香薷气香味辛。诸家咸称为治暑要药。但暑有不同。而方法亦随异设。若乘凉饮冷。致
阳气
为阴寒所遏遂病头痛发热恶寒口燥。或霍乱而成吐泻固宜用此以升散风寒消水和脾古方亦有
用大顺散者。盖暑月之用香薷。亦犹三冬之用麻黄。若气虚则不宜轻用也。其有起居失宜。
饮食失节。劳役斫丧之人。中暑大汗。燥渴喘促。脉见芤虚。或迟细。或吐或泻乃劳倦内伤
不足之症。须清暑益气汤。或人参白虎汤。去石膏及苦寒之味。而主以益气清火之品。则善
矣。又有伤暑而兼夹阴尤须舍时从症倘此而概投香薷耗泄真阳。必变而为惕 亡阳之祸。殊犯
虚虚之戒。若形气俱实而伤暑者。投以HT 水之属。无不愈也。今人暑月不拘有无伤暑煎此代
茶。岂知气香主窜。味辛主散。元气虚者反以招暑取中。亦如久饮川芎而得暴亡之害者也
。又
有谓香薷善治诸水。盖水多主藏虚。惟形气未羸。病在经腑者深师薷术丸用之可效。但不得
一例视也唯能明于气化之义者斯可与语治水之方矣试思气化之义云何。
许学士本事方云伤寒病。医者须顾表里。循次第。昔范云为梁武帝属官。得时疫热疾。召
徐
文伯诊之。是时武帝有九锡之命。期在旦夕。云恐不预求速愈。文伯曰此甚易。但恐二年后
不起。云曰朝闻道。夕死可矣。况二年乎。文伯乃以火 地。布桃柏叶于上。令云卧之。
少顷汗出。粉之。翼日遂愈。后二年云果卒。取汗先期。尚能促寿。况罔顾表里时日。便欲
速愈乎。夫桃叶发汗。亦良法也。尚有此戒。可不慎欤。愚按伤寒论汗吐下三法未始不善。
虽曰西北形气病气俱实者用之相宜。但今亦须斟酌耳。设若东南风气巽弱。禀赋不实者。虽
有可汗可吐可下之症。宜从清解。超绳墨规矩之外。而获不汗不吐不下之妙。且以完其氤氲
清纯之元气。不至浪剂潜促天年。保全綦大矣。而人多不知也。经曰邪气盛则实精气夺则虚
大凡病之实者皆气之虚也。知治其实昧救其虚则虚者益。虚致实者益实病。斯殆矣故经曰。
不能治其
虚。安问其余夫汗固以解表邪。而表邪未甚。轻汗之卫气不几亏欤。吐固以宣中积。而中积
未满。轻吐之。胃气不几亏欤。下固以泄里实。而里实未坚。妄下之。营气不几亏欤。亏卫气胃气
营气便亏元气矣元气一伤。老者绝。少者不复矣。然不特此也。每见时师不拘何病。概以麦
芽山楂神曲橘红半夏为健脾之物。以青皮枳壳枳实浓朴槟榔香附为调气之物。乃曰脾得健
则食进。气获调则病瘥。夫此辈之所谓健脾者政败脾也所谓调气者乃损气也粗工既惜费而售贱
药愚人喜便宜而甘隐戮。其失等耳。此人亦多不知也。予因叹范云之殉虚荣而丧实命若过赤松
钓台不识当作何如想乎。
香薷气味芳香，味道辛。各家都称它是治疗暑病的要药。但是暑病有不同的类型，治疗方法也随之不同。如果是乘凉饮冷，导致阳气被阴寒之气遏制而生病，出现头痛、发热、恶寒、口燥等症状，或者霍乱引起呕吐腹泻，固然适宜用香薷来升散风寒、消除水湿、调和脾胃。古方中也有使用大顺散的。大概暑月使用香薷，就像严冬使用麻黄一样。如果气虚则不适宜轻易使用。那些起居失常、饮食无度、劳累过度耗损身体的人，中暑后大汗淋漓、口干渴、气喘急促，脉象呈现芤脉（浮大中空）或虚弱，或迟细，或者呕吐或腹泻，这是劳倦内伤导致的不足之症，必须使用清暑益气汤，或者人参白虎汤，去掉石膏及苦寒的药物，而以益气清火的药物为主，这样就很好了。又有伤暑而兼夹阴证（素体阳虚复感暑邪），尤其需要舍弃时令常规而依据症状治疗。倘若对此一概投以香薷，会耗泄真阳，必然转变为惊恐不安、亡阳的祸患，严重违反了“虚虚”（使虚者更虚）的禁忌。如果形体和正气都充实而伤暑的人，投以香薷水之类的药物，没有不痊愈的。现在的人暑天不管有没有伤暑，煎煮香薷代茶饮用，哪里知道香气主走窜，辛味主发散，元气虚的人反而因此招致暑邪侵袭，也如同长期饮用川芎而导致突然死亡的危害一样。又有人说香薷善于治疗各种水肿。大概水肿多因肾藏功能虚弱所致，只有形体和正气尚未衰弱，病在经络和腑脏的人，深师薷术丸使用它可以见效。但不能一概而论。只有能明白气化道理的人，才可以与他谈论治疗水肿的方法。试思考气化的道理是什么？
许学士在《本事方》中说：治疗伤寒病，医生必须顾护表里关系，遵循治疗次第。从前范云担任梁武帝的属官时，得了时行疫热疾病，召徐文伯诊治。当时武帝有接受九锡（古代帝王对大臣的最高礼遇）的命令，期限就在早晚之间。范云担心不能赶上，寻求快速痊愈。徐文伯说：这很容易，但恐怕两年后无法起身（去世）。范云说：“朝闻道，夕死可矣”，何况是两年呢？徐文伯于是烧红地炭，铺上桃叶和柏叶在上面，让范云躺在上面。一会儿汗出，给他擦粉。第二天就痊愈了。两年后果然去世了。取汗法提前使用，尚且能缩短寿命，何况是不顾表里关系和时间次序，就想快速痊愈呢？桃叶发汗，也是很好的方法，还有这样的戒律，能不谨慎吗？我按语：《伤寒论》中的汗、吐、下三法未尝不好，虽然说是西北地区形气和病气都实证的人使用适宜，但现在也必须斟酌。假设东南风气柔弱，禀赋不实的人，虽然有可汗、可吐、可下的症状，适宜从清热解郁的角度治疗，超越常规的规矩之外，获得不汗、不吐、不下的妙处，并且保全其氤氲清纯的元气，不至于因为滥用药剂暗中缩短寿命，保全性命是非常大的。然而很多人不知道。经典说：邪气盛则实，精气夺则虚。大凡病属于实的，都是气的虚损造成的。只知道治疗其实证，而不知挽救其虚证，那么虚者会更虚，导致实证的原因也会更实，病情就危险了。所以经典说：不能治疗其虚，还问其余做什么？发汗固然可以解除表邪，但如果表邪不重，轻率发汗，卫气岂不是亏损了吗？催吐固然可以宣通中焦积滞，但如果中焦积滞未满，轻率催吐，胃气岂不是亏损了吗？攻下固然可以泄除里实，但如果里实未坚，妄用攻下，营气岂不是亏损了吗？亏损了卫气、胃气、营气，就会亏损元气。元气一旦受损，老年人绝命，年轻人也不能恢复健康了。不仅如此，常见当时的医生不拘泥于什么病，一概用麦芽、山楂、神曲、橘红、半夏作为健脾的药物，用青皮、枳壳、枳实、厚朴、槟榔、香附作为调气的药物，却说脾得到健运则食欲进，气得到调理则病好转。这些人所谓的健脾，实际上是败坏脾；所谓的调气，实际上是损耗气。粗劣的医生既吝惜费用而售卖廉价药，愚蠢的人喜欢便宜而甘愿隐藏杀戮（指伤害身体），他们的过失是一样的。这些人也不知道。我因此感叹范云为了虚荣而丧失生命，如果经过赤松子钓鱼的台址，不知会作何感想呢。
