舌见红色。热蓄于内也。不问何经。宜用透顶清神散治之。
\r将瘟舌图\pt101a2.bmp\r
【介按】舌色如淡红、嫩红、或白中带红。外证初起微寒。继即发热不已。口渴甚者。温邪初起也。治宜辛凉清解。
如纯红或鲜红起刺者。胆经与营分邪热炽盛也。治宜苦寒清解。如不解，是温邪伏于少阴。而发于少阳之表。治以滋少
阴之液。则少阳之热自解。如舌绛神呆。语言颠倒。小便赤涩。点滴如稠者。此热结膀胱也。急宜导赤清热。如舌色鲜
红。神昏谵语。见于斑疹已透之后者。热痰乘于胞络也。治宜清热消痰。若舌色鲜泽纯红。外证神昏、谵语、烦躁不宁
者。温邪入于胞络也。轻则于清解药中，加广郁金、鲜石菖蒲等味以开之。重则用牛黄丸至宝丹等、以芳香开窍，又据
《舌鉴辨正》谓“将瘟舌。即纯红舌。非纯而不杂。即瘀红之色也。”脏腑热极者、中时疫者、误服温补者，皆有之。宜
三黄白虎加连翘。或大小承气等酌用。此舌亦有表证者。则两脸周身必发热、头晕、目眩、乍热乍寒、脉浮数。邪热在
太阳也。宜薄荷、荆芥、葛根、生甘草、凉散表邪。不可遽用“寒凉攻下”。今此舌只用含有刺戟性之透顶清神散以吹鼻
取嚏。因病在神识昏愦之际。乃是临时救急之法也。
透顶清神散
猪牙皂角 细辛 白芷 当归
上为细末。各等分。和匀。病患先噙水一口。以药少许吹鼻内。吐出水。取嚏为度。如未嚏，仍用此药吹入。凡瘟
疫之家。不拘已未患者。皆宜用之。
【介按】此方取细辛、皂角。善能刺戟神经以开窍。配以白芷之芳香上达。当归之通脉舒筋。仿通关散之意以吹鼻
取嚏。凡遇神识昏愦。人事不知之症。临时用之。即能开窍而苏神也。
舌色呈现红色。这是热邪蓄积在体内的表现。不论病在何经，适宜使用透顶清神散进行治疗。
【介按】舌色如淡红、嫩红，或者白色中带有红色。外证初起时微有恶寒，随后即持续发热。口渴严重者，是温邪初起的征象。治疗宜用辛凉清解法。如果是纯红色或鲜红色且伴有芒刺的，是胆经与营分邪热炽盛的表现。治疗宜用苦寒清解法。如果症状未缓解，说明温邪伏于少阴，而发于少阳之表。治疗应滋养少阴之津液，则少阳之热自然解除。如果舌色绛红且神情呆滞，言语颠倒错乱，小便赤涩，点滴量少且粘稠，这是热结膀胱的表现。急需采用导赤清热法。如果舌色鲜红，出现神昏谵语，且在斑疹已经透出之后出现的，是热痰乘袭心包络的表现。治疗宜清热消痰。若舌色鲜泽纯红，外证表现为神昏、谵语、烦躁不安的，是温邪侵入心包络的表现。轻症则在清解药中加入广郁金、鲜石菖蒲等药物以开窍；重症则使用牛黄丸、至宝丹等药物，以芳香开窍。另外，根据《舌鉴辨正》记载：“将瘟舌，即纯红舌，并非纯而不杂，而是瘀红的颜色。”脏腑热极者、患时疫者、误服温补药者，都可能出现这种舌象。适宜选用三黄白虎汤加连翘，或大小承气汤等酌情使用。此舌象也有兼有表证的，此时两脸及周身必然发热，头晕目眩，忽冷忽热，脉浮数，这是邪热在太阳经的表现。适宜用薄荷、荆芥、葛根、生甘草等凉散表邪。不可急于使用“寒凉攻下”法。此处仅使用含有刺激性成分的透顶清神散吹入鼻腔取嚏，因为病情处于神识昏愦之际，这是临时的救急之法。
透顶清神散
猪牙皂角、细辛、白芷、当归
以上药材研为细末，各等分，混合均匀。患者先含一口水，取少许药粉吹入鼻内，吐出水分，以打出喷嚏为度。如果未打喷嚏，仍用此药吹入。凡是瘟疫之家，无论是否患病，都适宜使用此方。
【介按】此方选取细辛、皂角，善于刺激神经以开窍。配合白芷的芳香上达，当归的通脉舒筋，仿照通关散之意，通过吹鼻取嚏来急救。凡遇到神识昏愦、人事不知的症状，临时使用，即可开窍苏醒神志。
The tongue appears red. This indicates heat accumulating within the interior. Regardless of which meridian is affected, Tou Ding Qing Shen San (Penetrating Top Clearing Spirit Powder) should be used for treatment.
