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Xiangru Yin (Mosla Decoction) is a general-purpose medication for summer, and it is common for wealthy families to keep this medicine on hand. They let the elderly and children take it frequently to prevent heatstroke. However, few people are suitable for its use, while many are not. If used mistakenly, it will inevitably cause illness. Why? Because Mosla (Xiangru), as a single herb, has an aromatic and penetrating aroma but a sinking-cold nature. Precisely because of its penetrating nature, it can penetrate through the upper and lower parts of the body to remove damp-heat that is stagnant and steaming. Precisely because of its cold nature, it can relieve thirst and remove irritability, and clear fire pathogens that are knotted and struggling. However, only those who truly have a Yang constitution, truly possess fire pathogens, truly have strong Spleen and Stomach Qi, consume excessive rich and sweet foods, and prefer cold while fearing heat, can tolerate it. Relying on its cooling properties, it may not be without benefit. But if one's original Qi is inherently insufficient, taking it can most easily damage Qi. If the fire pathogen is not an excess condition, taking it will ruin Yang Qi. Those who are naturally endowed with Yin-deficient or soft constitutions, those approaching middle age, those with poor dietary health, and those with inherently weak physiques, who do not understand the benefits and harms and blindly imitate by using it recklessly, will invariably aggravate latent Yin-cold, damage Stomach Qi, and lead to symptoms such as vomiting, diarrhea, abdominal pain, and even critical Yin-cold collapse syndromes. If Coptis Rhizome (Huanglian) is added, its coldness becomes even more severe; Magnolia Bark (Houpo) breaks Qi, so neither is suitable. Users must exercise caution.

Zhang Zhongjing stated: Injury by the Qi of the four seasons can all result in disease. In winter, severe cold strikes; if illness occurs immediately upon injury, it is named Cold Damage (Shanghan). If illness does not occur immediately, cold toxins hide within the skin and muscles, transforming into Warm Disease (Wenbing) in spring, and into Summerheat Disease (Shubing) in summer. Summerheat disease involves heat that is more severe than that of warm diseases. Therefore, laborers often suffer from warm-heat diseases in spring and summer, all caused by cold exposure in winter, not by epidemic Qi. Epidemic Qi refers to situations where spring should be warm but suddenly becomes extremely cold; summer should be extremely hot but turns extremely cool; autumn should be cool but turns extremely hot; winter should be cold but turns extremely warm. This is having the Qi of a different season at the wrong time. Thus, throughout the year, illnesses among young and old are often similar; this is called epidemic Qi.

The *Neijing* states: When the Taiyang channel suffers from Summerheat-Heat, it is called Zhong Yue (heatstroke/sunstroke). The patient sweats, fears cold, has body heat, and feels thirsty; Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng) is the primary treatment. When the Taiyang channel suffers from Dampness, the body is hot and painful with a faint pulse; this is also caused by injuring cold water in summer, with water qi circulating within the skin; Yiwu Gaudi Tang (Single Melon Pedicel Decoction) should be used to induce vomiting. When the Taiyang channel suffers from Wind-Dampness, there is fever, aversion to cold, heaviness and pain in the body, and the pulse is wiry, fine, hollow, and slow. After urination, the patient feels chilly with goosebumps, hands and feet are cold, slight exertion causes body heat, the mouth opens (gasping), and the front teeth are dry. If sweating methods are used, aversion to cold worsens; if moxibustion/warming needles are added, fever worsens; if purgatives are used repeatedly, strangury worsens.

Li Dongyuan (Jiegu) stated: Obtained while resting is Summerheat (Zhongshu); obtained while moving/exerting is Heatstroke (Zhongre). Summerheat is a Yin syndrome; Heatstroke is a Yang syndrome.

Chen Wuyue stated: Summerheat-heat tends to enter the Heart. Pathogens in the Heart cause chest oppression and stuffiness, leading to unconsciousness. Entering the Liver causes dizziness and numbness/paralysis. Entering the Spleen causes drowsiness and unawareness. Entering the Lung causes wheezing, fullness, and flaccidity. Entering the Kidney causes Xiao Ke (wasting-thirst syndrome). For patients dying of heatstroke, treatment must absolutely avoid cold medicines; only warming and nourishing methods are appropriate.

