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In summer, if a person suddenly faints, loses consciousness, and has cold extremities, this is termed Shu Jue (Summerheat Collapse), which belongs to Yin Wind (here referring to the false cold syndrome caused by internal closure of summerheat pathogen). Cold-natured medicines should not be used abruptly; instead, acrid-warm medicines should first be used to disperse and resolve the pathogen. After the patient regains consciousness, acrid-cool medicines should then be used to clear fire and eliminate the root cause. Misusing hot medicines or moxibustion will lead to immediate death. Administering child's urine mixed with ginger juice can also facilitate recovery.

Lin notes: Shu Jue (Summerheat Collapse) is caused by heat pathogen blocking the orifices. One should first take one or two qian of Zijin Ding (Purple Gold Pill) ground in cool water. Once the collapse resolves, Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) or Huanglian Xiangru Yin (Coptis and Elsholtzia Drink) may be selected. If accompanied by dampness, Baihu Jia Cangzhu Tang (White Tiger Plus Atractylodes Macrocephala Decoction) is used. For yin deficiency, Maidong Tang (Ophiopogon Decoction) or Shengmai San (Generate the Pulse Powder) is prescribed, with adjustments made according to the condition. Juices from watermelon, reed rhizome, radish, and sugarcane are all cooling and moistening agents that can be consumed.

The above discusses Shu Jue (Summerheat Collapse). If Han Jue (Cold Collapse) is mistaken for heat, disaster will follow swiftly. However, the differentiation between cold and heat must not be ignored. Whenever there are cold extremities, a cold body, cyanotic complexion, curled-up posture, dark blue fingernails and toenails, abdominal pain without thirst, clear and white urine, loose stools, and a faint and slow pulse, it is Han Jue (Cold Collapse) due to yang depletion in the lower jiao. If, however, there are cold extremities, a hot body, flushed face, dry lips, dry mouth, bitter/thick tongue coating, eyes closed or open, restlessness, thirst, scanty and painful urination, dry stool, and a slippery pulse, it is Re Jue (Heat Collapse) due to yin depletion in the lower jiao.

However, Han Jue (Cold Collapse) can also present with sudden restlessness and agitation, where the patient desires to sit in mud or well water; this is Dai Yang Syndrome (Floating Yang Syndrome) caused by extreme yin generating false heat, and it should not be treated as heat. Re Jue (Heat Collapse) can also present with cold limbs and hidden pulse; this is because the heat pathogen has entered the interior, preventing the free flow of qi and blood, known as "extreme fire resembling water," and it should not be treated as cold. How to differentiate whether a hidden pulse indicates heat (slippery and rapid) or cold (faint and slow) when a person suddenly loses consciousness, has cold limbs, and a hidden pulse? Although the pulses at the six positions of both hands may temporarily be imperceptible, there must be one or two positions at the Chi position (cun-kou pulse) that are not hidden; even if the pulses at both hands are hidden, there must be two or three positions among the twelve meridian arteries that are not hidden. Within these non-hidden pulse positions, carefully examine whether they are faint/slow or slippery/rapid to determine cold or heat. If indeed all pulses on the body are hidden, the person has already suffocated and died.

The causes of sudden collapse (Bao Jue) are indeed numerous. Here, we discuss only cold and heat. However, not only must cold and heat be differentiated, but even Wen Bing (Warm Diseases) and Shu Bing (Summerheat Diseases), which are both collapses due to deep heat, have different treatments, let alone cold versus heat. Therefore, differentiation is indispensable.