寶鑑Bogam

Formulas · Text · Donguibogam 東醫寶鑑

Summerheat

Seo

한글 서  ·  Pinyin Shu

Heat illness as the classical physicians saw it — the vacuous pulse that tells sunstroke from fever, the two kinds of heat collapse, and why the treatment is to supplement rather than to cool

暑

Sixteen sections and thirty-seven prescriptions, and the chapter turns on a single diagnostic point made over and over: in summerheat the pulse is vacuous. Sunstroke and a fever can look alike — a hot body, thirst, sweating — but the fever's pulse is full and forceful and the sunstroke's is thin, hollow and slow, because heat consumes qi where cold injures form. From that one observation the whole chapter follows. The 夏暑宜補氣 section argues that summer requires supplementing and not cooling, on the reasoning that the yang has all gone to the surface and left the belly empty, and Li Dongyuan is quoted dismissing the popular doctrine of hidden yin within in summer as a misreading of the word vacuity. Against that stands the equally insistent line that treating summerheat means clearing the heart and freeing the urine, and the mineral powders of the 暑熱煩渴 section do exactly that. The chapter's finest distinction is the one between 中暑 and 中熱 — heat taken quietly, in a cool hall or a shaded room, which presents with chills and body ache and is treated with warm aromatics; and heat taken in motion, by the traveller or the field labourer in the sun, which presents with a burning skin and desperate thirst and is treated with gypsum. That is heat exhaustion separated from heat stroke four centuries before the terms existed, and the treatments assigned to each are not far wrong. The emergency section is a mixture of the sound and the folkloric: get the patient into the shade, do not give cold water, warm the navel with hot cloths — all correct, and beside them the packing of hot roadside dust on the chest. The pharmacy is the mildest in the whole book. There is no aconite here and no cinnabar; the chapter's defining drug is elsholtzia, and its most loved preparation is a mume-and-honey cordial stirred into cold water that became a summer drink at the Korean court and is still made. Of everything in it, perhaps eight formulas remain in ordinary use, which for a chapter this short is a high proportion.

2.1 Summerheat Is the Ministerial Fire Carrying Out Its Office 暑者相火行令也

2.1.1
Source원문

夏至日後病熱爲暑. 暑者, 相火行令也. 夏月人感之, 自口齒而入, 傷心包絡之經. 其爲證, 煩則喘喝ㆍ靜則多言ㆍ身熱而煩心ㆍ大渴引飮ㆍ頭疼ㆍ自汗ㆍ倦怠ㆍ少氣, 或下血ㆍ發黃ㆍ生癍; 甚者火熱制金ㆍ不能平木ㆍ搐搦ㆍ不省人事矣. 《節齋》

Translation영역
Heat disease after the summer solstice is summerheat. Summerheat is the ministerial fire carrying out its office. In the summer months a man is affected by it, and it enters by the mouth and teeth and injures the channel of the heart envelope. As a pattern it is: when vexed, panting and gasping; when quiet, much talking; a hot body with a vexed heart; great thirst and drinking; headache; spontaneous sweating; weariness; shortness of qi; and sometimes blood passed below, yellowing, and blotches breaking out. In the severe case fire heat restrains metal so that it cannot level wood, and there is convulsion and loss of consciousness.
Clinical note임상 주석
The chapter opens with a date rather than a symptom: heat disease after the summer solstice is summerheat. Before the solstice the same presentation is called warm disease and belongs to the Epidemic chapter, and the division is calendrical, not clinical. What follows is a complete list of heat-illness signs — panting, confusion or garrulousness, burning skin, desperate thirst, headache, sweating, weakness, and in the severe case convulsion and coma. Heat stroke progressing to seizures and unconsciousness is exactly that progression. The blood passed below and the blotches are heat-related coagulopathy, which is a feature of severe hyperthermia and is remarkable to find recorded here.

Jeoljae 節齋

2.2 Cold Damage Transmits and Changes into Warm Disease or Summerheat 傷寒傳變爲溫爲暑

2.2.1
Source원문

凡病傷寒而成溫者, 先夏至日者爲病溫《詳見瘟疫》, 後夏至日者爲病暑. 暑當與汗皆出, 勿止. 《內經》

Translation영역
Whenever one falls ill of cold damage and it becomes warm disease: before the summer solstice it is warm disease, and after the summer solstice it is summerheat. Summerheat should be let out together with the sweat, and the sweating must not be stopped.
Clinical note임상 주석
Two lines from the Neijing, and the second is the chapter's one piece of advice that runs against all its formulas: summerheat should go out with the sweat, and the sweating must not be stopped. Everything the chapter later prescribes for excessive sweating — astragalus, schisandra, the pulse-generating formulas — is in tension with it, and the tension is real. Sweating is how a body sheds heat, and stopping it in a hot climate is dangerous; but a patient who has sweated until the pulse is thin has lost volume he cannot spare. The chapter never resolves this, and the modern answer, replacing the fluid and salt rather than either stopping or encouraging the sweat, was not available to it.

Naegyeong 內經

2.3 The Pulse 脉法

2.3.1
Source원문

傷暑脉虛. ○脉虛ㆍ身熱, 得之傷暑脉一作氣. 《仲景》

Translation영역
Where summerheat has done injury the pulse is vacuous. A vacuous pulse with a hot body — this comes of injury by summerheat. One text has 'qi' for 'pulse'.

