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Among the five zang organs, the stomach's function lies in receiving and containing. When summerheat pathogen is inhaled, it must lodge here. However, when there is qi deficiency with mental confusion, the initial presentation often involves fright, convulsions, or jue-ni (reversal cold). During summer and autumn, one must absolutely not mistake this for fright-epilepsy.

Treating malaria syndromes requires distinguishing the involvement of the twelve meridians; its complexity is comparable to that of cough syndromes. If treated by mediocre pediatric practitioners, they merely use Xiao Chai Hu Tang (Minor Bupleurum Decoction) without Ren Shen (Ginseng), or employ herbs such as Xiang Ru (Moslae Herba) and Ge Gen (Puerariae Radix).

Wang Shihiong's Note: The world universally acts this way, so what blame can be placed on pediatric doctors? They do not know that Chai Hu (Bupleuri Radix) depletes Liver Yin, and Ge Gen exhausts Stomach fluids, leading to frequent changes in the condition.

Wang Shihiong's Note: Regarding the drawbacks of Chai Hu and Ge Gen, these two sentences appear in Lin Beihai's reprinted edition of Zhang Sinong's "Quan Shu Zhi Shu" (Complete Book on Treating Summerheat). Ye Tianshi cited this; it was not fabricated. Xu Huixi's (Xu Lingtai's) reckless commentary lacks proper textual research. Young children possess a "pure yang" constitution, and summerheat is heat energy.

Wang Shihiong's Note: In heaven it is called summerheat, on earth it is called heat; thus, summerheat is simply the qi of heat. The ancient assertion of "yin summerheat" is extremely ridiculous. Dividing zhong shu (heatstroke) and zhong re (summerheat illness) into two diseases splits one qi into two. Claiming that summerheat combines with dampness to form disease merges two qis into one; how can this be acceptable? Malaria symptoms must present with abundant heat, vexation, and thirst. If the pathogen enters from the Lung, Gui Zhi Bai Hu Tang (Cinnamon Twig and White Tiger Decoction) should be used; two doses will surely cure it. If cold food causes stagnation and presents with signs of Taiyin Spleen disease, initially use Zheng Qi San (Regular Qi Powder) or acrid-warm herbs such as Cao Guo (Tsaoko Fructus), Sheng Jiang (Zingiberis Rhizoma Recens), and Ban Xia (Pinelliae Rhizoma).

Wang Shihiong's Note: Remember firmly, this is the method for treating illnesses caused by cold-dampness during the summer month. Formulary texts state that Cao Guo treats excessive cold in the Taiyin, and Zhi Mu (Anemarrhenae Rhizoma) treats excessive heat in the Yangming. For chronic malaria with sallow complexion, white lips, profuse sweating, and weakness, Si Shou Yin (Four Beasts Decoction) must be used.

Wang Shihiong's Note: Since the pathogen has departed and the healthy qi is depleted, this medicine can be used. For yin deficiency with internal heat, Bie Jia (Testudinis Carapax et Plastrum), Shou Wu (Polygoni Multiflori Radix), and Zhi Mu are required. If stools become loose, these are contraindicated. For chronic malaria damaging Ying blood with excess cold, add Gui Zhi (Cinnamomi Ramulus) and Sheng Jiang. Refer to the medication listed at the end of the Malaria section in "Guo Yi".

Wang Shihiong's Note: Ye Tianshi's discussion on various manifestations of malaria and dysentery in "Jing Yue Fa Hui" is worth consulting.

Medicines for initial summerheat, wind-dampness, and heat malaria:
For epigastric fullness and oppression: Zhi Ke (Aurantii Fructus), Jie Geng (Platycodonis Radix), Xing Ren (Armeniacae Semen Amarum), Hou Po (Magnoliae Officinalis Cortex) [these two are best for asthma], Gua Lou Pi (Trichosanthis Pericarpium), Shan Zhi (Gardeniae Fructus), Xiang Chi (Fermented Soybean).
For headache, use light acrid-cool agents: Lian Qiao (Forsythiae Fructus), Bo He (Menthae Haplocalycis Herba), Chi Shao (Paeoniae Radix Rubra), Ling Yang Jiao (Capricornus Saigae), Man Jing Zi (Vittariae Fructus), Hua Shi (Talcum) [light and penetrating to clear the upper jiao]. For severe cases, use Shi Gao (Gypsum Fibrosum); for thirst, use Hua Fen (Trichosanthis Radix); for vexation and thirst, use Zhu Ye Shi Gao Tang (Bamboo Leaf and White Tiger Decoction). For intense heat, use Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), and Shan Zhi.
Summer body pain belongs to dampness; Qiang Huo (Notopterygii Rhizoma et Radix) and Fang Feng (Saposhnikoviae Radix), being acrid-warm, should be avoided. Use Mu Fang Ji (Stephaniae Tetrandrae Radix) and Can Sha (Bombyx Batryticatus).

