专门因为这些导致暑病,则是不对的。如果执着于口吃寒物、身犯寒气,就按照冬季寒病的方法来治疗,那就差之千里了。
寒邪损伤形体,热邪损伤气机。为什么这么说呢?人与天地同属一个整体(橐籥)。夏季天气浮越于地表,人气也就浮越于肌表。何况被盛暑所伤,皮肤腠理开疏,气随津液化为汗液发泄于体外,这样表里之气都虚弱了。不善于养生的人,外受暑热侵袭,内食生冷戕害脾胃,怎么可能还能正常运化呢?因此水谷停滞积聚,化为湿热,引发呕吐、泄泻,严重时吐泻并作,出现腹部绞痛、心烦意乱的症状。如果不立即发病,湿热郁结于内,日后就会演变成疟疾或痢疾。现在的“大顺散”并不是治疗暑热的药物,而是治疗暑月因饮用过多凉水致病的方剂吧。
During the bitter heat of summer, healthy individuals who seek to avoid the heat by resting in deep halls and large mansions, cool pavilions, or cold chambers, or by using large fans and windmills to generate breeze, contract what is termed "yin syndrome obtained through stillness" (Jing De Zhi Yin Zheng). The symptoms necessarily include headache, aversion to cold, bodily stiffness and tension, pain in the limbs and joints, mental restlessness, high fever of the skin and flesh without sweating. This occurs because yin-cold pathogens restrain the body, preventing the universal yang qi from extending and rising. It is appropriate to use acrid-warm formulas to release the exterior and disperse cold. Herbs such as Magnoliae Officinalis Cortex (Nanpu), Perillae Folium (Zisu), Puerariae Radix (Gange), Pogostemonis Herba (Huoxiang), Notopterygii Rhizoma et Radix (Qianghuo), and Atractylodis Rhizoma (Cangzhu) may be selected. If the exterior has been invaded by cold and the interior simultaneously injured by consuming ice water and raw/cold fruits and vegetables, Dried Ginger (Ganjiang), Amomi Fructus (Suosha), and Mass Medicae Fermentatae (Shenqu) should be added to the aforementioned herbs. These are not treatments for the summerheat pathogen itself, but rather treatments for diseases caused by the conditions of summer.
Note: The distinction between "obtained through stillness" and "obtained through movement," corresponding to severe summerheat (Zhong Shu) and mild summerheat injury (Shang Shu), originates from Zhang Jiegou, a theory subsequently adopted by later generations. However, during the height of summer, the blazing fire feels like roasting; everywhere is hot. Thus, ancients spoke of avoiding summerheat but never of avoiding cold. Deep halls and broad mansions are precisely for avoiding summerheat; how could one enter them and be harmed by cold? Moreover, the coolness of rooms and houses serves to protect yang qi; how could it restrain or injure it? Even within luxurious dwellings, there must inevitably be instances of venturing out into the heat for social engagements; those who suffer from summerheat injury acquire it through movement. Laozi stated, "If humans can maintain constant clarity and stillness, heaven and earth will all return to unity." Stillness itself can dispel summerheat; how could one contract summerheat from it? As for cold items like ice water and fruits, excessive consumption naturally damages the spleen and stomach, generating various miscellaneous syndromes, such as diarrhea and dysentery. It is acceptable to say that accumulation of these items internally causes such issues; however, claiming they specifically cause summerheat disease is incorrect. If one insists on treating oral intake of cold items and physical exposure to cold air by applying the same methods used for winter cold diseases, the error would be thousands of miles wide.
Cold damages the form (xing), while heat damages qi. Why is this so? Humans and heaven and earth share the same structure (tuoyue). In summer, heavenly qi floats on the earth's surface, so human qi floats on the muscular exterior. Furthermore, when injured by intense summerheat, the skin pores become open and sparse, and qi and fluids transform into sweat, excreting externally. Consequently, both exterior and interior qi become deficient. Those unskilled in self-care allow summerheat to damage them externally and raw/cold foods to harm them internally; how can digestion and transformation function properly? Therefore, food and water stagnate and accumulate, transforming into damp-heat, manifesting as vomiting and diarrhea. In severe cases, both vomiting and diarrhea occur simultaneously, accompanied by abdominal colic and mental confusion. If illness does not appear immediately, damp-heat lingers and stifles internally, eventually evolving into malaria or dysentery at a later date. The current formula, Dashun San (Great Harmony Powder), is not a medicine for treating summerheat-heat, but rather a prescription for illnesses caused by excessive consumption of cool drinks during the summer months.