Junggyeong 仲景

2.3.2
Source원문

暑傷於氣, 所以脉虛; 弦ㆍ細ㆍ芤ㆍ遲, 體狀無餘. 《脉訣》 ○中暑之脉, 陽弱陰虛ㆍ微遲似芤. 《三因》

Translation영역
Summerheat injures the qi, and so the pulse is vacuous; wiry, fine, hollow and slow — there is no more to its form than this. The pulse of summerheat stroke is yang weak and yin vacuous, faint and slow and resembling the hollow.

Maekgyeol 脉訣 · Samin Geukil Byeongjeungbangnon 三因

2.3.3
Source원문

暑脉弦ㆍ細ㆍ芤ㆍ遲, 何也? 蓋寒傷形ㆍ熱傷氣, 氣傷則氣消而脉虛弱, 所以弦ㆍ細ㆍ芤ㆍ遲皆虛脉也. 《本事》

Translation영역
Why is the summerheat pulse wiry, fine, hollow and slow? Because cold injures the form and heat injures the qi; and when the qi is injured the qi is consumed and the pulse becomes vacuous and weak, so that wiry, fine, hollow and slow are all vacuous pulses.

Boje Bonsabang 本事

2.3.4
Source원문

暑脉虛而微弱, 或浮大而散, 或隱不見. 夫微弱ㆍ隱伏, 皆虛類也. 《正傳》

Translation영역
The summerheat pulse is vacuous and faintly weak, or floating and large and scattered, or hidden and not to be found. Now the faintly weak and the hidden are all of the vacuous kind.

Uihak Jeongjeon 正傳

2.3.5
Source원문

中暑與熱病相似, 但熱病脉盛ㆍ中暑脉虛, 以此辨之. 《活人》

Translation영역
Summerheat stroke and heat disease resemble each other, but in heat disease the pulse is exuberant and in summerheat stroke the pulse is vacuous; by this they are distinguished.
Clinical note임상 주석
The most important section in the chapter, and five sources say the same thing: in summerheat the pulse is vacuous. The Benshi's explanation is the best of them — cold injures the form and heat injures the qi, so a cold illness gives a tight full pulse and a heat illness a thin empty one. Read physiologically that is correct and clinically useful: heat illness proceeds through vasodilation, sweating and volume loss, so the pulse is thin, fast and easily compressed, while the pulse of a febrile infection with intact volume is full. The differential in the last line, exuberant for heat disease and vacuous for summerheat stroke, is the single piece of this chapter a modern clinician would still use at the bedside. A pulse hidden and not to be found is shock.

Hwarinseo 活人

2.4 The Forms and Signs of Summerheat Disease 暑病形證

2.4.1
Source원문

暑病身熱ㆍ自汗ㆍ口乾ㆍ面垢而已. 《入門》

Translation영역
Summerheat disease is a hot body, spontaneous sweating, a dry mouth and a grimy face — no more than that.

Uihak Immun 入門

2.4.2
Source원문

傷暑之證, 面垢ㆍ自汗ㆍ身熱ㆍ背寒ㆍ煩悶ㆍ大渴ㆍ倦怠ㆍ少氣ㆍ毛聳ㆍ惡寒, 或頭疼, 或霍亂, 或四肢厥冷, 但身體無痛. 《直指》

Translation영역
The pattern of injury by summerheat: a grimy face, spontaneous sweating, a hot body, a cold back, vexed oppression, great thirst, weariness, shortness of qi, the hairs standing up and aversion to cold; sometimes headache, sometimes sudden turmoil, sometimes the four limbs reversed and cold — but the body is without pain.

Injae Jijibang 直指

2.4.3
Source원문

中暑之證, 六脉沉伏ㆍ冷汗自出ㆍ悶絶而昏ㆍ不知人矣. 《直指》

Translation영역
The pattern of summerheat stroke: the six pulses sunken and hidden, cold sweat coming out of itself, oppression to the point of collapse, clouding, and not knowing people.

Injae Jijibang 直指

2.4.4
Source원문

太陽中暍者, 暑病也. 發熱ㆍ惡寒ㆍ身重ㆍ頭痛, 其脉弦細芤遲, 小便已灑灑然ㆍ毛聳ㆍ手足逆冷, 少有勞身卽熱ㆍ口開ㆍ前板齒燥. 若發汗則惡寒甚, 加溫鍼則發熱甚, 數下之則淋甚. 《仲景》

Translation영역
Taiyang sunstroke is summerheat disease. There is fever, aversion to cold, a heavy body and headache; the pulse is wiry, fine, hollow and slow; after passing urine there is a shiver, the hairs stand up and the hands and feet are reversed and cold; on the slightest exertion the body grows hot, the mouth hangs open and the front teeth are dry. If sweating is induced the aversion to cold is severe; if the warm needle is added the fever is severe; and if purging is repeated the dribbling is severe.

Junggyeong 仲景

2.4.5
Source원문

何故灑然毛聳? 蓋熱則諸毛孔開, 故洒然惡寒. 口開ㆍ前板齒燥者, 齒乃骨之精, 今燥者骨熱也. 鍼藥不能治, 當灸大顀穴. 《雲歧》

Translation영역
Why the shiver with the hairs standing up? Because when there is heat all the hair pores open, and so there is a shiver and aversion to cold. As for the mouth hanging open and the front teeth dry — the teeth are the essence of the bones, and their being dry now is heat in the bones. Needle and medicine cannot treat it; dazhui should be moxaed.
Clinical note임상 주석
Zhongjing's description of sunstroke is the best clinical paragraph in the chapter, and two of its details are worth singling out. The mouth hanging open with the front teeth dry is a patient mouth-breathing and profoundly dehydrated — the one sign in the whole chapter that can be seen from across a room, and the commentary's inference from it, that the heat has reached the bone, is the tradition's way of saying this is now deep and dangerous. And the three contraindications are correct in every particular: do not sweat him, do not warm him, do not purge him. Each would worsen a volume-depleted patient, and Zhongjing names the consequence of each. The grimy face of the Immun's four-word summary is salt dried on the skin.

