It causes a generalized heavy feeling associated with distention, dizziness and a heavy head, general malaise and a stuffy sensation in the chest, abdominal swelling and an exuding and prolonged skin disease. It consumes yin fluid. There may be a dry sore feeling in the nose, mouth and throat, a coarseness of the skin, a cough with scanty sputum and possible haemoptysis. Tuberculosis is an example. These represent the same pathogen, but at different intensities.
Fire is the most severe, and warmth the mildest.
As with summer heat the yin may be damaged and this will affect the level of consciousness. The main difference is that summer heat only occurs in the summer and is generally less severe than fire. Diseases that are caused by heat are generally of abrupt onset and rapid change, they are nearly always acute infections. Initially the patient may complain of a high fever, chill, thirst, restlessness, irritability and profuse sweating. In severe cases the patient may be in coma with convulsion.