洁古云。静而得之为中暑。动而得之为中热。中暑者阴证。中热者阳证。东垣云。避
暑热于深堂大厦。得之者名曰中暑。其病必头痛恶寒。身形俱急。肢节疼痛而烦
心。肌肤火热无汗。为房室之阴寒所遏。使周身阳气不得伸越。大顺散主之。若行
人或农夫。于日中劳役得之者。名曰中热。其病必苦头痛。发躁热恶热。扪之肌肤
大热。必大渴引饮。汗大泄。无气以动。乃为天热外伤肺气。苍术白虎汤主之。窃谓
暑热者。夏之令也。大行于天地之间。人或劳动。或饥饿。元气亏乏。不足以御天令
亢极。于是受伤而为病。名曰中暑。亦名曰中热。其实一也。今乃以动静所得分之
何哉。夫中暑热者。固多在劳役之人。劳役则虚。虚则邪入。邪入则病。不虚则天令
虽亢。亦无由以伤之。彼避暑于深堂大厦。得头痛恶寒等证者。盖亦感冒微风。或
静夜着凉耳。不可以中暑名之。其所以烦心与肌肤火热者。非暑邪也。身中阳气。
受外邪所遏而作也。既非暑邪。其可以中暑名乎。苟欲治之。则辛温轻扬之剂发
散可也。夫大顺散一方。甘草最多。干姜、杏仁、肉桂次之。除肉桂外。其三物皆炒者。
原其初意。本为冒暑伏热。引饮过多。脾胃受湿呕吐。水谷不分。脏腑不调所立。故
甘草、干姜。皆经火炒熟。又肉桂而非桂枝。盖温中药也。内有杏仁。不过取其能下
气耳。若以此药治静而得之之证。吾恐不能解表。反增内烦矣。今世俗往往不明。
类曰夏月阴气在内。大顺散为必用之药。吁。其误也。不亦甚欤。夫阴气非寒气也。
盖夏月阳气发散于外。而阴气则在内耳。岂竟视阴气为寒气。而用温热之药乎。
阴果为寒。何以夏日则饮冰乎。然则苍术白虎汤。岂可视为通行之药。必参之治
暑诸方。随所见之证而用之。然后合理。若夫所谓静而得之之证。虽当夏月。即非
暑病。宜分出之。勿使后人有似同而异之惑。
洁古说：在静止状态下感受暑邪的称为中暑，在活动状态下感受暑邪的称为中热。中暑属于阴证，中热属于阳证。
东垣说：在深堂大厦中躲避暑热而得病的，名叫中暑。这种病必定出现头痛、恶寒（怕冷）、身体和筋脉拘急、肢节疼痛且心中烦闷的症状，肌肤发热但无汗。这是因为房室中的阴寒之气遏制了周身阳气，使其不能舒展升发。治疗以大顺散为主方。如果是行路的人或农夫，在烈日下劳作而得病的，名叫中热。这种病必定痛苦于头痛，烦躁发热、怕热，触摸肌肤感觉非常烫手，必定极度口渴想喝水，大汗淋漓，气短无力不想活动。这是天热外伤肺气所致，治疗以苍术白虎汤为主方。
我认为：暑热是夏季的气候特征，广泛流行于天地之间。人如果因为劳作或饥饿，导致元气亏乏，不足以抵御亢极的天时气候，于是受伤而生病，这名叫中暑，也名叫中热。其实两者是一样的。现在为什么要根据动静来区分它们呢？
那些中暑热的人，确实多在劳役之人身上发生。劳役会导致人体虚弱，虚弱则邪气容易入侵，邪气入侵则发病；如果不虚弱，即使天时气候亢盛，也没有途径伤害人体。那些在深堂大厦中避暑，出现头痛、恶寒等症状的人，大概也是感冒了微风，或者在静夜受凉罢了，不可以称之为中暑。他们之所以出现心中烦闷和肌肤火热的症状，并不是暑邪造成的，而是体内的阳气受到外邪遏制而产生的。既然不是暑邪，怎么可以称之为中暑呢？如果想要治疗这种情况，使用辛温轻扬的药剂发散即可。
大顺散这一方剂，甘草用量最多，干姜、杏仁、肉桂次之。除了肉桂以外，其他三味药都是炒过的。推究其最初的本意，原本是为了解决因冒犯暑热伏火，饮水过多，导致脾胃受湿、呕吐、水谷不分、脏腑不调而立方的。所以甘草、干姜都经过火炒熟，而且用的是肉桂而不是桂枝，这属于温中药。方中有杏仁，不过是取其能降气的功效罢了。如果用这个药去治疗“静而得之”的病证，我恐怕不仅不能解表，反而会增加内部的烦热。
如今世俗之人往往不明白这一点，常说夏天月份阴气在内，大顺散是必用的药物。唉，这错误也太严重了吧！所谓的阴气并不是寒气。大概是夏天阳气发散于体表，而阴气则在体内罢了。怎么能竟然把阴气看作寒气，而使用温热性质的药物呢？如果阴气真的是寒，为什么夏天人们要喝冰水呢？
既然如此，那么苍术白虎汤，难道可以看作是通用的药物吗？必须参考治疗暑病的各种方剂，根据所见的证候来选用，这样才合理。至于所谓“静而得之”的病证，即使在夏季，也不是暑病，应当将其区分出来，不要让后人产生似是而非的困惑。
Jieguo stated: Contracting heatstroke while in a state of rest is called *Zhongshu* (Summerheat Stroke); contracting it while in motion is called *Zhonger* (Heatstroke). *Zhongshu* belongs to Yin syndromes, whereas *Zhonger* belongs to Yang syndromes.
