时疫善忘者，蓄血之所致也。蓄血在上焦，其脉芤，胸前及心下必痛，必拒按而软，犀角地黄汤主之。蓄血在
中焦，其脉或芤、或弦、或涩，两胁及脐上必有痛处拒按而软，桃仁承气汤主之。蓄血在下焦，其脉多沉
结，脐下必有痛处拒按而软，抵当汤主之。
善忘虽为蓄血主证，然必验之大小便。屎虽 ，大便反易，其色必黑，小便自利，方为蓄
血之的证。否则，仍当参之多言、谵狂诸法治之。
时疫昏沉，热入至深极险证也。盖热初蒸及心之经，则心神不安，多梦呓，醒时自清。蒸心之经渐深，则心神
渐烦，多言，所言皆日用当行之事，无糊涂语。蒸及心包，则精神间有昏处，多言间有糊涂语，犹清白语居多。
迨蒸心包渐深，则心神昏处居多，言多妄见妄闻，甚至疑鬼疑神，非人所见闻者，犹省人语也。至热直入心脏，则
昏沉全不省人事矣。此热入浅深之次第，见证轻重之辨也。所以多言谵语，热之浮浅者，栀、芩、知、膏可解；
发狂，热之深结者，硝、黄可解；至昏沉，热之至深者，非犀角、黄连、羚羊角、牛黄，莫能解也。昏沉虽系热
深，更有夹痰气，夹胃结，夹血结之分。胸满、舌白，系夹痰气，当加川贝、栝蒌、半夏、莱菔子于犀、连诸药
中；舌黄及燥黑，腹满硬痛者，当加犀、连于三承气汤中；痛而软者，蓄血，加桃仁、丹皮、赤芍于犀、连药
中。治昏沉之大法备矣。
以上皆实证，更有虚证，亦所当知。屡经汗、下、清利之后，表里无热，胸腹无阻，二便自利，而神情由倦而
渐昏，由昏而渐沉，乃大虚之危证。大剂生脉散加桂、附、 、术、苓、芍，急救其阴阳，亦不逮矣。
时疫出现发狂症状，是谵语（神志不清，胡言乱语）的严重表现，也是由疫热熏蒸心脏所致，治疗方法与谵语相同。
时疫出现善忘（记忆力减退、健忘）症状，是由蓄血（血液瘀滞体内）所致。若蓄血在上焦，脉象呈现芤脉（浮大中空，如按葱管），胸前及心窝处必定疼痛，且按压时感觉柔软并抗拒按压，应使用犀角地黄汤治疗。若蓄血在中焦，脉象可能是芤脉、弦脉或涩脉，两胁部及肚脐上方必定有疼痛点，按压时感觉柔软并抗拒按压，应使用桃仁承气汤治疗。若蓄血在下焦，脉象多呈沉结（沉而迟缓有力或间歇），肚脐下方必定有疼痛点，按压时感觉柔软并抗拒按压，应使用抵当汤治疗。
善忘虽然是蓄血的主要证候，但必须通过观察大小便来验证。如果大便虽然干硬难解，但排出反而容易，且颜色必定发黑，小便通畅自如，这才是蓄血的确切证据。否则，仍应当参考治疗多言、谵狂等病症的方法进行处理。
时疫出现昏沉（神志昏迷、嗜睡），是热邪深入至极的危险证候。起初热邪刚熏蒸到心经时，心神不安，多梦呓语，清醒时神志清楚。随着热邪熏蒸心经逐渐加深，心神逐渐烦躁，多言语，所说的都是日常应当做的事情，没有糊涂的话。热邪熏蒸到心包络时，精神偶尔会出现昏沉，多言语中偶尔夹杂糊涂话，但清白的语言仍占多数。等到热邪熏蒸心包络逐渐加深，心神昏沉的情况居多，言语多为妄见妄闻，甚至怀疑鬼神，说出常人无法见闻的话语，但尚能保留部分清醒的语言。直到热邪直接侵入心脏，则完全昏沉，不省人事了。这是热邪入侵深浅的次序，也是辨别见证轻重的关键。所以，对于多言谵语，属于热邪浮浅的，用栀子、黄芩、知母、石膏可以解除；对于发狂，属于热邪深结的，用芒硝、大黄可以解除；至于昏沉，属于热邪极深的，非犀角、黄连、羚羊角、牛黄不能解除。昏沉虽然属于热邪深重，还有夹带痰气、夹带胃腑实结、夹带血瘀的区别。胸膈满闷、舌苔白，属于夹带痰气，应当在犀角、黄连等药物中加入川贝母、瓜蒌、半夏、莱菔子；舌苔黄及干燥发黑，腹部胀满硬痛者，应当在三承气汤中加入犀角、黄连；疼痛且腹部柔软者，属于蓄血，应当在犀角、黄连等药物中加入桃仁、牡丹皮、赤芍。治疗昏沉的大法已经完备。
以上所述皆为实证，还有虚证，也应当知晓。在多次经过发汗、攻下、清热利湿治疗后，表里已无热象，胸腹无阻滞感，大小便通畅，但神情从疲倦逐渐转为昏沉，从昏沉逐渐转为深度昏迷，这是大虚证的危重表现。此时即使使用大剂量的生脉散加入桂枝、附子、人参、白术、茯苓、白芍，以急救阴阳，恐怕也难以挽回。
When epidemic febrile diseases manifest as mania (violent mental disorder), it is a severe form of delirium (incoherent speech due to disturbed spirit), caused by epidemic heat steaming the Heart. The treatment is the same as for delirium.
