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Damp-heat causing jaundice presents with sweating on the head only, difficulty in urination, thirst, and involves the Yangming (Yang Brightness) channel. If a patient has chronic cold-dampness, after sweating therapy, the jaundice transforms from the Yin aspect involving the Taiyin (Great Yin) channel. Yang jaundice has a bright color, while Yin jaundice has a dark color; Sunyang (Greater Yang) blood accumulation syndrome may also present with mania. For exterior excess type jaundice without sweat, Mahuang Lianqiao Xiaodou Tang (Ephedra, Forsythia, and Adzuki Bean Decoction) is indicated. For interior excess type jaundice with constipation, Yinchen Hao Tang (Artemisiae Scopariae Herba Decoction) and Zhizi Baipi Tang (Gardeniae Cortex Phellodendri Decoction) are used to clear heat. Yin jaundice is primarily treated with Yinchen Sini Tang (Artemisiae Scopariae and Aconite Root Decoction). For cases with loose stools and urinary retention/difficulty, Yichen Wuling San (Artemisiae Scopariae and Five-Ingredient Poria Powder) is used to promote diuresis. Blackening around the mouth accompanied by soft sweat (cold sweat) indicates a critical condition. A body dry and withered like being smoked by fire indicates extinction of Yang qi.

In Shanghan (Cold Damage), the appearance of macules and rashes results from improper use of sweating or purging methods, where external pathogens are trapped and internal heat erupts immediately upon infection, characteristic of epidemic Qi. When exterior pathogens oppress the Ying (Nutritive) and Wei (Defensive) levels, they manifest externally on the skin and vessels as sha (sand-like spots), zhen (rashes), and ban (macules). White sha resembles skin millet grains, while red zhen appears continuously like bean-sized spots. Red color indicates mild disease, crimson indicates severe disease, and black often indicates death; pale red and sparse/dark colors indicate Yin-cold patterns. If not yet fully erupted, Shengma Gegen Tang (Cimicifugae Rhizoma and Puerariae Radix Decoction) combined with Xiaodu Xijiao Yin (Detoxifying and Rhino Horn Decoction) is used. For high heat, Sanhuang Shigao Tang (Three-Yellow and Gypsum Decoction) is decocted. Once fully erupted, Qingdai Xiaoban Yin (Indigo Naturalis Macule-Clearing Decoction) is used for modification and clearing. The method for sha and zhen is consistent with the aforementioned Shuangjie San (Double-Resolving Powder).

[Note] The emergence of macules, rashes, and sha in Shanghan are all caused by inappropriate sweating or purging, leading to entrapment of external pathogens and eruption of internal heat. Only epidemic infections appear immediately upon contraction due to the fierce and rapid nature of the pathogen. Manifestation at the Wei level constitutes sha; since Wei governs Qi, the color is white like skin millet. Manifestation at the Ying level constitutes zhen and ban; since Ying governs Blood, superficial redness is zhen, and deep severity is ban. Ban shapes resemble beans, sometimes merging into large patches. Red color in macules/rashes is mild, crimson is severe, and black is fatal, determining prognosis based on the depth of heat. Pale red, sparse, and dark colors occur when pathogens remain in the Three Yang channels but have entered the interior forming macules/rashes, transforming via the Yin aspect, or resulting from excessive intake of cold medicines. This is termed Yin-macule, Yin-sha. Yin-rash should be treated according to Yin-cold principles. For incompletely erupted macules with mild exterior heat, Shengma Gegen Tang combined with Xiaodu Xijiao Yin is used. For severe exterior heat, Sanhuang Shigao Tang is used to disperse. For fully erupted cases, Qingdai Xiaoban Yin is used with modifications to clear. For early-stage sha and zhen with unclear exterior-interior status, Shuangjie San is used first to regulate both levels, followed by other methods as previously described.