斑疹烦热神昏，舌黄尖绎，夜则谵妄，斑疹并
透，此热渐入营。宜用玉女煎加元参、连翘、人中
黄、鲜石斛、鲜菖蒲、青竹叶等味。清营转气也。
上条在气，此条入营，盖斑疹已透，而热犹未清，更兼
神昏夜谵，舌黄尖绛，入营之状昭然。故宜玉女煎两清气
血，合连翘、元参化斑，石斛养胃，人中黄解毒，菖蒲、竹
叶清营，使其从营转气，由气达表，不致入血为妙。
斑疹舌绎而黑，神昏谵语，烦燥妄笑，此热入心
包。宜用玉女煎加犀角、元参心、连翘心，鲜菖蒲、
牛黄丸等味，清营透斑也。
上条热入营络，此条热入心胞，渐延血分。夫营与心
胞，似为一症，实则营浅心深，却有层次之分。《温热论》
所谓卫之后方言气，营之后方言血。此为的辨。故心主血，
心热则血热，血热则神昏妄笑，舌绛而焦。非藉白虎清气，
生地凉血，犀角、元参、连翘化斑，菖蒲清窍，则热何由
解，斑何由化耶!
斑疹舌黑尖绎，神昏妄笑，扬手掷足，寻衣摸
床，此热入血分。宜用犀角地黄汤加元参，连翘、鲜
石斛、鲜菖蒲、青竹叶、牛黄丸、人中黄，人参等
味，凉血化斑也。
斑疹既透，烦热更甚，至舌黑尖绛，神昏妄笑，乃热已
入血，阴伤风动;扬手掷足，寻衣摸床，正虚不能胜邪，将
厥之兆也。急宜犀角地黄汤凉血，元参、连翘、石斛清热，
人参扶正，菖蒲、竹叶清心，人中黄化斑解毒，牛黄丸宜窍
逐秽，庶济危险于万一耳。
斑疹显现，伴有烦热、神志昏迷，舌苔黄而舌尖红绛，夜间出现胡言乱语，斑疹同时透出，这是热邪逐渐深入营分。适宜使用玉女煎加入玄参、连翘、人中黄、鲜石斛、鲜石菖蒲、青竹叶等药物。此法旨在清解营分热邪并透转至气分。
上一条论述病位在气分，本条论述病位已入营分。大概是因为斑疹已经透出，但热邪仍未清除，再加上神志昏迷、夜间胡言乱语，舌苔黄而舌尖红绛，进入营分的症状表现十分明显。因此适宜用玉女煎来气血两清，配合连翘、玄参化解斑疹，石斛滋养胃阴，人中黄解毒，石菖蒲、竹叶清解营分热邪，使热邪从营分转出到气分，再由气分达于体表，不致使病情深入血分，这才是妙处。
斑疹显现，舌质红绛且呈黑色，神志昏迷、胡言乱语，烦躁不安、无故嬉笑，这是热邪侵入心包络。适宜使用玉女煎加入犀角、玄参心、连翘心、鲜石菖蒲、牛黄丸等药物，以清解营分热邪并透发斑疹。
上一条是热邪侵入营络，本条是热邪侵入心包，逐渐蔓延至血分。营分与心包络，看似症状相似，实际上营分病位较浅，心包病位较深，是有层次区别的。《温热论》中所说的“卫分之后才谈及气分，营分之后才谈及血分”，这是对这一过程的准确辨析。因此，心主血脉，心热则导致血热，血热则引起神志昏迷、无故嬉笑，舌质红绛且干枯焦黑。如果不借助白虎汤清气分热，生地黄凉血，犀角、玄参、连翘化解斑疹，石菖蒲开通心窍，那么热邪如何能解除，斑疹如何能消散呢！
斑疹显现，舌苔黑而舌尖红绛，神志昏迷、无故嬉笑，举手投足狂乱，抓空摸床，这是热邪深入血分。适宜使用犀角地黄汤加入玄参、连翘、鲜石斛、鲜石菖蒲、青竹叶、牛黄丸、人中黄、人参等药物，以凉血化斑。
斑疹既然已经透出，烦热反而更加严重，直到舌苔黑、舌尖红绛，神志昏迷、无故嬉笑，这是热邪已经进入血分，阴液受损引动肝风；举手投足狂乱，抓空摸床，正是正气虚弱不能抵御邪气，即将发生厥证的征兆。急需使用犀角地黄汤凉血，玄参、连翘、石斛清热，人参扶助正气，石菖蒲、竹叶清心，人中黄化解斑疹并解毒，牛黄丸开窍逐除秽浊之气，或许能在万分之一的危险中挽救生命。
Maculae and papules appear accompanied by vexatious heat, clouding of spirit (clouding of consciousness), yellow tongue coating with a crimson tip, and delirium at night. The maculae and papules emerge simultaneously, indicating that the pathogenic heat is gradually entering the Ying (Nutrient) level. It is appropriate to use Yunu San (Jade Woman Decoction) added with Xuanshen (Radix Scrophulariae), Lianqiao (Forsythiae Fructus), Renzhonghuang (Calculus Bovis processed with human excrement), fresh Shihu (Dendrobii Caulis), fresh Shichangpu (Acori Tatarinowii Rhizoma), and Qingzhuyezi (Bambusae Folium). This method clears the Ying level and transforms the heat back to the Qi level.
