夏令伏邪，至深秋而发，发汗不解，继又泄泻。此伏里之证，与暴感不同，所以表散、
不能取效。病有四旬，脉细搏如刃，面色消夺，犹里热口渴，舌色白，病中溃泄，此久热迫
蒸，阴阳失守，苦药燥损，津液日枯。因热致病，医不以河间三时法则分三焦以逐邪，昧于
从事节庵陋习，宜乎淹淹不已。若不急调，久延虚怯一途，古人所谓因病致损也，慎之！
卷心竹叶 生地炭 生白芍 米炒麦冬 炒丹皮 乌梅肉
伏暑深秋乃发，是属里证，虽经遗泄，系阴虚夹邪。忌用温散，再伤阴液。今自利口渴
腹满，可与四逆散方法。
黄芩 枳实 六一散 生芍 广皮白
夏季暑热内伏，秋凉伏邪内发。初起耳窍流脓，已非风寒在表。今十余日大便不解，目
黄赤，舌起黄苔，耳聋昏谵，渐有内闭之状，非轻症也。
连翘 黄芩 大黄 黑栀 生甘草 枳实
急火煎四十沸，即滤清服。
湿热之邪郁于气分，身热目黄自利。夏月受之，深秋而发。
木防己 杏仁 黄芩 生石膏 枳实 白芍
脉沉目黄，气喘呛呕，脘闷肢冷潮热，汗出略缓，少顷复热。病九日不解，口干自利。
此湿邪内胜为热，三焦不通，夏伏至霜降而发，其病为重。
杏仁 半夏 山茵陈 鲜石菖蒲 浓朴 草果仁 茯苓皮 川通草
久痛，用辛温两通气血不效。病已十年，不明起病之由。今便溏溺赤，水谷湿热不运，
必夹湿阻气，主以分消。
薏苡仁 浓朴 猪苓 茯苓皮 蔻仁 山茵陈 泽泻
又 香砂平胃散，加茯苓、茵陈。
酒客湿热内蕴，长夏湿热外加。医不晓客邪兼有宿病，发散消导，胃汁大伤，先利粘腻
而吐血。今两跗麻痹，膝中逆冷，阴液枯涸，脉络少气，舌绛烦渴，溺赤短涩，热未尽，本
先夺，偻废之象，恐不能免。
滑石 生石膏 寒水石 白芍 川柏 麦冬 鲜生地 阿胶 炙草 麻仁
舌白心黄，湿着太阴，食不运，呕吐。
杏仁 广皮白 草果仁 藿梗 浓朴 半夏
痛胀得吐而安，随发寒热，口苦目黄，皆湿热内扰，胃口不清。《灵枢》谓中气不足，
溲便为变矣。
柴胡 花粉 谷芽 生姜 黄芩 半夏 枳实 大枣
暑湿虽去，胃气未复，务宜薄味静养，勿令客邪再扰。
川石斛 广皮 半夏曲 煨益智仁 茯苓 青皮
热秽上加，头胀脘痞，宜蔬食清上。
竹叶心 桑叶 黄芩 连翘 花粉 杏仁
脉沉舌赤，邪入血分，烦躁，神气欲昏，用竹叶地黄汤。
竹叶心 浙生地 犀角尖 连翘心 元参 细叶菖蒲
初病伏暑伤于气分，潮热渴饮，邪犯肺也。失治则遂传膻中，遂舌绛缩，小便忽闭，鼻
血，环口疮蚀，耳聋神呆，此气分之邪热漫延于血分矣。夫肺主卫，心主营，营卫二气，昼
夜流行于经隧之中，与邪相遇，或凉或热。今则入于络，津液被劫，必渐昏昧，所谓内闭外
犀角尖 元参心 金银花 鲜生地 连翘 细叶菖蒲根
心营肺卫同治。
鲜生地 蔗汁 生甘草梢 麦门冬 花粉
暑湿本阴邪，必伤于气分，久则三焦均受，自头巅胸胁，流行皆阻，便溺不爽，但湿久
而生热，治湿必究其本。
桂苓甘露饮。
伏暑得新凉，身热咳嗽，治在肺。舌白不 ，囊肿，暑必兼湿，湿滞为肿。
芦根 茯苓 淡竹叶 杏仁 通草
夏季感受的伏邪，到了深秋时节发作，经过发汗治疗症状未解，随后又出现腹泻。这是体内潜伏的病证，与突然感受外邪不同，因此使用解表发散的方法不能取得疗效。病程已四十天，脉象细弱且搏动如刀刃般坚硬，面色憔悴枯槁，仍然感到体内发热、口渴，舌苔色白，病中伴有泄泻，这是因为长期发热逼迫蒸腾，导致阴阳失调失守，苦寒药物燥烈损伤了津液，使得津液日渐枯竭。因为热邪致病，医生没有按照刘河间“三时法则”分上、中、下三焦来逐除邪气，而拘泥于节庵（李东垣）的狭隘习气，难怪病情缠绵不愈。如果不紧急调理，长久拖延会导致虚损怯弱的局面，这就是古人所说的因病致损，务必谨慎！
处方：卷心竹叶、生地炭、生白芍、米炒麦冬、炒丹皮、乌梅肉。
伏暑在深秋才发作，属于里证，虽然经过遗精泄泻，但属于阴虚夹带邪气。忌用温散之法，以免再次损伤阴液。如今自利（腹泻）、口渴、腹满，可以参照四逆散的方义进行治疗。
处方：黄芩、枳实、六一散、生芍药、广皮白。
夏季暑热内伏，秋季凉气使伏邪在内发作。起初耳窍流脓，说明已经不是风寒在表。如今十多天大便不通，眼睛发黄发红，舌起黄苔，耳聋、神志昏乱谵语，逐渐有内闭的症状，这不是轻症。
处方：连翘、黄芩、大黄、黑栀子、生甘草、枳实。
