冬温烦热，舌绛，神昏谵妄，斑紫或黑，脉数
或促，此邪入血分。宜用犀角地黄汤加鲜石斛、元参
心、连翘心、人中黄、广郁金、鲜菖蒲、至宝丹、
青竹叶等味，凉血透邪也。
上条舌绛苔黄，斑疹隐约 虽已神昏，邪尚在营，此条
舌绛而焦，班紫而黑，神昏谵妄，是邪已入血，非凉血清热
则万无生理。故用犀角、生地、丹皮、赤芍，合元参，连翘、
中黄、石斛，菖蒲凉血破瘀，兼至宝丹芳香逐邪。若再不
解，则邪无泄越，症必危矣。
冬温烦热，舌绎而干，斑疹湿透，神迷妄笑，
寻衣摸床，手足振颤，此阴伤风动。宜用炙甘草汤
去姜桂，加牡蛎、鲜石斛、鲜菖蒲等味，养阴却热也。
热不解而舌干色绛，斑已透而神迷妄笑，乃热极阴伤，
阳动化风。故寻衣摸床，手足摇动。若非毓阴和阳，恐难挽
回造化。必藉参，甘、胶、地、麦冬、牡蛎、菖蒲、石斛扶
正养阴，则液返津回，肝阴内复，而风阳自熄焉。
冬温初起，舌遽干，神便昏，烦热脉数，或吐
或泄，此邪盛正虚。宜用《金柜》麦门冬汤加桑叶，
地骨皮、鲜石斛、鲜菖蒲、鲜稻根等味，甘凉养胃。
偿吐泻伤阳，无热，神迷多寐，脉软不食，宜用人
参温胆汤，甘温和胃也。
凡病初起，便见舌干神昏，乃正需邪盛，不克支持，最
为险候。若烦热舌干，胃阴更损，故甩麦冬、法夏，西参、
甘草、粳米，桑叶，骨皮，石斛，甘凉濡润，以醒胃气。偿
吐泻伤阳，而神迷如寐，脉软无热，乃伤及胃阳，宜用温胆
和胃，人参养正为妙。
冬温病出现烦躁发热，舌质深红，神志昏迷并胡言乱语，皮肤出现紫色或黑色的斑疹，脉象快速或急促，这是邪气侵入血分。适宜使用犀角地黄汤，加入鲜石斛、元参心、连翘心、人中黄、广郁金、鲜石菖蒲、至宝丹、青竹叶等药物，以凉血透散邪气。
上一条所述为舌质深红且苔黄，斑疹隐约可见，虽然已有神志昏迷，但邪气尚在营分；这一条所述为舌质深红而焦枯，斑疹呈紫色或黑色，神志昏迷并胡言乱语，这是邪气已入血分，如果不采用凉血清热的方法，则绝无生机。因此使用犀角、生地黄、牡丹皮、赤芍，配合元参、连翘、人中黄、石斛、石菖蒲，以凉血破瘀，兼用至宝丹芳香逐邪。如果病情仍不缓解，则邪气无法宣泄，症状必然危重。
冬温病出现烦躁发热，舌质深红而干燥，斑疹湿透，神志迷乱并无故发笑，手抓空摸床，手足震颤，这是阴液损伤导致肝风内动。适宜使用炙甘草汤，去掉生姜和肉桂，加入牡蛎、鲜石斛、鲜石菖蒲等药物，以滋养阴液清除热邪。
如果热邪不解且舌干色绛，斑疹已经透出但神志迷乱无故发笑，这是热极导致阴液损伤，阳气妄动化生风邪。因此出现手抓空摸床、手足摇动的症状。如果不是通过滋养阴液调和阳气，恐怕难以挽回生机。必须借助人参、甘草、阿胶、地黄、麦冬、牡蛎、石菖蒲、石斛来扶助正气、滋养阴液，使津液恢复，肝阴内复，则风阳自然平息。
冬温病初起，舌面突然干燥，神志昏沉，烦躁发热脉数，或者呕吐或者腹泻，这是邪气盛而正气虚。适宜使用《金匮要略》中的麦门冬汤，加入桑叶、地骨皮、鲜石斛、鲜石菖蒲、鲜稻根等药物，以甘凉之性养胃。
倘若因呕吐腹泻损伤了阳气，表现为无热、神志迷乱多睡、脉象软弱、不能进食，适宜使用人参温胆汤，以甘温和胃。
凡是疾病初起，就出现舌干神昏，这是正气不足而邪气亢盛，身体无法支撑，属于最为危险的证候。如果是烦躁发热伴舌干，说明胃阴进一步受损，因此使用麦冬、法半夏、西洋参、甘草、粳米、桑叶、地骨皮、石斛，以甘凉濡润之法，来唤醒胃气。倘若因呕吐腹泻损伤阳气，而神志迷乱如同熟睡，脉象软弱无热，这是伤及了胃阳，适宜使用温胆汤调和胃气，用人参养护正气，这才是妙法。
In winter-warmth disease, characterized by irritability and fever, a crimson tongue (Shé Jiàng, deep red tongue), coma with delirious speech (Shén Hūn Chán Wàng, loss of consciousness with incoherent talking), purple or black macules (Bān Zǐ Huò Hēi, purpura or blackish skin eruptions), and a rapid (Mài Shù, fast pulse) or hurried (Cuì, irregularly intermittent pulse) pulse, this indicates the pathogen has entered the Blood Level (Xuè Fèn). It is appropriate to use Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) added with fresh Shibao (Dendrobium officinale stem), Yuan Shen Xin (Scrophulariae Radix heart), Lian Qiao Xin (Forsythiae Fructus heart), Ren Zhong Huang (Homo Fermentum Nigrum), Guang Yu Jin (Curcumae Radix), fresh Chang Pu (Acori Tatarinowii Rhizoma), Zhibao Dan (Treasure of Life Pill), and Qing Zhu Ye (Bambusae Folium), to cool the blood and vent the pathogen.
