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邵兰荪医案 · 暑(1/2) · 清

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遗风王暑风湿热，寒热交作，脉濡，舌滑微黄，脘闷欲呕。宜和中祛邪。
青皮（八分）桂枝（五分）仙半夏（钱半）广藿香（二钱）浓朴（一钱）炒知母（钱半）
酒炒条芩（二钱）防己（钱半）大腹皮（三钱）原滑石（四钱）焦六曲（四钱）
清煎二帖∶
介按∶暑挟湿邪，入于膜原，故寒热脘闷呕恶。治以辛香温化之品，开达膜原之邪，确
是对症疗法。
里汪暑邪寒热，脉弦数，头疼脘闷，溲数。宜和中清邪。（七月三号丙午二十九日）
青蒿子（钱半）藿香（三钱）佩兰（钱半）青皮（八分）炒知母（钱半）白芷（八分）
滑
石（四钱）威灵仙（钱半）仙半夏（钱半）大豆卷（三钱）蔻壳（钱半）（引）荷叶（一角）
二帖。
又清解已效，脉虚细，寒热交作，午后稍瘥，舌滑白根微黄，便利。宜清暑和中。（七
月六号丙午初二日）
藿香梗（二钱）仙半夏（钱半）银花（钱半）连翘（三钱）滑石（四钱）黄芩（钱半）
赤苓（四钱）大豆卷（三钱）蔻仁（八分）扁豆衣（三钱）通草（钱半）（引）荷叶（一角）
二帖。
介按∶此与前案大同小异，而处方亦是开达膜原，但湿热较轻，故初则头痛而用祛风之
品，继则寒热，至午后少瘥，而仍以清暑为主。
遗风庞暑风夹湿，寒热如疟，渴饮，溲数，脉濡右大，舌白，中心嫩黄。宜清解，防
重。（八月十一号丁未二十九日）
淡竹叶（钱半）香薷（七分）蝉衣（钱半）牛蒡子（三钱）连翘（三钱）光杏仁（三钱）
六
一散（四钱，包煎）通草（钱半）薄荷（五分）天花粉（三钱）银花（二钱）（引）鲜荷叶（
一角）
二帖。
又寒热未除，脉弦濡，舌黄滑，腹中濯濯。姑宜清暑和中。（八月十五号戊申初三日）
广藿香（二钱）青蒿子（钱半）炒青皮（八分）炒枳壳（钱半）焦山栀（三钱）连翘（
三钱）山楂（三钱）原滑石（四钱）省头草（三钱）条芩（钱半）通草（钱半）（引）鲜荷
叶（一角）
介按∶叶香岩曰。暑邪必挟湿，状如外感风寒，忌用柴、葛、羌、防。如肌表热无汗，
辛凉轻剂无误。香薷辛温气升，热伏易吐。佐苦降如杏仁、黄连、黄芩，则不吐。宣通上焦
，如杏仁、连翘、薄荷、竹叶，暑热深入，伏热烦渴，白虎汤、六一散。今此人寒热如疟，
是属暑而挟湿之候。初方悉宗叶氏之意，次因寒热未除，故于清暑之中，又佐清少阳余热之
味。
里汪暑风伤肺，头疼发热，汗微不出，脉右浮濡，身痛，溲数，舌微黄。宜清解，
防变重。（五月十九日）
香薷（八分）桔梗（钱半）薄荷（钱半）天花粉（三钱）连翘（三钱）象贝（钱半）
六一散（四钱）蔻仁（八分冲）白芷（八分）炒知母（钱半）光杏仁（三钱）
清煎二帖。
介按∶暑风先伤气分，是属上焦之病。治以辛凉微苦，廓清肺气为主。
蜀阜马，暑湿伤气，脘闷发热，脉濡，右弦细，舌滑白，溺数，恶心。宜开气分为治。
（八月初四日）
栝蒌皮（三钱）藿香梗（二钱）仙半夏（钱半）炒枳壳（钱半）川朴（一钱）省头草（
三钱）条芩（钱半）苦丁茶（钱半）通草（钱半）蔻壳（钱半）滑石（四钱）
介按∶暑为熏蒸之气，湿为腻浊之邪，热处湿中，阻于气分，日久不解，蔓延中焦。故
脘闷呕恶，发热溺数。治以芳香止呕，苦辛开肺。
马安赵暑湿伤气，舌灰黄，汗出发热，脉虚，右濡，头目不爽，溲数。宜清热利湿为
治，防重。（七月二十五号丁未十二日）
淡竹叶（钱半）焦六曲（四钱）焦栀子（三钱）藿香（三钱）连翘（三钱）赤苓（四钱）
条芩（二钱）光杏仁（三钱）苦丁茶（钱半）大豆卷（三钱）滑石（四钱）（引）鲜荷叶（
一角）
二帖。
介按∶肺主皮毛，今以肺气被郁，则自汗发热而头目不爽，脉虚右濡，尤为伤暑挟湿之
征。治以辛凉轻剂清解上焦，兼以渗湿，方法极是
安昌姚暑湿伤气，呕渴身热，大便自利，脉弦濡数，舌黄滑，腹痛，症非轻藐。宜清
热和中。候正。（七月十八号丁未初五日）
藿梗（二钱）焦六曲（四钱）炒黄芩（钱半）天花粉（三钱）六一散（四钱，包）连翘
（三钱）枳壳（钱半）佩兰（三钱）银花（三钱）石菖蒲（八分）大豆卷（三钱）
清煎一帖。
又清热和中，自利呕渴悉瘥，脉濡，右弦数，舌黄滑。身热已缓，头晕耳鸣，仍遵前
法加减为稳。（七月二十二号丁未初九日）
广藿香（钱半）苦丁茶（钱半）条芩（钱半）省头草（三钱）六一散（四钱）扁豆衣（
二钱）赤苓（四钱）通草（钱半）银花（三钱）连翘（三钱）焦山栀（三钱）
清煎三帖。
介按∶暑湿兼秽，由口鼻吸受而伤气分，渐入膈膜，下渗大肠，以致呕渴身热，腹痛自
利。
故以清热和中之剂，诸恙悉瘥。次诊头晕耳鸣，是属肝胆余热，上犯清窍，而治法注重上焦
湿热。亦是良方。
西池余暑湿伤气，潮热，溺赤，大便如酱，脉濡细数，舌心焦黄，口甜。宜清利，防
变。
晚蚕砂（三钱）仙半夏（钱半）光杏仁（三钱）苦丁茶（钱半）连翘（二钱）赤苓（钱
半）
大腹皮（三钱）淡竹叶（钱半）大豆卷（三钱）炒黄芩（钱半）原滑石（四钱）荷叶（一圈）
二帖。
次诊潮热已退，脉左濡，右细，舌黄燥，口甜，溲溺赤，大便闭。宜泻心汤加减，
防变。
仙半夏（钱半）炒黄芩（钱半）广郁金（三钱）省头草（三钱）炒川连（六分）炒枳实
（二钱）浓朴（一钱）通草（钱半）生白芍（钱半）光杏仁（三钱）赤苓（三钱）
二帖。
三诊舌转嫩黄尚腻，脉两手弦细，口尚甜。系脾瘅，胃钝。宜泻心汤加减。
仙半夏（钱半）焦神曲（三钱）炒谷芽（三钱）新会皮（钱半）炒川连（六分）杏仁（
三钱）赤苓（三钱）滑石（四钱）炒枳实（钱半）蔻壳（钱半）省头草（三钱）
清煎三帖。