Ungi 雲歧

2.5 Emergency Rescue in Summerheat Stroke 中暑救急

2.5.1
Source원문

夏月在道中中熱暍死者, 急扶在陰涼處, 取途中熱塵土積死人心, 又積臍上作窩, 令人尿其中, 卽活. 《三因》

Translation영역
For one struck down and killed by heat on the road in the summer months, quickly support him into a shaded cool place, take hot dust and earth from the road and heap it on the dead man's chest, and heap more on the navel to make a hollow, and have someone urinate into it, and he revives.

Samin Geukil Byeongjeungbangnon 三因

2.5.2
Source원문

中暑悶倒, 急扶在陰涼處, 切不可與冷水. 以布巾衣物蘸熱湯熨臍中及氣海, 續以熱湯淋布上, 令煖徹臍腹, 卽漸醒. 如倉卒無湯, 掬道上熱土積於臍上, 冷則易之. 《三因》

Translation영역
For summerheat stroke with oppression and collapse, quickly support him into a shaded cool place, and on no account give him cold water. Dip a cloth or garment in hot water and press it on the navel and at qihai, and keep pouring hot water over the cloth so that the warmth penetrates the navel and abdomen, and he gradually comes round. If in the haste there is no hot water, scoop up hot earth from the road and heap it on the navel, changing it when it cools.

Samin Geukil Byeongjeungbangnon 三因

2.5.3
Source원문

凡覺中暑, 急嚼生薑一大塊, 冷水送下. 如已迷悶, 嚼大蒜一大瓣, 冷水送下; 不能嚼, 水硏灌之. 或灌人尿半椀, 或車輪土 五錢, 冷水調ㆍ澄淸飮之. 《丹心》

Translation영역
Whenever summerheat stroke is felt coming on, quickly chew a large piece of fresh ginger and send it down with cold water. If he is already confused and oppressed, chew a large clove of garlic and send it down with cold water; and if he cannot chew, grind it in water and pour it in. Or pour in half a bowl of human urine; or take 5 don of earth from a cart wheel, stir it into cold water, let it settle and drink the clear part.

Dangye Simbeop 丹心

2.5.4
Source원문

中暑發昏, 以新汲水滴兩乳, 以扇扇之; 重者地漿灌之, 卽醒. 若與冷水飮, 卽死. 《四要》

Translation영역
For summerheat stroke with clouding, drip newly drawn water on the two nipples and fan him; in the severe case pour in earth broth and he wakes at once. But if cold water is given him to drink, he dies.

Uihak Sayo 四要

2.5.5
Source원문

中暑昏悶ㆍ痰壅ㆍ不省, 至聖來復丹《方見寒門》爲末, 井水調下. 《丹心》

Translation영역
For summerheat stroke with clouding and oppression, phlegm congesting and loss of awareness, powder Jiseong-naebok-dan and take it stirred into well water.

Dangye Simbeop 丹心

2.5.6
Source원문

中暑不省, 皂莢(燒)ㆍ甘草(炒)爲末, 每二錢, 溫水調下. 《得效》

Translation영역
For summerheat stroke with loss of awareness, powder burnt gleditsia pod and stir-fried licorice and take 2 don each time stirred into warm water.

Uibang Yuchwi 得效

2.5.7
Source원문

中暑神昏ㆍ驚悸ㆍ妄言, 辰砂益元散《方見寒門》井水調下 二錢. 《入門》

Translation영역
For summerheat stroke with the spirit clouded, fright palpitations and wild speech, take 2 don of Jinsa-igwon-san stirred into well water.
Clinical note임상 주석
Four of the instructions here are exactly right and have not changed: get him into the shade, do not give cold water to drink, cool the skin with water and fanning, and apply warmth to the abdomen. Evaporative cooling by wetting the skin and fanning is still the recommended field treatment for heat stroke, and the warning against cold water by mouth — stated twice, and once with the flat claim that it kills — reflects the real risk of vomiting and aspiration in a confused patient. Against that stands the roadside dust heaped on the chest and the urine poured into a hollow at the navel, which is folk practice of the plainest kind, and the earth broth, which is clay water settled and decanted. The ginger chewed at the first warning is interesting on its own: something chewed and swallowed with cold water at the onset is a sensible way to test whether a man can still protect his airway.

Uihak Immun 入門

2.6 Distinguishing Sunstroke from Heat Stroke 中暍中熱之辨

2.6.1
Source원문

仲景傷寒論中一證曰中暍, 卽中暑也. 脉虛而微弱ㆍ煩渴引飮ㆍ體熱自汗, 宜淸暑益氣湯等補益之劑. ○一證曰熱病, 卽中熱也. 脉洪而緊盛ㆍ頭痛ㆍ身熱ㆍ口燥ㆍ心煩, 宜白虎湯等淸涼之劑. 《正傳》

Translation영역
One pattern in Zhongjing's Shanghanlun is called sunstroke, which is summerheat stroke. The pulse is vacuous and faintly weak, there is vexing thirst and drinking, a hot body and spontaneous sweating, and supplementing prescriptions such as Cheongseo-ikgi-tang are appropriate. Another pattern is called heat disease, which is heat stroke. The pulse is surging, tight and exuberant, with headache, a hot body, a parched mouth and a vexed heart, and cooling prescriptions such as Baekho-tang are appropriate.

