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(The *Neijing* states: When a disease originates from Yang, and purgation is mistakenly applied, heat enters and forms Jie Xiong (Chest Binding); when a disease originates from Yin, and purgation is mistakenly applied, Pi Syndrome (Glomus) forms. This is because the purgation was too early. Cheng Wuji's commentary stating "No fever and aversion to cold indicates origin from Yin" is incorrect. No fever and aversion to cold belong to Yin Syndromes; how could there be a rationale for mistaken purgation? Moreover, would it only result in Pi Syndrome? Zhang Zhongjing's reference to Yin and Yang here refers to Exterior and Interior. If the pathogen is in the Exterior, sweating should be induced, but purgation is mistakenly used, resulting in Jie Xiong; if the pathogen is in the Interior but has not yet entered the Fu organs, and purgation is prematurely applied, Pi Syndrome results.)

Jie Xiong presents with variations of Large/Small, Cold/Heat, and Water, Blood, Food, and Phlegm types. Pi Syndrome involves shallower transmission, characterized merely by Qi stagnation. If no purgation has been performed, it is not termed Jie Xiong; if caused by Phlegm, Food, or Heat, treatment follows symptoms, and there is no pain upon palpation.

Severe pain upon deep palpation indicates Large Jie Xiong. (*Da Xian Xiong Tang*)
Pain only upon light palpation indicates Small Jie Xiong. (*Xiao Xian Xiong Tang*)
Accompanied by irritability, thirst, and constipation indicates Heat Jie Xiong. (*Da Xian Xiong Tang* plus *Huang Lian*)
Absence of fever/thirst and clear, copious urine indicates Cold Jie Xiong. (*Zhi Shi Li Zhong Tang*)
Palpitations, sweating on the head, absence of high fever, and gurgling sounds upon abdominal rubbing indicate Water Jie Xiong. (*Ban Xia Fu Ling Tang*)
Chest fullness and pain, rinsing mouth without swallowing, forgetfulness resembling mania, black stools, and free urination indicate Blood Jie Xiong. (*Xi Jiao Di Huang Tang*)
Slippery pulse, asthma, and cough indicate Phlegm Jie Xiong. (*Huang Qin Ban Xia Sheng Jiang Tang* plus *Zhi Shi*)
Large pulse at the Qi Kou (Cun Kou) position indicates Food Jie Xiong. (*Xiao Xian Xiong Tang* plus *Zhi Shi* and *Hou Po*)

Jie Xiong accompanied by macules, jaundice, mania, and hiccups is the most severe. A sunken, small pulse indicates death. Jie Xiong symptoms present with severe restlessness indicates death.

Pi Syndrome resulting from mistaken purgation requires waiting for Exterior symptoms to resolve before applying purgation. (*Chai Hu Zhi Jie Tang*)
Aversion to cold, sweating, and epigastric fullness indicate Pi with Cold-Excess. (*Fu Zi Xie Xin Tang*)
Unresolved Exterior symptoms with epigastric fullness constitute Zhi Jie (Branch Binding). (*Chai Hu Gui Zhi Tang*)
High heat with Pi indicates Heat Pi. (*Da Huang Huang Lian Xie Xin Tang*)
More cold than heat indicates Cold-Heat Complex Pi. (*Ban Xia Xie Xin Tang*)

(Fa Ban [Eruption of Macules] is due to heat-toxin in the Stomach Meridian. Purgation too early allows heat to enter the Stomach vacuity, causing Fa Ban; purgation too late leaves heat stagnant in the Middle, also causing Fa Ban. The Stomach governs muscles/skin, so eruptions rise slightly under the skin without distinct pustules. Small ones are sesame-sized, large ones are like Euryale seeds. Mild cases resemble scattered stars; severe cases resemble brocade patterns. Bright red indicates Stomach Heat, easy to treat; purple-black indicates extreme Heat, difficult to treat; black indicates Rotting Stomach, invariably fatal. There are six types of Fa Ban: 1. Shang Han Fa Ban, 2. Shi Qi Fa Ban, 3. Wen Du Fa Ban, 4. Yang Du Fa Ban, 5. Nei Shang Han Fa Ban, 6. Yin Zheng Fa Ban. Additionally, Zhen [Rash] resembles Ban but belongs to the Lung system, as the Lung governs skin/hair, presenting with pointed papules. Only Yin Zhen resembles brocade patterns without papules, making it hard to distinguish. However, Zhen is a Lung disorder, necessarily accompanied by nasal congestion, runny nose, cough, and heavy voice. Zhen pulses are typically floating and large; Ban pulses are typically surging and rapid. Zhen often appears at the beginning of illness; Ban often appears at the end. They differ naturally. Occasionally, Shi Qi causes Fa Ban from onset, requiring careful clinical observation. Alas, the eruption of Ban determines life or death instantly. I have studied this deeply and claim unique insights, hence the detailed discussion below.)

