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In cases of latent summerheat (Latent Summerheat) presenting with fever, severe asthma (Asthma) preventing lying flat, hoarse phlegm sounds, and a stiff, oppressive sensation in the chest, this indicates summerheat stagnation obstructing the lung collaterals.
It is appropriate to use Tingli Dazao Decoction (Celandine and Jujube Decoction) combined with Liuyi Powder (Six-to-One Powder), Loquat Leaf, and other ingredients, to thoroughly clear the lung heat.
The previous clause discussed symptoms of hypochondriac pain, excessive phlegm, and cough; this clause discusses symptoms of chest oppression/stiffness, hoarse phlegm sounds, and asthma, indicating the disease is deeper than mere cough. Although asthma has distinctions between deficiency and excess syndromes, and treatments differ between targeting the Lung and Kidney, in this case, due to the internal emergence of latent summerheat, accompanied by body fever, chest oppression, and hoarse phlegm, the signs must include a yellow and greasy tongue coating, a slippery and rapid pulse, yellow-red urine, and a robust/abundant physique. This constitutes an Excess Syndrome of the Lung (Lung Excess). Therefore, it is suitable to use the bitter-cold nature of Celandine Fruit (Fructus Lepidii) to drain lung heat. However, ancient physicians feared damage to the stomach, so they combined it with the sweet nature of Jujube (Fructus Ziziphus Jujubae) to moderate the effect, allowing the medicine to gradually tame and eliminate the damp-phlegm obstruction in the Upper Jiao. Those who use Celandine Fruit without Jujube fail to understand the core methodology of Zhang Zhongjing. Additionally, combining Liuyi Powder and Loquat Leaf serves to clear qi-level heat and promote diuresis to remove dampness.

Latent summerheat presenting with aversion to cold and fever, fluctuating in intensity and intermittently appearing, resembling malaria but not being malaria, with a white tongue coating and a large pulse, indicates that summerheat is necessarily complicated by dampness. This miasmic, sticky, and turbid pathogen lies latent in the Lung and Stomach. It is appropriate to use Wendan Decoction (Warm the Gallbladder Decoction) added with Apricot Seed (Semen Armeniacae Amarum), Tetrapanacis Medulla (Medulla Tetrapanacis), Artemisiae Annuae Herba (Herba Artemisiae Annuae), and Scutellariae Radix (Radix Scutellariae) to unblock the Stomach Fu organ and vent the pathogen.
Cases of latent summerheat with dampness also have distinctions in severity. In severe cases, the momentum is difficult to delay, and the pathogen emerges suddenly when conditions are ripe; in mild cases, the pathogen remains latent until the autumn dew brings cold air, the wind becomes crisp, yang qi gradually收敛 (converges/retracts), and the interstices (Cou Li) close, leaving no gap for the latent pathogen, which then finally emerges. The manifested symptoms resemble malaria but are not malaria, possibly accompanied by slight aversion to cold or only fever, without distinguishable Six Channel (Six Channels) patterns or separable Exterior-Interior (Exterior and Interior) relationships. A white tongue coating and a large pulse clearly indicate deficient righteous qi and abundant dampness. If the pathogen is not driven out from the middle jiao, it will inevitably transform into a malaria disorder. Therefore, using Wendan Decoction to unblock the Stomach Fu, adding Apricot Seed and Tetrapanacis Medulla to clear the hypochondrium and vent dampness, and adding Scutellariae Radix and Artemisiae Annuae Herba to clear qi-level heat and vent liver fire, allows the pathogen to be completely resolved.

When latent summerheat presents with intense heat, restlessness, delirium, and confusion, worsening at night, with a dry tongue and rapid pulse, this indicates the pathogen has transmitted inward. It is appropriate to use Glehniae Radix (Radix Glehniae), Sweet Apricot Seed (Semen Armeniacae Amarum), Trichosanthis Radix (Radix Trichosanthis), Fritillariae Cirrhosae Bulbus (Bulbus Fritillariae Cirrhosae), Mori Folium (Folium Mori), Rehmanniae Radix Preparata (Radix Rehmanniae Preparata), fresh Acori Tatarinowii Rhizoma (Rhizoma Acori Tatarinowii), Forsythiae Fructus (Fructus Forsythiae), and Yiyuan Powder (Yiyuan Powder) to simultaneously clear both the Ying (Nutrient) and Wei (Defensive) levels.
This passage states that unresolved latent pathogens gradually transform into heat. Restlessness, delirium, and confusion, worsening at night, indicate the pathogen has moved from the Wei level to the Ying level, transitioning from Yang to Yin. Thus, the tongue coating becomes increasingly dry, and the pulse becomes increasingly rapid. Since the pathogen has entered the interior, merely clearing the exterior level is of no benefit. Only by using Glehniae Radix, Apricot Seed, Fritillariae Cirrhosae Bulbus, Trichosanthis Radix, Rehmanniae Radix Preparata, Mori Folium, Forsythiae Fructus, Acori Tatarinowii Rhizoma, and Yiyuan Powder to clear qi-level heat and cool blood can one prevent the pathogen from transmitting into the Blood level, thereby avoiding complications such as coma and convulsions.