Library

[Qian Yi] Each of the five Zang organs has a corresponding manifestation: the Liver corresponds to *shui dou* (water pox), the Lungs to *nong bao* (pus-filled blisters), the Heart to *ban zhen* (macules and papules), the Spleen to *zhen* (rash), and when it transforms into the Kidneys, it turns black. [Hai Zang]
The Liver's *shui dou* may appear greenish; the Lungs' *nong bao* may appear white; the Spleen's *zhen* may resemble the color of bran; the Heart's *ban zhen* appears red; if the pathogen returns to the Kidneys, the color becomes black. These are the five colors. In general, for variola and exanthems, a single color indicates a favorable prognosis, while a mixture of two or three colors indicates an ominous prognosis. First, regarding the varying sizes of lesions: during the ten months in the womb, the infant consumes the turbid blood of the five Zang organs. After birth, these toxins must be expelled; thus, the appearance of sores and rashes reflects the fluids of the five Zang organs. The Liver governs tears, the Lungs govern nasal mucus, the Heart governs blood, and the Spleen manages blood containment. There are five names for these eruptions: The Liver manifests as *shui dou* because tears flow like water, appearing greenish and small; the Lungs manifest as *nong bao* because nasal mucus is thick and turbid like pus, appearing whitish and large; the Heart manifests as *ban zhen*, governing blood, appearing reddish and small, secondary to *shui dou*; the Spleen manifests as *zhen*, appearing reddish-yellow and small. Because nasal mucus and tears are discharged abundantly, the *nong bao* and *shui dou* are larger; since blood nourishes internally and is not discharged as much, the *ban zhen* and *zhen* are smaller. Furthermore, patients with *shui dou* or *nong bao* have little nasal mucus or tears, because the fluids are exhausted through the sores. It is like a blister containing water; once the water leaves, the blister shrivels. [Lou Quanshan] The aforementioned *shui dou* is commonly known as chickenpox; *nong bao* is commonly known as smallpox; *ban zhen* is commonly known as measles rash; *zhen* is commonly known as measles. Smallpox lesions are the largest, followed by chickenpox, then *ban zhen* and *zhen*, with measles being the smallest, appearing faintly like millet seeds. [Zhang Yuansu] The sores of the four Zang organs differ in name and form. The Liver presents as *shui dou*; its fluid is tears, which flow like water, appearing slightly green and small. The Lungs present as *nong bao*; its fluid is nasal mucus, which resembles pus, appearing slightly white and large. The Heart governs blood, presenting as *ban zhen*, appearing red and small. The Spleen governs blood containment, presenting as *zhen*, appearing reddish-yellow and superficial. This describes their initial appearance. However, after five to seven days, regardless of which organ they originated from, they all transform into bloody scabs (*xue jie*), the bloody scabs turn into pus (*nong jie*), and after the pus stage, they crust over and heal. One might ask: If the Lungs present as *nong bao*, why do bloody scabs later form pus? The reason is that when the Lungs present as *nong bao*, it refers to the initial eruption being faint and pus-like, white rather than yellow. The pus formed after the bloody scab stage indicates the sore is mature, enclosing yellow pus, which is yellow rather than white. Although both are called *nong bao*, the nature of the pus differs. Similarly, the Spleen presenting as *zhen* refers to the initial yellowish-red color with small sores. When it matures into pus, forms scabs, and heals, it is fundamentally different from what is termed cutaneous rash, despite sharing the name. The Heart's *ban zhen* is also significantly different from warm toxicity, winter-warmth, or other types of macular eruptions. [Wan Mingzhai] In observing the five Zang manifestations of sores and rashes, one must determine which Zang organ's syndrome is most severe, indicating that this organ harbors the most toxin. If Liver toxin is excessive, *shui dou* will erupt, causing itching and eye diseases; one should preemptively resolve Liver toxin using Qianghuo Tang (Notopterygium Decoction) augmented with Qingpi (Aurantii Fructus Pericarpium) and Chaihu (Bupleuri Radix). If Lung toxin is excessive, wheezing, coughing, persistent thirst, and irritability will increase, with the patient scratching the eyebrows, eyes, nose, and face; one should preemptively resolve Lung toxin using Xiebai San (Drain White Powder) combined with Ganjie Tang (Licorice and Platycodon Decoction), augmented with Niubangzi (Arctii Fructus) and Tianhuafen (Trichosanthis Radix). If Heart toxin is excessive, the eruption may fail to rise, accompanied by delirium, desire for water, restlessness, crying, and teeth grinding; one should preemptively resolve Heart toxin using Daochi San (Guide Out Red Powder) augmented with Huanglian (Coptidis Rhizoma) and Chen Sha (Cinnabar). If Spleen toxin is excessive, the lesions may turn grayish-white, accompanied by itching, vomiting, and diarrhea; one should preemptively protect the Spleen and Stomach to resolve the toxin, using Sijunzi Tang (Four Gentlemen Decoction) or Tiaoyuan Tang (Regulate Origin Decoction), augmented with Baishao Yao (Paeoniae Radix Alba), Fangfeng (Saposhnikoviae Radix), and Lianqiao (Forsythiae Fructus). The Kidneys do not present with balanced syndromes; if the ears and extremities are hot, it is a sign of death.
Qianghuo Tang (for fever) Xiebai San (for Lungs) Ganjie Tang (for throat) Daochi San (for Heart) Sijunzi Tang (for vomiting and diarrhea) Tiaoyuan Tang (i.e., Baoyuan Tang)