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Erchen Tang (Two-Aged Decoction, without Gancao/Radix Glycyrrhizae), Sojae Seminis Germinatum (Doudouan), Artemisiae Annuae Herba (Qinghao), Gentianae Macrophyllae Radix (Qinjiao), Jiao Liuqu (Scorched Six-Ingredient Fermented Dough), Setariae Italicae Fructus Germinatus (Guya), Zingiberis Rhizoma Recens (Shengjiang), Jujubae Fructus (Hongzao).

Ren Yuan commented: Shu-Xie (Summerheat Pathogen) differs from Wen-Xie (Warm Pathogen), and Fu-Shu (Latent Summerheat) is no exception. When summerheat is contracted and manifests immediately, it is called Shu-Xie (Summerheat Pathogen). When one contracts Shu-Shi (Summerheat-Dampness) during the summer months but does not manifest immediately, and later in autumn contracts cool wind which closes the sweat pores, preventing the pathogen from expelling rapidly, the exterior presents with aversion to cold while the interior presents with fever. The alternating chills and fever persist without cessation, resembling Malaria (Nue-Ji), which is termed Fu-Shu (Latent Summerheat). Ancients stated that alternating chills and fever belong to Shaoyang disease. I assert that the alternating chills and fever caused by latent Shu-Shi pathogens are entirely due to Spleen and Stomach pathology. The Shaoyang Gallbladder Qi (Shaoyang Danjia) is affected secondarily due to the failure of Spleen and Stomach transformation. The Spleen is Yin Earth; it dislikes dampness and prefers dryness. Dryness promotes ascending transformation, whereas dampness stagnates and prevents ascending. The Stomach is Yang Earth; it dislikes heat and prefers coolness. Coolness promotes descending flow, whereas heat obstructs and prevents descending. When ascending and descending mechanisms are blocked and stagnant, chest and abdominal fullness and oppression frequently occur. Wood resides within Earth; when Earth loses its balance of warmth and coolness, Wood inevitably fails to flourish smoothly—this is an inevitable trend. When dampness is heavy, chills predominate; when heat is severe, fever predominates. Heat consumes fluids leading to thirst. Dampness stagnating in the middle jiao causes thirst but little desire to drink. When dampness and heat steam each other, stomach turbidity fails to transform, and the tongue coating often presents as white and greasy. A crimson tongue base indicates heat suppressed by dampness; a pale tongue indicates excess dampness. Transformation to yellow, dry, or grey/black states indicates heat exceeding dampness. Dampness can also transform into dryness and fire. Chest and abdominal fullness, hardness upon palpation with resistance, or accompaniment by phlegm or food retention, vary according to the patient's constitutional root and the severity of the contracted pathogen.

Regarding treatment:
In the initial stage, bitter, acrid, aromatic, and bland methods constitute the correct approach. Merely using diaphoresis (sweating method) is of no benefit. Bitter flavors drain heat, acrid flavors circulate qi, aromatics resolve depression, and bland flavors promote urination/drainage. This allows the stagnation in the Middle Jiao to be resolved; sweating occurs naturally without forcing it, and bowel movements normalize without purgatives. This is the method for treating pathogens in the Qi level. If the pathogen enters the Ying (Nutritive) level, the approach differs. If it has just entered the Ying level, one may still vent the Ying pathogen back to the Qi level and resolve it from the Qi level. If it has already sunk into the Ying level, presenting with mental confusion and delirious speech, formulas such as Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction), Niuhuang Wan (Calculus Bovis Pill), or Zhibao Dan (Precious Treasure Pill) are necessary. When fluid depletion leads to dryness, resulting in stubborn fullness and hardness, with pathogenic excess in the Yangming Fu organs, the method of nourishing yin and unblocking the bowels is the same as for Warm Pathogens. However, Warm Pathogens transform into fire; when the fire subsides, the disease resolves. Latent Summerheat transforms from dampness into dryness; when dryness is removed, dampness may return. This is because although dampness transforms into dryness, it ultimately remains a Yin pathogen, and dampness most injures the Middle Jiao. When Middle Qi is deficient, Yin-dampness easily arises. Therefore, when clearing heat for six or seven days, one must carefully protect the Middle Qi. Purging methods also differ. For Warm Pathogens, purging should be rapid; for Latent Summerheat, purging should be slow. Purging clears pathogens in Warm Pathogens, but may not clear them in Latent Summerheat. Warmth belongs to Fire, is Yang, and acts swiftly; Summerheat combined with Dampness is largely Yin and acts slowly. Warm Pathogens often involve Shaoyin, whereas Latent Summerheat often involves Taiyin. There are cases where constipation persists for half a month with chest and abdominal fullness, yet it still belongs to formless damp-heat and cannot be purged. One must always examine the tongue. If the coating is thick and white without transforming to yellow and dry, purging is contraindicated even if there is fullness. Purging will not subdue the pathogenic force, will severely damage Middle Qi, and make treatment more difficult. One must understand the four characters "Qi circulation leads to disease resolution"; regarding the treatment of Latent Summerheat, this covers more than half the understanding. Furthermore, if heat is scorching but sweating is scant, and the tongue coating is dry and grey-yellow, yet thirst is slight or drinking leads to chest oppression, cool and bitter herbs may be used but must be assisted with aromatic herbs. One must be cautious with cooling and moistening, sinking and heavy substances like Guiban (Tartarich Nux), Biejia (Carapax Trionycis), Xianshidu (Fresh Dendrobii Caulis), and Xianshengdi (Fresh Rehmanniae Radix). It is often seen that these increase dryness. The reason is that Summerheat invariably combines with Dampness; if Middle Qi fails to ascend and transform, cooling and moistening agents suppress and inhibit qi mechanism, causing the pathogen to become even more entrenched.