痰盛搐掣，大便秘结，当以枳壳、大黄、灵脂、甘草利之。小便赤涩，心热狂吼，以辰
砂五苓散入灯心行之，既利大肠矣，利小便矣。而风证乍作，面色乍红，常有怫郁之状何耶？
表热表邪犹未解也。人参羌活散加青皮、紫苏、薄荷主之，参苏饮亦可矣。
其人脉涩，必有漱水之证，必有呕恶痰涎之证，必有两脚厥冷之证，亦必有小腹结急之
证，或唾红，或鼻衄，此皆滞血作热之明验也。用药不止于柴胡、黄芩，当以川芎、白芷、
桃仁、五灵脂、甘草佐之。大便秘结者，于中更加大黄、浓蜜，使滞血一通，黑物流利，则
热不复作。
伤寒留蓄恶血，内外俱热，昏愦谵语，亦有耳聋虚鸣之证，与少阳经受病相似，如服小
柴胡汤不效，当以黄连一分，赤茯苓半分锉细入灯心，煎与之。男女通用。凡大小产、热入
血室、小柴胡汤力所不及者，于内加五灵脂，仍以黄连赤茯苓汤佐之。盖心生血，黄连、茯
苓皆清心凉血之剂，所以收功。若夫疏利血毒，则《活人书》桃仁承气汤有余勇矣。
肾气内虚，邪热流入于肾经，其脉洪大，小便频数，所出涩少，赤浊而痛，此不可以牵
牛行
诸有里热，法当通利大便，然下后肠头热肿而坠重者，此更有热，有淤血挟气而蓄在下
焦也。更用黄连、黄芩、大黄辈下之，于内以炒阿胶、炒枳壳、百药煎为佐，多入浓蜜并乌
梅同煎，姜钱四五片可也。
痰涎壅盛且出现抽搐，大便秘结不通，应当使用枳壳、大黄、五灵脂、甘草来通利大便。若小便颜色红赤且排尿涩痛，伴有心火亢盛导致的狂躁吼叫，应使用辰砂五苓散并加入灯心草煎服以引导热邪下行。既然大肠的积滞已通，小便也通畅了，但风证却时发时止，面色时而发红，常呈现出一种郁结不舒的状态，这是为什么呢？这是因为表层的发热和表邪仍然没有解除。此时应以人参羌活散为基础，加入青皮、紫苏、薄荷为主治方剂，参苏饮也可以使用。
如果患者的脉象涩滞，必定伴有想漱口但不欲吞咽的症状，必定伴有呕吐恶心及痰涎的症状，必定伴有双脚冰冷的症状，也必定伴有小腹拘急疼痛的症状，或者唾血，或者鼻出血，这些都是瘀血化热的明确证据。用药不能仅仅局限于柴胡、黄芩，应当以川芎、白芷、桃仁、五灵脂、甘草作为辅助药物。对于大便秘结的患者，在此基础上再加入大黄和浓蜂蜜，使瘀血得以通畅，黑色的瘀血排出顺畅，那么热邪就不再发作。
伤寒病导致恶血留滞蓄积，内外都发热，神志昏沉糊涂且说胡话，也有耳聋或虚性耳鸣的症状，这与少阳经受邪所致的病症相似。如果服用小柴胡汤（Minor Bile Duct Decoction）无效，应当使用黄连一分、赤茯苓半分，锉碎后加入灯心草煎煮给患者服用。男女通用。凡是因生产（包括流产和难产）、热邪陷入血室（Heat entering the blood chamber），以及小柴胡汤力量不足以应对的情况，应在方中加入五灵脂，仍以黄连赤茯苓汤作为辅助。因为心主生血，黄连和茯苓都是清心凉血的药剂，所以能取得疗效。如果要疏泄利导血中的毒邪，那么《活人书》中的桃仁承气汤（Tao Ren Cheng Qi Tang, Peach Kernel Drainage Decoction）就足以胜任了。
肾气内部虚弱，邪热流入肾经，脉象洪大，小便频数，尿量涩少，尿液浑浊色赤且排尿疼痛，这种情况不可以使用牵牛子（Pharbitidis Semen, Morning Glory Seed）来行气逐水。
凡是有里热（Internal Heat）的情况，治法应当通利大便。然而，在泻下之后，肛门肠头发热肿胀且感觉沉重下坠，这说明体内还有余热，且有瘀血挟带气机郁结蓄积在下焦。此时应再用黄连、黄芩、大黄等药进行泻下治疗，并在方中加入炒阿胶、炒枳壳、百药煎作为佐药，多加浓蜂蜜和乌梅一同煎煮，生姜四五片即可。
When phlegm is abundant and convulsions occur, accompanied by constipation, one should use Zhiqiao (Bitter Orange Pericarp), Dahuang (Rhubarb Root and Rhizome), Wulingzhi (Trogopterus Dung), and Gancao (Licorice Root) to promote bowel movement. If urine is red and scanty with dysuria, and there is heart heat causing manic roaring, Chensha Wuling San (Cinnabar Five-Ingredient Powder with Poria) combined with Dengxincao (Juncus Effusus Stem) should be administered to guide the pathogenic factor downward. Once the large intestine is unblocked and urination is smooth, yet the wind syndrome appears intermittently, the complexion turns red at times, and there is often a state of depression or stagnation, why is this? It is because the exterior heat and exterior pathogenic factors have not yet been resolved. In this case, Renshen Qianghuo San (Ginseng and Notopterygium Decoction) added with Qingpi (Aurantii Fructus Immaturus), Zisu (Perilla Leaf), and Bohe (Menthae Haplocalycis Herba) should be used as the main prescription; Sushen Yin (Perilla and Ginseng Decoction) may also be used.
