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Wan Mizhai's Medical Case Record: Gan Dawen studied medicine under me. His eldest son developed a fever. Upon examination, I said, "This is sha zhen (a rash-causing infectious disease). If the rash does not erupt within three days, the body surface becomes cool while internal heat persists, indicating that toxic fire is latent inside. This causes irritability and restlessness. Immediate treatment is necessary, otherwise it will be critical." Gan Dawen wept and begged for treatment. I prescribed Gegen Tang (Pueraria Decoction) with added Mahuang (Ephedrae Herba) and Shigao (Gypsum Fibrosum) to disperse the pathogen. After one dose, the rash fully erupted but appeared white rather than red. I stated, "This indicates blood deficiency." I then prescribed Siwu Tang (Four Substances Decoction) with Fangfeng (Saposhnikoviae Radix). After one dose, the rash color turned red, and the patient recovered.

Another record states: Wu Daosong suffered from limb rashes. After three days of treatment, the rash had not erupted, and he was extremely irritable. Someone suggested using Jingfang Baidu San (Schizonepeta and Saposhnikovia Powder to Overcome Toxicity). I said, "These are all heating herbs without detoxifying properties. Moreover, given the intense summer heat, the formula lacks herbs to harmonize the season. This will exacerbate Yang excess and Yin deficiency, leading to disharmony in the Yangming channel, which is why the rash fails to erupt." I used Liangge San (Cooling Chest Powder) by Dongyuan with added Xuanshen (Scrophulariae Radix) and Shengma (Cimicifugae Rhizoma). After one dose, the rash erupted, and the patient recovered in three days.

Another record states: The son of Scholar Yang from Yunyang experienced bloody diarrhea after the rash. I provided a prescription containing Danggui Shao (Tip of Angelica Sinensis Root), Shengdihuang (Rehmanniae Radix Recens), Baishao (White Peony Root), Chao Huangqin (Fried Scutellariae Radix), Chao Huanglian (Fried Coptidis Rhizoma), Renshen (Ginseng Radix et Rhizoma), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), Zhike (Aurantii Fructus Immaturus), and Wumei Rou (Mume Fructus Flesh). The condition stabilized. During the local outbreak of rash, this prescription proved effective for patients with bloody dysentery associated with the rash.

Another record states: A young girl from the Zhou family in the same county developed cough and loss of voice after the rash. I prescribed Ganjie Tang (Licorice and Platycodon Decoction) with Chao Niubangzi (Fried Arctii Fructus), Chao Kuhuqin (Fried Scutellariae Radix), and Tianhuafen (Trichosanthis Radix) made into a powder. It was taken with Boheye Tang (Menthae Haplocalycis Decoction), boiled once more, and the patient recovered.

Sunongsu's Medical Case Record: In the Jiaxu year of the Wanli era, from mid-autumn to winter, rash diseases were prevalent. Within three months, I treated 72 children and adults. The Shen family, a prominent clan in Tiao Creek, was notable. When Guan Yi Gong, a Grand Secretary serving as an Official of Evaluations, had his young son suffering from wheezing, coughing, hoarseness, fever, diarrhea, and purple, non-resolving macules, I cured him using Xiaowubi San (Small Five-Immortal Powder).

Another record states: Cheng Xiaoshan suffered a stroke and asked me to examine him. His seven-year-old son had had the rash for over a month, still febrile, with cough, hoarseness, emaciation, and total hair loss. Doctors were helpless, and the family wept. I examined the child. Xiaoshan said, "The family is panicked, thinking the child cannot survive." I replied, "This is Gan syndrome (malnutrition syndrome), triggered by post-rash deficient heat. Daluwei Wan (Large Aloe Pill) will cure him completely." The Cheng family initially doubted me, believing I was not a pediatric specialist, unaware that this was merely a supplementary skill for general practitioners. They prepared the medicine, and the child recovered before finishing the course.

Jiang Yingsu's Medical Case Record: A three-year-old boy had delayed and prematurely resolved rash, accompanied by fever, cough, lethargy, and anorexia. I diagnosed incomplete eruption due to early suppression by wind-cold. I urgently prescribed Ma Huang (Ephedrae Herba) boiled with Congbai (Allii Fistulosi Bulbus) at 8 fen, modified Siwu Tang (Four Substances Decoction) replacing Shudi with Shengdihuang, adding Xingren (Armeniacae Semen Amarum), Tianhuafen (Trichosanthis Radix), Congbai, and Jiang (Zingiberis Rhizoma). After taking it, the rash re-erupted profusely, and the patient recovered in three days. Generally, rashes originating from the Fu organs require nourishing Yin and suppressing Yang; harsh/drying medicines must be avoided. Misuse leads to asthma, thirst, and delirium, often causing death. Warming-drying herbs like Renshen (Ginseng Radix et Rhizoma), Fuzi (Aconiti Lateralis Radix Preparata), Banxia (Pinelliae Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), and Danggui (Angelicae Sinensis Radix) are contraindicated. Only clearing heat and nourishing blood is appropriate. For delayed eruption, slight dispersing agents may be added to reach the exterior.

