【证】 众人一般者是。
【治】 有三法∶宜补,宜散,宜降。
大黄 黄芩 黄连 人参 桔梗 苍术 防风 滑石粉 人中黄 香附子
上神曲丸,送下随宜。气虚四君子;血虚四物汤;痰,二陈汤;热甚,童便作汤送下。
春夏不服麻黄,秋冬不服桂枝;夏不服青龙,冬不服白虎。
【脉】 脉虚身热,或浮自汗。自汗者,火动而散故也。
【因】 夏火太热,损伤肺金元气。其感有二∶动而得之,乃辛苦之人,动而火
胜,热伤气也,脉洪而大。静而得之,乃安乐之人,静而湿胜,火胜金位也,脉沉而实。
【证治】 暑喜归心。入心则噎塞,昏不知人;入肝则眩晕;入肺则喘满、痿 ;
入脾则昏睡不觉;入肾则消渴。病则
怠惰嗜
卧,四肢不收,精神不足,两脚痿弱,头疼恶热,躁热,大渴引饮,大汗。因动而中,白虎
加
入参汤主方。头疼恶寒,拘急肢节疼,大热无汗。因静而中,大顺散、白虎加苍术。有阴胜
阳之极,甚则传肾肝为痿厥,清暑益气汤主之。
凡中 死,切忌与冷水凉处,须沃以汤,宜黄龙丸主之。
心虚伤暑,身热头痛,烦满而渴,五苓散主之。肺虚伤暑,身热烦闷而喘,白虎汤主之
。脾虚伤暑,则为 疟,常山饮主之。
黄连香薷汤 治暑。挟痰加半夏;虚加参、 。
清暑益气汤 治暑伤金,虚甚。
玉龙丸 曾用治暑。油炒半夏、姜汁丸。
补中益气汤 治疰夏痰渗。
二苓汤 治春夏之交,病似伤寒,自汗体重,痛难转侧,此名中湿。
泽泻(一两) 滑石(二两) 茯苓 猪苓 白术(半两)
暑风挟火,痰实者,可用吐法。
玉龙丸 治暑泄泻,或二便秘。
焰硝 明矾 滑石 硫黄(一两) 白面(六两)
水丸,水下。
【症状表现】 如果众人的病情表现一致,即属于此类。
处方组成:大黄、黄芩、黄连、人参、桔梗、苍术、防风、滑石粉、人中黄、香附子。
以上药物用神曲制成丸剂,根据具体情况选择送服汤剂。气虚者用四君子汤;血虚者用四物汤;有痰者用二陈汤;热势极盛者,用童子尿煎汤送下丸药。
春夏季节不服用麻黄类辛温发汗药,秋冬季节不服用桂枝类辛温解表药;夏季不服用大青龙汤(辛温峻汗),冬季不服用白虎汤(辛寒清热)。
【脉象】 脉象虚弱且身体发热,或者脉浮且自汗。自汗的原因,是火邪扰动导致津液外散所致。
【病因】 夏季火热之气过盛,损伤了肺金的元气。感受暑邪有两种情况:因活动而得病,多见于辛勤劳作之人,活动时阳气升动而火邪偏胜,热邪耗伤正气,脉象洪大而有力;因静处而得病,多见于安逸享乐之人,静处时湿气偏胜,火邪克制肺金之位,脉象沉而实。
【证候与治疗】 暑邪容易归入心经。暑邪入心则出现噎塞感,神志昏迷不知人事;入肝则出现眩晕;入肺则出现气喘胸满、肢体痿软;入脾则昏睡不醒;入肾则出现消渴症。患病后表现为倦怠嗜卧,四肢无力不收摄,精神不足,两脚痿弱,头痛且厌恶炎热,烦躁发热,极度口渴想饮水,大汗淋漓。因活动而中暑的,以白虎加人参汤为主方。若见头痛恶寒,拘急且肢节疼痛,高热无汗,属另一种情况。因静处而中暑的,用大顺散或白虎加苍术汤。若有阴气胜阳气至极的情况,甚至传变至肝肾导致痿厥,用清暑益气汤主治。
凡是中暑致死的情况,切忌给予冷水或凉处,必须用热水浇淋,宜用黄龙丸主治。
心虚伤暑,表现为身体发热、头痛、烦闷而渴,用五苓散主治。肺虚伤暑,表现为身体发热、烦闷而喘,用白虎汤主治。脾虚伤暑,则发展为疟疾,常用常山饮主治。
黄连香薷汤:治疗暑病。挟痰者加半夏;体虚者加人参、甘草。
清暑益气汤:治疗暑邪伤及肺气,虚损严重者。
玉龙丸:曾用于治疗暑病。用油炒半夏,姜汁泛为丸剂。
补中益气汤:治疗疰夏(夏季慢性疲劳综合征)伴痰湿渗泄。
二苓汤:治疗春夏之交,病症类似伤寒,自汗、身体沉重,疼痛难以转侧,此名为中湿。
处方组成:泽泻(一两)、滑石(二两)、茯苓、猪苓、白术(半两)。
暑风挟火,痰实者,可以使用吐法。
[Symptoms] If the symptoms are consistent among the general population, it belongs to this category.
[Treatment Principles] There are three treatment methods: tonification (Bu), dispersion (San), and descending (Jiang).
