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Ban (macules/petechiae) occurs when intense heat injures the blood level. The heat fails to dissipate, resulting in interior excess and exterior deficiency, allowing the pathogenic heat to emerge through the skin due to this deficiency, forming macules. Mild cases resemble rashes, while severe cases resemble patterns on brocade. This may occur if the condition was originally yang-type but was mistakenly treated with hot medicines; or if sweating should have been induced but wasn't, or purgation should have been performed but wasn't; or if the disease persisted despite sweating or purgation therapies. There are two main syndromes: one is Wendu (Warm Toxicity), where cold was contracted in winter and manifests in spring; after failed sweating and purgation, the pathogen remains unresolved, causing macules. The other is Rebing (Heat Disease), caused by contracting miasmic pathogens during an unseasonably warm winter, which manifests upon encountering spring warmth. Sweating must be strictly avoided; inducing sweat will further open the pores and exacerbate the macular eruption. Initially, emerging macules resemble mosquito bites. Macules typically appear on the chest and abdomen, whereas mosquito bites are found only on the hands and feet. If the pulse is surging and large, the patient is confused and drowsy, and the spots turn from red to crimson, it is macules. If the pulse is not surging and large, the patient is calm, and the spots turn from red to yellow, it is merely a mosquito bite. If there is spontaneous diarrhea, shortness of breath, dry stool impaction, or black macules resembling fruit skins, even a master physician like Lu Yi would find it difficult to treat. Generally, if the disease persists after sweating or purgation, accompanied by cold feet, deafness, irritability, cough, and vomiting, these are signs of macule eruption. For Wendu with macules, accompanied by cough, chest oppression, diarrhea, vomiting, and sores in the lower body and mouth, use Huanglian Jupi Tang (Coptis and Tangerine Peel Decoction). For Yangdu (Yang Toxin), characterized by brocade-like macules, red face, sore throat, surging-large pulse, and unconsciousness, use Sanhuang Shigao Tang (Three Yellows and Gypsum Decoction); if there is dry stool and thirst, use Tiaowei Chengqi Tang (Regulate the Stomach and Guide Out Excess Powder) to purge. The general formula for macules is Shengma Xijiao Tang (Cimicifuga and Rhinoceros Horn Decoction); for cases with more heat, use Xuanshen Shengma Lianyi Wu Tang (Scrophularia, Cimicifuga, and Coptis Single-Ingredient Decoction).

Kuang (Mania) results from excessive Yang (Chong Yang), where deep-seated heat toxins merge into the Heart, causing the Shen (Spirit) to be unsettled and the will unstable. Initially, symptoms include little sleep, lack of appetite, delirious speech, and irrational laughter. In severe cases, patients climb high places singing, discard clothes and run, jump over walls and roofs, and curse others regardless of kinship. These are all due to hyperactive solitary Yang; without aggressive purgation, how can it be stopped? If mania arises because sweating was indicated but not performed, leading to stasis-heat in the interior and blood accumulation in the Lower Jiao (Lower Burner), the urine will be clear and frequent, stools dark/black. Although appearing manic at times, it has not reached full mania; treat with Tao Ren Chengqi Tang (Peach Kernel and Magnolia Bark Decoction). Chong Yang refers to Yangdu, presenting with surging-large pulse, red face, sore throat, tidal fever, brocade-like macules, or yellow-red diarrhea; treat with Yangdu Shengma Tang (Yang Toxin Cimicifuga Decoction). If ineffective, use Sanhuang Shigao Tang; if stools are hard, use Tiaowei Chengqi Tang to purge. If Taiyang Bing (Taiyang Disease) is unresolved and heat binds to the Bladder, causing mania-like symptoms followed by bleeding, the disease resolves. If exterior symptoms persist, administer Guizhi Tang (Cinnamon Twig Decoction). If exterior symptoms have resolved but there is only lower abdominal urgency and binding, a deep pulse, jaundice, dry lips with desire to rinse mouth but no swallow, and clear urination, this is also a blood syndrome. For mild mania, use Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction); for severe cases, use Tao Ren Chengqi Tang to purge. If there is delirious speech, fixed gaze, involuntary urination and defecation, or post-sweating intense heat, restless pulse, delirium, and inability to eat, these are critical and ominous signs.