热邪积久，郁于皮肤，轻则发为小斑，重则发为丹毒。平人发斑，如锦纹，或赤色，大
便结，心中烦躁，总为热郁，甚则防风通圣散，轻则解毒防风汤，疏风、清热、凉血，或汗或下，
随治可愈。至于伤寒发斑，又
非寻常之比，或因下之太早，汗之太迟，有表里俱虚，有温毒热毒，不可汗下，惟可以化
斑汤、升麻汤之类；若热毒深入，斑发紫黑，多不可救也。
丹毒则有火邪结炽，挟风而作，由热毒搏于荣血而风乘之，所以赤浮肌肉而为之走注也。
火与血皆主于心。丹毒自内而出，游走于四肢易治，自四肢而走于身，入于心腹者难治，甚则
肌肉糜烂，大可畏也，敷之不散，宜用 针砭刺出血，无不愈。
防风通圣散 治实热郁结，发为锦斑。（方见风门。）
解毒防风汤 治斑疹痒痛。
防风 地骨皮 黄 芍药 荆芥 枳壳 牛蒡子（各等分）
水煎温服。
治阳毒栀子汤 治伤寒壮热，百节痛而发斑。
升麻 栀子仁 黄芩 芍药 石膏 知母 杏仁 柴胡 甘草
上水二盏，姜三片、豆豉百粒，煎服。
犀角消毒饮 治风热发斑。（方见瘾疹门）
玄参升麻汤 治伤寒吐下后发斑，甚则烦躁。
玄参 升麻（各一钱） 甘草（一钱）
水煎服。
人参白虎汤（一名化斑汤） 治伤寒汗下失期以致发斑，急服此。
人参（一钱） 石膏（三钱） 知母（钱半） 甘草（六分）
上水盏半，加粳米一合，煎八分，不拘时服。
消毒饮 治一切赤丹、火丹。
牛蒡子 荆芥（各一钱） 甘草 防风（各六分） 升麻（五分） 犀角（磨，一钱） 麦门
冬桔梗（各八分）朴硝（钱半）
上水煎服。
蓝叶散 治诸丹赤肿。
白芷 川芎 柴胡 赤芍药 升麻（各五分） 干葛 生地黄 山栀仁 石膏（各八分）
甘草 杏仁 知母（各六分） 蓝叶 黄芩 玄参（各一钱）
上水煎服。
上青散 治一切丹毒。
蓝青 知母 甘草 杏仁（各六分） 黄芩 升麻（各八分） 柴胡 石膏 寒水石（各一钱）
山栀仁 赤芍药 羚羊角（磨。各八分)
上水煎服。
When pathogenic heat accumulates for a long time and stagnates in the skin, it manifests as small macules (maculae) in mild cases, or erysipelas (erysipelatous inflammation) in severe cases. In ordinary individuals, the appearance of macules resembles brocade patterns or appears red, accompanied by constipation and mental restlessness; this is generally attributed to heat stagnation. Severe cases may be treated with Fangfeng Tongsheng San (Saposhnikovia Decoction to Unblock All Obstructions), while mild cases may be treated with Jiedu Fangfeng Tang (Detoxifying Saposhnikovia Decoction). Through methods such as releasing the exterior to dispel wind, clearing heat, and cooling the blood—either via diaphoresis (sweating method) or purgation (draining method)—recovery can be achieved according to the specific syndrome. However, macules caused by Cold Damage (Shanghan) are not comparable to ordinary cases. They may result from premature purgation or delayed diaphoresis, leading to deficiency in both the exterior and interior, or they may involve warm toxins or heat toxins, in which case neither diaphoresis nor purgation should be used. Instead, formulas such as Huaban Tang (Macule-Transforming Decoction) or Shengma Tang (Cimicifuga Decoction) should be employed. If heat toxins penetrate deeply and the macules turn purple-black, the condition is often incurable.
Erysipelas arises from the intense accumulation of fire pathogens combined with wind. It occurs when heat toxins contend within the Ying (nutritive) blood, allowing wind pathogens to invade, causing redness to float on the muscles and wander unpredictably. Both fire and blood are governed by the Heart. Erysipelas originating internally and wandering to the four limbs is easy to treat; however, if it spreads from the limbs to the trunk and enters the heart and abdomen, it is difficult to treat. In severe cases, muscle erosion may occur, which is highly alarming. If topical applications fail to dissipate the swelling, pricking with needles or stone lancets (bian) to release blood is indicated, and recovery is invariably achieved.
