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Chunwen (Spring-warmth disease) presenting with a crimson or black tongue, delirium, restlessness, coma, and rapid pulse, along with purpura and macules that are purple-black, indicates heat entering the Blood level. It is appropriate to use Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) added with Yuanx Shen (Heart of Radix Scrophulariae), Lianqiao Xin (Heart of Fructus Forsythiae), Xian Shihu (Fresh Dendrobii Caulis), Xian Changpu (Fresh Rhizoma Acori Tatarinowii), Zicao (Radix Arnebiae/Lithospermi), and Zhibao Dan (Treasure of Life Pill), etc., to cool the blood and clear heat.

The previous clause described coma, crimson tongue, appearance of purpura/macules, and rapid pulse, indicating heat in the Ying (Nutritive) level of the Heart. This clause describes a crimson, scorched-black tongue, confusion, delirium, and inappropriate laughter, with a rapid pulse and purple purpura, indicating heat transmitting to the Blood level. Ancient texts state that purple purpura signifies extreme stomach heat, while black indicates rotting of the stomach. Pathogenic factors affecting the Pericardium lead to inappropriate laughter. The Heart governs the Blood; Heart heat causes Blood heat, and Blood heat results in black purpura. The tongue is the sprout of the Heart; Heart heat causes the tongue to become scorched. Without large doses of herbs that cool the blood and break up stasis, it is difficult to resolve the purpura and macules. One must rely on Xijiao (Hornis Rhinocerotis), Shengdihuang (Radix Rehmanniae Preparata), Chishao (Radix Paeoniae Rubra), and Mudanpi (Cortex Moutan) to cool the blood, and Yuan Shen (Radix Scrophulariae), Lianqiao (Fructus Forsythiae), Changpu (Rhizoma Acori Tatarinowii), and Zhibao Dan (Treasure of Life Pill) to clear the Heart. If the purpura turns red and the spirit becomes clear, there is hope for treatment. However, this is also a critical condition where nine out of ten patients may die. If symptoms such as constipation, abdominal hardness, and a black, scorched-yellow tongue appear alongside those mentioned above, Liangge San (Cool the Diaphragm Powder) can be administered. Once the bowels move, pathogenic heat will be instantly expelled, and the disease momentum will subside rapidly.

Chunwen presenting with vexation, heat, and excessive thirst, confused spirit resembling sleep, curled tongue, and retracted scrotum, cold limbs, and coma, indicates heat sinking into the Jueyin (Terminal Yin) channel, with the True Yin about to dry up. It is appropriate to use Xijiao (Hornis Rhinocerotis), Lingyangjiao (Hornis Saigae Tataricae), Shengdihuang (Radix Rehmanniae Preparata), Yuan Shen (Radix Scrophulariae), Lianqiao (Fructus Forsythiae), Tiandong (Radix Asparagi), Maidong (Radix Ophiopogonis), Muli (Concha Ostreae), Ejiao (Colla Corii Asini), Gouteng (Ramulus Uncariae cum Uncis), and Xian Changpu (Fresh Rhizoma Acori Tatarinowii), etc., to clear the Luo (Collateral) vessels and extinguish wind.

According to Zhang Zhongjing's *Shanghan Lun* (Treatise on Cold Damage), in the Jueyin chapter: "Vexation, heat, and thirst, Qi rushing up to strike the Heart, hunger but no desire to eat." Now, accompanied by coma and curled tongue, body fluids are consumed. The Jueyin Liver is a Zhiyin (Extreme Yin) organ, having entry but no exit. As Zhang Zhongjing stated, "The deeper the heat, the deeper the cold extremities; the milder the heat, the milder the cold extremities." Fewer cold extremities and more heat indicate recovery; more cold extremities and less heat indicate deepening disease. Thus, cold limbs and coma are inevitable. Furthermore, the Jueyin Liver meridian ascends to follow the pharynx and tongue, and descends to surround the genitalia. Therefore, when diseased, it inevitably presents with curled tongue and retracted scrotum. At this time, pathogenic factors are deep and righteous Qi is exhausted. We tentatively use Xijiao (Hornis Rhinocerotis), Lingyangjiao (Hornis Saigae Tataricae), Shengdihuang (Radix Rehmanniae Preparata), and Yuan Shen (Radix Scrophulariae) to clear the Ying and Luo levels; Tiandong (Radix Asparagi) and Maidong (Radix Ophiopogonis) to strengthen Water (Yin); Ejiao (Colla Corii Asini) and Muli (Concha Ostreae) to anchor Yang; and Gouteng (Ramulus Uncariae cum Uncis) and Changpu (Rhizoma Acori Tatarinowii) to extinguish wind. If Yin is replenished and Yang anchored, heat recedes, and the spirit clears, there begins to be a chance for life. However, success is only one in a hundred.