Chapter 7: Summerheat Damage: Pulse, Signs, and Treatment
Seventh Treatise on the Pulse, Signs, and Treatment of Summer-Heat Injury
(Regarding cold damage as a disease name, it is because it is the most violent and lethal pathogenic qi. Those who are immediately affected after being struck by this pathogenic qi are called cold damage; those who are not immediately affected, with the cold toxin lurking in the skin and muscles, turning into warmth disease in spring and summer-heat disease in summer. Summer-heat disease is a condition where the heat pathogen is more severe than warmth disease.) Quoted from the Fourth Treatise on Cold Damage Examples.
In summer-heat injury, the lung is first affected; the lung is the residence of qi. Summer-heat injures the primordial qi, and the pulse at the inch opening is vacuous. There is thirst, sweating, clouded spirit, and shortness of breath. It is treated primarily with Bamboo Leaf and Gypsum Decoction.
Bamboo Leaf and Gypsum Decoction Formula
Bamboo leaves (two handfuls), polished round-grained rice (half a sheng), pinellia (half a sheng, washed), gypsum (one jin), ginseng (three liang), ophiopogon (one sheng), licorice (two liang, honey-fried).
These seven medicinals: use one dou of water, first decoct six medicinals, take six sheng of liquid, remove the dregs, add the polished round-grained rice, decoct until the rice is cooked, the decoction is ready. Warmly take one sheng, three times daily.
In summer-heat injury, with fever, sweating, thirst, and a floating and large pulse, it is called sunstroke. It is treated primarily with White Tiger plus Ginseng, Coptis, and Donkey-Hide Gelatin Decoction.
White Tiger plus Coptis and Donkey-Hide Gelatin Decoction Formula
Anemarrhena (six liang), gypsum (one jin, broken, wrapped in cotton cloth), licorice (two liang, honey-fried), polished round-grained rice (six ge), ginseng (three liang), coptis (three liang), donkey-hide gelatin (two liang).
These seven medicinals: use one dou of water, first decoct six medicinals until the rice is cooked and the decoction is ready, then remove the dregs, add the donkey-hide gelatin to melt and dissolve. Warmly take one sheng, three times daily.
In summer-heat injury, after sweating, there is fever, vexation, hoarse voice, and a pulse that is instead floating and rapid. This is due to injury of the lung’s fluids. It is treated primarily with Lily and Rehmannia plus Oyster Shell Decoction.
Lily and Rehmannia plus Oyster Shell Decoction Formula
Lily bulbs (seven pieces), rehmannia juice (one sheng), oyster shell (two liang).
These three medicinals: first wash the lily bulbs with water, soak overnight until white froth appears, pour off the water. Separately use two sheng of spring water, decoct the lily and oyster shell, take one sheng of liquid, remove the dregs, add the rehmannia juice, then decoct again to take one sheng and five ge. Divide into two portions and take warmly.
In summer-heat injury, with water qi below the heart, sweating, cough, thirst with desire to drink water, but vomiting immediately after drinking, and a pulse that is weak and slippery, it is treated primarily with Trichosanthes and Poria Decoction.
Trichosanthes and Poria Decoction Formula
Trichosanthes fruit (one large piece, crushed with skin and seeds), poria (three liang), pinellia (three liang, washed), coptis (two liang), licorice (one liang, honey-fried).
These five medicinals: use five sheng of water, decoct to take two sheng of liquid. Warmly take one sheng, twice daily.
In summer-heat injury, with fever and no sweating, this is due to water qi moving within the skin. The pulse will definitely be floating and slippery. First bathe the body with hot water to induce sweating, then administer Bamboo Shavings and Pinellia Decoction.
Bamboo Shavings and Pinellia Decoction Formula
Bamboo shavings (two liang), trichosanthes root (two liang), poria (three liang), pinellia (half a sheng, washed).
These four medicinals: use five sheng of water, decoct to take three sheng of liquid. Divide into three portions and take warmly.