Xiangru (Moslae Herba) has an aromatic odor and a pungent taste. All schools regard it as an essential herb for treating summerheat. However, summerheat presents in different patterns, and treatment methods vary accordingly. If one indulges in cooling off and consuming cold substances, causing yang qi to be suppressed by yin-cold, resulting in illness with symptoms such as headache, fever, aversion to cold, and dry mouth, or if cholera-like vomiting and diarrhea occur, it is indeed appropriate to use Xiangru to ascend and disperse wind-cold, eliminate dampness, harmonize the stomach, and strengthen the spleen. Ancient formulas also include Dashun San (Great Harmony Powder). Generally, the use of Xiangru in summer months is analogous to the use of Mahuang (Ephedrae Herba) in the three winter seasons. However, it should not be used lightly in cases of qi deficiency. For individuals whose daily routine is irregular, diet is unregulated, and who are worn out by labor and overexertion, suffering from summerheat with profuse sweating, dry thirst, panting, and a pulse that is Kou (cork-pulse, floating and empty) or deficient, or slow and fine, or accompanied by vomiting or diarrhea, these are insufficiency syndromes caused by internal injury from fatigue. One must use Qingshu Yiqi Tang (Clear Summerheat and Boost Qi Decoction) or Renshen Baihu Tang (Ginseng White Tiger Decoction), removing Shigao (Gypsum Fibrosum) and other bitter-cold herbs, focusing instead on herbs that boost qi and clear fire; this would be excellent. In cases of summerheat injury complicated by latent yin deficiency (internal cold due to yang deficiency), one must set aside seasonal conventions and treat based on symptoms. If Xiangru is indiscriminately administered in such cases, it will deplete true yang, inevitably leading to the disaster of fright and collapse of yang, severely violating the contraindication of "making the deficient more deficient." For those with both robust constitution and excess pathogenic factors suffering from summerheat, administering Xiangru water will invariably lead to recovery. Nowadays, people brew Xiangru as tea during summer regardless of whether they have summerheat injury. They do not realize that aromatic scents promote dispersion, and pungent flavors promote scattering; for those with deficient yuan qi, this反而会招致暑邪 (attracts summerheat and invites strike). It is similar to the harm of sudden death caused by long-term consumption of Chuanxiong (Ligustici Chuanxiong Rhizoma). Some say Xiangru effectively treats various types of edema. Edema is mostly due to kidney storage deficiency; it is only effective for Shen Shi Rui Zhu Wan (Shen Shi's Rue and Atractylodes Pill) when the physical constitution and qi are not yet emaciated, and the disease is in the meridians and fu organs. However, it cannot be applied uniformly. Only those who understand the principles of qi transformation can discuss formulas for treating edema. Consider what the meaning of qi transformation is.