Uihak Jeongjeon 正傳

2.6.2
Source원문

靜而得之爲中暑. 中暑者, 陰證, 當發散也. 或避暑於深堂大厦得之, 其證必頭痛ㆍ惡寒ㆍ身形拘急ㆍ肢節疼痛而煩心ㆍ肌膚大熱無汗, 爲房室之陰寒所遏ㆍ使周身陽氣不得伸越. 宜蒼朮白虎湯《方見寒門》, 或六和湯加羌活ㆍ川芎ㆍ蒼朮, 或二香散. 《東垣》

Translation영역
Got in stillness, it is summerheat stroke. Summerheat stroke is a yin pattern and should be broken out and dispersed. It may be got while avoiding the heat in a deep hall or a great mansion, and its pattern is certainly headache, aversion to cold, the body's form tight and urgent, aching limb joints with a vexed heart, and the flesh and skin greatly hot without sweating — the yin cold of the chamber having checked it so that the yang qi of the whole body cannot stretch out and pass. Changchul-baekho-tang is appropriate, or Yukhwa-tang with notopterygium, chuanxiong and atractylodes lancea added, or Ihyang-san.

Dongwon 東垣

2.6.3
Source원문

動而得之爲中熱. 中熱者, 陽證, 爲熱傷元氣也. 若行人或農夫於日中勞役得之, 其證必苦頭痛ㆍ發躁熱ㆍ惡熱ㆍ捫之肌膚大熱ㆍ必大渴引飮ㆍ汗大泄ㆍ無氣以動, 乃爲天熱外傷肺氣. 宜人參白虎湯ㆍ竹葉石膏湯《二方幷見寒門》. 《東垣》

Translation영역
Got in motion, it is heat stroke. Heat stroke is a yang pattern and is heat injuring the original qi. It may be got by a traveller or a farmer labouring in the middle of the day, and its pattern is certainly a distressing headache, agitation and heat, aversion to heat, the flesh and skin greatly hot to the touch, great thirst and drinking without fail, sweat pouring out and no qi left to move with — this is heaven's heat injuring the lung qi from without. Insam-baekho-tang or Jukyeop-seokgo-tang are appropriate.
Clinical note임상 주석
The chapter's finest piece of reasoning and the one worth the whole of it. Heat taken in stillness and heat taken in motion are different illnesses: the man who sheltered from the sun in a cool shaded hall comes in with chills, body ache, tight limbs and a hot dry skin, and is given warm aromatics; the traveller or the farm labourer who worked through noon comes in with a pounding head, burning skin, desperate thirst, pouring sweat and no strength left, and is given gypsum. That is very close to the modern separation of heat exhaustion from exertional heat stroke, and the social detail — who gets which, and where — is what makes the distinction usable. Li Dongyuan's explanation, that the cold of the chamber checked the yang so it could not get out, is wrong; his observation that the two groups of patients present oppositely and need opposite treatment is right, and treating the exertional case with cooling and fluid is still the correct answer.

Dongwon 東垣

2.7 In Summerheat the Qi Should Be Supplemented 夏暑宜補氣

2.7.1
Source원문

人與天地同一槖籥. 子月一陽生, 寅月三陽生, 巳月六陽生, 陽盡出於上, 此氣之浮也. 人之腹屬地, 氣於此時浮於肌表ㆍ散於皮毛, 腹中之陽虛矣. 世言夏月伏陰在內, 此陰字有虛之義; 若作陰冷看, 其誤甚矣. 火令之時ㆍ流金爍石, 何陰冷之有? 孫眞人製生脉散令人夏月服之, 非虛而何? 《東垣》

Translation영역
Man and heaven and earth are one and the same bellows. In the eleventh month one yang is born, in the first month three yang, in the fourth month six yang, and the yang has wholly come out above — this is the floating of the qi. A man's belly belongs to earth, and at this season the qi floats to the flesh and surface and scatters into the skin and hair, and the yang within the belly is vacuous. The world says that in the summer months hidden yin lies within; this word yin carries the sense of vacuity, and to read it as yin cold is a grave error. At the season when fire holds office, when metal flows and stone is scorched, where is there yin cold? Master Sun made Saengmaek-san for men to take in the summer months — and if not for vacuity, then for what?

Dongwon 東垣

2.7.2
Source원문

宜生脉散ㆍ淸氣飮ㆍ參薷飮ㆍ黃芪湯ㆍ黃芪人參湯ㆍ淸暑益氣湯ㆍ十味香薷飮.

Translation영역
Saengmaek-san, Cheonggi-eum, Samyu-eum, Hwanggi-tang, Hwanggi-insam-tang, Cheongseo-ikgi-tang or Simmi-hyangyu-eum are appropriate.
Clinical note임상 주석
Li Dongyuan correcting a popular error, and the correction is a piece of philology: people say hidden yin lies within in summer, and they take yin to mean cold, when it means vacuity. At the season when metal flows and stone is scorched, where is there cold? His own account — the yang has all gone to the surface and the belly is left empty — is not physiology, but what it leads to is sound practice. A man working through a hot summer is depleted, not chilled and not simply overheated, and giving him ginseng, astragalus and ophiopogon rather than cold bitter drugs is the better treatment. The whole supplementing wing of this chapter, seven formulas, rests on this paragraph.

