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Rash (Zhen, 疹) and macula (Ban, 斑) are essentially similar, but maculae appear faintly within the skin and are visible to the eye, whereas rashes appear as clustered elevations on the muscles and can be felt by touch. Maculae arise from the interaction of the Six Excesses (Liu Yin, 六淫), while rashes result from the long-term accumulation of toxic heat (Du Wa, 毒瓦斯). The treatment for maculae focuses on cooling and resolving toxicity, whereas the priority in treating rashes is to vent them through the skin and support the interior. However, rashes belong to Yang syndromes; they should initially appear on the head and face until fully erupted. Rashes are associated with Heart Fire (Xin Huo, 心火), while maculae are associated with rootless fire of the San Jiao (Triple Burner, 三焦), though both may invade the Lung (Fei, 肺). Although both conditions involve long-standing internal heat where Yang invades Yin, causing eruptions, generally, maculae often involve deficient Yang, while rashes mostly involve excess heat. Therefore, for maculae caused by internal injury where deficient fire wanders externally, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with Ge Gen (Puerariae Radix) and Shao Yao (Paeoniae Radix), or Tiao Zhong Tang (Regulate the Middle Decoction) for tonification and descending fire, is appropriate. For rashes, initial treatment should focus on venting and supporting, followed by clearing and resolving. However, deficient rashes can be treated using methods for maculae, and excess maculae can be treated using methods for rashes; thus, there is no need to rigidly distinguish between maculae and rashes, but rather to judge based on deficiency and excess.

Mania (Kuang, 狂) is a type of Yang toxin. It arises when Taiyang disease (Taiyang Bing, 太阳病) fails to undergo purgation, leading to Yang toxin and heat stagnating in the upper body, resulting in manic running, delirious speech, red face, sore throat, tidal fever, muttering alone, hallucinations (seeing ghosts), dyspnea with irritability, five-palm heat (Wu Xin Fan Re, 五心烦热), swollen lips, hiccups (Yue, 哕), or generalized jaundice. If the pulse is excess (Shi Mai, 实脉), this is a favorable Yang syndrome, requiring only purgation to bring peace. If mania is uncontrollable, inhaling the smoke of burnt charcoal can calm the patient, allowing for subsequent differentiation of Yin and Yang. However, if there is urinary incontinence, fixed gaze with non-reactive pupils, staring, and delirious speech, this indicates Kidney exhaustion. Since the Kidney stores essence and will, excessive diarrhea leads to loss of fluids, depletion of essence, and loss of spirit, transforming into a state resembling mania; this is a critical condition (Huai Zheng, 坏症). Furthermore, if after four or five days, exterior pathogens have fully entered the interior, presenting with hardness and fullness in the lower abdomen, cyanotic veins on the skin, black stools, patent urination, and mania, this indicates blood stasis (Xu Xue, 蓄血) in the Lower Jiao (Xia Jiao, 下焦). Treatment requires promoting blood discharge; black stools indicate blood stasis. Patent urination indicates pathology in the Blood level without Qi involvement. This occurs because heat from the Taiyang channel enters the Bladder (Pang Guang, 膀胱) and clashes with blood, accumulating in the lower abdomen and causing mania. The Classic states: "Heat binding in the Bladder, the person resembles mania." It also states: "Blood pooling below causes confusion and forgetfulness." If blood cannot overcome heat and is forced downward, the heat dissipates with the blood and the condition resolves. Mania belongs to Yang excess, while restlessness (Zao, 躁) belongs to Yin deficiency. Although symptoms are similar, their deficiency and excess nature differs significantly; practitioners must distinguish them carefully.