Utilizing the Same Named Formula “Qing Shu Yi Qi Decoction” for Summer Heat and Qi Deficiency

Click on 【Herb Query】, then click the upper right corner 【···】to set asStar/Top for easy accessCurrently, there are many exercise videos online, and some people have started practicing along, even running outdoors in the hot weather to sweat more. However, after a few days of practice, they feel unwell, their mental state worsens, and they easily become irritable and fatigued. Climbing stairs makes them feel dizzy, and they may feel an increase in body temperature and thirst. This situation indicates mild heat stroke caused by improper exercise in hot weather, which is classified as a Yang heat syndrome with both Qi and body fluids injured. One can try Wang’s Qing Shu Yi Qi Decoction. This decoction originates from Wang Mengying’s “Wen Re Jing Wei” and is indicated for the syndrome of injury to Qi and body fluids due to summer heat. Clinical manifestations include body heat, excessive sweating, thirst, irritability, short and red urine, fatigue, and a weak and rapid pulse as key diagnostic points. This formula differs from Li Dongyuan’s Qing Shu Yi Qi Decoction mentioned later, which emphasizes the patient’s constitution, particularly those who are usually deficient in both Qi and Yin, and suddenly feel the invasion of summer dampness, leading to symptoms such as body heat, headache, thirst, spontaneous sweating, fatigue in the limbs, chest tightness, heaviness in the body, loss of appetite, loose stools, short and red urine, greasy tongue coating, and a weak pulse. Reference dosage: 5g of Xi Yang Shen (American Ginseng), 15g of Shi Hu (Dendrobium), 9g of Mai Dong (Ophiopogon), 3g of Huang Lian (Coptis), 6g of Zhu Ye (Bamboo Leaves), 15g of He Geng (Lotus Stem), 6g of Zhi Mu (Anemarrhena), 3g of Gan Cao (Licorice), 15g of Jing Mi (Glutinous Rice), and 30g of Xi Gua Cui Yi (Watermelon Peel). Method of preparation: Decoction in water, one dose per day, taken twice daily. The sweet and cool properties of Xi Gua Cui Yi help clear summer heat and generate fluids, while the “Sui Xi Ju Yin Shi Pu” states that Xi Gua Cui Yi: “cools and clears summer heat.” Xi Yang Shen has sweet and bitter flavors, is cool in nature, benefits Qi, clears heat, and generates fluids. The “Ben Cao Cong Xin” states: “It tonifies the lungs, reduces fire, generates body fluids, and alleviates fatigue. It is suitable for those who are deficient yet have fire.” These two herbs together serve as the monarch herbs. Summer heat injures Yin, and He Geng can assist Xi Gua Cui Yi in clearing heat and relieving summer heat, while also regulating Qi and relieving chest tightness. Shi Hu and Mai Dong, both sweet and cold, help Xi Yang Shen to benefit Qi, nourish Yin, clear heat, and generate fluids, serving as minister herbs. Summer heat disturbs the heart, so a small amount of bitter and cold Huang Lian is used to clear heat and drain fire, enhancing the ability to clear heat and dispel summer heat. Zhi Mu, being bitter and cold, not only drains fire but also nourishes Yin, making it a wonderful herb; Zhu Ye, being sweet and bland, can clear heat and relieve irritability, all serving as assistant herbs. Summer heat injures Qi, so Jing Mi can benefit Qi and generate fluids, while Gan Cao harmonizes the stomach and prevents cold and cooling herbs from harming the stomach, and can also harmonize the properties of the herbs, serving as a guiding herb. The combination of these herbs allows for a synergy of heat-clearing herbs with Qi-tonifying herbs, benefiting without retaining pathogens, and draining pathogens without harming the upright Qi; generating fluids without causing turbidity, and drying without harming fluids, collectively achieving the effects of clearing heat, benefiting Qi, nourishing Yin, and generating fluids. However, Qing Shu Yi Qi Decoction is not solely Wang’s formula; Li Dongyuan also discusses it in his “Pi Wei Lun”. Li Dongyuan’sQing Shu Yi Qi Decoction is found in the “Nei Wai Shang Bian Huo Lun • Shu Shang Wei Qi Lun”, based on the “Suwen” stating, “Qi deficiency and body heat are caused by summer heat” and further points out, “During the long summer, damp heat prevails.” This formula is aimed at individuals who are usually Qi deficient and experience summer dampness with fluid injury, presenting symptoms such as fatigue in the limbs, poor spirit, chest tightness, shortness of breath, body heat and irritability, loose stools, yellow and scant urine, loss of appetite, thirst, spontaneous sweating, heaviness in the body, pale tongue with teeth marks, greasy or dry tongue coating, and a weak or rapid pulse. Reference dosage: 3g of Huang Qi (Astragalus), 3g of Cang Zhu (Atractylodes), 3g of Sheng Ma (Cimicifuga), 15g of Ren Shen (Ginseng), 15g of Ze Xie (Alisma), 15g of Shen Qu (Malt), 15g of Ju Pi (Tangerine Peel), 10g of Bai Zhu (White Atractylodes), 10g of Mai Men Dong (Ophiopogon), 10g of Dang Gui (Angelica), 6g of Zhi Gan Cao (Honey-fried Licorice), 10g of Qing Pi (Green Tangerine Peel), 10g of Huang Bai (Phellodendron), 10g of Ge Gen (Kudzu), and 10g of Wu Wei Zi (Schisandra). This formula is derived from the modified Ba Zhen Tang, emphasizing the effects of clearing summer heat, transforming dampness, and generating fluids, with a greater focus on benefiting Qi and strengthening the spleen. Li advocates treating summer diseases with methods that clear dryness, thus this formula, while treating summer diseases, contains fewer heat-clearing herbs, with its main efficacy being to strengthen the spleen and dry dampness. Characteristics of Summer Heat Pathogenic Factors Summer heat is a Yang pathogenic factor with distinct seasonality, primarily occurring after the summer solstice and before the beginning of autumn. Therefore, the “Suwen • Re Lun” states: “Diseases occurring before the summer solstice are due to warmth, while those occurring after are due to summer heat.” Its pathogenic characteristics include: Summer heat is a Yang pathogenic factor, and its nature is hot. Summer heat is generated from fiery heat, which belongs to Yang, thus summer heat is classified as a Yang pathogenic factor. Therefore, its pathogenicity often presents a series of symptoms such as high fever, thirst, flushed face, and a rapid pulse, which are indicative of Yang heat. Summer heat rises and easily disturbs the spirit, injuring fluids and depleting Qi. In summer, we can see the heat rising from the scorching playground, which is a manifestation of summer heat rising. Thus, it easily disturbs the spirit or invades the head, leading to symptoms such as chest tightness and restlessness, and dizziness. We can also observe that when water is poured onto a hot iron plate, a portion of the water instantly evaporates, indicating that summer heat is a Yang pathogenic factor, and it can cause the pores to open and lead to excessive sweating, easily injuring body fluids. Since Qi and body fluids are closely related, both originating from the transformation of food and water by the spleen and stomach, and both circulating throughout the body via the San Jiao, Qi and body fluids can transform into each other; that is, Qi can generate fluids, and fluids can also transform into Qi. Therefore, if one of them is damaged, the transformation of the other will correspondingly decrease. Moreover, body fluids are also one of the carriers of Qi, so when summer heat causes disease, it depletes body fluids while Qi also escapes in large amounts. Thus, clinically, in addition to symptoms of thirst, dry lips, and short red urine indicating insufficient body fluids, one may also observe shortness of breath, fatigue, and in severe cases, sudden fainting or loss of consciousness due to lack of nourishment to the clear orifices.