脉 脉诀云∶脉虚身热。得之伤暑。脉浮自汗。或浮大而散。或洪而大。或弦细芤迟而隐。
伏而弱。或虚迟无力中。得洪缓。皆曰暑病也。或浮而虚者。暑风也。
症 戴氏云∶暑乃夏令炎暑也。有冒。有伤。有中。三者有轻重之分。或腹痛泄泻水者。胃
与大肠受之。作呕者。胃口有痰。此二者冒暑也。宜黄连、退暑热。香薷、消蓄水。或身热
头疼。燥乱不宁。或身如针刺者。为伤暑。此为热伤血分也。宜人参白虎汤。加黄芩、柴胡
、或咳嗽。发热发寒。盗汗不止。脉数者。热在肺经。乃火乘金也。此为中暑。宜清肺黄连
香薷饮。清暑益气汤之类。急治则可。少迟则难治矣。暑风。乃相火行令也。感之自口鼻而
入。伤心包络之经。故卒倒不省人事也。其脉虚浮。外症头疼口干。面垢自汗。倦怠少气。
或背寒恶热。名曰暑风也。
治 按洁古云动而得之。乃辛苦之人。动而火胜。热伤气也。脉洪而大。宜人参白虎汤主之
。静而得之。乃安乐之人。静而湿胜。火伤金位。脉沉而实。宜大顺散。或苍术白虎汤主之
。有阴胜阳者。宜清暑益气汤。大抵暑症。只宜黄连香薷饮。清暑益气汤。五苓散白虎汤等
药。挟痰。加半夏、虚。加参 之类。暑风。有挟火挟痰者。二陈汤。加黄连主之。实者。
可用吐法。昏迷不省人事者。先以苏合香丸。次以黄连香薷饮。加羌活、或用双解散。加香薷、尤妙。
方 黄连香薷饮治暑症。自汗。烦渴而噪。
香薷（三钱） 浓朴（姜制） 扁豆（姜炒各二钱） 黄连（一钱五分）
上作一服。用水二钟。煎一钟。井水沉冷服。
远行受热者。加人参、石膏、滑石（各等分）、甘草（五分）、此动而得之。
噪渴引饮。自汗。脉沉。加人参（一钱五分）、麦门（二钱）、五味（一钱）、此静而得之。
虚烦身热。自汗。清暑益气汤。
伤暑挟痰。加半夏、南星（各一钱）、姜汁竹沥传送。
呕吐。加干姜（五分）、藿香、半夏、陈皮（各一钱）。
挟泻。加五苓散（五钱）
暑风。加防风、羌活（各一钱）、有痰壅盛。再加半夏、陈皮（各八分）。
又方 清暑益气汤养脾。清肺。补中。行湿。夏秋治暑通用。
黄 人参 白术（各一钱五分） 当归 苍术 陈皮 麦冬（各一钱） 神曲 泽泻 黄柏
（各七分） 青皮 甘草 升麻 干葛（各五分） 五味（十二粒）
上用姜一片。枣一枚。煎。食远稍热服。
暑泻。加浓朴、扁豆（各一钱），去当归、麦门冬。
暑痢。加黄芩、黄连、槟榔、枳壳（各八分）、木香（六分）、乌梅（二个）。
暑疟。加柴胡、黄芩（各一钱）、川芎、草果（各八分）、倍用青皮。
暑渴。加石膏（二钱）、知母、粳米（各一钱五分）。
伏暑之时。头痛。身热。脚软。精神短少。四肢无力。不思饮食。怠惰嗜卧。俗呼为注夏。
加白芍药、半夏（各一钱）、川芎（七分），去泽泻、青皮。
暑风。加防风、羌活、荆芥穗、香薷（各一钱），去泽泻、青皮、黄柏。
中暑。脉微迟。或隐伏。渴而下利。四肢厥冷。不省人事。
本方加熟附（一钱）、以行参 之功。达于四肢。而自温矣。勿作寒治。
脉象：《脉诀》说：脉象虚而身体发热，这是因伤暑所致。脉象浮且自汗，或者浮大而散，或者洪大，或者弦细芤迟且隐伏微弱，或者在虚迟无力的脉象中兼见洪缓之象，都称为暑病。若脉象浮而虚，则是暑风。
症状：戴氏说：暑是夏季的炎热之气。有冒暑、伤暑、中暑三种，三者有轻重之分。如果腹痛泄泻如水，是胃与大肠受邪；作呕者，是因为胃口有痰。这两种情况属于冒暑。适宜用黄连退暑热，香薷消蓄水。如果出现身热头痛、烦躁不安，或者身体感觉如针刺般疼痛，这是伤暑，属于热邪损伤血分。适宜用人参白虎汤，加黄芩、柴胡。如果有咳嗽、发热恶寒、盗汗不止、脉数者，说明热在肺经，这是火克金（火乘金）。这属于中暑。适宜用清肺黄连香薷饮、清暑益气汤等方剂。急治可以痊愈，稍迟缓则难以治疗。暑风，是相火当令之时感受邪气所致。邪气从口鼻而入，侵犯心包络经脉，所以突然昏倒不省人事。其脉象虚浮，外症表现为头疼口干、面部污垢、自汗、倦怠少气，或者背部怕冷但厌恶热气，这叫暑风。