If the patient's pulse is choppy, there must be symptoms of rinsing the mouth without swallowing water, vomiting and nausea with phlegm-saliva, coldness in both feet, and urgency/tightness in the lower abdomen. There may also be hemoptysis or epistaxis. These are all clear signs of stagnant blood generating heat. Medication should not be limited to Chaihu (Bupleuri Radix) and Huangqin (Scutellariae Radix); instead, Chuanxiong (Ligusticum Chuanxiong Rhizome), Baizhi (Angelicae Dahuricae Radix), Taoren (Persicae Semen), Wulingzhi (Trogopterus Dung), and Gancao (Licorice Root) should be used as adjuvants. For those with constipation, add Dahuang (Rhubarb Root and Rhizome) and thick honey to the formula to ensure the stagnant blood flows freely. Once the black turbid matter is discharged smoothly, the heat will no longer recur.
In typhoid fever, if evil blood remains and accumulates, causing heat inside and outside, confusion, delirium, and even deafness or tinnitus due to deficiency, it resembles diseases of the Shaoyang channel (Shaoyang Channel). If Xiaochaihu Tang (Minor Bile Duct Decoction) is ineffective, use 1 part Huanglian (Coptidis Rhizoma) and 0.5 part Chifufu Ling (Red Poria), finely chopped, decocted with Dengxincao (Juncus Effusus Stem) for administration. This is applicable to both men and women. For any cases involving miscarriage or difficult labor, heat entering the blood chamber (Re Ru Xue Shi), or situations where Xiaochaihu Tang lacks sufficient strength, add Wulingzhi (Trogopterus Dung) to the formula, still using Huanglian Chifufu Ling Tang (Coptis and Red Poria Decoction) as an adjuvant. Since the heart governs blood generation, and both Huanglian (Coptidis Rhizoma) and Fuling (Poria) are agents that clear the heart and cool the blood, they can achieve success. To vent and drain blood toxins, Tao Ren Cheng Qi Tang (Peach Kernel Drainage Decoction) from *Ren Shu* (The Book of Human Life) possesses ample vigor.
When kidney qi is internally deficient, evil heat flows into the kidney meridian. The pulse is surging and large, urination is frequent, but the flow is scanty and obstructed, with turbid, red, and painful urine. In such cases, Qiuniu Zi (Pharbitidis Semen) should not be used to promote diuresis.
Generally, when there is internal heat, the method should involve promoting bowel movements. However, after purgation, if the anus and rectum feel hot, swollen, and heavy/descending, this indicates residual heat and the accumulation of stagnant blood mixed with qi stagnation in the lower jiao. One should again use agents like Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), and Dahuang (Rhubarb Root and Rhizome) to purge. Adjuvants such as fried Ejiao (Donkey-Hide Gelatin), fried Zhiqiao (Bitter Orange Pericarp), and Baiyao Jian (Myrobalan Ferment) should be added. More thick honey and Wumei (Mume Fruit) should be included in the decoction, along with four or five slices of fresh ginger.