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Summerheat pathogenic factors are divided into two types: Yin Summerheat and Yang Summerheat, which must be distinguished. When people reside in cool pavilions or water-side structures, exposed to wind and coolness all day, and enjoy eating refreshing cold teas and drinks, their Yang Qi becomes obstructed. The resulting illness presents with aversion to wind, high fever, scanty sweating, and a deep, sluggish pulse, or may manifest as abdominal pain, vomiting, and diarrhea. This is a Yin syndrome occurring in summer; it should not be called Cold Damage (Shanghan), but rather named Yin Summerheat. Predecessors treated such conditions primarily with Dashun San (Greatly Smooth Powder) or Lizhong Tang (Regulate the Middle Decoction), and for milder cases, Pingwei San (Calm the Stomach Powder). I find the properties of Shengjiang (Dried Ginger) and Rougui (Cinnamon Bark) too acrid and intense. Treating disease requires first considering the annual climate trends and avoiding damaging the body's natural harmony, which is crucial. Therefore, I formulated a prescription named Shengshi Hezhong Tang (Moisture-Dispersing and Middle-Harmonizing Decoction), containing Zisuye (Perilla Leaf) (use if there is aversion to cold), Banxia (Pinelliae Rhizoma), Fuling (Poria), Chenpi (Citri Reticulatae Pericarpium), and Zhigancao (Prepared Licorice Root) (these four ingredients form Erchen Tang [Two-Aged Decoction] to resolve phlegm and overcome dampness), Houpo (Magnoliae Officinalis Cortex), and Shenqu (Massa Medicata Fermentata) (to warm the middle and promote digestion). If the fingernails indeed appear grayish, then Danfuzi (Aconiti Lateralis Radix Praeparata) and Ganjiang (Zingiberis Rhizoma) can be added, each in small doses (fen).

Yang Summerheat occurs from traveling on roads or staying in simple shelters. Although the degree of labor and rest differs, the mechanism of contracting the disease is the same. Summerheat pathogen is formless and enters through the mouth and nose. It damages the Qi aspect of the body, leading to shortness of breath and a deficient pulse. Since Summerheat first affects the Heart, it causes mental restlessness, insomnia, and excessive sweating (as the Heart governs fluids). Symptoms may also include fever, weakness in the limbs, thirst for frozen beverages, and dark, turbid urine. Even if all six pulses are deficient and fine, the general treatment principle should be to clear Summerheat and promote diuresis to remove dampness. Drugs such as Huashi (Talcum), Danyezhu ye (Lophatheri Herba), Huangqin (Scutellariae Radix), Lianqiao (forbidden context? No, Lian is Coptidis Rhizoma/Lian), Fuling (Poria), and Yiyiren (Coicis Semen) can be selected. These should be supplemented with Qi-tonifying agents. Formulas such as Renshen Baihu Tang (Ginseng White Tiger Decoction) and Qingshu Yiqi Tang (Clear Summerheat and Boost Qi Decoction) can all be consulted for use.

A neighbor's son, aged thirteen or fourteen, had a pale complexion and a weak constitution. At that time, it was the Dog Days of summer. He went out to attend an external school. Under the blazing midday sun, many people drank well water. The neighbor's son also drank two cups, after which he could no longer go to school. His eyes were wide open, his spirit dull, and he lay listlessly on his bed. His father and elder brothers invited someone to prick the Shaoshang (LU11) acupoint, releasing a small amount of purple blood, followed by the administration of Shaya medicines (plague/summerheat antidotes). By the hour of Xu (7-9 PM), they invited me to examine him. His six pulses were imperceptible, and his fingernails were entirely gray. I said, "This is a case of Cold contracted during the Dog Days, known as Yin Summerheat. If he had taken Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction), he might have been saved, but now it is too late." He passed away after noon.

Another person returned home after traveling, suffering from abdominal pain, wanting to vomit but unable to do so, and wanting to defecate but unable to do so. This is Dry Huoluan (Stomach Intestine Turmoil), also known as Jiaochang Sha (Intestine-Twisting Plague). It is appropriate to use fried salt dissolved in hot water, drink it when warm, and induce vomiting by stimulating the throat. Alternatively, one can use a porcelain plate dipped in sesame oil to scrape the chest and back extensively until the Qi of the internal organs flows freely, allowing for vomiting and defecation, which would render the condition harmless. This person did not know the treatment method and consumed a bowl of old ginger soup, resulting in death. This falls under the category of Yang Summerheat.