Library

In the initial stage of Summerheat Injury (Shangshu), characterized by anhidrosis, aversion to cold, headache, feverish sensation in the body, thirst without desire to drink, white tongue coating, and nausea/vomiting, this indicates that pathogenic factors have initially invaded the Wei (Defensive) level. It is appropriate to use Xiangru Yin (Elsholtzia Decoction) with added Xingren (Apricot Seed), Bohe (Mint), Tongcao (Tetrapanax Pith), Dajuan (Soybean Yellow Peel), Lianqiao (Forsythia Fruit), Niuli (Burdock Fruit), and Si Gua Ye (Loofah Leaf). The disease can be resolved through sweating.

(1) Xiangru Yin: The Xiangru Yin referred to in this section follows its formula principle; therefore, in the subsequent annotations, only the sovereign herb Xiangru (Elsholtzia Herba) is selected, while the rest are omitted. This applies similarly to "Fu Shu Tiao Bian Di Yi" (First Section on Differentiating Latent Summerheat).

Summerheat invariably carries dampness and first injures the Qi level. When people sit quietly to enjoy coolness, summer wind attacks the muscle surface, causing Yang to be suppressed by Yin-dampness. The Couli (pores) become closed and stagnant, leading to symptoms such as headache, feverish sensation, aversion to cold, and anhidrosis. If dampness accumulates and transforms into heat, the situation may spread rapidly like a prairie fire. Stomach fluids failing to ascend cause thirst, but internal accumulation of dampness leads to no desire to drink. Loss of Lung Qi dispersion causes irritability and urge to vomit. Combined with a white, greasy tongue coating and a slow, large pulse, these signs indicate the presence of dampness. The treatment uses Xiangru because it is light and floating in texture and warm in nature with dispersing properties, acting as the Ephedra of summer, good at venting the exterior. Adding Xingren benefits the Lung, Bohe and Niuli dispel wind, while Lianqiao, Dajuan, and Tongcao drain dampness and clear heat. Since the pathogen is at the Wei level, it should first be resolved by sweating to prevent transmission to the interior.

After sweating for Summerheat Injury, if the headache decreases but the fever persists, the tongue coating gradually turns yellow, and the pulse becomes flooding with thirst, this indicates that the pathogen was not resolved by sweating and the heat has extended to the Qi level. It is appropriate to use Baihu Tang (White Tiger Decoction) with added Xingren, Tongcao, Lianqiao, Dan Zhuye (Bamboo Leaf), and Pipa Ye (Loquat Leaf). If the headache has not ceased, add Gegen (Kudzu Root) and Bohe for cooling and dispersing.

Continuing from the previous section, since sweating failed to resolve the heat, the exterior pathogen gradually transmits to the Qi level. Thus, the headache decreases, the tongue turns yellow, and the flooding pulse with thirst indicates excessive heat in the Qi level. Baihu Tang is used to directly clear the heat of the Yangming Qi level. If pain in the forehead persists, indicating incomplete elimination of external pathogens, Gegen and Bohe must be added to vent the exterior and dispel wind, as the head is the gathering place of Clear Yang, which cannot be reached without wind-dispelling herbs.