急火煎煮四十沸，即滤去渣滓服用。
湿热之邪郁结在气分，身体发热、目黄、自利。夏季感受此邪，深秋发作。
处方：木防己、杏仁、黄芩、生石膏、枳实、白芍。
脉沉、目黄，气喘呛咳呕吐，胃脘闷胀、四肢发冷、潮热，出汗后稍缓解，片刻后又发热。病九日未解，口干、自利。
这是湿邪内盛化为热邪，三焦不通，夏季潜伏至霜降时节发作，病情较重。
处方：杏仁、半夏、山茵陈、鲜石菖蒲、浓朴、草果仁、茯苓皮、川通草。
久痛，使用辛温两通气血的方法无效。病程已有十年，不清楚发病的原因。如今大便溏薄、小便赤红，水谷湿热不能运化，必然夹杂湿气阻滞气机，主要采用分消法治疗。
处方：薏苡仁、浓朴、猪苓、茯苓皮、蔻仁、山茵陈、泽泻。
又方：香砂平胃散，加茯苓、茵陈。
嗜酒之人湿热内蕴，长夏季节湿热外加。医生不了解客邪兼有宿疾，使用发散和消导之法，导致胃汁大伤，先出现排泄粘腻之物并吐血。如今双脚背麻痹，膝盖逆冷，阴液枯涸，脉络少气，舌质绛红、烦躁口渴，小便赤短涩滞，热邪未尽，本元先夺，恐怕难免出现佝偻废用的景象。
处方：滑石、生石膏、寒水石、白芍、川柏、麦冬、鲜生地、阿胶、炙甘草、麻仁。
舌苔白中心黄，湿气着留于太阴脾经，食物不能运化，呕吐。
处方：杏仁、广皮白、草果仁、藿梗、浓朴、半夏。
疼痛胀满得吐后缓解，随即发作寒热，口苦、目黄，都是湿热内扰，胃口不清。《灵枢》说中气不足，大小便就会发生变异。
处方：柴胡、花粉、谷芽、生姜、黄芩、半夏、枳实、大枣。
暑湿虽去，胃气未复，务必宜清淡饮食、静养，不要让客邪再次扰乱。
处方：川石斛、广皮、半夏曲、煨益智仁、茯苓、青皮。
热秽之气上乘，头胀、胃脘痞闷，宜吃蔬菜清淡食物清利上部。
处方：竹叶心、桑叶、黄芩、连翘、花粉、杏仁。
脉沉、舌赤，邪气进入血分，烦躁，神气欲昏，使用竹叶地黄汤。
处方：竹叶心、浙生地、犀角尖、连翘心、元参、细叶菖蒲。
初病伏暑伤于气分，潮热渴饮，邪气侵犯肺脏。失治则传变至膻中，于是舌绛缩短，小便忽然闭塞，鼻出血，口周疮蚀，耳聋神呆，这是气分的邪热蔓延到了血分。肺主卫气，心主营气，营卫二气，昼夜流行于经络隧道之中，与邪气相遇，或凉或热。如今邪气入络，津液被劫夺，必然逐渐昏昧，所谓内闭外……
处方：犀角尖、元参心、金银花、鲜生地、连翘、细叶菖蒲根。
心营与肺卫同治。
处方：鲜生地、蔗汁、生甘草梢、麦门冬、花粉。
暑湿本是阴邪，必定伤于气分，久了则三焦均受累，从头顶到胸胁，气机流行皆受阻，大小便不爽利，但湿气久了而生热，治疗湿气必须追究根本。
处方：桂苓甘露饮。
伏暑遇到新凉，身体发热咳嗽，治疗重点在肺。舌苔白不润，阴囊肿胀，暑必兼湿，湿气停滞导致肿胀。
处方：芦根、茯苓、淡竹叶、杏仁、通草。
The latent pathogenic factor contracted in summer manifests in late autumn. Sweating fails to resolve the condition, followed by diarrhea. This is a syndrome of latent pathogens within the interior, distinct from sudden external contraction; thus, exterior-releasing methods are ineffective. The illness has persisted for forty days. The pulse is fine and hard like a blade, the complexion is withered and depleted, yet there is internal heat and thirst. The tongue coating is white, and there is loose stool during the illness. This results from prolonged fever forcing evaporation, leading to a loss of