四诊舌色犹黄，胃气不振，脉濡，左弦细，便结，心泛。宜养胃清利，最怕变端。
遍金钗（三钱）栝蒌皮（三钱）藿梗（二钱）鸡内金（三钱）省头草（三钱）光杏仁（
三钱）谷芽（四钱）淡竹叶（一钱）原滑石（四钱）陈皮（钱半）晚蚕砂（三钱）
五诊舌色未清，大便稍下，饥不欲食，顷六脉虚细，胃逆恶心。湿热犹存，仍遵前法
加减，不致变端无虑。
遍金钗（三钱）柏子仁（三钱）栝蒌皮（三钱）通草（钱半）省头草（三钱）合欢皮（
三钱）藿梗（二钱）蕤仁（钱半）鸡内金（三钱）白茯神（四钱）炒谷芽（四钱）
介按∶暑而兼湿，锢结不解，最为淹缠难愈之症。治疗之际，务须辨明暑多与湿多之异
，盖
因过用清凉以治暑，则湿愈留恋，过用温燥以利湿，则化热劫津。故此案历经四诊，而尚虑
变端，实因湿热胶结，一时难以分化。至于方法，尚属步骤井然。惟钗斛一味，虽是滋养胃
液之妙品，但湿热尚存，用得太早，须防有恋邪之患。口甘一证，古人名曰脾瘅，因五味入
口，必藏于胃，赖脾脏为之行其精气，津液在脾，故令口甘。其人必素食甘美多肥之品，肥
则令人内热，甘则令人中满，其气上溢，转为消渴。内经谓治之以兰，除陈气也，后人均以
佩兰治之，但佩兰之功效，不如建兰叶之生津止渴，以除胃中陈积蓄热之气为愈也。
蜀阜马冒暑受风，头疼发热，肢战，脉浮数，右关劲，脘闷气冲，咽喉如有物阻，舌
微黄，根浓，症属棘手。宜防痉厥，候正。（六月初二日）
银花（三钱）连翘（三钱）橘核（钱半）射干（钱半）广橘红（一钱）焦山栀（二钱）
甘菊（二钱）薄荷（一钱）炒僵蚕（二钱）光杏仁（三钱）竹叶（钱半）（引）荷叶（一角）
一帖。
介按∶暑月受风，先伤气分，是以头疼发热，日久不解，化热而引动肝风，以致
肢战气冲。治以清气分之热，迨气分之热整肃，则肝风自平。
大义汪稚孩暑风夹湿，脉浮大，舌滑白，汗多发热，渴饮。恐变惊风，姑宜清热祛邪
。（又月二十四日）
栝蒌根（三钱）密银花（二钱）大豆卷（三钱）淡竹叶（钱半）连翘（三钱）扁豆衣（
三钱）赤苓（四钱）白蔻仁（八分，冲）六一散（三钱）光杏仁（三钱）枳壳（钱半）
清煎二帖。
介按∶稚年纯阳之体，感受夏月之风热与湿，最防化热劫液，引动肝风而为痉厥，况其
汗多发热渴饮诸端。是属热炽显然。故治法宜清热达邪。
遗风庞右耳下肿，夹杂暑湿，便泻，腹痛，脉弦濡，舌根微黄。姑宜清暑和中。（六
月二十四日）
藿香梗（三钱）大腹皮（三钱）通草（钱半）左金丸（八分）益元散（三钱）赤苓（三
钱）扁豆衣（三钱）南木香（六分）苦丁茶（钱半）焦山栀（三钱）新会皮（钱半）
清煎三帖。
介按∶暑气下降，湿浊上腾，人在湿热蒸腾之中，感受其气，兼以秽浊夹杂，归于脾胃
而
为泄泻，走于中道则腹痛。治宜清热开郁，佐以芳香淡渗。俾秽浊湿邪，由此可以分消。
杭垣施素患痰饮，新受暑气夹湿，潮热，咳嗽气急，脉濡滑数，舌白，根微黄。姑宜
清气消痰。
栝蒌皮（三钱）光杏仁（三钱）广橘红（一钱）赤茯苓（四钱）川贝（二钱）连翘（三
钱）扁豆衣（三钱）白蔻仁（八分）六一散（三钱，荷包）淡芩（钱半）白前（钱半）
清煎三帖。
介按∶治痰饮当以温药和之，但新受暑邪，先犯气分。故其治法，先清其暑，兼消痰湿
。
遗风徐暑风热湿，呛咳，耳木，脉濡数，舌白，根微黄。神识乍愦，症势重险。宜防
厥闭，候正。（七月二十四日）
石菖蒲（八分）焦山栀（三钱）橘红（一钱）老式天竺黄（钱半）远志（八分）滑石（
四钱
）光杏仁（三钱）炒黄芩（钱半）苦丁茶（钱半）象贝（三钱）淡竹叶（三钱引）荷叶（
一角）
三帖。
介按∶暑热下逼，湿浊上腾，其邪从口鼻吸受，气分先阻，而上焦清肃不行，以致呛咳
。但
暑而挟湿，系是熏蒸粘腻之邪，最难分解。郁久化热烁津，遂变神昏耳聋，险象毕露。此种
症候，先须认明暑风湿热，何者为重，分别施治，庶几奏效。今以暑热挟痰湿，由肺而渐逼
心胞，最防厥闭之候。治以肃肺化痰，涤暑开窍，以解胞络之危，洵是佳计。
西柱沈暑风夹湿，呛咳，面浮，舌红，根黄，口渴，溺多，素患脾泄。宜清暑消痰为
法，防重。（七月二十二日）
乌元参（三钱）橘红（一钱）天花粉（三钱）石莲子（三钱）益元散（四钱）扁豆衣（
三钱）茯苓（四钱）省头草（三钱）银花（二钱）川贝（钱半）淡竹叶（三钱）
清煎三帖。
介按∶暑湿挟痰，留恋上焦，湿痰阻气，气不化津，则口渴而舌红根黄。但素患脾泄
之人
，尤防湿热横渗而化浮肿，治以清热消痰，兼用扁豆衣、石莲子、茯苓等之扶脾渗湿，是标
本兼顾之方。
安昌李暑风夹湿，咳嗽吐血，脉寸大，舌白，根微黄，潮热。宜防瘵。（六月十二日）
栝蒌皮（钱半）淡竹叶（钱半）茜根（二钱）小蓟草（三钱）川贝（三钱）扁豆衣（三
钱）
焦山栀（三钱）银花（三钱）六一散（四钱）光杏仁（三钱）白前（钱半）荷花露（二两冲
引）茅草根（一两）三贴。
介按∶此是暑热烁肺，复燃阳络，以致络血上溢。治以涤暑保肺，清络止血。较诸叶香
岩治五姓一方，尤为敏捷。
某妇伏暑呕渴发热，脉寸滑数，冲气撞脘，溲数。癸水趱迟，慎恐变端。宜泻心汤加
减，候正。（十月十一号九月初二日）
炒川连（八分）枳实（钱半）省头草（三钱）原滑石（四钱）仙半夏（钱半）生白芍（
三钱）广郁金（三钱）蔻壳（钱半）酒炒黄芩（钱半）光杏仁（三钱）橘白（一钱）
清煎二帖。
介按∶暑热伏于心膈之间，治以芩、连、半夏，仿泻心汤之意而泄其热，又佐杏仁、蔻
壳以
止其呕。惟冲气撞脘，尚少镇冲之品，而癸水趱迟，系是血虚之候。此方先清其暑，治法最
佳。待暑解之后，再行调经补血，自无内外夹杂之虞。
安昌余伏暑秋发，始起寒热，脉濡细，舌微白，底红，潮热，头胀，肢楚，大便不爽
。姑宜清利。
晚蚕砂（四钱包）青皮（八分）苦丁茶（三钱）川石斛（三钱）光杏仁（三钱）焦山栀
（三

