阳毒热极失汗下，舌卷焦黑鼻煤烟，昏噤发狂如见鬼，咽疼唾血赤云斑。六七日前
尚可治，表里俱实黑奴丸，热盛解毒里实下，表实三黄石膏煎。
【注】阳毒，谓阳热至极之证也。失汗下，谓应汗不汗，应下不下，失其汗下之时也。热
毒炎炎不已，故舌卷焦黑，鼻内生煤烟也。热毒内攻乘心，故神昏噤栗，发狂如见鬼神，咽
疼唾血也。热毒外薄肌肤，故发赤色如锦云之斑也。六、七日前，谓日浅毒未深入，故
尚可治。表里俱实，谓有是证，无汗不大便者，宜黑奴丸两解之。无表里实证热盛者，宜
黄连解毒汤。兼燥渴者，合白虎汤清之。里实不便者，宜解毒承气汤下之，表实无汗者，
宜三黄石膏汤发之。
阴毒寒极色青黑，咽痛通身厥冷寒，重强身疼如被杖，腹中绞痛若石坚，或呕或利
或烦躁，或出冷汗温补先，无汗还阳退阴汗，
急灸气海及关元。
【注】阴毒，谓阴寒至极之证也。血脉受阴毒邪，故面色青黑也。阴毒内攻于里，故
咽痛腹中绞痛也。阴毒外攻于表，故厥冷通身，重强疼痛如被杖也，独阴无阳不化，故
阴凝腹若石之坚硬也。或呕吐、或下利，或烦躁、或冷汗出，皆阳虚不足或有之证，均以温补
为先，宜四逆汤倍加人参。若有是证，其人无汗，宜还阳散、退阴散，温而汗之，使
寒毒散而阳伸也。凡遇此证，俱宜急灸气海、关元二、三百壮，随服药饵，未有不生者也。
阳毒（阳气亢盛至极的毒证）因热势极盛而未能及时发汗或攻下，导致舌体卷缩、焦黑，鼻腔内如煤烟般乌黑，神志昏迷、牙关紧闭、发狂似见鬼魅，咽喉疼痛、咳唾带血，皮肤出现红色如云片状的斑疹。发病六至七天之前尚可治疗，若表里俱实，可用黑奴丸；热盛解毒兼里实者，用承气类方剂攻下；表实无汗者，用三黄石膏汤。
【注】阳毒，是指阳气热邪达到极致的病证。“失汗下”，是指应当发汗而未发汗，应当攻下而未攻下，错过了使用汗法或下法的时机。热毒炽盛不止，所以舌体卷缩焦黑，鼻腔内生有煤烟样的黑色分泌物。热毒向内攻冲侵犯心脏，所以出现神志昏乱、牙关紧闭战栗、发狂仿佛看见鬼神、咽喉疼痛、咳唾出血。热毒向外迫及肌肤，所以皮肤发出红色如锦缎云纹般的斑疹。六、七天以前，说明病程尚短，毒邪未深入，所以还可以治疗。所谓“表里俱实”，是指具备上述症状，且无汗、大便不通的患者，适宜用黑奴丸同时解除表里之邪。若无表里实证但热毒炽盛者，适宜用黄连解毒汤。兼有燥渴症状的，合用白虎汤以清热生津。里实便秘者，适宜用解毒承气汤攻下；表实无汗者，适宜用三黄石膏汤发汗解表。
阴毒（阴寒至极的毒证）表现为面色青黑，咽喉疼痛，全身厥冷畏寒，身体沉重僵硬疼痛如同被棍棒殴打，腹部绞痛坚硬如石头，或者呕吐、腹泻、烦躁不安，或者出冷汗，此时应以温补为先。无汗者宜用还阳散、退阴散，通过温通发汗使寒毒消散、阳气伸展。紧急时灸治气海穴和关元穴。
【注】阴毒，是指阴寒邪气达到极致的病证。血脉受到阴毒邪气的侵袭，所以面色呈现青黑色。阴毒向内攻冲于体内，所以咽喉疼痛、腹部绞痛。阴毒向外攻冲于体表，所以全身厥冷，身体沉重僵硬疼痛如同被杖击一般。独阴无阳无法气化，所以阴寒凝滞于腹部，坚硬如石。或者呕吐、或者下利、或者烦躁、或者出冷汗，这些都是阳气虚弱的表现，治疗均应以温补为首要原则，适宜用四逆汤并倍加人参。如果具备上述症状，患者无汗，适宜用还阳散、退阴散，通过温补发汗的方法，使寒毒散去而阳气恢复。凡是遇到此类病证，都应当紧急灸治气海、关元二穴二百至三百壮，随后服用药物，没有不痊愈的。
Yang Du (Toxic Heat Syndrome) arises when extreme heat fails to be resolved through sweating or purging. Symptoms include a curled, scorched-black tongue, nasal passages resembling coal smoke, coma with locked jaws, mania as if seeing ghosts, sore throat, hemoptysis, and red macules on the skin like cloud patterns. Within six to seven days of onset, it is still treatable. If both exterior and interior are excess, Heinu Wan (Black Slave Pill) is indicated. For excessive heat requiring detoxification combined with interior excess, purgatives are used. For exterior excess without sweat, Sanhuang Shigao Decoction (Three-Yellow Gypsum Decoction) is indicated.
[Note] Yang Du refers to a syndrome where yang-heat reaches its extreme. "Loss of sweating and purging" means that sweating or purging should have been performed but was not, missing the appropriate timing. The blazing heat toxin persists, causing the tongue to curl and turn black, and coal-smoke-like deposits in the nose. The heat toxin attacks inwardly affecting the Heart, leading to mental confusion, locked