Yin-Yang regulation. Bitter-cold drugs have dried and damaged fluids, causing daily depletion of body fluids. Since the disease was caused by heat, the physician failed to apply Liu Hejian's "Three Seasons Rule" to differentiate the Upper, Middle, and Lower Jiao to expel the pathogen. Instead, he adhered to the narrow habits of Jie'an (Li Dongyuan), which explains why the illness lingers without end. If not urgently regulated, prolonged delay will lead to deficiency and weakness, as the ancients called it: damage due to illness. Be cautious!
Prescription: Bamboo Leaf Heart (Zhuye Xin), Charred Rehmannia Root (Shengdi Tan), Raw White Peony Root (Sheng Baishao), Rice-fried Ophiopogon Tuber (Mijiao Maidong), Fried Moutan Bark (Chaodanpi), Dark Plum Flesh (Wumei Rou).
Latent summerheat manifesting in late autumn belongs to interior syndromes. Although seminal emission or diarrhea has occurred, it indicates Yin deficiency with accompanying pathogens. Warm-releasing methods are contraindicated to avoid further injuring Yin fluids. Currently, with spontaneous diarrhea, thirst, and abdominal fullness, one may refer to the method of Sini San (Four Counterflow Powder).
Prescription: Scutellaria Root (Huangqin), Immature Bitter Orange (Zhishi), Liuyisan (Six-to-One Powder), Raw Peony Root (Sheng Shaoyao), Tangerine Peel White (Guangpi Bai).
Summer heat lies latent internally; autumn coolness causes the latent pathogen to emerge internally. Initially, pus flowed from the ear canal, indicating that wind-cold was no longer at the exterior. Now, after more than ten days, there is constipation, yellow and red eyes, yellow tongue coating, deafness, delirium, and signs of gradual internal closure. This is not a mild condition.