Dongyuan stated: One who seeks refuge from summer heat in deep halls and large mansions and contracts the disease is named as having *Zhongshu*. The symptoms must include headache, aversion to cold, stiffness of the body and limbs, pain in the joints accompanied by vexation, hot skin without sweat. This occurs because the yin-cold of the dwelling suppresses the body's yang qi, preventing it from extending and rising. The primary formula for treatment is Dashun San (Greatly Smooth Powder). If a traveler or farmer contracts the disease after laboring under the midday sun, they are named as having *Zhonger*. The symptoms must include severe headache, irritability, fever, aversion to heat, burning-hot skin upon touch, extreme thirst with an urge to drink copiously, profuse sweating, and lethargy due to lack of qi. This results from heavenly heat injuring the Lung qi externally. The primary formula for treatment is Cangzhu Baizhu Tang (Atractylodes and White Tiger Decoction).
I hold that summer heat is the seasonal command of summer, prevailing widely between heaven and earth. If a person labors or goes hungry, causing their primordial qi to become deficient and insufficient to resist the extreme climatic conditions, they will be injured and fall ill. This is called *Zhongshu*, also called *Zhonger*. In reality, they are one and the same. Why then distinguish them based on motion and stillness?
Those who contract summer heat indeed mostly occur among those engaged in labor. Labor leads to deficiency; deficiency allows pathogenic factors to enter; entry of pathogenic factors leads to disease. If there is no deficiency, even if the climatic conditions are extreme, there is no pathway for injury. Those who seek refuge in deep halls and large mansions and present with symptoms such as headache and aversion to cold have likely merely caught a slight wind or chilled themselves during a quiet night. They cannot be termed as having *Zhongshu*. The reason for their vexation and hot skin is not due to summerheat pathogens, but rather the body's internal yang qi being suppressed by external pathogens. Since it is not a summerheat pathogen, how can it be termed *Zhongshu*? If one wishes to treat this, dispersing with acrid-warm and light-yang agents is sufficient.
Dashun San contains the largest amount of Gancao (Licorice Root), followed by Ganjiang (Dried Ginger), Xingren (Apricot Seed), and Rougui (Cinnamon Bark). Except for Rougui, the other three herbs are stir-fried. Investigating its original intent, it was established primarily for cases where one ventured into summer heat and latent fire, drank excessively, leading to dampness affecting the spleen and stomach, vomiting, indistinguishable food and water, and disharmony of the zang-fu organs. Therefore, Gancao and Ganjiang are both stir-fried until cooked, and Rougui is used instead of Guizhi (Cinnamon Twig), as it is a warming herb. The inclusion of Xingren serves only to direct qi downward. If this medicine were used to treat the condition contracted through stillness, I fear it would fail to release the exterior and might instead increase internal vexation.
Currently, laypeople often fail to understand this, claiming that in summer months, yin qi resides internally, making Dashun San an essential medication. Alas, this error is too grave! The so-called yin qi is not cold qi. It is simply that in summer, yang qi disperses outward, while yin qi remains inward. How can one regard yin qi as cold qi and use warm-hot medicines? If yin were truly cold, why do people drink ice in summer?
Therefore, can Cangzhu Baizhu Tang be regarded as a universal remedy? One must refer to various formulas for treating summerheat and apply them according to the observed syndromes to ensure rationality. As for the so-called condition contracted through stillness, even if it occurs in summer, it is not a summerheat disease. It should be distinguished clearly to prevent future confusion arising from apparent similarities and actual differences.