[Commentary by Jie] If the tongue color is pale red, tender red, or white with a hint of red, and the exterior symptoms initially present with slight aversion to cold followed by persistent fever, severe thirst indicates the initial stage of warm pathogen invasion. Treatment should employ acrid-cool clearing and resolving methods. If the tongue is purely red or bright red with prickles, it indicates excessive heat in the Gallbladder Meridian and Ying (Nutritive) Level. Treatment should employ bitter-cold clearing and resolving methods. If there is no relief, it suggests that the warm pathogen is latent in Shao Yin (Lesser Yin) but manifesting on the exterior of Shao Yang (Lesser Yang). Treatment should nourish the fluids of Shao Yin, whereupon the heat of Shao Yang will naturally resolve. If the tongue is crimson and the spirit is dull with disordered speech, accompanied by dark, scanty, and viscous urine, this indicates heat binding in the Bladder. Urgent treatment with Dao Chi Qing Re (Guide Out Redness and Clear Heat) method is required. If the tongue is bright red, accompanied by coma and delirious speech appearing after the eruption of macules and papules, this indicates hot phlegm attacking the Pericardium Collateral. Treatment should clear heat and resolve phlegm. If the tongue is fresh, lustrous, and purely red, with exterior symptoms of coma, delirious speech, and restlessness, this indicates the warm pathogen has entered the Pericardium Collateral. In mild cases, add Guang Yu Jin (Curcuma Aromatica Rhizome) and Xian Shi Chang Pu (Acori Tatarinowii Rhizoma) to clearing and resolving formulas to open the orifices. In severe cases, use Niu Huang Wan (Calculus Bovis Pill) or Zhi Bao Dan (Treasure of Life Pill) to open the orifices with aromatic substances. Furthermore, according to *She Jian Bian Zheng* (Differentiation of Tongue Diagnosis), "Jiang Wen She (Pre-epidemic tongue) is essentially a pure red tongue; not purely uniform, but rather a stasis-red hue." It appears in cases of extreme internal heat, seasonal epidemics, or misapplication of warming and tonifying drugs. Suitable treatments include San Huang Bai Hu Tang (Three Yellows White Tiger Decoction) plus Lian Qiao (Forsythiae Fructus), or Xiao Cheng Qi Tang (Minor Order the Qi Decoction) and Da Cheng Qi Tang (Major Order the Qi Decoction) used as appropriate. This tongue presentation may also accompany exterior syndromes: bilateral facial flushing, whole-body fever, dizziness, vertigo, alternating chills and fever, and a floating-rapid pulse indicate pathogenic heat in the Tai Yang (Greater Yang) Meridian. Treatment should use Bo He (Menthae Haplocalycis Herba), Jing Jie (Schizonepetae Spica), Ge Gen (Puerariae Lobatae Radix), and Sheng Gan Cao (Glycyrrhizae Radix et Rhizoma Preparatum) to cool and dissipate exterior pathogens. One must not hastily use "cold purgatives." Here, only Tou Ding Qing Shen San (Penetrating Top Clearing Spirit Powder), containing irritating components, is blown into the nose to induce sneezing. Because the condition involves clouded consciousness, this is a temporary emergency measure.
Tou Ding Qing Shen San (Penetrating Top Clearing Spirit Powder)
Zhu Ya Zao Jiao (Gleditsiae Sinensis Fructus Cum Spina), Xi Xin (Asari Radix et Rhizoma), Bai Zhi (Angelicae Dahuricae Radix), Dang Gui (Angelicae Sinensis Radix)
Grind all ingredients into a fine powder in equal proportions and mix well. The patient first holds a mouthful of water. Blow a small amount of the powder into the nose, spit out the water, and continue until sneezing occurs. If sneezing does not occur, repeat the application. For households affected by epidemic febrile diseases, whether patients are present or not, this formula is suitable.
[Commentary by Jie] This formula utilizes Xi Xin (Asari Radix et Rhizoma) and Zhu Ya Zao Jiao (Gleditsiae Sinensis Fructus Cum Spina), which effectively stimulate the nerves to open the orifices. Combined with the ascending aromatic nature of Bai Zhi (Angelicae Dahuricae Radix) and the meridian-unblocking and tendon-relaxing properties of Dang Gui (Angelicae Sinensis Radix), it mimics the mechanism of Tong Guan San (Pass Through Gate Powder) to induce sneezing via nasal insufflation. In cases of clouded consciousness or loss of awareness, its temporary use can open the orifices and restore mental clarity.