春温舌黑神昏，烦躁咬牙，手足振颤，时或抽
搐，此热极风生，已成痉厥。宜用东洋参、鲜生地、
元参心、连翘心、鲜石斛、羚角、钩藤、石决明、白
芍、鲜菖浦等味，扶正熄风也。
神昏舌黑，烦躁不安，阳津阴液俱耗。阴亏则阳乏交
恋，少阳木火变为状火，化出内风，肆横旋扰，内逼神明，
外窜经脉，故手足振动。然此亦有虚实之分。其
虚者，阴伤风动，热走胃络，固宜清之朴之。其实者，热结
在腑，肠胃拥塞，便闭口噤，又宜功之疏之。其间虚实，大
相迳庭，若勿辨明，贻害无穷。兹云手足振颤，咬牙切齿，
一似啮物;兼之神昏舌黑，虚象昭然。雇用生地，元参，连
翘，石斛，白芍以养阴清热，羚角，石决明，钩藤，菖蒲以
清络熄风，东洋参以扶补正气，庶机可保万一焉。
春温热渴不己，舌光色绎，心悸神迷，此热伤胃
阴。宜用复脉汤去姜桂，加地骨皮、鲜石斜、牡蛎、
白芍等味，甘凉养阴也。
舌绎而光，是无苔也，烦热消渴，胃宵津凅也。更兼心悸
神迷，营液亦耗。若不养阴，必致痉厥。非借复脉之生地，
鲜斛(1)，麦冬，甘草以养胃阴,阿胶、牡蛎、白芍以滋肝
阴，则恐阳动风生，难免昏痉之变。
春温经旬不解，舌干紫晦，烦热消渴，神迷脉
数，此肝肾阴伤。宜用人参固本汤加阿胶、牡蛎，鲜
(1)鲜斛：复脉汤原方无此药。
石斛、鲜菖蒲、广郁金等味，凉肝滋肾也。
上条舌绎神迷·热渴不已，胃津营液俱耗，宜用甘寒。
此条舌干紫晦，神迷脉数，是肝肾阴伤，宜与咸寒。故用二
冬、二地以状水，牡蛎以柔肝，甘草、石斛以养胃，
菖蒲、郁金以宣窍，毋使阳升风动，而变痉厥焉。
Spring-warmth disease presenting with a black tongue coating, coma, restlessness, teeth grinding, tremors of the hands and feet, and occasional convulsions indicates that heat has reached its extreme level generating wind, resulting in spasm and convulsion (Jing-Jue). It is appropriate to use Dongyang Ginseng, fresh Rehmanniae Radix (Shengdi), Nardostachyos Radix et Rhizoma Xin (Yuanshenxin), Forsythiae Fructum Xin (Lianqiaoxin), fresh Dendrobii Caulis (Shihu), Antaeotocornu Sinense (Lingjiao), Uncariae Ramulus cum Uncis (Gouteng), Halituss Gypsum (Shijueming), Paeoniae Radix Alba (Baishao), and fresh Acori Tatarinowii Rhizoma (Changpu) to support healthy qi and extinguish wind.
Coma and black tongue coating accompanied by restlessness indicate the consumption of both yang fluids and yin fluids. When yin is deficient, yang lacks attachment and becomes agitated; Shaoyang ministerial fire transforms into vigorous fire, generating internal wind. This wind rages and disturbs internally, pressing upon the spirit (Shen), and externally invades the meridians, causing tremors of the limbs. However, this condition can be differentiated into deficiency and excess patterns. In deficiency patterns, yin injury leads to wind movement, and heat travels through the stomach collaterals; thus, clearing heat and nourishing yin is indicated. In excess patterns, heat is knotted in the fu organs, causing blockage in the intestines and stomach, constipation, and trismus; thus, purging and unblocking are indicated. The distinction between deficiency and excess is significant. Failure to distinguish them clearly will lead to endless harm. The symptoms described here—tremors of the limbs, teeth grinding as if biting objects, along with coma and a black tongue—clearly manifest deficiency patterns. Fresh Rehmanniae Radix (Shengdi), Nardostachyos Radix et Rhizoma (Yuanshen), Forsythiae Fructum (Lianqiao), Dendrobii Caulis (Shihu), and Paeoniae Radix Alba (Baishao) are employed to nourish yin and clear heat; Antaeotocornu Sinense (Lingjiao), Halituss Gypsum (Shijueming), Uncariae Ramulus cum Uncis (Gouteng), and Acori Tatarinowii Rhizoma (Changpu) are used to clear heat from the collaterals and extinguish wind; Dongyang Ginseng is used to tonify healthy qi, thereby preserving life in a critical situation.
In spring-warmth disease, persistent fever and thirst, a red and glossy tongue without coating, palpitations, and mental confusion indicate that heat has damaged stomach yin. It is appropriate to use Fumai Decoction (Fumai Tang) removing Zingiberis Rhizoma Recens (Jiang) and Cinnamomi Cortex (Gui), adding Corticis Lycii Radicis (Digupi), fresh Dendrobii Caulis (Shihu), Ostreae Concha (Muli), and Paeoniae Radix Alba (Baishao) to nourish yin with sweet-cool substances.
A red and glossy tongue indicates the absence of coating; irritability, fever, and polydipsia indicate dryness of stomach fluids. Palpitations and mental confusion further indicate the consumption of nutritive fluids. If yin is not nourished, spasm and convulsion will inevitably result. Without relying on Shengdi, fresh Shihu, Ophiopogonis Radix (Maidong), and Glycyrrhizae Radix et Rhizoma (Gancao) from Fumai Decoction to nourish stomach yin, and Eburiae Sclerotium (Ejiao), Ostreae Concha (Muli), and Paeoniae Radix Alba (Baishao) to nourish liver yin, one fears that yang will move excessively generating wind, leading to coma and spasm.
If spring-warmth disease persists for more than ten days without resolution, presenting with a dry, purple, and dull tongue, irritability, fever, polydipsia, mental confusion, and rapid pulse, it indicates damage to liver and kidney yin. It is appropriate to use Renshen Guben Decoction (Renshen Guben Tang) adding Eburiae Sclerotium (Ejiao), Ostreae Concha (Muli), fresh Dendrobii Caulis (Shihu), fresh Acori Tatarinowii Rhizoma (Changpu), and Curcumae Radix (Yujin) to cool the liver and nourish the kidneys.
The previous case mentioned a red, glossy tongue, mental confusion, and persistent heat and thirst, indicating consumption of stomach fluids and nutritive fluids, suitable for sweet-cold methods. This case presents with a dry, purple, and dull tongue, mental confusion, and rapid pulse, indicating liver and kidney yin damage, suitable for salty-cold methods. Therefore, Asparagi Radix (Tianmen dong) and Ophiopogonis Radix (Maidong), Rehmanniae Radix Preparata (Shudi) and Rehmanniae Radix (Shudi) are used to strengthen water to control fire; Ostreae Concha (Muli) is used to soften the liver; Glycyrrhizae Radix et Rhizoma (Gancao) and Dendrobii Caulis (Shihu) are used to nourish the stomach; Acori Tatarinowii Rhizoma (Changpu) and Curcumae Radix (Yujin) are used to open orifices, preventing yang from rising and wind from moving, thus avoiding transformation into spasm and convulsion.