Xu Xueshi stated in *Ben Shi Fang*: When treating shaoyang disease, physicians must attend to the exterior and interior, following the proper sequence. Once, Fan Yun, an official under Emperor Wu of Liang, contracted an epidemic febrile disease. He summoned Xu Wenbo for diagnosis. At that time, Emperor Wu was about to receive the Nine Bestowals (the highest honor granted to ministers), expected imminently. Fan Yun feared he would not survive to witness it and sought a rapid cure. Xu Wenbo said, "This is easy, but I fear you will not rise again in two years." Fan Yun replied, "If I hear the Dao in the morning, I am content to die in the evening," let alone two years. Xu Wenbo then heated charcoal bricks, spread Tao Ye (Peach Leaf) and Bo Ye (Cupressus Leaf) upon them, and instructed Fan Yun to lie on them. After a short while, sweat appeared, and powder was applied. By the next day, he had recovered. Two years later, Fan Yun indeed passed away. Using diaphoresis prematurely still shortened his lifespan; how much more so would ignoring the exterior-interior relationship and timing in pursuit of a quick cure? Tao Ye-induced diaphoresis is also a good method, yet even this carries warnings; how can one not be cautious? My commentary: The sweating, vomiting, and purging methods in *Shanghan Lun* are not inherently bad. Although suitable for people in the northwest with robust constitutions and excess pathogenic conditions, they must now be carefully considered. Assuming the climate in the southeast is gentle and weak, and constitutions are not solid, even if symptoms indicate the need for sweating, vomiting, or purging, it is appropriate to adopt clearing and resolving methods, transcending rigid rules to achieve the subtlety of curing without sweating, vomiting, or purging, thereby preserving the ethereal and pure yuan qi, avoiding the secret shortening of life through reckless medication. This preservation is of great importance, yet many do not understand. The Classics state: "When pathogenic qi is excessive, it is excess; when essence and qi are depleted, it is deficiency." Generally, diseases manifesting as excess are rooted in qi deficiency. Knowing how to treat the excess but failing to rescue the deficiency will make the deficiency worse and the excess more entrenched, leading to peril. Thus, the Classics say: "If one cannot treat the deficiency, what is there to ask about the rest?" Sweating certainly resolves exterior pathogens, but if the exterior pathogen is mild, light sweating might impair wei qi. Vomiting certainly clears middle jiao accumulation, but if the accumulation is not full, light vomiting might impair stomach qi. Purging certainly drains interior excess, but if the interior excess is not firm, rash purging might impair ying qi. Impairment of wei qi, stomach qi, and ying qi leads to the impairment of yuan qi. Once yuan qi is damaged, the elderly perish, and the young fail to recover. Moreover, it is not just this. I often see contemporary physicians, regardless of the disease, indiscriminately using Maiya (Hordei Fructus Germinatus), Shanzha (Crataegi Fructus), Shenqu (Massa Medicata Fermentata), Juhong (Exocarpium Citri Reticulatae Rubrum), and Banxia (Pinelliae Rhizoma) as spleen-strengthening agents, and Qingpi (Aurantii Fructus Pericarpium), Zhike (Aurantii Fructus), Zhishi (Aurantii Fructus Immaturus), Houpo (Magnoliae Officinalis Cortex), Binglang (Arecae Semen), and Xiangfu (Cyperi Rhizoma) as qi-regulating agents, claiming that a strengthened spleen improves appetite and regulated qi alleviates disease. What these practitioners call "strengthening the spleen" actually damages it; what they call "regulating qi" actually depletes it. Incompetent doctors save costs by selling cheap herbs, and foolish people prefer cheapness while ignorantly accepting self-harm; their errors are equivalent. These people also do not understand. I sigh that Fan Yun sacrificed his real life for vanity. If he had visited the fishing terrace of Chisongzi, what would he have thought?