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For varicella and rashes caused by blood heat, only cool and dispersing methods are suitable; harsh bitter-cold drugs should not be used vigorously. Over-administration of herbs such as Scutellariae Radix (Huangqin) and Coptidis Rhizoma (Huanglian) will inevitably damage the Spleen and Stomach internally and close the muscles externally. Damage to the Spleen and Stomach leads to reduced appetite and diarrhea; in severe cases, it results in profuse watery diarrhea without restraint, eventually leading to deficiency-cold syndrome. Closure of the muscles prevents the steaming and transforming Qi from circulating; stagnation of the interstices causes the rash to fail to erupt and fill with pus, ultimately resulting in collapse (internal sinking of the rash). This is the evidence of a heat syndrome transforming into a deficiency syndrome. Once deficiency manifestations appear, treatment should follow the principle of treating deficiency; one must not be rigidly attached and fear using warming tonics such as Ginseng Radix et Rhizoma (Renshen), Caryophylli Flos (Dingxiang), and Cinnamomi Ramulus (Guizhi). If observed on the sixth or seventh day, both Muxiang San (Aucklandia Powder) and Yigong San (Yi Gong Decoction) can be applied. However, stop medication once the disease is cured; do not overdose to avoid the disaster of draining the pond to catch all fish.

When toxin is abundant and obstructed, it is indeed appropriate to use lifting and dispersing methods assisted by cooling agents, so that the heat-toxin may be pacified and cease. If dispersing is excessive, it will inevitably lead to emptiness of the muscle surface and dispersion of Yuan Qi (Original Qi), causing clear fluid to pour internally, or resulting in empty swollen shells, itching and collapse with external peeling, or ulceration that fails to heal. All kinds of variations may occur, and internal Qi cannot guard itself. A slight injury to diet will cause diarrhea; if diarrhea does not stop, it transforms into deficiency-cold, leading to Qi collapse, irritability, thirst, chest oppression, mental confusion, chills, and teeth grinding—symptoms that know no bounds. At the initial eruption, although it is due to blood heat obstruction, after three or four days, if the body becomes fever-free and the lesions do not grow, how can one refrain from administering mild-warming agents? Such as Guanyuan (possibly referring to specific cinnamon preparations or ingredients), Chuanxiong Rhizoma (Chuanxiong), and Zingiberis Rhizoma Recens (Ganjiang). When internal Qi is warmed, external Qi naturally harmonizes. After diarrhea, the interior must be deficient; even if there are abdominal distension, irritability, thirst, panting, and urgency, how can this still be considered excess-heat? It is merely due to internal deficiency and the internal attack of sunken toxins. Therefore, for excess-heat syndromes that have experienced diarrhea on the seventh, eighth, or ninth day, treatment should always address deficiency. If there are indications for Muxiang San or Yigong San, administer them. Unless there are signs of ice-hardness (hard and cold texture), especially after diarrhea, never mistakenly administer warming agents. Because cases presenting with collapse, inversion, dryness, and withering, but without ice-hardness or diarrhea, are mostly caused by internal attack of heat-toxin; in such cases, Baixiang Wan (Baixiang Pill) and Zhuwei Gao (Pig Tail Paste) should be used. Mistakenly administering warming agents would render even Lu Yi (Bian Que) unable to save the patient.