Another record states: My cousin's nine-year-old daughter had premature resolution of rash, leading to cough, high fever, emaciation, anorexia, and excessive vomiting of phlegm for over half a month. I diagnosed blood deficiency and prescribed Siwu Tang (Four Substances Decoction) with Xingren (Armeniacae Semen Amarum), Ejiao (Colla Corii Asini), Maidong (Ophiopogonis Radix), Wuweizi (Schisandrae Chinensis Fructus), and Paojiang (Prepared Zingiberis Rhizoma). One dose stopped fever and cooled the body; two doses cured the cough and phlegm.

Fang Yinshan's Medical Case Record: A two-year-old son of the Cheng family had delayed and prematurely resolved rash, resulting in asthma, high fever, short tongue, inability to nurse, and lethargy. Doctors gave up. I used Xuanshen (Scrophulariae Radix), Fuling (Poria), Gancao (Glycyrrhizae Radix et Rhizoma), Maidong (Ophiopogonis Radix), Shengma (Cimicifugae Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Gegen (Puerariae Lobatae Radix), Mahuang (Ephedrae Herba), Dailing (Stemonae Radix), Huangqin (Scutellariae Radix), Zhimu (Anemarrhenae Rhizoma), Xijiao (Rhinocerotis Cornu - *Note: Substitute with Buffalo Horn in modern practice*), and Shigao (Gypsum Fibrosum), named Xijiao Shigao Tang (Rhino Horn and Gypsum Decoction). Symptoms halved after one dose; cured after two.

Taihan Ji records: Wu Qiao was known for his medical skills in his hometown. His brother's infant son had persistent steaming fever, convulsions, and coma. Doctors were baffled. Wu Qiao diagnosed rash suppressed by cold pathogens. He noted that previous medications had damaged the Middle Qi. Instead of relying solely on herbs, he placed a bottle of boiling water nearby, removed the lid, and had the nurse hold the child near it, covered with blankets, allowing steam to fumigate the child gently while administering mild internal-supporting herbs. The rash erupted, and the illness resolved. A similar case in the Wang family responded to the same method. His prudence earned him respect as a good doctor.

Miao Xiyong's Medical Case Record: He Zhiren's youngest son suffered severe sha zhen. Unaware, the family fed him meat. Upon arrival, I exclaimed, "This is extremely severe sha zhen! How can it be underestimated?" I prescribed Xihe Liu (Tamarici Cacumen) 2 liang, mixed with Xuanshen (Scrophulariae Radix) 3 qian, Zhimu (Anemarrhenae Rhizoma) 5 qian, Beimu (Fritillariae Cirrhosae Bulbus) 3 qian, Maimendong (Ophiopogonis Radix) 2 liang, Shigao (Gypsum Fibrosum) 1.5 liang, and Zhu Ye (Bambusae Folium) 70 pieces. After two doses, the rash fully erupted, turning the body red. I continued with four doses. By evening, Zhiren asked if the child was safe. I replied, "Although the rash has erupted, persistent irritability remains; safety is not guaranteed." I prescribed Shigao (Gypsum Fibrosum) 3 liang, Zhimu (Anemarrhenae Rhizoma) 1 liang, Maimendong (Ophiopogonis Radix) 3 liang, plus Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), and Huangbai (Phellodendri Cortex) 5 qian each, Xihe Liu (Tamarici Cacumen) 1 liang, and Zhu Ye (Bambusae Folium) 200 pieces, decocted strongly. Irritability ceased, and the child recovered.

Lin's Commentary: Miao used such a large amount of Xihe Liu. Is there no concern about excessive warming and ascending? He always uses Shigao (Gypsum Fibrosum) to control it, likely following Zhang Zhongjing's principle of combining Mahuang (Ephedrae Herba) and Shigao (Gypsum Fibrosum). However, for children with weak constitutions, this is dangerous.

Zhu Jichuan's Medical Case Record: A child had rash in the first lunar month. The body showed faint signs of weakness, with no rash on the head or face, pale-blue complexion, asthma, distension, and confusion. The right Cun pulse was faint. I reasoned that deficient Zheng Qi could not drive pathogens upward to the head and face. Treatment should focus on tonifying and assisting ascent. I prescribed Mahuang Guizhi Tang (Ephedra and Cinnamon Twig Decoction) with Renshen (Ginseng Radix et Rhizoma) 2 qian, decocted in water. Additionally, I washed the head, face, hands, and feet with a decoction of Yuanscong (Coriandri Fructus) and Fangfeng (Saposhnikoviae Radix). The rash penetrated, symptoms subsided, and the child recovered.

