时疫循衣、摸床、撮空者，热盛神昏而四肢实也。当察其舌。舌苔白，或无苔，有热无结也，犀角、黄连、石
膏为主；舌有燥苔，或黄黑、燥裂、芒刺，有热有结也，大黄、芒硝为主。屡经汗、下后，胸胁仍有拒痛者，邪未
尽也，仍宜清利。无拒痛者，阴虚而阳亢也，生地、麦冬、枣仁、茯神安神为主。
时疫初起多睡，兼身重者，热邪阻滞其经脉也，有汗白虎汤，无汗或加麻黄。屡经汗、下后，表里热愈甚，二
便俱利而身痛、多睡者，阴伤也，四物，六味、生脉三方合用，大剂养阴方效，失治即危。服此数剂，身痛已和，
表里热退，而仍多睡者，于三方中加生枣仁即愈。若夫平素脾虚多睡，多痰嗜睡者，一受疫证，必更嗜睡，当于时
疫药中，参之以理脾消痰之品。
诸病身冷皆属阴证，在时疫多属热证，须从气、色、神、脉、舌苔中辨其端倪。果系时疫，则当分初、中、末
以治之，不可紊也。时疫初起，往往有身冷、自利，腹痛、作呕，全似阴证者。若舌有浓白苔，身有秽气，心
烦、多汗，面色油垢，小便黄、短、数，有一、二证现，便是疫邪直入太阴，先里后表，非真阴寒证。兼呕利，藿
香正气散、四苓散；无呕利，达原饮。服一、二剂后，即发热矣。时疫传变发热之后，谵妄、昏沉，舌燥，腹满、
便秘而身冷者，先表后里证，三承气、大柴胡选用；无结证者，白虎汤。时疫末路，屡经汗、下，表里无邪，胸、
腹无滞，二便自和而身冷者，当以脉为主。脉虚细不振者，用药太过而成脱证也，急宜温补，少缓即死，生脉散
加、术、苓、芍，平补阴阳；冷甚者加熟附子。
时疫身冷一证，最难下手。初起时，若寒热不辨，且勿妄投汤剂，当少待之，多则一、二日，少则半日，多有
自行传变，即发热、烦渴者，此时则易于用药。若已经发热传变之后，变为身冷，则自有口燥、舌干、不得卧诸证
在，此时药不可缓，缓则热深厥深，虽下后厥回，往往亡阴而死。身冷与恶寒不同，而病机颇同，当与恶寒条参
看。
在时行疫病中，出现循衣摸床、撮空理线等症状的，是热邪炽盛导致神志昏迷，而四肢表现为实证。此时应当观察患者的舌象。如果舌苔发白，或者没有舌苔，说明有热邪但无积滞结聚，治疗应以犀角、黄连、石膏为主；如果舌上有干燥的苔垢，或者呈现黄色、黑色，伴有干燥裂纹或芒刺，说明既有热邪又有积滞结聚，治疗应以大黄、芒硝为主。经过多次发汗和攻下治疗后，胸胁部位仍然有按压疼痛（拒按）现象的，说明病邪尚未清除干净，仍宜采用清热利湿的方法。如果没有按压疼痛的现象，则是阴虚而阳气亢盛，治疗应以生地、麦冬、酸枣仁、茯神来安神为主。
时行疫病初起时多嗜睡，兼有身体沉重的，是热邪阻滞了经脉所致，如果有汗，用白虎汤；如果没有汗，可以加入麻黄。经过多次发汗和攻下治疗后，表里热势更加严重，大小便通畅但身体疼痛、多嗜睡的，是阴液受损的表现，将四物汤、六味地黄丸、生脉散三方合用，大剂量服用养阴方剂才能见效，延误治疗就会危及生命。服用这几剂药后，如果身体疼痛缓解平和，表里热势消退，但仍然多嗜睡的，在上述三方中加入生酸枣仁即可痊愈。如果是平素脾虚导致的多嗜睡，或多痰导致的嗜睡者，一旦感染疫病，必定会更加嗜睡，应当在治疗疫病的药物中，参入调理脾胃、消除痰浊的药物。
各种疾病出现的身体寒冷都属于阴证，但在时行疫病中多属于热证，必须从气色、神色、脉象、舌苔中辨别其端倪。如果确实是时行疫病，就应当分初、中、末三个阶段来治疗，不可混乱。时行疫病初起时，往往会出现身体寒冷、自发性腹泻、腹痛、呕吐，完全像阴证的样子。如果舌上有浓白的苔垢，身体散发秽浊之气，心烦、多汗，面色油垢，小便黄、短、频数，只要有一两个症状出现，就是疫邪直接侵入太阴经，病机是先里后表，并非真正的阴寒证。兼有呕吐和腹泻的，用藿香正气散、四苓散；没有呕吐和腹泻的，用达原饮。服用一、两剂药后，就会发热。时行疫病传变并出现发热之后，如果出现谵语妄言、昏沉、舌燥、腹部胀满、便秘且身体寒冷的，属于先表后里的证候，选用三承气汤或大柴胡汤；没有积滞结聚证候的，用白虎汤。时行疫病的末期，经过多次发汗和攻下，表里已无邪气，胸腹无停滞，二便自然调和却身体寒冷的，应当以脉象为主要依据。脉象虚弱细弱且不振作的，是因为用药过度而导致脱证，急需温补，稍加迟缓就会死亡，可用生脉散加白术、茯苓、芍药，平和地补益阴阳；寒冷严重的加熟附子。
时行疫病中的身体寒冷这一证候，最难着手治疗。初起时，如果不能辨别寒热，切勿盲目投药，应当稍作等待，最多一两天，最少半天，很多情况下会自行传变，出现发热、烦渴等症状，这时就容易用药。如果已经发热传变之后，转变为身体寒冷，则自然会有口燥、舌干、无法安卧等症状，此时用药不可迟缓，迟缓则会导致热邪深入、四肢厥冷加重，即使攻下后厥逆回阳，也往往会因亡阴而死。身体寒冷与恶寒不同，但病机颇为相似，应当参考恶寒的条文一起研读。
In the context of epidemic febrile diseases, patients exhibiting behaviors such as grasping at clothes (xun yi mo chuang), picking at empty air (cuo kong), are suffering from heat excess causing spirit confusion, while their limbs present with excess syndrome. At this time, one must observe the tongue. If the tongue coating is white, or absent, it indicates heat without accumulation/stagnation; treatment should focus on Rhinoceros Horn (Xijiao), Coptis Rhizome (Huanglian), and Gypsum (Shigao). If there is a dry coating, or yellow/black colors, with dry cracks or prickles, it indicates both heat and accumulation/stagnation; treatment should focus on Rhubarb (Dahuang) and Mirabilite (Mangxiao). After repeated sweating and purging treatments, if there is still pain upon pressure in the chest and hypochondrium, the pathogenic factor has not been completely cleared, and clearing heat and promoting drainage remains appropriate. If there is no pain upon pressure, it indicates yin deficiency with yang hyperactivity; treatment should focus on Rehmannia Root (Shengdi), Ophiopogon Tuber (Maidong), Ziziphus Seed (Zaoren), and Poria (Fushen) to calm the spirit.
