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The body appears red as if coated with cinnabar, and the eyes burn like fire. When macules (skin eruptions) appear, the patient may scream wildly, losing self-awareness due to consciousness disturbance. This occurs because heat in the blood level fails to dissipate and spills out when righteous qi is deficient. In such cases, Sanhuang Qingdai Tang (Three-Yellow and Indigo Decoction) is most appropriate.

"Macules" refer to skin eruptions caused by heat damaging the blood level. When blood heat stagnates and does not disperse, it manifests as interior excess and exterior deficiency, emerging on the skin as spots. Causes include: mistakenly using warming therapies for thirst syndromes; failing to induce sweating when indicated; failing to purge when indicated; or pathogenic factors remaining unresolved after sweating or purging methods. Additionally, premature purging may drive heat into the stomach, while delayed purging may leave heat lingering in the stomach. All these conditions can lead to macules. Mild cases resemble rashes, while severe cases present as dense patterns like brocade. If the macules turn purple-black, indicating extreme heat and rotting of the stomach qi, death is inevitable. This constitutes the syndrome of Yang-toxin macules in Shanghan (Cold Damage). Whenever macules are about to emerge but have not fully erupted, Shengma Gegen Tang (Cimicifugae et Puerariae Decoction) should be used first to vent the toxin. If the heat is severe, Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) should be administered as the primary treatment. Herbs such as Qingdai (Indigo Naturalis), Daqingye (Isatidis Leaf), Zhimu (Anemarrhenae Rhizoma), Shigao (Gypsum Fibrosum), Huanglian (Coptidis Rhizoma), Huangbai (Phellodendri Cortex), and Huangqin (Scutellariae Radix) may also be used until the macules resolve. If macules appear after excessive sweating, vomiting, or purging due to extreme deficiency, Renshen Baitu Tang (Ginseng and White Talc Decoction) is appropriate. There are also cases of macules caused by Warm-Toxin, which result from contracting cold in winter and manifesting in spring; Yuan Shen Shengma Tang (Scrophulariae et Cimicifugae Decoction) is suitable for resolving this. Macule syndromes must never be treated with sweating methods, as this would further open the pores and worsen the eruption. Nor should one hastily use purging methods, as this would severely damage Yin fluids and risk the internal collapse of the toxin, often leading to untreatable conditions. Caution is essential.

Shengma Gegen Tang consists of four ingredients; combined with Shaoyao (Paeoniae Radix Alba) and Gancao (Glycyrrhizae Radix et Rhizoma), it forms a key formula. It is a crucial prescription for treating fever and headache in Shanghan, as well as initial fever in smallpox and rashes.

If the patient experiences muscle twitching (Rou Yu) and tendon tremors (Jin Ti) after excessive sweating and transmission to another meridian, the condition is indeed difficult to treat; otherwise, it indicates that pathogenic factors have entered the large meridians, presenting with symptoms resembling convulsions or epilepsy. If improper sweating disturbs the meridians, causing body tremors and shaking, Fuling Guizhi Zhu (Poria, Cinnamon Twig, and Atractylodes combination, referring to Zhenwu Tang context) is indicated. If there is "moving qi" (Dong Qi) in the left abdomen and purging was mistakenly applied, sudden muscle twitching is a particularly adverse sign.

"Tendon tremors and muscle twitching" are caused by excessive sweating or purging, leaving exterior pathogens unresolved and depleting qi and blood, thereby depriving muscles and tendons of nourishment. Alternatively, if not caused by sweating, it results from pathogenic heat clashing within the blood vessels, causing palpitations and throbbing. Zhang Zhongjing specifically established Zhenwu Tang (True Warrior Decoction) to remedy errors resulting from such treatments. Furthermore, if there is "moving qi" in the upper, lower, left, or right regions of the abdomen, neither sweating nor purging methods should be used; otherwise, tendon tremors and muscle twitching will inevitably occur. Specifically, moving qi in the left abdomen contraindicates both sweating and purging; applying them will cause these symptoms. Moving qi in the right abdomen is even more strictly a contraindication for sweating and purging.