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Maoles (Rash) favor coolness and dislike dampness, while smallpox favors warmth and dislikes cold; this is indeed their general principle. However, treatment must also be appropriate to the specific situation. For instance, when maoles first appear, a warm environment is required for them to emerge easily. Therefore, in the initial stage of eruption, as long as the rash toxins are fully expelled, the toxins will naturally resolve. This differs from smallpox, where the toxin resolves only after progressing through the stages of "bud" (papule), "flower" (vesicle/pustule), and "fruit" (crust). When smallpox matures, if it is too warm, it may instead become ulcerated and fail to heal, indicating that smallpox also favors coolness in its later stages. Thus, in treating both smallpox and maoles, one must avoid excessive heat and excessive cold, ensuring a balance of warmth and coolness so that Yin and Yang achieve harmony; this constitutes correct treatment.

Smallpox benefits from internal fullness and can use tonifying formulas; maoles contraindicate internal fullness and require only dispersing and resolving methods. Their approaches are only slightly similar during the initial fever stage when releasing the exterior. After eruption, smallpox should be treated by tonifying Qi to generate Blood, whereas maoles should be treated by nourishing Yin to restrain Yang. Why? Because intense heat from maoles boils the Yin aspect, leading to significant depletion of Blood, and Fire overacts on Metal (Lung). Therefore, treatment focuses primarily on clearing Heat and nourishing Yin, without disturbing Qi. Harsh and drying agents are deeply contraindicated from beginning to end. The world recognizes the severity of smallpox but fails to realize that maoles are even more lethal; medical texts often neglect this, which is truly lamentable.

The toxins of macules and rashes all originate from Fire. The *Neijing* states: "In the era of He Xi (intense heat), diseases manifest as sores and ulcers." Thus, when Shaoyin Ministerial Fire or Shaoyang Triple Burner Fire governs the year or season, or when the annual运气 (Yun) is Fire, Lung Metal is constrained, and most cases arise from pathogenic invasion. Mild cases present like mosquito bites or raised swellings in the skin, named *Yinzhen* (Urticaria/Hives). Severe cases present like red halos around pearl-like spots or patches resembling brocade patterns, named *Ban Zhen* (Macules and Papules/Rash). Generally, red color indicates a favorable prognosis, while black indicates an unfavorable one. These conditions resemble Typhoid Fever (Shanghan) with fever, typically erupting 3-4 days after onset and crusting over 7-8 days. All such cases belong to Pathogenic Heat; the treatment method is solely Acrid-Cool release and resolution. Even if vomiting and diarrhea occur, warm tonics must absolutely not be used; herbs like Cardamomi Fructus (Doukou) and Zingiberis Radix Preparata (Ganjiang) must never be lightly employed. During the initial eruption, profuse sweating is especially contraindicated; only mild diaphoretic formulas like Shengma Gegen Touxie Decoction should be used. Therefore, medication requires careful consideration and cannot be applied uniformly.

