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Wang Haicang stated: The disease of macules (Zhen) arises from the fetus in the womb being immersed in and absorbing the turbid essence of the mother's blood, which accumulates into toxic heat. This is primarily due to the stagnation of Taiyin Dampness-Earth, combined with the steaming action of the Ministerial Fire and Sovereign Fire. Since the infant's true Qi is vigorous and righteous Qi is abundant, there is no room for pathogenic factors; or it may be caused by cold weather injuring the exterior or the interior, thereby giving rise to the disease. Treatment should follow the principle: if the pathology is external, treat externally; if internal, treat internally. When both interior and exterior are harmonized, the macular toxin will naturally emerge. For those with aversion to cold, use dispersing methods to release the exterior; for high fever, use draining methods to clear heat; for thirst, use clearing methods to quench thirst; for constipation, use purgative methods to promote bowel movement; for fright, use calming methods to settle the spirit; for diarrhea, use separating methods to resolve dampness. One must not adhere rigidly to a single treatment method. Generally speaking, the treatment principles for Cold Damage (Shanghan) and macules are similar; prescribing herbs according to the affected meridians is considered the highest theory. If within five days of onset, various diseases cannot be distinguished from macules, one must not hesitate or doubt; dispersing methods must be employed. However, treatment should correspond to the specific injury and manifested symptoms, which will not hinder the emergence of the macules. If dispersing methods are forced inappropriately, the resulting complications would be countless.

Predecessors stated that purgatives should not be used at either the beginning or the end of the disease. Why? It is said that at the beginning, purgatives are forbidden because the toxin has not yet manifested on the surface; using purgatives prevents the pathogenic factor from extending outward. In this stage, the pulse and symptoms indicate an exterior pattern without interior involvement, hence the prohibition. At the end, purgatives are forbidden because the toxin has already manifested externally, there is no internal root, the stool is loose, and there are no interior patterns; using purgatives would cause the macular Qi to sink inward, hence the prohibition. Some also suggested keeping warm and avoiding wind. However, if the macules have emerged and the body is hot, and the weather is warm, why cover up and prevent ventilation? Many people in later generations adhered rigidly to these two sentences, failing to adapt to seasonal changes and human circumstances, leading to many errors. Generally, diagnosis should focus on the pulse. Through superficial, middle, and deep palpation—using light, moderate, and heavy pressure—one can assess deficiency and excess, determine the location (interior/exterior), and ensure a perfect outcome.

For external injury: Shengma Decoction (Cimicifugae Decoction).
For internal injury: Zhishi Pill (Immature Bitter Orange Pill).
For constipation: Zhizhu Pill (Atractylodes and Immature Bitter Orange Pill).
For cold injury: Wenshen Pill (Spirit-Calming Pill).
For aversion to cold: Dispersing method with Fangfeng Cangzhu Tang (Saposhnikovia and Atractylodes Decoction).
For severe exterior heat: Draining method (Here "exterior" refers generally to the Three Yang meridians). When Yang is excessive, Qi tends to ascend; "draining" here means treating so as to prevent Qi from ascending upward.
For severe constipation: Purgative method, selecting Tao Ren Chengqi Tang (Peach Kernel and Cinnamon Twig Decoction), Sishun Yin (Four-Compliance Drink), or Chaihu Yin (Bupleurum Drink), depending on whether the pathology is in the Qi level or Blood level.
For thirst: Clearing method. For severe thirst: Baihu Tang (White Tiger Decoction); for mild thirst: Liangge San (Cooling Chest Powder).
For urinary obstruction: Promoting urination method, such as Daochi San (Guiding Out Red Powder) or Bazheng San (Eight-Righteous Powder), choosing herbs based on the affected meridian of the Upper, Middle, or Lower Jiao.
For fright: Calming method, graded by severity.
For diarrhea: Separating method, differentiated by cold and heat.

Herbs for Manifested Patterns:
For slow emergence: Huadu Tang (Toxin-Resolving Decoction).
For excessive emergence: Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) or Digupi Shuniuzi Tang (Cortex Lycii and Arctii Decoction).
For throat discomfort: Jiegeng Gancao Zhizi Tang (Platycodon and Licorice Decoction with Arctii seeds).
For irritability: Jiegeng Gancao Zhizi Tang (Platycodon and Licorice Decoction with Gardenia).
For Lung Qi obstruction: Zicao Gancao Zhike Tang (Arnebia, Licorice, and Aurantium Decoction).
For slow emergence in the Taiyang channel: Jingjie Gancao Fangfeng Tang (Schizonepeta, Licorice, and Saposhnikovia Decoction).
For slow emergence in the Yangming channel: Shengma plus Zicao Tang (Cimicifuga and Arnebia Decoction).
For slow emergence in the Shaoyang channel: Suqiao Fangfeng Tang (Scutellaria and Saposhnikovia Decoction).
For slow emergence in the four limbs: Fangfeng Shaoyao Gancao Tang (Saposhnikovia, Peony, and Licorice Decoction).