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The origin of cold damage and heat diseases lies in the fact that "fire" (pathogenic heat) moves before it fully arises, while "water" (Kidney Yin) is depleted on days when water energy should be at its peak. The treatment principle focuses on rescuing Yin fluids, employing clearing and moistening methods.

When sweating is excessive, diuresis is contraindicated; when urination is excessive, diaphoresis (sweating therapy) is contraindicated.

There are two types of summerheat disease: one is "Zhong" (smitten), i.e., heatstroke; the other is "Shang" (injured), i.e., injury by summerheat. Heatstroke occurs during physical activity due to extreme weather heat, damaging Lung Qi; it is not a disease caused by direct pathogenic invasion of the body form. It is primarily treated with Renshen Baihu Tang (Ginseng and White Tiger Decoction). Injury by summerheat occurs during the summer season when one is confined in cool or cold indoor environments, preventing the dispersion of Yang Qi throughout the body; it is contracted during rest or stillness and is not a Yin-cold syndrome. (Wang Xushan stated: This condition arises from internal slight accumulation of summerheat qi, suppressed externally by cool and yin air, which is what is meant by "cold wrapping summerheat." Some claim this is direct transmission of cold, having no relation to summerheat syndromes; this view is erroneous.) It is treated with Tiaozhong Yiqi Tang (Regulate Middle and Boost Qi Decoction) added with Fuzi (Aconite Root), and after the fever subsides, Qingxu Yiqi Tang (Clear Summerheat and Boost Qi Decoction) is used for regulation. Symptoms of heatstroke include a pulse that is deep, surging, and large; extreme thirst with desire to drink; body heat; and irritability. Symptoms of injury by summerheat include a deep and solid pulse; bodily stiffness and discomfort; pain in limbs and joints; irritability; skin heat without sweat. In the early stage, there may be slight aversion to cold, which can be treated with exterior-releasing methods.

Zhongre (Smitten by Heat) and Zhongyue (Smitten by Summerheat) are summerheat syndromes, often contracted by those who travel and labor. Symptoms include aversion to heat, intense skin heat, extreme thirst with desire to drink, profuse sweating leading to Qi deficiency and weakness in movement, as heat damages Lung Qi. It is treated with Baihu Tang (White Tiger Decoction) combined with Shengmai San (Generate Pulse Powder).

Diseases of dryness-heat resemble heat syndromes but involve impaired Stomach Qi movement. There is a lack of Jin-Ye (body fluids) internally, leading to dryness and desiccation. Patients seek soup or water to save themselves, but this is not true thirst; rather, it is dry mouth. Although the tongue is dry, the root of the tongue remains moist. The patient desires to drink but consumes little. The pulse is hollow, large, and weak. In severe dryness cases, patients may exhibit Zhengsheng (repetitive, low-pitched muttering) without Zhanyu (delirious speech); this is a syndrome of Blood depletion. Huangqi Danggui Tang (Astragalus and Angelica Decoction) is appropriate. Administering Baihu Tang (White Tiger Decoction) or Wuling San (Five-Ingredient Powder with Poria) would be fatal.

Case Record
A seventeen-year-old male fell ill in early autumn with body heat resembling fire. By the sixth day, he continued delirious speech, picking at empty air, was unconscious and unrecognizable, suffered diarrhea thirty to forty times daily, and kept his eyes open unable to sleep. He was administered Gancao (Licorice Root) 4 qian, Dangguishen (Angelica Sinensis Root Heart) 3 qian, and Maidong (Ophiopogon Tuber) 5 qian as a decoction. His eyes closed slightly, and the previously hollow-large pulse became somewhat restrained. Subsequently, heavy doses of Shengdihuang (Rehmannia Root Preparata), Baishao (White Peony Root), Dangguishen (Angelica Sinensis Root Heart), Maidong (Ophiopogon Tuber), Wuweizi (Schisandra Fruit), and Gancao (Licorice Root) were used. Afterwards, his spirit cleared, diarrhea ceased, and he recovered through conditioning. This was a true case of dryness disease resembling the Baihu Tang syndrome. His diarrhea resulted from Kidney dryness. Therefore, Shengdihuang (Rehmannia Root Preparata) was used to astringe.