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In children, macules that are swollen and raised on the exterior belong to Shaoyang Xianghuo (Ministerial Fire of Shaoyang), and are called "ban" (macules). Red spots that remain within the skin without protruding belong to Shaoyin Junhuo (Monarchial Fire of Shaoyin), and are called "zhen" (papules/rash).

These conditions differ in terms of Yin/Yang and severity. For Yang ban, treatment involves supporting the interior, clearing heat, resolving macules, and cooling blood; this is an urgent treatment of the branch (symptoms). For Yin zhen, treatment involves regulating the middle jiao and warming the stomach, causing the rash to subside naturally; this is treating the root when the condition is not acute. Generally, there are more herbs for stabilizing the interior than for releasing the exterior, and purgative methods should never be used recklessly from beginning to end.

Yang toxin macules may appear on the face, back, or limbs, being extremely dense with patterns resembling brocade. Reddish color indicates Stomach Heat. Purple-black color indicates rotting of the Stomach tissue. This occurs either because purgatives were administered too early, allowing heat to enter the Stomach via deficiency, or because purgatives were administered too late, preventing Stomach Heat from venting. One should administer Xiaoban Qingdai Yin (Macule-Resolving Indigo Decoction).

Yin zhen may appear on the chest, back, hands, and feet, being sparse and small. This results from uncontrolled fire accumulating in the chest, steaming upward into the Lungs, and transmitting to the skin, forming spots resembling bites from mosquitoes, midges, fleas, or lice, rather than the dense brocade-like pattern. Lizhong Tang (Regulate the Middle Decoction) is suitable for primary treatment; the fire will naturally descend, and the spots will recede.

If macules and rashes are accompanied by spontaneous vomiting and diarrhea, do not treat them recklessly. Since the toxic qi is exiting through both upper and lower orifices, it is appropriate to regulate the Qi of the middle jiao. If, after vomiting and diarrhea, the entire body breaks out in macules resembling brocade, this indicates heat entering the Stomach via deficiency. Such symptoms often occur in summer and are primarily treated with Huaban Tang (Resolve Macules Decoction).

Huaban Tang Composition: Huanglian (Coptidis Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), Chaihu (Bupleuri Radix), Shanzhiren (Gardeniae Semen), Xuanshen (Scrophulariae Radix), Shengma (Cimicifugae Rhizoma), Shengdi (Rehmanniae Radix), Huangqin (Scutellariae Radix), Renshen (Ginseng Radix), Qingdai (Indigo Naturalis). Use three slices of Shengjiang (Zingiberis Rhizoma Recens) and twenty grains of Douchi (Sojae Semen Praeparatum) as guides.

Another formulation: Cangzhu (Atractylodis Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Sharen (Amomi Fructus), Baishao (Paeoniae Radix Alba, stir-fried), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Huoxiangye (Agastaches Herba), Jiegeng (Platycodonis Radix), Banxia (Pinelliae Rhizoma), Baizhi (Angelicae Dahuricae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Zhike (Aurantii Fructus Immaturus), Chuanxiong (Ligustici Chuanxiong Rhizoma). Use three slices of Shengjiang (Zingiberis Rhizoma Recens) as a guide.

Another formulation: Renshen (Ginseng Radix), Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Shuizhuye (Phyllostachys Viridis Folium). Use Jingmi (Oryza Sativa Germen) as a guide.

If the macules are red, they are easy to treat; if black, they are difficult to treat.

Children's yinzhen (urticaria/pruritic rash) mostly belongs to the Spleen, as it appears faintly between the skin layers and is often pruritic. If it is not red, it is formed by the combination of Wind and Dampness. It can be treated with Jiawei Qianghuo San (Modified Notopterygium Powder) or Jiajian Gongdu San (Modified Toxin-Attacking Powder), which is also effective.