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Lanhou Sha (Rotting Throat with Sand-like Rash) is a condition not recorded in ancient texts, emerging in recent times, and prone to contagion. Practitioners often attribute it to wind-heat toxic pathogens affecting the Taiyin (太阴) and Yangming (阳明) meridians. However, the mechanism leading to ulceration requires detailed examination. Consider an analogy: if an object is subjected to intense fire, it appears dry; yet, one fails to realize that it is actually damp-heat stagnation and steaming that cause the rotting. For this condition, if caused by wind-heat, treatment should employ clearing and venting methods; if caused by damp-heat, clearing and draining methods are appropriate; if caused by phlegm-fire congealation, reducing and descending methods are indicated. When pathogens are expelled, the rash emerges, and once the rash emerges, the ulceration naturally ceases. Conversely, excessive use of cold-cooling herbs will inevitably drive pathogens inward, with consequences too dire to enumerate.

Some cases are treatable, while others are not. A foul odor in the mouth is termed "Huiyang" (Return of Yang). If the color of the lesion is pale yellow or deep yellow, it is caused by phlegm-fire and is treatable. Other signs indicating untreatability include ulceration extending to the uvula (Xiaoshe), nasal congestion, closed eyes, progressive depletion of Yuan Qi (Original Qi), deep-seated toxic factors, and a white appearance resembling rice paper. In summary, this disease results from contracting abnormal qi of heaven and earth. Consequently, individuals differ in their deficiency or excess constitution, leading to variations in the severity of symptoms. Other throat and sand-rash conditions have been detailed by ancients, so no further elaboration is needed here.

Regarding Dansha (Cinnabar Rash), medical formularies lack detailed descriptions. Upon investigating its origin, I find it stems solely from wind-cold, warm-heat, or epidemic pestilential qi. Thus, releasing the exterior and clearing heat each have their appropriate indications. Proper treatment leads to recovery quickly; improper treatment brings disaster instantly. The approach essentially falls into two categories: dispersing or clearing. In the initial stage, patients experience chills, mild fever, or high fever accompanied by aversion to cold. Although they suffer from sore throat, irritability, and thirst, the priority must be to release the exterior and vent pathogens. Even if clearing and dispersing are combined, the emphasis remains on "dispersing," adhering to the principle of "Fa Zhi" (Venting) for "Fire Yu" (Stagnant Fire). Indiscriminate use of cold-cooling herbs causes further exterior closure and intensifies internal fire, worsening the sore throat and accelerating ulceration. Those ignorant of this principle may argue that despite cold herbs, the fire remains fierce, failing to recognize the error of non-dispersion, and mistakenly believing more cooling is needed. This leads to further suppression, pathogen invasion, and death.

Some claim this condition strictly requires dispersing; I consider this view biased. As stated earlier, during the phase of alternating chills and fever, dispersing is urgent to promote sweating and rash emergence. Once chills cease, the exterior wind-cold is resolved, but internal pathogenic fire flares up. At this stage, using cold-cooling herbs to drain heat is appropriate; once heat clears, the disease resolves. Persisting with acrid-warm dispersing formulas allows fire to thrive with wind, increasing swelling and spreading ulceration, potentially causing dysphagia and excruciating pain like knife cuts. Occasionally, suggestions to use cooling herbs are criticized as suppressing pathogens. However, blazing heat kills swiftly; the harm lies in bias towards dispersing and vilifying clearing. One side praises dispersing and condemns cold; the other condemns dispersing and praises cold. The key lies in adapting to the sequence and timing, exercising flexibility to hit the mark accurately. Furthermore, post-recovery often involves limb soreness and stiffness due to Yin injury from fire scorching and meridian malnourishment. Treatment should nourish Yin, differing from Bi Syndrome (Obstruction Syndrome). This is my limited insight, offered for discussion with experts.