Heat of the Summer

As the season shifts into the height of summer, patients frequently present with symptoms linked to heat and its associated patterns. This article explores the common syndromes that present during summer months, how they may align or depart what we are taught in school and outlines effective treatment strategies using both traditional herbal theory and modern formulas.

The Local Nature of Summer Heat

In Chinese medicine, “Summer-Heat” is recognized as a distinct seasonal pathogenic factor. Summer-Heat frequently combines with Dampness, due to seasonal humidity, and with Wind, due to increased outdoor exposure.

Classical texts and authors such as Maciocia and Bensky describe the characteristics of Summer-Heat in detail, the associated patterns and diseases.  These classical sources draw from a geographical location and time when summers brought extreme heat and dampness through rain, humidity and even monsoons.  

Our climate and geographic location will influence the patterns we see in our practices. Being based in Northern California, I rarely see the classic Summer-Heat pattern unless it is caused by food consumption.  Out here we don’t get any rain from April to October and have very little humidity.  The damp component that is classically associated with summer-heat just doesn’t exist here.  

As providers we must adapt to the local conditions, the times and to our patients.  Going on 20 years of practice I have finally learned to put aside some of the dogma and to listen to what my patient’s body is trying to tell me.  I must do this if I have any hope of helping them.

What I do see in the summer months is more varied, usually less severe, and not taught in the schools.  

In my clinic, I often encounter three common patterns during the summer season:

1. Wind-Heat – typically presenting as seasonal colds, early-stage febrile disease, sunburn, or mild heatstroke. These are often diagnosed as Wind-Heat invasions.
   
   
2. Damp-Heat – frequently observed in gastrointestinal presentations such as food poisoning, stomach flu, or digestive upset caused by heavy or improperly stored foods.
   
   
3. Blood-Heat – manifesting in skin conditions like rashes, hives, or poison oak reactions triggered by sun exposure or outdoor contact with plants or allergens.

This breakdown aligns with the physiological and pathological themes discussed in Maciocia, Bensky and other authors but they are not discussed as useful lens for seasonal treatment planning.

Wind-Heat

During summer, colds often present with mild fever, sore throat, headache, and sweating—symptoms characteristic of Wind-Heat invasion.  In the Wen Bing it is explained that Wind-Heat enters via the Wei level, often disrupting the Lung's dispersing and descending function.  This may result from viral exposure as we understand it, but it can also result from  sun overexposure, or prolonged activity in hot conditions.  I find treating all manner of heat related conditions can be very effective with External Wind-Heat formulas that are not typically thought of: sun burns, sunstroke, headaches, rashes and certain viruses, can all be treated with wind-heat formulas if they are due to overexposure to external heat with the right presentation. 

Herbal Strategy

• • Jin Yin Hua (Lonicerae Flos) and Lian Qiao (Forsythiae Fructus) to release the exterior and clear toxic heat.
    
    
  • Bo He (Menthae Haplocalycis Herba) and Ju Hua (Chrysanthemi Flos) to cool and disperse Wind-Heat from the upper burner.
    
    
  • Niu Bang Zi (Arctii Fructus) and Chan Tui (Cicadae Periostracum) to benefit the throat and vent early-stage rashes.
    
    

Clinical Application: Yin Qiao San - Febris 

Febris is designed to clear external Wind-Heat and resolve early-stage febrile conditions.
It can be used for:

• • Summer colds and flu
  • Early-stage sunstroke 
  • Sunburn with pink to light red color
  • Heat Rash
  • Headaches from sun/heat exposure
    
    

Clinically, Febris is a useful adjunct for patients presenting with simultaneous exterior symptoms and early-stage inflammation. It may also be beneficial post-sun exposure to prevent escalation of symptoms.

Damp-Heat

Traditionally associated with summer-heat, I still see this in the clinic, just not to the degree in which it is taught. Summer heat can bring increased humidity, barbecues, travel, and poor food hygiene—conditions ripe for Damp-Heat invasion of the Stomach and Intestines. Patients may report nausea, bloating, loose stools, or vomiting. 

Key herbs include:

• • Huo Xiang (Agastachis Herba) and Pei Lan (Eupatorii Herba) to aromatically transform Dampness and release the exterior.
    
    
  • Huang Qin (Scutellariae Radix) and Huang Lian (Coptidis Rhizoma) for intense Damp-Heat and toxic accumulation.
    