Epidemic febrile diseases often begin with excessive sleepiness accompanied by heaviness of the body, which is caused by heat pathogens obstructing the meridians. If there is sweating, Baihu Tang (White Tiger Decoction) is used; if there is no sweating, Ephedra Herba (Mahuang) may be added. After repeated sweating and purging treatments, if the heat in both the exterior and interior becomes more severe, yet urination and defecation are free, while body pain and excessive sleepiness persist, it indicates damage to yin fluids. Combining Siwu Tang (Four Substance Decoction), Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), and Shengmai San (Generate the Pulse Powder) in large doses of yin-nourishing formulas can be effective; neglecting treatment leads to danger. After taking several doses, if body pain subsides and resolves, and exterior/interior heat recedes, but excessive sleepiness persists, adding raw Ziziphus Seed (Sheng Zaoren) to the three aforementioned formulas will lead to recovery. For those who habitually suffer from excessive sleepiness due to spleen deficiency, or sleepiness due to phlegm, once infected with an epidemic disease, they will inevitably become even sleepier. In this case, herbs for regulating the spleen and eliminating phlegm should be incorporated into the epidemic-treating medications.
Body coldness in various diseases generally belongs to yin syndromes, but in epidemic febrile diseases, it mostly belongs to heat syndromes. One must discern its clues from the complexion, spirit, pulse, and tongue coating. If it is indeed an epidemic febrile disease, treatment must be divided into early, middle, and late stages without confusion. In the early stage of epidemic febrile diseases, body coldness, spontaneous diarrhea, abdominal pain, and vomiting often occur, resembling yin syndromes completely. If there is a thick white tongue coating, a foul odor from the body, irritability, profuse sweating, an oily/dirty facial complexion, and yellow, short, frequent urination, the presence of one or two of these symptoms indicates that the epidemic pathogen has directly entered the Taiyin channel. The pathology is interior first then exterior, not a true yin-cold syndrome. With accompanying vomiting and diarrhea, Huoxiang Zhengqi San (Agastache Powder to Rectify the Qi) and Siling San (Four-Ingredient Powder) are used; without vomiting and diarrhea, Dayuan Yin (Origin-Reaching Drink) is used. After one or two doses, fever will appear. After the epidemic febrile disease transmits and fever appears, if delirium, coma, dry tongue, abdominal fullness, constipation, and body coldness occur, it is a syndrome of exterior first then interior; Sanshengqi Tangs (Three Chengqi Formulas) or Daxiehu Tang (Major Rhabarber and Bupleurum Decoction) are selected based on indication; if there are no signs of accumulation/stagnation, Baihu Tang (White Tiger Decoction) is used. In the late stage of epidemic febrile diseases, after repeated sweating and purging, with no pathogenic factors in the exterior or interior, no stagnation in the chest or abdomen, and normal urination and defecation, yet body coldness persists, the pulse should be the primary guide. A weak, fine, and unassertive pulse indicates collapse syndrome caused by excessive medication; urgent warming and tonification are required, otherwise death will ensue quickly. Shengmai San (Generate the Pulse Powder) added with Atractylodes Macrocephala Rhizome (Baizhu), Poria (Fuling), and White Peony Root (Shaoyao) provides balanced tonification of yin and yang; for severe cold, Prepared Aconite Lateral Root (Shu Fuzi) is added.
The symptom of body coldness in epidemic febrile diseases is the most difficult to treat. In the early stage, if cold and heat cannot be distinguished, do not blindly administer decoctions. Wait for a short time, ranging from half a day to one or two days, during which the disease often undergoes spontaneous transmission, presenting with fever and thirst, making medication easier to apply. If, after fever and transmission have already occurred, the condition transforms into body coldness, symptoms such as dry mouth, dry tongue, and inability to lie down will naturally be present. Medication at this time must not be delayed; delay leads to deep heat and deep cold (heat entering the interior causing cold extremities). Even if cold extremities return after purging, death from yin exhaustion often follows. Body coldness differs from aversion to cold, but the pathological mechanism is quite similar; therefore, it should be studied in conjunction with the section on aversion to cold.