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Commentary states: Cold damages the form, heat damages the Qi. Why is this so? Humans and Heaven-Earth are like a bellows (Tuoyue). In summer, the Qi of Heaven floats on the earth's surface, thus the Qi of humans floats on the muscle-surface. Moreover, when injured by intense summer heat, the skin pores become loose and open, and Qi and fluids are excreted as sweat to the exterior. Thus, both the exterior and interior Qi are deficient. Those who fail to preserve their health properly suffer external injury from summer heat and internal damage from raw and cold foods; how can the body transform and transport them effectively? Consequently, food and water stagnate and accumulate, transforming into damp-heat, leading to vomiting and diarrhea. In severe cases, both vomiting and diarrhea occur simultaneously, accompanied by sudden abdominal pain and mental confusion. If illness does not manifest immediately, damp-heat may remain constrained internally, potentially developing into malaria or dysentery later. The present Dashun San (Greatly Prosperous Powder) is not a medicine for treating summer-heat syndrome, but rather a formula for treating illnesses caused by excessive consumption of cold drinks during summer.

Note: This commentary is precise and appropriate, but Dashun San should not be used lightly.

Commentary states: Febrile diseases occurring after the Summer Solstice are termed summer-heat. Summer-heat belongs to the phase fire (Xiang Huo) in command. When humans contract it in summer, the pathogen enters through the mouth and teeth, affecting the Pericardium Meridian of Hand-Jueyin. The pulse may be deficient, or floating, large, and scattered, or wiry, thin, hollow, and slow. This is because heat damages Qi, causing Qi depletion and resulting in a weak pulse. Symptoms include sweating, irritability, panting, thirst; if quiet, there is excessive talking; body heat with irritability, heart pain, extreme thirst desiring drink, headache, spontaneous sweating, fatigue, shortness of breath, or lower bleeding, jaundice, and macules. In severe cases, fire-heat controls Metal (Lung), failing to subdue Wood (Liver), leading to spasms, convulsions, and loss of consciousness. The method for treating summer-heat is best to clear Heart fire and promote urination. Since summer-heat damages Qi, tonifying True Qi is essential. There are also cases of aversion to cold or cold limbs, severe coma and unconsciousness, Huoluan (cholera-like disorder), vomiting and diarrhea with phlegm-stasis, retching, abdominal pain, and dysentery. These are not injuries directly caused by summer-heat, but diseases self-induced due to summer conditions. Because they arise from summer conditions, they are also called summer-heat diseases. However, the treatment methods differ.

Note: Jiezhai’s commentary covers Qi, pulse, symptoms, and formulas comprehensively and exquisitely. It is worth copying and keeping by one’s side during summer. Guyan and Jiezhai are omitted here due to generational distance, but since they originally belong to Danxi’s supplementary remarks, they are attached tentatively.

Lin notes: Jiezhai’s commentary seems plausible but is actually incorrect. The Six Qi of Heaven (Wind, Cold, Summer-Heat, Dampness, Dryness, Fire) correspond to the Five Elements of Earth (Wood, Fire, Water, Earth, Metal, Fire). Jun Huo (Monarch Fire) illuminates, while Xiang Huo (Ministerial Fire) takes its place. Summer-heat corresponds to Jun Huo and the Li Trigram (Fire). Li is empty in the middle, symbolizing dual illumination. Therefore, it is said that summer-heat often carries dampness. Summer-heat enters the Heart first, corresponding to Jun Huo. The Pericardium governs the Hand-Jueyin Ministerial Fire. Its Qi connects with the Heart, and its pulse links to the Heart. Treating Heart diseases often involves treating the Pericardium because the Heart is the Palace of the Monarch and, by principle, does not accept pathogens directly. One cannot discard Jun Huo to speak only of Xiang Huo. If one cannot even clarify the Six Qi, how can such text be recommended for study?