The preceding clause describes a crimson tongue with yellow coating and faint macules; although there is coma, the pathogen remains at the Ying (Nutrient) Level (Yíng Fèn). This clause describes a crimson and scorched tongue with purple or black macules and coma with delirious speech, indicating the pathogen has entered the Blood Level. Without cooling the blood and clearing heat, there is no hope for survival. Therefore, Xijiao (Rhinoceros Hornis Cornu - *Note: Substitute with Buffalo Horn in modern practice*), Sheng Di Huang (Rehmanniae Radix), Mu Dan Pi (Moutan Cortex), Chi Shao Yao (Paeoniae Radix Rubra) are combined with Yuan Shen (Scrophulariae Radix), Lian Qiao (Forsythiae Fructus), Ren Zhong Huang (Homo Fermentum Nigrum), Shi Hu (Dendrobii Caulis), and Chang Pu (Acori Tatarinowii Rhizoma) to cool the blood and break stasis, while utilizing Zhibao Dan (Treasure of Life Pill) to expel pathogens with its aromatic properties. If the condition still does not resolve, the pathogen will have no outlet, and the symptoms will become critical.
Winter-warmth disease presenting with irritability and fever, a crimson and dry tongue, macules that are moist and fully erupted, confused spirit with inappropriate laughter, picking at empty air and bedclothes (Xún Yī Mō Chuáng), and tremors of the hands and feet, indicates Yin injury leading to internal wind movement. It is appropriate to use Zhigancao Tang (Honey-fried Licorice Decoction), removing Jiang (Zingiberis Rhizoma Recens) and Gui (Cinnamomi Ramulus), adding Mu Li (Ostrea Concha), fresh Shi Hu (Dendrobii Caulis), and fresh Chang Pu (Acori Tatarinowii Rhizoma), to nourish Yin and eliminate heat.
If heat persists and the tongue becomes dry and crimson, and although macules have erupted, the spirit is confused with inappropriate laughter, this signifies extreme heat damaging Yin, causing Yang to move and transform into wind. Hence, the symptoms of picking at empty air and bedclothes and shaking of the limbs occur. Unless Yin is nurtured and Yang is harmonized, it may be difficult to restore vitality. One must rely on Ren Shen (Ginseng Radix et Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), E Jiao (Colla Corii Asini), Di Huang (Rehmanniae Radix), Mai Dong (Ophiopogonis Radix), Mu Li (Ostrea Concha), Chang Pu (Acori Tatarinowii Rhizoma), and Shi Hu (Dendrobii Caulis) to support righteous Qi and nourish Yin. When fluids return and saliva recovers, Liver Yin is restored internally, and wind-Yang naturally extinguishes.
At the onset of winter-warmth disease, if the tongue suddenly becomes dry, the spirit is confused, there is irritability and fever with a rapid pulse, or vomiting and diarrhea occur, this indicates excess pathogen and deficient Zheng Qi (Righteous Qi). It is appropriate to use Maidong Tang (Ophiopogon Decoction) from *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet), added with Sang Ye (Mori Folium), Di Gu Pi (Lycii Cortex), fresh Shi Hu (Dendrobii Caulis), fresh Chang Pu (Acori Tatarinowii Rhizoma), and fresh Dao Gen (Oryzae Sativae Radix), using sweet and cool properties to nourish the Stomach.
If vomiting and diarrhea injure Yang, resulting in absence of heat, confused spirit with excessive sleepiness, a soft pulse, and inability to eat, it is appropriate to use Renshen Wendan Tang (Ginseng Gallbladder-Calming Decoction) to harmonize the Stomach with sweet and warm properties.
Whenever a disease begins with sudden dryness of the tongue and confusion of the spirit, it indicates that Zheng Qi is insufficient while the pathogen is exuberant, and the body cannot sustain itself; this is the most dangerous prognosis. If there is irritability, fever, and a dry tongue, Stomach Yin is further damaged. Therefore, Mai Dong (Ophiopogonis Radix), Fa Ban Xia (Pinelliae Rhizoma Preparatum), Xi Shen (Panacis Quinquefolii Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), Jing Mi (Oryzae Semen), Sang Ye (Mori Folium), Gu Pi (Lycii Cortex), and Shi Hu (Dendrobii Caulis) are used. Their sweet and cool, moistening nature aims to awaken Stomach Qi. If vomiting and diarrhea injure Yang, leading to a spirit confused as if in deep sleep, a soft pulse, and absence of heat, this indicates injury to Stomach Yang. It is advisable to use Wendan Tang (Gallbladder-Calming Decoction) to harmonize the Stomach and Ren Shen (Ginseng Radix et Rhizoma) to nourish Zheng Qi.