温疟者，由伤寒之热未已，再感于寒，变为温疟，或过经坏病变为温疟而寒热羁留者，皆因寒热相
搏而成。治宜散寒解热为主，并用加减小柴胡汤。如热多倍加柴胡，寒多，倍加桂枝而或柴胡葛根
散其寒、石膏知母解其热也。
时行者，谓春应暖而反寒，夏应热而反凉，秋应凉而反热，冬应寒而反温是也。盖四时不正乖戾之
气，流行期间而有其气，是以一岁之中，长幼之病相似，此则时行之气也。其外症有类伤寒，治宜解
散，并用升麻葛根汤。然时行犹外入之感冒，而瘟疫乃内出之邪毒也。
寒疫者，非时感冒之暴寒，亦时行之气也。伤寒例曰、从春分以后，至秋分节前，天有暴寒，皆时行寒
疫也。其症憎寒恶风，头痛身热，或用消风百解散，或用六神通解散加减。大抵此病与温病及暑病
相似，但治理有殊耳。然温暑之热，自内而出，寒疫之邪，寒抑阳气，乃外感者也。故治宜解表。若温暑，
又兼表里者也。
温邪上受，首先犯肺，逆传心胞，肺主气属?，心主血属营，辨营?气血，虽与伤寒同，若论治法，则与
伤寒大异。盖伤寒之邪，留恋在表，然后化热入里，温邪则热变最速，未传心胞，邪尚在肺，肺主气，其
合皮毛，故云在表，在表初用辛凉轻剂，挟风则加入薄荷牛蒡之属，挟湿加芦根滑石之流，或透风
于热外，或渗湿于热下，不与热相搏，势必孤矣。不尔，风挟温热而燥生，清窍必干，谓水主之气，不能
上荣，两阳相劫也。湿与温合，蒸郁而蒙蔽于上，清窍为之壅塞，浊邪害清也。其病有类伤寒，其验之
之法，伤寒多有变症温热虽久，在一经不移。以此为辨。
前言辛凉散风，甘淡驱湿，若病仍不解，是渐欲入营也。营分受热，则血液受劫，心神不安，夜甚无寐，
或斑点隐隐。即撤去气药，如从风热陷入者，用犀角竹叶之属，如从湿热陷入者，犀角花露之品，参
入凉血清热方中。若加烦躁大便不通，金汁可以加入，老年或平素有寒者，以人中黄代之，急急透
斑为要。若斑出热不解者，胃津亡也，主以甘寒，重则如玉女煎，轻则如梨皮蔗浆之类。或其人肾水
素亏，虽未及下焦，先自彷徨矣，必验之于舌，如甘寒之中，加入咸寒，务在先安未受邪之地，恐其陷
入易易耳。若其邪始终在气分流连者，可冀其战汗透邪，法宜益胃，令水与汗并，热达腠开，邪从汗
出。解后胃气空虚，当肤冷一昼夜，待气还、自温暖如常矣。盖战汗而解，邪退正虚，阳从寒泄，故渐肤
冷，未必即成脱症，此时宜令病者安舒静卧，以养阳气来复，旁人切勿惊徨、频频呼唤，扰其元神，使
其烦躁。但诊其脉，若虚软和缓，虽倦卧不语，汗出肤冷，却非脱症。若脉急疾，躁扰不卧，肤冷汗出，便
为气脱之症矣。更有邪盛正虚，不能一战而解，停一二日再战汗而愈者，不可不知。再论气病有不
传血分，而邪留三焦，亦如伤寒中少阳病也，彼则和解表里之半，此则分消上下之势，随症变法，如
近时杏朴苓等类，或如温胆汤之走泄，因其仍在气分，犹可望其战汗之门户，转疟之机括。大凡看
法，?之后、方言气，营之后、方言血，在?汗之可也，到气才可清气，入营犹可透热转气 ，如犀角玄参
羚羊等物，入血就恐耗血动血，直须凉血散血，如生地丹皮阿胶赤芍等物，否则前后不循缓急之
法，虑其动手便错，反至慌张矣。且吾吴、湿邪害人最广，如面色白者，须要顾其阳气，湿胜则阳微也。
法应清凉，然到十分之六七，即不可过于寒凉，恐成功反弃，何以故邪，湿热一去，阳亦衰微也。面色
苍者，须要顾其津液，清凉到十分之六七，往往热减身寒者，不可就云虚寒而投补剂，恐炉烟虽熄，
灰中有火也，须细察精详，方少少与之，慎不可直率而往也。又有酒客里湿素盛，外邪入里，里湿为
合，在阳旺之躯，胃湿恒多，在阴盛之体，脾湿亦不少，然化热则一。热病救阴则易，通阳最难，救阴不
在血而在津与汗，通阳不在温而在利小便。然较之杂症，则有不同也。
再论三焦不得从外解，必致成里结，里结于何，在阳明胃与肠也。亦须用下法，不可以气血之分，就
不可下也。但伤寒热邪在里，劫烁津液，下之宜猛，此多湿邪内搏，下之宜轻，伤寒大便溏为邪已尽，
不可再下，湿温病大便溏为邪未尽，必大便硬，慎不可再攻也，以屎燥为无湿矣。再人之体，脘在腹
上，其地位处于中，按之痛，或自痛，或痞胀，当用苦泄，以其入腹近也。必验之于舌，或黄或浊，可与小
陷胸汤或泻心汤，随症治之。或白不燥，或黄白相兼，或灰白不渴，慎不可乱投苦泄。其中有外邪未
解、里先结者，或邪郁未伸，或素属中冷者，虽有脘中痞痛，宜从开泄，宣通气滞，以达归于肺，如近俗
之杏蔻橘桔等是，轻苦微辛，具流动之品可耳。
再前云舌黄或浊，须要有地之黄，若光滑者，乃无形湿热，中已虚象，忌前法。其脐以上为大腹，或
满或胀或痛，此必邪已入里矣，表症必无，或十之存一。亦要验之于舌，或黄甚，或如沈香色，或如灰
黄色。或老黄色，或中有断纹，皆当下之，如小承气汤，用槟榔青皮枳实元明粉生首乌等。若未现此
等舌，不宜用此等法，恐其中有湿聚太阴为满，或寒湿错杂为痛，或气壅为胀，又当以别法治之。
再黄胎不甚厚而滑者，热未伤津，犹可清热透表。若虽薄而干者，邪虽去而津受伤也，苦重之药当
禁宜甘寒轻剂可也。
再论其热传营，舌色必绛，绛、深红色也。初传绛色中兼黄白色，此气分之邪未尽也，泄?透营，两和
可也。纯绛鲜泽者，胞络受病也，宜犀角鲜生地连翘郁金石菖蒲等。延之数日，或平素心虚有痰，外
热一陷，里络就闭，非菖蒲郁金等所能开，须用牛黄丸、至宝丹之类以开其闭，恐其昏厥为痉也。
再色绛而舌中心干者，乃心胃火燔，劫烁津液，即黄连石膏亦可加入。若烦渴烦热，舌心干四边色
红，中心或黄或白者，此非血分也，乃上焦气热烁津，急用凉膈散散其无形之热，再看其后转变可
也。慎勿用血药，以滋腻难散。至舌绛望之若干，手扪之原有津液，此津亏湿热熏蒸，将成浊痰蒙闭
心胞也。
再有热传营血，其人素有瘀伤宿血在胸膈中，挟热而搏，其舌色必紫而暗，扪之湿，当加入散血之
