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When fever occurs and coincides with the cessation of menstruation, the blood aspect is empty; therefore, Chaihu Siwu Tang (Bupleurum Four Substances Decoction) should be taken early to prevent pathogenic toxins from entering due to deficiency. If there are already symptoms of aversion to cold with high fever, unclear consciousness, hallucinations (seeing or hearing things that are not there), delirious speech, and picking at empty air, this is because the Blood Chamber (uterus) is empty and heat pathogens have entered it. The Blood Chamber refers to the arterial vessels (here referring to the physiological structures/areas closely related to blood circulation), which is governed by the Liver. Treatment should utilize Siwu Tang (Four Substances Decoction) combined with Daochi San (Guide Out Red Powder), added with Ophiopogonis Radix (Maidong) and Anshen Wan (Calming Spirit Pill), administered alternately. Furthermore, any woman whose menstruation ceases is termed Ju Jing (menstruation occurring once every three months). If the cycle completes without discharge, the pathology lies in the Heart and Spleen; the toxin of carbuncles and rashes originally belongs to the Heart. Moreover, since the Spleen is the source of Qi and Blood, if the Heart and Spleen are diseased first, the Blood Chamber will not flow smoothly, and impurities will accumulate between the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel). Consequently, the fire toxin of carbuncles and rashes will stagnate within the Ming Men (Gate of Life) and Bao Hu (Uterus); when it should be expelled but is not, toxic pathogens remain latent, causing deficiency to prevail and pathogenic factors to become perverse, which is inevitable. Therefore, at the initial stage of fever, one should eliminate accumulated impurities, preferably using Tao Ren Cheng Qi Tang (Peach Kernel and Rhubarb Decoction to Order the Qi) as the main formula, followed by treatment with Siwu Tang combined with Yunqi San (Harmonizing Qi Powder) added with Carthami Flos (Honghua) and Akebiae Caulis (Mutong). One must ensure neither excessive fullness nor deficiency. Even if it is Ju Jing, provided the smallpox/rash rises and swells normally, diet remains normal, and there is no abdominal pain or other distress, over-treatment is unnecessary. In cases where the Sea of Blood is dry, menstruation does not flow, yet smallpox/rash erupts simultaneously, the treatment method should also focus on regulating the Heart and Spleen, harmonizing the interior so that pathogens do not remain latent but emerge daily; otherwise, toxins stagnate between the Wei Qi (Defensive Qi) and Ren Mai, two heats merge and attack each other, leading to uncontrolled bleeding, or failure of toxins to exit resulting in panting, abdominal distension, or rash sinking inward.

In women suffering from smallpox/rash, if menstruation suddenly starts followed by sudden loss of voice and inability to speak, it is because the Heart governs Blood, and the tongue is the sprout of the Heart. Loss of blood leads to Heart deficiency; Heart deficiency causes the Shaoyin Meridian (Heart-Kidney channel) to fail to nourish upwards, resulting in sudden aphonia. Initially, Danggui Yangxin Tang (Angelica Tonifying Heart Decoction) should be used to nourish Heart Blood and open the Heart orifices. Once speech returns, Shiquan Dabu Tang (Ten Substance Great Tonic Decoction) should be used for regulation. Additionally, if menstruation is heavy during the eruption phase, causing the rash to fail to rise, lacking luster and vigor, not plump, not red and vibrant, with flat tops, gray-white color, or turning cyan, dry, and black-sunken, these are signs of interior deficiency and rash sinking back inward. Treatment should involve alternating administration of Shiquan Dabu Tang and Duoming Dan (Life-Snatching Pill). If the rash becomes plump, swollen, and red-vibrant, or if a new batch emerges from within the existing lesions, these are auspicious omens. However, if accompanied by abdominal distension, rapid panting, delirium, restlessness, severe chills with teeth grinding, and cold extremities, it is a fatal condition.