凡斑既出，须得脉洪数有力，身温足温者易治。若脉沉小，足冷元气虚弱者难治。
发斑红赤为胃热，若紫不赤为热甚，紫黑为胃烂，故赤斑半生半死，黑斑者九死一生。大抵鲜红起发稀朗
者吉，紫黑者难治，杂黑斑烂者死也。
凡斑欲出未出之际，且与升麻汤先透其毒。脉虚加人参，食少而大便不实加白术。
斑见已出，不宜再发也。斑不可汗，斑烂不宜下。如脉洪数，热甚烦渴者，人参化斑汤，若消斑毒，犀角
玄参汤。
凡发斑疹，先将红纸点灯照看病患面部、胸膛、背上、四肢，有红点起者，乃发斑也。若大红点发于皮肤
之上谓之斑；小红靥行于皮肤不出起者谓之疹。盖疹轻而斑重也。先将姜汁喷于斑上，以后照阴阳虚实寒热而
用药。
凡丹疹皆是恶毒热血蕴蓄于命门，遇君相二火合起即发也。如遇热时，以防风通圣散辛凉之剂解之；寒月
以升麻葛根汤等辛温之剂解之。凡丹疹先从四肢起而后入腹者死。
发斑者，热毒蕴于胸中也。
升麻汤 治阳毒赤斑，出狂言吐脓血。
升麻（二钱） 犀角屑 射干 人参 生甘草（各一钱）
上锉一剂，水二盏，煎至一盏，去渣，温服。
人参化斑汤
人参（一钱） 石膏（二钱） 知母（三钱） 甘草（五分） 粳米（一撮）
上锉一剂，水煎服。斑盛加大青。
犀角玄参汤
犀角（一钱） 升麻（二钱） 香附（一钱） 黄芩（一钱半） 人参（五分） 玄参（一钱） 甘草
（三分）
上锉一剂，加大青，水煎服。
隐疹者，红点如蚤螫之状也。防风通圣散。（方见中风。）
升麻葛根汤
升麻（二钱） 葛根（二钱） 芍药（二钱） 甘草（三分）
上锉一剂，水煎服。
犀角消毒汤
牛蒡子 荆芥穗 防风 甘草 犀角（一钱半，镑为细末，不入汤煎。）
上锉一剂，水二盏，煎至一盏，调犀角末服。
Whenever macules and papules have erupted, the prognosis is favorable if the pulse is surging, rapid, and forceful, and the body and feet are warm. If the pulse is deep and fine, the feet are cold, and the primordial Qi is deficient, the prognosis is poor.
Red macules indicate stomach heat; purple but not red indicates extreme heat; purple-black indicates rotting of the stomach. Therefore, patients with red macules have a fifty-fifty chance of survival, while those with black macules have nine chances of death and one of life. Generally speaking, macules that are bright red, raised, and sparsely distributed are auspicious (good prognosis); those that are purple-black are difficult to treat; those mixed with black spots and ulcerated will result in death.
When macules and papules are about to erupt but have not yet appeared, administer Shengma Tang (Cimicifugae Decoction) first to vent the toxicity. If the pulse is deficient, add Renshen (Ginseng Radix et Rhizoma); if appetite is poor and stools are loose, add Baizhu (Atractylodis Macrocephalae Rhizoma).
Once macules have appeared, sweating methods should not be used again. Macules cannot be treated by inducing sweat; ulcerated macules should not be treated by purgation. If the pulse is surging and rapid, with extreme heat, irritability, and thirst, use Renshen Huaban Tang (Ginseng Macule-Resolving Decoction); to eliminate macule toxins, use Xijiao Xuanshen Tang (Rhinoceros Horn and Scrophulariae Decoction).
Regarding the eruption of macules and papules, first illuminate the patient's face, chest, back, and limbs with a lamp lit by red paper. If red spots appear raised, it is macules. Large red spots on the skin surface are called "ban" (macules); small red spots hidden within the skin without rising are called "zhen" (papules). Generally, zhen is mild and ban is severe. First, spray ginger juice onto the macules, then prescribe medication according to Yin-Yang, deficiency-excess, and cold-heat patterns.
Dan zhen (erysipelas-like rashes) are caused by malignant toxic hot blood accumulating in the Mingmen (Gate of Life), which erupts when the Ministerial Fire and Sovereign Fire combine. In hot weather, resolve it with Fangfeng Tongsheng San (Saposhnikovia Universal Release Powder), a pungent-cool formula; in cold months, resolve it with Shengma Gegen Tang (Cimicifugae and Puerariae Decoction), a pungent-warm formula. If Dan zhen starts from the four limbs and then enters the abdomen, the prognosis is fatal.
The cause of macules is heat-toxin accumulating in the chest.
Shengma Tang: Treats Yang Du (Yang Toxin) causing red macules, accompanied by delirious speech and vomiting of pus and blood.
Ingredients: Shengma (2 qian), Xijiao xie (Rhinoceros Horn shavings), Shegan (Belamcandae Rhizoma), Renshen (Ginseng Radix et Rhizoma), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma) (each 1 qian).
Preparation: Decoct all ingredients as one dose in two cups of water until one cup remains, strain, and take warm.
Renshen Huaban Tang
Ingredients: Renshen (1 qian), Shigao (Gypsum Fibrosum, 2 qian), Zhimu (Anemarrhenae Rhizoma, 3 qian), Gancao (Licorice Root, 0.5 qian), Jingsmi (Glutinous Rice, a pinch).
Preparation: Decoct as one dose in water. Add Daqingye (Isatidis Folium) if macules are severe.
Xijiao Xuanshen Tang
Ingredients: Xijiao (1 qian), Shengma (2 qian), Xiangfu (Cyperi Rhizoma, 1 qian), Huangqin (Scutellariae Radix, 1.5 qian), Renshen (0.5 qian), Xuanshen (Scrophulariae Radix, 1 qian), Gancao (Licorice Root, 0.3 qian).
Preparation: Decoct all ingredients as one dose with Daqingye in water.
Yin zhen: Symptoms present as red spots resembling flea bites. Use Fangfeng Tongsheng San. (Formula see Stroke chapter.)
Shengma Gegen Tang
Ingredients: Shengma (2 qian), Gegen (Puerariae Lobatae Radix, 2 qian), Shaoyao (Paeoniae Radix, 2 qian), Gancao (Licorice Root, 0.3 qian).
Preparation: Decoct as one dose in water.
Xijiao Xiaodu Tang
Ingredients: Niubangzi (Arctii Fructus), Jingjie sui (Schizonepetae Spica), Fangfeng (Saposhnikoviae Radix), Gancao (Licorice Root), Xijiao (1.5 qian, pounded into fine powder, not decocted with the soup).
Preparation: Decoct all other ingredients as one dose in two cups of water until one cup remains, mix with the Xijiao powder, and take.