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When heat from summerheat is severe, presenting with a scorched tongue, coma, delirious speech, inappropriate laughter, picking at bedclothes, grasping at empty air, and finger movements resembling sorting threads, this indicates pathogenic excess and righteous deficiency. It is appropriate to use Renshen Guben Tang (Ginseng Root Decoction for Securing the Foundation) added with Muli (Oyster Shell), Baishao (White Peony Root), Xuanshen (Scrophulariae Radix), Xian Shihu (Fresh Dendrobii Caulis), Xian Changpu (Fresh Acori Tatarinowii Rhizome), Lingjiao (Antelopis Cornu), and Gouteng (Uncariae Ramulus cum Uncis) to support the righteous qi and expel the pathogen.

This passage discusses blazing heat in the Ying (Nutritive) and Xue (Blood) levels, hence the black tongue, coma, and delirium. Extreme heat injures Yin, causing the loss of True Yuan (Original Qi), leading to picking at bedclothes and grasping at empty air, which are signs of critical danger. Recent practitioners attribute these symptoms to extreme heat in the Pericardium, failing to realize that this is actually severe injury to Kidney Yang, where Water fails to control Fire, generating internal Wind through Yang transformation, causing continuous turmoil, reflecting a state of Failure of Water and Fire to Interact. It is appropriate to use Renshen (Ginseng), Dihuang (Rehmanniae Radix - both Sheng and Shu), Donggu (Asparagi Radix and Ophiopogonis Radix), Gancao (Licorice Root), Muli (Oyster Shell), and Baishao (White Peony Root) to tonify Yin and assist Yang, combined with Lingjiao (Antelopis Cornu) and Gouteng (Uncariae Ramulus cum Uncis) to clear the collaterals and extinguish wind, thereby preserving life by a narrow margin.

After many days of summerheat illness, with a yellow, scorched, or black tongue, constipation, hardness and pain in the lower abdomen, and frequent passing of gas (Zhuan Shi Qi), this indicates dry fecal impaction. It is appropriate to use Xiao Chengqi Tang (Minor Order the Qi Decoction) added with Yuanmingfen (Mirabilite), Xian Shihu (Fresh Dendrobii Caulis), Xuanshen Xin (Center of Scrophulariae Radix), Xian Changpu (Fresh Acori Tatarinowii Rhizome), and Sheng Shouwu (Prepared Polygoni Multiflori Radix) to resolve internal accumulation and preserve Stomach fluids.

A red tongue body with yellow coating turning scorched black, resembling the color of agarwood, indicates true blackness due to Kidney Yin depletion. After prolonged heat scorching, fluids are exhausted and pathogens stagnate; it is difficult to resolve via sweating or cooling purgation. With constipation and abdominal hardness, accompanied by frequent passing of gas, this corresponds to Zhang Zhongjing's statement: "Frequent passing of gas indicates dry feces." Urgently use Xiao Chengqi Tang combined with Yuanmingfen (Mirabilite) and Sheng Shouwu (Prepared Polygoni Multiflori Radix), imitating Zhang Zhongjing's method of "urgent purgation to preserve fluids," which neither damages the Stomach nor fails to resolve accumulation, making it highly appropriate.

Following vomiting and diarrhea during summerheat illness, with a yellow and greasy tongue coating and discomfort in the chest and diaphragm, this indicates Yang pathogens sinking inward, predisposing to Pi Syndrome (Stagnation). It is appropriate to use Banxia Xiexin Tang (Pinellia Decoction to Drain the Epigastrium), using bitter drugs to descend and acrid drugs to unblock, preventing the formation of stagnation.

According to Zhang Zhongjing's *Shanghan Li* (Treatise on Cold Damage Examples): Pi Syndrome often arises because exterior pathogens remain unresolved, and premature purgation allows Yang pathogens to sink inward due to deficiency, knotting below the chest. Unable to descend or ascend, long-term obstruction leads to mutual knotting of Yin and Yang, creating a palpable mass in the epigastrium that is non-tender upon pressure, termed Pi Syndrome. Although summer-damp pathogens differ from cold damage initially, the mechanism of sinking into Pi syndrome due to vomiting and diarrhea is the same. Therefore, Huangqin (Scutellariae Radix) and Huanglian (Coptidis Rhizoma) are used for their bitter-cold nature to descend heat, while Jiang (Zingiberis Rhizoma Recens) and Banxia (Pinelliae Rhizoma) are used for their acrid-warm nature to unblock Yang, allowing heat to drain and Yang to flow freely, causing the Pi Syndrome to dissipate spontaneously.