“When in the skies there is heat, and on the earth there is fire...its nature is Summerheat.” (Su Wen, Chapter 67)
We still think of “flu season” or “cold season” but our ancestors had to be exquisitely sensitive to the seasonal and environmental conditions that could trigger illness. Whether from the prevalence of disease carrying insects or animals at certain times, spoiled food in warm weather, crowded, airless conditions in cold weather, or the weather itself… as in the case of Summerheat. I enjoyed refreshing my memories about the theory, diagnosis and treatment of Summerheat, and hope you do as well!
We don’t see a lot of Summerheat in the clinic these days. If someone has heatstroke or sunpoisoning, they are probably (and unfortunately!) not coming in to see their TCM practitioner. But it’s helpful to understand the mechanisms of Summerheat and how to treat it, both for home care and first aid, and as a reminder of how heat can enter the body, and be guided out of it.
The onset of Summerheat invasion is very abrupt. It’s considered a yang pathogen, moving quickly and strongly. Someone can go from fine to showing symptoms in minutes. Mild Summerheat is something we’ve probably all seen and experienced personally. It’s characterized by thirst, headache, profuse sweating, dizziness and dry mouth and tongue. Severe cases will have fever, mental confusion and even convulsions. The tongue will be red and the pulse will be rapid and surging. The external heat pathogen is injuring the Yin energy and fluids of the body - a classic example of ‘excess transforms to deficiency.’ The Yang nature of Summerheat leads it to move upward and outward (the Yang directions). Summerheat invasion can be complicated with Damp, Cold or Wind, either from internal or external sources, bringing other symptoms into the mix.
Treatment of Summerheat
Acupuncture treatment for Summerheat focuses on clearing Heat - needling Du 14, UB 40, LI 11 - the classic cooling points. PC 6 is also appropriate - it clears heat, but also directly connects to and regulates the Heart, the organ of the Fire element, and most vulnerable to attack from a heat pathogen.
Gua sha is an excellent heat clearing remedy and can easily be done at home (or at the beach!) Gua sha the back, neck, shoulders and even the armpit and the crook of the elbow.
Classically, the focus of herbal treatment would be on heat clearing, such as Bai Hu Tang. I have used shi gao (gypsum) alone topically (dissolved in water) to good effect on a sunburn, although it’s unlikely your patients have it in the medicine cabinet. Bai bian dou (hyacinth bean), he ye (lotus leaf) lu dou (mung bean) and xi gua (watermelon) are the summerheat clearing herbs in the materia medica, and all are the kind of food herb that can be kept on hand and either added to meals or at the ready should someone get overheated. Fresh apricots are also a folk remedy for summerheat. I’ve suggested an easy recipe for treating mild cases, using cucumber and mint, at the end of the article.
Treating complicating patterns
Damp: Summerheat Damp is very common, and some texts indicated that all summerheat patterns have a damp component. Certainly in hot humid climates, Summerheat Damp is what you’ll see and suffer from. It can also be caused by drinking large amounts of cold drinks in reaction to hot weather, damaging the spleen and adding damp to the heat. In addition to heat signs, the patient may feel a sense of oppression or obstruction in the chest or stomach, congestion in the ears, and have a phlegmy cough, scanty urine, or clear, watery diarrhea.
Cold: Summerheat can easily be complicated by cold in modern times! Hot weather outside and frigid air conditioning brings the two pathogens together. The Cold constricts the energy of the body and causes pain, leading to symptoms such as headache and body aches, fever, vomiting and diarrhea.
Patient education: This is a great time to teach TCM based health habits! Eating and especially drinking appropriately to the season, protecting the body and especially the back of the neck from wind in air-conditioned offices, and regular acupuncture treatments are all habits to share with your patients so they can thrive during the summerheat season.
SummerHeat Rescue Drink.
I’ve suggested cucumber here as a substitute for xi gua. Cultivated melons are quite sweet and can be too hard on the spleen or increase dampness. The cucumber will cool you off in a jiffy.
In a blender puree a whole cucumber (about 1-2 cups of flesh) and a small handful of fresh mint. If the cucumber is not organic or has a thick skin, peel first. Dilute with an equal amount of room temperature filtered water and sip slowly. You may add a squeeze of lime to taste.
Bensky, Dan and Randall Barolet. Chinese Herbal Medicine: Formulas and Strategies. Eastland Press, 1990.
Bensky, Dan and Andrew Gamble. Chinese Herbal Medicine: Materia Medica, Revised Edition. Eastland Press, 1993.
Deadman, Peter and Mazin Al-Khafaji. A Manual of Acupuncture, Revised Edition. Eastland Press, 2005
Deng, Tietao. Practical Diagnosis in Traditional Chinese Medicine. Churchill Livingstone, 1999.
Maciocia, Giovanni. The Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists. Churchill Livingstone, 1989.
Ni, Maoshing, PhD, and Cathy McNease. The Tao of Nutrition. Seven Star Communications, 1987.
Xinnong, Cheng. Chinese Acupuncture and Moxibustion. Foreign Languages Press, 1999.