伏温由少阴而发，外出于三阳经证，内结于胃腑，则见阳明腑证。其证虽深浅不一，但由阴出阳，于病机
为顺，均在可治之例。惟有伏邪已动，而热象郁滞，不达于三阳，亦不归于胃腑，而即窜入厥阴者，在手厥阴
则神昏谵语，烦躁不寐，甚则狂言无序，或蒙闭不语。在足厥阴则抽搐蒙痉，昏眩直视，甚则循衣摸床。此等
凶证，有兼见者，有独见者，有腑热内结，邪气充斥而溃入者，有阴气先亏，热邪乘虚而陷入者，有挟痰涎而
蒙闭者，有挟蓄血而如狂者。凡遇此等重证，第一先为热邪寻出路，如在经者，从斑汗解，在腑者，从二便出
是也。至照顾正气，转在第二层。盖气竭则脱，阴涸则死，皆因热邪燔劫而然。用药于祛邪中，参以扶正养阴
，必使邪退，而正气乃能立
脚。如徒见证治证，但以清心泄肝、化热养津之剂，就题面敷衍。虽用药并无大谬，而坐失事机，迨至迁延生
变，措手不及，谁之咎欤。今姑就手足厥阴见证各条，拟治法如下∶
凡热重昏谵，至夜增剧，舌底绛色，此热灼于营也，以犀角地黄为主方。烦躁不寐，口渴舌板，神情昏扰
，热郁于上也，以凉膈散为主方。神志烦乱，小溲赤涩，舌尖干红，热劫心阴也，异赤各半汤为主方。面赤神
烦，大渴多汗，热燔阳明之经也，白
虎汤为主方。大便秘结，或热结旁流，唇焦齿垢，舌刺焦黄者，热结阳明之腑也，以三承气为主方。又如热蒸
痰升，蒙闭神明者，加用至宝、紫雪、菖蒲汁之类。痉掣搐搦，肝风升扰者，加用羚羊角、钩藤、石决明之类
。病证纷繁，治难缕述，而总以祛邪扶正两意为提纲。祛邪之法，已列于前。至扶正之法，在温病以养阴为主
，以温热必伤阴液也。人参难得佳者，且病家无力者多，岂能概用；惟西洋参甘凉养津，施于温热伤阴者，最
为合用。余如生地滋肾阴，白芍养肝阴，石斛养胃阴，沙参养肺阴，麦冬养心阴。如遇虚体或久病阴伤者，无
论发表攻里剂中，均可加入。其或热已窜入厥阴，而邪之藏于少阴者，热气尚伏而不扬，宜于清泄中，仍兼疏
托。或热已内陷营阴，而邪之走于经者，表气尚郁而不达，宜于凉营中，再参透表。其最重者，邪热内燔，而
外面反无热象，甚至肢厥肤冷，脉涩数而不畅，必得大剂泄热透邪，乃使热势外扬，脉象转见洪大，庶可免厥
深闭脱之危也。
伏气温病由少阴经发起，若向外透发至三阳经证候，或向内结聚于胃腑，则表现为阳明腑实证。这些证候虽然深浅程度不同，但属于由阴出阳的病理过程，符合疾病向愈的病机趋势，均属于可治疗的范畴。唯有伏邪已经发动，但热象郁滞不畅，既不能透达于三阳经，也不能归并于胃腑，反而直接窜入厥阴经的，在手厥阴心包经则出现神志昏迷、胡言乱语、烦躁不安、无法入睡，严重时会狂言无序，或者蒙蔽清窍而沉默不语；在足厥阴肝经则出现抽搐、强直性痉挛、昏眩、两眼直视，严重时会出现循衣摸床（手指无意识地抓摸衣物或床沿）的症状。这类凶险的证候，有的兼见多种症状，有的单独出现。其成因有：因腑中热结，邪气充斥而溃散内陷的；有因阴气先已亏损，热邪乘虚陷入的；有挟带痰涎而蒙蔽心窍的；有挟带瘀血而导致如狂状态的。凡是遇到这类重症，首要任务是给热邪寻找出路，如果邪气在经，通过发斑、发汗来解除；如果邪气在腑，通过大小便排出。至于顾护正气，则是第二层面的考虑。因为气竭会导致脱证，阴液枯竭会导致死亡，这都是由于热邪猛烈焚烧劫夺津液所致。用药时在祛除邪气的同时，参入扶正养阴的药物，必须使邪气退去，正气才能稳固立足。如果仅仅针对症状治疗，只使用清心泻肝、清热生津的方剂，就题面敷衍应付，虽然用药没有大错，但却坐失战机，等到病情迁延发生变故，措手不及，这是谁的过错呢？现在暂且根据手足厥阴经出现的各种见证，拟定治法如下：
凡是热势沉重导致神志昏迷、胡言乱语，夜间加重，舌底呈绛色，这是热邪灼伤营分，以犀角地黄汤为主方。烦躁不安、无法入睡，口渴、舌苔板滞，神情昏乱，这是热邪郁结于上焦，以凉膈散为主方。神志烦乱、小便短赤涩痛、舌尖干红，这是热邪劫耗心阴，以导赤散合各半汤（异赤各半汤）为主方。面色红赤、神志烦扰、极度口渴、多汗，这是热邪炽盛于阳明经，以白虎汤为主方。大便秘结，或者热结旁流（燥屎内结而流出稀水），嘴唇焦裂、牙齿上有垢腻、舌苔刺手焦黄，这是热邪结聚于阳明腑，以三个承气汤（大承气汤、小承气汤、调胃承气汤）为主方。又如热邪蒸腾导致痰浊上升，蒙蔽神明的，加用至宝丹、紫雪丹、石菖蒲汁等药物。出现痉挛抽搐、肝风升动扰乱筋脉的，加用羚羊角、钩藤、石决明等药物。病证纷繁复杂，治疗方法难以一一详述，但总以祛邪和扶正两个意思为提纲。祛邪的方法，前面已经列出。至于扶正的方法，在温病中以养阴为主，因为温热病必然损伤阴液。人参难以得到佳品，而且贫困患者较多，岂能普遍使用；只有西洋参味甘性凉能滋养津液，施用于温热病损伤阴液的患者，最为合适。其余如生地黄滋补肾阴，白芍滋养肝阴，石斛滋养胃阴，沙参滋养肺阴，麦冬滋养心阴。如果遇到体质虚弱或久病阴伤的患者，无论在使用发表或攻里的方剂中，都可以加入这些药物。如果热邪已经窜入厥阴，而邪气潜伏在少阴，热气尚且潜伏而不张扬，应当在清泄热邪的同时，兼用疏托之法。或者热邪已经内陷营阴，而邪气走窜于经络，表气尚且郁闭而不能通达，应当在凉营解毒的同时，再参入透表之法。其中最严重的情况，是邪热在内焚烧，而体表反而没有热象，甚至四肢厥冷、皮肤发凉，脉象涩数而不通畅，必须使用大剂量泄热透邪的药物，才能使热势向外发散，脉象转为洪大，这样才能避免厥深闭脱的危险。
Fever-heat diseases originating from latent warmth arise from the Shaoyin channel. If they emerge outward to manifest in the Yangming channels or accumulate inwardly in the Stomach fu-organ, Yangming Fu-organ syndrome (syndrome characterized by accumulation of heat and dryness in the intestines) appears. Although these syndromes vary in depth, their progression from Yin to Yang follows a favorable pathological