    
  • Bai Dou Kou (Amomi Fructus Rotundus) and Sha Ren (Amomi Fructus) to awaken the Spleen and aid digestion.
    
    

Clinical Application: Huo Xiang Zheng Qi San - GastroRest 

Gastrorest addresses acute or subacute Damp-Heat presentations in the digestive tract. It is well-suited for:

• • Food poisoning and traveler’s diarrhea
  • Viral gastroenteritis (“stomach flu”)
  • Postprandial bloating and sluggish digestion during humid weather
    
    

By supporting both the Spleen and Stomach while clearing pathogenic Damp-Heat, Gastrorest is a balanced formula that alleviates symptoms while preserving digestive integrity.

Blood-Heat and Summer Skin Conditions

The summer sun, poison oak, and exposure to irritants during outdoor activities often result in dermatological complaints. Such dermatological complaints are often seen as expressions of Blood-Heat, which can manifest with redness, itching, raised lesions, or weeping eruptions. According to classical theory, Heat in the Blood level pushes to the surface, disturbing the vessels and tissues of the skin.  Clinically I view this as a more extreme version of Wind-Heat where the external heat has penetrated deeper into the body.  When sunburns become dark red or even a little purple, when heat rash also has a temperature, or when poison oak isn’t just pink with small blisters but is dark red with large welts.

Key herbs for Blood Heat skin symptoms include:

• • Zi Cao (Arnebiae/Lithospermi Radix) and Mu Dan Pi (Moutan Cortex) to cool Blood and clear heat from Ying level.
    
    
  • Fang Feng (Saposhnikoviae Radix) and Bai Xian Pi (Dictamni Cortex) to treat Wind-Damp-related dermatological issues.
    
    
  • Ku Shen (Sophorae Flavescentis Radix) and Tu Fu Ling (Smilacis Glabrae Rhizoma) to detoxify and treat itching, eczema, and weeping rashes.
    
    

Key herbs for general Blood Heat symptoms include:

• • Sheng Di Huang (Rehmannia Root) and Xuan Shen (Scrophularia Root)
    
    
  • Mu Dan Pi (Moutan Cortex) and Chi Shao (Red Peony Root) to move and cool the blood

Clinical Application: Dermaleaf Formula

Dermaleaf is intended for dermatological conditions arising from Wind-Heat and Blood-Heat, including:

• • Poison oak and poison ivy reactions
  • Heat rash and sun-induced eruptions
  • Contact dermatitis from plants or insects
    
    

Its internal action cools the Blood and addresses systemic inflammation, while also venting and calming the skin. Dermaleaf can be used alongside topical treatments for enhanced resolution.

Clinical Integration: Diagnostic Nuance and Layered Treatment

In practice, summer presentations often involve overlapping patterns. For instance, a patient with gastroenteritis may also exhibit low-grade fever and a skin rash, implicating both Damp-Heat and Blood-Heat. In such cases, formulas like Gastrorest and Dermaleaf may be combined or alternated, depending on the dominant symptom.

Similarly, early-stage heatstroke or sun overexposure may involve both Wind-Heat and Qi-level Heat with digestive implications, calling for a pairing of Febris and Dermaleaf. (A common pairing)

Differentiating the level and location of the pathogen is crucial:

• Wei-level Heat → Febris
• Middle Jiao Damp-Heat → Gastrorest
• Blood-level or skin-level Heat → Dermaleaf
  
  

Supportive acupuncture points can reinforce these strategies:

• LI4, LI11, and Du14 for dispersing Wind-Heat
• ST36, SP9, and Ren12 for transforming Dampness
• SP10, UB17, and LI11 for cooling the Blood

Conclusion

Summer is a time to get out, play and see the world, yet it also poses challenges to keeping the  body healthy. By recognizing and addressing the common pathologies of Wind-Heat, Damp-Heat, and Blood-Heat, acupuncturists can offer timely and effective treatment rooted in the traditions of Chinese medicine but not handcuffed by them.

Formulas like Febris, Gastrorest, and Dermaleaf offer modern applications of classical principles—clearing Heat, resolving Dampness, and cooling the Blood—while meeting the seasonal needs of today’s patients. Integrating these tools into summer treatment plans allows practitioners to prevent escalation, reduce symptom severity, and maintain optimal health in harmony with nature’s rhythms.