白话

【背景信息】
书名：邵兰荪医案作者：邵兰荪朝代：清章节：暑(1/2) 类别：医论

遗风王患者感受暑、风、湿、热邪气，寒热交替发作，脉象濡软，舌苔滑腻微黄，胃脘部闷胀欲呕吐。适宜采用调和脾胃、祛除病邪的方法。
处方：青皮（八分）桂枝（五分）仙半夏（钱半）广藿香（二钱）浓朴（一钱）炒知母（钱半）
酒炒条芩（二钱）防己（钱半）大腹皮（三钱）原滑石（四钱）焦六曲（四钱）
清水煎煮，服用两帖。
按语：暑邪挟带湿邪，侵入膜原（半表半里之隙），所以出现寒热往来、胃脘闷胀、恶心呕吐的症状。治疗使用辛香温化的药物，以开达膜原之邪，确实是正确的对症疗法。

里汪患者感受暑邪，出现寒热症状，脉象弦而数，头痛，胃脘闷胀，小便频数。适宜调和脾胃，清解邪气。（七月三号丙午二十九日）
处方：青蒿子（钱半）藿香（三钱）佩兰（钱半）青皮（八分）炒知母（钱半）白芷（八分）
滑石（四钱）威灵仙（钱半）仙半夏（钱半）大豆卷（三钱）蔻壳（钱半）（药引）荷叶（一角）
服用两帖。
复诊：清解法已见效，脉象虚细，寒热交替发作，午后稍有好转，舌苔滑白，根部微黄，大小便正常。适宜清解暑邪，调和脾胃。（七月六号丙午初二日）
处方：藿香梗（二钱）仙半夏（钱半）银花（钱半）连翘（三钱）滑石（四钱）黄芩（钱半）
赤苓（四钱）大豆卷（三钱）蔻仁（八分）扁豆衣（三钱）通草（钱半）（药引）荷叶（一角）
服用两帖。
按语：此案与前案大同小异，但处方同样是开达膜原。只是湿热较轻，所以初诊时头痛使用了祛风药物，继诊时寒热在午后稍减，但仍以清解暑邪为主。

遗风庞患者感受暑风夹湿，寒热如疟疾状，口渴饮水，小便频数，脉象濡软且右侧较大，舌苔白，中心嫩黄。适宜清解，防止病情加重。（八月十一号丁未二十九日）
处方：淡竹叶（钱半）香薷（七分）蝉衣（钱半）牛蒡子（三钱）连翘（三钱）光杏仁（三钱）
六一散（四钱，包煎）通草（钱半）薄荷（五分）天花粉（三钱）银花（二钱）（药引）鲜荷叶（一角）
服用两帖。
复诊：寒热未除，脉象弦濡，舌苔黄滑，腹部有水声漉漉。暂宜清解暑邪，调和脾胃。（八月十五号戊申初三日）
处方：广藿香（二钱）青蒿子（钱半）炒青皮（八分）炒枳壳（钱半）焦山栀（三钱）连翘（三钱）山楂（三钱）原滑石（四钱）省头草（三钱）条芩（钱半）通草（钱半）（药引）鲜荷叶（一角）
按语：叶天士说：暑邪必定挟带湿气，症状像外感风寒，忌用柴胡、葛根、羌活、防风等药。如果肌表发热无汗，使用辛凉轻剂无误。香薷性辛温且气升，若热伏于内容易引发呕吐。配合苦降的药物如杏仁、黄连、黄芩，则不会呕吐。宣通上焦，可用杏仁、连翘、薄荷、竹叶。若暑热深入，伏热烦渴，可用白虎汤、六一散。现在此人寒热如疟，属于暑邪挟湿的证候。初方完全遵循叶氏之意，次诊因寒热未除，所以在清解暑邪之中，又佐以清泄少阳余热的药物。

里汪暑风伤肺，头痛发热，汗微出不出，脉象右浮濡，身体疼痛，小便频数，舌苔微黄。适宜清解，防止变重。（五月十九日）
处方：香薷（八分）桔梗（钱半）薄荷（钱半）天花粉（三钱）连翘（三钱）象贝（钱半）
六一散（四钱）蔻仁（八分冲服）白芷（八分）炒知母（钱半）光杏仁（三钱）
清水煎煮，服用两帖。
按语：暑风先伤气分，属于上焦的病。治疗以辛凉微苦，廓清肺气为主。

蜀阜马，暑湿伤气，胃脘闷胀发热，脉象濡，右侧弦细，舌苔滑白，尿多，恶心。适宜开通气分为治。（八月初四日）
处方：栝蒌皮（三钱）藿香梗（二钱）仙半夏（钱半）炒枳壳（钱半）川朴（一钱）省头草（三钱）条芩（钱半）苦丁茶（钱半）通草（钱半）蔻壳（钱半）滑石（四钱）
按语：暑是熏蒸之气，湿是腻浊之邪，热处湿中，阻于气分，日久不解，蔓延至中焦。所以出现胃脘闷胀、恶心呕吐、发热、尿多。治疗以芳香止呕，苦辛开肺。

马安赵暑湿伤气，舌苔灰黄，出汗后发热，脉象虚，右侧濡，头目不清爽，小便频数。适宜清热利湿为治，防止病情加重。（七月二十五号丁未十二日）
处方：淡竹叶（钱半）焦六曲（四钱）焦栀子（三钱）藿香（三钱）连翘（三钱）赤苓（四钱）条芩（二钱）光杏仁（三钱）苦丁茶（钱半）大豆卷（三钱）滑石（四钱）（药引）鲜荷叶（一角）
服用两帖。
按语：肺主皮毛，现在肺气被郁遏，所以自汗发热且头目不爽，脉象虚右濡，更是伤暑挟湿的征象。治疗以辛凉轻剂清解上焦，兼以渗湿，方法非常正确。

安昌姚暑湿伤气，呕吐口渴身热，大便自利，脉象弦濡数，舌苔黄滑，腹痛，病症非轻。适宜清热和中。候正。（七月十八号丁未初五日）
处方：藿梗（二钱）焦六曲（四钱）炒黄芩（钱半）天花粉（三钱）六一散（四钱，包煎）连翘（三钱）枳壳（钱半）佩兰（三钱）银花（三钱）石菖蒲（八分）大豆卷（三钱）
清水煎煮，服用一帖。
复诊：清热和中，自利、呕吐、口渴全部痊愈，脉象濡，右侧弦数，舌苔黄滑。身热已缓，头晕耳鸣，仍遵照前法加减为稳。（七月二十二号丁未初九日）
处方：广藿香（钱半）苦丁茶（钱半）条芩（钱半）省头草（三钱）六一散（四钱）扁豆衣（二钱）赤苓（四钱）通草（钱半）银花（三钱）连翘（三钱）焦山栀（三钱）
清水煎煮，服用三帖。
按语：暑湿兼秽浊之气，由口鼻吸入而伤气分，渐入膈膜，下渗大肠，以致呕吐、口渴、身热、腹痛、自利。所以用清热和中的药剂，诸症悉愈。次诊头晕耳鸣，属于肝胆余热，上犯清窍，而治法注重上焦湿热。也是良方。

