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Whenever a rash erupts, from the onset of fever until the eruption subsides completely, if the pulse at the right Cun (inch) position is found to be surging (Hong), large, and forceful, even if other symptoms are present, they will not cause harm. This is the critical method for determining life and death.

Zhang Jingyue stated: According to this principle, it means that a Yang syndrome presents with a Yang pulse; if the pulse is fine (Xi) and soft (Ruan) without strength, it indicates that a Yang syndrome presents with a Yin pulse. Since the Yuan Qi (Original Qi) is already weak, how can it overcome this pathogenic toxin? This forms the basis of safety or danger. Therefore, whenever a Yin pulse is diagnosed, one should identify it as a Yin syndrome and urgently rescue the Shen Yuan (Spiritual Root). It is appropriate to employ warming and tonifying methods to support the interior (Tuo Fa) used in Shanghan (Cold Damage) treatment, adjusting according to circumstances. If one stubbornly regards measles as a Yang toxin and indiscriminately uses cold-natured clearing herbs, adverse consequences are inevitable.

Although rashes differ from smallpox, they also arise from fetal toxins accumulating in the Spleen and Lung, thus manifesting between the skin, hair follicles, muscles, and flesh. However, due to transient contagion, where sizes appear similar, none do not originate from epidemic pestilential qi (Tian Xing Li Qi); this is their source. Although the origin is internal, the manifestations mostly belong to the Exterior level; thus, the internal fetal toxin is similar to that of smallpox. The external presence of exterior pathogens resembles Shanghan. The toxicity generally stems from the blazing of Ministerial Fire (Xiang Huo) and Sovereign Fire (Jun Huo affecting the Taiyin channel), causing injury to the Spleen and Lung. Consequently, symptoms include coughing, sneezing, facial swelling, redness of the cheeks, edema of the eyelids, watery eyes, clear nasal discharge, yawning, mental fatigue, alternating chills and fever, slightly cold hands and feet, night-time sleep disturbances with palpitations or fright, nausea, vomiting, or retching, or rubbing the face, lips, and nose with hands. These are the signs of an erupting rash. At this stage, it is timely to use herbs that resolve toxicity and disperse pathogens to vent the evil outward, preventing stagnation within, thereby avoiding further complications. However, for all rash syndromes, there must be facial redness, coldness of the middle finger, and frequent coughing. Furthermore, high fever must persist for five to six days before red spots appear all over the body. This distinguishes them from smallpox and Shanghan.

For smallpox, the goal is complete eruption without residual pathogens; for rashes, the goal is complete emergence so that no disease remains. If pathogenic qi is constrained and obstructed, it stays and does not depart; if healthy Qi is damaged, it becomes exhausted and fails to expand. When toxins return to the Five Zang organs, four types of transformations occur: returning to the Spleen causes incessant diarrhea; returning to the Heart causes persistent irritability and heat with convulsions; returning to the Lung causes coughing with hemoptysis; returning to the Kidney causes rotting gums and gan erosion (nutritional deficiency ulcers).

Master Cheng stated: Measles in the initial stage resemble wind-cold damage, presenting with headache, cough, and severe heat, red eyes, and red cheeks. If eruptions appear within one or two days, the condition is mild; exterior resolution is necessary. One must avoid exposure to wind and cold, as well as rich meat and strong-flavored foods. Violating these precautions may generate phlegm-saliva, transforming into convulsions, leading to critical danger. If vomiting and diarrhea occur simultaneously at the onset, it is a favorable (Shun) pattern; dry vomiting resembling cholera is an unfavorable (Ni) pattern; failure to erupt indicates imminent peril and death.

Zhang Jingyue stated: There are four categories under the umbrella of Dou Zhen (Smallpox and Rashes): namely, Dou (Smallpox), Zhen (Rash), Ma (Measles), and Ban (Macules). Smallpox erupts successively and gradually, growing from small to large, varying in density, with distinguishable locations and granules. Rashes erupt all at once; those large are like Perilla seeds (Su Zi), medium-sized like mustard seeds (Jie Zi), and small like silkworm eggs (Can Zi), forming granular patches. Measles are the finest, fragmented like mosquito bites, appearing blurred. Macules have no granules, appearing only as patches of red-purple resembling clouds or brocade. Generally, rashes and measles/macules are of the same category, belonging to the type of macule-emitting Shanghan. Smallpox, however, belongs to a different category. The toxin of smallpox originates from the Liver and Kidney, emerging from the Middle and Lower Jiao; therefore, digestion is never fundamentally impaired throughout the course, relying entirely on grain and water essence. Thus, ability to eat is auspicious, inability to eat is ominous. Hence, treating smallpox requires attending to the Spleen and Stomach.

The toxin of measles arises from unresolved exterior pathogens invading internally the Taiyin and Yangming channels, affecting the Upper and Middle Jiao; consequently, patients often lose appetite. Therefore, treating measles requires only dispersing fire pathogens; once the pathogen disperses, appetite returns naturally. Thus, the treatment of smallpox and rashes has distinct emphases as described above.