品，如琥珀丹参桃仁丹皮等。不尔，瘀血与热为伍，阻遏正气，遂变如狂发狂之症。若紫而肿大者，乃
酒毒冲心，若紫而干晦者，肾肝色泛也，难治。舌色绛，而上有粘腻似苔非苔者，中挟穟浊之气，急加
芳香逐之。舌绛，欲伸出口而抵齿难骤伸者，痰阻舌根，有内风也。舌绛而光亮，胃阴亡也，急用甘凉
濡润之品。若舌绛而干燥者，火邪劫营，凉血清火为要。舌绛而有碎点白黄者，当生疳也，大红点者，
热毒乘心也，用黄连金汁。其有虽绛而不鲜，干枯而痿者，此肾阴涸，急以阿胶鸡子黄地黄天冬等
救之，缓则恐涸极而无救也。其有舌独中心绛干者，此胃热，心营受灼也，当于清胃方中加入清心
之品，否则延及于尖，为津干火盛也。舌尖绛独干，此心火上炎，用导赤散泻其府。
再舌胎白厚而干燥者，此胃燥气伤也，滋肾药中加甘草，令甘守津还之意。舌白而薄者，外感风寒
也，当疏散之。若白干薄者，肺津伤也，加麦冬花露芦根汁等轻清之品，为上者上之也。若白苔绛底
者，湿遏热伏也，当先泄湿透热，防其就干也，勿忧之，再从里透于外，则变润矣。初病舌就干，神不昏
者，急养正，微加透邪之药。若神已昏，此内匮矣，不可救药。又不拘何色舌，上生芒刺者，皆是上焦热
极也，当用青布拭冷薄荷水揩之，即去者轻，旋即生者险矣。舌苔不燥，自觉闷极者，属脾湿盛也。或
有伤痕血迹者，必问曾经搔挖否，不可以有血而便为枯症，仍从湿治可也。再有神情清爽，舌胀大
不能出口者，此脾湿胃热郁极化风，而毒延口也，用大黄磨入当用剂内，则舌胀自消矣。
再舌上白苔粘腻，吐出浊厚涎沫者，口必甜味也，为脾瘅病，乃湿热气聚，与榖气相搏，土有余也，盈
满则上泛，当用省头草，芳香辛散以逐之则退。若舌上苔如?者，胃中宿滞挟浊穟郁伏，当急急开
泄，否则闭结中焦，不□煤隐隐者，不渴肢寒，知挟阴病。如口渴烦热，平时胃燥舌也，不可攻之。若燥者，
甘寒益胃。若润者，甘温扶中。此何故，外露而里无也。
若舌黑而滑者，水来?火，为阴症，当温之。若见短缩，此肾气竭也，为难治，欲救之，加人参五味子勉
希万一。舌黑而干者，津枯火炽。急急泻南补北。若燥而中心厚1者，土燥水竭，急以咸苦下之。
舌淡红无色者，或干而色不荣者，当是胃津伤而气无化液也，当用炙甘草汤，不可用寒凉药。
若舌白如粉而滑，四边色紫绛者，瘟疫病初入募原，未归胃府，急急透解，莫待传陷而入为险恶之
病。且见此舌者，病必见凶，须要小心。凡斑疹初见，须用纸捻照看胸背两?，点大而在皮肤之上者
为斑，或云头隐隐，或琐碎小粒者为疹。又宜见而不宜见多。按方书谓斑色红者属胃热，紫者热极，
黑者胃烂，然亦必看外症所合，方可断之。然而春夏之间，湿病俱发疹为甚，且其色要辨，如淡红色，
四肢清，口不甚渴，脉不洪数，非虚斑、即阴斑。或胸微见数点，面赤足冷，或下利清榖，此阴盛格阳于
上而见，当温之。若斑色紫小点者，心包热也。点大而紫，胃中热也。黑斑而光亮者，热胜毒盛，虽属不
治，若其人气血充者，或根据法治之，尚可救。若黑而晦者，必死。若黑而隐隐四旁赤色，火郁内伏，大用
清凉透发，间有转红成可救者。若夹斑带疹，皆是邪之不一，各随其部而泄。然斑属血者恒多，疹属
气者不少，斑疹皆是邪气外露之象，发出宜神情清爽，为外解里和之意，如斑疹出而昏者，正不胜
邪，内陷为患，或胃津内涸之故。
再有一种白1，小粒如水晶色者，此湿热伤肺，邪虽出而气液枯也，必得甘药补之。或未至久延伤
及气液，乃湿郁?分，汗出不彻之故，当理气分之邪。或白如枯骨者多凶，为气液竭也。
再温热之病，看舌之后，亦须验齿。齿为肾之余，龈为胃之络。热邪不燥胃津，必耗肾液。且二经之血
皆走其地，病深动血，结瓣于上。阳血者色必紫，紫如干漆。阴血者色必黄，黄如酱瓣。阳血若见，安胃
为主。阴血若见，救肾为要。然豆瓣色者多险，若症还不逆者，尚可治，否则难治矣。何以故耶，盖阴下
竭、阳上厥也。
齿若光燥如石者，胃热甚也。若无汗恶寒，?偏胜也，辛凉泄胃，透汗为要。若如枯骨色者，肾液枯也，
为难治。若上半截润，水不上承，心火炎上也，急急清心救水，俟枯处转润为妥。若咬牙啮齿者，湿热
化风，痉病。但咬牙者，胃热，气走其络也。若咬牙而脉症皆衰者，胃虚，无榖以内荣，亦咬牙也。何以故
耶，虚则喜实也。舌本不缩而硬，而牙关咬定难开者，此非风痰阻络，即欲作痉症，用酸物擦之即开，
酸走筋，木来泄土故也。
若齿垢如灰糕样者，胃气无权，津亡湿浊用事，多死。而初病齿缝流清血，痛者胃火冲激也，不痛者
龙火内燔也。齿焦无垢者死，齿焦有垢者，肾热胃劫也，当微下之，或玉女煎清胃救肾可也。
再妇人病温，与男子同，但多胎前产后，以及经水适来适断。大凡胎前病，古人皆以四物加减用之
谓护胎为要，恐来害?。如热极，用井底泥蓝布浸冷覆盖腹上等，皆是保护之意。但亦要看其邪之
可解处，用血腻之药不灵，又当审察，不可认板法。然须步步保护胎元，恐损正邪陷也。至于产后之
法，按方书谓慎用苦寒药，恐伤其已亡之阴也。然亦要辨其邪能从上中解者，稍从症用之，亦无妨
也。不过勿犯下焦，且属虚体，当如虚怯人病邪而治。总之，毋犯实实虚虚之禁。况产后当血气沸腾
之候，最多空窦，邪势必乘虚内陷，虚处受邪，为难治也。如经水适来适断，邪将陷血室，少阳伤寒，言
之详悉，不必多赘。但数动与正伤寒不同，仲景立小柴胡汤，提出所陷热邪，参枣扶胃气，以冲脉隶
属阳明也，此与虚者为合治。若邪热陷入与血相结者，当宗陶氏小柴胡汤去参枣加生地桃仁查
肉丹皮或犀角等。若本经血结自甚，必少腹满痛，轻者刺期门，重者小柴胡汤去甘药加延胡归尾
桃仁，挟寒加肉桂心，气滞者加香附陈皮枳壳等。然热陷血室之症，多有谵语如狂之象，防是阳明
胃实，当辨之，血结者身体必重，非若阳明之轻旋便捷者。何以故耶。阴主重浊，络脉被阻，侧旁气痹
