脉多沉伏。或细而散。或绝无。滑伯仁曰。脉者血之波澜。故发斑者。血散于肌肤。故
脉伏。脉阳浮而数。阴实而大。火盛在表。故阳脉浮数。下焦实热。故阴脉实大。
夫斑。有色点而无头粒者是也。疹浮小有头粒者。随出随收。收则又出者是也。非若斑
之无
头粒者。当明辨之。若斑发赤红。为胃热。若紫而不赤者。为热甚。如紫黑者。为胃烂。故
赤者半生半死。黑色者九死一生。大抵鲜红起发稀朗者吉。紫黑者难治。杂黑斑烂者死也。
凡斑欲出未出之际。宜先以升麻汤透其毒。脉虚。加人参。食少而大便不实。加白术。斑已
出不宜再发者。斑不可汗。斑烂者不宜下。如脉洪数。热甚烦渴者。人参化斑汤。
一论阳毒赤斑。口出狂言。吐脓血。乃热毒蕴于胸中而发斑。宜以
升麻汤
升麻（二钱） 犀牛角屑 射干 人参 生甘草（各一钱）
上锉一剂。水煎。温服。
一论只因内热发出。皮肤如蚊虫之啮。不宜汗下。但清热降火凉血气为要。若斑黑为不
治之症。宜用
人参化斑汤
人参（三钱） 石膏（一两） 知母（二钱五分） 当归 紫草茸 白茯苓（去皮） 甘草（各
三钱）
上锉一剂。水煎服。
一论气分有热发斑者。宜用
柴胡汤
柴胡（三钱） 黄芩（二钱） 半夏（姜炒二钱） 人参（一钱） 紫草（二钱） 黄连（二钱） 茯苓（二钱） 甘
草（二钱）
上锉一剂。生姜煎服。
一论血分有热发斑者。宜
当归散
当归（三钱） 赤芍（二钱） 生地黄（三钱） 黄连（六分） 红花（八分） 石膏（二钱）
上锉一剂。水煎服。
一论瘾疹。因风热客于肌腠。气血积阻而成也。宜
加味败毒散
羌活 独活 前胡 柴胡 当归 川芎 枳壳（去穣） 桔梗 茯苓 人参（各五分）
薄荷 甘草 白术 防风 荆芥 苍术（米泔水浸） 赤芍 生地黄（各五分）
上锉一剂。姜、枣。水煎。温服。此因感冒风湿。以致发斑者。服之良验。
一论斑者。如胭脂点而不起粒者是也。红斑可治。紫斑十活其一。黑斑十无一生。如有
斑见。宜服
解毒化斑汤
牡丹皮 生地黄 木通 归尾 远志（甘草汤泡去心） 犀角（以乳汁磨下一二钱） 紫
草茸 知母 牛蒡子 茜根 甘草（生带梢者） 穿山甲（炒成珠研末一钱）
上用水煎药。调下山甲末并犀角汁同服。
The pulse is mostly deep and hidden (Chen Fu). It may be fine and scattered (Xi San), or completely imperceptible. Hua Bo-ren stated: "The pulse is the ripple of blood." Therefore, when macules erupt, blood scatters into the skin and muscles, causing the pulse to become hidden. If the pulse is floating and rapid in the Yang position, and solid and large in the Yin position, it indicates excessive fire on the exterior, hence the Yang pulse is floating and rapid; excess heat in the Lower Jiao causes the Yin pulse to be solid and large.
"Ban" (Macules) are characterized by colored spots without granular heads. "Zhen" (Papules/Rash) are raised, small, and have granular heads; they appear and disappear quickly, reappearing after receding, unlike Ban which lacks granular heads. These must be clearly distinguished. If the macules are bright red, it indicates Stomach Heat. If purple but not red, it indicates extreme heat. If purple-black, it indicates rotting of the Stomach. Thus, red macules indicate a prognosis of half survival and half death; black macules indicate nine deaths for every one survivor. Generally, fresh red macules that emerge sparsely and clearly are auspicious; purple-black ones are difficult to treat; those mixed with black and rotting are fatal.
When macules are about to emerge but have not yet appeared, it is appropriate to first use Shengma Tang (Cimicifugae Decoction) to vent the toxicity. If the pulse is deficient, add Renshen (Ginseng Radix et Rhizoma); if appetite is poor and stools are loose, add Baizhu (Atractylodis Macrocephalae Rhizoma). Once macules have emerged, further sweating is contraindicated as macules should not be treated with diaphoresis; if macules are ulcerated, purgation is contraindicated. If the pulse is flooding and rapid, with severe heat, restlessness, and thirst, Renshen Huaban Tang (Ginseng Macule-Transforming Decoction) is indicated.
