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In winter-warmth disease, if the tongue coating is yellow and dry, accompanied by restlessness, coma, and delirium, with a wiry or deep-hidden pulse, constipation, abdominal hardness, and frequent passing of flatus, this indicates heat accumulation in the fu organs. It is appropriate to use fresh Rehmanniae Radix (Shengdihuang), raw Polygoni Multiflori Caulis (Sheng Shouwu), fresh Dendrobii Caulis (Xian Shihu), Rhubarb (Dahuang), and Mirabilite (Yuanmingfen) to slightly purge the heat while preserving Yin fluids.

If winter-warmth disease does not resolve despite standard treatment, and the tongue body becomes crimson with yellow, scorched, or sedge-colored coating, this is an indication for purgation. Combined with abdominal hardness and frequent passing of flatus—which Zhang Zhongjing referred to as "passing flatus" indicating dry feces—one should imitate the Tiaowei Chengqi Decoction (Regulate the Stomach and Accomplish the Qi Decoction), combined with Rehmanniae Radix (Shengdihuang), Dendrobii Caulis (Shihu), and Polygoni Multiflori Caulis (Shouwu). This combination can both remove accumulation and nourish Yin.

At the onset of warm-toxin disease, symptoms include irritability, fever, aversion to cold, thirst, a crimson tongue, nasal dryness, dry breath, sore throat, and rapid pulse, indicating that pathogenic factors have invaded the qi level. It is appropriate to use Mint (Bohe), Forsythiae Fructum (Lianqiao), Cornu Bubali (Lingjiao), Mulbai Folium (Sangye), Niu Bang Zi (Niubangzi/Dali), fresh Dendrobii Caulis (Xian Shihu), Glehniae Radix (Shashen), Apricot Seed (Xingren), Platycodonis Radix (Jiegeng), and Licorice Root (Gancao) to release the exterior with acrid-cool properties.

The origin of warm-toxin lies in previously latent warmth pathogens followed by new exposure to warmth; the two types of warmth scorch each other, causing disease even without wind-cold induction. However, warmth added to warmth increases the severity, making it more urgent than winter-warmth. Thus, upon onset, there is irritability and slight aversion to cold. If heat exists in both the interior and exterior, thirst and a crimson tongue occur; if heat pathogens obstruct upwards, sore throat and nasal dryness result. Since the pathogen is at the qi level, one should use Mint and Niubang Zi to dispel wind; Shashen and Sangye to clear heat; Lianqiao and Lingjiao to transform toxic heat; and Gancao and Jiegeng to benefit the throat. One must strictly avoid acrid-warm herbs that aid heat and damage body fluids, which would otherwise facilitate transmission and progression.

In warm-toxin disease, if sweating leads to intensified fever, red face, dry lips, withered teeth, crimson tongue, thirst, rapid pulse, and coma, this indicates pathogenic factors remaining in the ying (nutritive) level. It is appropriate to use fresh Rehmanniae Radix (Shengdihuang), Cornu Bubali (Lingjiao), fresh Dendrobii Caulis (Xian Shihu), Scrophulariae Radix (Xuanshen), Lonicerae Japonicae Flos (Yinjinhua), Mulbai Folium (Sangye), Gypsum Fibrosum (Shigao), fresh Acori Tatarinowii Rhizoma (Xian Changpu), and young Bamboo Leaves (Qingzhuye) to simultaneously clear the ying and wei (defensive) levels.

Intensified fever after sweating, red face, withered teeth, crimson tongue, rapid pulse, and gradual loss of consciousness indicate that pathogens are about to enter the ying level. Therefore, one should imitate the Yinvu Decoction (Jade Woman Decoction) to simultaneously clear the heart ying and lung wei, assisting with detoxification as the key principle.