连胸背皆拘束不遂，故去邪通络，正合其病，往往延久上逆心胞，胸中痛，即陶氏所谓血结胸也。王
海藏出一桂枝红花汤加海蛤桃仁，原为表里上下一齐尽解之理。看此方大有巧手，故录出以备
学者之用。
温疟，是由于伤寒的热邪尚未消退，再次感受寒邪，从而转化为温疟；或者是疾病经过传变后转为温疟，导致寒热症状长期滞留的，都是因为寒邪与热邪相互搏结而形成的。治疗应当以散寒解热为主，并配合使用加减小柴胡汤。如果热象较重，就加倍使用柴胡；如果寒象较重，就加倍使用桂枝，或者选用柴胡葛根散来散寒、石膏知母来清热。
时行感冒，是指春天本该温暖却反而寒冷，夏天本该炎热却反而凉爽，秋天本该凉爽却反而炎热，冬天本该寒冷却反而温暖的反常气候。这是因为四时不正的乖戾之气在流行期间出现，所以在一岁之中，无论老少，患病症状都相似，这就是时行之气所致。其外在症状类似于伤寒，治疗应当以解散表邪为主，并配合使用升麻葛根汤。然而，时行感冒如同外来的普通感冒，而瘟疫则是体内产生的邪毒。
寒疫，是非时节的暴寒侵袭，也属于时行之气的一种。《伤寒例》中说：从春分以后到秋分节前，天空出现暴寒，都属于时行寒疫。其症状表现为怕冷恶风、头痛身热，可以使用消风百解散，或者使用六神通解散进行加减。大抵这种病与温病及暑病相似，但治疗方法有所不同。然而，温病和暑病的热邪是从体内发出的，而寒疫的邪气是寒邪抑制了阳气，属于外感病。因此治疗应当解表。至于温病和暑病，则兼有表证和里证。
温邪从上焦口鼻侵入，首先侵犯肺脏，若病情逆传，则传入心包。肺主气属卫，心主血属营。辨别营分和气血，虽然与伤寒相同，但若论治法，则与伤寒大不相同。因为伤寒的邪气留恋在体表，然后化热入里；而温邪的热变速度最快，在未传入心包之前，邪气尚在肺。肺主气，外合皮毛，所以说邪气在表。在表的初期，使用辛凉轻剂；如果挟有风邪，则加入薄荷、牛蒡子之类；如果挟有湿邪，则加入芦根、滑石之类。或者将风邪透出于热邪之外，或者将湿邪渗出于热邪之下，使邪气不与热邪相搏结，邪气势必孤立无援。如果不这样处理，风挟带温热而导致燥热内生，清窍必然干燥，这是因为水精之气不能上荣，两阳（风与温）相互劫夺所致。湿与温相结合，蒸腾郁滞而蒙蔽于上，清窍因此壅塞不通，这是浊邪伤害清阳。这种病症状类似伤寒，验证的方法在于：伤寒多有变化之症，而温热病即使日久，也停留在一经不移。以此作为鉴别依据。
前面提到用辛凉散风、甘淡驱湿，如果病仍不愈，说明邪气逐渐进入营分。营分受热，则血液被耗伤，心神不安，夜间加重无法入睡，或者皮肤出现隐隐约约的斑点。此时应立即撤去清气药，如果是从风热陷入营分的，使用犀角、竹叶之类；如果是从湿热陷入营分的，使用犀角、花露等品，参入凉血清热方中。如果出现烦躁、大便不通，可以加入金汁；老年人或平时体质偏寒者，用人中黄代替，急切地以透发斑疹为要务。如果斑出后热势不退，是因为胃津亡失，主治以甘寒之法，重的如玉女煎，轻的如梨皮、甘蔗浆之类。如果其人肾水素来亏虚，虽未波及下焦，但先自彷徨不定，必须通过舌象来验证，如在甘寒药中加入咸寒药，务必先在未受邪的地方安固正气，防止邪气轻易陷入。如果邪气始终在气分流连，可以期望通过战汗来透发邪气，治法宜益胃，令水液与汗并出，热达腠理开泄，邪气随汗而出。解战后胃气空虚，会出现皮肤发冷一昼夜的情况，待气机回复，自然会像往常一样温暖。这是因为战汗而解，邪退正虚，阳气随寒邪外泄，所以逐渐皮肤发冷，未必立即变成脱证。此时应让病人安静舒适地躺卧，以养阳气恢复，旁人切勿惊慌失措、频频呼唤，扰乱其元神，使其烦躁。只需诊察脉象，如果脉象虚软和缓，虽然疲倦躺卧不语，出汗且皮肤发冷，也不是脱证。如果脉象急疾，躁动不安无法躺卧，皮肤冷汗出，就是气脱之症了。更有邪盛正虚，不能一次战汗而解，停一二日再战汗而痊愈的，不可不知道。再论述气分病有不传入血分，而邪气留滞在三焦的，也像伤寒中的少阳病一样，彼处是和解表里之半，此处是分消上下之势，随症状变化治法，如近期常用的杏仁、厚朴、茯苓等类，或者如温胆汤那样的走泄之法，因其仍在气分，还可望通过战汗透邪，作为转枢的机括。大凡看法，卫之后才说气，营之后才说血，在卫汗之可也，到气才可清气，入营犹可透热转气，如犀角、玄参、羚羊角等物，入血就怕耗血动血，必须直接凉血散血，如生地、丹皮、阿胶、赤芍等物，否则前后不遵循缓急之法，担心动手便错，反而导致慌张。况且我们吴地，湿邪害人最广，如面色白的人，须要顾护其阳气，湿胜则阳气微弱。治法应当清凉，但如果到了十分之六七的程度，就不可过于寒凉，恐怕成功反被废弃，为什么呢？湿热一去，阳气也随之衰微。面色苍黑的人，须要顾护其津液，清凉到十分之六七，往往热减身寒的，不可就说他是虚寒而投补剂，恐怕炉烟虽熄，灰中有火，须仔细考察详审，才稍微给予补剂，千万不要直率冒进。又有酒客体内湿气素盛，外邪入里，里湿与之相合，在阳气旺盛之躯，胃湿恒多，在阴气旺盛之体，脾湿也不少，然而化热则是一样的。热病救阴容易，通阳最难，救阴不在补血而在生津与保汗，通阳不在温补而在利小便。然而这与杂症有所不同。
再论述三焦邪气不得从外解，必致成里结，里结在哪里？在阳明胃与肠。也必须用下法，不可以因为是气血之分，就认为不可下。但是伤寒热邪在里，劫烁津液，攻下宜猛；此病多湿邪内搏，攻下宜轻。伤寒大便溏说明邪气已尽，不可再下；湿温病大便溏说明邪气未尽，必须到大便变硬，才慎不可再攻，以屎燥表示无湿了。再人之体，脘在腹上，其地位处于中焦，按压疼痛，或自痛，或痞胀，当用苦泄法，因为其入腹近也。必须验之于舌，如果苔黄或浊，可以用小陷胸汤或泻心汤，随症治疗。如果苔白不燥，或黄白相兼，或灰白不渴，千万不可乱投苦泄药。其中有外邪未解、里先结者，或邪郁未伸，或素属中冷者，虽然有脘中痞痛，宜从开泄法，宣通气滞，以达归于肺，如近期世俗用的杏仁、蔻仁、橘皮、桔梗等是，轻苦微辛，具有流动之性的药物即可。