mechanism and falls within the scope of treatable conditions. However, when latent pathogens have activated but the heat signs are stagnant and obstructed, failing to reach the Three Yang channels or return to the Stomach fu-organ, instead rushing directly into the Jueyin channels: in the Hand Jueyin (Pericardium), it manifests as coma with delirious speech, irritability and insomnia, and in severe cases, disordered manic talk or mutism due to obstruction; in the Foot Jueyin (Liver), it manifests as convulsions and stiff spasms, dizziness with fixed gaze, and in severe cases, picking at clothes and bedrails (a sign of extreme neurological disturbance). These critical syndromes may present with combined or isolated symptoms. Etiologies include: pathogenic factors overflowing due to internal accumulation in the fu-organs; collapse into deficiency due to prior depletion of Yin qi; obstruction by phlegm-fluids; or mania-like states caused by blood stasis. In encountering such severe cases, the primary priority is to provide an exit route for the heat pathogen: if the pathogen is in the channels, resolve it through sweating or purpura eruption; if in the fu-organs, expel it via urination and defecation. Protecting healthy qi is a secondary consideration. Exhaustion of Qi leads to collapse, and depletion of Yin leads to death, both resulting from the fierce burning and劫 (plundering) of fluids by heat pathogens. Medication must combine pathogen expulsion with supporting healthy qi and nourishing Yin, ensuring that once the pathogen recedes, healthy qi can take root. Merely treating symptoms with formulas for clearing Heart fire, draining Liver heat, resolving heat, and nourishing fluids constitutes superficial management. Although the medication may not be fundamentally erroneous, this approach misses the optimal timing for intervention. When the condition lingers and complications arise unexpectedly, whose fault is it? Hereinafter, treatment methods are proposed based on the manifestations of Hand and Foot Jueyin syndromes:
For heavy heat causing coma and delirium, worsening at night, with a crimson tongue base, indicating heat scorching the Ying (Nutritive) level, use Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) as the main formula. For irritability, insomnia, thirst, stiff tongue coating, and confused mental state, indicating heat stagnating in the Upper Jiao, use Liangge San (Cooling the Diaphragm Powder) as the main formula. For mental restlessness, dark and scanty urine, and a dry red tongue tip, indicating heat consuming Heart Yin, use Yichi Geban Tang (Half-Daohchi Half-Other