Library

After the Beginning of Summer (Lixia), summer heat prevails. At this time, people often experience headache, nausea, fever with aversion to cold, cold hands and feet, heavy and painful limbs and joints, loss of appetite; or rapid breathing with panting, or shortness of breath. In severe cases, touching the skin feels like burning fire; or there is colicky pain in the abdomen and intestines, or bleeding from the mouth and nose. These symptoms resemble Taiyang disease (diseases affecting the Taiyang channel). Those who do not understand may mistakenly diagnose it as Taiyang disease and use diaphoretic herbs for wind-heat, or induce sweating by adding clothing, which further depletes Yuan Qi (Primordial Qi) without realization.

This condition belongs to Yin deficiency in summer, with insufficient Yuan Qi, where damp-heat steams the body, suddenly damaging Yuan Qi. Upon initial contraction, one feels bone soreness and leg weakness, mental fatigue, drowsiness, reluctance to speak, resembling a drunken dream state; or no sweat, or continuous slight sweating, or profuse uncontrollable sweating; irritability and thirst desiring water, chest and epigastrium fullness and oppression, yellow and scanty urine, loose and frequent stools; or vomiting, diarrhea, or constipation; or cholera-like disorder unceasing. These syndromes are vastly different from Taiyang disease. Treating according to the season and urgently addressing the symptoms yields immediate results. As the saying goes, "Do not violate Tian He (Heavenly Harmony/Natural Order)," which is precisely following the way of the seasons.

There are also cases without headache, body pain, or aversion to cold; the treatment methods remain the same. For mild cases, Wu Ling San (Five-Ingredient Powder with Poria) is used to promote urination, guiding Fire downward so that summer heat resolves naturally; or Xiang Ru Yin (Elsholtzia Decoction) is used for acrid-warm dispersion to expel summer heat toxin, with Papaya (Mugua, Fructus Chaenomelis) being a key herb to restrain summer heat. Or Huo Xiang Zheng Qi San (Agarwood and Patchouli Powder to Rectify the Qi), Shi Wei Xiang Ru Yin (Ten-Ingredient Elsholtzia Decoction), etc. For severe cases, Ren Shen Bai Du San (Ginseng Powder to Overcome Toxins), Gui Ling Gan Lu Yin (Cinnamon Twig, Atractylodes Macrocephala, Talcum, and Other Herbs Sweet Dew Decoction), Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction), Bai Hu Tang (White Tiger Decoction), etc., are used. For weak constitutions, Sheng Mai San (Generate the Pulse Powder), Qing Shu Yi Qi Tang (Clear Summer Heat and Benefit Qi Decoction), Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), etc., are employed. If internal and external factors are not distinguished, and severity and strength are ignored, and all cases are treated generally with harmonizing methods, achieving 100% efficacy and immediate response, then Liu He Tang (Six-Harmonies Decoction) is the best. There are many famous authors of medical formularies throughout history who have elaborated on this; among them, Zhu Danxi is the most detailed and essential. In recent times, Mr. Wang Yutai has works such as *Zheng Zhi Zhun Sheng* (Standardized Diagnosis and Treatment) and *Zheng Zhi Lei Fang* (Classified Formulas for Diagnosis and Treatment), uniquely grasping the essence, hitting the critical points, demonstrating skillful mastery comparable to ancient masters. These are texts physicians should read and ponder deeply; the formulas follow below.

Lin's Note: The discussion on the treatment of summer heat syndromes in this section is concise and to the point, serving as a wake-up call (*Yi Men Bang He*), yet it is not as streamlined as Zhang Zhongjing's approach. Section One discusses the general outline of summer heat syndromes: In Taiyang Zhong Yue (Summer Heat Strike), there is fever and aversion to cold, heaviness and pain in the body, with a pulse that is wiry, fine, hollow, and slow. After urination, there is a shivering sensation with hair standing on end, and cold extremities. Slight exertion causes fever, open-mouth breathing, and dryness of the anterior teeth. If diaphoresis is induced, aversion to cold worsens; if moxibustion/heat needle is applied, fever worsens; if purgatives are used repeatedly, strangury worsens. Summer heat is a Yang pathogen from the sun, mostly entering via the mouth, nose, skin, and hair, initially presenting with chills and fever. The heaviness, pain, and wiry/fine/hollow/slow pulse indicate that summer heat often combines with dampness; the wiry/fine/hollow/slow pulse contains a soggy quality indicating dampness. Taiyin governs the exterior, and the Bladder also governs the exterior. Heat pathogen damages Qi, hence the shivering after urination. Cold extremities occur because Yang Qi is internally constrained and cannot reach the exterior. Heat and dampness prevail internally, while Qi floats externally, causing hot breath, fever, and dry teeth. Diaphoresis further damages exterior Qi; heat needles increase dryness and heat; purgation causes heat pathogen to sink inward. This illustrates the contraindications for pulse and symptoms in summer heat disease without providing a formula. Section Two states: In Taiyang Zhong Re (Summer Heat Heat), characterized by sweating, aversion to cold, fever, and thirst, Bai Hu Jia Ren Shen Tang (White Tiger Decoction plus Ginseng) is the primary treatment. This indicates that for severe heat, clearing heat and generating fluids is appropriate. Section Three states: In Taiyang Zhong Yue, with fever, pain, heaviness, and a weak pulse, this is caused by injuring cold water in summer, with water qi circulating in the skin. Yi Wu Gua Di Tang (Single-Ingredient Momordica Seed Decoction) is the primary treatment. This addresses cases where dampness is severe and heat is mild, using Momordica seed to remove water qi from the body, face, and limbs; once water is removed, summer heat has no basis and resolves naturally. Observing these three methods standing together, one can infer by analogy. Regarding the severity of heat and dampness in summer heat, treatment leaves nothing to be desired. Who says Changsha (Zhang Zhongjing) only knows how to treat cold and not summer heat!