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Heatstroke causing fever, a sensation of vexation in the epigastrium, and nausea with a desire to vomit, indicates that summer-heat pathogen has invaded the Upper Jiao (Upper Burner), leading to disharmony between the Lung and Stomach. It is appropriate to use herbs such as Perilla Leaf (Ziye), Agastache Leaf (Huoxiang Ye), White Cardamom Shell (Baikou Qiao), and Humanoid Ash (Renzhongbai) to unblock Lung Qi.

Ancient texts define "Ou" (vomiting with sound but no substance) as having sound without substance, and "Tu" (vomiting without sound but with substance) as having substance without sound. However, "Ou" is associated with the Spleen, while "Tu" is associated with the Stomach. Furthermore, there is a condition characterized by continuous "yaya" sounds, resembling belching but short and abrupt, called "Yue" (hiccups or dry heaves), which also resides in the Stomach; this is essentially hiccups (E'ni), representing a sign of Stomach Qi failure, as stated in the *Neijing*: "When Earth fails, its sound is Yue." Another condition involves continuous "yaya" sounds similar to hiccups but slow and prolonged, called "Yi" (belching), which is associated with the Liver. Currently, the pathogen invades the Upper Jiao and has not yet fully transmitted to the Stomach, manifesting as nausea due to Lung Qi disharmony. Therefore, Ziye, Huoxiang Ye, Bai Zhi, and Kouqiao are used for their acrid, aromatic, light, and thin properties, reaching precisely the Lung level. Renzhongbai is added because summer-heat is inherently a turbid pathogen, employing a turbid agent to attack turbidity (using turbidity to combat turbidity).

Summer-heat causing simultaneous vomiting and diarrhea: if vomiting stops but diarrhea persists, Wei Qin Tang should be used to drain it; if diarrhea stops but vomiting persists, Huanglian Wendan Tang should be used to harmonize it.

When both vomiting and diarrhea occur, the pathogen has distributed itself. Now, if vomiting stops but diarrhea continues, it indicates that the Upper Jiao has been cleared, and the pathogen has shifted downward. Wuling San is used to separate and drain fluids, combined with Pingwei San to drive out dampness. If diarrhea stops but vomiting continues, it indicates the pathogen is in the Middle Jiao. Huanglian Wendan Tang is used, employing bitter descent and acrid unblocking to prevent pathogen stagnation in the Middle Jiao, thereby avoiding the formation of fullness and distension (Pi Zhang), which is crucial.

For summer-heat-induced persistent vomiting and diarrhea, gradually leading to cold extremities (Jue) and cold sweating, and even muscle cramps (Zhuanjin) and numbness, Liuhe Tang is suitable for early stages. In severe cases, Sini Tang is used with additions of Evodia Fruit (Wuyu), Chaenomelum Fructus (Mugua), and Coptis Rhizome (Chuanlian) stir-fried with ginger juice, to warm the Stomach and subdue the Liver.

Whenever summer-heat affects the Spleen, if it manifests in autumn, it becomes Malaria or Dysentery; if it strikes suddenly, it becomes Cholera-like syndrome (Huo Luan). Now, persistent vomiting and diarrhea lead to cold extremities, cold sweat, and weak qi, causing exhaustion of Yang Jin (Yang fluids) and Yin fluids, and damage to Blood, Qi, Ying, and Wei. The body and muscles become sunken rapidly, and muscle cramps and paralysis occur because Blood and Qi cannot reach the four extremities. Urgent large-dose strong tonification of Middle Yang is required, combined with harmonizing Ying and benefiting Qi, hoping to stop vomiting and diarrhea, warm the limbs, and consolidate sweat, which signifies the return of Yang. If dispersing methods are used again, it would be like throwing a stone down a well (exacerbating the condition). Regarding frequent vomiting where medicine is difficult to swallow, due to Yin excess internally rejecting Yang-tonifying drugs, Sini Tang is used with Evodia Fruit and Chaenomelum Fructus to calm the Liver and consolidate fluids. Additionally, 3-4 fen of Coptis Rhizome stir-fried with ginger juice is decocted separately to obtain one cup of liquid, which is dripped into the medicine for drinking. This utilizes similarity to attract, preventing expulsion via vomiting, following the principle of adding human urine and pig bile in Zhang Zhongjing's Baitong Tang. Further observing muscle-cramp Cholera-like syndrome, seen frequently in recent years, even spreading like an epidemic among many simultaneously, although it is a common disease phenomenon, it ultimately results from climatic invasion. Generally, south of the Yangtze River, the terrain is low and air is humid; areas along rivers and coasts have heavier fog, dew, and dampness than elsewhere. Thus, Dampness pathogen causes illness throughout the year, with mountain miasma doubling in summer and autumn. If a person has inherent deficiency of Zheng Qi (Upright Qi), summer-heat, foulness, and damp-turbidity invade through deficiency, entering directly via mouth and nose to the central pathway. Suddenly, chest and abdomen become stuffy and painful, with vexation and restlessness, and inability to vomit or defecate; this belongs to Bi Syndrome (Closed Syndrome) and requires induced vomiting. Conversely, chest and abdominal stuffiness followed immediately by vomiting and diarrhea, even frequent episodes, with cold limbs, profuse sweat, sudden emaciation, muscle cramps, and numbness, belongs to Tuo Syndrome (Collapsing Syndrome) and requires warming and tonification. Because simultaneous vomiting and diarrhea pour out food and water, continuous cold sweat leaks Qi and fluids, exhausting Yang Jin and Yin fluids, damaging Blood, Qi, Ying, and Wei, failing to nourish sinews and vessels, naturally leading to limb joint spasms, numbness, and insensitivity. At this time, urgent large-scale tonification is needed: Fuzi Lizhong Tang to warm and regulate Middle Yang, combined with Evodia Fruit and Chaenomelum Fructus to relax sinews and vent the Liver; or Wu Mei Anwei Wan removing Phellodendron Cortex (Huangbai), doubling Ginseng Radix (Renshen) and Aconite Lateral Root Preparata (Fuzi), which is also an excellent prescription for this indication. I encounter these symptoms often and use this decoction, achieving remarkable effects repeatedly, making it more suitable than using Sini Tang or Lizhong Tang alone.