Wang Shihiong's Note: Dou Juan (Sojae Preparata) can also be used.

When summerheat-pathogen injures the body, initially affecting the Qi level, if unresolved after many days, it gradually enters the Blood level. This presents as thirst but little desire to drink, crimson lips and tongue. Huang Qin, Huang Lian, Shi Gao, and Zhi Mu will be ineffective. One must use blood-invigorating/clearing herbs, aided by only one herb that clears Qi-level heat.
For mild cases, use Qing Hao (Artemisiae Annuae Herba), Dan Pi (Moutan Cortex), Xi Jiao (Rhinocerotis Cornu - *Note: substitute with Buffalo Horn in modern practice*), Zhu Ye Xin (Bambusae Folium), Xuan Shen (Scrophulariae Radix), Xian Sheng Di (Rehmanniae Radix Recens), Xi Sheng Di (Rehmanniae Radix Praeparata), Mu Tong (Akebiae Caulis) [also induces sweating], and Dan Zhu Ye (Lophatheri Herba). Wang's Note: This refers to the herb Lophatherum, distinct from Bamboo Leaf Heart. If heat persists causing stagnation, select from Xie Xin Tang (Drain the Epigastrium Decoctions).

In summer, prolonged heat entering the blood level most frequently results in Blood Stasis. Xu Zhongke states: These are words born of experience. With delirium, coma, and mania, the diagnostic sign is clear, long urination accompanied by black stool; Tao He Cheng Qi Tang (Peach Kernel and Mirabilite Decoction) is the essential medicine.
Malaria treatment often uses Mei Guo (Mume Fructus), employing the principle of sourness to drain Wood and calm Earth.

Wang Shihiong's Note: Contraindicated when the pathogen has not yet declined. Using Chang Shan (Daphnes Genkwa Bark) and Cao Guo is to劫 (rob/seize) Taiyin cold. Chang Shan moves rapidly, preventing the two pathogens from combining; this is referred to as "simultaneously treating phlegm."

Wang Shihiong's Note: Do not use recklessly if there is no cold-phlegm internally. Using Ren Shen and Sheng Jiang constitutes Lu Jiang Yin (Dew Ginger Drink): one aspect consolidates Yuan Qi, the other disperses pathogenic factors, taking the meaning of unblocking spirit and removing filth.

Wang Shiong's Note: Only usable when the pathogen has declined and healthy qi is already deficient. In summary, chronic malaria leads to qi depletion; any herb that strengthens Gallbladder Qi can stop malaria; it is not necessarily due to a "malaria ghost."

Wang Shihiong's Note: Cases of possession by entities occur occasionally; not every malaria case involves evil spirits. Furthermore, chronic malaria entering the blood level may form a "malaria mother" (splenomegaly); use Bie Jia Jian Wan (Turtle Shell Pill). If using decoctions, blood-invigorating and collateral-unblocking methods suffice.

Xu Zhongke says: For infants who have not yet eaten grain, suffering from persistent malaria, use strong sugar water decoction; I have tested this and it is effective. Xu notes: This is also a folk remedy. Wang's Note: Using autumn dew water to decoct rock sugar is even better.

Wang Shihiong's Note: For those who eat grain, if malaria persists chronically, one must investigate the cause of persistence and treat accordingly.

Dysentery, anciently called "Zhi Xia" (stagnant downflow), occurs because turbid stagnation exists in the interior before downward discharge. However, stagnation may be in the Qi level or Blood level, caused by cold injury or heat injury, with various reasons. Modern people equate stagnation solely with food retention, using only digestive aids and imposing dietary taboos.