再前面说舌苔黄或浊，须要有根之黄，如果光滑者，乃无形湿热，中焦已现虚象，忌用前法。其脐以上为大腹，或满或胀或痛，这一定是邪气已入里了，表症肯定没有，或者十之一二还有。也要验之于舌，如果苔黄甚，或如沉香色，或如灰黄色，或老黄色，或中有断纹，都当下之，如小承气汤，用槟榔、青皮、枳实、元明粉、生首乌等。如果没有出现这些舌象，不宜用此等法，恐怕其中有湿聚太阴为满，或寒湿错杂为痛，或气壅为胀，又当以别法治之。
再黄胎不甚厚而滑者，热未伤津，还可以清热透表。如果虽薄而干者，邪气虽去而津液受伤，苦重之药当禁，宜甘寒轻剂。
再论述热传营分，舌色必绛，绛是深红色。初传绛色中兼黄白色，这是气分之邪未尽，泄卫透营，两和可也。纯绛鲜泽者，心胞络受病，宜犀角、鲜生地、连翘、郁金、石菖蒲等。拖延数日，或平素心虚有痰，外热一陷，里络就闭，非菖蒲郁金等所能开，须用牛黄丸、至宝丹之类以开其闭，恐其昏厥变为痉病。
再舌色绛而舌中心干者，乃心胃火燔，劫烁津液，即黄连、石膏亦可加入。如果烦渴烦热，舌心干四边色红，中心或黄或白者，这不是血分病，乃上焦气热烁津，急用凉膈散散其无形之热，再看其后转变也可。慎用血药，以免滋腻难散。至舌绛望之若干，手扪之原有津液，这是津亏湿热熏蒸，将成浊痰蒙闭心胞。
再有热传营血，其人素有瘀伤宿血在胸膈中，挟热而搏，其舌色必紫而暗，扪之湿，当加入散血之品，如琥珀、丹参、桃仁、丹皮等。不这样，瘀血与热为伍，阻遏正气，遂变如狂发狂之症。如果紫而肿大者，乃酒毒冲心；如果紫而干晦者，肾肝色泛也，难治。舌色绛，而上有粘腻似苔非苔者，中挟秽浊之气，急加芳香逐之。舌绛，欲伸出口而抵齿难骤伸者，痰阻舌根，有内风也。舌绛而光亮，胃阴亡也，急用甘凉濡润之品。如果舌绛而干燥者，火邪劫营，凉血清火为要。舌绛而有碎点白黄者，当生疳也，大红点者，热毒乘心也，用黄连、金汁。其有虽绛而不鲜，干枯而痿者，此肾阴涸，急以阿胶、鸡子黄、地黄、天冬等救之，缓则恐涸极而无救也。其有舌独中心绛干者，此胃热，心营受灼也，当于清胃方中加入清心之品，否则延及于尖，为津干火盛也。舌尖绛独干，此心火上炎，用导赤散泻其腑。
再舌苔白厚而干燥者，此胃燥气伤也，滋肾药中加甘草，令甘守津还之意。舌白而薄者，外感风寒也，当疏散之。如果白干薄者，肺津伤也，加麦冬、花露、芦根汁等轻清之品，为上者上之也。如果白苔绛底者，湿遏热伏也，当先泄湿透热，防其就干也，勿忧之，再从里透于外，则变润矣。初病舌就干，神不昏者，急养正，微加透邪之药。如果神已昏，此内匮矣，不可救药。又不拘何色舌，上生芒刺者，皆是上焦热极也，当用青布拭冷薄荷水揩之，即去者轻，旋即生者险矣。舌苔不燥，自觉闷极者，属脾湿盛也。或有伤痕血迹者，必问曾经搔挖否，不可以有血而便为枯症，仍从湿治可也。再有神情清爽，舌胀大不能出口者，此脾湿胃热郁极化风，而毒延口也，用大黄磨入当用剂内，则舌胀自消矣。
再舌上白苔粘腻，吐出浊厚涎沫者，口必甜味也，为脾瘅病，乃湿热气聚，与谷气相搏，土有余也，盈满则上泛，当用省头草，芳香辛散以逐之则退。如果舌上苔如霉者，胃中宿滞挟浊秽郁伏，当急急开泄，否则闭结中焦，不口渴肢寒，知挟阴病。如口渴烦热，平时胃燥舌也，不可攻之。如果燥者，甘寒益胃。如果润者，甘温扶中。这是什么缘故？外露而里无也。
如果舌黑而滑者，水来克火，为阴症，当温之。如果见短缩，此肾气竭也，为难治，欲救之，加人参、五味子勉希万一。舌黑而干者，津枯火炽。急急泻南补北。如果燥而中心厚者，土燥水竭，急以咸苦下之。
舌淡红无色者，或干而色不荣者，当是胃津伤而气无化液也，当用炙甘草汤，不可用寒凉药。
如果舌白如粉而滑，四边色紫绛者，瘟疫病初入募原，未归胃府，急急透解，莫待传陷而入为险恶之病。且见此舌者，病必见凶，须要小心。凡斑疹初见，须用纸捻照看胸背两侧，点大而在皮肤之上者为斑，或云头隐隐，或琐碎小粒者为疹。又宜见而不宜见多。按方书谓斑色红者属胃热，紫者热极，黑者胃烂，然亦必看外症所合，方可断之。然而春夏之间，湿病俱发疹为甚，且其色要辨，如淡红色，四肢清，口不甚渴，脉不洪数，非虚斑、即阴斑。或胸微见数点，面赤足冷，或下利清谷，此阴盛格阳于上而见，当温之。如果斑色紫小点者，心包热也。点大而紫，胃中热也。黑斑而光亮者，热胜毒盛，虽属不治，若其人气血充者，或根据法治之，尚可救。如果黑而晦者，必死。如果黑而隐隐四旁赤色，火郁内伏，大用清凉透发，间有转红成可救者。如果夹斑带疹，皆是邪之不一，各随其部而泄。然斑属血者恒多，疹属气者不少，斑疹皆是邪气外露之象，发出宜神情清爽，为外解里和之意，如斑疹出而昏者，正不胜邪，内陷为患，或胃津内涸之故。
再有一种白痦，小粒如水晶色者，此湿热伤肺，邪虽出而气液枯也，必得甘药补之。或未至久延伤及气液，乃湿郁卫分，汗出不彻之故，当理气分之邪。或者白如枯骨者多凶，为气液竭也。
再温热之病，看舌之后，亦须验齿。齿为肾之余，龈为胃之络。热邪不燥胃津，必耗肾液。且二经之血皆走其地，病深动血，结瓣于上。阳血者色必紫，紫如干漆。阴血者色必黄，黄如酱瓣。阳血若见，安胃为主。阴血若见，救肾为要。然豆瓣色者多险，如果症还不逆者，尚可治，否则难治矣。为什么呢？盖阴下竭、阳上厥也。
齿如果光燥如石者，胃热甚也。如果无汗恶寒，风偏胜也，辛凉泄胃，透汗为要。如果如枯骨色者，肾液枯也，为难治。如果上半截润，水不上承，心火炎上也，急急清心救水，俟枯处转润为妥。如果咬牙啮齿者，湿热化风，痉病。但咬牙者，胃热，气走其络也。如果咬牙而脉症皆衰者，胃虚，无谷以内荣，亦咬牙也。为什么呢？虚则喜实也。舌本不缩而硬，而牙关咬定难开者，此非风痰阻络，即欲作痉症，用酸物擦之即开，酸走筋，木来泄土故也。
