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Heat caused by summerheat injury involves the fire pathogen damaging the Heart, with the primordial Qi dissipating and the pathogenic heat invading the interior, thus causing fever. There is profuse sweating, inability to move due to Qi deficiency, and a pulse that is deficient, slow, and forceless; this indicates that external heat pathogens have damaged the Ying (Nutritive) Qi. Treatment should focus on internal regulation.

My commentary: In summer, Yang Qi floats externally while Yin Qi remains latent internally. The treatment method should primarily regulate and tonify Yang Qi, assisted by resolving summerheat. This is an excellent application of the principle from the *Nei Jing* (Inner Canon) of "abandoning the season to follow the symptoms." Therefore, for the aforementioned symptoms, one must investigate the etiology to treat accordingly. One should not indiscriminately use formulas like Xiangru Yin (Mosla Decoction), which scatter Yang Qi and damage True Yin, thereby exacerbating the condition. Furthermore, using mint decoction as tea during summer is unknown to many; it inadvertently scatters the body's True Qi, similar to how prolonged use of Chuanxiong Tang (Sichuan Lovage Decoction) can lead to sudden death. (See later sections for details.)

Diseases are categorized into Gan (Infection/Contact), Shang (Injury), and Zhong (Strike). Gan affects the skin and hair, being mild; Shang extends to muscles, being slightly severe; Zhong involves the Zang-Fu organs, being the most severe. Cold pathogens include Gan Han (Cold Contact), Shang Han (Cold Injury), and Zhong Han (Cold Strike). Wind pathogens include Gan Feng (Wind Contact), Shang Feng (Wind Injury), and Zhong Feng (Wind Strike). Summerheat pathogens include Gan Shu (Summerheat Contact), Shang Shu (Summerheat Injury), and Zhong Shu (Summerheat Strike). These must be differentiated by severity and exterior-interior status, with distinct treatments. Similarly, Zhong Shi (Dampness Strike), Zhong Qi (Qi Strike), and Zhong Du (Toxin Strike) are all termed "Zhong." "Zhong" means center, indicating that the pathogen directly enters the interior, hence constituting a severe disease.

When treating abdominal pain, if it is a new onset, one must inquire about dietary intake, exposure to pathogens, and presence of food stagnation. Immediately administer herbs that harmonize the Middle Jiao and promote digestion. If the duration is long, and the patient has taken many acrid-warm drying-hot drugs, resulting in vomiting, inability to retain food, chest and diaphragm fullness, dry mouth and tongue, and difficult urination and defecation, despite internal stagnant heat or pre-existing chronic conditions exacerbated by pathogenic invasion, use herbs that open depression, move Qi, descend fire, and moisten dryness, such as Chuanxiong Rhizoma (Chuanxiong), Cyperi Rhizoma (Xiangfu), Gardeniae Fructus stir-fried (Chao Shanzhi), Coptidis Rhizoma (Huanglian), and Ginger Juice (Jiangzhi). For severe cases, add Natrii Sulfas (Mangxiao). However, when treating chronic abdominal pain, bitter-cold and salty-cold herbs must be added to warm-dispersing formulas. Warm methods treat the branch (symptoms), while cold methods treat the root (etiology).

My commentary: For abdominal pain due to Spleen-Stomach deficiency and undigested food, or accompanied by abdominal pain, use Liujunzi Tang (Six Gentlemen Decoction). For excessive food intake leading to stagnation without digestion, or accompanied by abdominal pain, use Renshen Yangwei Tang (Ginseng Stomach-Nourishing Decoction). If food is digested but the Spleen-Stomach is injured, or accompanied by abdominal pain, use Liujunzi Tang plus Danggui Radix (Danggui). If there is heat in the Stomach causing pain in the epigastrium and abdomen with vomiting, use Erchen Tang (Two Aged Herbs Decoction) plus Huanglian and Shanzhi. If Spleen-Stomach deficiency causes reduced appetite and abdominal pain, use Liujunzi Tang. For Spleen-Stomach deficiency-cold, use the previous formula plus Paojiang (Prepared Ginger). Generally, abdominal distension and pain that do not hurt upon pressure indicate deficiency, while pain upon pressure indicates excess. Remaining cases require clinical discretion.

Li Mengqing, Vice Director, frequently suffered from abdominal pain, which resolved each time he took Buzhong Yiqi Tang (Middle-Boosting Qi-Supplementing Decoction) plus Shanzhi. One day, after anger-induced abdominal pain with a wiry-tight pulse, he took thirty pills of Zuojin Wan (Left Metal Pill) swallowed with the previous decoction and recovered.

A woman suffered from heart and abdominal pain unresponsive to various medicines. I treated her with stir-fried black Shanzhi and Jiegeng Platycodon Root, resulting in recovery.

Scholar Shen HTwen had internal food retention and external wind-cold invasion, presenting with headache, fever, nausea, and abdominal pain. He was given Renshen Yangwei Tang plus Chuanxiong, Baizhi, Shenqu, [missing character], Xiangfu, and Jiegeng. After one dose, all symptoms subsided. The next day, abdominal pain became severe and frightening, but was relieved by manual pressure. This indicated Spleen Qi deficiency allowing guest cold to invade, representing internal deficiency-cold with external false-heat. He was treated with Xiangsha Liujunzi Tang plus Muxiang and Paojiang. Pain decreased by 60-70%. Subsequently, taking the same formula minus Muxiang and Sharen (one cup) led to complete recovery.

The mother of Xu Daofu, a government student, suffered severe pain in the epigastrium corresponding to the heart. The Right Cun and Guan pulses were absent; the Left pulse was faint and nearly imperceptible. Extremities were cold, and the condition was critical. Observation revealed dark bluish discoloration around the eyelids, indicating Spleen deficiency with Liver Wood overacting. She was administered Renshen, Baizhu, Fuling, Chenpi, and Gancao to tonify Middle Qi; Muxiang to harmonize Stomach Qi and move Liver Qi; and Wuzhuyu to disperse cold in the Spleen-Stomach and stop abdominal pain. An urgent dose was prepared, taken boiling hot first, followed by the remainder after brewing. All ailments were cured.