（《活人》）
治发斑咽痛（发斑者，阳明胃热也∶咽痛者，少阴相火也）。
元参 升麻 甘草，等分。
此足阳明、少阴药也。升麻能入阳明，升阳而解毒；元参能入少阴，壮水以制火；甘草
甘平，能散能和，故上可以利咽，而内可以散斑也。
本方除元参，加犀角、射干、黄芩、人参，名阳毒升麻汤∶治阳毒发斑，头项背痛，狂
躁骂詈，咽肿吐血。温服取汗。
（节庵）
治伤寒热邪传里，里实表虚，阳毒发斑（血热不散，蒸于皮肤则为斑，轻如疹子，重若
锦纹，紫黑者热极而胃烂也，多死。此或因阳证投设热药，或因下早，表热乘虚入胃，或因
下迟，热留胃中，皆发斑。斑证有六∶曰伤寒发斑，或下早，或下迟也；曰温毒发斑，冬时
感寒，至春始发也；曰热病发斑，冬时感寒，至夏乃发也；曰时气发斑，天疫时行之气也，
治略相同；曰内伤发斑，先因伤暑，次食凉物，逼其暑火浮游于表也，宜加香薷、扁豆；曰
阴证发
宜大
青黛 黄连 犀角 石膏 知母 元参 栀子 生地黄 柴胡 人参 甘草。加姜、枣
煎，入苦酒（醋也）一匙，和服。大便实者，去人参，加大黄。
此足阳明药也。发斑虽由胃热，亦诸经之火有以助之。青黛、黄连以清肝火，栀子以清
心肺之火，元参、知母、生地以清肾火，犀角、石膏以清胃火，此皆大寒而能解郁热之毒者。
引以柴胡，使达肌表（柴胡清少阳相火；使以姜枣，以和营卫）；其用人参、甘草者，以和
胃也，
(From *Ren Shu*)
Treats macules (skin eruptions) accompanied by sore throat. (Macules are caused by heat in the Yangming Stomach channel; sore throat is caused by ministerial fire of the Shaoyin Kidney channel.)
Xuanshen (Scrophulariae Radix), Shengma (Cimicifugae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), in equal proportions.
These are herbs acting on the Foot-Yangming and Foot-Shaoyin channels. Shengma enters the Yangming channel, raises yang qi and resolves toxicity; Xuanshen enters the Shaoyin channel, nourishes yin water to control fire; Gancao is sweet and neutral, capable of dispersing and harmonizing, thus it can benefit the throat upwards and disperse macules internally.
Removing Xuanshen from this formula and adding Xijiao (Rhinocerotis Cornu), Shegan (Belamcandae Rhizoma), Huangqin (Scutellariae Radix), and Renshen (Ginseng Radix et Rhizoma), it is named Yangdu Shengma Tang (Yang-Detox Cinnamon Twig Decoction): treats macules due to Yang-toxin, with pain in the head, neck, and back, mania, cursing, swollen throat, and hematemesis. Take warm to induce sweating.
(Jie'an's Note)
Treats cold damage where pathogenic heat transmits inward, resulting in excess in the interior and deficiency at the exterior, causing Yang-toxin macules. (When blood-heat does not dissipate, it steams into the skin forming macules; mild cases resemble rashes, severe cases resemble brocade patterns. Purple-black color indicates extreme heat leading to stomach rot, often fatal. This may be due to administering hot medicines for Yang-patterns, purging too early allowing exterior heat to enter the stomach via deficiency, or purging too late leaving heat in the stomach, all causing macules. There are six types of macule syndromes: 1. Cold-damage macules, occurring whether purged too early or too late; 2. Warm-toxin macules, contracting cold in winter and manifesting in spring; 3. Heat-disease macules, contracting cold in winter and manifesting in summer; 4. Seasonal-qi macules, caused by epidemic pestilence qi, treated similarly; 5. Internal-injury macules, initially suffering from summerheat, then eating cold foods forcing summerheat-fire to float to the exterior, should add Xiangru (Elsholtziae Herba) and Biandou (Dolichoris Semen); 6. Yin-pattern macules, use Daqingdai (Indigo Naturalis), Huanglian (Coptidis Rhizoma), Xijiao (Rhinocerotis Cornu), Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), Xuanshen (Scrophulariae Radix), Zhizi (Gardeniae Fructus), Shengdihuang (Rehmanniae Radix), Chaihu (Bupleuri Radix), Renshen (Ginseng Radix et Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma). Decoct with Jiang (Zingiberis Rhizoma) and Zao (Jujubae Fructus), mix with Kujiu (Vinegar) one spoonful, and take orally. If stool is solid, remove Renshen and add Dahuang (Rhei Radix et Rhizoma).
This acts on the Foot-Yangming channel. Although macules originate from Stomach-heat, they are also assisted by fire from other channels. Qingdai and Huanglian clear Liver-fire; Zhizi clears Heart and Lung-fire; Xuanshen, Zhimu, and Shengdihuang clear Kidney-fire; Xijiao and Shigao clear Stomach-fire. These are all great-cold substances capable of resolving stagnant heat-toxin. Chaihu is used as a guiding herb to reach the muscle layer (Chaihu clears Shaoyin ministerial fire; Jiang and Zao are used as envoy herbs to harmonize Ying and Wei); Renshen and Gancao are used to harmonize the Stomach.