The previous clause discussed pathology in the Qi level; this clause discusses pathology entering the Ying level. Generally, although the maculae and papules have emerged, the heat remains unclarified, compounded by clouding of spirit and delirium at night, along with a yellow tongue coating and crimson tip, making the signs of entering the Ying level evident. Therefore, it is appropriate to use Yunu San (Jade Woman Decoction) to clear both Qi and Blood levels simultaneously, combined with Lianqiao (Forsythiae Fructus) and Xuanshen (Radix Scrophulariae) to resolve the maculae, Shihu (Dendrobii Caulis) to nourish Stomach Yin, Renzhonghuang (Calculus Bovis processed with human excrement) to detoxify, and Shichangpu (Acori Tatarinowii Rhizoma) and Zhuyezi (Bambusae Folium) to clear the Ying level. This allows the heat to transform from Ying to Qi, and from Qi to reach the exterior, avoiding entry into the Xue (Blood) level, which is the essence of the treatment.
Maculae and papules appear with a crimson and black tongue body, clouding of spirit, delirious speech, restlessness, and inappropriate laughter. This indicates that heat has entered the Pericardium (Xinbao). It is appropriate to use Yunu San (Jade Woman Decoction) added with Xijiao (Rhinocerotis Cornu), Xuanshenxin (Medulla Sparganii), Lianqiaoxin (Core Forsythiae Fructus), fresh Shichangpu (Acori Tatarinowii Rhizoma), and Niuhuang Wan (Calculus Bovis Pill), to clear the Ying level and vent the maculae.
The previous clause described heat entering the Ying collaterals; this clause describes heat entering the Pericardium, gradually extending into the Xue (Blood) level. Although Ying level and Pericardium pathology seem similar, the Ying level is superficial while the Pericardium is deep, reflecting distinct hierarchical layers. As stated in *Wenre Lun* (Treatise on Warm Diseases): "After the Wei (Defensive) level, one speaks of the Qi level; after the Ying level, one speaks of the Xue level." This provides an accurate differentiation. Since the Heart governs the Blood, Heart heat leads to Blood heat; Blood heat causes clouding of spirit and inappropriate laughter, resulting in a crimson and scorched tongue body. Without relying on Baihu Tang (White Tiger Decoction) to clear Qi-level heat, Shengdi Huang (Rehmanniae Radix) to cool the Blood, Xijiao (Rhinocerotis Cornu), Xuanshen (Radix Scrophulariae), and Lianqiao (Forsythiae Fructus) to resolve maculae, and Shichangpu (Acori Tatarinowii Rhizoma) to open orifices, how could the heat be resolved and the maculae dissipated?
Maculae and papules appear with a black tongue body and crimson tip, clouding of spirit, inappropriate laughter, flinging hands and feet, and groping at clothes and bedsides. This indicates that heat has entered the Xue (Blood) level. It is appropriate to use Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) added with Xuanshen (Radix Scrophulariae), Lianqiao (Forsythiae Fructus), fresh Shihu (Dendrobii Caulis), fresh Shichangpu (Acori Tatarinowii Rhizoma), Qingzhuyezi (Bambusae Folium), Niuhuang Wan (Calculus Bovis Pill), Renzhonghuang (Calculus Bovis processed with human excrement), and Renshen (Ginseng Radix et Rhizoma), to cool the Blood and resolve maculae.
Since the maculae and papules have emerged, the vexatious heat intensifies further. When the tongue becomes black with a crimson tip, accompanied by clouding of spirit and inappropriate laughter, it signifies that heat has entered the Xue (Blood) level, damaging Yin fluids and stirring internal wind. Flushing hands and feet, and groping at clothes and bedsides, indicate that righteous Qi is too weak to overcome the pathogenic factor, signaling an impending Jue syndrome (collapse). Urgently, Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) should be used to cool the Blood, Xuanshen (Radix Scrophulariae), Lianqiao (Forsythiae Fructus), and Shihu (Dendrobii Caulis) to clear heat, Renshen (Ginseng Radix et Rhizoma) to support righteousness, Shichangpu (Acori Tatarinowii Rhizoma) and Zhuyezi (Bambusae Folium) to clear the Heart, Renzhonghuang (Calculus Bovis processed with human excrement) to resolve maculae and detoxify, and Niuhuang Wan (Calculus Bovis Pill) to open orifices and expel turbidity, thereby perhaps saving life from extreme danger.