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Jieguo stated: Contracting heatstroke while in a state of rest is called *Zhongshu* (Summerheat Stroke); contracting it while in motion is called *Zhonger* (Heatstroke). *Zhongshu* belongs to Yin syndromes, whereas *Zhonger* belongs to Yang syndromes.

Dongyuan stated: One who seeks refuge from summer heat in deep halls and large mansions and contracts the disease is named as having *Zhongshu*. The symptoms must include headache, aversion to cold, stiffness of the body and limbs, pain in the joints accompanied by vexation, hot skin without sweat. This occurs because the yin-cold of the dwelling suppresses the body's yang qi, preventing it from extending and rising. The primary formula for treatment is Dashun San (Greatly Smooth Powder). If a traveler or farmer contracts the disease after laboring under the midday sun, they are named as having *Zhonger*. The symptoms must include severe headache, irritability, fever, aversion to heat, burning-hot skin upon touch, extreme thirst with an urge to drink copiously, profuse sweating, and lethargy due to lack of qi. This results from heavenly heat injuring the Lung qi externally. The primary formula for treatment is Cangzhu Baizhu Tang (Atractylodes and White Tiger Decoction).

I hold that summer heat is the seasonal command of summer, prevailing widely between heaven and earth. If a person labors or goes hungry, causing their primordial qi to become deficient and insufficient to resist the extreme climatic conditions, they will be injured and fall ill. This is called *Zhongshu*, also called *Zhonger*. In reality, they are one and the same. Why then distinguish them based on motion and stillness?

Those who contract summer heat indeed mostly occur among those engaged in labor. Labor leads to deficiency; deficiency allows pathogenic factors to enter; entry of pathogenic factors leads to disease. If there is no deficiency, even if the climatic conditions are extreme, there is no pathway for injury. Those who seek refuge in deep halls and large mansions and present with symptoms such as headache and aversion to cold have likely merely caught a slight wind or chilled themselves during a quiet night. They cannot be termed as having *Zhongshu*. The reason for their vexation and hot skin is not due to summerheat pathogens, but rather the body's internal yang qi being suppressed by external pathogens. Since it is not a summerheat pathogen, how can it be termed *Zhongshu*? If one wishes to treat this, dispersing with acrid-warm and light-yang agents is sufficient.

Dashun San contains the largest amount of Gancao (Licorice Root), followed by Ganjiang (Dried Ginger), Xingren (Apricot Seed), and Rougui (Cinnamon Bark). Except for Rougui, the other three herbs are stir-fried. Investigating its original intent, it was established primarily for cases where one ventured into summer heat and latent fire, drank excessively, leading to dampness affecting the spleen and stomach, vomiting, indistinguishable food and water, and disharmony of the zang-fu organs. Therefore, Gancao and Ganjiang are both stir-fried until cooked, and Rougui is used instead of Guizhi (Cinnamon Twig), as it is a warming herb. The inclusion of Xingren serves only to direct qi downward. If this medicine were used to treat the condition contracted through stillness, I fear it would fail to release the exterior and might instead increase internal vexation.

Currently, laypeople often fail to understand this, claiming that in summer months, yin qi resides internally, making Dashun San an essential medication. Alas, this error is too grave! The so-called yin qi is not cold qi. It is simply that in summer, yang qi disperses outward, while yin qi remains inward. How can one regard yin qi as cold qi and use warm-hot medicines? If yin were truly cold, why do people drink ice in summer?

Therefore, can Cangzhu Baizhu Tang be regarded as a universal remedy? One must refer to various formulas for treating summerheat and apply them according to the observed syndromes to ensure rationality. As for the so-called condition contracted through stillness, even if it occurs in summer, it is not a summerheat disease. It should be distinguished clearly to prevent future confusion arising from apparent similarities and actual differences.