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In Taiyang disease (Disease of the Taiyang Channel), facial redness may be attributed to either exterior heat or interior heat, but it predominantly stems from exterior syndromes. Consequently, the patient presents with fever and scanty sweating, with floating and rapid pulses throughout all six positions; treatment via diaphoresis (inducing sweating) leads to resolution. If Taiyang symptoms are present with anhidrosis (absence of sweating) and a floating-tight pulse, Jiajian Qianghuo Tang (Modified Notopterygium Decoction) is indicated. If there is sweating and a floating-slow pulse, Jiajian Fangfeng Tang (Modified Saposhnikovia Decoction) is used. For Yangming disease (Disease of the Yangming Channel) presenting with anhidrosis, fever, and a floating-tight pulse, Gegen Tang (Pueraria Decoction) is prescribed. If there is sweating and a surging-long pulse, Gange Shigao Tang (Kudzu and Gypsum Decoction) is employed. In Shaoyang disease (Disease of the Shaoyang Channel), if there is anhidrosis, aversion to cold, and a floating-tight pulse, Qianghuo Chaihu Tang (Notopterygium and Bupleurum Decoction) is used; if there is sweating and a wiry pulse, Xiaochaihu Tang (Minor Bupleurum Decoction) is indicated.

If facial redness results from interior heat, accompanied by profuse sweating, absence of aversion to cold, thirst with desire to drink, and deep-rapid pulses, Zhimu Shigao Tang (Anemarrhena and Gypsum Decoction) or Liangge San (Cooling the Diaphragm Powder) should be administered. In cases of Yangming interior heat with facial redness and constipation, Jiuhuang Dahuang (Wine-processed Rhizoma Rhei Preparatio) is added to Liangge San to clear heat from the blood level. Failure to use Dahuang promptly may lead to epistaxis (nosebleed). For Wind-Warmth syndromes characterized by sweating, fever, and facial redness, Fangfeng Gange Shigao Tang (Saposhnikovia, Kudzu, and Gypsum Decoction) is appropriate. If the onset lacks fever, thirst, or dry lips, yet features a deep-slow pulse and facial redness, this indicates "Yin extremity causing restlessness" (Ji Yin Fa Zao); in such cases, Sini Tang (Frigid Extremities Decoction) is separately prescribed.

When Taiyang disease persists for eight or nine days, resembling malaria with alternating fever and chills where heat predominates over cold, and without vomiting or loose stools, spontaneous recovery is likely. If episodes occur two or three times daily and the pulse becomes slightly slow, healing is imminent. A faint pulse with aversion to cold indicates deficiency of both Yin and Yang; diaphoresis, purgation, or emesis must be avoided. Facial flushing with heat suggests the pathogen has not yet resolved due to the inability to produce slight sweating, resulting in pruritus; Guizhi Mahuang Ge Ban Tang (Combined Decoction of Cinnamon Twig and Ephedra in Half Dosage) is suitable.

This section addresses facial redness and heat caused by exterior pathogens, detailing symptoms similar to malaria.

Furthermore, in Taiyang disease, a floating-slow pulse with facial heat/redness and tremors indicates that after six to seven days, sweating should occur leading to resolution. If fever persists instead, the condition improves. A slow pulse signifies deficient Yang, preventing sweating and causing pruritus.

Because Yang Qi is weak and unable to generate sweat, facial heat and redness occur. By the sixth or seventh day, when sweating should occur, tremors indicate impending resolution through sweating. Fever implies the restoration of Yang Qi and recovery. However, if the slow pulse reflects deficient Yang, preventing the trembling and febrile response necessary for sweating, pruritus will persist.

In Yangming disease, facial redness contraindicates purgation. Misapplication of purgatives will inevitably cause fever, jaundice (yellow discoloration), and dysuria (difficult urination).

Facial redness is a sign that the exterior pathogen seeks to resolve through sweating. Erroneous purgation prevents the dispersion of exterior heat. Heat stagnating upward steams yellow color onto the skin; heat stagnating downward binds in the Bladder, causing dysuria. Although no specific formula is listed here, given it is Yangming disease, Fangfeng Gange Tang (Saposhnikovia and Kudzu Decoction) should be used to resolve exterior heat-induced jaundice. Given dysuria, Zhuling Tang (Polyporus Decoction) should be used to separate and drain damp-heat from the Lower Jiao.

The Chapter on Combined Diseases states: In combined diseases of two Yang channels, if Taiyang disease was initially treated with incomplete sweating, the pathogen transfers to Yangming, manifesting as continuous mild sweating and absence of aversion to cold. If Taiyang symptoms remain unresolved, purgation is contraindicated as it constitutes adverse treatment; instead, mild diaphoresis is indicated. If the face shows persistent bright redness, this indicates Yang Qi constrained in the exterior; treatment should involve resolving the exterior through fumigation. If sweating was insufficient, leading to constrained Yang Qi unable to vent, and the patient fails to sweat despite the need, they will experience irritability, unknown pain locations shifting between abdomen and limbs, shortness of breath, and restlessness. This is solely due to incomplete sweating; repeating diaphoresis will cure the condition. How is incomplete sweating diagnosed? Through a choppy pulse.