如果齿垢如灰糕样者，胃气无权，津亡湿浊用事，多死。而初病齿缝流清血，痛者胃火冲激也，不痛者龙火内燔也。齿焦无垢者死，齿焦有垢者，肾热胃劫也，当微下之，或玉女煎清胃救肾可也。
再妇人病温，与男子同，但多胎前产后，以及经水适来适断。大凡胎前病，古人皆以四物汤加减用之，谓护胎为要，恐来害胎。如热极，用井底泥蓝布浸冷覆盖腹上等，皆是保护之意。但亦要看其邪之可解处，用血腻之药不灵，又当审察，不可认板法。然须步步保护胎元，恐损正邪陷也。至于产后之法，按方书谓慎用苦寒药，恐伤其已亡之阴也。然亦要辨其邪能从上中解者，稍从症用之，亦无妨也。不过勿犯下焦，且属虚体，当如虚怯人病邪而治。总之，毋犯实实虚虚之禁。况产后当血气沸腾之候，最多空窦，邪势必乘虚内陷，虚处受邪，为难治也。如经水适来适断，邪将陷血室，少阳伤寒，言之详悉，不必多赘。但数动与正伤寒不同，仲景立小柴胡汤，提出所陷热邪，参枣扶胃气，以冲脉隶属阳明也，此与虚者为合治。如果邪热陷入与血相结者，当宗陶氏小柴胡汤去参枣加生地、桃仁、楂肉、丹皮或犀角等。如果本经血结自甚，必少腹满痛，轻者刺期门，重者小柴胡汤去甘药加延胡、归尾、桃仁，挟寒加肉桂心，气滞者加香附、陈皮、枳壳等。然而热陷血室之症，多有谵语如狂之象，防是阳明胃实，当辨之，血结者身体必重，非若阳明之轻旋便捷者。为什么呢？阴主重浊，络脉被阻，侧旁气痹连胸背皆拘束不遂，故去邪通络，正合其病，往往延久上逆心胞，胸中痛，即陶氏所谓血结胸也。王海藏出一桂枝红花汤加海蛤、桃仁，原为表里上下一齐尽解之理。看此方大有巧手，故录出以备学者之用。
Wen Mang (Warm Malaria) arises when the heat pathogen from Shang Han (Cold Damage) has not yet subsided, and the patient is again exposed to cold, transforming into Wen Mang; or it may transform into Wen Mang after the disease has progressed through stages, resulting in lingering alternating chills and fever. All these cases are caused by the struggle between cold and heat pathogens. Treatment should primarily focus on dispersing cold and resolving heat, combined with the use of Jia Jian Xiao Chai Hu Tang (Modified Minor Bupleurum Decoction). If heat symptoms predominate, increase the dosage of Chai Hu (Bupleuri Radix); if cold symptoms predominate, increase the dosage of Gui Zhi (Cinnamomi Ramulus), or alternatively use Chai Hu Ge Gen San (Bupleurum and Pueraria Powder) to disperse cold, and Shi Gao (Gypsum Fibrosum) and Zhi Mu (Anemarrhenae Rhizoma) to resolve heat.
Shi Xing (Seasonal Epidemic Cold) refers to abnormal climatic conditions: spring should be warm but is cold, summer should be hot but is cool, autumn should be cool but is hot, and winter should be cold but is warm. This is due to the prevalence of irregular, adverse qi of the four seasons during their respective periods. Consequently, throughout the year, people of all ages suffer from similar illnesses, which is attributed to the Qi of Shi Xing. The external symptoms resemble those of Shang Han, so treatment should focus on releasing the exterior, combined with Sheng Ma Ge Gen Tang (Ephedra and Kudzu Root Decoction). However, Shi Xing is akin to an external common cold, whereas Wen Yi (Plague Epidemic) involves internal toxic pathogens.
