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The terms "ban" (macules) and "zhen" (papules/urticaria) are defined not by color, but by morphology. Therefore, macules may appear red, purple, or black, yet all are termed "ban". Macules are flat, level with the skin surface, and do not protrude at all. The term "mosquito bites" refers to the appearance of macules forming as discrete spots. The term "brocade patterns" refers to macules appearing as confluent patches. Papules ("zhen"), however, protrude above the skin surface; large ones resemble sorghum grains common in the north, while small ones resemble millet seeds. They also present in red or purple colors, with black being rare, and are generally milder than macules. There is also a condition called "white papules" occurring in the Wei division (the superficial defensive layer), shaped like amaranth seeds, white in color, which, when ruptured, release clear fluid. The occurrence of such white papules is considered highly auspicious, indicating that pathogenic factors are dispersing along with the eruption. The morphological characteristics of macules and papules have been fully described. Discussing macules first, the general cause is the failure to resolve pathogenic toxins, which remain stagnant in the Blood division. For instance, if sweating should have been induced but was not, exterior pathogens remain unresolved; if purgation should have been applied but was not, interior pathogens remain unresolved; if purgation is applied too early, pathogens sink inward and remain unresolved; if clearing heat should be employed but is not, excessive fire remains unresolved; if tonification should be used but is not, weakness prevents resolution. (This scenario is rare in plague diseases.) Alternatively, if Yang syndromes are mistakenly treated with warming and tonifying methods, Yang hyperactivity remains unresolved; if Yin syndromes are mistakenly treated with cold and cooling methods, Yin stagnation remains unresolved. (These scenarios do not occur in plague diseases.) If pathogens remain unresolved, they penetrate directly into the Yin division, stagnate and generate heat, leading to depletion of fluids and exhaustion of blood, resulting in disease. This represents a severe condition affecting both Ying (nutritive) and Wei (defensive) qi. When treatments involving sweating, purging, warming, and clearing fail, and symptoms such as cold feet, deafness, mental restlessness, cough, and vomiting appear, these are signs of macule eruption. Fresh red macules indicate a favorable prognosis; purple macules indicate a mortality rate of five out of six; black macules indicate a mortality rate of ten out of eleven. Densely packed, confluent macules are strictly contraindicated. Whether macules have erupted or not, if the pulse is surging, rapid, and forceful, and the body is warm with warm feet, the condition is easy to treat. If the pulse is deep and fine, feet are cold, and Yuan Qi (original qi) is weak, the condition is difficult to treat. During the period before or after eruption, one must strictly avoid indiscriminately administering cold-natured medicines and drinking cold liquids, lest this damage Stomach Qi and induce vomiting. One must also avoid exposure to strong fragrances or odors, and must not recklessly induce sweating or apply purgatives, as this would deplete the Qi of both the exterior and interior, causing even greater harm. If the pulse is weak, or if there has been recent sexual intercourse, careful inquiry is essential. In treating plague-related macule eruptions, it is crucial to carefully assess the patient's deficiency or excess, the location of the syndrome as exterior or interior, and whether the pulse exhibits Shen (spirit/vitality). Wu Keyi’s discussion on macule eruption mentions only purgation as a method, which is insufficient to cover its variations. Cheng Wuji stated that patients with macule eruptions should not be treated with sweating methods, whereas Zhang Jingyue argued that pathogens entering from the exterior should still exit from the interior. For cases where the pulse is rapid without sweat and exterior symptoms persist, treatment must still follow the sweating method to resolve the exterior. Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) is the primary formula for treating macules, and thus Cheng Wuji’s assertion against sweating is considered incorrect. It is my opinion that Cheng Wuji’s prohibition against sweating referred specifically to herbs like Mahuang (Ephedrae Herba), Guizhi (Cinnamomi Ramulus), and Zisu (Perillae Folium), rather than to Xijiao Dihuang Tang.