春温舌绛或黑，谵妄烦躁，神昏脉促，斑疹紫
黑，此热入血分。宜用犀角地黄汤加元参心、连翘
心、鲜石斜、鲜菖蒲、紫草、至宝丹等昧，凉血清热
也。
上条神昏舌绛，斑疹脉数，热在心营。此条舌绛焦黑，
昏谵妄笑，脉促斑紫，热传血分。古称斑色紫为胃热，黑则
胃烂。邪在心胞则妄笑。心主血，心热则血热，血热则斑
黑。舌为心苗，心热则舌焦。斯非大剂凉血破瘀，则斑疹难
化。须藉犀角、生地，赤芍、丹皮凉血，元参、连翘、菖
蒲、至宝清心，徜得斑红神爽，庶可望治。然亦九死一生之
候，若见症如前，而或便闭腹硬，舌黑焦黄，可与凉膈散丁
之，俾大便一通，邪热顿祛，则病势霍然矣。
春温烦热消渴，神迷如寐，舌卷囊缩，肢逆昏
厥，此热陷厥阴，真阴欲凅。宜用犀角、羚角、生
地、元参、连翘，天冬、麦冬、牡蛎、阿胶、钩藤，
鲜菖蒲等味，清络熄风也。
按仲景《伤寒》厥阴条云，烦熟消渴，气上撞心，饥不
欲食，今兼神昏舌卷，津液消耗。且厥阴为至阴之脏，有入
无出，仲景所谓热深厥亦深，热微厥亦微，厥少热多，是为
病解，厥多热少，病渐入深，其肢冷昏厥，势所必至。况厥
阴肝脉上循咽舌，下绕阴器，故为病必舌卷囊缩。斯时邪深
正竭，勉用犀角、羚角、生地、元参以清营络，天冬，麦冬
以壮水，阿胶、牡蛎以潜阳，钩藤、菖蒲以熄风，俾阴充阳
潜，热退神清，始有生机，然亦百中图一而己。
春温病出现舌质深红或发黑，胡言乱语、烦躁不安，神志昏迷、脉搏急促，斑疹颜色紫黑，这是热邪深入血分。适宜使用犀角地黄汤加入元参心、连翘心、鲜石斛、鲜石菖蒲、紫草、至宝丹等药物，以凉血清热。
上一条所述神志昏迷、舌质深红、斑疹出现、脉搏快，是热邪在心营。这一条所述舌质深红焦黑，神志昏乱、胡言乱语、嬉笑无常，脉搏急促、斑疹色紫，是热邪传入血分。古人称斑色紫为胃热极盛，黑色则说明胃气腐烂。邪气侵犯心包络则导致嬉笑无常。心主血脉，心热则血热，血热则斑疹变黑。舌为心之苗窍，心热则舌体焦枯。这并非大剂量凉血破瘀之法不能化解斑疹。必须借助犀角、生地黄、赤芍、牡丹皮来凉血，元参、连翘、石菖蒲、至宝丹来清心，倘若斑疹转为红色、神志清爽，才有望治愈。然而这也是九死一生的危重证候，如果见到上述症状，同时伴有便秘、腹部坚硬、舌苔黑而焦黄，可以给予凉膈散治疗，使大便一通，邪热顿时祛除，那么病情就会迅速好转。
春温病出现烦热、口渴多饮，神志迷蒙如睡梦中状态，舌体卷缩、阴囊收缩，四肢逆冷、昏厥，这是热邪陷入厥阴经，真阴即将枯竭。适宜使用犀角、羚羊角、生地黄、元参、连翘、天冬、麦冬、牡蛎、阿胶、钩藤、鲜石菖蒲等药物，以清透络脉、熄风止痉。
按张仲景《伤寒论》厥阴篇记载：烦热、口渴，气上冲心，饥饿但不欲进食，如今兼有神志昏迷、舌体卷缩，津液消耗严重。且厥阴肝脏属于至阴之脏，有入无出，正如张仲景所说“热越深则四肢厥冷越甚，热轻微则四肢厥冷也轻微”，厥冷少而发热多是疾病向愈的表现，厥冷多而发热少，病情逐渐加深，其四肢冰冷、昏厥之势是必然结果。况且厥阴肝脉上行连接咽喉和舌根，下行环绕生殖器，所以发病时必定出现舌体卷缩、阴囊收缩。此时邪气深重、正气衰竭，勉强使用犀角、羚羊角、生地黄、元参来清解营分和络脉的热邪，天冬、麦冬来滋养肾水（滋阴），阿胶、牡蛎来潜降阳气，钩藤、石菖蒲来熄风止痉，使得阴液充足、阳气潜藏，热退神清，始有生机，但这也只是百中取一的成功率罢了。
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.