Prescription: Forsythia Fruit (Lianqiao), Scutellaria Root (Huangqin), Rhubarb (Dahuang), Black Gardenia Seed (Heizhi), Raw Licorice Root (Sheng Gancao), Immature Bitter Orange (Zhishi).
Decoct rapidly over high heat for forty boils, then filter and take the clear liquid.
Damp-heat pathogen stagnates in the Qi level, causing fever, jaundice, and spontaneous diarrhea. Contracted in summer, it manifests in late autumn.
Prescription: Stephania Tetrandra Stem (Mufangji), Apricot Seed (Xingren), Scutellaria Root (Huangqin), Raw Gypsum Sherd (Sheng Shigao), Immature Bitter Orange (Zhishi), White Peony Root (Baishao).
Pulse is deep, eyes are yellow, with wheezing, coughing, vomiting, epigastric oppression, cold limbs, and tidal fever. Perspiration brings slight relief, but fever returns shortly after. The illness has persisted for nine days without resolution, accompanied by dry mouth and spontaneous diarrhea.
This is dampness dominating internally transforming into heat, with obstruction of the Triple Burner. Latent in summer, it manifests at Frost Descent (Shuangjiang), indicating a severe condition.
Prescription: Apricot Seed (Xingren), Pinellia Tuber (Banxia), Artemisia Capillaris Herb (Shanyinch'en), Fresh Acorus Rhizome (Xian Shichangpu), Magnolia Bark (Nongpo), Areca Seed (Caoguoren), Poria Skin (Fuling Pi), Trichosanthes Root (Chuandongcao).
Chronic pain treated with acrid-warm methods to unblock Qi and Blood was ineffective. The illness has lasted ten years, and the origin is unknown. Currently, there is loose stool and dark urine, indicating failure to transport water and grain damp-heat. It must involve dampness obstructing Qi mechanism; the primary treatment is differentiation and elimination (Fenxiao).
Prescription: Coix Seed (Yiyiren), Magnolia Bark (Nongpo), Polyporus (Zhu Ling), Poria Skin (Fuling Pi), Cardamom Seed (Kou Ren), Artemisia Capillaris Herb (Shanyinch'en), Alisma Rhizome (Zexie).
Another prescription: Xiangsha Pingwei San (Aucklandia and Amomum Powder to Pacify the Stomach), added with Poria (Fuling) and Artemisia Capillaris Herb (Yinch'en).
In wine drinkers, damp-heat is internally accumulated; in midsummer, external damp-heat adds to it. Physicians did not understand that the exogenous pathogen coexists with chronic disease. Using releasing and digesting methods severely injured stomach fluids, first causing discharge of sticky matter and hematemesis. Now, both dorsums of the feet are numb, knees feel reverse-cold, Yin fluids are exhausted, meridians lack Qi, the tongue is crimson with irritability and thirst, urine is dark, scanty, and difficult. Heat is not fully cleared, while the root is already depleted. The appearance of kyphosis and disability seems unavoidable.
Prescription: Talcum (Huashi), Raw Gypsum Sherd (Sheng Shigao), Cold Water Stone (Han Shuishishi), White Peony Root (Baishao), Phellodendron Bark (Chuanbai), Ophiopogon Tuber (Maidong), Fresh Rehmannia Root (Xian Shengdi), Donkey-hide Gelatin (Ejiao), Honey-fried Licorice Root (Zhi Cao), Hemp Seed (Maren).
Tongue coating is white with a yellow center, indicating dampness attaching to the Taiyin Spleen. Food is not transported, leading to vomiting.
Prescription: Apricot Seed (Xingren), Tangerine Peel White (Guangpi Bai), Areca Seed (Caoguoren), Patchouli Stem (Huogeng), Magnolia Bark (Nongpo), Pinellia Tuber (Banxia).
