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Lei Shaoyi stated: In the late summer season, contracting summerheat pathogen presents with distinctions between Yin Summerheat and Yang Summerheat. The disease of Yin Summerheat arises from staying in deep halls and large mansions to seek coolness when the weather is hot and steaming, or from exposure to large fans and windmills; this is a Yin syndrome obtained through stillness. The pulse is floating, wiry, and forceful, or floating and tight; symptoms include headache, aversion to cold, bodily stiffness and constraint, pain in the limbs and joints accompanied by vexation, high fever of the skin without sweat. This is caused by Yin-cold forcing the body's Yang Qi to be unable to extend and ascend. It is appropriate to use the Acrid-Warm Exterior-Resolving method, removing Fangfeng (Saposhnikovia Root) and adding Xiangru (Elsholtzia Herb) and Huoxiang (Patchouli Herb). For vomiting and regurgitation, add Fuling (Poria) and Banxia (Pinellia Tuber); for diarrhea, add Houpo (Magnolia Bark) and Muxiang (Aucklandia Root).

There is also the disease of Yang Summerheat, which occurs due to long-distance travel or labor in fields under the pressing sun; this is a Yang syndrome obtained through movement. The pulse is floating, surging, and forceful, or surging and rapid; symptoms include a dirty complexion, panting and coughing, high fever with vexation, thirst with desire to drink, steaming heat with spontaneous sweating. This is caused by intense heat steaming the body, making the interior and exterior all hot. It is appropriate to use the Cooling-Clearing and Summerheat-Scouring method, removing Bian Dou (Dolichos Lablab Seed) and Tong Cao (Tetrapanax Pith), and adding Shigao (Gypsum Fibrosum) and Yangshen (American Ginseng). For vomiting and regurgitation, add Zhuru (Bamboo Shavings) and Huanglian (Coptis Rhizome); for diarrhea, add Gegen (Kudzu Root) and Heye (Lotus Leaf). One must further examine the patient's constitution and deficiency/excess status to prescribe medication, ensuring no impropriety.

Zhang Jiebin stated: Yin Summerheat syndrome may be at the exterior or in the interior, and is mostly seen in wealthy and idle people. It is generally caused by indulgence and lack of caution regarding wind and cold. Yang Summerheat syndrome is mostly seen in those who work hard and toil, caused by exposure to summerheat, which is often unavoidable due to circumstances. However, when summerheat presses upon people, they fear it and can avoid it, so few contract it; when Yin-cold attacks people, it feels pleasant and goes unnoticed, so many contract it. Therefore, among those suffering from summerheat diseases, Yang Summerheat is rarely seen, while Yin Summerheat accounts for eight or nine out of ten. Nowadays, when treating summerheat diseases, if one sees symptoms like fever and headache, one invariably says this is "Zhong Shu" (Summerstroke), using nothing but cooling herbs. This failure to understand medical principles is severe.

Jiang Cheng stated: Mr. Zhang Jiebin’s assertion that Yin Summerheat is more common than Yang Summerheat is most accurate. Nowadays, people treat summerheat without distinguishing Yin and Yang; upon seeing fever, they immediately administer cooling medicines. Such reckless practice harms people significantly.

Wang Andao stated: The Qi of summerheat and heat is the same; both are illnesses contracted in summer months due to pathogenic factors. How can one single summerheat pathogen be divided into Yin and Yang syndromes for naming? Those who avoid heat by staying in deep halls or by recklessly consuming ice-cooled fruits and melons are suffering from what the Classics call "mouth receiving cold substances, body encountering cold Qi." These should be treated similarly to Yin-type Cold Damage occurring in autumn and winter, and should not be named Summerstroke.

Shen Yaofeng stated: Summerheat, heat, and fire are all names for the single Qi of the summer season. Later generations failed to observe clearly, spreading baseless talk, which has no relevance to clinical conditions and instead confuses medical principles.

Yang Ruhou stated: Headache, aversion to cold, bodily stiffness, limb pain, vexation, and high fever of the skin without sweat indicate injury by cold during the summer month. Headache with dry heat sensation, high fever of the skin, extreme thirst with copious drinking, profuse sweating, and lethargy with inability to move indicate injury by heat during the summer month. The Classics state: "When flame-fire is excessive, summerheat prevails," indicating that summerheat is fire and heat. Later generations called the condition obtained through stillness "Zhong Shu" (Summerstroke) and that obtained through movement "Zhong Re" (Heatstroke), dividing summerheat and heat into Yin and Yang syndromes; this naming contradicts ancient meanings. Even more so, establishing the names Yin Summerheat and Yang Summerheat merely causes confusion. Here, the distinction is made between Cold Damage in summer and Heat Injury in summer.