治法：按洁古先生所说，动而得之，是指辛勤劳作之人，活动时火气胜，热邪伤气。脉象洪大，适宜用人参白虎汤主治。静而得之，是指安逸之人，静止时湿气胜，火邪伤肺（金位）。脉象沉实，适宜用大顺散或苍术白虎汤主治。有阴胜阳者，适宜用清暑益气汤。大体上暑症，只适宜用黄连香薷饮、清暑益气汤、五苓散、白虎汤等药物。挟痰者，加半夏；体虚者，加人参之类。暑风，有挟火挟痰者，用二陈汤加黄连主治。实证者，可用吐法。昏迷不省人事者，先用苏合香丸，再用黄连香薷饮加羌活，或者用双解散加香薷，尤其妙效。
方剂：黄连香薷饮治疗暑症，自汗，烦渴而噪扰。
香薷（三钱）、浓朴（姜制）、扁豆（姜炒，各二钱）、黄连（一钱五分）。
以上为一服量，用水二钟，煎至一钟，用井水冷却后服用。
远行受热者，加人参、石膏、滑石（各等分）、甘草（五分），此为动而得之。
噪渴引饮，自汗，脉沉，加人参（一钱五分）、麦门冬（二钱）、五味子（一钱），此为静而得之。
虚烦身热，自汗，用清暑益气汤。
伤暑挟痰，加半夏、南星（各一钱），用姜汁、竹沥送服。
呕吐，加干姜（五分）、藿香、半夏、陈皮（各一钱）。
挟腹泻，加五苓散（五钱）。
暑风，加防风、羌活（各一钱）；有痰壅盛者，再加半夏、陈皮（各八分）。
又一方：清暑益气汤养脾、清肺、补中、行湿，夏秋治疗暑症通用。
人参、白术（各一钱五分）、当归、苍术、陈皮、麦冬（各一钱）、神曲、泽泻、黄柏（各七分）、青皮、甘草、升麻、干葛（各五分）、五味子（十二粒）。
以上用生姜一片、大枣一枚，煎煮，饭后稍热时服用。
暑泻，加浓朴、扁豆（各一钱），去掉当归、麦门冬。
暑痢，加黄芩、黄连、槟榔、枳壳（各八分）、木香（六分）、乌梅（二个）。
暑疟，加柴胡、黄芩（各一钱）、川芎、草果（各八分），加倍使用青皮。
暑渴，加石膏（二钱）、知母、粳米（各一钱五分）。
伏暑之时，头痛，身热，脚软，精神短少，四肢无力，不思饮食，怠惰嗜卧，俗呼为注夏。加白芍药、半夏（各一钱）、川芎（七分），去掉泽泻、青皮。
暑风，加防风、羌活、荆芥穗、香薷（各一钱），去掉泽泻、青皮、黄柏。
中暑，脉微迟，或隐伏，口渴而下利，四肢厥冷，不省人事。
本方加熟附子（一钱），以发挥人参的功效，达于四肢，从而身体自温。不要当作寒证治疗。
(Shangshu [Heatstroke due to Injury], Huoluan [Cholera-like Syndrome], Xiexie [Diarrhea], Liji [Dysentery], Nueji [Malaria])
Pulse: The *Mai Jue* (Classic of Pulses) states: A deficient pulse accompanied by body heat indicates injury from summerheat. A floating pulse with spontaneous sweating, or a large and scattered pulse, or a surging pulse, or a string-taut, fine, hollow, slow, and hidden pulse, or a weak pulse, or a surging and moderate pulse amidst a deficient and slow, forceless pulse, are all termed Summerheat Disease. If the pulse is floating and deficient, it is Shufeng [Summerwind].
