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Subsequently, methods for modifying the formula according to changed syndromes were established as follows. If Heart Fire invades the Spleen Earth, this indicates that the Blood has been harmed by Fire pathogen, preventing its ascending and dispersing nature; Yang Qi is latent within the "Earth" (referring to the human Spleen). In such cases, Danggui (Angelicae Sinensis Radix) must be used to harmonize the Blood, and a small amount of Huangbai (Phellodendri Cortex) should be employed to nourish True Yin. For syndromes of Spleen and Stomach deficiency, a small amount of Shengma (Cimicifugae Rhizoma) is required, as it serves as the guiding herb for the Foot-Yangming Stomach Meridian and Foot-Taiyin Spleen Meridian. It enables the movement of Yang Qi through the Yang pathways, migrating from the Spleen and Stomach towards the left (corresponding to Spring generation), where Shaoyang executes the command of Spring, generating the roots of all things. Additionally, Chaihu (Bupleuri Radix) is added to facilitate the migration of various meridians to the right (corresponding to Autumn harvest), generating and dispersing the Qi of Yin and Yang, thereby nourishing the harmonious Qi of Spring. If Spleen deficiency arises because Hyperactive Heart Fire attacks the Earth element. Secondly, if Lung Qi is affected by pathogens and injured by Heat, Huangqi (Astragali Radix) must be used in the largest dose, followed by Gancao (Glycyrrhizae Radix et Rhizoma), and then Renshen (Ginseng Radix). These three are all sweet-warm Yang herbs. When Spleen Qi begins to weaken, Lung Qi often fails first; therefore, the sweet-warm nature of Huangqi is used to benefit the Qi of the skin and hair, and to close the Couli (pores and interstices), preventing spontaneous sweating which would damage Yuan Qi. For symptoms such as upper body wheezing, shortness of breath, and reluctance to speak, Renshen must be used to tonify. To clear Heart Fire invading the Spleen, Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma) is required to drain fire heat and tonify Yuan Qi in the Spleen and Stomach; however, the dosage of Gancao should be minimal to avoid causing fullness. If there is urgent pain in the Spleen and Stomach, or extreme deficiency of Spleen and Stomach manifesting as abdominal cramping and contraction, and tension of the abdominal skin, Gancao should be used in larger amounts. The Classic states: "For conditions of urgency, use soothing methods." If treating on an ad hoc basis, Shengma must be added to guide the Qi upward; otherwise, the pathogenic factor migrating left may become firm and strong, refusing to recede, potentially leading to flesh growth at the nape and buttocks moving along the Yin pathway. Thus, guidance is used to move Qi along the Yang pathway, allowing Clear Qi to emerge from the Earth, migrate rightward and ascend, thereby harmonizing the Qi of Yin and Yang. If there is fullness in the Middle Jiao, remove Gancao; if cough is severe, remove Renshen; if there is dryness of the mouth and throat, add Gegen (Puerariae Lobatae Radix). If Spleen and Stomach are already deficient and unable to ascend and float, and their generating Qi is damaged by Deficient Fire (Yin Fire), Ying Blood is severely depleted, and Ying Qi is latent within the Earth. With Intense Deficient Fire slowly simmering day by day, Blood and Qi become scarce. Since the Pericardium and the Heart govern Blood, a reduction in Blood means the Heart lacks nourishment, resulting in mental confusion and irritability. This disease is named "Xin Huo" (Heart Confusion), referring to a state of mental perplexity, vexation, and unease. This occurs because Clear Qi does not ascend, Turbid Qi does not descend, and Clear and Turbid interfere with each other, causing chaos in the Chest. This leads to reverse flow and disorder of Blood and Qi throughout the body. The Classic states: "For disorders rising from below, use draining and dispersing methods." Therefore, acrid-warm and sweet-warm agents should be added to generate Yang; when Yang generates, Yin grows. One might ask: "How can sweet-warm herbs generate Blood? Are they not blood-tonifying herbs?" The answer lies in the method of Zhang Zhongjing: For Blood deficiency, Renshen is used to tonify; when Yang Qi is vigorous, it can generate Yin Blood. Additionally, Danggui is added to harmonize Blood, and a small amount of Huangbai is suitable to rescue Kidney Water. Sweet-cold herbs drain fire heat; once fire decreases, Heart Qi becomes peaceful and calm. If vexation and chaos persist despite this, a small amount of Huanglian (Coptidis Rhizoma) is added to eliminate it. This is done to tonify Kidney Water, making Kidney Water abundant so that Heart Fire naturally descends, supporting the Yang Qi within the Earth. If Qi floats and the Heart is chaotic, Zhusha Anshen Wan (Cinnabar Calming the Spirit Pill) is used to stabilize and secure it. Once vexation subsides, do not continue taking it to prevent excessive draining of Yang Qi leading to sinking. If there is epigastric stuffiness, a small amount of Huanglian is also added. Qi chaos in the chest is due to interference between Clear and Turbid Qi, so Chenpi (Citri Reticulatae Pericarpium) is used to regulate it, assisting the ascent of Yang Qi and dispersing stagnant Qi, while further aiding the action of various sweet and acrid herbs. Therefore, during the late summer when Damp-Earth is dominant and external Fire pathogens are strong, Cangzhu (Atractylodis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), and Zexie (Alismatis Rhizoma) can be added on an ad hoc basis to distribute and eliminate Damp-Heat from above and below. When Dampness is excessive, digestion of food is impaired, leading to reduced appetite and loss of taste for grains; Chao Qu (Fermented Wheat Mass) is added to digest food. Regarding bowel movements, Wuweizi (Schisandrae Chinensis Fructus), Maidong (Ophiopogonis Radix), and Renshen are added to drain fire, benefit Lung Qi, and assist in recovering the depletion associated with Autumn. This is the prescription used during the Sanfu days when Late Summer Qi is at its peak.

Note: This discussion on Summerheat syndromes from *Zhengzhi Zhunsheng* (Mirror of Medicine) is extremely refined and meticulous, establishing a paradigm of the King's Way (gentle and balanced treatment). It cannot be fully recorded here; only the essential points are excerpted below. The Modified Qingshu Yiqi Tang (Clear Summerheat and Boost Qi Decoction) is particularly considered a masterpiece attuned to Li Dongyuan's theories.