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After the macules and papules (Ban Zhen) have subsided, there is coughing with a low voice, intense heat in the body, a red tongue with little coating. This indicates that the Sha-heat (Sha-re) lingers, damaging the Yin fluids of the Lung and Stomach. It is appropriate to use Glehniae Radix (Shashen), Trichosanthis Radix (Huafen), sweet Prunus armeniaca seed (Tianxing), Lycii Cortex (Digupi), Fritillariae Cirrhosae Bulbus (Chuanbei), raw Glycyrrhizae Radix et Rhizoma (Shenggancao), Morus Albae Cortex (Sangbaipi), mung bean shell (Lvdouke), and Loquat leaf (Pipaye) to clear the Lung and nourish the Stomach.

The Lung and Stomach are the pathways through which Ban Zhen pathogens enter and exit. Now that the pathogen has retreated but heat remains intense, with hoarse coughing, a red tongue with little coating, it shows that residual heat lingers, consuming the fluids of the Lung and Stomach. Therefore, Glehniae Radix (Shashen), Apricot Seed (Xingren), Fritillariae Cirrhosae Bulbus (Chuanbei), Morus Albae Cortex (Sangpi), Lycii Cortex (Digupi), and Loquat leaf (Pipaye) are used; this combination primarily clears the Lung and moistens dryness while generating fluids. Combined with mung bean shell (Lvdouke), raw Glycyrrhizae Radix et Rhizoma (Shenggancao), and Rice (Jingmi) to nourish the Stomach and detoxify, one must ensure that heat does not remain deep in the Lung, brewing into consumptive tuberculosis (Lao Lao). This requires utmost caution.

After the macules and papules, swelling of lymph nodes in the neck and submandibular region occurs, with trismus (lockjaw), alternating chills and fever, and a rapid pulse. This is due to Sha-toxin stagnation and knotting. It is appropriate to use Isatidis Radix (Langen), Euphrasiae Herba (Mabo), Scrophulariae Radix (Yuanshen), Forsythiae Fructus (Lianqiao), Lonicerae Japonicae Flos (Yinhua), Platycodonis Radix (Jiegeng), Bombyx Batryticatus (Jiangcan), Fritillariae Thunbergii Bulbus (Tubeimu), Glycyrrhizae Radix et Rhizoma (Gancao), and Prunellae Spica (Xiakucao) to soften hardness and resolve toxins.

Although the macules and papules have subsided, heat knots in the Upper Jiao. Swelling under the jaw belongs to the Yangming channel, swelling below the ear belongs to the Shaoyang channel, and swelling on the neck and nape belongs to the Taiyang channel. Generally, this results from heat stagnation in the three Yang channels, with wind-toxin attacking upward, causing trismus and forming epidemic toxic diseases (Shi Du). Therefore, bitter and pungent methods are used to drain downward and clear the Upper Jiao. Treatment must be administered according to the meridians to achieve rapid resolution, preventing the complication of ulceration and rupture.

Before the macules and papules appear, there is hot swelling in the neck and submandibular region extending to the head and face, with swollen skin and red color. This is Da Tou Wen (Big Head Plague). It is appropriate to use Dongyuan's Puji Xiaodu Yin (Universal Benefit Decoction for Eliminating Toxins), employing bitter and pungent methods to resolve the pathogen.

Whenever Da Tou Wen first appears, it must initially present with aversion to cold, vexing heat, headache, thirst, red and swollen neck and face extending to the entire head. However, differentiation by channel and syndrome is necessary. Swelling below the ears and on the cheeks belongs to the Shaoyang channel; swelling on the face and nose/forehead belongs to the Yangming channel; swelling on the vertex and neck/nape belongs to the Taiyang channel. There are also cases where the entire head swells, known as San Yang He Bing (Combined Disease of the Three Yang Channels), anciently called Da Tou Wen. Relatives avoid visiting each other for fear of contagion. Dongyuan’s formulation of Puji Xiaodu Yin is most appropriate. It uses Scutellariae Radix (Huangqin) and Coptidis Rhizoma (Huanglian) for bitter-cold fire-draining, and Cimicifugae Rhizoma (Shengma) and Bupleuri Radix (Chaihu) for pungent-cool yang-raising. Fearing that the bitter-cold nature of Huangqin and Huanglian might go directly into the intestines and stomach, they are all stir-fried with wine to facilitate upward movement, combining ascending and descending mechanisms to form an unchangeable method. Additionally, Menthae Haplocalycis Herba (Bohe) and Arctii Fructus (Niubangzi) dispel wind, Forsythiae Fructus (Lianqiao) and Scrophulariae Radix (Yuanshen) clear heat, Isatidis Radix (Langen) and Euphrasiae Herba (Mabo) detoxify, Platycodonis Radix (Jiegeng) and Glycyrrhizae Radix et Rhizoma (Gancao) carry the herbs upward, and Bombyx Batryticatus (Jiangcan) guides them into the collaterals. Observing this prescription reveals great skill; only those deeply versed in the heart-method of Zhang Zhongjing’s classics can reach such subtlety.