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For cases caused by overexertion and fatigue without external pathogenic invasion, or where there is slight fever but the pulse is slow, large, and forceless, completely lacking in tightness and rapidity, or where there is reluctance to speak and a preference for lying down, or frequent sweating, this constitutes the syndrome of heat arising from exhaustion. It naturally differs from headache, tight pulse, and soreness/pain in bones and muscles caused by external invasions. Treatment should primarily focus on tonification and nourishment; once Qi recovers, the condition will resolve. For deficiency in the Yang aspect, Si Jun Zi Tang (Four Gentlemen Decoction) or Wu Jun Zi Jian (Five Gentimen Decoction) are appropriate. For deficiency in the Yin aspect, San Yin Jian (Three Yin Decoction), Wu Yin Jian (Five Yin Decoction), Da Ying Jian (Great Camp Decoction), or Xiao Ying Jian (Small Camp Decoction) are suitable. If the Middle Qi of the Spleen and Stomach is injured, Li Zhong Tang (Regulate the Middle Decoction) or Yang Zhong Jian (Nourish the Middle Decoction) are indicated. If both Qi and Blood are deficient, Wu Fu Yin (Five Blessings Drink), Ba Zhen Tang (Eight Treasures Decoction), or Shi Quan Da Bu Tang (Ten Complete Great Tonifying Decoction) are recommended.

One: When alternating chills and fever result from overexertion, irregular hunger, or satiety, it is because during hunger, the Qi of the Zang organs becomes weak, and during exertion, the Cou Li (pores and interstitial spaces) open. When the Cou Li are open, pathogens easily invade; when Zang Qi is weak, pathogens easily enter. Therefore, those who do not exercise caution regarding dietary intake and overexertion often suffer from symptoms such as headache, fever, and aversion to cold. Although these are attributed to internal injury, they actually involve external invasion; although there is external invasion, the root lies in internal injury. Thus, Li Dongyuan formulated Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), using Ren Shen (Ginseng Root), [Original text missing character, typically Huang Qi], Dang Gui (Angelica Sinensis Root), Bai Zhu (Atractylodes Macrocephala Rhizome), augmented with Sheng Ma (Cimicifugae Rhizome) and Chai Hu (Bupleuri Radix), to assist the growth-promoting Qi. This causes Stomach Qi to ascend, thereby restoring Qi to the Middle Jiao and allowing Yang to reach the exterior. This is indeed an excellent method of harmonizing. However, nowadays, cases where overexertion damages Yin and affects Essence and Blood are particularly common; thus, herbs like Ren Shen and Bai Zhu may sometimes be unsuitable. I have therefore newly formulated Bu Yin Yi Qi Jian (Nourish Yin and Augment Qi Decoction). For cases where Yang is deficient below, Kidney Water is insufficient to generate sweat, and pathogens remain unresolved, this formula is superior. I have written treatises on three formulas for treating the Spleen and on Bu Zhong Yi Qi Tang, which can be found in the subsequent Dietary Section for reference.

One: When overexertion leads to pathogenic invasion resulting in Shang Han (Cold Damage), fever, headache, and body pain, if the pulse is tight and pathogens are abundant, dispersing and resolving methods must necessarily be employed. If the underlying deficiency is not severe but the exterior pathogens remain unresolved, Zheng Chai Hu Yin (Correct Bupleurum Drink) is appropriate. If external pathogens are combined with Fire, Yi Chai Hu Yin (First Bupleurum Drink) is used. If external pathogens are combined with Cold, Er Chai Hu Yin (Second Bupleurum Drink) is used. If Qi and Blood are slightly deficient, San Chai Hu Yin (Third Bupleurum Drink) or Si Chai Hu Yin (Fourth Bupleurum Drink) are used. In cases of severe deficiency where pathogens are difficult to resolve, Li Yin Jian (Regulate Yin Decoction) or Da Wen Zhong Yin (Great Warm the Middle Decoction) are indicated, and delay is inadvisable.

One: During the hot summer season, whether traveling on roads or working in fields, excessive overexhaustion in individuals with weak constitutions makes them most susceptible to Summerheat Injury. This also falls under the category of overexertion; detailed discussions on treatment can be found in the Summerheat Syndrome section under the Yang Summerheat article.