温邪化热外出，其熏蒸于气分者，为烦热、口渴等证。其燔灼于营分者，血为热扰，每每血由肺络而溢出
为咳血，由吐而出为吐血，上行清道为鼻衄、齿衄，下行浊窍为溲血。便血。凡此皆血为热邪所迫，不安其络
，因而上溢下决。惟血既外夺，则邪热亦随血而泄，病势宜由此而减，乃为吉象。若血既外夺，而里热仍盛，
昏谵烦躁∶仍不轻减，即属重症。推其故，盖有二焉∶一则伏热重而蒸郁过深，络血虽溢，而里热之留伏尚
多也，一则营阴虚而为燔灼所伤，阴血枯竭，而不能托邪外出也。邪重者，宜凉血泄邪，如犀、地、栀、丹、
银花、连翘、茅根、侧柏之类∶血虚者，宜养血清热，如地、芍、栀、丹、阿胶、元参之类。总以凉阴泄热为
主脑，血虚者兼以滋养，邪实者兼以清泄，必使血止而热亦因此而解，斯为顺手耳。此等症，每有急求止血，
过用清凉，以致血虽止，而上则留瘀在络，胸胁板痛；下则留瘀在肠，垢痢瘀紫。甚或留瘀化热，变为暮热朝
凉，咳痰带血，见种种阴损之候。昧者不察，误认为虚，漫投补剂，遂迁延不愈，愈恋愈虚，以致不救，可慨
也夫。
凡瘀留在肠胃者，易于疏化，以其在康庄大道，不在细微曲折之处，药力易于疏通也。若瘀留于肺肝血络
之中，则络道蚕丛，药力既非一时可到，而又不宜于猛剂攻消；只有通络化瘀泄热之法，缓缓图功。如曹仁伯
清瘀热汤之法，最为得窍，学人宜仿此用之（清瘀热汤──旋、绛、葱、苇、枇）。
温邪转化为热邪向外发散，熏蒸于气分时，表现为烦热、口渴等症状。若燔灼于营分，血液受热扰动，常常从肺络溢出导致咳血，通过呕吐排出为吐血，向上经清道流出为鼻衄、齿衄，向下经浊窍排出为尿血、便血。凡此种种，都是血液被热邪逼迫，不能安守于脉络之中，因而向上溢出、向下决裂。既然血液已经外泄，那么邪热也会随着血液的排出而消散，病情应当由此减轻，这属于吉兆。如果血液虽然外泄，但体内热势仍然旺盛，出现神志昏乱、胡言乱语、烦躁不安，且症状没有明显减轻，这就属于重症。推究其原因，大概有两点：一是伏藏的热邪深重，蒸腾郁结过深，虽然络脉中的血液溢出，但体内的热邪留伏仍然很多；二是营阴亏虚，受到燔灼损伤，阴血枯竭，无法托举邪气外出。对于邪气盛者，宜采用凉血泄邪的方法，如犀角、地黄、栀子、丹皮、金银花、连翘、白茅根、侧柏叶等；对于血虚者，宜采用养血清热的方法，如地黄、芍药、栀子、丹皮、阿胶、玄参等。总以凉养阴液、泄除热邪为主要原则，血虚者兼用滋养之法，邪实者兼用清泄之法，必须使出血停止且热邪随之解除，这才是顺理成章的治疗。这类病症中，常有患者急于止血，过度使用清凉药物，导致虽然血止住了，但上部则在络脉中留下瘀血，引起胸胁僵硬疼痛；下部则在肠道留下瘀血，导致排泄物如垢腻、痢疾且颜色紫黑有瘀块。甚至有的因瘀血化热，转变为傍晚发热、早晨凉爽，咳嗽痰中带血，出现各种阴液亏损的症状。不明医理的人不加考察，误认为是虚证，随意投用补剂，致使病情迁延不愈，越留恋病邪身体越虚弱，最终导致死亡，实在令人感慨。
凡是瘀血停留在肠胃部位的，容易疏通化解，因为肠胃如同康庄大道，不在细微曲折之处，药力容易疏通。如果瘀血停留在肺肝的血络之中，则络脉通道狭窄曲折，药力并非一时能够到达，而且也不适宜用猛烈的药剂攻逐消散；只有采用通络化瘀泄热的方法，缓缓图谋功效。如曹仁伯的清瘀热汤之法，最为切中要害，学习中医的人应当仿效这种方法使用（清瘀热汤──旋覆花、绛香、葱白、苇茎、枇杷叶）。
When pathogenic warmth transforms into heat and moves outward, if it steams and steeps in the Qi level (Qi Fen), it manifests as symptoms such as vexation and heat, thirst, etc. If it blazes and scorches in the Ying level (Ying Fen), the blood is disturbed by heat, often overflowing from the lung collaterals causing hemoptysis (coughing up blood), being vomited out as hematemesis (vomiting blood), flowing upward through the clear orifices as epistaxis (nosebleed) or gingival bleeding, and flowing downward through the turbid orifices as hematuria (blood in urine) or hematochezia (blood in stool). All these cases occur because the blood is forced by pathogenic heat, unable to remain within its collaterals, thus overflowing upward and bursting downward. Since the blood has been lost externally, the pathogenic heat should also dissipate with the blood loss, and the disease condition should thereby subside; this is considered a favorable sign. However, if blood has been lost externally but the interior heat remains vigorous, accompanied by coma, delirium, and severe restlessness that does not significantly abate, it belongs to severe conditions. Investigating the causes, there are generally two reasons: first, the latent