Prescription Composition: Rhizoma et Radix Notoginseng (Dahuang), Cortex Eucommiae (Huangqin), Rhizoma Coptidis (Huanglian), Radix Ginseng (Renshen), Flos Platycodonis (Jiegeng), Rhizoma Atractylodis Macrocephalae (Cangzhu), Ramulus Saposhnikoviae (Fangfeng), Talcum (Huashifen), Human Excrement Middle Layer (Renzhonghuang), Rhizoma Cyperi (Xiangfuzi).
The above herbs are processed with Massa Medicata Fermentata (Shenqu) into pills. They should be taken with appropriate decoctions based on individual conditions. For Qi deficiency, use Sijunzi Tang (Four Gentlemen Decoction); for Blood deficiency, use Siwu Tang (Four Substances Decoction); for Phlegm, use Erchen Tang (Two Aged Herbs Decoction); for severe heat, take the pills down with urine from a healthy child (Tongbian).
In spring and summer, do not administer Ephedrae Herba (Mahuang)-based diaphoretic formulas; in autumn and winter, do not administer Cinnamomi Ramulus (Guizhi)-based exterior-releasing formulas. In summer, do not administer Da Qinglong Tang (Great Blue Dragon Decoction); in winter, do not administer Baihu Tang (White Tiger Decoction).
[Pulse] The pulse is deficient with body fever, or floating with spontaneous sweating. Spontaneous sweating occurs because Fire pathogen agitates and scatters the fluids.
[Etiology] Summer Fire is excessively hot, damaging the Yuan Qi (Original Qi) of Lung Metal. There are two ways of contracting the pathogen: Contracting through activity usually affects hardworking individuals; physical exertion causes Yang to rise and Fire to prevail, leading to Heat injuring Qi, resulting in a洪大 (Hongda, surging and large) pulse. Contracting through stillness usually affects leisurely individuals; stillness allows Dampness to prevail, with Fire overcoming the position of Metal, resulting in a沉实 (Chenshi, deep and solid) pulse.
[Syndrome and Treatment] Summer-heat tends to enter the Heart channel. Entering the Heart causes choking sensation and coma/unconsciousness; entering the Liver causes dizziness; entering the Lung causes asthma, chest fullness, and flaccidity; entering the Spleen causes lethargy and unconscious sleep; entering the Kidney causes Xiao Ke (Wasting-Thirst syndrome). The disease manifests as lassitude, desire to lie down, limbs unable to hold themselves, insufficient spirit, weak legs, headache, aversion to heat, irritability, intense thirst with desire to drink, and profuse sweating. For cases contracted through activity, Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng) is the main formula. If there is headache, aversion to cold, stiffness, joint pain, high fever, and no sweat, it indicates a different pattern. For cases contracted through stillness, Dashun San (Great Harmony Powder) or Baihu Jia Cangzhu Tang (White Tiger Decoction plus Atractylodes Macrocephala Rhizome) are used. In extreme cases where Yin overcomes Yang, transmitting to Liver and Kidney causing Wei Jue (Flaccidity-Jue syndrome), Qingshu Yiqi Tang (Clear Summer-heat and Tonify Qi Decoction) is used.
For those who die from heatstroke, cold water or cool places must strictly be avoided. Hot water should be poured over them, and Huanglong Wan (Yellow Dragon Pill) is indicated.
For Heart deficiency with summer-heat injury, manifesting as body fever, headache, irritability, fullness, and thirst, Wuling San (Five Ling Powder) is used. For Lung deficiency with summer-heat injury, manifesting as body fever, irritability, stuffiness, and asthma, Baihu Tang (White Tiger Decoction) is used. For Spleen deficiency with summer-heat injury, leading to Nue (Intermittent Fever/Malaria), Changshan Yin (Changshan Decoction) is commonly used.
Huanglian Xiangru Tang (Coptis and Elsholtzia Decoction): Treats summer-heat. Add Banxia (Pinellia Rhizome) if accompanied by Phlegm; add Renshen (Ginseng) and Gancao (Licorice Root) if deficient.
Qingshu Yiqi Tang (Clear Summer-heat and Tonify Qi Decoction): Treats summer-heat injuring Lung Qi, especially in severe deficiency.
Yulong Wan (Jade Dragon Pill): Previously used to treat summer-heat. Made from oil-fried Banxia (Pinellia Rhizome) rolled in Ginger Juice.
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction): Treats Zhuxia (Summer-heat fatigue syndrome) with Phlegm-Damp leakage.
Er Ling Tang (Two Poria Decoction): Treats the transition between spring and summer, where symptoms resemble Taiyang disease (Cold Damage), with spontaneous sweating, heavy body, and pain making turning difficult. This is named Zhong Shi (Dampness Strike).
Prescription: Ze Xie (Alisma Rhizome, 1 liang), Huashi (Talcum, 2 liang), Fuling (Poria), Zhuling (Polyporus), Baizhu (Atractylodes Macrocephala Rhizome, 0.5 liang).
For Summer-Wind with Fire and excess Phlegm, emesis (Tu Fa) can be used.
Yulong Wan (Jade Dragon Pill): Treats summer-heat diarrhea or constipation/urinary retention.
Prescription: Yanxiao (Saltpeter), Mingfan (Alumen), Huashi (Talcum), Liuhuang (Sulfur, 1 liang), Baifan (White Flour, 6 liang).
Make into water pills, take with warm water.