中热神清，能食便闭，目瞑不寐，而多惊惕，此
热留胆络，营卫失度。，宜用秫米半夏汤加羚角、丹
皮、姜汁炒枣仁、酒浸郁李仁、猪胆皮、龙齿、蒺藜
等味，清胆热而下肝系也。
能食神清，病退之象。溺赤便闭，目惧惊惕，乃热延胆
络，肝系横急。《灵枢》所谓：卫气行阳二十五度，行阴赤
二十五度，一日一夜周于一身。又云：卫气行阳则寤，行阴
则寝。乃但行于阳，则阳添盛，而不得入于阴，则阴气衰，
故寤而不寐，目瞑惊惕不宁;因胆热肝横，胃失冲和，营卫
失度，仿（内经）秫米半夏和胃气之升降，枣仁、郁李、龙
齿，下肝系以镇惊，羚角、猪胆、丹皮，清胆热而泄火风为
妙。
中热汗大泄，口大渴，身大热，气喘神倦，脉虚
且大，并不鼓指，此热伤气分,阳不恋阳。宜用人
参、黄祗、白术、麦冬、五味、地骨皮、甘草、生地、
牡蛎，白芍等蛛，甘温除热也。
汗多口渴，身热气喘，神倦脉大，既非外感之形，又无
内伤之象，显系热伤气分，阴乏恋交，阳遂上冒。仿东垣甘
温能除大热，故用人参、黄祗、白术、甘草甘温益气，生地、
牡蛎、五味，白芍咸寒固阴，俾阴阳交固，而大命回于顷刻
焉。
中热汗大出，口大渴，心中恶热，肢冷脉微，神
疲倦卧，时或烦躁，此因热伤阳，阴失交恋，气脱之
候将至。宜用十四味大建中汤，护阳摄阴也。
， 上条脱证未现，此条脱形既着，做肢冷脉微，若更烦
躁，是立危矣。故用十全大补加附子、麦冬、苁蓉;阴阳并
补，庶几抠纽复续，而转危为安也。
中热病证见神志清醒，能进食，大便闭结，眼睛闭合却失眠，且多受惊悸。这是热邪留滞于胆经络脉，导致营卫运行失常。适宜使用秫米半夏汤，加入羚羊角、牡丹皮、姜汁炒酸枣仁、酒浸郁李仁、猪胆皮、龙齿、蒺藜等药物，以清泄胆热并下行肝系之气。
若能进食且神志清醒，是病情向愈的迹象。小便赤黄、大便闭结、眼睛畏光惊恐，乃是热邪蔓延至胆络，肝气横逆急迫。《灵枢》记载：卫气在阳分运行二十五周次，在阴分运行二十五周次，一昼夜循环全身一周。又说：卫气行于阳分则人清醒，行于阴分则人入睡。如今卫气只行于阳分，导致阳气偏盛，无法进入阴分，致使阴气衰弱，所以清醒而无法入睡，眼睛闭合却惊恐不安；这是因为胆热肝气横逆，胃气失去冲和之性，营卫运行失常。仿照《内经》中秫米半夏汤调和胃气升降之法，用酸枣仁、郁李仁、龙齿下行肝系以镇惊安神，用羚羊角、猪胆、牡丹皮清泄胆热并疏散风火，此为妙法。
中热病证见大汗淋漓，口大渴，身体大热，气喘且精神疲倦，脉象虚大且不充实有力（不鼓指），这是热邪损伤了气分，阳气不能固守。适宜用人参、黄芪、白术、麦冬、五味子、地骨皮、甘草、生地、牡蛎、白芍等药物，采用甘温除热法治疗。
汗多口渴，身热气喘，精神疲倦脉大，这既不是外感病的表现，也没有内伤病的征象，显然是热邪损伤气分，阴液缺乏以留恋交合，阳气于是上越冒犯。仿效李东垣“甘温能除大热”的理论，故用人参、黄芪、白术、甘草等甘温药物益气，用地黄、牡蛎、五味子、白芍等咸寒药物固护阴液，使阴阳交固，从而在顷刻间挽回生命。
中热病证见大汗出，口大渴，心中厌恶热邪，四肢冰冷，脉象微弱，精神疲倦想躺卧，时而烦躁，这是因为热邪损伤了阳气，阴气失去交恋，气脱的危候即将出现。适宜使用十四味大建中汤，以保护阳气、摄纳阴液。
上一条所述的气脱证尚未显现，这一条所述的气脱形态已经明显，如四肢冷、脉微细，如果再加上烦躁，就立刻处于危险境地。因此使用十全大补汤加入附子、麦冬、肉苁蓉；阴阳双补，或许能使枢纽重新连接，从而转危为安。
Zhongre (Intense Heat) with clear consciousness, ability to eat, and constipation, accompanied by closed eyes but insomnia and frequent startles, indicates that heat remains in the Gallbladder collaterals, causing a loss of regulation in Ying (Nutritive) and Wei (Defensive) Qi. It is appropriate to use Shumi Banxia Tang (Glutinous Rice and Pinellia Decoction) added with Lingjiao (Antelope Horn), Danpi (Moutan Cortex), Zao Ren (Semen Ziziphi Spinosae stir-fried with ginger juice), Yuli Ren (Semen Pruni Armeniacae soaked in wine), Zhudanzi (Pericarpium Porci Bilei), Longchi (Dent Draconis), Jili (Fructus Tribuli), etc., to clear Gallbladder heat and descend Liver system Qi.
