"Shame on you, Barack Obama. It is time you ran a campaign consistent with your messages in public - that's what I expect from you," Clinton said angrily, waving the mailings in the air.
"Meet me in Ohio, and let's have a debate about your tactics," she added.
The two presidential candidates will meet in a televised debate in Cleveland Tuesday.
Clinton spoke to reporters after an early morning rally at Cincinnati Technical College, one of several events she has held across Ohio this week. After losing eleven straight contests to Obama since Super Tuesday, the former first lady is banking on a strong showing in primaries in Ohio and Texas on March 4 to save her fading candidacy.
With so much on the line and the clock ticking, Clinton ripped into Obama much more directly and forcefully than she has in the past.
She compared Obama to President Bush during the rally, suggesting the country had already taken a gamble on an inexperienced candidate who promised change.
"People talk a lot about change. We have lived through some of the worst change that anyone could imagine the last seven years," she said to loud applause. "People thought we were getting a compassionate conservative, didn't they? It turned out he was neither. We have lived with the consequences of those mistakes."
But the New York senator saved her toughest words for Obama's mailings, saying she refused to see the campaign "polluted" by such tactics.
"Enough about the speeches, and the big rallies, and then using tactics right out of (former Bush political adviser) Karl Rove's playbook. This is wrong and every Democrat should be outraged," Clinton said.
Clinton's advisers have repeatedly criticized the Obama campaign's health care mailing, which says her plan for universal coverage would "force" everyone to purchase insurance even if they can't afford it. Her plan requires everyone to be covered, but it offers tax credits and other subsidies to make insurance more affordable.
Obama's plan does not include the so-called "individual mandate" for adults, and he has argued that people cannot be required to buy coverage if they can't afford it. He has said his first priority is bringing down costs.
The Illinois senator's plan does include a mandate requiring parents to buy health insurance to cover children.
Read the Obama campaign's health care mailing here.
The second mailing, on the North American Free Trade Agreement, quotes a 2006 Newsday article suggesting Clinton believed the agreement had been a "boon" to the economy. NAFTA and other trade agreements are extremely unpopular in Ohio, which has suffered an exodus of blue-collar jobs to other countries in part due to such agreements.
It's a particularly sensitive matter for Clinton, whose husband championed and pushed for passage of the agreement as president. She is counting on the support of white, working class voters in the state.
"I am fighting to change NAFTA," she insisted. "Neither of us were in the Senate when NAFTA passed. Neither voted one way or the other."
Clinton said Newsday had corrected the record about her views on the agreement. Indeed, the paper published a blog item earlier this month saying Obama's use of the word "boon" was unfair.
"Obama's use of the citation in this way does strike us as misleading. The quote marks make it look as if Hillary said "boon," not us. It's an example of the kind of slim reeds campaigns use to try to win an office."
Earlier, Newsday published an item saying the word "boon" had been their "characterization of how we best understood her position on NAFTA, based on a review of past stories and her public statements."
As evidence of their concern about the issue, the Clinton campaign released two new ads in Ohio, including one featuring John Glenn - a former astronaut and U.S. senator from Ohio for 24 years - saying Clinton would fix trade agreements like NAFTA.
Obama spokesman Bill Burton said the campaign stood by the accuracy of the mailings.
"We look forward to having a debate this Tuesday on the facts, and the facts are that Senator Clinton was a supporter of NAFTA and the China permanent trade treaties until this campaign began," he said. "And she herself has said that under the Clinton health care plan, she would consider 'going after the wages' of Americans."
Clinton also pushed back on questions about how her campaign had burned through nearly $130 million, only to be vastly outspent by Obama on ads and organization in several key states.
She also denied having overspent on campaign consultants. Financial reports published this week showed she had paid $7.5 million to the consulting firm of her senior strategist Mark Penn for polling and direct mail services. Clinton's top media adviser, Mandy Grunwald, was paid more than $2 million to produce ads.
"Our money goes to directly communicating with voters. That's where the money goes," Clinton said.
She added that she felt good about her prospects in Ohio and Texas but refused to say whether she needed to win both states to stay in the race.
"Let's let the people of Ohio vote. Let's actually have an election and then we can look at the results," she said.