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Ocular diseases may present with excess heat syndromes. If the heat persists despite repeated administration of cooling medicines, and the ocular disease remains chronic and unhealed, it is generally due to latent pathogenic factors (Fu Qi, hidden pathogens) transforming into heat and transferring this heat to the eyes. In the late spring of the Bingyin year, Li XX, an apprentice at a spinning mill, suffered from an eye condition that had not healed for a long time. The eyelids were red and swollen, pterygium (fleshy growth) obscured the pupil, and he felt severe distending pain in the eyeballs. Additionally, he experienced deafness and nasal congestion, resulting in the loss of vision and hearing, requiring assistance to walk. His pulse was surging, long, and very forceful on both sides. He felt intense heat in his heart/chest region. The tongue coating was white, but yellow in the center. Previously, his stools were dry; however, due to frequent use of Western medicine, he now defecated once daily. I determined this was caused by winter latent cold transforming into heat upon exposure to spring yang energy. This heat attacked upward, affecting the eyes, ears, and nose. I prescribed a large dose of Baihu Tang (White Tiger Decoction) to clear heat from the Yangming channel, adding Baishao (Radix Paeoniae Alba) and Longdancao (Herba Gentianae) to simultaneously clear heat from the Shaoyang channel. The patient stated that there was a Western doctor in the factory who prohibited taking medicine from outsiders. Since previous treatments failed, he secretly sought my treatment. He suggested that pills or powders would be acceptable, but decoctions could not be prepared in the factory. I said, "This is easy. I have a self-made miraculous eye remedy. I will give you one packet; your eyes will heal immediately after ingestion." Thus, I gave him 1.5 liang of finely ground raw Shigypsum (Gypsum Fibrosum), instructing him to divide it into six doses, taken three times daily with warm water. He should drink plenty of warm water afterward until a slight sweat appears. Three days later, he returned. The eye disease had improved by eighty to ninety percent, deafness and nasal congestion had resolved, the feeling of heat in the chest had subsided, and his pulse had normalized. I gave him another 1 liang of finely ground raw Shigypsum to be taken in six doses. After finishing the medication, he was completely cured. I did not explicitly state that the raw Shigypsum powder was for treating the eyes, fearing he might refuse to take it if he knew. Later, I frequently encountered patients with eye diseases caused by latent heat transforming from latent pathogens, and this prescription proved effective in all cases.

Hejian Tiansan San (i.e., Liuyi San / Six-to-One Powder) is an excellent remedy for clearing summerheat. However, its application varies by region: it is most suitable for the South. In the North, modifications are necessary. Southern summerheat often combines with dampness, so heavy use of Huashi (Talcum) is appropriate to drain dampness and thereby purge heat. In the North, summerheat illness rarely involves dampness, or may even involve dryness. Using heavy Huashi to drain dampness in such cases would remove moisture while exacerbating dryness, making the summerheat difficult to dissipate. Therefore, I formulated a modified prescription: Huashi (Talcum) 4 liang, raw Shigypsum (Gypsum Fibrosum) 4 liang, Fen Gancao (Radix Glycyrrhizae Preparata) 2 liang, Zhusha (Cinnabar) 1 liang, and Bohebing (Menthol) 1 qian. These are ground into a fine powder. Each dose is 2 qian, named Jiawei Tiansan San (Modified Tiansan San). It is effective for northern summerheat and equally effective for southern summerheat. The rationale of the formula: Huashi and Shigypsum resolve summerheat heat; Shigypsum clears heat and penetrates the exterior, assisted by Menthol, allowing heat to disperse through the skin. Huashi clears heat and promotes diuresis, harmonized by Gancao (Raw Radix Glycyrrhizae is best used as powder for diuresis without damaging Yin fluids), allowing heat to exit via urination. To prevent summerheat qi from invading internally and injuring the Heart channel with heat, I added Zhusha (Cinnabar), following the principle of Yi Yuan San (Tiansan San plus Cinnabar), to cool Heart blood and calm the Spirit, preventing palpitations and mental confusion.
Exposure to summerheat does not necessarily cause immediate illness. Often, like winter latent pathogens, it hides in the Membrane Source (Moyuan). In autumn, severe cold stimuli trigger a sudden outbreak, causing abdominal pain and diarrhea. This diarrhea is acute and urgent, occurring more than ten times per hour. Vomiting and diarrhea may also alternate. In severe cases, leg cramps may occur. However, the body is not cold, the pulse is not obstructed, and the patient feels intense internal heat, urgently desiring cold drinks and ice. This is still summerheat pathology, distinct from Cholera (Huoluan). In the late summer of the Dingmao year, summerheat was abnormal. Many such cases appeared after the Mid-Autumn Festival. Heavy doses of raw Shigypsum decoction administered with Yi Yuan San cured the illness. For severe abdominal pain, add Baishao (Radix Paeoniae Alba) and Gancao (since Yi Yuan San contains little Gancao) to the Shigypsum decoction, then administer Yi Yuan San. For severe diarrhea, add Shanyao (Rhizoma Dioscoreae Hypoglaucae) and Gancao to the Shigypsum decoction, then administer Yi Yuan San; or use my Ziyin Qingzao Tang (Nourish Yin and Clear Dryness Decoction) with over 1 liang or 2 liang of raw Shigypsum, decocted together. Those craving ice can be given ice directly; those craving well water can be given well water. Allow them to consume as much as they wish without hindrance. Furthermore, if vomiting persists, allowing the patient to eat ice as desired will stop the vomiting, and abdominal pain and diarrhea will also resolve. Even if other symptoms do not resolve simultaneously, once vomiting stops, the condition becomes easier to manage with medication.