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Whenever macules (maculae) and papules (papular eruptions) first appear, one must use a rolled paper tube to inspect the chest, back, and both hypochondriac regions against light. Those with larger spots located above the skin surface are called "macules" (ban); those that appear vaguely like cloud patterns or as fine,琐碎 small granules are called "papules" (zhen). It is appropriate for them to appear, but not in excessive numbers. Medical texts state that red macules belong to stomach heat, purple ones indicate extreme heat, and black ones indicate rotting of the stomach qi; however, one must also correlate external symptoms before making a diagnosis.

During spring and summer, dampness diseases often present with severe macules and papules. If the macules are pale red, the limbs are cold, there is no significant thirst, and the pulse is neither surging nor rapid, this is either deficiency macules (xu ban) or yin macules (yin ban). Or if only a few points appear slightly on the chest, the face is red while the feet are cold, or there is diarrhea with undigested food, this indicates excess yin repelling yang upward; it should be treated with warming methods.

If the macules are purple with small dots, it is heat in the Pericardium; if large and purple, it is heat in the stomach. Black macules that are bright and lustrous, although considered untreatable, may still be saved if the patient's qi and blood are robust and treated according to proper methods; if they are black and dull, death is certain. Black macules that are faintly visible with reddish surroundings indicate fire pathogen constrained and latent within; copious cooling and resolving agents should be used to vent the pathogen, and occasionally turning red may lead to recovery.

There are also cases where macules and papules occur together, indicating diverse pathogens; each should be drained according to its location. Generally, macules relate more often to the blood level, while papules relate to the qi level. Both macules and papules are manifestations of pathogens emerging outward. During their eruption, if the spirit remains clear, it signifies that the exterior is resolved and the interior is harmonized. If the patient becomes confused after the eruption, it indicates that righteous qi cannot overcome the pathogen, leading to internal collapse, or it is a sign of exhaustion of stomach fluids.

Another type is Bai Bao (white crystalline vesicles), which are small and crystal-clear in color. This results from damp-heat injuring the Lung; although the pathogen has exited, qi and fluids are depleted. Sweet-natured tonifying herbs must be used. If the condition has not prolonged, and qi/fluids are not yet damaged, it is due to dampness constraining the Defensive (Wei) level and incomplete sweating; one should regulate the qi-level pathogen. If the Bai Bao are dry and white like bone, the prognosis is mostly ominous, indicating exhaustion of qi and fluids.

Furthermore, women suffering from warm diseases are similar to men, but often involve periods before pregnancy, postpartum, or during menstruation just starting or stopping. Historically, conditions before pregnancy were treated with modifications of Si Wu Tang (Four Substances Decoction), fearing harm to the fetus. For extreme heat, methods such as applying mud from well bottoms or cold-soaked blue cloth over the abdomen were used, all intending to protect the fetus. However, these should only be used if the pathogen can be resolved thus. If blood-nourishing, cloying herbs are ineffective, careful examination is required; one must not be dogmatic, but rather step-by-step protect the fetal origin, fearing damage to righteous qi and internal invasion of pathogens.

Regarding the postpartum period, texts advise caution with bitter-cold herbs to avoid damaging already depleted yin. However, one must distinguish whether the pathogen can be resolved from the Upper or Middle Jiao; slight use according to symptoms is acceptable. One must simply avoid violating the Lower Jiao. Since the postpartum body is deficient, treatment should follow that for weak individuals suffering from pathogens. Moreover, postpartum is a time when blood and qi are turbulent, creating many "empty voids"; pathogens inevitably invade through these deficiencies. Pathogens affecting deficient areas are difficult to treat.

If menstruation has just started or stopped, the pathogen is about to sink into the Blood Chamber (Xue Shi). Shaoyang Cold Damage discusses this in detail, so no further elaboration is needed here. However, this differs from typical Cold Damage. Zhang Zhongjing established Xiao Chai Hu Tang (Minor Bupleurum Decoction) to extract sunk heat pathogens, using Ginseng and Jujube to support Stomach qi, because the Chong Mai (Penetrating Vessel) belongs to the Yangming channel. This approach fits only deficiency patterns. If heat pathogens sink and bind with blood, one should follow Tao Hua's method: modify Xiao Chai Hu Tang by removing Ginseng and Jujube, adding Sheng Di Huang (Rehmanniae Radix), Tao Ren (Persicae Semen), Shan Zha (Crataegi Fructus), Mu Dan Pi (Moutan Cortex), or Xi Jiao (Rhinocerotis Cornu). If blood stasis in the original channel is severe, causing lower abdominal fullness and pain, mild cases require needling Qi Men (LR14); severe cases require modifying Xiao Chai Hu Tang by removing sweet/calm herbs, adding Yan Hu Suo (Corydalis Rhizoma), Dang Gui Wei (Angelicae Sinensis Radix Caulis), Tao Ren, Rou Gui Xin (Cinnamomi Ramulus Cortex), or Xiang Fu (Cyperi Rhizoma), Chen Pi (Citri Reticulatae Pericarpium), Zhi Ke (Aurantii Fructus Immaturus) for qi stagnation. Symptoms of heat sinking into the Blood Chamber often include delirium and manic-like behavior, resembling Yangming Stomach heat. This pathology requires careful differentiation. Blood binding causes heaviness of the body, unlike the lightness seen in Yangming disease. Why? Yin governs heaviness and turbidity; when collaterals are obstructed, qi bi-zhang (obstruction) affects the sides of the body, extending to the chest and back, causing blockage. Therefore, expelling pathogens and unblocking collaterals matches the pathology. Often, if prolonged, pathogens ascend to the Pericardium, causing chest bi-pain, known as Tao's "Blood Binding Chest" (Xue Jie Xiong). Wang Haizang proposed Gui Zhi Hong Hua Tang (Cinnamon Twig and Safflower Decoction) plus Hai Ge Ke (Arcae Concha) and Tao Ren, aiming to resolve pathogenic factors simultaneously from exterior/interior and upper/lower; this formula is highly ingenious.