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The *Yellow Emperor's Inner Classic* states: "Contracting heat from summer leads to sweating; if vexed, there is panting and chest fullness; if quiet, there is excessive talking. The body feels like burning charcoal, but the pathogen disperses through sweating." It also states: "When Qi is abundant but the body feels cold, it is contracted as Cold Damage (Shanghan); when Qi is deficient but the body feels hot, it is contracted as Summerheat Injury (Shangshu)." Infants suffer more severely during summer and autumn. This is because Fire and Earth energies are prosperous in late summer, causing injury to Metal (Lung) and Water (Kidney). With tender Yang and weak Yin, harmony of Heaven and Human is already lost. Added to this is summerheat, causing Yang Qi to float on the exterior, while raw and cold foods damage the interior. Failure to nourish properly in summer prevents the generation of Metal (Lung), leading to summerheat disease. However, some fall ill directly from summerheat, while others become ill due to the summer environment. Although the manifestations differ, all stem from summerheat. Therefore, summerheat diseases are divided into two syndromes: Yin Summerheat and Yang Summerheat. Treatments are as different as ice and charcoal, and must be distinguished carefully.

Yin Summerheat refers to contracting cold pathogens during summer. Children from affluent families, fearing heat and seeking coolness, fail to avoid cold. They may dwell in deep halls or wide mansions, or dress inadequately during fluctuating temperatures, allowing cold pathogens to invade the muscle-surface. Symptoms include headache, absence of sweating, aversion to cold, bodily stiffness and urgency, and soreness/pain in the four limbs. Since cold is contracted during the summer month, although named Yin Summerheat, it is essentially Cold Damage (Shanghan). Treatment should employ warming and dispersing methods, such as Wuji San (Five Accumulations Powder) or Qingshu Yiqi Tang (Summerheat-Resolving and Qi-Nourishing Decoction). If there is no aversion to cold but rather fever, Renshen Baizhu Tang (Ginseng and White Tiger Decoction) is used; after the fever subsides, Tiaoyuan Shengmai San (Regulate Origin and Generate Pulse Powder) is used for tonification.

Others may suffer from improper diet, overeating raw fruits, melons, cool tea, or cold water, causing cold-cold pathogens to injure the Zang organs, resulting in symptoms such as vomiting, diarrhea, and abdominal pain. This is also due to contracting cold in summer, with cold pathogens residing internally. Treatment focuses on warming the middle Jiao, using Jiawei Wuling San (Modified Five-Ling Powder); if ineffective, Lizhong Tang (Regulate the Middle Decoction) is used.

Yang Summerheat often affects children from humble backgrounds. They may sit exposed to scorching sun, lie on hot ground, or bathe in cold mountain streams. Symptoms include fever, headache, restlessness/vexation, extreme thirst, profuse sweating, a surging and slippery pulse, dry and constipated stool, and red, painful urination. For these, Baihu Tang (White Tiger Decoction) is indicated. If the pulse is deficient, accompanied by vexation/thirst and shortness of breath, Renshen Baizhu Tang (Ginseng and White Tiger Decoction) is used. If dizziness occurs, Shengmai San (Generate Pulse Powder) is used. If accompanied by vomiting and diarrhea, Ruiling Tang (Agastache and Poria Decoction) is used.

In treating summerheat diseases, one must primarily distinguish between Yin/Yang and Cold/Excess patterns. If external heat pathogens invade and internal restlessness/heat exists, this is Heat in both Exterior and Interior, constituting a Yang syndrome. Treatment should employ clearing and tonifying methods as described above. If the pulse is deficient and forceless, or if there is aversion to cold/back cold, nausea/vomiting, abdominal pain/diarrhea, slight coldness in the four limbs and nasal tip, dislike for cool drinks, rapid breathing/shortness of breath, or general weakness/lack of movement, these belong to the Yin pattern within a Yang context. In such cases, one must focus solely on protecting Yuan Qi (Original Qi), using Sijunzi Tang (Four Gentlemen Decoction) as the primary treatment, or Lizhong Tang (Regulate the Middle Decoction) with added Shaoyao (Paeoniae Radix Alba). If deficiency-cold is severe, one must set aside seasonal considerations and follow the syndrome; Fuzi (Aconiti Lateralis Radix Praeparata) and Rougui (Cinnamomi Cortex) are essential. One must absolutely not rigidly use cold-cooling herbs for "summerheat" merely based on the name, as the resulting disaster would be incalculable.