The ability to eat and clear consciousness are signs of disease receding. Red urine, constipation, fearfulness, and startles indicate that heat has extended into the Gallbladder collaterals, and the Liver system is tense and horizontal. As stated in *Ling Shu* (Spiritual Pivot): Wei Qi circulates 25 cycles in Yang and 25 cycles in Yin, completing one full circuit of the body in a day and night. It also states: When Wei Qi moves in Yang, one is awake; when it moves in Yin, one sleeps. Since it now only moves in Yang, Yang becomes excessive and cannot enter Yin, leading to deficient Yin. Thus, one is awake but cannot sleep, and experiences closed eyes with restless startles. This is due to Gallbladder heat and horizontal Liver Qi, causing the Stomach to lose its harmonious nature and Ying and Wei Qi to lose regulation. Following the method from *Nei Jing* (Inner Canon) where Shumi Banxia Tang harmonizes the ascending and descending of Stomach Qi, using Zao Ren, Yuli Ren, and Longchi to descend Liver system Qi and calm fright, while Lingjiao, Zhudan, and Danpi clear Gallbladder heat and drain fire and wind, is an excellent approach.
Zhongre with profuse sweating, intense thirst, high fever, panting, mental fatigue, and a pulse that is empty, large, and not forceful upon pressure (not drumming the fingers), indicates that heat has injured the Qi aspect, and Yang fails to retain Yang. It is appropriate to use Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Maidong (Ophiopogonis Radix), Wuweizi (Schisandrae Fructus), Digupi (Cortex Lycii), Gancao (Glycyrrhizae Radix et Rhizoma), Shengdi (Rehmanniae Radix), Muli (Concha Ostreae), and Baishao (Paeoniae Radix Alba), employing the method of sweet-warm to remove heat.
Profuse sweating, thirst, fever, panting, mental fatigue, and a large pulse are neither signs of external contraction nor internal injury. Clearly, this is heat injuring the Qi aspect, with Yin lacking the capacity to retain and interact, causing Yang to ascend and overwhelm. Following Li Dongyuan's principle that "sweet-warm can remove great heat," Renshen, Huangqi, Baizhu, and Gancao are used as sweet-warm herbs to tonify Qi, while Shengdi, Muli, Wuweizi, and Baishao are used as salty-cold herbs to consolidate Yin, ensuring the interaction and consolidation of Yin and Yang, thereby rescuing life in an instant.
Zhongre with profuse sweating, intense thirst, aversion to heat in the heart, cold limbs, faint pulse, mental fatigue with a desire to lie down, and occasional irritability, indicates that heat has injured Yang, Yin has lost its connection, and the syndrome of Qi collapse is imminent. It is appropriate to use Shisiwei Dajianzhong Tang (Fourteen-Ingredient Great Building Middle Decoction) to protect Yang and grasp Yin.
In the previous paragraph, the collapse syndrome had not yet appeared; in this paragraph, the form of collapse is evident, such as cold limbs and faint pulse. If irritability is added, the condition will be immediately critical. Therefore, Shiquan Dabu Tang (Ten-Ingredient Great Tonifying Decoction) is used with added Fuzi (Aconiti Lateralis Radix Praeparata), Maidong, and Congrong (Cynomorii Herba); tonifying both Yin and Yang may allow the pivot to reconnect, turning danger into safety.