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The latent pathogenic factor contracted in summer manifests in late autumn. Sweating fails to resolve the condition, followed by diarrhea. This is a syndrome of latent pathogens within the interior, distinct from sudden external contraction; thus, exterior-releasing methods are ineffective. The illness has persisted for forty days. The pulse is fine and hard like a blade, the complexion is withered and depleted, yet there is internal heat and thirst. The tongue coating is white, and there is loose stool during the illness. This results from prolonged fever forcing evaporation, leading to a loss of Yin-Yang regulation. Bitter-cold drugs have dried and damaged fluids, causing daily depletion of body fluids. Since the disease was caused by heat, the physician failed to apply Liu Hejian's "Three Seasons Rule" to differentiate the Upper, Middle, and Lower Jiao to expel the pathogen. Instead, he adhered to the narrow habits of Jie'an (Li Dongyuan), which explains why the illness lingers without end. If not urgently regulated, prolonged delay will lead to deficiency and weakness, as the ancients called it: damage due to illness. Be cautious!
Prescription: Bamboo Leaf Heart (Zhuye Xin), Charred Rehmannia Root (Shengdi Tan), Raw White Peony Root (Sheng Baishao), Rice-fried Ophiopogon Tuber (Mijiao Maidong), Fried Moutan Bark (Chaodanpi), Dark Plum Flesh (Wumei Rou).

Latent summerheat manifesting in late autumn belongs to interior syndromes. Although seminal emission or diarrhea has occurred, it indicates Yin deficiency with accompanying pathogens. Warm-releasing methods are contraindicated to avoid further injuring Yin fluids. Currently, with spontaneous diarrhea, thirst, and abdominal fullness, one may refer to the method of Sini San (Four Counterflow Powder).
Prescription: Scutellaria Root (Huangqin), Immature Bitter Orange (Zhishi), Liuyisan (Six-to-One Powder), Raw Peony Root (Sheng Shaoyao), Tangerine Peel White (Guangpi Bai).

Summer heat lies latent internally; autumn coolness causes the latent pathogen to emerge internally. Initially, pus flowed from the ear canal, indicating that wind-cold was no longer at the exterior. Now, after more than ten days, there is constipation, yellow and red eyes, yellow tongue coating, deafness, delirium, and signs of gradual internal closure. This is not a mild condition.
Prescription: Forsythia Fruit (Lianqiao), Scutellaria Root (Huangqin), Rhubarb (Dahuang), Black Gardenia Seed (Heizhi), Raw Licorice Root (Sheng Gancao), Immature Bitter Orange (Zhishi).
Decoct rapidly over high heat for forty boils, then filter and take the clear liquid.

Damp-heat pathogen stagnates in the Qi level, causing fever, jaundice, and spontaneous diarrhea. Contracted in summer, it manifests in late autumn.
Prescription: Stephania Tetrandra Stem (Mufangji), Apricot Seed (Xingren), Scutellaria Root (Huangqin), Raw Gypsum Sherd (Sheng Shigao), Immature Bitter Orange (Zhishi), White Peony Root (Baishao).

Pulse is deep, eyes are yellow, with wheezing, coughing, vomiting, epigastric oppression, cold limbs, and tidal fever. Perspiration brings slight relief, but fever returns shortly after. The illness has persisted for nine days without resolution, accompanied by dry mouth and spontaneous diarrhea.
This is dampness dominating internally transforming into heat, with obstruction of the Triple Burner. Latent in summer, it manifests at Frost Descent (Shuangjiang), indicating a severe condition.
Prescription: Apricot Seed (Xingren), Pinellia Tuber (Banxia), Artemisia Capillaris Herb (Shanyinch'en), Fresh Acorus Rhizome (Xian Shichangpu), Magnolia Bark (Nongpo), Areca Seed (Caoguoren), Poria Skin (Fuling Pi), Trichosanthes Root (Chuandongcao).

Chronic pain treated with acrid-warm methods to unblock Qi and Blood was ineffective. The illness has lasted ten years, and the origin is unknown. Currently, there is loose stool and dark urine, indicating failure to transport water and grain damp-heat. It must involve dampness obstructing Qi mechanism; the primary treatment is differentiation and elimination (Fenxiao).
Prescription: Coix Seed (Yiyiren), Magnolia Bark (Nongpo), Polyporus (Zhu Ling), Poria Skin (Fuling Pi), Cardamom Seed (Kou Ren), Artemisia Capillaris Herb (Shanyinch'en), Alisma Rhizome (Zexie).
Another prescription: Xiangsha Pingwei San (Aucklandia and Amomum Powder to Pacify the Stomach), added with Poria (Fuling) and Artemisia Capillaris Herb (Yinch'en).