When the greater yang channel is struck by heat pathogen, it is sunstroke disease. (The Shuowen Jiezi says: “Sunstroke means summer-heat injury.”) The patient has sweating, aversion to cold, body fever, and thirst. It is treated primarily with White Tiger plus Ginseng Decoction.
White Tiger plus Ginseng Decoction Formula
Anemarrhena (six liang), gypsum (one jin, broken, wrapped in cotton cloth), licorice (two liang, honey-fried), polished round-grained rice (six ge), ginseng (three liang).
These five medicinals: use one dou of water, decoct until the rice is cooked, the decoction is ready, then remove the dregs. Warmly take one sheng, three times daily.
In greater yang channel sunstroke, with body fever, pain, and heaviness, and a pulse that is weak, this is due to injury by cold water in summer, with water qi moving within the skin. It is treated primarily with Polyporus plus Ginseng Decoction; the Single-Medicinal Melon-Stalk Decoction also treats it.
Polyporus plus Ginseng Decoction Formula
Polyporus (one liang), poria (one liang), talc (one liang), alisma (one liang), donkey-hide gelatin (one liang), ginseng (three liang).
These six medicinals: use four sheng of water, first decoct five medicinals to take two sheng of liquid, add the donkey-hide gelatin to melt and dissolve. Warmly take seven ge, three times daily.
Single-Medicinal Melon-Stalk Decoction Formula
Melon stalks (twenty pieces).
The above medicinal is cut into pieces. Use one sheng of water, decoct to take five ge of liquid, remove the dregs, and take in a single dose.
All persons suffering from summer-heat disease should sweat. If they do not sweat, they will definitely develop fever; those with fever will definitely not sweat. One must not induce sweating. Inducing sweating will cause fever, vexation, and loss of voice. This is dryness of the lung’s fluids; if there is rapid breathing and qi rushing upward, it is untreatable.
In summer-heat injury, with restless sleep at night, vexation, delirious speech, red tongue, and a rapid pulse, this is summer-heat attacking the heart. It is treated primarily with Coptis, Pinellia, Gypsum, and Licorice Decoction.
Coptis, Pinellia, Gypsum, and Licorice Decoction Formula
Coptis (three liang), pinellia (half a sheng, washed), gypsum (one jin, broken, wrapped in cotton cloth), licorice (two liang, honey-fried).
These four medicinals: use five sheng of water, decoct to take three sheng of liquid, remove the dregs. Warmly take one sheng, three times daily.
In greater yang channel sunstroke, with fever, aversion to cold, body heaviness and pain, a pulse that is thin, fine, hollow, and slow, after urination, shivering with body hair standing on end, and cold hands and feet; slight exertion causes body fever; open-mouth breathing, dry incisor teeth. If sweating is induced, the aversion to cold becomes more severe; if warm needling is used, the fever becomes more severe; if purging is repeatedly applied, the urinary dribbling becomes more severe. It is treated primarily with White Tiger plus Cinnamon Twig, Ginseng, and Peony Decoction.
White Tiger plus Cinnamon Twig, Ginseng, and Peony Decoction Formula
Anemarrhena (six liang), gypsum (one jin, broken, wrapped in cotton cloth), licorice (two liang, honey-fried), polished round-grained rice (six ge), cinnamon twig (one liang), ginseng (three liang), peony (two liang).
These seven medicinals: use eight sheng of water, decoct until the rice is cooked and the decoction is ready. Warmly take one sheng, three times daily.
In summer-heat injury, with a weak pulse, thirst, profuse sweating, and dizziness, it is treated primarily with Ginseng and Gypsum Decoction.
Ginseng and Gypsum Decoction Formula
Ginseng (three liang), gypsum (one jin, broken, wrapped in cotton cloth), bamboo leaves (one handful), coptis (one liang), pinellia (half a sheng, washed).
These five medicinals: use six sheng of water, decoct to take three sheng of liquid, remove the dregs. Warmly take one sheng, three times daily. In patients with summer-heat injury, there is no headache. Headache indicates wind pathogen; head heaviness indicates dampness.