Han Yi (Cold Epidemic) is a sudden exposure to cold out of season, also belonging to the category of Shi Xing. The *Shang Han Li* states: "From after the Spring Equinox to before the Autumn Equinox, if there is sudden cold weather, it is classified as a seasonal cold epidemic." Symptoms include aversion to cold and wind, headache, and body heat. Treatments may include Xiao Feng Bai Jie San (Wind-Dispersing Hundred-Resolution Powder) or Liu Shen Tong Jie San (Six-Spirit Unblocking Resolution Powder) with modifications. Generally, this disease resembles Wen Bing (Warm Diseases) and Shu Bing (Summerheat Diseases), but the therapeutic principles differ. The heat in Wen Bing and Shu Bing originates internally, whereas the pathogen in Han Yi is cold that suppresses Yang Qi, making it an external contraction. Therefore, treatment should focus on releasing the exterior. In contrast, Wen Bing and Shu Bing involve both exterior and interior patterns.
Wen Xie (Warm Pathogen) enters from the upper jiao (mouth and nose), first attacking the Lung. If the condition deteriorates reversely, it transmits to the Pericardium. The Lung governs Qi and belongs to Wei (Defensive Qi); the Heart governs Blood and belongs to Ying (Nutritive Qi). Differentiating between Ying and Qi levels is similar to Shang Han, but the treatment methods are vastly different. The pathogen in Shang Han lingers at the exterior before transforming into heat and entering the interior, whereas the heat transformation in Wen Xie is most rapid. Before transmitting to the Pericardium, the pathogen remains in the Lung. Since the Lung governs Qi and connects with the skin and hair, it is said to be at the exterior. In the initial stage at the exterior, use mild acrid-cool agents. If accompanied by Wind, add Bo He (Menthae Haplocalycis Herba) and Niu Bang Zi (Arctii Fructus); if accompanied by Dampness, add Lu Gen (Phragmitis Rhizoma) and Hua Shi (Talcum). Alternatively, vent the Wind outside the Heat, or drain the Dampness below the Heat, so that the pathogens do not struggle with the Heat, leaving them isolated. Otherwise, Wind carrying Warmth generates Dryness, causing the clear orifices to become dry because the essence of Water cannot nourish the upper regions; this is called the mutual depletion of two Yangs. When Dampness combines with Warmth, steaming and stagnation occur, obscuring the upper orifices, causing obstruction; this is turbid pathogen harming the clear. The illness resembles Shang Han, but differentiation is made thus: Shang Han often presents with changing symptoms, while Wen Re (Warm-Thermal diseases) remain in one level for a long time.
As previously mentioned, using acrid-cool to disperse Wind and sweet-bland to drive out Dampness, if the disease persists, it indicates the pathogen is gradually entering the Ying level. Heat in the Ying level consumes Blood, causing mental restlessness, worse at night with insomnia, or faint macules appearing under the skin. Immediately remove Qi-level drugs. If entering from Wind-Heat, use Xi Jiao (Rhinocerotis Cornu) and Zhu Ye (Bambusae Folium); if entering from Damp-Heat, use Xi Jiao and Hua Lu (Flower Dew), incorporating them into blood-cooling and heat-resolving formulas. If irritability and constipation occur, Jin Zhi (Charred Human Feces) can be added; for the elderly or those with chronic cold constitutions, Ren Zhong Huang (Human Manure processed with bamboo) is used instead. Urgently focus on venting the macules. If macules appear but heat does not subside, it indicates the loss of Stomach Yin. Treat with sweet-cold methods; severe cases use Yu Nu Jian (Jade Woman Decoction), mild cases use Pear Skin and Sugarcane Juice. If the person has inherent Kidney Yin deficiency, even if the lower jiao is not yet affected, anxiety arises. Verify via the tongue; add salty-cold herbs to sweet-cold formulas to secure areas not yet invaded, preventing easy penetration. If the pathogen lingers in the Qi level without transmitting, hope for resolution via Battle Sweat (Zhan Han). The method benefits the Stomach, allowing fluids to mix with sweat, reaching the pores, opening the interstices, and expelling the pathogen via sweat. After resolution, Stomach Qi is empty, causing skin coldness for a day and night; as Qi returns, warmth normalizes. Since battle sweat resolves the pathogen, leaving righteous Qi deficient, Yang escapes with cold, causing gradual skin coldness; this is not necessarily Collapse Syndrome. Allow the patient to rest comfortably to nourish recovering Yang; attendants must not panic or call frequently, disturbing the Yuan Shen (Original Spirit). Check the pulse: if weak, soft, and slow, despite fatigue and silent lying down with sweaty cold skin, it is not collapse. If the pulse is rapid, restless, unable to lie down, with cold sweaty skin, it is Qi Collapse. If pathogen excess and righteous deficiency prevent single-resolution, waiting one or two days for another battle sweat may lead to recovery.
Regarding Qi-level diseases not transmitting to Blood but lingering in the Three Burners, it resembles Shaoyang disease in Shang Han. There, harmonize half-exterior/half-interior; here, separate and eliminate upper and lower tendencies, modifying methods per symptoms, such as using Xing Ren (Armeniacae Semen Amarum), Pu Huo (Magnoliae Officinalis Cortex), Ling Zhu (Poria), etc., or Wen Dan Tang (Warm Gallbladder Decoction) for draining. Since still in Qi level, battle sweat resolution is possible. Generally, discuss Qi after Wei (Defensive), and Blood after Ying (Nutritive). For Wei, induce sweating; for Qi, clear heat; for Ying, vent heat to turn it back to Qi, using Xi Jiao, Xuan Shen (Scrophulariae Radix), Ling Yang Jiao (Capricornis Cornu), etc. Entering Blood risks consuming and agitating blood; directly cool blood and dissipate stasis using Sheng Di Huang (Rehmanniae Radix), Mu Dan Pi (Moutan Cortex), E Jiao (Colla Corii Asini), Chi Shao (Paeoniae Radix Rubra), etc. Otherwise, ignoring urgency leads to errors. In our Wu region, Dampness harms widely. Those with pale faces need Yang protection; excessive Dampness weakens Yang. Use cooling methods, but stop at 60-70% intensity to avoid overcooling, which might fail because removing Damp-Heat also weakens Yang. Those with dark complexions need Yin protection. At 60-70% cooling, if heat decreases and body feels cold, do not assume deficiency-cold and tonify; the fire may be extinguished but embers remain. Examine carefully before slight tonification. Wine drinkers have internal Dampness; external pathogens combine with it. In Yang-excess constitutions, Stomach Dampness is common; in Yin-excess, Spleen Dampness is common; both transform into Heat similarly. Saving Yin in Heat diseases is easy; unblocking Yang is difficult. Saving Yin relies on fluids and sweat, not blood; unblocking Yang relies on promoting urination, not warming. This differs from miscellaneous diseases.
