At present, the main use of Chinese medicine in the treatment of sepsis and sepsis shock is "four patterns and four methods". Although this method is suitable for clinical treatment, it is difficult for doctors to use, and the relationship between "four patterns" has not been clarified. The author introduces the dialectical thinking of "ministerial fire theory", and aims to interpret "four patterns and four methods". Sepsis and sepsis shock can be devided into four stages: Yang excess, Yin insufficient, fire damage, and fire decay, which corresponding to four disease stages: heat syndrome, heat syncope, cold syncope, and decaying, and the corresponding treatments are heat clearing, nourishing Yin, rescue Yang, rescue shock respectively. Abdominal problems should be considered during this process.