冬温烦热，舌绛，神昏谵妄，斑紫或黑，脉数
或促，此邪入血分。宜用犀角地黄汤加鲜石斛、元参
心、连翘心、人中黄、广郁金、鲜菖蒲、至宝丹、
青竹叶等味，凉血透邪也。
上条舌绛苔黄，斑疹隐约 虽已神昏，邪尚在营，此条
舌绛而焦，班紫而黑，神昏谵妄，是邪已入血，非凉血清热
则万无生理。故用犀角、生地、丹皮、赤芍，合元参，连翘、
中黄、石斛，菖蒲凉血破瘀，兼至宝丹芳香逐邪。若再不
解，则邪无泄越，症必危矣。
冬温烦热，舌绎而干，斑疹湿透，神迷妄笑，
寻衣摸床，手足振颤，此阴伤风动。宜用炙甘草汤
去姜桂，加牡蛎、鲜石斛、鲜菖蒲等味，养阴却热也。
热不解而舌干色绛，斑已透而神迷妄笑，乃热极阴伤，
阳动化风。故寻衣摸床，手足摇动。若非毓阴和阳，恐难挽
回造化。必藉参，甘、胶、地、麦冬、牡蛎、菖蒲、石斛扶
正养阴，则液返津回，肝阴内复，而风阳自熄焉。
冬温初起，舌遽干，神便昏，烦热脉数，或吐
或泄，此邪盛正虚。宜用《金柜》麦门冬汤加桑叶，
地骨皮、鲜石斛、鲜菖蒲、鲜稻根等味，甘凉养胃。
偿吐泻伤阳，无热，神迷多寐，脉软不食，宜用人
参温胆汤，甘温和胃也。
凡病初起，便见舌干神昏，乃正需邪盛，不克支持，最
为险候。若烦热舌干，胃阴更损，故甩麦冬、法夏，西参、
甘草、粳米，桑叶，骨皮，石斛，甘凉濡润，以醒胃气。偿
吐泻伤阳，而神迷如寐，脉软无热，乃伤及胃阳，宜用温胆
和胃，人参养正为妙。
In winter-warmth disease, characterized by irritability and fever, a crimson tongue (Shé Jiàng, deep red tongue), coma with delirious speech (Shén Hūn Chán Wàng, loss of consciousness with incoherent talking), purple or black macules (Bān Zǐ Huò Hēi, purpura or blackish skin eruptions), and a rapid (Mài Shù, fast pulse) or hurried (Cuì, irregularly intermittent pulse) pulse, this indicates the pathogen has entered the Blood Level (Xuè Fèn). It is appropriate to use Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) added with fresh Shibao (Dendrobium officinale stem), Yuan Shen Xin (Scrophulariae Radix heart), Lian Qiao Xin (Forsythiae Fructus heart), Ren Zhong Huang (Homo Fermentum Nigrum), Guang Yu Jin (Curcumae Radix), fresh Chang Pu (Acori Tatarinowii Rhizoma), Zhibao Dan (Treasure of Life Pill), and Qing Zhu Ye (Bambusae Folium), to cool the blood and vent the pathogen.
The preceding clause describes a crimson tongue with yellow coating and faint macules; although there is coma, the pathogen remains at the Ying (Nutrient) Level (Yíng Fèn). This clause describes a crimson and scorched tongue with purple or black macules and coma with delirious speech, indicating the pathogen has entered the Blood Level. Without cooling the blood and clearing heat, there is no hope for survival. Therefore, Xijiao (Rhinoceros Hornis Cornu - *Note: Substitute with Buffalo Horn in modern practice*), Sheng Di Huang (Rehmanniae Radix), Mu Dan Pi (Moutan Cortex), Chi Shao Yao (Paeoniae Radix Rubra) are combined with Yuan Shen (Scrophulariae Radix), Lian Qiao (Forsythiae Fructus), Ren Zhong Huang (Homo Fermentum Nigrum), Shi Hu (Dendrobii Caulis), and Chang Pu (Acori Tatarinowii Rhizoma) to cool the blood and break stasis, while utilizing Zhibao Dan (Treasure of Life Pill) to expel pathogens with its aromatic properties. If the condition still does not resolve, the pathogen will have no outlet, and the symptoms will become critical.
