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The disease manifests on the nose and forehead with redness and swelling, extending to severe swelling of both eyes that prevents them from opening, with the entire forehead and face becoming red and swollen; this belongs to the Yangming channel. If accompanied by high fever, panting, dry mouth and tongue, painful and obstructed throat, and a rapid and large pulse, Puji Xiaodu Yin (General Relief Detoxification Decoction) should be used as the primary treatment. If there is excessive internal excess heat, Tongsheng Xiaodu Yin (Universal Protection Detoxification Decoction) is indicated. If the onset occurs around the ears (above, below, front, and back) along with redness and swelling at the temporal regions, this belongs to the Shaoyang channel. If accompanied by muscle heat, worsening heat in the late afternoon, alternating chills and fever, bitter taste in the mouth, dry throat, eye pain, and fullness in the hypochondrium, Xiao Chaihu Tang (Minor Bupleurum Decoction) added with Huatufen (Tetracentrae Semen), Qianghuo (Notopterygii Rhizoma et Radix), Jingjie (Schizonepetae Spica), Lianqiao (Forsythiae Fructus), Huangqin (Scutellariae Radix), and Lianzi (Coptidis Rhizoma) is appropriate. If the onset occurs on the vertex, the nape of the neck, and behind the eyes with redness and swelling, this belongs to the Taiyang channel, and Jingfang Baidu San (Schizonepeta and Saposhnikovia Powder to Overcome Toxins) is suitable. If all three Yang channels are affected simultaneously, concentrating on the head, face, ears, eyes, and nose, Puji Xiaodu Yin should be used, with Qingliang Jiuku San (Cooling and Suffering-Relieving Powder) applied externally. The treatment principle should proceed from mild to urgent measures; otherwise, the pathogenic factor will lie latent. "Mild" measures include reducing fever and detoxifying; for deficient individuals, supporting Yuan Qi (Original Qi) is necessary; for those with weak Stomach Qi and poor appetite, assisting Stomach Qi is required. Only when fecal impaction and intense internal heat are present should Dahuang (Rhei Radix et Rhizoma) be used to purge, thereby extracting the root of the toxin; this constitutes the method of "mild first, then urgent." Generally, this toxin first swells on the nose and forehead, then on the eyes, then on the ears, spreading from the ears to the head and connecting to the posterior brain; if it forms a lump and does not dissipate, it will inevitably suppurate. Folk wisdom states: "In cases of Da Tou Tian Xing (Big Head Epidemic), relatives do not visit each other; those infected often cannot be saved." During the Taihe era, many suffered from this disease. Physicians used Chengqi Tang (Chengqi Decoction) plus Lan Gen (Isatidis Radix) to purge, resulting in slight relief, but the condition returned the next day. Repeated purging provided temporary relief, yet the disease was never cured, gradually becoming critical. Li Dongyuan examined the patient and said: "The upper half of the body is governed by Heaven Qi; the lower half by Earth Qi. Here, evil heat lodges between the Heart and Lung, attacking upward to cause severe swelling of the head and face. Using Chengqi Tang to purge excess heat from the Stomach would be punishing the innocent (treating the wrong organ). Therefore, I prescribe Puji Xiaodu Yin Zi, which has saved many lives."

After Han (sweating) or Xia (purging) treatments for Shanghan (Cold Damage) are incomplete, residual pathogens may knot one cun two fen three li behind the ear, or cause hardness and swelling under both ears; this is named Wei Du (Residual Toxicity). It must be dissipated quickly; delay will lead to suppuration. Lianqiao Baidu San (Forsythia Powder to Overcome Toxins) is indicated. If the neck is swollen and painful, add Weilingxian (Akebiae Caulis); if the stool is hard, add Dahuang (Rhei Radix et Rhizoma) and Chuanshanjia (Manis Squama). If swelling with pus fails to resolve, or if it is broken or unbroken, use Neituo Xiaodu San (Internal Support Detoxification Powder) added with Zaosen (Gleditsiae Spina), Shengma (Cimicifugae Rhizoma), Yinhua (Lonicerae Japonicae Flos), and Gancao (Glycyrrhizae Radix et Rhizoma). Although ancient medical texts discuss these methods, the reality is often due to prolonged heat damaging Yin. Specifically, extreme deficiency of Yin in the Shaoyang and Shaoyin channels leads to deficient fire rushing upward, causing swelling and pain in the cheeks and behind the ears. The Classics state: "When Ying Qi (Nutritive Qi) does not flow smoothly and reverses within the flesh, abscesses and swellings arise." Moreover, the area one cun square behind the ear belongs to the Kidney; what toxicity could there be? Treatment should focus on nourishing Yin, resolving phlegm, dispersing stagnation, and harmonizing the Liver, after which the swelling will heal spontaneously. Herbs such as Shudi (Rehmanniae Radix Praeparata), Maidong (Ophiopogonis Tuber), Tubei Mu (Fritillariae Thunbergii Bulbus), Baishao (Paeoniae Radix Alba), Lianqiao (Forsythiae Fructus), Gancao (Glycyrrhizae Radix et Rhizoma), and Jiegeng (Platycodonis Radix) can be used, slightly assisted by small amounts of Qingpi (Citri Reticulatae Pericarpium Viride) and Chaihu (Bupleuri Radix). If the Chi pulse (radial pulse position corresponding to the Kidney/Lower Jiao) is very weak, the method of "treating the lower to cure the upper" should be employed, using herbs that guide fire back to its source, causing the swelling to dissipate without direct treatment. If mistakenly treated as a toxic accumulation and attacked with purgatives, the swelling will become more hardened and severe, likely leading to other diseases and endangering life. Careful deliberation is required.