Symptoms: Dai Shi stated: Summerheat is the scorching qi of summer. There are three types: Maoshu [Encountering Summerheat], Shangshu [Injury from Summerheat], and Zhongshu [Struck by Summerheat], which differ in severity. If there is abdominal pain and watery diarrhea, the Stomach and Large Intestine are affected; if vomiting occurs, it is due to phlegm in the stomach opening. These two conditions belong to Maoshu. It is appropriate to use Huanglian (Coptidis Rhizoma) to clear summerheat-heat, and Xiangru (Moslae Herba) to resolve accumulated water. If there is body heat, headache, restlessness, or a sensation like needle pricks on the body, this is Shangshu, where heat injures the Blood level. It is appropriate to use Renshen Baihu Tang (Ginseng White Tiger Decoction), adding Huangqin (Scutellariae Radix) and Chaihu (Bupleuri Radix). If there is cough, fever alternating with chills, unremitting night sweats, and a rapid pulse, the heat is in the Lung Meridian, representing Fire overcoming Metal. This is Zhongshu. It is appropriate to use Qingfei Huanglian Xiangru Yin (Lung-Clearing Coptis and Mosla Decoction) or Qingshu Yiqi Tang (Clear Summerheat and Boost Qi Decoction). If treated urgently, recovery is possible; if delayed, it becomes difficult to treat. Shufeng [Summerwind] occurs when the Ministerial Fire is in command, and pathogenic factors enter via the mouth and nose, invading the Pericardium Meridian, causing sudden collapse and loss of consciousness. The pulse is floating and deficient. External symptoms include headache, dry mouth, greasy face, spontaneous sweating, fatigue, shortness of breath, aversion to cold on the back but aversion to heat. This is named Shufeng.
Treatment: According to Jiegu, "obtained through movement" refers to laborers whose activity causes Fire to prevail, injuring Qi with Heat. The pulse is surging and large; Ren Shen Baihu Tang (Ginseng White Tiger Decoction) is indicated. "Obtained through stillness" refers to those living in comfort, where Stillness causes Dampness to prevail, injuring the Metal position (Lungs) with Fire. The pulse is deep and solid; Da Shun San (Great Harmony Powder) or Cangzhu Baihu Tang (Atractylodes White Tiger Decoction) is indicated. In cases of Yin prevailing over Yang, Qingshu Yiqi Tang (Clear Summerheat and Boost Qi Decoction) is indicated. Generally, for Summerheat syndromes, only Huanglian Xiangru Yin (Coptis and Mosla Decoction), Qingshu Yiqi Tang (Clear Summerheat and Boost Qi Decoction), Wuling San (Five-Ingredient Powder with Poria), and Baihu Tang (White Tiger Decoction) are suitable. For cases complicated by Phlegm, add Banxia (Pinelliae Rhizoma); for deficiency, add Renshen (Ginseng Radix et Rhizoma), etc. For Shufeng [Summerwind] complicated by Fire and Phlegm, Erchen Tang (Two-Aged Decoction) with added Huanglian (Coptidis Rhizoma) is used. For excess patterns, emesis may be induced. For coma and loss of consciousness, first administer Suhexiang Wan (Styrax Pill), followed by Huanglian Xiangru Yin (Coptis and Mosla Decoction) with added Qianghuo (Notopterygii Rhizoma et Radix), or Shuangjie San (Double Release Powder) with added Xiangru (Moslae Herba), which is particularly excellent.
Formulas: Huanglian Xiangru Yin (Coptis and Mosla Decoction) treats Summerheat syndromes with spontaneous sweating, vexatious thirst, and restlessness.
Xiangru (Moslae Herba) (3 qian), Nongpu (Magnoliae Officinalis Cortex prepared with ginger), Bian Dou (Vigna Radiata Seed stir-fried with ginger, each 2 qian), Huanglian (Coptidis Rhizoma) (1.5 qian).
Take as one dose. Add 2 zhong of water, decoct to 1 zhong. Serve cold after chilling in well water.
For those overheated during long journeys, add Renshen (Ginseng Radix et Rhizoma), Shigao (Gypsum Fibrosum), Huashi (Talcum) (each equal parts), Gancao (Licorice Radix et Rhizoma) (0.5 qian). This is for "obtained through movement."
For restlessness, thirst with desire to drink, spontaneous sweating, and a deep pulse, add Renshen (Ginseng Radix et Rhizoma) (1.5 qian), Maimen Dong (Ophiopogonis Radix) (2 qian), Wuwei Zi (Schisandrae Fructus) (1 qian). This is for "obtained through stillness."