Wang Shihiong's Note: Moreover, some rigidly adhere to the saying "dysentery patients who can eat will not die," regardless of the pathogen type or severity, forcing food intake, leading to severe deterioration and death in many cases.

The phrase "dysentery patients who can eat will not die" means that if a dysentery patient can eat, it indicates a non-fatal prognosis; it does not mean forcing food upon those who hate grains.

Both malaria and dysentery arise in summer and autumn, caused by damp-heat郁蒸 (stifling steaming), leading to spleen-stomach failure in transporting water and grain. Damp-heat scorches the Qi, making blood viscous. Abdominal pain precedes dysentery, followed by incomplete relief after defecation. If illness occurs after eating melons or cold water, it may not immediately transform into heat; initially, use acrid-warm dispersing and draining agents.

Wang Shihiong's Note: Although it may not immediately transform into heat, if there is internal summerheat-dampness stagnation, intending to develop into dysentery, and eating raw/cold food triggers the onset, one must still examine pulse and symptoms to determine treatment. Do not hastily diagnose it as a cold syndrome; I have seen this often, hence the caution. If there are dozens of passages of pus and blood, with abdominal pain and tenesmus, initially use宣通 (disperse and unblock) to drive out heat, such as Huang Qin, Huang Lian, and Da Huang (Rhei Radix et Rhizoma), adding Gan Cao (Glycyrrhizae Radix) to moderate. Unlike Taiyang disease with hard feces requiring Mang Xiao (Mirabilite) to soften hardness and purge the lower jiao, here bitter herbs overcome dampness and cold herbs expel heat, which is sufficient to cure the disease. Ancient wisdom states: Invigorating blood heals pus and blood in stool; directing qi eliminates tenesmus. Blood-invigorating and cooling herbs include Dan Pi, Tao Ren (Persicae Semen), Yan Hu Suo (Corydalis Rhizoma), Hei Zha (Crataegi Fructus Carbonized), Gui Wei (Angelicae Sinensis Radix), and Hong Hua (Carthami Flos). Qi-directing herbs include Mu Xiang (Aucklandiae Radix), Bing Lang (Arecae Semen), Qing Pi (Citri Reticulatae Pericarpium Viride), Zhi Shi (Aurantii Fructus Immaturus), Hou Po, and Ju Pi (Citri Reticulatae Pericarpium). Secular standard practices are limited to this. Generally, malaria injuring meridians can be delayed; dysentery affecting zang organs, if mis-treated, becomes critical. The major principle of diagnosis is first determining constitutional strength, observing whether skin is rough or tender, and inquiring about lifestyle and etiology. In acute stages with solid constitution, the aforementioned methods apply. In chronic stages with depleted qi and spirit, even with abdominal pain and tenesmus, careful examination is needed; do not indiscriminately use purging and clearing-depletion methods.

Jin Kou Li (Dysentery with inability to swallow food/water) is caused by heat rising and turbidity attacking. Strong bitter-cold herbs like Huang Qin, Huang Lian, and Shi Lian Zi (Nelumbinis Nucillus) are used to clear heat, while Ren Shen assists Stomach Qi. Once heat opens, appetite returns; medicines should be taken frequently over two to three days. Xu notes: Ren Shen must be used with heat-clearing herbs to be appropriate.

Children suffer most from heat diseases because their constitution is pure yang; when the six climatic factors invade, qi and blood all transform into heat.

Wang Shihiong's Note: Adults, though not purely yang, often have yin deficiency; external pathogens transforming into heat is also very easy. Undigested food fermenting internally also transforms into heat. However, there are cases of recurrent fever after releasing the exterior, after purging interior heat, or after promoting urination. Nourishing yin and clearing heat fails to remove the fever. Zhang Jiming states that when Yuan Qi has no anchor, floating yang causes sudden heat. Liu Shen Tang (Six Spirits Decoction) is the primary formula.

In late autumn when coolness begins, young children suffer fever and cough.