Another record states: A child ate excessively during rash eruption, causing food stagnation, abdominal fullness, constipation, high fever, and delirium. I attributed this to food obstruction preventing toxin resolution. I used Dahuang (Rhei Radix et Rhizoma), Zhishi (Aurantii Fructus Immaturus), Gualou Ren (Trichosanthis Semen), Houpo (Magnoliae Officinalis Cortex), Gancao (Glycyrrhizae Radix et Rhizoma), and Huanglian (Coptidis Rhizoma) to purge. However, asthma, cough, high fever, slow pulse, and cold limbs persisted. I then used Fuzi Lizhong Tang (Aconite Decoction to Warm the Middle) followed by Guishao Liujunzi Tang (Angelica and Peony Six-Gentlemen Decoction) to cure.

Another record states: A child had fever and cough with faint rash. Doctors used rash-dispersing herbs, but the rash neither emerged nor resolved. I diagnosed hidden rash caused by external wind-cold stagnation, distinct from typical Fu organ rash. I cured it with Xiong Su San (Ligusticum and Perilla Powder).

Another record states: A child had abundant rash resembling brocade patterns, with some red papules, high fever, irritability, thick tongue coating, and constipation. I diagnosed simultaneous macules and rash. I used Tiaowei Chengqi Tang (Regulating the Stomach and Purging Down Decoction) to purge, followed by Baihu Tang (White Tiger Decoction) combined with Gegen Tang (Pueraria Decoction) to cure.

Another record states: A child had fever, rash, vomiting, and diarrhea. I considered initial vomiting and diarrhea during rash eruption as a sign of Yang fire venting, which is auspicious. I used Shengma Gegen Tang (Cimicifuga and Pueraria Decoction) to release the exterior. The rash fully penetrated, and the child recovered. If accompanied by food injury, digestive herbs are added to the above formula.

Another record states: A girl took cold-natured herbs and ate raw pears, causing the rash to vanish quickly. She developed rapid breathing, chest fullness, blue face, cold limbs, closed eyes, hoarseness, and fainting. I diagnosed toxin suppressed by cold, forcing inward attack. I prescribed Mahuang Tang (Ephedra Decoction) with Gegen (Puerariae Lobatae Radix), Zisu (Perillae Folium), Gancao (Glycyrrhizae Radix et Rhizoma), Jiegeng (Platycodonis Radix), and Shengjiang (Zingiberis Rhizoma Recens). Covered with blankets, she sweated and regained consciousness. The rash re-emerged with worse asthma. I reasoned that sudden use of drying/hot Mahuang (Ephedrae Herba) exacerbated toxic fire and lung heat. I prescribed moistening/clearing herbs: Gancao (Glycyrrhizae Radix et Rhizoma), Jiegeng (Platycodonis Radix), Niubangzi (Arctii Fructus), Qianhu (Peucedani Radix), Xingren (Armeniacae Semen Amarum), Xuanshen (Scrophulariae Radix), Zhimu (Anemarrhenae Rhizoma), Tianhuafen (Trichosanthis Radix), Huangqin (Scutellariae Radix), and Maimendong (Ophiopogonis Radix) to cure the asthma.

Another record states: A pregnant woman had severe fever with rash, leading to miscarriage and difficult labor. I burned 3 cun of Yujiao (Fish Maw/Collagen) to ash, mixed with 1 fen of Muxiang (Moschus), powdered it, and administered with fine wine. Delivery occurred immediately. For severe dystocia or breech presentation, 1 chi of Yujiao (Fish Maw/Collagen) prepared similarly allows immediate delivery, though the fetus may not survive.

Another record states: A pregnant woman had severe fever with rash, lower abdominal pain, and bleeding. I attributed this to heat disturbing the fetus. I prescribed Shengma Gegen Tang (Cimicifuga and Pueraria Decoction) with Jingjie (Schizonepetae Spica), Zisu (Perillae Folium), Huangqin (Scutellariae Radix), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Ejiao (Colla Corii Asini), Baizhu (Atractylodis Macrocephalae Rhizoma), Chenpi (Citri Reticulatae Pericarpium), and Sharen (Amomi Fructus). Bleeding stopped, and the condition resolved. Failure to treat this way could result in fetal loss and death of mother and child, or death of the child only.

Another record states: A child had fully erupted rash but suffered asthma, distension, constipation, high fever, and delirium. I diagnosed incomplete toxin expulsion. I used Huanglian (Coptidis Rhizoma), Zhishi (Aurantii Fructus Immaturus), Gualou Ren (Trichosanthis Semen), Sangbaipi (Mori Cortex), Digupi (Lycii Cortex), Zhimu (Anemarrhenae Rhizoma), Shigao (Gypsum Fibrosum), and Renzhonghuang (Human Excrement Yellow) to cure.

