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Pathogenic factors of Damp-Heat (Shī Rè, damp-heat) enter from the exterior in one or two cases out of ten, and enter via the mouth and nose in eight or nine cases out of ten. The Yangming channel is the sea of water and grain, and the Taiyin organ is the wet earth viscera; therefore, diseases often occur in both the Yangming and Taiyin channels/organs.

The exterior of the Taiyin involves the four limbs and also relates to the Yangming; the exterior of the Yangming involves the muscles and also relates to the chest. Therefore, chest stuffiness (xiōng pǐ, a sensation of fullness and obstruction in the chest) is an inevitable symptom of Damp-Heat disease, while limb fatigue and muscle discomfort/pain will inevitably appear concurrently.

The Mo Yuan (Membrane Source, a specific location between the interior and exterior), externally connects to the muscles and internally approaches the stomach fu-organ; it is the gateway of the Sanjiao (Triple Burner) and actually constitutes the half-exterior half-interior of the entire body. Pathogens received from above directly tend toward the middle pathway; thus, diseases often localize at the Mo Yuan. In summary, Damp-Heat diseases differ not only from Cold Damage (Shāng Hán, cold damage syndrome) but are also significantly distinct from Warm Diseases (Wēn Bìng, warm disease syndrome). Warm Disease involves simultaneous pathology of the Shaoyin and Taiyang; Damp-Heat involves simultaneous pathology of the Yangming and Taiyin. Here, symptoms are discussed without pulse diagnosis because the pulse presentation in Damp-Heat has no fixed pattern: it may be洪 (Hóng, surging/vigorous), 缓 (Huǎn, slow/relaxed), 伏 (Fú, deep-hidden), or 细 (Xì, fine/thready). Thus, it is difficult to restrict practitioners' judgment with a fixed pulse pattern.

In Damp-Heat syndromes, Yangming pathology must accompany Taiyin pathology. People merely know that the zang-fu organs are connected and share the nature of wet earth, but they do not realize that this should be compared to Warm Disease where Shaoyin pathology is invariably involved. When Shaoyin fails to store essence, wood and fire blaze internally; when Wind pathogen attacks externally, the exterior and interior correspond, resulting in Warm Disease. When Taiyin suffers internal injury, leading to stagnation and accumulation of Dampness and fluids, and external pathogens arrive again, the interior and exterior attract each other, resulting in Damp-Heat disease. These all arise first from internal injury followed by exposure to external pathogens, rather than transmission from fu-organs to zang-organs. If a Damp-Heat syndrome does not involve internal injury and the Middle Qi (Zhōng Qì, central qi) is solid, the disease will necessarily be mild. There are cases where illness begins due to Dampness and is subsequently aggravated by hunger and labor; these also belong to internal injury complicated by Dampness, where both root and branch are diseased simultaneously. However, labor injuring the Spleen results in deficiency (Xu, deficient condition), while stagnation of Dampness and fluids results in excess (Shí, excess condition). Therefore, regarding internal injury versus external contraction, which is more prevalent, and whether the condition is deficient or excess, one must weigh and judge during clinical practice.

After continuous rain during the summer months, when sunlight shines warmly, turbid Dampness steams upward. When humans are in this steaming environment of Damp-Heat and become infected, Summerheat and Dampness combine. Mixed with foul and turbid air, if inhaled by humans, it becomes Sha Du (Sha Toxin, epidemic toxin). Once human Zheng Qi (True Upright Qi, vital energy) becomes deficient, pathogens of Summerheat, Dampness, and Turbidity are all inhaled via the mouth and nose and spread throughout the Sanjiao. Ascending to reach the Heart, it is called Zhong Sha (Central Sha); entering the Stomach, it is called Huo Luan (Cholera-like disorder); occupying the Mo Yuan, it presents as alternating Chills and Fever (Hán Rè); returning to the Intestines and Stomach, it presents as Diarrhea (Xiè Xiè). Generally, Summerheat-Heat pathogens that erupt suddenly and severely are called Shi Wen (Damp-Warmth); those that erupt late and mildly are called Han Re Ru Nüe (Chills and fever resembling Malaria) or Fu Shu Wan Fa (Late-onset latent Summerheat); those that erupt immediately upon exposure are called Han Re or Xie Xie; those whose latent pathogens erupt only in autumn are then called Nüe (Malaria) or Li Ji (Dysentery). A single pathogen infection can cause multiple diseases; how can clinicians fail to investigate the root and source for treatment?