Wang Shihiong's Note: Adults also commonly suffer this. The syndrome resembles spring Wind-Warmth. But "Warmth" implies gradual heating, while "Coolness" implies gradual cooling. Illnesses in spring stem from the residual closure of winter; injuries in autumn occur after the venting of summer. Their constitutions differ in deficiency and excess. Xu notes: Words of a wise person. Warmth enters from above, Dryness injures from above; the logic is equal, both affecting Lung Qi. People mistakenly recognize sudden exposure to wind-cold and indiscriminately administer Taiyang/Solitary-Yang dispersants,劫 (depriving) fluids, worsening dryness, leading to dangerous wheezing. If indeed bound by sudden coolness externally, with fever, phlegm, and cough, only Cong Chi Tang (Scallion and Fermented Soybean Decoction) or Su Geng (Perillae Caulis), Qian Hu (Peucedani Radix), Xing Ren, Zhi Shi, and Jie Geng should be used, for just one or two doses. More often, incompetent doctors know it is a heat disease and use Bai Du San modified with Huang Qin and Huang Lian, not knowing that increasing bitterness aids dryness, inevitably causing other complications. One should use acrid-cool and sweet-moist formulas; atmospheric dryness will naturally flatten and heal. Beware of using bitter-dry herbs that劫 (rob) Stomach fluids.

Wang Shihiong's Note: Summer venting is why latent summerheat syndromes are more common than latent cold.

Autumn Dryness syndrome affects the Qi level first; treating the Lung is urgent. If lingering for dozens of days, the disease enters the Blood level, and light-floating Lung herbs cannot treat it. One must assess constitution and symptom details. As ancients said, treating disease should be lively and flexible, like a pearl rolling on a plate.

Shen Yaofeng says: In heaven it is Dryness, on earth it is Metal; Dryness is one of the five qi.

Wang Shihiong's Note: From the perspective of the five qi, Dryness is a Cool pathogen; yin condensation causes dryness, which is its fundamental nature. However, the characters "Autumn Dryness" both contain fire components because autumn follows summer, and the residual flames of fire have not ceased. If fire subsides and yin is exhausted, dryness becomes its secondary manifestation. Treatment divides into warm-moist and cool-moist methods. Since Metal is described as "following change," fundamental nature diseases are rare, while secondary manifestation diseases are common. This explains why the character contains fire. The "Nei Jing" states: "For dryness, moisten it." Haifeng says: Dryness qi victory and restitution. Such concise analysis demonstrates great literary power. Yet, nothing dries things more than fire. Thus, fire is never without dryness, and dryness always comes from fire. Discussing Heat-Warmth via fire is discussing dryness. Without discussing dryness, where do the two "thirst" characters in Zhang Zhongjing's clauses come from? Furthermore, the heat disease clause states: "Oral dryness and thirst," explicitly pointing out the character "dryness." Yu Jiayan says: Ancients considered dryness-heat as summerheat, hence using Bai Hu Tang as the main treatment. This is a profound insight. Understanding this, there is no doubt that Heat-Warmth syndromes involve Fire Qi combined with Dryness.

Wang Shihiong's Note: Modern people consider summerheat a yin pathogen and claim summerheat contains dampness; these are nonsense.

Xu Huixi says: The discussions in this volume are peaceful, precise, every word like gold and jade, worthy of emulation and transmission. Having assimilated the true essence of the ancients, he is not just a famous doctor, but a master. I admire him deeply!

Huang Tui says: The Master is a renowned doctor in Wu region. Starting with pediatrics, his scholarship advanced daily, expanding his scope to Internal Medicine, achieving a grand synthesis. While his theory on Warm diseases follows He Jian, his prescriptions are meticulous, truly surpassing his teacher. However, readers must first study the theories of Zhang Zhongjing and subsequent masters before exploring Ye Tianshi's prescription logic, lest they become rootless duckweed.

Wang Shihiong's Note: Ye Tianshi's medical cases were compiled by later generations. Only this volume, "You Ke Yao Lue" (Essentials of Pediatrics), was personally finalized by the Master. Hua Shi printed it after the cases to pass down. Xu considered it "words of gold and jade." Regrettably, grand masters viewed it merely as pediatric treatment, an appendage to the collection, paying little attention. Pediatric students regarded it as a guide for grand medicine, ignoring it further. Even those expounding Ye's teachings, such as Dong Fu, Ju Tong, and Xu Gu, overlooked it. I argue that although stated for children, adults are no different. Therefore, after "Wen Re Lun" (Treatise on Warm-Heat), I appended sections on Spring Warmth, Summer Summerheat, and Autumn Dryness, drawing inferences to extend beyond mere pediatric care.