暑热同气也，昔分为二。燥火异体也，今合为一。李明之曰∶静而得之为伤暑，动而得之为中热。盖谓闲逸
人，偶憩广亭高榭，为水木阴寒所抑，天气不伸而伤暑。辛苦人负
重劳作，耦耕远役，火暑迸逐而热中。王安道以静得者即是阴症，非暑也。邵行甫曰∶暑与热同气而异名，大概
谓日中火烈，行人趱程，未能便食，口体如烧，卒然昏蹶，不省人事，为中 ，名中热亦可也。素封家无长幼，
寒暄皆不能耐，甫入夏即池水亭阁安其身，沉李浮瓜爽其口，昼则环冰挥扇，夜卧以竹簟藤床，炎蒸不来，清风
满座，内有伏阴，外受凉气，汗不出则阴愈入而阳愈不发，一时昏晕，寒热交作，呕吐腹痛，乃夏月感寒，不可
执暑令之说，而用治暑之剂也。三说行甫为优，安道次之。愚意大暑流行，无所不至，纵凉以冰扇水石，终不到
凛冽地位，且外寒所遏，暑火不伸，则寒为标，热为本，只先以轻清散其表，继以凉平清其里，终以辛甘温遂其
初，无不愈者。若便名阴症，名感寒，一用辛热之物，亦已过矣。神静阴生，形役阳亢。生阴者，脏腑天成之火，
真火也。亢阳者，物欲过极，扰乱逆郁，脏腑之火迭起，名曰五志之火，邪火也。天成之火生生不已，五志之火
乃能为病。火分邪正，燥一于虚。经曰∶诸涩枯涸，皴揭干劲，皆属于燥。河间曰∶风、热、火，同阳也；燥、
湿、寒同阴也。第燥金虽属秋阴，而异于寒湿，反同其风热。东垣曰∶饥饱劳役损伤脏气，及食辛热浓味，助火
耗血，致真阴亏少，便难燥结。然亦有风热阴阳，临事当分别主治。如火盛风生，风能胜湿，风燥也。风胜生热，
耗其津液，热燥也。阳实阴虚，丙火熬干癸水，阳燥也。风劲清肃，燥气入里，出于皮肤，阴燥也。若夫内外发
热，暑、火、燥皆有之，望、问不得其情，须征以诊切。客感风寒发热，脉浮紧，头痛鼻涕，明知其热在外，汗
之而已。内伤饮食发热，脉滑数，胸满噫气，明知其热在内，消导则安。热
发脉无神力，四肢倦怠，有汗，不恶寒，此劳损表里虚症，补养自退。阳虚发热，不任风寒，自汗，脉浮濡或大
而无力。阴虚发热，脉数而微芤或涩小，多作于午后。郁热者，手足心热，肌肤不甚热，热不伸越也。烦热者，
即虚烦躁热也。痨热者，其热在骨，骨蒸热是也。总而言之，热有虚有实，虚者燥，实者火也。热有中有发，中
自外来，发由内出，虽欲合之，焉得而合之。暑热之中人，发于症为火，是暑即火、火即暑也。火威之炎烈，冷
物近之必热，是燥即火、火即燥也，虽欲分之，焉得而分之。嗟夫！暑火燥热，体气异同如此，昔分今合，固在
圆机者默相商榷也。故谚有之曰∶后之视今，犹今视昔，此合彼分，是二是一。
暑与热，气机相同，过去被分为两类；燥与火，形体不同，现在合为一类。李东垣说：静处所得为伤暑，动处所得为中热。这是指闲逸之人，偶尔在宽敞的亭台楼阁休息，被水木阴寒之气所遏制，天气不得舒展而致伤暑。辛苦之人负重劳作，耦耕远役，火热暑气逼迫追逐而致热中。王安道认为静处所得者即是阴证，不是暑病。邵行甫说：暑与热气同而名异，大体是指烈日当空，行人赶路，不能及时进食，口体如烧，突然昏厥，不省人事，称为中暍（中暑），叫中热也可以。富裕人家无论长幼，都不能耐受寒暑变化，刚入夏就住在池水亭阁中以安身，吃着沉于水中的李、浮于水的瓜以爽口，白天环绕冰块挥扇，夜晚睡在竹席藤床上，炎蒸之气不来，清风满座，体内有伏阴，外受凉气，汗不出则阴气愈入而阳气愈不发散，一时昏晕，寒热交作，呕吐腹痛，这是夏季感受寒邪，不可拘执暑令之说，而用治疗暑病的方剂。三种说法中，邵行甫的观点最优，王安道次之。我的观点是：大暑流行，无所不至，纵然用冰、扇、水、石来降温，终究达不到凛冽的程度，而且外寒所遏制，暑火不得舒展，那么寒为标，热为本，只先用轻清之药发散其表，继用凉平之药清解其里，最后用辛甘温之药恢复其初，没有不痊愈的。如果便命名为阴证、感寒，一概使用辛热之物，也就太过分了。神静则阴生，形役则阳亢。产生阴的是脏腑天然之火，即真火。亢盛的阳是物欲过极，扰乱逆郁，脏腑之火迭起，名为五志之火，即邪火。天然之火生生不息，五志之火才能致病。火分邪正，燥归于虚。《内经》说：各种涩滞枯涸、皮肤皴裂揭起干硬的症状，都归属于燥。刘河间说：风、热、火，同属阳；燥、湿、寒，同属阴。只是燥金虽然属于秋阴，但不同于寒湿，反而同于风热。李东垣说：饥饱劳役损伤脏气，以及食用辛辣浓味食物，助火耗血，导致真阴亏少，大便干燥难解。然而也有风热阴阳之分，临事应当分别主治。如火盛风生，风能胜湿，此为风燥。风胜生热，耗损津液，此为热燥。阳实阴虚，丙火熬干癸水，此为阳燥。风劲清肃，燥气入里，出于皮肤，此为阴燥。至于内外发热，暑、火、燥都有这种情况，望诊、问诊不得其情，必须通过诊察切脉来验证。外感风寒发热，脉浮紧，头痛流鼻涕，明知热在外，发汗即可治愈。内伤饮食发热，脉滑数，胸满嗳气，明知热在内，消食导滞则安。发热脉无神力，四肢倦怠，有汗，不恶寒，这是劳损导致的表里虚证，补养自然退热。阳虚发热，不耐风寒，自汗，脉浮濡或大而无力。阴虚发热，脉数而微芤或涩小，多发生在午后。郁热者，手足心热，肌肤不甚热，热不得伸展越出。烦热者，即虚烦躁热。痨热者，其热在骨，即骨蒸热。总而言之，热有虚有实，虚者为燥，实者为火。热有中（中暑）有发（内发），中自外来，发由内出，虽然想将它们合并，怎么能合并呢？暑热中人，发作时表现为火症，是暑即火、火即暑。火威炎烈，冷物靠近它必热，是燥即火、火即燥，虽然想将它们分开，怎么能分开呢？唉！暑、火、燥、热，体气异同如此，过去分列现在合并，本来就在圆通机变者心中默默商讨权衡。所以谚语说：后视今，犹今视昔，此合彼分，是二是一。
Shu (Summerheat) and Re (Heat) share the same Qi nature, yet were historically divided into two categories; Zao (Dryness) and Huo (Fire) differ in form, yet are now combined into one. Li Dongyuan stated: "Obtained while at rest is Shangshu (Injury by Summerheat); obtained during exertion is Zhongre (Heatstroke)." This refers to leisurely individuals who occasionally rest in spacious pavilions or high towers, where they are suppressed by the yin-cold of water and wood, causing the heavenly Qi to fail to extend, resulting in Injury by Summerheat. For laborers bearing heavy loads, working in pairs, or