西池余暑湿伤气，潮热，尿赤，大便如酱，脉象濡细数，舌心焦黄，口甜。适宜清利，防止变化。
初诊处方：晚蚕砂（三钱）仙半夏（钱半）光杏仁（三钱）苦丁茶（钱半）连翘（二钱）赤苓（钱半）大腹皮（三钱）淡竹叶（钱半）大豆卷（三钱）炒黄芩（钱半）原滑石（四钱）荷叶（一圈）
服用两帖。
次诊：潮热已退，脉象左濡，右细，舌苔黄燥，口甜，小便赤，大便闭结。适宜泻心汤加减，防止变化。
处方：仙半夏（钱半）炒黄芩（钱半）广郁金（三钱）省头草（三钱）炒川连（六分）炒枳实（二钱）浓朴（一钱）通草（钱半）生白芍（钱半）光杏仁（三钱）赤苓（三钱）
服用两帖。
三诊：舌苔转为嫩黄尚腻，两手脉象弦细，口尚甜。系脾瘅（脾热口臭），胃气迟钝。适宜泻心汤加减。
处方：仙半夏（钱半）焦神曲（三钱）炒谷芽（三钱）新会皮（钱半）炒川连（六分）杏仁（三钱）赤苓（三钱）滑石（四钱）炒枳实（钱半）蔻壳（钱半）省头草（三钱）
清水煎煮，服用三帖。
四诊：舌色犹黄，胃气不振，脉象濡，左侧弦细，大便干结，心中泛恶。适宜养胃清利，最怕发生变故。
处方：遍金钗（三钱）栝蒌皮（三钱）藿梗（二钱）鸡内金（三钱）省头草（三钱）光杏仁（三钱）谷芽（四钱）淡竹叶（一钱）原滑石（四钱）陈皮（钱半）晚蚕砂（三钱）
五诊：舌色未清，大便稍通，饥饿但不欲食，顷间六脉虚细，胃气上逆恶心。湿热犹存，仍遵前法加减，不致有变故忧虑。
处方：遍金钗（三钱）柏子仁（三钱）栝蒌皮（三钱）通草（钱半）省头草（三钱）合欢皮（三钱）藿梗（二钱）蕤仁（钱半）鸡内金（三钱）白茯神（四钱）炒谷芽（四钱）
按语：暑邪兼湿，锢结不解，是最为缠绵难愈的病症。治疗之际，务必辨明暑多还是湿多。因为过用清凉药治暑，则湿邪更留恋；过用温燥药利湿，则化热劫伤津液。所以此案历经四诊，还担心变故，实因湿热胶结，一时难以分化。至于治疗方法，步骤井然。唯独钗斛一味，虽是滋养胃液的妙品，但湿热尚存，用得过早，须防备有恋邪之患。口甘一证，古人名为脾瘅，因为五味入口，必藏于胃，赖脾脏为之行其精气，津液在脾，所以令口甘。其人必素食甘美多肥之品，肥则令人内热，甘则令人中满，其气上溢，转为消渴。内经谓治之以兰，除陈气也，后人多以佩兰治之，但佩兰的功效，不如建兰叶生津止渴，以除胃中陈积蓄热之气为愈也。

蜀阜马冒暑受风，头痛发热，肢体颤抖，脉象浮数，右关脉劲，胃脘闷胀气冲，咽喉如有物阻，舌苔微黄，根部浓，病症属棘手。适宜防止痉厥，候正。（六月初二日）
处方：银花（三钱）连翘（三钱）橘核（钱半）射干（钱半）广橘红（一钱）焦山栀（二钱）甘菊（二钱）薄荷（一钱）炒僵蚕（二钱）光杏仁（三钱）竹叶（钱半）（药引）荷叶（一角）
服用一帖。
按语：暑月受风，先伤气分，所以头痛发热，日久不解，化热而引动肝风，以致肢体颤抖、气冲。治疗以清气分之热，待气分之热整肃，则肝风自平。

大义汪稚童暑风夹湿，脉象浮大，舌苔滑白，汗多发热，口渴饮水。恐变为惊风，暂宜清热祛邪。（又月二十四日）
处方：栝蒌根（三钱）密银花（二钱）大豆卷（三钱）淡竹叶（钱半）连翘（三钱）扁豆衣（三钱）赤苓（四钱）白蔻仁（八分，冲服）六一散（三钱）光杏仁（三钱）枳壳（钱半）
清水煎煮，服用两帖。
按语：稚年纯阳之体，感受夏月之风热与湿，最防化热劫液，引动肝风而为痉厥，何况其汗多、发热、渴饮诸端。这是热炽盛的明显表现。所以治法宜清热达邪。

遗风庞右耳下肿，夹杂暑湿，便泻，腹痛，脉象弦濡，舌根微黄。暂宜清暑和中。（六月二十四日）
处方：藿香梗（三钱）大腹皮（三钱）通草（钱半）左金丸（八分）益元散（三钱）赤苓（三钱）扁豆衣（三钱）南木香（六分）苦丁茶（钱半）焦山栀（三钱）新会皮（钱半）
清水煎煮，服用三帖。
按语：暑气下降，湿浊上腾，人在湿热蒸腾之中，感受其气，兼以秽浊夹杂，归于脾胃而为泄泻，走于中道则腹痛。治疗宜清热开郁，佐以芳香淡渗。使秽浊湿邪，由此可以分消。

杭垣施素患痰饮，新受暑气夹湿，潮热，咳嗽气急，脉象濡滑数，舌苔白，根部微黄。暂宜清气消痰。
处方：栝蒌皮（三钱）光杏仁（三钱）广橘红（一钱）赤茯苓（四钱）川贝（二钱）连翘（三钱）扁豆衣（三钱）白蔻仁（八分）六一散（三钱，荷包）淡芩（钱半）白前（钱半）
清水煎煮，服用三帖。
按语：治痰饮当以温药和之，但新受暑邪，先犯气分。所以其治法，先清其暑，兼消痰湿。

遗风徐暑风热湿，呛咳，耳木（耳聋），脉象濡数，舌苔白，根部微黄。神识乍愦（昏乱），症势重险。适宜防止厥闭，候正。（七月二十四日）
处方：石菖蒲（八分）焦山栀（三钱）橘红（一钱）老式天竺黄（钱半）远志（八分）滑石（四钱）光杏仁（三钱）炒黄芩（钱半）苦丁茶（钱半）象贝（三钱）淡竹叶（三钱引）荷叶（一角）
服用三帖。
按语：暑热下逼，湿浊上腾，其邪从口鼻吸入，气分先阻，而上焦清肃不行，以致呛咳。但暑而挟湿，是熏蒸粘腻之邪，最难分解。郁久化热烁津，遂变神昏耳聋，险象毕露。此种症候，先须认明暑风湿热，何者为重，分别施治，庶几奏效。今以暑热挟痰湿，由肺而渐逼心胞，最防厥闭之候。治以肃肺化痰，涤暑开窍，以解胞络之危，确是佳计。

西柱沈暑风夹湿，呛咳，面浮，舌红，根部黄，口渴，溺多，素患脾泄。适宜清暑消痰为法，防止加重。（七月二十二日）
处方：乌元参（三钱）橘红（一钱）天花粉（三钱）石莲子（三钱）益元散（四钱）扁豆衣（三钱）茯苓（四钱）省头草（三钱）银花（二钱）川贝（钱半）淡竹叶（三钱）
清水煎煮，服用三帖。
按语：暑湿挟痰，留恋上焦，湿痰阻气，气不化津，则口渴而舌红根黄。但素患脾泄之人，尤防湿热横渗而化浮肿，治以清热消痰，兼用扁豆衣、石莲子、茯苓等之扶脾渗湿，是标本兼顾之方。

安昌李暑风夹湿，咳嗽吐血，脉象寸大，舌苔白，根部微黄，潮热。适宜防止痨病。（六月十二日）
处方：栝蒌皮（钱半）淡竹叶（钱半）茜根（二钱）小蓟草（三钱）川贝（三钱）扁豆衣（三钱）焦山栀（三钱）银花（三钱）六一散（四钱）光杏仁（三钱）白前（钱半）荷花露（二两冲引）茅草根（一两）三贴。
按语：此是暑热烁肺，复燃阳络，以致络血上溢。治疗以涤暑保肺，清络止血。较诸叶天士治五姓一方，尤为敏捷。

某妇伏暑呕渴发热，脉象寸滑数，冲气撞脘，小便频数。月经推迟，慎恐变故。适宜泻心汤加减，候正。（十月十一号九月初二日）
处方：炒川连（八分）枳实（钱半）省头草（三钱）原滑石（四钱）仙半夏（钱半）生白芍（三钱）广郁金（三钱）蔻壳（钱半）酒炒黄芩（钱半）光杏仁（三钱）橘白（一钱）
清水煎煮，服用两帖。
按语：暑热伏于心膈之间，治疗以芩、连、半夏，仿泻心汤之意而泄其热，又佐杏仁、蔻壳以止其呕。惟冲气撞脘，尚少镇冲之品，而癸水趱迟，系是血虚之候。此方先清其暑，治法最佳。待暑解之后，再行调经补血，自无内外夹杂之虞。