If the Three Burners cannot resolve externally, internal binding occurs in the Yangming Stomach and Intestines. Purging is necessary, regardless of Qi/Blood distinction. In Shang Han, internal heat consumes fluids, requiring strong purgatives; here, internal Dampness requires gentle purgatives. In Shang Han, loose stool means pathogen exhaustion, no more purging; in Wet-Warmth, loose stool means pathogen remains, wait until stool hardens before cautious purging, as dry stool indicates no Dampness. The epigastrium is central; tenderness or fullness requires bitter-draining due to proximity to abdomen. Verify via tongue: yellow or turbid coating allows Xiao Xian Xiong Tang (Minor Chest-Harmonizing Decoction) or Xie Xin Tang (Drain the Epigastrium Decoction). White non-dry, yellow-white mixed, or gray-white non-thirsty coatings forbid bitter-draining. If exterior unresolved and interior bound, or Qi stagnation, use opening-draining methods like Xing Ren, Kou Ren (Amomi Fructus), Ju Pi (Citri Reticulatae Pericarpium), Jie Geng (Platycodonis Radix) to move Qi to the Lung. Light bitter-sweet, mobile herbs suffice.
Yellow/turbous coating needs roots; smooth coating indicates formless Damp-Heat and deficiency, forbidding previous methods. Fullness/pain above navel indicates interior pathogen, likely no exterior signs. Yellow/dark/gray/yellow-black or cracked tongues require purging, e.g., Xiao Cheng Qi Tang with Bing Lang (Arecae Semen), Qing Pi (Citri Reticulatae Pericarpium Viride), Zhi Shi (Aurantii Fructus), Yuan Ming Fen (Mirabilite), Shou Wu (Polygoni Multiflori Radix). Absence of these signs warns against purging, considering Taiyin Damp-fullness, Cold-Damp pain, or Qi distension. Thin slippery yellow coating allows clearing heat/releasing exterior; thin dry coating indicates fluid injury, forbidding heavy bitter herbs, using sweet-cold light agents.
Heat transmitting to Ying shows crimson tongue. Initial crimson with yellow/white indicates residual Qi pathogen; release Wei and vent Ying. Pure bright crimson indicates Pericardium involvement; use Xi Jiao, Fresh Sheng Di Huang, Lian Qiao (Forsythiae Fructus), Yu Jin (Curcumae Radix), Shi Chang Pu (Acori Tatarinowii Rhizoma). Delayed cases or phlegm-Heart deficiency with trapped heat require Niu Huang Wan (Calculus Bovis Pill) or Zhi Bao Dan (Precious Treasure Pill) to open closure, preventing coma/spasms. Crimson tongue with dry center indicates Heart/Stomach Fire consuming fluids; add Huang Lian (Coptidis Rhizoma) and Shi Gao. Irritation/thirst with dry center/red sides/yellow-white center indicates Upper Jiao Qi Heat, not Blood; use Liang Ge San (Cool the Diaphragm Powder) for formless heat, avoiding cloying blood herbs. Crimson tongue looking dry but moist to touch indicates fluid deficiency with Damp-Heat steaming, impending turbid-phlegm blocking Pericardium.
Heat transmitting to Ying/Blood with prior chest diaphragm blood stasis causes purple-dark tongue; add blood-dispersing herbs like Hu Po (Electrum), Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma), Tao Ren (Persicae Semen), Mu Dan Pi. Otherwise, stasis-heat obstructs Zheng Qi, causing mania. Purple-swollen tongue indicates Wine Toxic attacking Heart; purple-dry/dull indicates Kidney/Liver color flooding, difficult to treat. Crimson tongue with sticky non-coating indicates turbid Qi; add aromatic dispellers. Crimson tongue stiff-to-protrude indicates Phlegm blocking root/Internal Wind. Crimson-shiny tongue indicates Stomach Yin death; urgently use sweet-cool moistening agents. Crimson-dry tongue indicates Fire harassing Ying; cool blood/clear fire is key. Crimson with white/yellow spots indicates impending mouth ulcers; large red dots indicate Heat-Toxin attacking Heart; use Huang Lian and Jin Zhi. Crimson-dull-dry-withered tongue indicates Kidney Yin exhaustion; urgently save with E Jiao, Ji Zi Huang (Galuli Album), Di Huang (Rehmanniae Radix), Tian Dong (Asparagi Radix), lest exhaustion be incurable. Crimson-center-only tongue indicates Stomach Heat burning Heart Ying; add Heart-clearing herbs to Stomach-clearing formulas, else spreading to tip causes fluid dryness/Fire excess. Crimson-dry tip indicates Heart Fire flaming upward; use Dao Chi San (Direct the Flow Powder) to drain the Fu organ.
Thick dry white coating indicates Stomach Dryness/Qi injury; add Gan Cao (Glycyrrhizae Radix et Rhizoma) to Kidney-nourishing herbs for sweet-retention/fluid-return. Thin white coating indicates Exterior Wind-Cold; disperse. Dry thin white coating indicates Lung Fluid injury; add Mai Dong (Ophiopogonis Radix), Hua Lu, Lu Gen juice for upper-region clearing. White coating with crimson base indicates Damp-suppressing Heat; first drain Damp/vent Heat to prevent drying, then transform from interior to exterior for moisture. Initial dry tongue without coma requires nourishing Righteous Qi with slight pathogen-expelling herbs; coma indicates internal depletion, incurable. Any tongue with prickles indicates extreme Upper Jiao Heat; wipe with green cloth dipped in cold mint water. Disappearing prickles are mild; recurring are dangerous. Moist tongue with extreme stuffiness indicates Spleen Dampness. Scratch marks/blood require inquiry; do not assume dryness, treat as Dampness. Clear spirit with swollen tongue unable to exit mouth indicates Spleen Damp/Stomach Heat transforming into Internal Wind/toxicity extending to mouth; add Da Huang (Rhei Radix et Rhizoma) to formula to reduce swelling.
Sticky thick white coating with foul saliva and sweet taste indicates Pi Dan (Spleen Dysentery/Damp-Heat accumulation); use Sheng Tou Cao (Houttuyniae Herba) for aromatic-acrid dispersion. Mold-like coating indicates old food retention with turbid Qi; urgently open-drain, else middle jiao closure. Non-thirsty cold limbs indicate Yin-binding; thirst/fever indicates Stomach Dryness, do not purge. Dry requires sweet-cold benefiting Stomach; moist requires sweet-warming supporting Middle. Reason: exterior present, interior absent.
