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During periods of extreme heat, illness may arise from overexertion. Whether one labors on long journeys or in the fields, or if the body is inherently weak with reduced food intake yet still subjected to labor, or if one maintains a long-term vegetarian diet leading to chronic deficiency of Stomach Qi (Stomach Energy) compounded by physical strain, the symptoms include intense fever of the skin and muscles, restlessness and stifling sensation, extreme aversion to heat, and thirst with desire to drink water. This resembles the Yangming Cold Damage Heat Syndrome (a syndrome treated with Baihu Tang / White Tiger Decoction). However, the patient experiences shortness of breath and wheezing rising from the nose and mouth; this is a syndrome of chronic Spleen and Stomach deficiency and insufficiency of Yuan Qi (Original Qi). The body also aches, with symptoms worsening towards sunset, inevitably accompanied by delirium, high fever, thirst, and unceasing stifling discomfort. The pulse is flooding (Hong) but empty upon pressure, or faint and weak. In the Baihu Tang syndrome, the pulse is flooding and forceful, which differs from internal injury causing middle-heat. Treatment should employ Qingshu Yiqi Tang (Clear Summerheat and Boost Qi Decoction).

Ingredients: Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Shenqu (Massa Medicata Fermentata), Zexie (Alismatis Rhizoma) (each 0.5 qian); Huangqi (Astragali Membranacei Radix) (1.5 qian, reduce by 0.5 qian if sweating is slight); Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma); Huangbai (Phellodendri Cortex soaked in wine); Gegen (Puerariae Lobatae Radix); Qingpi (Citri Reticulatae Pericarpium Viride); Dangguishen (Angelicae Sinensis Radix); Maimendong (Ophiopogonis Tuber) (each 0.3 qian); Cangzhu (Atractylodis Rhizoma) (1.5 qian); Shengma (Cimicifugae Rhizoma) (1 qian); Wuweizi (Schisandrae Chinensis Fructus) (9 berries).

The above fifteen ingredients are chopped. Prepare as one dose. Add two zhan of water, decoct until one zhan remains, remove the dregs, and take slightly warm after meals at a considerable distance from eating.

Some individuals, after laboring physically and sitting or lying in cool places, subsequently develop a Wei Xu (Deficiency of the Defensive Level) syndrome, rendering them unable to tolerate wind and cold. They suffer from shortness of breath, reluctance to speak with low voice, lassitude, weakness, and lack of strength. This occurs because strenuous labor causes Yin Fire (Yin Huo) in the Kidney to boil up. Subsequently, removing clothes or resting in cool places after bathing prevents the Yin Fire from dispersing properly, causing it to return to the skin. The Cou Li (pores and interstices) become extremely deficient, lacking Yang Qi. Constrained by wind and coolness, the exterior becomes deficient and cannot tolerate wind and cold. The presentation resembles external contraction with aversion to wind, but it must not be treated as an external contraction. It is appropriate to use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). (Formula seen previously)

Due to physical overexertion and irregular diet, the Spleen and Stomach (Central Pivot) transform into cold-dampness, leading to wandering pain and jaundice. Treatment should employ Xiaojianzhong Tang (Minor Construct the Middle Decoction), or Dajianzhong Tang (Major Construct the Middle Decoction), or Lizhong Tang (Regulate the Middle Decoction). (Formulas seen previously)

[Xiaojianzhong Tang]
Shaoyao (Paeoniae Radix Alba) (6 liang); Guizhi (Cinnamomi Ramulus); Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) (each 2 liang); Dazao (Ziziphi Jujubae Fructus) (7 pieces); Shengjiang (Zingiberis Rhizoma Recens) (3 liang); Jiaoyi (Maltose) (1 sheng).

Chop the above ingredients. Add seven sheng of water, decoct until three sheng remain, remove the dregs, add Jiaoyi, and gently heat over a low fire until dissolved. Take one sheng warm, three times daily.