Donguibogam · Seo

2.8 Summerheat Has Three Patterns — Braving It, Being Struck by It, and Being Injured by It 暑有冒暑中暑傷暑三證

2.8.1
Source원문

其腹痛ㆍ水瀉者, 胃與大腸受之; 惡心ㆍ嘔吐者, 胃口有痰飮. 此冒暑也. 宜用黃連香薷散ㆍ淸暑六和湯ㆍ消暑十全飮ㆍ解暑三白散.

Translation영역
Where there is abdominal pain and watery diarrhoea, the stomach and large intestine have received it; where there is nausea and vomiting, there is phlegm-rheum at the stomach's mouth. This is braving summerheat. Hwangryeon-hyangyu-san, Cheongseo-yukhwa-tang, Soseo-sipjeon-eum or Haeseo-sambaek-san should be used.

Donguibogam · Seo

2.8.2
Source원문

其身熱ㆍ頭疼ㆍ躁亂不寧, 或身如鍼刺者, 此爲熱傷在肉分, 此傷暑也. 宜用人參白虎湯ㆍ小柴胡湯《二方幷見寒門》.

Translation영역
Where there is a hot body, headache, agitation and disquiet, or the body feels as though pricked with needles, the heat has done its injury in the flesh division — this is being injured by summerheat. Insam-baekho-tang or Sosiho-tang should be used.

Donguibogam · Seo

2.8.3
Source원문

其咳嗽ㆍ發寒熱ㆍ盜汗不止ㆍ脉數者, 熱在肺經, 此中暑也. 宜用淸肺生脉飮ㆍ白虎湯ㆍ益元散. 《丹心》

Translation영역
Where there is cough, chills and fever, night sweating that will not stop and a rapid pulse, the heat is in the lung channel — this is being struck by summerheat. Cheongpye-saengmaek-eum, Baekho-tang or Igwon-san should be used.
Clinical note임상 주석
A third classification, cutting across the two already given, and this one sorts by organ: the stomach and intestine case with pain and diarrhoea, the flesh case with burning and prickling skin, and the lung case with cough and night sweats. The prickling skin of the second is worth noting — it is the sensation patients describe in heat rash and in the early stage of heat illness, and the chapter has a word for it. Dangye's use of 中暑 here for the lung case contradicts Li Dongyuan's use of the same term two sections earlier for the quiet-shade case, and the Bogam prints both without comment, which is a fair warning that the chapter's three vocabularies do not reconcile.

Dangye Simbeop 丹心

2.9 Summerheat Wind 暑風

2.9.1
Source원문

中暑復傷風ㆍ搐搦ㆍ不省人事者, 宜先服蘇合香元《方見氣門》, 候其蘇省, 乃與他藥. 《得效》

Translation영역
For one struck by summerheat and then injured by wind, with convulsion and loss of consciousness, Sohaphyang-won should be taken first, and when he has come round other medicines may be given.

Uibang Yuchwi 得效

2.9.2
Source원문

暑風ㆍ暑厥者, 但以手足搐搦爲風ㆍ手足逆冷爲厥. 幷宜二香散, 或人參羌活散《方見小兒》合香薷散服之. 《入門》

Translation영역
As to summerheat wind and summerheat reversal: convulsion of the hands and feet is wind, and the hands and feet reversed and cold is reversal. For both, Ihyang-san is appropriate, or Insam-ganghwal-san combined with Hyangyu-san.

Uihak Immun 入門

2.9.3
Source원문

夏月感寒者, 乃取涼之過也. 或納涼於涼亭水閣ㆍ風寒以傷其外, 又食氷雪生冷苽果以傷其內. 其證頭疼ㆍ身痛ㆍ發熱惡寒, 或胸腹痛ㆍ嘔吐泄瀉. 宜藿香正氣散《方見寒門》去白朮代蒼朮加羌活. 若感暑風ㆍ痰塞ㆍ喘急, 六和湯倍半夏加羌活ㆍ川芎. 《醫鑑》

Translation영역
One affected by cold in the summer months has it from excess in taking the cool. He may take the cool in a cool pavilion or a waterside gallery, so that wind and cold injure him without; and he eats ice and snow and raw cold melons and fruit, so that they injure him within. The pattern is headache, body pain, fever with aversion to cold, or chest and abdominal pain with vomiting and diarrhoea. Gwakhyang-jeonggi-san with the atractylodes replaced by atractylodes lancea and notopterygium added is appropriate. If summerheat wind is contracted with phlegm blocking and hurried panting, Yukhwa-tang with the pinellia doubled and notopterygium and chuanxiong added.
Clinical note임상 주석
Convulsion is wind and cold limbs are reversal — two outcomes of the same heat illness separated by a single sign, and both are real: seizures occur in severe hyperthermia and cold extremities are the mark of circulatory collapse. The third passage is the chapter's most socially specific and most modern-sounding: the illness of taking the cool too far. A cool pavilion, a waterside gallery, iced drinks and raw fruit, and then headache, body ache, chills and diarrhoea. Anyone who has spent a summer moving between air conditioning and the street will recognize both the behaviour and the result, and the treatment — a warm aromatic formula for the stomach — is what a practitioner would still reach for.

Uihak Jeonggam 醫鑑

2.10 Summerheat with Vexing Thirst 暑熱煩渴

2.10.1
Source원문

身熱ㆍ自汗ㆍ煩渴引飮, 卽中暍也. 宜人參白虎湯ㆍ竹葉石膏湯《方幷見寒門》ㆍ益元散ㆍ玉露散ㆍ黃連香薷散ㆍ淸肺生脉飮ㆍ桂苓甘露飮ㆍ通苓散ㆍ濯熱散ㆍ醍醐湯ㆍ春澤湯.

