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After prolonged heat from summerheat, one feels no hunger at all; the tongue is dry, appearing red or black, yet lacks a greasy coating. This is known as a "mirror tongue." It results from heat devouring stomach fluids, causing Qi to fail in transforming into fluids. It is appropriate to use American ginseng (Radix Panacis Quinquefolii), Ophiopogon tuber (Ophiopogonis Radix), Huoshan Dendrobium (Dendrobii Officinalis Caulis), Anemarrhena rhizome (Anemarrhenae Rhizoma), White peony root (Paeoniae Radix Alba), Quince fruit (Chaenomelis Fructus), Jian lotus seed flesh (Nelumbinis Semen), fresh rice sprout (Hordei Fructus Germinatus), and licorice root (Glycyrrhizae Radix et Rhizoma). This employs the method of combining sweet and sour flavors to generate Yin.

Following any febrile disease, if the tongue is dry, red, smooth, and devoid of coating, it is termed a mirror tongue. Regardless of the specific condition, nourishing Yin should always be the primary approach. If the tongue is black, dry, and red without coating, this is called "blackness without ground," indicating severe Yin injury and fluid exhaustion. Urgent treatment with sweet-cool Yin-nourishing herbs is required. Thus, American ginseng, licorice, Ophiopogon, and rice sprouts are combined with White peony and Quince to generate Yin via the sweet-sour method, embodying the principle of Jia-Ji transforming into Earth (Spleen-Stomach). If scorched-black color appears with even more intense heat, Rehmannia root (Rehmanniae Radix) and Anemarrhena should be added to moisten Yin and harmonize Yang. Although the methods are thus defined, the subtle application depends entirely on the practitioner's insight.

After many days of summerheat illness, there is no significant fever, the pulse is soft, and spirit is fatigued. The patient remains silent and lethargic, resembling sleep, responding only slightly when called, without irritability. This indicates confusion between pathogenic factors and healthy Qi, with damp-turbidity obscuring the clear orifices, making both clearing and tonifying difficult. One should exclusively use fresh Agastache leaf (Agastaches Herba), fresh rice leaf (Oryzae Sativa Folium), fresh lotus leaf (Nelumbinis Folium), fresh Eupatorium leaf (Eupatorii Herba), fresh Acorus rhizome (Acori Tatarinowii Rhizoma), white cardamom seed (Cardamomi Fructus), and Yiyuan San (Benefit Origin Powder). These employ acrid-cool clearing and resolving methods to transform residual pathogens.

Absence of high fever, soft pulse, and fatigue indicate that the disease is receding. However, silence and desire to sleep, inability to fully awaken upon calling, drinking only when offered but not seeking water otherwise, suggest residual pathogens lingering in the Triple Burner, preventing the free movement of Clear Yang. Clearing would damage Yang, while tonifying would aid dampness, presenting a dilemma. It is best to use fresh Agastache, rice leaves, Eupatorium, lotus leaves, and Acorus, utilizing their light texture and thin aroma to drive out turbidity. Combined with white cardamom and Yiyuan San, they unblock Yang and promote Qi circulation, ensuring healthy Qi is not harmed while dampness is dispelled.

With summerheat, excessive sweating, and persistent fever for over ten days, white miliary pruritus (Bai Fan) appears on the chest and abdomen, resembling crystal grains. This indicates damp-heat transforming and the leakage of Qi and fluids. Urgent treatment requires American ginseng, Forsythia fruit (Forsythiae Fructus), sweet apricot kernel (Armeniacae Semen Amarum), Trichosanthes root (Trichosanthis Radix), wolfberry bark (Lycii Cortex), honeysuckle flower (Lonicerae Japonicae Flos), Ophiopogon, mung bean shell (Phaseoli Radiati Testa), and fresh lotus leaf to clear and nourish Qi and fluids.

Persistent fever and sweating with failure to recover indicate depleted healthy Qi. The appearance of Bai Fan signifies leakage of Qi and fluids; dispersing methods must not be used further to avoid damaging Qi. Instead, American ginseng, Ophiopogon, honeysuckle, and mung bean shell should be used to clear and nourish Qi/fluids while resolving pathogens. If the tongue is red with scanty fluids and food tastes bland, use Fu Mai Tang (Pulse-Recovering Decoction) minus Ginger and Cinnamon Twig to nourish Yin and benefit Qi. If the tongue is pale with scanty coating and the Stomach fails to accept food, use Liu Jun Zi Tang (Six Gentlemen Decoction) plus Oyster shell (Concha Ostreae) and White Peony to support Stomach Qi and astringe Yin. Do not hesitate due to the presence of Bai Fan. Contemporary physicians often treat Bai Fan using methods for Sha syndrome (sand/heat stroke rash). They fail to recognize that Sha syndrome involves Wind-Heat of the Taiyin, while macules/petechiae involve Fire-Toxin of the Yangming. Early faint appearances warrant clearing and venting; once distinct spots appear, resolution and transformation are needed. Even then, aggressive venting is avoided to prevent internal emptiness and pathogen collapse. Bai Fan, however, is a sign of Qi and fluid leakage. Applying dispersing and diaphoretic methods after its appearance risks fatal Qi exhaustion. I have observed that not only young, inexperienced practitioners fall into this error, but even seasoned elderly doctors struggle to discern this distinction. I mention this to seek the opinion of experts.