论注夏
天师曰∶坚治者，怠惰不振，用坚药以坚其气，或坚其骨也。坚气者，如人夏月无阴，到三伏之
时，全无气力，悠悠忽忽，惟思睡眠，一睡不足再睡，再睡不足，则懒于语言，或梦遗不已，或夜热不
休者是也。此皆肾水泄于冬天，夏月阳胜，阴无以敌，所以如此。必须峻补其肾水，水足而骨髓充满，
则骨始有力，而气不下陷矣。方用熟地一两，山茱萸四钱，北五味一钱，麦门冬三钱，白芍三钱，当归二
钱，白术三钱，茯苓一钱，陈皮一钱，生枣仁二钱，芡实三钱，水煎服。方名软坚汤。得此方妙在纯是补
阴，而全无坚治之法，然坚之意已寓于中矣。盖骨空则软，补其骨中之髓，则骨不坚而坚也。此方之妙，
可以治以上之气软骨软，无不全愈，终不必再立坚骨之法也。
此亦有凡小儿十岁以上，十岁以下，天癸水未至，亦有患前症者，岂皆冬不藏精之故耶？而非然也。
盖小儿最不忌口，一见瓜果凉热之物，尽意饱啖；久则胃气弱矣，再则脾气坏矣，又肾气寒矣，遂至肾水
耗去，亦如冬不藏精之症。方又不可全用前方，当以补胃补脾补肾三经为主，不可纯用补肾一经之味也。
方用白术一钱，茯苓一钱，熟地三钱，北五味五分，麦冬一钱，当归一钱，白芍二钱，陈皮三分，山
楂三粒，枳壳二分，人参五分。水煎服。（〔批〕健脾生水汤。）一剂立愈，不必再服也。此方脾肺肾
俱为统治，而又平肝木，肝既得养，则心亦泰然。此五脏皆用补剂，而小儿纯阳，尤易奏功，不若大人
之必须多服也，夏天小儿最宜服一二剂，再无注夏之病。此又坚治之一法，留心儿科者，幸察之。
张公曰∶坚治法妙。
华君曰∶君多小儿症治。
【注释：注夏】
天师说：所谓“坚治法”，是针对精神倦怠、萎靡不振的症状，使用具有“坚固”作用的药物来充实其正气，或者强健其骨骼。所谓“坚气”，就像人在夏季缺乏阴精滋养时，到了三伏天（一年中阳气最盛、天气最炎热的时候），完全感到没有力气，精神恍惚，只想睡觉，一次睡不够还要再睡，反复睡眠仍不解乏，从而懒得说话，或者出现频繁的梦遗，或者夜间发热不止等情况。这些都是因为在冬季肾水（肾阴）耗泄，导致夏季阳气偏胜，阴精不足以制约阳气，所以出现上述症状。必须大力补益肾水，肾水充足后骨髓得以充盈，骨骼才能有力，正气才不会下陷。方剂用熟地黄一两，山茱萸四钱，北五味子一钱，麦门冬三钱，白芍三钱，当归二钱，白术三钱，茯苓一钱，陈皮一钱，生酸枣仁二钱，芡实三钱，加水煎服。此方名为软坚汤。这个方子的妙处在于全是滋阴补血的药物，完全没有直接采用“坚治”的方法，但“坚”的意蕴已经蕴含在其中了。因为骨骼空虚就会显得软弱，补充骨中的精髓，那么骨骼看似不坚实则变得坚固。这个方子的奇妙之处在于，可以治愈上述因气虚和骨软引起的各种病症，没有不能痊愈的，最终不必再另外设立专门强健骨骼的方法。
这种情况也有发生在十岁以上、十岁以下的小儿身上，他们的天癸（指青春期发育成熟的标志，此处指生殖精气）尚未到来，也患有前面提到的症状，这难道都是由于冬季没有藏精的缘故吗？并非如此。大概是因为小儿最不忌口，一见瓜果等寒热食物，就尽情饱食；时间久了胃气就会虚弱，接着脾气就会受损，进而肾气也会受寒，导致肾水消耗，也像冬季不藏精所致的病症一样。此时方剂又不能完全使用前面的方子，应当以补胃、补脾、补肾三经为主，不可单纯只使用补肾一味的药物。方剂用白术一钱，茯苓一钱，熟地黄三钱，北五味子五分，麦冬一钱，当归一钱，白芍二钱，陈皮三分，山楂三粒，枳壳二分，加水煎服。（批注：健脾生水汤。）服用一剂立刻痊愈，不需要再服用。这个方子同时调理脾、肺、肾三脏，又能平和肝木，肝脏得到滋养后，心脏也能安宁。这个方子五脏都用补剂，而小儿属于纯阳之体，更容易见效，不像大人需要多服。夏天的小儿最适合服用一到两剂，就不会再患“注夏”病。这又是坚治法的一种，留心儿科治疗的医生，希望仔细考察。
[Commentary: Zhu Xia (Summer Lethargy)]
The Heavenly Master said: The so-called "Jian Zhi Fa" (Method of Strengthening) is used for symptoms of lethargy and lack of vigor. It employs herbs with "strengthening" properties to consolidate the Zheng Qi (Upright Qi) or strengthen the bones. Regarding "consolidating Qi," it refers to situations where, in summer lacking Yin essence, during the San Fu days (the hottest period of the year), one feels completely devoid of strength, spiritless and vague, desiring only sleep. One sleep is insufficient, followed by another, yet still not relieved, leading to reluctance to speak, frequent nocturnal emissions, or persistent night fever. These conditions arise because the Kidney Water (Kidney Yin) was depleted in winter; thus, in summer when Yang is excessive, there is insufficient Yin to counteract it. Therefore, one must vigorously tonify the Kidney Water. Once the water is sufficient, the bone marrow becomes full, the bones gain strength, and the Qi no longer sinks. The prescription consists of Shu Di Huang (Prepared Rehmannia Root) 1 liang, Shan Zhu Yu (Cornus Fruit) 4 qian, Bei Wu Wei Zi (Schisandra Berry) 1 qian, Mai Men Dong (Ophiopogon Tuber) 3 qian, Bai Shao (White Peony Root) 3 qian, Dang Gui (Angelica Sinensis) 2 qian, Bai Zhu (Atractylodes Rhizome) 3 qian, Fu Ling (Poria) 1 qian, Chen Pi (Tangerine Peel) 1 qian, Sheng Suan Zao Ren (Ziziphus Seed) 2 qian, and Qian Shi (Euryale Seed) 3 qian. Decoct in water and take orally. This formula is named Ruan Jian Tang (Softening and Strengthening Decoction). The brilliance of this formula lies in its pure Yin-tonifying nature, without explicitly employing a "strengthening" method; however, the intent of strengthening is embedded within it. When bones are empty, they appear soft; by replenishing the marrow within the bones, the bones become strong despite appearing soft. The efficacy of this formula can cure all aforementioned conditions related to Qi deficiency and bone softness, ensuring complete recovery, thereby eliminating the need to establish separate methods for strengthening bones.
This condition also occurs in children aged ten and above or ten and below, whose Tian Gui (Reproductive Essence/Menstruation) has not yet arrived, yet they suffer from the aforementioned symptoms. Is this solely due to failing to store essence in winter? Not necessarily. Generally, children do not observe dietary restrictions; upon seeing fruits and melons or other cold/hot foods, they eat to satiety. Over time, the Stomach Qi weakens, then the Spleen Qi deteriorates, and subsequently the Kidney Qi becomes cold, leading to the depletion of Kidney Water, mimicking the syndrome caused by failing to store essence in winter. In such cases, the previous formula cannot be used entirely. The treatment should focus on tonifying the Stomach, Spleen, and Kidney meridians, rather than using only Kidney-tonifying herbs exclusively. The prescription consists of Bai Zhu (Atractylodes Rhizome) 1 qian, Fu Ling (Poria) 1 qian, Shu Di Huang (Prepared Rehmannia Root) 3 qian, Bei Wu Wei Zi (Schisandra Berry) 5 fen, Mai Dong (Ophiopogon Tuber) 1 qian, Dang Gui (Angelica Sinensis) 1 qian, Bai Shao (White Peony Root) 2 qian, Chen Pi (Tangerine Peel) 3 fen, Shan Zha (Hawthorn Fruit) 3 pieces, and Zhi Ke (Bitter Orange Fruit) 2 fen. Decoct in water and take orally. [Commentary: Jian Pi Sheng Shui Tang (Spleen-Strengthening and Water-Generating Decoction)]. One dose brings immediate cure, and further doses are unnecessary. This formula simultaneously regulates the Spleen, Lung, and Kidney, while also pacifying the Liver Wood. Once the Liver is nourished, the Heart becomes tranquil. Although this formula uses tonics for all five Zang organs, children possess a "Pure Yang" constitution, making them more responsive to treatment compared to adults who require prolonged administration. For children in summer, taking one or two doses prevents "Zhu Xia" disease. This represents another aspect of the Jian Zhi (Strengthening) method. Pediatric practitioners should pay close attention to this.
Master Zhang said: The Jian Zhi Fa (Method of Strengthening) is excellent.
Lord Hua said: You have treated many pediatric cases.