Translation영역
A hot body, spontaneous sweating and vexing thirst with drinking — this is sunstroke. Insam-baekho-tang, Jukyeop-seokgo-tang, Igwon-san, Ongno-san, Hwangryeon-hyangyu-san, Cheongpye-saengmaek-eum, Gyeryeong-gamro-eum, Tongryeong-san, Takyeol-san, Jeho-tang or Chuntaek-tang are appropriate.
Clinical note임상 주석
Eleven formulas for one complaint, which makes this the chapter's largest prescribing section, and the eleven divide into three quite different approaches. The mineral powders — Igwon-san, Ongno-san, Gyeryeong-gamro-eum — cool and drain through the urine. The moistening formulas replace fluid. And Takyeol-san does the opposite of both, astringing with alum and mume to stop the loss. A physician choosing among them had to decide whether his patient was hot, dry or leaking, and the chapter gives him the means for each.

Donguibogam · Seo

2.11 Summerheat Disease with Vomiting and Diarrhoea 暑病吐瀉

2.11.1
Source원문

暑毒入腸胃, 致腹痛ㆍ惡心ㆍ嘔吐ㆍ泄瀉. 宜香薷散ㆍ六和湯ㆍ消暑十全飮ㆍ解暑三白散ㆍ香薷湯ㆍ香朴飮子ㆍ縮脾飮ㆍ大順散ㆍ桂苓元.

Translation영역
Summerheat toxin enters the stomach and intestines and brings on abdominal pain, nausea, vomiting and diarrhoea. Hyangyu-san, Yukhwa-tang, Soseo-sipjeon-eum, Haeseo-sambaek-san, Hyangyu-tang, Hyangbak-eumja, Chukbi-eum, Daesun-san or Gyeryeong-won are appropriate.
Clinical note임상 주석
Nine formulas, and the last two are the interesting ones: Daesun-san and Gyeryeong-won are warming prescriptions standing at the end of a list of cooling ones, for the patient whose summer diarrhoea came from iced drinks and cold food rather than from the heat itself. The chapter's willingness to treat a summer illness with dried ginger and cassia is its most useful departure from the obvious, and the 暑熱通治藥 section further on explains why: most summer stomach illness is cold taken in to relieve heat.

Donguibogam · Seo

2.12 The Pattern of Latent Summerheat 伏暑證

2.12.1
Source원문

伏暑之證, 背寒ㆍ面垢ㆍ少有勞身卽熱ㆍ口開ㆍ前板齒燥ㆍ小便已灑灑然ㆍ毛聳. 《仲景》

Translation영역
The pattern of latent summerheat: a cold back, a grimy face, the body growing hot on the slightest exertion, the mouth hanging open, the front teeth dry, a shiver after passing urine and the hairs standing up.

Junggyeong 仲景

2.12.2
Source원문

伏暑者, 卽冒暑久而藏伏三焦腸胃之間, 變出寒熱往來ㆍ霍亂吐瀉ㆍ瘧痢ㆍ煩渴, 或腹痛下血. 宜酒蒸黃連丸ㆍ消暑元ㆍ桂苓甘露散. 《入門》

Translation영역
Latent summerheat is braving summerheat long continued, so that it is stored and lies hidden between the triple burner and the stomach and intestines, and emerges transformed as chills and fever coming and going, sudden turmoil with vomiting and diarrhoea, malaria and dysentery, and vexing thirst, or abdominal pain with blood passed below. Jujeung-hwangryeon-hwan, Soseo-won or Gyeryeong-gamro-san are appropriate.

Uihak Immun 入門

2.12.3
Source원문

每於夏月復發者, 爲伏暑也. 《入門》

Translation영역
One who relapses every summer has latent summerheat.
Clinical note임상 주석
The category is a theoretical convenience and the observation behind it is nonetheless real: some people are ill every summer, and the same complaints come back each year. The tradition explained that by supposing the heat of a previous summer had lodged in the body and lay hidden until the season brought it out again, which is wrong; but the symptom list — recurring chills and fever, diarrhoea, dysentery, thirst, blood in the stool — is a fair description of the chronic enteric and parasitic illness that in fact recurs with the warm season, and dysentery and malaria are named in it outright. The one sharp diagnostic line is the last: relapse every summer is what defines it.

Uihak Immun 入門

2.13 Summer-Pouring Disease 注夏病

2.13.1
Source원문

人有遇春末夏初ㆍ頭痛ㆍ脚弱ㆍ食少ㆍ體熱, 世俗謂之注夏病, 屬陰虛ㆍ元氣不足. 宜補中益氣湯去升ㆍ柴, 加黃栢ㆍ白芍藥ㆍ麥門冬ㆍ五味子; 有痰加天南星ㆍ半夏. 《丹心》

Translation영역
There are people who at the end of spring and the beginning of summer have headache, weak legs, poor appetite and a hot body, and the world calls it summer-pouring disease; it belongs to yin vacuity with insufficient original qi. Bojungikgi-tang with the cimicifuga and bupleurum removed and phellodendron, white peony, ophiopogon and schisandra added is appropriate; where there is phlegm, add arisaema and pinellia.

Dangye Simbeop 丹心

2.13.2
Source원문

宜服生脉散及參歸益元湯. 《丹心》

Translation영역
Saengmaek-san and Samgwi-ikwon-tang should be taken.
Clinical note임상 주석
A seasonal syndrome with a popular name, which the Bogam records as the world's word for it: late spring and early summer, headache, weak legs, no appetite, a feeling of heat. That is heat intolerance in a depleted person at the turn of the season, and it is a real complaint — the first hot weeks of the year are harder than the hot months that follow, before any acclimatization. The treatment is Li Dongyuan's central-qi formula with its two lifting drugs taken out, which is the right modification: nothing needs raising in a patient whose trouble is that he is already hot and dry.

