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Summer heat is scorching and consumes the primordial Qi (Vital Energy). Therefore, illness inevitably presents with fatigue, weak pulse, fever, spontaneous sweating, irritability, a dirty complexion, and cyanotic lips. Li Dongyuan considered that contracting disease through activity is "Zhongre" (Heatstroke), while contracting it through stillness is "Shangshu" (Summerheat Injury), asserting that Heat is Yang and Summerheat is Yin. This is actually inaccurate. Since the character "Shu" (Summerheat) contains the radical for "Sun," Shu is essentially Heat; why must names be distinguished? However, the terms "Activity" and "Stillness" do serve as distinctions of Yin and Yang. Here, we still divide them into "obtained through activity" and "obtained through stillness" to serve as the outline for this syndrome.

What is meant by "obtained through activity"? It refers to illness caused by long journeys under the blazing sun or carrying heavy loads while working. Symptoms include high fever (Fever and headache caused by Summerheat injury are identical to those of Cold Damage [Shanghan]; however, Cold Damage presents with a floating and tight pulse, whereas Summerheat presents with a surging and empty pulse, which serves as the differentiation. Xiangru [Moslae Herba] is an herb that releases the exterior and dispels summerheat; using Xiangru in summer is analogous to using Mahuang [Ephedrae Herba] in winter), extreme thirst, floating pulse, and spontaneous sweating. Baihu Renshen Tang (White Tiger with Ginseng Decoction) is indicated. If accompanied by a heavy and oppressive sensation in the body, this indicates Summerheat complicated by Dampness, and Cangzhu Baihu Tang (Atractylodes White Tiger Decoction) is indicated. If vomiting, diarrhea, and abdominal pain are present, this formula should not be used lightly. If the aforementioned symptoms include fever, body ache, dry mouth and throat, or vomiting and diarrhea, Huanglian Xiangru Yin (Coptis and Mosla Decoction) is indicated. There is also a condition called "Summerwind Syndrome," where Summerheat agitates Phlegm-Fire, blocking the Heart orifices, leading to sudden collapse and loss of consciousness. Induced vomiting is indicated, or one may administer Qianjin Xiaoshu Wan (Million Gold Summerheat-Dispelling Pill) from *Qianjin Fang*.

Baihu Tang (See *Shanghan Lun*)
Add 2 qian of Renshen [Panacis Ginseng Radix], named Baihu Renshen Tang. Treats symptoms such as sweating with aversion to heat, fever, and extreme thirst.
Add 2 qian of Cangzhu [Atractodis Rhizoma], named Cangzhu Baihu Tang. Treats symptoms such as sweating, fever, and cold feet.

Huanglian Xiangru Yin (Formula see *Shifang Miaoyong*)
Remove Huanglian [Coptidis Rhizoma], named Xiangru Yin (Mosla Decoction). The indications remain the same.
For Summerwind-induced convulsions, add 1 qian each of Qianghuo [Notopterygii Rhizoma et Radix] and Qinjiao [Gentianae Macrophyllae Radix]; for diarrhea, add 1.5 qian each of Baizhu [Atractodis Macrocephalae Rhizoma] and Fuling [Poria]; for unremitting deficiency sweating, add 1.5 qian of Baizhu and 3 qian of Zhi Huangqi [Astragali Radix]; for mental restlessness, add 1 qian each of Zhizi [Gardeniae Fructus] and Zhusha [Cinnabaris]; for vomiting, add 2 qian of Banxia [Pinelliae Rhizoma], 0.8 fen each of Huoxiang [Agastaches Herba] and Chenpi [Citri Reticulatae Pericarpium], and a small amount of Jiangzhi [Zingiberis Recens Juice].

What is meant by "obtained through stillness"? It refers to seeking coolness in deep halls and large buildings, where Yin-Cold obstructs the body, preventing the dispersion of Summerheat. For cases with cold extremities (Jue-ni), Dashun San (Great Harmony Powder) is indicated. For cholera-like vomiting, diarrhea, and thirst, Wuling San (Five-Ingredient Powder with Poria) is indicated. For those without thirst, Lizhong Tang (Regulate the Middle Decoction) is indicated. Some clever practitioners use these two decoctions to deliver 3 qian of Liuyi San (Six-to-One Powder); such ingenious methods are hard to convey in words.

Dashun San
Ganjiang [Zingiberis Rhizoma] (1 qian, stir-fried) Gancao [Glycyrrhizae Radix et Rhizoma] (0.8 fen, stir-fried) Xingren [Armeniacae Semen Amarum] (0.6 fen, skin and tip removed, stir-fried) Rougui [Cinnamomi Cortex] (0.6 fen)
Grind all into powder. Take 5 qian per dose. Boil in one cup of water until reduced to 0.7 cup, then take. If irritability occurs, mix with well-water (Jinghua Shui) and take 3–5 qian.

There are also cases where illness occurs only in summer and resolves after autumn; this is Summerheat injuring the Primordial Qi. It is like vegetation that withers under the intense sun but recovers with rain and dew; this condition is called "Zhu-xia Syndrome" (Stuck-summer Syndrome). Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) is indicated. Following *Xue Shi Yi An* (Cases of Master Xue), remove Shengma [ Cimicifugae Rhizoma] and Chaihu [Bupleuri Radix], add 1.5 qian of Maidong [Ophiopogonis Tuber], 0.5 fen each of Wuweizi [Schisandrae Fructus] and Huangbai [Phellodendri Cortex], and 0.3 fen of Paojiang [Zingiberis Rhizoma Preparatum]. Take for 3–4 doses.

Additionally, Shaomsan (Generate the Pulse Powder), Qingshu Yiqi Tang (Clear Summerheat and Augment Qi Decoction), and Liuyi San (Six-to-One Powder) are excellent formulas for dispelling summerheat. One cannot be without them for a moment in treating all summerheat diseases. Scholars should seek their profound principles within these three formulas; they cannot be exhaustively detailed here.