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The emergence and disappearance of rashes are usually regulated by the twelve two-hour periods (Shichen). For instance, if they appear after the Zi hour (11 PM–1 AM) and recede by Wu hour (11 AM–1 PM), or appear by Wu hour and recede after Zi hour, this represents the natural numerical order of creation where Yang generates Yin to complete it, or Yin generates Yang to complete it. Cases where rashes emerge and recede immediately are mild; however, if rashes persist continuously for three to four days without receding, it indicates excessive Yang toxicity, which should be treated with Daqing Tang (Great Blue Decoction) or a formula primarily composed of Jingjie (Schizonepetae Herba), Niubangzi (Arctii Fructus), Gancao (Glycyrrhizae Radix et Rhizoma), Xuanshen (Scrophulariae Radix), Shigao (Gypsum Fibrosum), and Jiegeng (Platycodonis Radix). If rashes hesitate to emerge, it is due to Wind-Cold binding the exterior and closing the skin pores tightly; this should be treated with Jingfang Baidu San (Schizonepeta and Saposhnikovia Powder to Overcome Toxicity).

If rashes have emerged but then disappear again, it is caused by being forced inward by Wind-Cold. If not treated promptly, the toxin will attack internally, leading to rash collapse and death. Urgently use Shengma Tang (Cimicifugae Decoction) added with Jingjie, Niubangzi, and Gancao, taken hot; then the rashes will surely re-emerge and the patient will be safe.

After six or seven days of fever, if it is clearly a case of rash eruption but no rash appears, this must be because the skin is thick and tough with closed pores, or due to an invasion of Wind-Cold, or previous vomiting and diarrhea, all of which can cause the toxin to lie latent. Urgently use formulas that support the interior and release the exterior, such as Mahuang Tang (Ephedra Decoction) with Xingren (Prunus Armeniacae Semen) removed and Chanui (Bombyx Batryticatus) and Shengma added. Externally apply Huisu Jiu (Coriander Wine). If there has been no bowel movement for some time, the internal toxin is severe and lying latent; treat with Liangge San (Cooling the Diaphragm Powder) from *Ju Fang* added with Niubangzi.

The only concern with rashes is whether they can be fully expressed; once fully expressed, the toxin is resolved. Therefore, when treating rashes during fever, one must observe the seasonal climate’s cold or heat to adjust treatment accordingly. In cases of severe cold season patterns, use Guizhi Gegen Tang (Cinnamon Twig and Pueraria Decoction) or Mahuang Tang to induce sweating; in cases of severe heat season patterns, use Shengma Gegen Tang or combine Ren Shen Baihu Tang (Ginseng White Tiger Decoction) to induce sweating; in neutral conditions, use Jingfang Baidu San to induce sweating. If one dose fails to produce rashes, administer another dose of the same decoction. Externally apply Huisu Jiu, and rub the whole body with Ramie root dipped in wine, ensuring rapid emergence. If after three or four attempts the rashes still do not emerge, accompanied by abdominal distension, pain, panting, and drowsiness, it is a fatal sign.

Zhang Jingyue stated: "According to Wan Quan’s method, it excellently adapts to the times and fully embodies the principle of releasing the exterior. However, the meaning of 'releasing the exterior' is also the most difficult to master. For example, when Ying and Wei deficiency prevents rash emergence, there are many such syndromes. If one only knows how to release but does not know how to nourish, those with weak Ying and Wei will not only fail to express the rash but may also exhaust their source. This may involve the Spleen and Stomach or Qi and Blood; one must grasp its subtlety to achieve efficacy. This is also related to the three methods of releasing the exterior in Cold Damage."

Once the rash toxin is fully expressed, the pathogenic qi dissipates, and the healthy qi naturally returns to harmony. If there is fever with restlessness, vomiting, or diarrhea, it indicates that the toxic pathogen is obstructed and has not yet fully emerged. For restlessness and heat, use Huanglian Jiedu Tang (Coptis Decoction to Resolve Toxin); for vomiting and diarrhea, use Chaihu Jupi Tang (Bupleurum and Tangerine Peel Decoction). Apply Huisu Jiu and the Ramie rubbing method externally as described previously. Once the rashes are fully expressed, the restlessness and heat will naturally subside, and vomiting will stop.

If rashes have receded but residual toxins remain, causing them to reappear after three days, or recurring five or six times without cessation, this is because exposure to Wind-Cold during the febrile stage allowed pathogenic qi to stagnate between the muscles, lingering without dispersing. Although previously dispersed, the resolution was incomplete. If complicated by other syndromes, treat according to the specific presentation.