Winter-warmth disease presenting with irritability and fever, a crimson and dry tongue, macules that are moist and fully erupted, confused spirit with inappropriate laughter, picking at empty air and bedclothes (Xún Yī Mō Chuáng), and tremors of the hands and feet, indicates Yin injury leading to internal wind movement. It is appropriate to use Zhigancao Tang (Honey-fried Licorice Decoction), removing Jiang (Zingiberis Rhizoma Recens) and Gui (Cinnamomi Ramulus), adding Mu Li (Ostrea Concha), fresh Shi Hu (Dendrobii Caulis), and fresh Chang Pu (Acori Tatarinowii Rhizoma), to nourish Yin and eliminate heat.
If heat persists and the tongue becomes dry and crimson, and although macules have erupted, the spirit is confused with inappropriate laughter, this signifies extreme heat damaging Yin, causing Yang to move and transform into wind. Hence, the symptoms of picking at empty air and bedclothes and shaking of the limbs occur. Unless Yin is nurtured and Yang is harmonized, it may be difficult to restore vitality. One must rely on Ren Shen (Ginseng Radix et Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), E Jiao (Colla Corii Asini), Di Huang (Rehmanniae Radix), Mai Dong (Ophiopogonis Radix), Mu Li (Ostrea Concha), Chang Pu (Acori Tatarinowii Rhizoma), and Shi Hu (Dendrobii Caulis) to support righteous Qi and nourish Yin. When fluids return and saliva recovers, Liver Yin is restored internally, and wind-Yang naturally extinguishes.
At the onset of winter-warmth disease, if the tongue suddenly becomes dry, the spirit is confused, there is irritability and fever with a rapid pulse, or vomiting and diarrhea occur, this indicates excess pathogen and deficient Zheng Qi (Righteous Qi). It is appropriate to use Maidong Tang (Ophiopogon Decoction) from *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet), added with Sang Ye (Mori Folium), Di Gu Pi (Lycii Cortex), fresh Shi Hu (Dendrobii Caulis), fresh Chang Pu (Acori Tatarinowii Rhizoma), and fresh Dao Gen (Oryzae Sativae Radix), using sweet and cool properties to nourish the Stomach.
If vomiting and diarrhea injure Yang, resulting in absence of heat, confused spirit with excessive sleepiness, a soft pulse, and inability to eat, it is appropriate to use Renshen Wendan Tang (Ginseng Gallbladder-Calming Decoction) to harmonize the Stomach with sweet and warm properties.
Whenever a disease begins with sudden dryness of the tongue and confusion of the spirit, it indicates that Zheng Qi is insufficient while the pathogen is exuberant, and the body cannot sustain itself; this is the most dangerous prognosis. If there is irritability, fever, and a dry tongue, Stomach Yin is further damaged. Therefore, Mai Dong (Ophiopogonis Radix), Fa Ban Xia (Pinelliae Rhizoma Preparatum), Xi Shen (Panacis Quinquefolii Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), Jing Mi (Oryzae Semen), Sang Ye (Mori Folium), Gu Pi (Lycii Cortex), and Shi Hu (Dendrobii Caulis) are used. Their sweet and cool, moistening nature aims to awaken Stomach Qi. If vomiting and diarrhea injure Yang, leading to a spirit confused as if in deep sleep, a soft pulse, and absence of heat, this indicates injury to Stomach Yang. It is advisable to use Wendan Tang (Gallbladder-Calming Decoction) to harmonize the Stomach and Ren Shen (Ginseng Radix et Rhizoma) to nourish Zheng Qi.