If the rash marks do not turn red, and fever worsens upon appearance, accompanied by headache, body pain, and irritability, use Shengma Tang or Touxie Jian.
If the rash is bright red and dense, accompanied by body pain and irritability, use Shengma Tang added with Arnebiae Radix seu Rhizoma (Zicao) and Forsythiae Fructus (Lianqiao).
If chills and fever occur simultaneously, accompanied by headache and stiffness of the neck and back, use Shengma Tang added with Notopterygii Rhizoma et Radix (Qianghuo), Saposhnikoviae Radix (Fangfeng), and Forsythiae Fructus (Lianqiao).
If there is swelling of the head, neck, and face, use Shengma Tang added with Armeniacae Semen Amarum (Niubangzi) and Schizonepetae Spica (Jingjie); if the pulse is strong, Fire is abundant, and thirst exists, clear and descend the Fire using Baihu Tang modified.
If there is spontaneous sweating, irritability, thirst, Qi stagnation, and a rapid pulse, use Huaban Tang.
If there is fever, irritability, thirst, and diarrhea, use Chai Ling Tang or Siling San; in summer, use Yiyuan San.
If the heat is severe, urine is red and difficult to pass, and there is delirium and fright, use Daochi San and Siling San added with Cinnabar (Chensha); in summer, use Yiyuan San added with Cinnabar (Chensha).
If cough is severe, use Ermu San, Maimendong Tang, or Qingfei Tang.
If there is wheezing/asthma, use Xiaochaihu Tang with Ginseng removed and Schisandrae Fructus (Wuweizi) added. (Note: Rash eruption is fundamentally not deficiency-type asthma; Wuweizi must absolutely not be added.)
If heat is severe causing epistaxis, hematochezia, or hematuria, use Huanglian Jiedu Tang; if bleeding is severe, use Xijiao Dihuang Tang.
If Shanghan causes vomiting, use Liujunzi Tang added with Agastachis Herba (Huoxiang) and Puerariae Radix (Gegen), or remove Ginseng; if heat causes vomiting, use Jiedu Tang; if urinary difficulty accompanies vomiting, use Siling San; if constipation persists for 1-2 days, use Daochi San.
If constipation, fever, and body pain exist, use Da Chaihu Tang; if abdominal distension and wheezing exist, use Qianhu Zhike Tang.
For throat discomfort, use Ganjie Tang; if accompanied by wind-heat cough, add Schizonepetae Spica (Jingjie).
For alternating chills and fever resembling malaria, use Xiaochaihu Tang; if accompanied by cough, remove Ginseng.
If fever persists after crusting falls off, use Shengma Tang; or remove Shengma and add Scutellariae Radix (Huangqin) and Coptidis Rhizoma (Huanglian), both stir-fried with wine.
For dysentery with red and white stool and abdominal pain, use Huangqin Shaoyao Tang, or add Zhiqi; for fever and abdominal pain, use Jiedu Tang.
If residual toxins remain and transform into carbuncles, sores, or boils, use Shengma Tang added with Schizonepetae Spica (Jingjie), Notopterygii Rhizoma et Radix (Qianghuo), Armeniacae Semen Amarum (Niubangzi), and Forsythiae Fructus (Lianqiao).

Zhang Jingyue stated: Regarding Wan's various detailed treatments for rash above, the conditions of diarrhea/dysentery and wheezing/asthma are the most prone to confusion. If these conditions stem from rash toxins, they should be treated accordingly. However, some are not caused by rash toxins. For example, quack doctors see a rash and indiscriminately use cold-cooling herbs, not knowing that some can be cooled and others cannot. Patients with weak Spleen Qi who have overused cold herbs, or those injured by eating raw/cold foods causing diarrhea, are common. Although triggered by the rash, this is actually not a disease of rash toxin. If no other heat signs or pulses are present, and pallor and weak Qi are observed, one must quickly rescue the Spleen and Kidney with urgent warming and tonification. Insisting that rash toxins cannot be warmed leads to danger; this is the fundamental knowledge physicians must possess. Similarly, regarding wheezing/asthma, there is great difference between excess and deficiency; nine out of ten cases are deficiency. If it is determined not to be a Fire condition nor external pathogen, but caused by severe purging or sweating leading to wheezing, this represents Qi collapse. Both cases require careful differentiation. Mistaking shortness of breath for wheezing/asthma is a grave error. Furthermore, the differentiation based on individual constitution and syndrome in the General Discussion of Smallpox applies equally to measles/rash; reference is advised. One must not assume all rash pathogens are Excess Fire, ignoring the harm of Deficiency Fire.

Xu Donggao stated: The saying "smallpox is difficult, rash is easy" is merely vulgar talk. In cases where Stomach Qi is originally weak, pathogenic invasion is deep, or eruption is hindered by diarrhea/dysentery, or the rash fails to fully emerge and repeatedly appears and disappears, pathogenic Qi gradually enters the Stomach, inevitably causing persistent diarrhea, recurrent eruption, and combined with wheezing/asthma, leading to critical danger. Such cases certainly cannot be called "easy." Therefore, whenever rash appears, if weakness is observed, tonify the Spleen and Stomach first. If the rash wants to emerge but cannot, urgently use interior-supporting and exterior-releasing methods to assist it. Purging (using downward-draining herbs) is contraindicated from start to finish, just as in smallpox treatment.