For deficiency-vexation and body heat with spontaneous sweating, use Qingshu Yiqi Tang (Clear Summerheat and Boost Qi Decoction).
For Shangshu [Injury from Summerheat] complicated by Phlegm, add Banxia (Pinelliae Rhizoma) and Nanxing (Arisaematis Rhizoma) (each 1 qian), administered with Jiangzhi (Zingiberis Recens Juice) and Zhuli (Bambusae Caulis in Taenia).
For vomiting, add Ganjiang (Zingiberis Rhizoma) (0.5 qian), Huoxiang (Agastaches Herba), Banxia (Pinelliae Rhizoma), Chenpi (Citri Reticulatae Pericarpium) (each 1 qian).
For accompanying diarrhea, add Wuling San (Five-Ingredient Powder with Poria) (5 qian).
For Shufeng [Summerwind], add Fangfeng (Saposhnikoviae Radix) and Qianghuo (Notopterygii Rhizoma et Radix) (each 1 qian); if Phlegm is abundant, add Banxia (Pinelliae Rhizoma) and Chenpi (Citri Reticulatae Pericarpium) (each 0.8 fen).
Another Formula: Qingshu Yiqi Tang (Clear Summerheat and Boost Qi Decoction) nourishes the Spleen, clears the Lungs, tonifies the Middle, and moves Dampness. It is commonly used in summer and autumn to treat Summerheat.
Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 1.5 qian), Danggui (Angelicae Sinensis Radix), Cangzhu (Atractylodis Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Maidong (Ophiopogonis Radix) (each 1 qian), Shenqu (Massa Medicata Fermentata), Zexie (Alismatis Rhizoma), Huangbai (Phellodendri Cortex) (each 0.7 fen), Qingpi (Citri Reticulatae Pericarpium Viride), Gancao (Licorice Radix et Rhizoma), Shengma (Cimicifugae Rhizoma), Genge (Puerariae Lobatae Radix) (each 0.5 fen), Wuwei Zi (Schisandrae Fructus) (12 grains).
Decoct with one slice of fresh ginger and one date. Take slightly warm after meals.
For Summerheat Diarrhea, add Nongpu (Magnoliae Officinalis Cortex) and Bian Dou (Vigna Radiata Seed) (each 1 qian), remove Danggui (Angelicae Sinensis Radix) and Maidong (Ophiopogonis Radix).
For Summerheat Dysentery, add Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Binglang (Arecae Semen), Zhike (Aurantii Fructus Immaturus) (each 0.8 fen), Muxiang (Aucklandiae Radix) (0.6 fen), Wumei (Mume Fructus) (2 pieces).
For Summerheat Malaria, add Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix) (each 1 qian), Chuanxiong (Ligustici Chuanxiong Rhizoma), Caoguo (Tsaoko Fructus) (each 0.8 fen), double the dosage of Qingpi (Citri Reticulatae Pericarpium Viride).
For Summerheat Thirst, add Shigao (Gypsum Fibrosum) (2 qian), Zhimu (Anemarrhenae Rhizoma), Jingmi (Oryza Sativa Germen) (each 1.5 qian).
During the period of latent Summerheat, with headache, body heat, weak legs, shortness of spirit, weakness in four limbs, lack of appetite, lethargy, and propensity to lie down (commonly called Zhu Xia [Attaching Summer]), add Baishao Yao (Paeoniae Radix Alba), Banxia (Pinelliae Rhizoma) (each 1 qian), Chuanxiong (Ligustici Chuanxiong Rhizoma) (0.7 fen), remove Zexie (Alismatis Rhizoma) and Qingpi (Citri Reticulatae Pericarpium Viride).
For Shufeng [Summerwind], add Fangfeng (Saposhnikoviae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Jingjiesui (Schizonepetae Spica), Xiangru (Moslae Herba) (each 1 qian), remove Zexie (Alismatis Rhizoma), Qingpi (Citri Reticulatae Pericarpium Viride), and Huangbai (Phellodendri Cortex).
For Zhongshu [Struck by Summerheat], with a faint and slow pulse, or hidden pulse, thirst with diarrhea, cold limbs, and loss of consciousness.
Add Shu Fuzi (Prepared Aconiti Lateralis Radix) (1 qian) to this formula to enhance the action of Renshen (Ginseng Radix et Rhizoma), reaching the four limbs to induce warmth. Do not treat as a Cold pattern.