When epidemic febrile diseases manifest as forgetfulness (memory loss), it is caused by blood stasis (accumulation of stagnant blood). If blood stasis is in the Upper Jiao, the pulse is Kou (floating, large, and empty in the middle, like pressing a scallion stem); there must be pain in the chest and epigastrium, which is tender upon pressure and feels soft; Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) should be administered. If blood stasis is in the Middle Jiao, the pulse may be Kou, Xian (wiry), or Se (choppy); there must be painful areas in the hypochondrium and above the umbilicus that are tender upon pressure and feel soft; Taoren Chengqi Tang (Peach Kernel and Magnolia Bark Decoction) should be administered. If blood stasis is in the Lower Jiao, the pulse is mostly Chenjie (deep and intermittent); there must be a painful area below the umbilicus that is tender upon pressure and feels soft; Didang Tang (Attack the Aorta Decoction) should be administered.
Although forgetfulness is a primary symptom of blood stasis, one must verify it through the urine and stool. Even if the feces are hard, if defecation is relatively easy and the color is invariably black, and urination is free and unobstructed, this constitutes the definitive evidence of blood stasis. Otherwise, treatment should still refer to methods for managing excessive talkativeness, delirium, and mania.
Coma (lethargy and unconsciousness) in epidemic febrile diseases is an extremely dangerous condition where heat has penetrated deeply. Initially, when heat begins to steam the Heart Meridian, the Heart Spirit becomes unsettled, leading to somniloquy (sleep-talking); upon waking, consciousness is clear. As heat steaming the Heart Meridian deepens, the Heart Spirit becomes increasingly irritable, with excessive talking about daily matters without confusion. When heat reaches the Pericardium, mental clarity occasionally lapses into drowsiness, and while talking excessively, some confused words appear, though clear speech predominates. As heat steaming the Pericardium deepens further, drowsiness predominates, speech involves hallucinations (seeing and hearing things that are not there), including suspicions of ghosts and gods, utterances beyond normal perception, yet some coherent language remains. Finally, when heat directly enters the Heart organ, complete coma occurs, with total loss of consciousness. This sequence illustrates the depth of heat penetration and helps distinguish the severity of symptoms. Therefore, for excessive talkativeness and delirium, indicating superficial heat, Zhi Zi (Gardeniae Fructus), Huang Qin (Scutellariae Radix), Zhi Mu (Anemarrhenae Rhizoma), and Shi Gao (Gypsum Fibrosum) can resolve it; for mania, indicating deep-seated heat binding, Mang Xiao (Natrii Sulfas) and Da Huang (Rhei Radix et Rhizoma) can resolve it; for coma, indicating extreme depth of heat, only Xi Jiao (Rhinocerotis Cornu), Huang Lian (Coptidis Rhizoma), Ling Yang Jiao (Caprae Hircus Cornu), and Niu Huang (Calculus Bovis) can resolve it. Although coma stems from deep heat, it may also involve concurrent phlegm-qi obstruction, stomach fu-organ accumulation, or blood stasis. Chest fullness and white tongue coating indicate concurrent phlegm-qi; add Chuan Bei Mu (Fritillariae Bulbus), Gua Lou (Trichosanthis Fructus), Ban Xia (Pinelliae Rhizoma), and Lai Fu Zi (Raphani Semen) to Xi Jiao and Huang Lian. Yellow, dry, or black tongue coating with abdominal fullness, hardness, and pain indicates stomach accumulation; add Xi Jiao and Huang Lian to San Chengqi Tang (Three Magnolia Bark Decoctions). Pain with abdominal softness indicates blood stasis; add Tao Ren (Persicae Semen), Mu Dan Pi (Moutan Cortex), and Chi Shao (Paeoniae Radix Rubra) to Xi Jiao and Huang Lian. The major principles for treating coma are thus established.
The above cases are all excess syndromes; deficiency syndromes must also be known. After repeated treatments with sweating, purging, clearing, and draining, if there is no heat in the exterior or interior, no obstruction in the chest and abdomen, and free urination and defecation, yet the spirit gradually declines from fatigue to lethargy, and from lethargy to deep coma, this is a critical deficiency syndrome. Even administering a large dose of Shengmai San (Generate the Pulse Powder) augmented with Gui Zhi (Cinnamomi Ramulus), Fu Zi (Aconiti Lateralis Radix Praeparata), Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria), and Bai Shao (Paeoniae Radix Alba) to urgently rescue Yin and Yang may prove insufficient.