时疫下后，气血俱虚，神思不清，惟向里床睡，似寐非寐，似寤非寤，呼之不应
，此正气夺，与其服药不当，莫如静守虚回，而神思自清，语言渐朗，若攻之脉必反数，四
肢渐厥，此虚虚之祸，危在旦夕，凡见此证，表里无大热者，宜人参养荣汤补之。能食者，
自然虚回，而前证自除；设不食者，正气愈夺，虚证转加，法当峻补。
三春旱草，得雨滋荣；残腊枯枝，虽灌弗泽。凡年高之人，最忌剥削，设投承气
，以一当十；设用参术，十不抵一。盖老年荣卫枯涩，几微之元气易耗而难复也。不比少年
气血生机甚捷，其势 然，但得邪气一除，正气随复。
所以
老年慎泻，少年慎补，何况误用耶！万有年高禀浓，年少赋薄者，又当从权，勿以常论。
温疫心下胀满，邪在里也，若纯用青皮、枳实、槟榔诸香燥破气之品，冀其宽胀
，此大谬也。不知内壅气闭，原有主客之分，假令根于七情郁怒，肝气上升，饮食过度，胃
气填实，本无外来邪毒、客气相干，止不过自身之气壅滞，投木香、砂仁、豆蔻
、枳壳之类
，上升者即降，气闭者即通，无不见效。今疫毒之气，传于胸胃，以致升降之气不利，因而
胀满，实为客邪累及本气，但得客气一除，本气自然升降，胀满立消，若专用破气之剂，但能
破正气，毒邪何自而泄？胀满何由而消？治法非用小承气弗愈。既而肠胃燥结，下既不通，中
气郁滞，上焦之气不能下降，因而充积，即膜原或有未尽之邪，亦无前进之路，于是表里上
中下三焦皆阻，故为痞满燥实之证。得大承气一行，所谓一窍通，诸窍皆通，大关通而百关
尽通也。向所郁于肠胃之邪，由此而下，肠胃既舒，在膜原设有所传不尽之余邪，方能到胃，
乘势而下也，譬若河道阻塞，前舟既行，余舟连尾而下矣。至是邪结并去，胀满顿除，皆藉
大黄之力。大黄本非破气药，以其润而最降，故能逐邪拔毒，破结导滞，加以枳、朴者，不
无
佐使云尔。若纯用破气之品，津液愈耗，热结愈固，滞气无门而出，疫毒无路而泄，乃望其
宽胸利膈，惑之甚矣。
温疫经过攻下治疗后，气血都虚弱，神志恍惚不清，只想面向里侧卧床睡觉，似睡非睡，似醒非醒，呼唤他不回应。这是正气被剥夺（正气极度虚弱），与其用药不当，不如安静守候，等待正气恢复，那么神志自然清醒，语言逐渐清晰。如果此时再用攻伐之法，脉象必然反而加快，四肢逐渐厥冷，这是“虚虚”（使虚者更虚）的祸患，危险就在旦夕之间。凡是见到这种证候，表里都没有大热的，适宜用人参养荣汤来补益。如果能进食，正气自然会恢复，前面的症状自然消除；假如不能进食，正气会更加虚弱，虚证加重，治法应当峻补。
春季三月草木干枯，得到雨水滋润才能繁荣；腊月残冬枯枝，即使浇灌也不能润泽。凡是年高的人，最忌讳攻伐剥削，如果投用承气汤类方剂，效果以一当十（指损伤极大）；如果使用人参、白术等补药，效果十不抵一（指补益极难见效）。因为老年人营卫之气枯涩，微弱的元气容易消耗且难以恢复。不像少年人气血生机非常迅速，其势如此，只要邪气一除，正气随即恢复。所以老年人慎用泻法，少年人慎用补法，何况误用呢！如果有年老禀赋浓厚，或年少禀赋薄弱的人，又应当权变处理，不要按常规论断。
温疫病出现心下胀满，说明邪气在里。如果单纯使用青皮、枳实、槟榔等香燥破气的药物，希望它们能宽消胀满，这是极大的错误。不知道内部壅塞气闭，原本有主气与客邪的区别。假使根源在于七情郁怒导致肝气上升，或饮食过度导致胃气填实，本没有外来邪毒、客气干扰，只不过是自己自身的气机壅滞，投用木香、砂仁、豆蔻、枳壳之类的药物，上升的气即下降，气闭的即通畅，没有不见效的。如今疫毒之气，传入胸胃，导致升降之气不利，因而胀满，实为客邪累及本气，只要客邪一除，本气自然升降，胀满立即消除。如果专用破气的药剂，只能破伤正气，毒邪从哪里排泄？胀满从哪里消除？治法非用小承气汤不可痊愈。继而肠胃干燥结滞，下部不通，中气郁滞，上焦之气不能下降，因而充积，即使膜原可能有未尽的邪气，也没有前进的道路，于是表里上下三焦都受阻，所以形成痞满燥实的证候。得大承气汤一行，所谓一个窍通，诸窍皆通，大关通而百关尽通。先前郁结在肠胃的邪气，由此而下，肠胃既已舒展，在膜原如果有所传未尽的余邪，方能到达胃，乘势而下。譬如河道阻塞，前面的船走了，后面的船连尾而下。到这时邪结并去，胀满顿除，都是借助大黄的力量。大黄本来不是破气药，因为它润降之力最强，所以能逐邪拔毒，破结导滞，加上枳实、厚朴，不过是作为佐使药罢了。如果纯用破气的药物，津液更加耗损，热结更加坚固，滞气没有门路而出，疫毒没有道路而泄，却指望它能宽胸利膈，真是迷惑之极了。
After the treatment of purgation for warm epidemic, both Qi and Blood are deficient. The spirit is unclear and confused; the patient only wishes to sleep facing inward on the bed, in a state between sleeping and waking, unresponsive to calls. This indicates that the Righteous Qi (Zheng Qi, healthy energy) has been depleted. Rather than administering inappropriate medication, it is better to remain quiet and wait for the Righteous Qi to recover naturally; then the spirit will clear, and speech will gradually become distinct. If attack methods are used now, the pulse will likely become rapid, and the four limbs will gradually become cold. This is the disaster of "making deficiency more deficient," with danger imminent at dawn or dusk. For any such syndrome where there is no significant heat in the exterior or interior, Ren Shen Yang Rong Tang (Ginseng Nourishing Harmony Decoction) should be used to tonify. If the patient can eat, the Righteous Qi will naturally recover, and the aforementioned symptoms will disappear spontaneously; if they cannot eat, the Righteous Qi will be further depleted, and the deficiency syndrome will worsen, requiring vigorous tonification.