安昌余伏暑秋发，始起寒热，脉象濡细，舌苔微白，底红，潮热，头胀，肢楚，大便不爽。暂宜清利。
处方：晚蚕砂（四钱包煎）青皮（八分）苦丁茶（三钱）川石斛（三钱）光杏仁（三钱）焦山栀（三

英文

[Background Information]
Book: Shao Lansun's Medical Cases; Author: Shao Lansun; Dynasty: Qing; Chapter: Summerheat (1/2); Category: Medical Discussion

Patient Wang from Yifeng: Contracted summerheat, wind, dampness, and heat pathogens. Chills and fever alternate. Pulse is soft (Ru). Tongue coating is slippery with slight yellow. Epigastric fullness with nausea. Treatment should harmonize the middle jiao and dispel pathogens.
Prescription: Qingpi (Green Tangerine Peel, 8 fen), Guizhi (Cinnamon Twig, 5 fen), Xian Banxia (Pinellia Tuber, 1.5 qian), Guang Huoxiang (Patchouli Herb, 2 qian), Nongpo (Magnolia Bark, 1 qian), Chao Zhimu (Anemarrhena Rhizome, fried, 1.5 qian), Jiu Chao Tiao Qin (Scutellaria Root, wine-fried, 2 qian), Fangji (Stephania Root, 1.5 qian), Dafupi (Areca Peel, 3 qian), Yuan Huashi (Talcum, 4 qian), Jiao Liuqu (Medicated Leaven, charred, 4 qian).
Decoct in clear water, take two doses.
Commentary: Summerheat combined with dampness enters the Membrane Source (Moyuan, a space between the exterior and interior). Hence chills and fever, epigastric fullness, and vomiting occur. Treating with acrid-aromatic warming agents to open and reach the Membrane Source is indeed the correct symptomatic therapy.

Patient Li from Li: Contracted summerheat pathogen, presenting with chills and fever. Pulse is wiry and rapid (Xuan Shu). Headache, epigastric fullness, frequent urination. Treatment should harmonize the middle jiao and clear pathogens. (July 3rd, Bingwu 29th day)
Prescription: Qinghaozi (Artemisia Annua Seed, 1.5 qian), Huoxiang (Patchouli Herb, 3 qian), Peilan (Eupatorium Leaf, 1.5 qian), Qingpi (Green Tangerine Peel, 8 fen), Chao Zhimu (Anemarrhena Rhizome, fried, 1.5 qian), Baizhi (Angelica Dahurica Root, 8 fen), Huashi (Talcum, 4 qian), Weilingxian (Syneilesis Aconitifolia Root, 1.5 qian), Xian Banxia (Pinellia Tuber, 1.5 qian), Da Dou Juan (Soybean Sprout, 3 qian), Kouqiao (Cardamom Shell, 1.5 qian). (Guiding drug): Heye (Lotus Leaf, one corner).
Take two doses.
Re-examination: Clearing therapy has been effective. Pulse is deficient and fine (Xu Xi). Chills and fever alternate, slightly better in the afternoon. Tongue coating is slippery white at root with slight yellow. Bowel movements are normal. Treatment should clear summerheat and harmonize the middle jiao. (July 6th, Bingwu 2nd day)
Prescription: Huoxiang Geng (Patchouli Stem, 2 qian), Xian Banxia (Pinellia Tuber, 1.5 qian), Yinhuajin (Honeysuckle Flower, 1.5 qian), Lianqiao (Forsythia Fruit, 3 qian), Huashi (Talcum, 4 qian), Huangqin (Scutellaria Root, 1.5 qian), Chiling (Poria Cocos with Red Sand, 4 qian), Da Dou Juan (Soybean Sprout, 3 qian), Kourén (Cardamom Seed, 8 fen), Biandouyi (Dolichos Lablab Seed Coat, 3 qian), Tongcao (Akebia Stem, 1.5 qian). (Guiding drug): Heye (Lotus Leaf, one corner).
Take two doses.
Commentary: This case is largely similar to the previous one, but the prescription also aims to open the Membrane Source. However, the damp-heat is lighter. Initially, headache was treated with wind-dispelling herbs. Subsequently, chills and fever were slightly relieved in the afternoon, yet the primary treatment remains clearing summerheat.

Patient Pang from Yifeng: Summerwind combined with dampness. Chills and fever resembling malaria. Thirst with drinking. Frequent urination. Pulse is soft (Ru) and larger on the right. Tongue coating is white, tender yellow in the center. Treatment should clear and resolve, preventing severity. (August 11th, Dingwei 29th day)
Prescription: Dan Zhuye (Lophatherum Herb, 1.5 qian), Xiangru (Elsholtzia Herb, 7 fen), Chan Yi (Cicada Slough, 1.5 qian), Niubangzi (Arctium Fruit, 3 qian), Lianqiao (Forsythia Fruit, 3 qian), Guang Xingren (Apricot Seed, 3 qian), Liuyi San (Six-to-One Powder, 4 qian, wrapped for decoction), Tongcao (Akebia Stem, 1.5 qian), Bohe (Mint, 5 fen), Tianhuafen (Trichosanthes Root, 3 qian), Yinhua (Honeysuckle Flower, 2 qian). (Guiding drug): Xian Heye (Fresh Lotus Leaf, one corner).
Take two doses.
Re-examination: Chills and fever persist. Pulse is wiry and soft (Xuan Ru). Tongue coating is yellow and slippery. Abdomen sounds gurgling (Zhuozhuo). Temporarily treat by clearing summerheat and harmonizing the middle jiao. (August 15th, Wushen 3rd day)
Prescription: Guang Huoxiang (Patchouli Herb, 2 qian), Qinghaozi (Artemisia Annua Seed, 1.5 qian), Chao Qingpi (Green Tangerine Peel, fried, 8 fen), Chao Zhike (Bitter Orange Fruit, fried, 1.5 qian), Jiao Shanzhi (Gardenia Fruit, charred, 3 qian), Lianqiao (Forsythia Fruit, 3 qian), Shanzha (Hawthorn Fruit, 3 qian), Yuan Huashi (Talcum, 4 qian), Shentoucao (Patchouli Herb, 3 qian), Tiao Qin (Scutellaria Root, 1.5 qian), Tongcao (Akebia Stem, 1.5 qian). (Guiding drug): Xian Heye (Fresh Lotus Leaf, one corner).
Commentary: Ye Tianshi stated: Summerheat must be accompanied by dampness, resembling external contraction of wind-cold. Avoid using Chaihu, Gegen, Qianghuo, Fangfeng. If there is surface heat without sweat, acrid-cool light agents are appropriate. Xiangru is acrid-warm and ascending; if heat is latent, it may cause vomiting. Assisting with bitter-descending herbs like Xingren, Huanglian, Huangqin prevents vomiting. To diffuse the upper jiao, use Xingren, Lianqiao, Bohe, Zhuye. If summerheat penetrates deeply causing latent heat, restlessness, and thirst, use Baihu Tang or Liuyi San. Now this patient has chills and fever like malaria, indicating summerheat with dampness. The initial prescription fully follows Ye's intent. In the second visit, since chills and fever persisted, herbs clearing residual heat from Shaoyang were added to the summerheat-clearing formula.

Patient Li from Li: Summerwind injuring Lung Qi. Headache, fever, slight sweating not coming out. Pulse is floating and soft (Fu Ru) on the right. Body pain, frequent urination. Tongue coating slightly yellow. Treatment should clear and resolve, preventing severity. (May 19th)
Prescription: Xiangru (Elsholtzia Herb, 8 fen), Jiegeng (Platycodon Root, 1.5 qian), Bohe (Mint, 1.5 qian), Tianhuafen (Trichosanthes Root, 3 qian), Lianqiao (Forsythia Fruit, 3 qian), Xiangbei (Fritillaria Bulb, 1.5 qian), Liuyi San (Six-to-One Powder, 4 qian), Kourén (Cardamom Seed, 8 fen, taken separately), Baizhi (Angelica Dahurica Root, 8 fen), Chao Zhimu (Anemarrhena Rhizome, fried, 1.5 qian), Guang Xingren (Apricot Seed, 3 qian).
Decoct in clear water, take two doses.
Commentary: Summerwind first injures Qi level, belonging to diseases of the Upper Jiao. Treatment focuses on acrid-cool and slightly bitter herbs to clear Lung Qi.