One discussion addresses Yang Toxicity causing red macules, with delirious speech and vomiting of pus and blood. This results from heat-toxin accumulating in the chest and erupting as macules. Shengma Tang (Cimicifugae Decoction) is indicated.
Shengma (Cimicifugae Rhizoma, 2 qian) Xijiaojiao Xi (Rhinoceros Horn Chips) Shegan (Belamcandae Rhizoma) Renshen (Ginseng Radix et Rhizoma) Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma, 1 qian each)
Crush these ingredients for one dose. Decoct in water and take warm.
One discussion addresses eruptions caused solely by internal heat, where the skin feels like insect bites. Sweating and purging are inappropriate; clearing heat, reducing fire, and cooling blood and Qi are essential. If macules turn black, it is an untreatable condition. Renshen Huaban Tang (Ginseng Macule-Transforming Decoction) is indicated.
Renshen (Ginseng Radix et Rhizoma, 3 qian) Shigao (Gypsum Fibrosum, 1 liang) Zhimu (Anemarrhenae Rhizoma, 2.5 qian) Danggui (Angelicae Sinensis Radix) Zicao Rong (Arnebiae Radix) Baifuling (Poria Cocos, peeled) Gancao (Licorice Root, 3 qian each)
Crush these ingredients for one dose. Decoct in water and take.
One discussion addresses macules caused by heat in the Qi level. Chaihu Tang (Bupleuri Decoction) is indicated.
Chaihu (Bupleuri Radix, 3 qian) Huangqin (Scutellariae Radix, 2 qian) Banxia (Pinelliae Tuber, stir-fried with ginger, 2 qian) Renshen (Ginseng Radix et Rhizoma, 1 qian) Zicao (Arnebiae Radix, 2 qian) Huanglian (Coptidis Rhizoma, 2 qian) Fuling (Poria Cocos, 2 qian) Gancao (Licorice Root, 2 qian)
Crush these ingredients for one dose. Decoct with fresh ginger and take.
One discussion addresses macules caused by heat in the Blood level. Danggui San (Angelica Powder) is indicated.
Danggui (Angelicae Sinensis Radix, 3 qian) Chishao (Paeoniae Radix Rubra, 2 qian) Sheng Dihuang (Rehmanniae Radix Recens, 3 qian) Huanglian (Coptidis Rhizoma, 6 fen) Honghua (Carthami Flos, 8 fen) Shigao (Gypsum Fibrosum, 2 qian)
Crush these ingredients for one dose. Decoct in water and take.
One discussion addresses Urticaria (Yinzhen), caused by wind-heat invading the muscle interstices, leading to accumulation and obstruction of Qi and Blood. Jiawei Baidu San (Modified Detoxifying Powder) is indicated.
Qianghuo (Notopterygii Rhizoma et Radix) Duhuo (Angelicae Pubescentis Radix) Qianhu (Peucedani Radix) Chaihu (Bupleuri Radix) Danggui (Angelicae Sinensis Radix) Chuanxiong (Ligustici Chuanxiong Rhizoma) Zhike (Aurantii Fructus, pith removed) Jiegeng (Platycodonis Radix) Fuling (Poria Cocos) Renshen (Ginseng Radix et Rhizoma, 5 fen each)
Bohe (Menthae Haplocalycis Herba) Gancao (Licorice Root) Baizhu (Atractylodis Macrocephalae Rhizoma) Fangfeng (Saposhnikoviae Radix) Jingjie (Schizonepetae Spica) Cangzhu (Atractylodis Rhizoma, soaked in rice water) Chishao (Paeoniae Radix Rubra) Sheng Dihuang (Rehmanniae Radix Recens, 5 fen each)
Crush these ingredients for one dose. Decoct with ginger and jujube in water, and take warm. This formula is effective for macules caused by cold-dampness invasion.
One discussion defines Ban (Macules) as resembling rouge spots without granular heads. Red macules are treatable; purple macules have a one-in-ten survival rate; black macules have zero survival. If macules appear, Jiedu Huaban Tang (Detoxifying Macule-Transforming Decoction) is indicated.
Mudanpi (Moutan Cortex) Sheng Dihuang (Rehmanniae Radix Recens) Mutong (Akebiae Caulis) Guiwei (Angelicae Sinensis Radix tail) Yuanzhi (Polygalae Radix, soaked in licorice decoction, heart removed) Xijiao (Rhinoceros Horn, ground with milk juice, 1-2 qian) Zicao Rong (Arnebiae Radix) Zhimu (Anemarrhenae Rhizoma) Niubangzi (Arctii Fructus) Qiangengen (Rubiae Radix) Gancao (Licorice Root, raw with tips) Chuanshanjia (Manis Squama, stir-fried until popping, ground to powder, 1 qian)
Decoct these ingredients in water. Mix in the Chuanshanjia powder and Xijiao juice, and take together.