In the spring months, when grasses are dry, they flourish only after receiving rain nourishment; in the late winter, dead branches remain unmoistened even if irrigated. Elderly people are most contraindicated against depletion and exploitation. If Cheng Qi Tang (Purgative Decoction) formulas are administered, the damage is tenfold compared to the benefit; if Ginseng (Ren Shen) and Atractylodes (Bai Zhu) are used, the effect is less than one-tenth of what is needed. This is because the Ying (Nutritive) and Wei (Defensive) Qi of the elderly are withered and stagnant, and their minute Yuan (Original) Qi is easily consumed and difficult to restore. This differs from youths, whose Qi and Blood have very rapid vitality. Their condition is such that once the pathogenic factor is removed, the Righteous Qi recovers immediately. Therefore, the elderly should cautiously use purgation, and youths should cautiously use tonification, let alone misuse them! However, for those who are elderly but have robust constitution, or young but have weak constitution, adjustments must be made according to circumstances, and one should not rely solely on general rules.
Warm epidemic presenting with fullness and distension below the heart indicates that the pathogen is in the interior. If one purely uses aromatic, dry, and Qi-breaking herbs such as Qing Pi (Green Tangerine Peel), Zhi Shi (Immature Bitter Orange), and Bing Lang (Areca Seed) hoping to relieve the distension, this is a great error. One fails to realize that internal obstruction and Qi closure originally distinguish between the host (Ben Qi, intrinsic Qi) and the guest (Ke Xie, extrinsic pathogen). Suppose the root lies in emotional depression and anger causing Liver Qi to rise, or excessive eating causing Stomach Qi to become filled and solid, without interference from external toxic pathogens or guest pathogens. It is merely an internal stagnation of one's own Qi. Administering herbs like Mu Xiang (Aucklandia Root), Sha Ren (Amomum Fruit), Dou Kou (Cardamom), and Zhi Ke (Bitter Orange Peel) will cause the rising Qi to descend and the closed Qi to open, yielding visible effects. Now, however, epidemic toxic Qi has transmitted to the chest and stomach, causing dysfunction of ascending and descending Qi, leading to distension. This is actually the guest pathogen affecting the host Qi. Once the guest pathogen is removed, the host Qi will naturally ascend and descend, and the distension will vanish immediately. If one exclusively uses Qi-breaking agents, they can only break the Righteous Qi; how can the toxic pathogen be excreted? How can the distension be resolved? The treatment method requires Xiao Cheng Qi Tang (Minor Purgative Decoction) to achieve cure. Subsequently, due to dryness and constipation in the intestines and stomach, lower blockage prevents the middle Qi from circulating freely, causing upper Jiao Qi to fail to descend and accumulate. Even if residual pathogens remain in the Mo Yuan (Membrane Source), there is no path forward. Thus, the exterior, interior, upper, middle, and lower Jiao are all obstructed, resulting in the syndrome of痞满燥实 (fullness, distension, dryness, and solidity). Administration of Da Cheng Qi Tang (Major Purgative Decoction) opens one aperture, thereby opening all apertures; once the major gate is opened, all minor gates are cleared. The pathogens previously stagnated in the intestines and stomach descend through this route. Once the intestines and stomach are relaxed, any residual pathogens remaining in the Mo Yuan can reach the stomach and descend with momentum. It is like a blocked river: once the front boat moves, the following boats follow in succession. At this point, the pathogenic accumulation is expelled, and distension is instantly relieved, all relying on the power of Da Huang (Rhubarb Rhizome). Da Huang is inherently not a Qi-breaking herb; due to its moistening and strongly descending nature, it can expel pathogens and extract toxins, break accumulations, and guide stagnation. Zhi Shi and Hou Po (Magnolia Bark) are added merely as assistant and guiding herbs. If purely Qi-breaking substances are used, body fluids are further depleted, heat accumulation becomes more fixed, stagnant Qi has no outlet, and epidemic toxins have no path to escape. To expect these to broaden the chest and benefit the diaphragm is extremely deluded.