Ma from Shufu: Summer-dampness injuring Qi. Epigastric fullness, fever. Pulse is soft (Ru), wiry and fine (Xuan Xi) on the right. Tongue coating is slippery white. Frequent urination, nausea. Treatment should open the Qi level. (August 4th)
Prescription: Gulou Pi (Trichosanthes Peel, 3 qian), Huoxiang Geng (Patchouli Stem, 2 qian), Xian Banxia (Pinellia Tuber, 1.5 qian), Chao Zhike (Bitter Orange Fruit, fried, 1.5 qian), Chuan Po (Magnolia Bark, 1 qian), Shentoucao (Patchouli Herb, 3 qian), Tiao Qin (Scutellaria Root, 1.5 qian), Kudingcha (Ilex Kudingcha Leaf, 1.5 qian), Tongcao (Akebia Stem, 1.5 qian), Kouqiao (Cardamom Shell, 1.5 qian), Huashi (Talcum, 4 qian).
Commentary: Summerheat is a steaming qi, dampness is a greasy turbid pathogen. Heat resides within dampness, obstructing the Qi level. If unresolved for long, it spreads to the Middle Jiao. Hence epigastric fullness, nausea, fever, and frequent urination. Treatment uses aromatic herbs to stop vomiting and bitter-acrid herbs to open the Lung.

Zhao from Ma'an: Summer-dampness injuring Qi. Tongue coating gray-yellow. Sweating followed by fever. Pulse is deficient, soft (Ru) on the right. Head and eyes feel unclear. Frequent urination. Treatment should clear heat and promote diuresis to remove dampness, preventing severity. (July 25th, Dingwei 12th day)
Prescription: Dan Zhuye (Lophatherum Herb, 1.5 qian), Jiao Liuqu (Medicated Leaven, charred, 4 qian), Jiao Zhizi (Gardenia Fruit, charred, 3 qian), Huoxiang (Patchouli Herb, 3 qian), Lianqiao (Forsythia Fruit, 3 qian), Chiling (Poria Cocos with Red Sand, 4 qian), Tiao Qin (Scutellaria Root, 2 qian), Guang Xingren (Apricot Seed, 3 qian), Kudingcha (Ilex Kudingcha Leaf, 1.5 qian), Da Dou Juan (Soybean Sprout, 3 qian), Huashi (Talcum, 4 qian). (Guiding drug): Xian Heye (Fresh Lotus Leaf, one corner).
Take two doses.
Commentary: The Lung governs skin and hair. Now Lung Qi is depressed, causing spontaneous sweating, fever, and unclear head/eyes. Pulse deficient and soft on the right is a sign of summerheat with dampness. Treatment uses acrid-cool light agents to clear the Upper Jiao and promotes dampness removal. The method is excellent.

Yao from Anchang: Summer-dampness injuring Qi. Vomiting, thirst, body heat. Spontaneous loose stools. Pulse is wiry, soft, and rapid (Xuan Ru Shu). Tongue coating yellow and slippery. Abdominal pain. Condition is not mild. Treatment should clear heat and harmonize the middle. Wait for proper diagnosis. (July 18th, Dingwei 5th day)
Prescription: Huo Geng (Patchouli Stem, 2 qian), Jiao Liuqu (Medicated Leaven, charred, 4 qian), Chao Huangqin (Scutellaria Root, fried, 1.5 qian), Tianhuafen (Trichosanthes Root, 3 qian), Liuyi San (Six-to-One Powder, 4 qian, wrapped), Lianqiao (Forsythia Fruit, 3 qian), Zhike (Bitter Orange Fruit, 1.5 qian), Peilan (Eupatorium Leaf, 3 qian), Yinhua (Honeysuckle Flower, 3 qian), Shichangpu (Acorus Rhizome, 8 fen), Da Dou Juan (Soybean Sprout, 3 qian).
Decoct in clear water, take one dose.
Re-examination: Clearing heat and harmonizing the middle cured spontaneous diarrhea, vomiting, and thirst. Pulse is soft, wiry and rapid on the right. Tongue coating yellow and slippery. Body heat has eased. Dizziness and tinnitus remain. Stick to the previous method with modifications for stability. (July 22nd, Dingwei 9th day)
Prescription: Guang Huoxiang (Patchouli Herb, 1.5 qian), Kudingcha (Ilex Kudingcha Leaf, 1.5 qian), Tiao Qin (Scutellaria Root, 1.5 qian), Shentoucao (Patchouli Herb, 3 qian), Liuyi San (Six-to-One Powder, 4 qian), Biandouyi (Dolichos Lablab Seed Coat, 2 qian), Chiling (Poria Cocos with Red Sand, 4 qian), Tongcao (Akebia Stem, 1.5 qian), Yinhua (Honeysuckle Flower, 3 qian), Lianqiao (Forsythia Fruit, 3 qian), Jiao Shanzhi (Gardenia Fruit, charred, 3 qian).
Decoct in clear water, take three doses.
Commentary: Summer-dampness mixed with turbidity is inhaled through mouth and nose, injuring Qi level, gradually entering the Diaphragm Source, and seeping down into the Large Intestine, causing vomiting, thirst, body heat, abdominal pain, and diarrhea. Thus, clearing heat and harmonizing the middle cured all symptoms. Dizziness and tinnitus in the second visit indicate residual heat from Liver and Gallbladder attacking clear orifices. The treatment focusing on Upper Jiao damp-heat is good.