If no hot water is available on the road, apply hot earth to the umbilicus, then have someone urinate on the earth, collect it, and apply it to the umbilicus; this demonstrates the principle. Whenever one feels heatstroke, urgently chew a large piece of fresh ginger and swallow with water. If already comatose or stifled, chew a large clove of garlic and swallow with water; if unable to chew, grind it in water and force-feed; the patient will awaken immediately.

Dai Shi stated: Sudden collapse in summer with loss of consciousness is named Summerwind (Shufeng).

Wang Jiezhai stated: The best method for treating summerheat is to clear the Heart and promote urination. Summerheat damages Qi, so tonifying True Qi is essential. There are also cases of aversion to cold, or cold extremities, severe coma/unconsciousness, Huoluan (cholera-like vomiting and diarrhea), phlegm-stagnation retching, abdominal pain, and dysentery. These are not injuries by summerheat per se, but diseases self-induced due to summer conditions. Because they arise from summer factors, they are also called summerheat diseases, but the treatment differs. If vomiting and diarrhea occur with a deep, faint pulse, cold medicines must not be used; Fuzi Dashun San (Aconite Great Harmony Powder) or Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction) plus Shaoyao (Peony) may be used. If excessive consumption of cold foods and over-drinking of tea in summer damages the Spleen and Stomach, resulting in vomiting, diarrhea, and Huoluan, then summerheat medications should generally favor warming the Spleen and digesting food. To treat dampness, promote urination; physicians must understand this principle.

Xue Lizhai stated: According to Mr. Dongyuan: During times of summerheat, healthy individuals who seek relief from heat by staying in deep halls and large buildings may contract what is named Summerheat (Zhongshu). Their illness definitely includes headache, aversion to cold, stiff body posture, joint pain, irritability, heat, and absence of sweat. This is caused by Yin-cold air from indoor environments obstructing the body's Yang Qi, preventing it from extending and ascending; Dadun San (Great Harmony Powder), a hot-natured drug, is the primary treatment. If pedestrians or farmers contract illness from labor under the midday sun, it is named Heatstroke (Zhongre). Their illness definitely includes severe headache, restlessness, heat, aversion to heat, burning skin, extreme thirst, sweating, and lethargy. This is caused by heavenly heat externally injuring Lung Qi; Cangzhu Baizhu Tang (Atractylodes and White Tiger Decoction), a cooling formula, is the primary treatment. If the patient's Original Qi is insufficient and previous remedies fail, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) should be used. Generally, in summer, Yang Qi floats outward, while Yin Qi hides inward. If diet and fatigue internally injure Middle Qi, or intense summer heat and labor externally injure Yang Qi, many suffer from this. The method should primarily focus on regulating and tonifying Original Qi, assisted by resolving summerheat. If it is Summerheat (Zhongshu), it is a Yin-cold syndrome; the method should primarily tonify Yang Qi, assisted slightly by resolving summerheat. Thus, ancient sages often used Ginger, Cinnamon Twig, Aconite, and similar substances. This is a good application of the *Neijing* principle of "abandoning the season to follow the syndrome." Now, patients dying of summerheat presentations often have blue-black fingernails or limbs. This is due to failing to investigate the cause, failing to warm and tonify the interior, and indiscriminately using Xiangru Yin and similar formulas. He further stated: Previous syndromes should be differentiated between Summerheat and Dampness, empty vs. deep pulses, absence vs. presence of sweat, fever vs. no fever, thirst vs. no thirst, diarrhea vs. no diarrhea, preference for cold vs. hot drinks. Differentiate their Yin-Yang and deficiency-excess nature; do not indiscriminately administer cold-cooling agents. This is because latent Yin resides inside during summer. Ancients used Fuzi Dashun San and similar formulas to warm and tonify Yang Qi; this had profound significance. Why do modern frail and elderly people, suffering from poor appetite, body fatigue, fever, thirst, or vomiting/diarrhea/abdominal pain/headache in summer, instead take Xiangru Yin, further damaging Original Qi, invariably attracting summerheat pathogens, leading to death? Regarding Qing Shu Yi Qi Tang (Clear Summerheat and Augment Qi Decoction), which contains Ze Xie, Cang Zhu, and Huang Bo, one must verify the presence of damp-heat stagnation before using it. Otherwise, it will inadvertently damage Yin. Medication usage requires careful examination.