In wine drinkers, damp-heat is internally accumulated; in midsummer, external damp-heat adds to it. Physicians did not understand that the exogenous pathogen coexists with chronic disease. Using releasing and digesting methods severely injured stomach fluids, first causing discharge of sticky matter and hematemesis. Now, both dorsums of the feet are numb, knees feel reverse-cold, Yin fluids are exhausted, meridians lack Qi, the tongue is crimson with irritability and thirst, urine is dark, scanty, and difficult. Heat is not fully cleared, while the root is already depleted. The appearance of kyphosis and disability seems unavoidable.
Prescription: Talcum (Huashi), Raw Gypsum Sherd (Sheng Shigao), Cold Water Stone (Han Shuishishi), White Peony Root (Baishao), Phellodendron Bark (Chuanbai), Ophiopogon Tuber (Maidong), Fresh Rehmannia Root (Xian Shengdi), Donkey-hide Gelatin (Ejiao), Honey-fried Licorice Root (Zhi Cao), Hemp Seed (Maren).

Tongue coating is white with a yellow center, indicating dampness attaching to the Taiyin Spleen. Food is not transported, leading to vomiting.
Prescription: Apricot Seed (Xingren), Tangerine Peel White (Guangpi Bai), Areca Seed (Caoguoren), Patchouli Stem (Huogeng), Magnolia Bark (Nongpo), Pinellia Tuber (Banxia).

Pain and distension are relieved by vomiting, followed by alternating chills and fever, bitter taste in the mouth, and yellow eyes. All indicate internal disturbance by damp-heat and unclear stomach appetite. The *Ling Shu* states that when Middle Qi is insufficient, urination and defecation undergo changes.
Prescription: Bupleurum Root (Chaihu), Trichosanthes Root (Huafen), Grain Sprout (Guya), Ginger (Shengjiang), Scutellaria Root (Huangqin), Pinellia Tuber (Banxia), Immature Bitter Orange (Zhishi), Jujube Date (Dazao).

Although summer-dampness has passed, Stomach Qi has not recovered. One must strictly adhere to bland flavors and quiet rest, preventing exogenous pathogens from disturbing again.
Prescription: Dendrobium Stem (Chuan Shihu), Tangerine Peel (Guangpi), Fermented Pinellia (Banxia Qu), Roasted Alpinia Oxyphylla Fruit (Wei Yizhiren), Poria (Fuling), Green Citrus Peel (Qingpi).

With heat and turbidity ascending, there is head distension and epigastric stuffiness. Vegetable food and clearing of the upper burner are appropriate.
Prescription: Bamboo Leaf Heart (Zhuye Xin), Mulberry Leaf (Sangye), Scutellaria Root (Huangqin), Forsythia Fruit (Lianqiao), Trichosanthes Root (Huafen), Apricot Seed (Xingren).

Pulse is deep, tongue is crimson. Pathogen has entered the Blood level. There is irritability, and spirit is about to become confused. Use Zhuye Dihuang Tang (Bamboo Leaf and Rehmannia Decoction).
Prescription: Bamboo Leaf Heart (Zhuye Xin), Zhejiang Rehmannia Root (Zhe Shengdi), Rhinoceros Horn Tip (Xijiao Jian), Forsythia Heart (Lianqiao Xin), Scrophularia Root (Yuann Shen), Fine-leaved Acorus (Xiye Changpu).

Initially, latent summerheat injured the Qi level, causing tidal fever and thirst. The pathogen attacked the Lung. Failure to treat properly leads to transmission to the Pericardium (Dan Zhong), resulting in a crimson, retracted tongue, sudden urinary retention, epistaxis, perioral ulceration, deafness, and mental dullness. This indicates Qi-level pathogenic heat spreading into the Blood level. The Lung governs Wei (Defensive) Qi, and the Heart governs Ying (Nutritive) Qi. Ying and Wei Qi circulate day and night through the collaterals. Meeting pathogens, they may be cool or hot. Now entering the collaterals, fluids are seized, leading gradually to confusion, known as internal closure...
Prescription: Rhinoceros Horn Tip (Xijiao Jian), Scrophularia Heart (Yuann Shenxin), Honeysuckle Flower (Jinyinhua), Fresh Rehmannia Root (Xian Shengdi), Forsythia Fruit (Lianqiao), Fine-leaved Acorus Root (Xiye Changpu Gen).
Simultaneous treatment of Heart Ying and Lung Wei.
Prescription: Fresh Rehmannia Root (Xian Shengdi), Sugarcane Juice (Zheshi), Raw Licorice Root Tip (Sheng Gancao Shao), Ophiopogon Tuber (Maidong), Trichosanthes Root (Huafen).

Summer-dampness is essentially a Yin pathogen, inevitably injuring the Qi level. Over time, all three Jiao are affected. Flow from the vertex to the chest and hypochondrium becomes obstructed, causing difficult urination and defecation. However, long-standing dampness generates heat; treating dampness requires addressing its root cause.
Prescription: Guiling Ganlu Yin (Cassia and Poria Sweet Dew Drink).

Latent summerheat meets new coolness, causing fever and cough. Treatment focuses on the Lung. Tongue coating is white and non-moist, scrotal swelling occurs. Summerheat must accompany dampness; damp stagnation causes swelling.
Prescription: Reed Rhizome (Lugen), Poria (Fuling), Light Bamboo Leaf (Dan Zhuye), Apricot Seed (Xingren), Tongcao (Tongcao).