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Summerheat disease presents with body heat, spontaneous sweating, thirst, and a greasy appearance of the face; other symptoms are due to subsequent transmission or concurrent internal injury. One must first inquire whether the patient has always had weak spleen and stomach, or if this occurred after a major illness or excessive labor. Even in cases of summerheat invasion, if such conditions apply, one should employ the method of clearing summerheat and benefiting qi (Qing Shu Yi Qi). If the patient is constitutionally strong and robust without deficiency, one should employ the method of dispelling summerheat and harmonizing the middle (Qu Shu He Zhong). Speaking from the perspective of contracting summerheat qi directly, it is called "Zhong Shu" (Heatstroke); speaking from the perspective of being forced by the sun, it is called "Zhong Yue" (Sunstroke). However, when summerheat initially enters, it goes through the mouth, nose, teeth, and cheeks, reaching the Heart Master and Pericardium collaterals. Since fire follows its own kind, ancient methods for treating summerheat involved pouring cold water on the body without letting the patient swallow it.

Regarding these summerheat syndromes, if there are spasms and convulsions of the hands and feet, it is termed "Wind"; if there is coldness of the extremities, it is termed "Jue" (Cold Reversal), which shares the same meaning as Heat Jue in Cold Damage diseases; Huanglian Xiangru Yin (Coptis and Elsholtzia Decoction) is indicated. Summerheat Wind arises from internal movement of the fire of the five zang organs due to overwork, which blazes together with external fire, causing Metal (Lung) to weaken and Wood (Liver) to flourish, generating wind. Xiangru Yin added with Qianghuo, or Liuhe Tang (Six Harmonies Decoction), combined with Xiaofeng San (Wind-Dispersing Powder), is used. For those who habitually have phlegm-fluids, where summerheat stirs up phlegm-heat generating wind, Liuhe Tang combined with Xingxiang San (Arisaema and Costus Powder) is used.

Summerheat toxin and phlegm-fire obstructing the chest require emesis according to the deficiency or excess of the body's constitution; this embodies the principle of "releasing stagnant fire." In cases of phlegmatic panting, urgent breathing, fullness, and coldness where medicines cannot be taken, urgently decoct Liuhe Tang and administer with 2 li of Moschus (She Xiang).

Intestinal colic (Jiao Chang Sha) involves unbearable abdominal pain, possibly radiating to the heart, with the patient rolling on the ground and cold extremities; this is intestinal contraction within the abdomen, which can be fatal in an instant. Administer one tael of salt dissolved in hot water via灌 (irrigation/gavage) to bring relief. Alternatively, use equal parts of aged Ai Ye (Artemisiae Folium), aged Zhang Mu (Cinnamomi Cortex), and aged Bi Tu (Wall Earth), decocted in water, administered continuously for three to four doses.

If sudden collapse occurs on the road making oral medication inconvenient, fearing qi collapse which is difficult to treat, urgently move the patient to a cool, shady place, avoiding lying on wet or cold ground. Scoop up warm earth from the path, place it on the umbilicus, make a small hole in it, and allow urine to drip into it. Wait to find fresh Ginger or Garlic to chew, swallowing with hot water or Child's Urine (Tong Bian), and wipe externally with cloth soaked in the mixture.

Note: The book *Yixue Rumen* (Introduction to Medicine), though published in its time, contains detailed content; thus, several excerpts are recorded for reference. Summerheat is a single qi; artificially distinguishing between Zhong Shu and Zhong Yue is forced.

It is stated: This matter is difficult to understand. Injury by summerheat has two types. Dynamic injury by summerheat involves excessive Heart Fire and complete deficiency of Lung Qi, resulting in a surging pulse. When movement leads to fire prevailing, it is heat injuring qi; hard-working people often contract this, treated with Baihu Jia Renshen Tang (White Tiger Plus Ginseng Decoction). Static injury by summerheat involves fire prevailing over Metal, with Lung Qi emerging to the exterior, resulting aversion to cold and a deep, rapid pulse. When stillness leads to dampness prevailing, the body feels heavy; leisurely people often suffer this, treated with Baihu Jia Cangzhu Tang (White Tiger Plus Atractylodis Macrocephalae Rhizoma Decoction). Injury by summerheat necessarily involves spontaneous sweating, coldness of the back, greasy face, or heat in the mouth with vexation, headache, fever, or body pain. Some experience severe pain, feeling as if bones are shattered, with extreme mental fatigue. This is because summerheat injures qi but not form. If the body does not ache, it differs from contracting wind-cold; Xiangru Yin or Liuhe Tang is appropriate. For vomiting with thirst, use Xiangru Tang (Elsholtzia Decoction) cooled in ice, or Wuling San (Five Ingredient Powder with Poria), combined with Swallowing Xiaoshu Wan (Relieving Summerheat Pill). For persistent vomiting, use Pipaye San (Loquat Leaf Powder) minus Gen Gen, swallowing Laifu Dan. For vomiting with phlegm, use Queshu San, swallowing Xiaoshu Wan, or Xiao Banxia Fuling Tang (Minor Arisaema and Poria Decoction), or Xiaoshu Yin. For those without diarrhea but with dry abdominal pain, decoct Liuhe Tang and mix with Suhexiang Wan (Styrax Pill). When summerheat enters the Heart first, since the Heart belongs to South Li Fire and things follow their kind, and the Small Intestine is the House of the Heart, benefiting the Heart meridian allows summerheat toxin to exit via the Small Intestine. Wuling San promotes urination and is a superior formula for treating summerheat. During summer months, if the body itches like needle pricks, occasionally with red swelling, it is also named Summerheat Wind; take powder of Liuhe Tang mixed with Xiaofeng San, taken with wine. For Summerheat Wind accompanied by alternating vomiting and diarrhea, use half a dose each of Liuhe Tang and Huoxiang Zhengqi San (Agastache Powder to Rectify the Qi), adding three Quanxie (Scorpio). If summerheat toxin lodges in the Upper Jiao, causing chest and diaphragm obstruction where medicine is vomited immediately upon entering the mouth or cannot pass through, or with upper asthma urgency, use Liuhe Tang cooled in ice, mixed with a small amount of Moschus. If summerheat qi persists unresolved, it becomes Fu Shu (Latent Summerheat), with heat inside and out, vexation, spontaneous sweating, great thirst preferring cold drinks; use Xiangru Yin plus 1 qian of Huanglian (Coptidis Rhizoma), followed by Baihu Tang (White Tiger Decoction). If medication fails, summerheat toxin has penetrated deeply, with constrained heat in the interior, delirious speech, irritability, desire to remove clothing, constipation, and dark, scanty urine; Tiaowei Chengqi Tang (Regulate the Stomach and Order the Qi Decoction) or Sanhuang Shigao Tang (Three Yellows and Gypsum Decoction) should be used.

Note: Chengqi Tang must absolutely not be used arbitrarily.