Library

Onset of disease before the Summer Solstice is termed *Wen Bing* (Warm Disease), while onset after the Summer Solstice is termed *Re Bing* (Heat Disease). These two conditions may arise from cold pathogenic factors latent during winter, or from sudden exposure to external pathogens at the time of onset. Those who contracted *Shang Han* (Cold Damage) in winter and transformed into warm-heat diseases in spring and summer do so because the pathogen varies in depth, resulting in differences in the speed of onset. (Ke Yunbo stated: For all cases where *Shang Han* evolves into a specific condition, the root lies in internal stagnant fire. Such individuals possess abundant Kidney Yang, have a propensity for sexual indulgence, and are externally affected by cold. Deficient Yang sinks into the Yin aspect. In winter, it does not manifest immediately. If the days of cold are few and accumulated heat is shallow, Yang fire responds to Spring Qi and manifests as *Wen* (Warmth); if the days of cold are many and stagnant heat is deep, Yang fire responds to Summer Qi and manifests as *Shu* (Summer Heat). Shen Qianlü stated: *Chun Wen* (Spring Warmth) does not entirely stem from latent cold; if one contracts the pathogenic factors of the current spring season and falls ill, it is also named *Wen*. Similarly, *Xia Re* (Summer Heat) does not entirely stem from latent cold; if one contracts the pathogenic factors of the current summer season and falls ill, it is also named *Re*. In these cases, the pathogen moves from the interior to the exterior, presenting without *Biao Zheng* (Exterior Syndrome). If an exterior syndrome is present, it must be due to a secondary contraction of external pathogens. *Wen Bing* is primarily treated with Huangqin Tang (Scutellaria Decoction), because the onset of *Chun Wen* occurs when the Shaoyang channel governs. *Re Bing* is primarily treated with Baihu Tang (White Tiger Decoction), because the onset of *Xia Re* occurs when the Yangming channel governs. Furthermore, *Re* is more severe than *Wen*, requiring the robust clearing power of Baihu Tang, as this period coincides with intense summer heat. Symptoms include aversion to cold being absent but aversion to heat being present, spontaneous sweating, thirst, and a洪大 (Hóng Dà - Surging and Large) pulse. Therefore, Shi Gao (Gypsum Fibrosum), with its pungent and cold nature, clears the heat accumulated in the Stomach Fu; Zhi Mu (Anemarrhenae Rhizoma), with its bitter and cold nature, purifies the source of latent pathogens in the Shaoyang; Gan Cao (Glycyrrhizae Radix et Rhizoma) and Jing Mi (Oryza Sativa), with their sweet and neutral nature, protect the Qi of the Lung and Stomach, thereby eliminating the heat. If the tongue coating is slippery, indicating residual exterior pathogens, Zhizi Chi Tang (Gardeniae and Fermented Soybean Decoction) is indicated. If there is thirst with desire to drink water, dry mouth, and dry tongue, the heat is in the interior and has consumed body fluids; Renshen Baihu Tang (Ginseng White Tiger Decoction) is indicated. If there is aversion to heat, irritability, severe thirst, abdominal fullness, and a yellow, dry, or even black and dry tongue coating, purgation is appropriate; Liangge San (Cooling the Diaphragm Powder) or Chengqi Tang (Descending the Qi Decoction) should be used. For heat combined with summer-dampness, Liangge San is combined with Tianshui San (Heaven and Water Powder). For difficulty in urination, Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) is used. For pathogens contracted in summer that manifest immediately upon infection, the pathogen enters via the mouth and nose, and treatment should target the Hand meridians, not using formulas for the Foot meridians. The method should be referred to the section on "Sudden Onset of Warm Disease" mentioned earlier.)