Yu from Xichi: Summer-dampness injuring Qi. Tidal fever. Red urine. Stool like paste. Pulse is soft, fine, and rapid (Ru Xi Shu). Tongue center scorched yellow. Sweet taste in mouth. Treatment should clear and promote diuresis, preventing changes.
Initial Prescription: Wan Can Sha (Mulberry Mantis Sand, 3 qian), Xian Banxia (Pinellia Tuber, 1.5 qian), Guang Xingren (Apricot Seed, 3 qian), Kudingcha (Ilex Kudingcha Leaf, 1.5 qian), Lianqiao (Forsythia Fruit, 2 qian), Chiling (Poria Cocos with Red Sand, 0.5 qian), Dafupi (Areca Peel, 3 qian), Dan Zhuye (Lophatherum Herb, 1.5 qian), Da Dou Juan (Soybean Sprout, 3 qian), Chao Huangqin (Scutellaria Root, fried, 1.5 qian), Yuan Huashi (Talcum, 4 qian), Heye (Lotus Leaf, one circle).
Take two doses.
Second Visit: Tidal fever subsided. Pulse is soft on left, fine on right. Tongue coating yellow and dry. Sweet taste in mouth. Red urine. Constipation. Treatment should modify Xiexin Tang, preventing changes.
Prescription: Xian Banxia (Pinellia Tuber, 1.5 qian), Chao Huangqin (Scutellaria Root, fried, 1.5 qian), Guang Yujin (Curcuma Aromatica Rhizome, 3 qian), Shentoucao (Patchouli Herb, 3 qian), Chao Chuanlian (Coptis Rhizome, fried, 6 fen), Chao Zhishi (Immature Bitter Orange Fruit, fried, 2 qian), Nongpo (Magnolia Bark, 1 qian), Tongcao (Akebia Stem, 1.5 qian), Sheng Baishao (White Peony Root, raw, 1.5 qian), Guang Xingren (Apricot Seed, 3 qian), Chiling (Poria Cocos with Red Sand, 3 qian).
Take two doses.
Third Visit: Tongue coating turned tender yellow and still greasy. Both hands pulse wiry and fine (Xuan Xi). Mouth still sweet. Syndrome is Pi Dan (Spleen Heat/Sweet Taste Disorder), stomach sluggish. Treatment should modify Xiexin Tang.
Prescription: Xian Banxia (Pinellia Tuber, 1.5 qian), Jiao Shenqu (Medicated Leaven, charred, 3 qian), Chao Guya (Sprouted Millet, fried, 3 qian), Xin Hui Pi (Tangerine Peel, 1.5 qian), Chao Chuanlian (Coptis Rhizome, fried, 6 fen), Xingren (Apricot Seed, 3 qian), Chiling (Poria Cocos with Red Sand, 3 qian), Huashi (Talcum, 4 qian), Chao Zhishi (Immature Bitter Orange Fruit, fried, 0.5 qian), Kouqiao (Cardamom Shell, 0.5 qian), Shentoucao (Patchouli Herb, 3 qian).
Decoct in clear water, take three doses.
Fourth Visit: Tongue color still yellow. Stomach Qi not vigorous. Pulse soft. Left side wiry and fine. Constipation. Heart feels nauseous. Treatment should nourish Stomach, clear heat, and promote diuresis. Most afraid of complications.
Prescription: Bian Jinchai (Dendrobium Officinale Stem, 3 qian), Gulou Pi (Trichosanthes Peel, 3 qian), Huo Geng (Patchouli Stem, 2 qian), Ji Neijin (Chicken Gizzard Lining, 3 qian), Shentoucao (Patchouli Herb, 3 qian), Guang Xingren (Apricot Seed, 3 qian), Guya (Sprouted Millet, 4 qian), Dan Zhuye (Lophatherum Herb, 1 qian), Yuan Huashi (Talcum, 4 qian), Chenpi (Aged Tangerine Peel, 1.5 qian), Wan Can Sha (Mulberry Mantis Sand, 3 qian).
Fifth Visit: Tongue color not cleared. Bowels slightly passed. Hungry but no desire to eat. Six pulses now deficient and fine (Xu Xi). Stomach Qi rebellious, nausea. Damp-heat still exists. Stick to previous method with modifications. No worry about complications.
Prescription: Bian Jinchai (Dendrobium Officinale Stem, 3 qian), Baizi Ren (Biota Seed, 3 qian), Gulou Pi (Trichosanthes Peel, 3 qian), Tongcao (Akebia Stem, 1.5 qian), Shentoucao (Patchouli Herb, 3 qian), Hehuan Pi (Albizia Bark, 3 qian), Huo Geng (Patchouli Stem, 2 qian), Ruren (Prunus Armeniaca Kernel, 1.5 qian), Ji Neijin (Chicken Gizzard Lining, 3 qian), Bai Fushen (Poria Cocos with Hostwood, 4 qian), Chao Guya (Sprouted Millet, fried, 4 qian).
Commentary: Summerheat combined with dampness, stuck and unresolved, is a lingering and difficult-to-cure syndrome. During treatment, one must distinguish whether summerheat or dampness predominates. Overusing cooling herbs for summerheat makes dampness linger; overusing warm-drying herbs for dampness generates heat and consumes fluids. Thus, after four visits, fear of complications persists due to sticky damp-heat. The method is orderly. However, Dendrobium (Jinchai) nourishes Stomach Yin but is used too early while damp-heat exists, risking retaining pathogens. Sweet taste in mouth is called Pi Dan (Spleen Heat) in ancient texts. Five flavors enter the mouth and store in the Stomach; Spleen distributes essence. Fluids in Spleen cause sweet taste. People eating rich/sweet foods generate internal heat and fullness, leading to Xiao Ke (Wasting-Thirst). Nei Jing says treat with Lan (Orchid/Acorus) to remove stale qi. Later doctors use Peilan (Eupatorium), but Jianlan Ye (Orchid Leaf) is better for generating fluids and removing stale heat.

Ma from Shufu: Exposed to summerheat and wind. Headache, fever. Trembling limbs. Pulse floating and rapid (Fu Shu). Right Guan pulse strong. Epigastric fullness, Qi rushing. Throat feels obstructed. Tongue coating slightly yellow, thick at root. Condition is tricky. Prevent convulsions/fainting. Wait for proper diagnosis. (June 2nd)
Prescription: Yinhua (Honeysuckle Flower, 3 qian), Lianqiao (Forsythia Fruit, 3 qian), Juhe (Tangerine Seed, 1.5 qian), Shegan (Belamcanda Rhizome, 1.5 qian), Guang Juhong (Tangerine Peel, 1 qian), Jiao Shanzhi (Gardenia Fruit, charred, 2 qian), Ganju (Chrysanthemum Flower, 2 qian), Bohe (Mint, 1 qian), Chao Jiangcan (Bombyx Batryticatus, fried, 2 qian), Guang Xingren (Apricot Seed, 3 qian), Zhuye (Lophatherum Herb, 1.5 qian). (Guiding drug): Heye (Lotus Leaf, one corner).
Take one dose.
Commentary: Wind contracted in summer first injures Qi level, causing headache and fever. Unresolved for long, it transforms into heat and stirs Liver Wind, causing limb trembling and Qi rushing. Treatment clears Qi level heat. Once Qi heat is settled, Liver Wind calms naturally.

Wang from Dayi: Child with summerwind and dampness. Pulse floating and large (Fu Da). Tongue coating slippery white. Profuse sweating, fever, thirst. Fear transformation into Convulsive Disease (Jing Feng). Temporarily clear heat and dispel pathogens. (Another month 24th day)
Prescription: Gulou Gen (Trichosanthes Root, 3 qian), Mi Yinhua (Honey-fried Honeysuckle Flower, 2 qian), Da Dou Juan (Soybean Sprout, 3 qian), Dan Zhuye (Lophatherum Herb, 1.5 qian), Lianqiao (Forsythia Fruit, 3 qian), Biandouyi (Dolichos Lablab Seed Coat, 3 qian), Chiling (Poria Cocos with Red Sand, 4 qian), Bai Kourén (White Cardamom Seed, 8 fen, taken separately), Liuyi San (Six-to-One Powder, 3 qian), Guang Xingren (Apricot Seed, 3 qian), Zhike (Bitter Orange Fruit, 1.5 qian).
Decoct in clear water, take two doses.
Commentary: Children are pure Yang bodies. Contracting summer wind-heat and dampness risks transforming heat, consuming fluids, stirring Liver Wind, and causing convulsions. Especially with profuse sweating, fever, and thirst, heat is obviously blazing. Treatment should clear heat and expel pathogens.

Patient Pang from Yifeng: Swelling below right ear, mixed with summer-dampness. Diarrhea, abdominal pain. Pulse wiry and soft (Xuan Ru). Tongue root slightly yellow. Temporarily clear summerheat and harmonize middle. (June 24th)
Prescription: Huoxiang Geng (Patchouli Stem, 3 qian), Dafupi (Areca Peel, 3 qian), Tongcao (Akebia Stem, 1.5 qian), Zuojin Wan (Left Metal Pill, 8 fen), Yiyuan San (Benefit Origin Powder, 3 qian), Chiling (Poria Cocos with Red Sand, 3 qian), Biandouyi (Dolichos Lablab Seed Coat, 3 qian), Nanmuxiang (Costus Root, 6 fen), Kudingcha (Ilex Kudingcha Leaf, 1.5 qian), Jiao Shanzhi (Gardenia Fruit, charred, 3 qian), Xin Hui Pi (Tangerine Peel, 1.5 qian).
Decoct in clear water, take three doses.
Commentary: Summer Qi descends, damp turbidity ascends. Humans exposed to steaming damp-heat contract this qi, mixed with turbidity, affecting Spleen/Stomach causing diarrhea, and moving through the middle pathway causing abdominal pain. Treatment should clear heat, open depression, assist with aromatic and bland diuretics to separate and eliminate turbid dampness.