1. Shang Han Fa Ban. Indicated sweating but not done, indicated purgation but not done, or premature purgation leads to heat accumulation in the Stomach and Fa Ban. Warm body, warm feet, surging-rapid-forceful pulse indicates easy treatment. Sunken pulse, cold feet, deficiency-complex indicates difficult treatment. Before eruption, use *Sheng Ma Ge Gen Tang* to vent. Purple-black color, add *Zi Cao Rong*. Deficient pulse, add *Ren Shen*. After eruption, do not re-sweat to avoid damaging Qi. Irritability, thirst, intense heat, surging-rapid pulse, use *Xi Jiao Da Qing Tang*. Delirium, hard stool, use *Da Chai Hu Tang* plus *Mang Xiao*. *Ma Huang* promotes sweating and worsens macule rot; *Cheng Qi* formulas purge interior and cause internal collapse. Thus, ancient texts strictly forbid them. *Da Qing* is essential for resolving macules; substitute with *Da Lan Ye* if unavailable. Avoid fragrant/foul odors during eruption, similar to smallpox. Do not use cold-cooling agents or eat raw/cold food during pre-eruption or eruption phases to prevent freezing toxins and hindering venting. For deficiency-complex, tonify True Qi first; failure to tonify due to rigidity often leads to untreatable conditions.

2. Shi Qi Fa Ban. Caused by irregular Qi of four seasons, leading to chills, fever, stiffness, vomiting, irritability, headache, dry nose, insomnia—these are prodromal signs of Fa Ban. Bright red and sparse is auspicious; purple-black and dense is ominous. Severe cases erupt after 2-3 days of fever; mild cases after 3-4 days. Assess Yuan Qi deficiency/excess via pulse strength. For deficiency, first use *Shen Hu San Bai Tang* to support Yuan Qi. For non-penetrating eruption, use *Sheng Ma Ge Gen Tang*; add *Zi Cao* for high heat. For dense eruption with sore throat, use *Gan Cao*, *Jie Geng*, *Xuan Shen*, *Zhi Mu*, *Sheng Ma*, *Xi Jiao*, *Huang Lian*. For post-eruption vomiting, use *Chen Pi*, *Ban Xia*, *Fu Ling*, *Huang Lian*, *Gan Cao*, *Sheng Jiang*.

3. Wen Du Fa Ban. Caused by Spring Warmth pathogens, or Winter Cold pathogens manifesting in Spring, or abnormal warmth in Winter. Treatment principles largely mirror Shang Han, though Winter Cold implies closure while Spring Warmth implies dispersal, showing slight differences. Pre-eruption with cough, chest oppression, vomiting: *Ge Gen Ju Pi Tang*. Post-eruption: Use *Hei Gao* or dissolve *Xi Jiao Da Qing Tang*. Pathogens contracted in Spring, manifesting in Summer follow this pattern.

4. Yang Du Fa Ban. High fever, delirium, red eyes, black nose, pre-eruption macules. Cool to resolve. (*Ge Gen*, *Sheng Ma*, *Zi Cao*, *Da Qing*, *Chen Pi*, *Gan Cao*). Purple-black, irritability, thirst: *San Huang Shi Gao Tang* plus *Xi Jiao*, *Da Qing*. Yang Du Fa Ban forming abscesses: Apply honey-fried *Sheng Ma*.

5. Nei Shang Han Fa Ban. Excessive cooling and cold food intake in summer causes internal/external cold, forcing Summer Heat Fire to float outward, causing Fa Ban. Few spots, no high fever, sunken-sluggish pulse. (*Tiao Zhong Tang* minus *Ma Huang*, *Gui Zhi*; plus *Hou Po*, *Gan Jiang*, *Xiang Ru*, *Bian Dou*).

6. Yin Zheng Fa Ban. Resembles mosquito bites or flea marks, more on limbs than trunk/back, pale red turning slightly yellow over time. Patient is quiet, pulse is weak. Heat torments Lung/Stomach, transmitting to skin. (*Sheng Ma*, *Huo Xiang*, *Chen Pi*, *Gan Cao*, *Ren Shen*, *Shu Fu Zi*, *Sheng Jiang*). Warming and tonifying agents restore Yang, causing Yin Fire to subside. This treats the root, not the branch. However, once the foundation is shaken, prognosis is poor. Only experienced physicians can save 40-50%. Physicians and families must not neglect this condition.