jaws with shivering, mania hallucinating spirits, sore throat, and spitting blood. The heat toxin presses outwardly on the skin, causing red rashes resembling brocade clouds. Six or seven days prior indicates a short duration where the toxin has not deeply penetrated, so treatment is still possible. "Excess in both exterior and interior" refers to presenting these symptoms with no sweat and constipation; Heinu Wan is suitable to resolve both aspects simultaneously. For cases without exterior-interior excess but with intense heat, Huanglian Jiedu Tang (Coptis Decoction for Detoxification) is indicated. If accompanied by dryness and thirst, combine with Baihu Tang (White Tiger Decoction) to clear heat. For interior excess with constipation, Jiedu Chengqi Tang (Detoxification Purgative Decoction) is used to purge. For exterior excess with no sweat, Sanhuang Shigao Tang (Three-Yellow Gypsum Decoction) is used to induce sweating.
Yin Du (Toxic Cold Syndrome) presents with cyanotic-black complexion, sore throat, generalized cold limbs and aversion to cold, heavy stiff body pain as if beaten by a club, and abdominal colic hard as stone. There may be vomiting, diarrhea, irritability, or cold sweat. In such cases, warming and tonifying must be prioritized. For those without sweat, Huan Yang San (Restore Yang Powder) and Tui Yin San (Push Away Yin Powder) are used to warm and induce sweating, dispersing cold toxin and extending yang. Urgently moxa Qihai (CV 6) and Guanyuan (CV 4).
[Note] Yin Du refers to a syndrome where yin-cold reaches its extreme. Blood vessels affected by yin-toxin cause the face to appear cyanotic and black. Yin-toxin attacking inward causes sore throat and abdominal colic. Yin-toxin attacking outward causes generalized cold limbs and heavy, stiff pain as if beaten. With only yin and no yang to transform, yin coagulates in the abdomen, making it hard as stone. Vomiting, diarrhea, irritability, or cold sweat are all signs of yang deficiency. Treatment should prioritize warming and tonifying, using Sini Tang (Frigid Extremities Decoction) with doubled Ren Shen (Ginseng Radix et Rhizoma). If these symptoms present with no sweat, Huan Yang San and Tui Yin San are indicated to warm and induce sweating, allowing the cold toxin to disperse and yang to recover. For any such case, urgently moxa Qihai (CV 6) and Guanyuan (CV 4) for two to three hundred moxibustion units, followed by herbal medicine, and recovery is assured.