Shi from Hangzhou: Chronic Phlegm-Fluid retention. Newly contracted summerheat with dampness. Tidal fever, cough, shortness of breath. Pulse soft, slippery, rapid (Ru Hua Shu). Tongue coating white, slightly yellow at root. Temporarily clear Qi and resolve phlegm.
Prescription: Gulou Pi (Trichosanthes Peel, 3 qian), Guang Xingren (Apricot Seed, 3 qian), Guang Juhong (Tangerine Peel, 1 qian), Chi Fuling (Red Poria Cocos, 4 qian), Chuan Bei (Fritillaria Bulb, 2 qian), Lianqiao (Forsythia Fruit, 3 qian), Biandouyi (Dolichos Lablab Seed Coat, 3 qian), Bai Kourén (White Cardamom Seed, 8 fen), Liuyi San (Six-to-One Powder, 3 qian, bagged), Dan Qin (Light Scutellaria Root, 1.5 qian), Baiqian (Cynanchum Stauntonii Root, 1.5 qian).
Decoct in clear water, take three doses.
Commentary: Treat Phlegm-Fluids with warm herbs to harmonize. But newly contracted summerheat first affects Qi level. Thus, clear summerheat first, then resolve phlegm-dampness.

Patient Xu from Yifeng: Summerwind, heat, dampness. Paroxysmal cough. Deafness (Er Mu). Pulse soft and rapid (Ru Shu). Tongue coating white, slightly yellow at root. Consciousness occasionally confused. Condition severe and dangerous. Prevent fainting/closure. Wait for proper diagnosis. (July 24th)
Prescription: Shichangpu (Acorus Rhizome, 8 fen), Jiao Shanzhi (Gardenia Fruit, charred, 3 qian), Juhong (Tangerine Peel, 1 qian), Lao Shi Tianzhuhuang (Old Sky Bamboo Resin, 1.5 qian), Yuanzhi (Polygala Root, 8 fen), Huashi (Talcum, 4 qian), Guang Xingren (Apricot Seed, 3 qian), Chao Huangqin (Scutellaria Root, fried, 1.5 qian), Kudingcha (Ilex Kudingcha Leaf, 1.5 qian), Xiangbei (Fritillaria Bulb, 3 qian), Dan Zhuye (Lophatherum Herb, 3 qian). (Guiding drug): Heye (Lotus Leaf, one corner).
Take three doses.
Commentary: Summerheat presses down, damp turbidity ascends. Pathogens inhaled through mouth/nose obstruct Qi level first. Upper Jiao clearing function fails, causing paroxysmal cough. Summerheat with dampness is sticky and hard to resolve. Long stagnation transforms heat, scorching fluids, leading to coma and deafness. Must identify which pathogen (summerheat, wind, damp, heat) is heavier. Here, summerheat with phlegm-dampness moves from Lung to Pericardium. Prevent fainting/closure. Treatment clears Lung, resolves phlegm, eliminates summerheat, opens orifices to save Pericardium. Excellent plan.

Shen from Xizhu: Summerwind with dampness. Paroxysmal cough. Facial edema. Red tongue, yellow root. Thirst. Frequent urination. Chronic Spleen Diarrhea. Clear summerheat and resolve phlegm. Prevent severity. (July 22nd)
Prescription: Wu Yuanshen (Black Rehmannia Root, 3 qian), Juhong (Tangerine Peel, 1 qian), Tianhuafen (Trichosanthes Root, 3 qian), Shilianzi (Nelumbo Nucifera Seed, 3 qian), Yiyuan San (Benefit Origin Powder, 4 qian), Biandouyi (Dolichos Lablab Seed Coat, 3 qian), Fuling (Poria Cocos, 4 qian), Shentoucao (Patchouli Herb, 3 qian), Yinhua (Honeysuckle Flower, 2 qian), Chuan Bei (Fritillaria Bulb, 1.5 qian), Dan Zhuye (Lophatherum Herb, 3 qian).
Decoct in clear water, take three doses.
Commentary: Summer-dampness with phlegm lingers in Upper Jiao. Phlegm-damp obstructs Qi, failing to transform fluids, causing thirst, red tongue, yellow root. Patients with chronic Spleen Diarrhea risk damp-heat spreading horizontally causing edema. Treatment clears heat, resolves phlegm, uses Biandouyi, Shilianzi, Fuling to support Spleen and drain dampness. Addresses both root and branch.

Li from Anchang: Summerwind with dampness. Cough with hemoptysis. Pulse large at Cun position. Tongue coating white, slightly yellow at root. Tidal fever. Prevent Tuberculosis (Zhai). (June 12th)
Prescription: Gulou Pi (Trichosanthes Peel, 1.5 qian), Dan Zhuye (Lophatherum Herb, 1.5 qian), Qiangen (Madder Root, 2 qian), Xiaoji Cao (Crepis Root, 3 qian), Chuan Bei (Fritillaria Bulb, 3 qian), Biandouyi (Dolichos Lablab Seed Coat, 3 qian), Jiao Shanzhi (Gardenia Fruit, charred, 3 qian), Yinhua (Honeysuckle Flower, 3 qian), Liuyi San (Six-to-One Powder, 4 qian), Guang Xingren (Apricot Seed, 3 qian), Baiqian (Cynanchum Stauntonii Root, 1.5 qian), Hehua Lu (Lotus Flower Dew, 2 liang, taken separately), Maocaogen (Imperata Rhizome, 1 liang). Three doses.
Commentary: Summerheat scorches Lung, ignites Yang Collaterals, causing collateral blood to overflow. Treatment eliminates summerheat, protects Lung, clears collaterals, stops bleeding. More agile than Ye Tianshi's formula for five surnames.

Certain Woman: Latent summerheat, vomiting, thirst, fever. Pulse slippery and rapid at Cun position. Rebellious Qi hits epigastrium. Frequent urination. Menstruation delayed. Fear complications. Modify Xiexin Tang. Wait for proper diagnosis. (October 11th, September 2nd)
Prescription: Chao Chuanlian (Coptis Rhizome, fried, 8 fen), Zhishi (Immature Bitter Orange Fruit, 1.5 qian), Shentoucao (Patchouli Herb, 3 qian), Yuan Huashi (Talcum, 4 qian), Xian Banxia (Pinellia Tuber, 1.5 qian), Sheng Baishao (White Peony Root, raw, 3 qian), Guang Yujin (Curcuma Aromatica Rhizome, 3 qian), Kouqiao (Cardamom Shell, 1.5 qian), Jiu Chao Huangqin (Scutellaria Root, wine-fried, 1.5 qian), Guang Xingren (Apricot Seed, 3 qian), Ju Bai (Tangerine Albedo, 1 qian).
Decoct in clear water, take two doses.
Commentary: Summerheat latent in Heart/Diaphragm. Use Qin, Lian, Banxia imitating Xiexin Tang to drain heat. Assist with Xingren, Kouqiao to stop vomiting. For rebellious Qi hitting epigastrium, lacks calming Qi herbs. Delayed menstruation indicates Blood deficiency. This formula first clears summerheat, best method. After summerheat resolves, regulate menstruation and tonify Blood, avoiding internal/external complexity.

Yu from Anchang: Latent summerheat manifesting in Autumn. Initial chills and fever. Pulse soft and fine (Ru Xi). Tongue coating slightly white, red base. Tidal fever. Head distension. Limb soreness. Bowel movement unsatisfactory. Temporarily clear and promote diuresis.
Prescription: Wan Can Sha (Mulberry Mantis Sand, 4 qian, wrapped), Qingpi (Green Tangerine Peel, 8 fen), Kudingcha (Ilex Kudingcha Leaf, 3 qian), Chuan Shihu (Dendrobium Officinale Stem, 3 qian), Guang Xingren (Apricot Seed, 3 qian), Jiao Shanzhi (Gardenia Fruit, charred, 3