Fangfeng Tongsheng San treats solid heat stagnation manifesting as brocade-like macules. (Formula see Wind Gate.)
Jiedu Fangfeng Tang treats macules and rashes accompanied by itching and pain.
Saposhnikovia Radix (Fangfeng), Groundcherry Root Bark (Digupi), Scutellaria Root (Huangqin), Peony Root (Shaoyao), Schizonepeta Spike (Jingjie), Bitter Orange (Zhike), and Arctium Fruit (Niubangzi) (equal parts).
Decoct in water and take warm.
Zhi Zi Tang for Treating Yang Toxin treats high fever from Cold Damage, pain in all joints, and the emergence of macules.
Cimicifuga Rhizome (Shengma), Gardenia Seed (Zhiziren), Scutellaria Root (Huangqin), Peony Root (Shaoyao), Gypsum (Shigao), Anemarrhena Rhizome (Zhimu), Apricot Seed (Xingren), Bupleurum Root (Chaihu), and Licorice Root (Gancao).
Take two cups of water, three slices of ginger, and one hundred grains of fermented soybean (Douchi); decoct and administer.
Xijiao Xiaodu Yin treats macules caused by wind-heat. (Formula see Urticaria Gate.)
Xuanshen Shengma Tang treats macules appearing after vomiting or purgation in Cold Damage, with severe restlessness.
Scrophularia Root (Xuanshen), Cimicifuga Rhizome (Shengma) (1 qian each), Licorice Root (Gancao) (1 qian).
Decoct in water and take.
Renshen Baihu Tang (also known as Huaban Tang) treats macules resulting from mistimed diaphoresis or purgation in Cold Damage; administer urgently.
Ginseng Root (Renshen) (1 qian), Gypsum (Shigao) (3 qian), Anemarrhena Rhizome (Zhimu) (1.5 qian), Licorice Root (Gancao) (6 fen).
Take one and a half cups of water plus one he of rice grain (Jingmi); decoct until reduced to 0.8 cup; take at any time.
Xiaodu Yin treats all types of red erysipelas and fire erysipelas.
Arctium Fruit (Niubangzi), Schizonepeta Spike (Jingjie) (1 qian each), Licorice Root (Gancao), Saposhnikovia Radix (Fangfeng) (6 fen each), Cimicifuga Rhizome (Shengma) (5 fen), Rhinoceros Horn (Xijiao) (ground, 1 qian), Ophiopogon Tuber (Mendong), Platycodon Root (Jiegeng) (8 fen each), Mirabilite (Puxiao) (1.5 qian).
Decoct in water and take.
Lanye San treats various forms of erysipelas with redness and swelling.
Angelica Dahurica Root (Baizhi), Ligusticum Rhizome (Chuanxiong), Bupleurum Root (Chaihu), Red Peony Root (Chishaoyao), Cimicifuga Rhizome (Shengma) (5 fen each), Kudzu Root (Gegen), Rehmannia Root (Shengdihuang), Gardenia Seed (Shanzhiren), Gypsum (Shigao) (8 fen each), Licorice Root (Gancao), Apricot Seed (Xingren), Anemarrhena Rhizome (Zhimu) (6 fen each), Isatis Leaf (Lanye), Scutellaria Root (Huangqin), Scrophularia Root (Xuanshen) (1 qian each).
Decoct in water and take.
Shangqing San treats all types of erysipelas.
Indigo Naturalis (Lanqing), Anemarrhena Rhizome (Zhimu), Licorice Root (Gancao), Apricot Seed (Xingren) (6 fen each), Scutellaria Root (Huangqin), Cimicifuga Rhizome (Shengma) (8 fen each), Bupleurum Root (Chaihu), Gypsum (Shigao), Aragonite (Han shuishishi) (1 qian each), Gardenia Seed (Shanzhiren), Red Peony Root (Chishaoyao), Antelope Horn (Lingyangjiao) (ground, 8 fen each).
Decoct in water and take.