Black slippery tongue indicates Water overcoming Fire (Yin syndrome); warm it. Shortened tongue indicates Kidney Qi exhaustion, difficult; save with Ren Shen (Ginseng Radix) and Wu Wei Zi (Schisandrae Fructus). Black dry tongue indicates fluid exhaustion/Fire blazing; urgently drain South (Heart) and tonify North (Kidney). Dry with thick center indicates Earth Dry/Water Exhausted; urgently purge with salty-bitter. Pale red/colorless or dry/unlustrous tongue indicates Stomach Fluid injury/Qi failing to generate fluid; use Zhi Gan Cao Tang (Honey-Fried Licorice Decoction), avoid cold-cool meds.
White powder-like slippery tongue with purple-crimson edges indicates Plague entering Mu Yuan (Oasis/Middle Layer), not yet Stomach Fu; urgently resolve, do not let it sink into dangerous pathology. This tongue indicates severe prognosis. Macules/Rashes: check chest/back. Large skin points are Macules (Ban); hidden/cloud-like or small granules are Rashes (Zhen). Better few than many. Red macules = Stomach Heat; Purple = Extreme Heat; Black = Rotting Stomach. Combine with external symptoms. Spring/Summer dampness often causes rashes. Light red, cool limbs, non-thirsty, non-rapid pulse indicates Deficiency/Yin Macule. Few chest points, red face/cold feet, or clear undigested food diarrhea indicates Yin Excess repelling Yang upward; warm it. Small purple macules = Pericardium Heat; Large purple = Stomach Heat. Bright black macules = Heat/Toxin excess, usually fatal, but resolvable if Qi/Blood sufficient. Dark dull black = Death. Black with surrounding red indicates trapped Fire; use heavy cooling/venting, sometimes turning red/resolvable. Mixed macules/rashes indicate varied pathogens; drain according to location. Macules mostly Blood-related; Rashes mostly Qi-related. Both show exterior pathogen; clear spirit indicates exterior resolution/interior harmony. Coma upon eruption indicates Righteous defeat/pathogen sinking or Stomach Fluid exhaustion.
White papules (Pi) crystal-like indicate Lung Damp-Heat injury; pathogen out but Qi/Fluid exhausted; tonify with sweet herbs. If not prolonged, Damp-stagnant in Wei level, incomplete sweating; regulate Qi level. White like dead bone indicates Qi/Fluid exhaustion, ominous.
After tongue diagnosis, examine teeth. Teeth are surplus of Kidney; gums are network of Stomach. Heat either dries Stomach Fluid or consumes Kidney Fluid. Blood from both meridians affects them. Deep disease moves blood, forming clots above. Yang blood is purple like dried lacquer; Yin blood is yellow like soybean paste. Yang blood appearance: stabilize Stomach. Yin blood appearance: save Kidney. Soybean-paste color is dangerous; treatable if symptoms not adverse, otherwise difficult. Reason: Yin exhausted below, Yang rebellious above.
Teeth shiny/dry like stone indicate severe Stomach Heat. No sweat/aversion to cold indicates Wind excess; use acrid-cool to drain Stomach/induce sweat. Like dead bone indicates Kidney Fluid exhaustion, difficult. Upper part moist/lower dry indicates Water not ascending/Heart Fire flaming; urgently clear Heart/save Water until moist. Grinding teeth indicates Damp-Heat transforming into Wind/Spasm. Only grinding indicates Stomach Heat moving along collaterals. Grinding with weak pulse/symptoms indicates Stomach deficiency/no grain nourishment; also grinding. Reason: deficiency prefers fullness. Tongue root stiff/jaw locked indicates Wind-Phlegm blocking collaterals or impending spasm; rub with sour substance to open (Sour enters sinews, Wood drains Earth).
Teeth tartar like gray cake indicates Stomach Qi powerless/Fluid lost/Damp-Turbidity dominant, often fatal. Bleeding gums painful indicate Stomach Fire rushing; painless indicate Dragon Fire (Ministerial Fire) internal blazing. Blackened teeth without tartar = Death. Blackened with tartar = Kidney Heat/Stomach劫 (plunder); gently purge or use Yu Nu Jian to clear Stomach/save Kidney.
Women with Warm diseases same as men, but often pre/post-partum or menstruation onset/interruption. Pre-partum: ancient texts use Si Wu Tang (Four Substances Decoction) modifications to protect fetus, fearing harm. Extreme heat: apply cold well-water mud/blue cloth on abdomen for protection. Assess pathogen resolvability; if blood-nourishing herbs ineffective, re-evaluate, do not stick rigidly. Step-by-step protect fetal origin, fear damaging Righteous/Sinking Pathogen. Post-partum: caution with bitter-cold to protect lost Yin. Assess if pathogen resolves from Upper/Middle; slight symptomatic use acceptable. Avoid Lower Jiao; treat as deficiency-cold constitution. Do not violate "tonify deficiency/exacerbate excess" prohibitions. Post-partum blood/Qi boiling creates voids; pathogen sinks into deficiency, difficult to treat. Menstruation onset/interruption: pathogen sinking into Blood Chamber. Shaoyang Shang Han details this; no need to repeat. Frequent movement differs from standard Shang Han. Zhang Zhongjing's Xiao Chai Hu Tang extracts sunk heat, Ginseng/Jujube support Stomach Qi (Chong Mai belongs to Yangming), suitable for deficiency. If Heat-Blood binding, follow Tao's Xiao Chai Hu Tang minus Ginseng/Jujube plus Sheng Di Huang, Tao Ren (Persicae Semen), Cha Rou (Crataegi Fructus), Mu Dan Pi, or Xi Jiao. If intrinsic Blood binding severe, lower abdominal fullness/pain: mild puncture Qi Men; severe Xiao Chai Hu Tang minus sweet herbs plus Yan Hu Suo (Corydalis Rhizoma), Gui Wei (Angelicae Sinensis Radix), Tao Ren; add Rou Gui Xin (Cinnamomi Cortex) for Cold; Xiang Fu (Cyperi Rhizoma), Chen Pi, Zhi Ke for Qi stagnation. Heat-sinking Blood Chamber often presents delirium/mania; distinguish from Yangming Stomach Excess. Blood binding causes heavy body, unlike Yangming agility. Reason: Yin is heavy/turbid; collateral blockage causes side/chest/back stiffness. Removing pathogen/uncollateralizing fits disease. Prolonged cases ascend to Pericardium, chest pain (Tao's Blood Binding Chest). Wang Haizang's Gui Zhi Hong Hua Tang (Cinnamon Twig and Safflower Decoction) plus Hai Ge (Arcaea Concha), Tao Ren aims simultaneous resolution of exterior/interior/upper/lower. Ingenious formula, recorded for study.