Formula) as the main formula. For facial redness, mental agitation, extreme thirst, and profuse sweating, indicating blazing heat in the Yangming channels, use Baihu Tang (White Tiger Decoction) as the main formula. For constipation or heat-binding with peripheral flow (liquid stool around hard feces), cracked lips, dental plaque, and prickly, scorched yellow tongue coating, indicating heat binding in the Yangming fu-organ, use the three Chengqi formulas (Da Chengqi Tang, Xiao Chengqi Tang, Tiaowei Chengqi Tang) as the main formula. Additionally, for heat steaming and rising phlegm obscuring the mind, add Zhibao Dan (Treasure of Life Pill), Zixue San (Purple Snow Powder), or Shichangpu juice. For spasms and convulsions due to ascending Liver wind, add Lingyangjiao (Antelope Horn), Gouteng (Uncaria Ramulus), and Shijueming (Concha Argopectis). Given the complexity of syndromes, treatments cannot be exhaustively listed, but the general principle revolves around expelling pathogens and supporting healthy qi. Expulsion methods were previously outlined. Regarding support, nourishing Yin is paramount in warm diseases because heat-warmth inevitably damages Yin fluids. Ren Shen (Ginseng Root) is difficult to obtain in high quality and is often unaffordable for patients; thus, it cannot be universally applied. Xi Yang Shen (American Ginseng Root), being sweet and cool, effectively nourishes fluids and is most suitable for heat-warmth damaging Yin. Other examples include Sheng Dihuang (Rehmanniae Radix) nourishing Kidney Yin, Bai Shao (Paeoniae Radix Alba) nourishing Liver Yin, Shihu (Dendrobii Caulis) nourishing Stomach Yin, Shashen (Glehniae Radix) nourishing Lung Yin, and Maidong (Ophiopogonis Radix) nourishing Heart Yin. In cases of constitutional deficiency or chronic Yin damage, these can be added to any exterior-releasing or interior-purging formulas. If heat has rushed into Jueyin while pathogens remain latent in Shaoyin, with heat concealed rather than manifest, clear and drain while simultaneously venting and releasing. If heat has sunk into Ying-Yin while pathogens move in the channels, with exterior Qi still obstructed, cool the Ying level while simultaneously penetrating the exterior. The most critical scenario involves internal blazing heat without external heat signs, even presenting with cold limbs and skin, and a choppy, rapid, yet unsmooth pulse. Large doses of heat-clearing and pathogen-expelling agents are required to force the heat outward, transforming the pulse to a surging and large character, thereby avoiding the danger of deep cold-jue leading to closure-collapse.