Pain and distension are relieved by vomiting, followed by alternating chills and fever, bitter taste in the mouth, and yellow eyes. All indicate internal disturbance by damp-heat and unclear stomach appetite. The *Ling Shu* states that when Middle Qi is insufficient, urination and defecation undergo changes.
Prescription: Bupleurum Root (Chaihu), Trichosanthes Root (Huafen), Grain Sprout (Guya), Ginger (Shengjiang), Scutellaria Root (Huangqin), Pinellia Tuber (Banxia), Immature Bitter Orange (Zhishi), Jujube Date (Dazao).
Although summer-dampness has passed, Stomach Qi has not recovered. One must strictly adhere to bland flavors and quiet rest, preventing exogenous pathogens from disturbing again.
Prescription: Dendrobium Stem (Chuan Shihu), Tangerine Peel (Guangpi), Fermented Pinellia (Banxia Qu), Roasted Alpinia Oxyphylla Fruit (Wei Yizhiren), Poria (Fuling), Green Citrus Peel (Qingpi).
With heat and turbidity ascending, there is head distension and epigastric stuffiness. Vegetable food and clearing of the upper burner are appropriate.
Prescription: Bamboo Leaf Heart (Zhuye Xin), Mulberry Leaf (Sangye), Scutellaria Root (Huangqin), Forsythia Fruit (Lianqiao), Trichosanthes Root (Huafen), Apricot Seed (Xingren).
Pulse is deep, tongue is crimson. Pathogen has entered the Blood level. There is irritability, and spirit is about to become confused. Use Zhuye Dihuang Tang (Bamboo Leaf and Rehmannia Decoction).
Prescription: Bamboo Leaf Heart (Zhuye Xin), Zhejiang Rehmannia Root (Zhe Shengdi), Rhinoceros Horn Tip (Xijiao Jian), Forsythia Heart (Lianqiao Xin), Scrophularia Root (Yuann Shen), Fine-leaved Acorus (Xiye Changpu).
Initially, latent summerheat injured the Qi level, causing tidal fever and thirst. The pathogen attacked the Lung. Failure to treat properly leads to transmission to the Pericardium (Dan Zhong), resulting in a crimson, retracted tongue, sudden urinary retention, epistaxis, perioral ulceration, deafness, and mental dullness. This indicates Qi-level pathogenic heat spreading into the Blood level. The Lung governs Wei (Defensive) Qi, and the Heart governs Ying (Nutritive) Qi. Ying and Wei Qi circulate day and night through the collaterals. Meeting pathogens, they may be cool or hot. Now entering the collaterals, fluids are seized, leading gradually to confusion, known as internal closure...
Prescription: Rhinoceros Horn Tip (Xijiao Jian), Scrophularia Heart (Yuann Shenxin), Honeysuckle Flower (Jinyinhua), Fresh Rehmannia Root (Xian Shengdi), Forsythia Fruit (Lianqiao), Fine-leaved Acorus Root (Xiye Changpu Gen).
Simultaneous treatment of Heart Ying and Lung Wei.
Prescription: Fresh Rehmannia Root (Xian Shengdi), Sugarcane Juice (Zheshi), Raw Licorice Root Tip (Sheng Gancao Shao), Ophiopogon Tuber (Maidong), Trichosanthes Root (Huafen).
Summer-dampness is essentially a Yin pathogen, inevitably injuring the Qi level. Over time, all three Jiao are affected. Flow from the vertex to the chest and hypochondrium becomes obstructed, causing difficult urination and defecation. However, long-standing dampness generates heat; treating dampness requires addressing its root cause.
Prescription: Guiling Ganlu Yin (Cassia and Poria Sweet Dew Drink).
Latent summerheat meets new coolness, causing fever and cough. Treatment focuses on the Lung. Tongue coating is white and non-moist, scrotal swelling occurs. Summerheat must accompany dampness; damp stagnation causes swelling.
Prescription: Reed Rhizome (Lugen), Poria (Fuling), Light Bamboo Leaf (Dan Zhuye), Apricot Seed (Xingren), Tongcao (Tongcao).