Initially, during Taiyang disease, incomplete sweating causes transfer to Yangming. Although termed combined disease, it involves pathogen transmission. Purgation is only permissible after complete resolution of exterior pathogens. If Taiyang symptoms persist, purgation is adverse; mild diaphoresis remains an option. Persistent facial redness indicates unexpelled pathogen due to failed sweating; this requires urgent exterior-resolving medication and herbal steam therapy. If initial sweating was inadequate, causing speech difficulties, this reflects unvented Yang pathogen, leading to irritability, groaning, shifting pain sensations, panting, and shortness of breath. Resolution comes from inducing proper sweating. Diagnosis of incomplete sweating relies on a choppy, blurred pulse indicating unexpressed exterior pathogens.

In Shaoyin disease, diarrhea with undigested food, interior cold with exterior heat, cold extremities, and faint-to-absent pulses, yet without aversion to cold and with facial redness, possibly accompanied by abdominal pain, dry retching, sore throat, or cessation of diarrhea with absent pulse, is treated with Tongmai Sini Tang (Pulse-Restoring Frigid Extremities Decoction). Recovery occurs if the pulse reappears.

In Jueyin diarrhea with deep-slow pulses, slight facial redness, mild fever, and diarrhea with undigested food, the patient will experience mental cloudiness followed by sweating and resolution, accompanied by slight cold extremities. This occurs because the patient exhibits "floating Yang on the face" (Dai Yang) with lower deficiency. Additionally, in diarrhea with undigested food, interior cold with exterior heat, sweating, and cold extremities, Tongmai Sini Tang is indicated.

Both preceding cases describe facial redness in Yin syndromes mimicking Yang, hence both utilize Sini Tang.

The *Jin Gui Yao Lue* states: When a patient presents with body heat, cold feet, neck stiffness, aversion to cold, intermittent head heat, facial redness, eye redness, isolated head tremor, sudden lockjaw, and opisthotonos (backward arching of the back), this is Spasm Disease (Jing Bing). Inducing sweating in such cases combines cold and dampness, further depleting the exterior, exacerbating aversion to cold. Post-sweating, the pulse becomes winding like a snake.

This describes facial redness in Spasm Disease. Zhang Zhongjing attributes Spasm Disease primarily to Blood deficiency and fluid dryness; thus, even with body heat, cold feet, neck stiffness, aversion to cold, and facial redness, diaphoresis is strictly prohibited. Refer to Jiajian Qianghuo Tang for Spasm Disease modifications.

Herbs: Qianghuo (Rhizoma Notopterygii), Duhuo (Radix Angelicae Pubescentis), Fangfeng (Radix Saposhnikoviae), Jingjie (Cacumen Schizonepetae), Chaihu (Radix Bupleuri), Gange (Radix Puerariae Lobatae), Guangpi (Pericarpium Citri Reticulatae), Gancao (Radix Glycyrrhizae).

Reddish complexion with exterior heat indicates a state desiring sweating, accompanied by floating-large-rapid-tight exterior pulses; thus, this formula is used.

Jiajian Fangfeng Tang (Modified Saposhnikovia Decoction) - See Headache.
Indicated for facial redness, spontaneous sweating, persistent fever, and floating-slow pulses.

Gegen Tang (Pueraria Decoction) - See Aversion to Cold.
Although Ma Huang Tang and Guizhi Tang are contraindicated in Yangming disease, this formula is used here due to anhidrosis and floating-tight pulses, representing a method for winter in northern regions.

Gange Shigao Tang (Kudzu and Gypsum Decoction) - See Alternating Fever and Chills.
For Yangming facial redness: if anhidrous with floating-tight pulse, use Gange Tang; if sudorous with surging-long pulse, use this formula.

Chaihu Qianghuo Tang (Bupleurum and Notopterygium Decoction) - i.e., Xiaochaihu Tang plus Qianghuo.
Facial redness occurs not only in Taiyang and Yangming but also when Shaoyang exterior pathogens remain unresolved; thus, Chaihu Tang is modified with Qianghuo and Fangfeng.

Xiaochaihu Tang (Minor Bupleurum Decoction) - See Alternating Fever and Chills.
The previous formulas treat Shaoyang-Taiyang exterior pathogens; this formula treats Shaoyang conditions involving both exterior and interior aspects.

Zhimu Shigao Tang (Anemarrhena and Gypsum Decoction)
Herbs: Zhimu (Rhizoma Anemarrhenae), Shigao (Gypsum Fibrosum), Mendong (Tuber Ophiopogonis), Zhuye (Folium Bambusae), Jingsmi (Seminis Orizae).
Zhang Zhongjing generally treats facial redness as exterior pathogen-related. However, Yangming interior heat rushing upward to the head and face, causing profuse sweating, thirst, and redness, is treated with this formula.

Liangge San (Cooling the Diaphragm Powder) - See Mania.
For Yangming interior heat with thirst and drinking water causing facial redness, use Zhimu Shigao Tang. If Stomach heat rushes upward affecting Lung Metal, use this formula. For hard stool, add Xuanmingfen (Mirabilite). For abdominal distension and constipation with purgative indications, use Dachengqi Tang (Major Order the Qi Decoction) or Xiaochengqi Tang (Minor Order the Qi Decoction).

Fangfeng Shigao Tang (Saposhnikovia and Gypsum Decoction) - i.e., Gange Shigao Tang plus Fangfeng.
Used for Yangming wind-heat causing facial redness.

Sini Tang (Frigid Extremities Decoction) - See Body Pain.
While reddish complexion usually indicates Yang pathogen, in Yin syndromes, it can result from floating deficient Yang; thus, this formula is used.