serving far away, the fire-summer heat presses and chases them, resulting in Heatstroke. Wang Andao argued that what is obtained while at rest is a Yin Syndrome (Yin Zheng), not Shu. Shao Xingfu said: "Shu and Re share the same Qi but have different names." Generally, this refers to when the sun is blazing at noon, travelers rush their journey, cannot eat promptly, feel as if their mouth and body are burning, suddenly faint, lose consciousness, which is called Zhonghe (Heatstroke); it may also be named Zhongre. Wealthy families, regardless of age, cannot tolerate cold or warmth. As soon as summer begins, they reside in pavilions by pools to comfort their bodies, eat plums sunk in water and melons floating on water to refresh their mouths, surround themselves with ice and wave fans by day, and sleep on bamboo mats and rattan beds by night. The stifling heat does not reach them, and cool breeze fills the room. Internally, there is latent Yin; externally, they contract Cold Qi. If sweat does not occur, Yin enters deeper while Yang fails to disperse, leading to sudden dizziness, alternating chills and fever, vomiting, and abdominal pain. This is contracting Cold in midsummer. One must not rigidly adhere to the theory of Summerheat and use formulas for treating Summerheat. Among these three theories, Shao Xingfu's is superior, followed by Wang Andao's. My view is: When Great Summerheat prevails, it reaches everywhere. Even if cooled by ice, fans, water, and stones, it never reaches a biting cold state. Moreover, when external Cold suppresses it, Shu-Huo cannot extend. Thus, Cold is the Branch (Biao), and Heat is the Root (Ben). First, use light and clear herbs to disperse the exterior; then, use cool and neutral herbs to clear the interior; finally, use acrid-sweet-warm herbs to restore the initial state. There will be no case that does not heal. If one simply labels it as Yin Syndrome or Contracted Cold and uses pungent-hot substances indiscriminately, it is excessive. Stillness of spirit generates Yin; physical toil causes Yang to hyperactivity. The source of Yin is the innate Fire of the Zang-Fu organs, known as True Fire (Zhen Huo). Hyperactive Yang results from extreme desires, causing disturbance, rebellion, stagnation, and successive flare-ups of organ fire, known as the Fire of Five Emotions (Wuzhi Zhi Huo), or Evil Fire (Xie Huo). The innate Fire generates life endlessly; only then can the Fire of Five Emotions cause disease. Fire is distinguished into evil and righteous; Dryness belongs to deficiency. The Classic states: "All cases of astringency, withering, drying, cracking, peeling, and stiffness belong to Dryness." Liu Wansu said: "Wind, Heat, and Fire are all Yang; Dryness, Dampness, and Cold are all Yin." Although Metal of Dryness belongs to Autumn Yin, it differs from Cold-Dampness and instead resembles Wind-Heat. Li Dongyuan said: "Hunger, fullness, and overwork damage the Qi of the Zang-Fu organs; consuming pungent, hot, and rich flavors aids Fire and consumes Blood, leading to a deficiency of True Yin and dry, difficult defecation." However, there are distinctions between Wind-Heat and Yin-Yang, which must be treated differently based on the situation. When Fire is abundant and Wind arises, Wind can overcome Dampness, resulting in Wind-Dryness. When Wind dominates and generates Heat, consuming Body Fluids, it results in Heat-Dryness. When Yang is excess and Yin is deficient, Bing Fire (Yang Fire) boils dry Gui Water (Yin Water), resulting in Yang-Dryness. When Wind is vigorous and肃 (clear/cold), Dryness Qi enters the interior and emerges from the skin, resulting in Yin-Dryness. Regarding internal and external fever, Shu, Huo, and Zao all present with fever. If observation and inquiry do not reveal the condition, diagnosis via pulse palpation is required. For exogenous Wind-Cold fever, the pulse is floating and tight, accompanied by headache and runny nose. Knowing the heat is external, sweating therapy suffices. For endogenous dietary injury fever, the pulse is slippery and rapid, with chest fullness and belching. Knowing the heat is internal, resolving stagnation brings peace. Fever with a pulse lacking strength, four-limb fatigue, sweating, and aversion to cold being absent indicates a deficiency syndrome of the exterior and interior due to劳损 (consumptive damage); nourishment and tonification will naturally resolve it. Yang-deficiency fever presents with intolerance to Wind-Cold, spontaneous sweating, and a floating, soggy, or large but forceless pulse. Yin-deficiency fever presents with a rapid, slightly hollow, or choppy-small pulse, often occurring in the afternoon. Stagnant Heat manifests as heat in the palms and soles, with the skin not feeling very hot, indicating heat that cannot extend outward. Vexatious Heat is essentially deficiency-induced vexatious heat. Consumption Heat (Lao Re) has its heat in the bones, known as bone-steaming fever. In summary, Heat has deficiency and excess types; deficiency is Dryness, excess is Fire. Heat has "Zhong" (midst/contracted) and "Fa" (emerging/internal) types. Zhong comes from outside; Fa arises from within. Although one wishes to merge them, how can they be merged? Shu-Re invading humans manifests as Huo symptoms; thus, Shu is Huo, and Huo is Shu. The fierceness of Fire makes cold objects hot upon contact; thus, Zao is Huo, and Huo is Zao. Although one wishes to separate them, how can they be separated? Alas! Shu, Huo, Zao, and Re have such similarities and differences in substance and Qi. Their historical division and current combination are indeed subject to silent deliberation by those with flexible wisdom. Hence the proverb: "The future views the present as the present views the past; this union and that division, are two yet one."