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Experiencing the evil of summer heat, which consumes Qi and injures body fluids, presents with symptoms such as fever, thirst, fatigue, sweating, and yellow urine. To elaborate, the summer heat syndrome includes heat injuring body fluids, summer dampness attacking the exterior, summer obstructing Qi mechanisms, summer obstructing the heart protector, and summer heat stirring wind.
Summer heat, referred to as “heat stroke” in the Shang Han Lun, describes the symptoms of heat exposure. When the body is exposed to high temperatures, symptoms such as sweating, chills, fever, and thirst arise due to vasodilation. Mild cases may present with headaches, dizziness, thirst, and excessive sweating. In severe cases, excessive sweating can lead to cold limbs, pale complexion, decreased blood pressure, and increased pulse rate. Severe cases may result in electrolyte imbalances, heat cramps, heat exhaustion, and heat stroke, treated with Bai Hu Tang (White Tiger Decoction) plus modifications. In high-temperature and high-humidity environments, the body’s ability to evaporate water is diminished, leading to heat stroke. In southern regions during summer, high humidity often leads to this type of heat stroke, hence summer dampness is frequently mentioned, especially in the south. Due to the propensity for heat stroke in high-temperature and high-humidity conditions, Zhang Zhongjing discusses cramps due to damp heat together.
Dampness, whether from external dampness or internal fluid metabolism disorders, obstructs Qi mechanisms or clear Yang, leading to symptoms such as heaviness, limb soreness, abdominal distension, and diarrhea. External dampness can arise from rain exposure, living in damp conditions, or being affected by mist. At this time, the skin and subcutaneous capillary beds undergo changes to prevent dampness invasion. Dampness can combine with other pathogenic factors, such as wind dampness or cold dampness, or heat dampness, treated with methods to dispel wind and dampness, and clear heat and resolve dampness. Pathogenic dampness can also arise from Yang deficiency of the lungs, spleen, or kidneys, leading to abnormal fluid distribution and the formation of dampness.
The pathogenic nature of dampness is closely related to Taiyin disease. The classical method of supporting Yang posits that Taiyin syndrome fundamentally involves insufficient Qi transformation, manifesting as decreased cellular function and increased pathological products. The body’s metabolic waste needs to be water-soluble or fat-soluble. When the body’s Qi transformation is insufficient, water-soluble or fat-soluble metabolic products accumulate in interstitial fluid or the lymphatic system, manifesting as dampness. This can lead to systemic or localized fluid metabolism disorders, excessive water content in tissues or cells, resulting in edema or increased exudation, which is also dampness. Depending on concentration, it can be classified as water Qi, water fluids, phlegm turbidity, etc. Under conditions of fluid metabolism disorders, there can be excitatory or inhibitory effects on function, or metabolic products can stimulate the body’s functions to enhance or diminish, leading to damp-heat or cold-damp conditions. The human body is largely composed of water, and regulating fluid metabolism disorders is a common focus in classical methods.
Dryness refers to external climatic dryness that injures Yin fluids, primarily manifesting as dryness of the skin, mouth, nose, and throat. Dryness can be categorized into heat dryness and cool dryness. Heat dryness presents with fever and open circulation at the surface, leading to fluid loss and decreased secretion from mucous glands. Cool dryness, on the other hand, is caused by constriction of surface circulation and secretion disorders from mucous glands. In autumn, warm temperatures can lead to warm dryness, while cool temperatures in late autumn can lead to cool dryness, presenting symptoms similar to exterior patterns of wind-heat or cold. Similar to wind-cold, dryness can also be classified as external dryness and internal dryness. In treatment, in addition to the conventional methods of nourishing Yin and moistening dryness, restoring glandular secretion function is also crucial. Dysfunction of glandular function often requires intervention in the capillary beds surrounding the glands, and relieving vascular spasms may require warming herbs. Additionally, protecting the stomach Qi and restoring the source of Qi and blood production to ensure sufficient Yin fluids and blood nourishment is also an important treatment strategy for dryness.
Fire primarily refers to the external invasion of fire-heat pathogens, while internal injury can arise from improper diet or excessive emotional stress. Common manifestations include excess Yang heat, presenting with fever, thirst, flushed face, constipation, and yellow urine. Fire, heat, and warm pathogens share similar properties, differing in urgency; warmth is a gradual increase in heat, while fire represents the extreme of heat. Excessive fire heat can cause Qi consumption and fluid injury, stirring wind and blood, easily leading to swellings. Treatment should focus on benefiting Yin and breaking Yang. External fire-heat syndromes are closely related to pathogenic microorganisms or conditionally pathogenic microorganisms, often presenting severe symptoms and strong inflammatory responses. Classical treatment for fire-heat syndromes typically employs Yangming-type formulas, such as Bai Hu Tang (White Tiger Decoction), Cheng Qi Tang (Purgative Decoction), Zhi Zi San (Gardenia Powder), and Qin Lian San (Scutellaria and Coptis Powder). However, it is important to note that pure fire-heat syndromes are extremely energy-consuming and cannot persist for long; during treatment, care must be taken not to damage stomach Qi, which can hinder recovery.
The core theory of the six excesses causing disease is to examine the human body within the context of the entire natural environment to investigate causes, mechanisms, and conduct differential diagnosis and treatment. External six excesses largely refer to abnormal natural climates, some of which favor the survival or reproduction of pathogenic microorganisms. Bacteria, viruses, and other pathogens are more likely to invade the human body under certain meteorological conditions. Therefore, the theory of six excesses causing disease is closely related to infections by conditionally pathogenic microorganisms. Regardless of the type of microbial infection, the body’s response patterns are limited. The six meridian differential diagnosis system for treating infectious diseases is based on this consideration, aiming to simplify treatment.
Written by | Zhao Jie, Shanxi Integrated Traditional Chinese and Western Medicine HospitalEdited by | Li RuiReviewed by | Li Xiuyun, Bai Xiaoyun