Dangye Simbeop 丹心

2.14 The Method of Managing Oneself in Summerheat 夏暑將理法

2.14.1
Source원문

衛生歌曰, 四時惟夏難將攝, 伏陰在內腹冷滑. 補腎湯藥不可無, 食飮稍冷休哺啜. 心旺腎衰何所禁, 特忌踈泄通精氣. 寢處惟宜謹密間, 黙靜志慮和心意. 氷漿菜茹不宜人, 必到秋來成瘧痢.

Translation영역
The Song of Hygiene says: of the four seasons it is summer alone that is hard to manage, for hidden yin lies within and the belly is cold and loose. Decoctions to supplement the kidney must not be lacking; and when food and drink are somewhat cold, stop and do not sup them. With the heart flourishing and the kidney declining, what is to be forbidden? Above all, avoid loosening and discharging and letting the essential qi pass out. For sleeping and resting, only a carefully closed room will do; keep the thoughts silent and still and the mind harmonious. Iced drinks and raw vegetables do not suit a man — he will surely come to malaria or dysentery when autumn arrives.

Wisaengga 衛生歌

2.14.2
Source원문

凡盛暑衝熱, 切不可以冷水洗手面, 大損人目. 《活人》

Translation영역
Whenever one has been exposed to heat in the height of summer, on no account wash the hands and face with cold water; it greatly damages the eyes.

Hwarinseo 活人

2.14.3
Source원문

夏一季是人脫精神之時. 心旺腎衰ㆍ腎化爲水, 至秋始凝ㆍ及冬乃堅. 是故尤愼房室ㆍ固養精氣. 《活人》

Translation영역
The one season of summer is the time when a man sheds his spirit. The heart flourishes and the kidney declines, and the kidney turns to water, which only congeals at autumn and hardens at winter. Therefore be especially careful of the bedchamber and guard and nourish the essential qi.

Hwarinseo 活人

2.14.4
Source원문

三伏之時ㆍ大熱傷氣, 養生家於此時尤愼之. 若縱酒恣色, 則令人內腎腐爛而死. 《入門》

Translation영역
In the season of the three fu periods the great heat injures the qi, and those who cultivate life are especially careful at this time. If a man gives himself to wine and licence, it will make his inner kidney rot and he will die.

Uihak Immun 入門

2.14.5
Source원문

人之心包絡與胃口相應. 胃氣稍虛, 或因飢冒暑, 則暑毒自口鼻而入, 凝之於牙頰ㆍ達之於心包, 如響應聲. 遇暑以還, 急漱口而勿嚥可也. 《直指》

Translation영역
A man's heart envelope and the mouth of the stomach answer to each other. When the stomach qi is somewhat vacuous, or when he braves the heat on an empty stomach, the summerheat toxin enters by the mouth and nose, congeals at the teeth and cheeks and reaches the heart envelope as an echo answers a sound. On coming in from the heat, it is well to rinse the mouth at once and not swallow.

Injae Jijibang 直指

2.14.6
Source원문

虛人及老人中暑迷厥不省, 宜竹葉石膏湯《方見寒門》加附子, 冷服之. 《回春》

Translation영역
For the vacuous and the aged struck by summerheat with confusion, reversal and loss of awareness, Jukyeop-seokgo-tang with aconite added should be taken cold.

Manbyeong Hoechun 回春

2.14.7
Source원문

太倉公辟瘟丹, 暑濕之月燒之, 能辟邪散氣. 方見瘟疫 《回春》

Translation영역
Daechanggong-byeogon-dan: burnt in the months of summerheat and damp, it can ward off evils and disperse their qi.
Clinical note임상 주석
A section of seasonal hygiene, and three of its rules are good. Do not sup cold food and drink; avoid iced drinks and raw vegetables, or you will have dysentery by autumn — which is the best single piece of public-health advice in the chapter, since raw food and unsafe cold water are precisely how summer enteric disease is acquired. Do not wash the face in cold water straight out of the heat. And rinse the mouth without swallowing when coming in from the sun, on an empty stomach especially. That last one has an odd elegance: the man is thirsty, his stomach is weak, and he is told to take the water into his mouth and spit it out — which is what a modern coach tells an athlete who cannot yet drink safely. The warnings about the bedchamber and the rotting kidney belong to the cultivation-of-life literature. The one prescription here is the strangest in the chapter: gypsum and bamboo leaf with aconite added, taken cold, for an old or depleted patient in heat collapse — cooling and warming at once, for a patient who is both overheated and shutting down.

Manbyeong Hoechun 回春

2.15 Medicines That Treat Summerheat Generally 暑熱通治藥

2.15.1
Source원문

治暑之法, 淸心ㆍ利小便最好. 暑傷氣, 宜補眞氣爲要. 《丹心》

Translation영역
As to the method of treating summerheat, clearing the heart and freeing the urine are best. Summerheat injures the qi, and supplementing the true qi is essential.

Dangye Simbeop 丹心

2.15.2
Source원문

夏月多食冷物ㆍ過飮茶水氷漿, 致傷脾胃ㆍ吐瀉霍亂. 故治暑藥多用溫脾ㆍ消食ㆍ治濕ㆍ利小便之藥, 須要識此意. 《丹心》

Translation영역
In the summer months people eat much cold food and drink too much tea, water and iced drinks, and so injure the spleen and stomach and have vomiting, diarrhoea and sudden turmoil. Therefore the medicines for summerheat much use drugs that warm the spleen, disperse food, treat damp and free the urine — this intention must be understood.