heat is heavy and the steaming and stagnation are too deep; although collateral blood overflows, much interior heat still remains latent; second, the Ying-Yin is deficient and damaged by blazing heat, leading to exhaustion of Yin-blood, which cannot support and expel the pathogen outward. For those with excess pathogen, cooling blood and draining pathogen is appropriate, using herbs such as Rhinoceros Horn (Xi Jiao), Rehmannia Root (Di Huang), Gardenia Fruit (Zhi Zi), Moutan Bark (Dan Pi), Honeysuckle Flower (Jin Yin Hua), Forsythia Fruit (Lian Qiao), Imperata Rhizome (Bai Mao Gen), and Biota Tops (Ce Bai Ye); for those with blood deficiency, nourishing blood and clearing heat is appropriate, using herbs such as Rehmannia Root (Di Huang), Peony Root (Shao Yao), Gardenia Fruit (Zhi Zi), Moutan Bark (Dan Pi), Donkey-Hide Gelatin (E Jiao), and Scrophularia Root (Xuan Shen). The main principle is always to cool the Yin and drain heat; for blood deficiency, add nourishment; for pathogenic excess, add clearing and draining. Only when bleeding stops and heat resolves simultaneously can the treatment be considered smooth and successful. In such cases, patients often seek rapid hemostasis and overuse cold-cooling agents, resulting in stopped bleeding but residual stasis in the upper collaterals causing chest and hypochondriac stiffness and pain, or residual stasis in the intestines causing foul diarrhea with purple-black clots. Even worse, stasis may transform into heat, changing into evening fever and morning chills, coughing with bloody sputum, presenting various signs of Yin damage. Ignorant practitioners, failing to examine carefully, mistakenly diagnose deficiency and indiscriminately administer tonics, causing the condition to linger and worsen, leading to death, which is truly lamentable.
Stasis remaining in the stomach and intestines is easy to disperse and resolve, as these organs are like broad highways, not located in minute and winding places, allowing medicinal power to easily unblock them. If stasis remains within the blood collaterals of the lungs and liver, the collateral pathways are narrow and winding; medicinal power cannot reach them instantly, and strong purgative agents are unsuitable. Only methods of unblocking collaterals, resolving stasis, and draining heat can slowly achieve results. For example, Cao Renbo's method of Qing Yu Re Tang (Clear Stasis-Heat Decoction) is most insightful, and students should imitate this usage (Qing Yu Re Tang ── Inula Flower (Xuan Fu Hua), Red Sandalwood (Jiang Xiang), Scallion White (Cong Bai), Reed Rhizome (Wei Gen), Loquat Leaf (Pi Pa Ye)).