Dangye Simbeop 丹心

2.15.3
Source원문

病暑者多無身痛; 間有痛者, 或爲澡浴水濕相搏耳. 《入門》

Translation영역
Those ill of summerheat mostly have no body pain; where there is pain now and then, it is from bathing, the water and damp contending with each other.

Uihak Immun 入門

2.15.4
Source원문

暑病通用香薷散ㆍ淸暑和中散ㆍ萬病無憂散.

Translation영역
For summerheat disease generally, Hyangyu-san, Cheongseo-hwajung-san or Manbyeong-muu-san are used.
Clinical note임상 주석
The second passage is the key to the whole chapter's pharmacy, and it explains what otherwise looks like a contradiction. Why is a chapter on heat illness full of warming aromatics, digestives and diuretics? Because most of the stomach trouble people bring in during summer was not caused by the heat but by what they did about it — cold food, too much tea and water, iced drinks. Treat the consequence, not the season. That is a genuinely good clinical observation, and the chapter's willingness to state it plainly, against its own name, is the mark of a compiler who had seen the patients. The absence of body pain in the first line is also a real differential: it separates summerheat from the cold-damage patterns, where aching is the rule.

Donguibogam · Seo

2.16 Simples 單方

2.16.1
Source원문

凡五種.

Translation영역
Five kinds in all.

Donguibogam · Seo

2.16.2
Source원문

石膏 天氣暑熱時得病, 以石膏爲主治. 碎一兩, 煮取汁服, 卽差. 《仲景》

Translation영역
Gypsum (石膏): For an illness contracted when the weather is hot with summerheat, gypsum is the sovereign treatment. Crush 1 nyang, boil it, take the liquid and drink, and it is cured.
Clinical note임상 주석
Five simples only, the shortest section of its kind in the book, and gypsum heads it as the cooling mineral for a hot season. 中暑, summerheat strike, covers everything from heat exhaustion to heat stroke, and the distinction is the one that matters: heat exhaustion is treated by moving the person into shade, cooling them and replacing salt and water, while heat stroke — a core temperature above 40 degrees with confusion or collapse — is a medical emergency in which active cooling must begin within minutes.

Junggyeong 仲景

2.16.3
Source원문

香薷 主一切暑病, 及霍亂吐瀉. 煮取汁服之, 生服亦佳. 《本草》

Translation영역
Elsholtzia (香薷): Governs every kind of summerheat illness, and sudden turmoil with vomiting and diarrhoea. Boil it, take the liquid and drink; taking it raw is also good.
Clinical note임상 주석
香薷 is the summer drug of East Asian practice — the chief ingredient of 香薷散 and of the whole family of formulas written for hot weather — and its pairing with 霍亂, sudden turmoil, is the clue to what the chapter is actually seeing: summer diarrhoea and vomiting, which is to say food-borne infection in the hot months. The treatment for that is fluid and salt replacement, and in a child or an older person it is urgent.

Boncho 本草

2.16.4
Source원문

大蓼 卽葒草也. 治熱暍心悶. 煮取濃汁飮之. ○夏月暍死, 亦灌之. 《本草》

Translation영역
Water pepper (大蓼): That is, the red-flowered knotweed. Treats heat prostration with oppression of the heart. Boil it, take the strong liquid and drink it. ○ For one struck dead by heat in the summer months, pour it in as well.
Clinical note임상 주석
暍死, struck dead by heat, is heat stroke with collapse, and the chapter is right that it kills. Pouring a decoction into an unconscious person is the worst thing to do — it goes into the lungs — and the actual treatment is to get them out of the heat, strip them, wet the skin and fan it, or immerse them in cold water, and call for help. Cooling first, everything else after.

Boncho 本草

2.16.5
Source원문

甛瓜 暑月食之, 不中暑氣. 少食之佳. 《本草》

Translation영역
Oriental melon (甛瓜): Eaten in the hot months one is not struck by summerheat qi. Eating a little of it is good.
Clinical note임상 주석
The one piece of prevention in the section, and the best advice in it: eat melon in hot weather. A melon is water and sugar and potassium, which is close to what a person sweating through a Korean August actually needs, and 少食之佳 — a little is good — is the compiler hedging against the cold, wet nature he would otherwise have to warn about.

Boncho 本草

2.16.6
Source원문

馬通 臘月馬糞乾者, 煎湯飮之. 治一切暑病. 《俗方》

Translation영역
Horse dung (馬通): Dried horse dung from the twelfth month, decocted and drunk. Treats every kind of summerheat illness.
Clinical note임상 주석
**This is not to be used.** Animal dung carries salmonella, E. coli and tetanus spores. 臘月, the twelfth month, is specified because dung gathered in the depth of winter was held to carry the cold of the season into a summer illness — the coldest possible drug for the hottest possible complaint. It is the section's only piece of pure correspondence, and the Sokbang attribution marks it as Korean folk practice rather than a classical prescription.

Sokbang 俗方

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Miscellaneous Disorders, Volume 3, Summerheat chapter. The Chinese text is collated against a transcription of the Kyujanggak printed edition carrying its leaf numbers and first-edition collation notes; original character forms (脉, 人參) are retained. Terminology follows Wiseman & Feng, A Practical Dictionary of Chinese Medicine. Translation and clinical notes are original to this site. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.