Another record states: A child had sore throat and swelling after rash. I diagnosed residual toxins. I used Ganjie Tang (Licorice and Platycodon Decoction) with Niubangzi (Arctii Fructus), Shegan (Belamcandae Rhizoma), Xuanshen (Scrophulariae Radix), Lianqiao (Forsythiae Fructus), and Zhimu (Anemarrhenae Rhizoma). Additionally, Gejin San (Kudzu and Hibiscus Powder) was insufflated into the throat to cure.

Another record states: A son had persistent phlegm-cough after rash following his wedding. Others attributed it to residual toxins and used clearing/resolving herbs, worsening the phlegm. I diagnosed Yin deficiency with uncontrolled Fire, causing afternoon tidal fever and severe cough. Treatment focused on nourishing Water (Yin). I used Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) base with Maidong (Ophiopogonis Radix) and Zhimu (Anemarrhenae Rhizoma) to cure.

Another record states: A child had intermittent dry cough after rash. I diagnosed Lung Qi deficiency due to excessive dispersing by previous doctors. I used Xiaoyigong San (Minor Extraordinary Assistance Powder) with Maimendong (Ophiopogonis Radix), Wuweizi (Schisandrae Chinensis Fructus), Beimu (Fritillariae Cirrhosae Bulbus), and Jiegeng (Platycodonis Radix) to cure.

Another record states: A child developed Gangrenous Mouth Ulcers (Zouma Yagan) after rash, with gum ulceration penetrating the nose. Previous treatments failed. I used dried cow dung tip, calcined on a tile, powdered, mixed with Renzhongbai (Calcinatus Natrii Carbonas) powder and Huangbai (Phellodendri Cortex) powder in equal parts, and insufflated it. The ulcers healed, gums regenerated, and the child recovered.

Another record states: A child had persistent dry cough after rash. I diagnosed Lung Qi deficiency from excessive dispersion during the rash phase, recommending Spleen and Lung tonification. Ignoring this, they used only cooling/cough-suppressing herbs. The child developed a hunched back and thin legs, a lifelong disability. Some develop pigeon chest from chronic cough. Mr. Qiyun stated: "Chronic cough after rash depletes Metal (Lung); Metal depletion fails to generate Kidney Water. The Kidneys govern marrow; without vital energy, bones wither and marrow diminishes. Wind-cold enters the marrow, stagnates, and causes spinal immobility." Treatment first uses Fengsang San (Wind-Expelling Powder) to dispel pathogens, then Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill) with Renshen (Ginseng Radix et Rhizoma), Duzhong (Eucommiae Cortex), Niuxi (Achyranthis Bidentatae Radix), Danggui (Angelicae Sinensis Radix), Shihu (Dendrobii Caulis), Heshouwu (Polygoni Multiflori Radix), Yimi (Coicis Semen), Tusizi (Cuscutae Semen), and Bibai (Dioscoreae Hypoglaucae Rhizoma), formed into honey pills with Lurong (Cervi Cornu Pantotrichum). Fengzhuang Jin Huoxue Gao (Wind-Dispersing, Tendon-Strengthening, Blood-Invigorating Plaster) is applied to convexities. Feishu (BL13) and Geshu (BL17) acupoints are moxa-ed. For a child with this condition and weak/soft Right pulses, indicating Spleen/Lung deficiency, I first used Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma), Beimu (Fritillariae Cirrhosae Bulbus), Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix Alba), Yimi (Coicis Semen), and Shihu (Dendrobii Caulis) decocted. Once Spleen Earth stabilized, I used the previous methods. Legs gained flesh, back curvature improved slightly, but full recovery was not achieved.

Shen Mingsheng's Medical Case Record: Shen Hanchen's wife had cough and fever. Mistakenly diagnosed as deficiency, Liuwei Dihuang Tang (Six-Ingredient Rehmannia Decoction) was used to nourish Yin, worsening the cough. Pulse was floating and rapid; Wind-Heat invaded the Lungs. I prescribed exterior-releasing herbs. Red rash erupted all over the body. After two doses, cough eased but rash remained untransmitted. I added Acrid-Cool herbs to clear exterior heat. Cough persisted, followed by diarrhea. Others blamed Cold-Clear herbs. I laughed, "Incorrect. Lung affected by Wind transforms into Heat. The Classic says: 'When pathogens combine with Yang, Yang becomes hot and Yin becomes deficient.' Initially, rash was about to erupt; Fire flared up the Hand-Taiyin channel causing cough. Now, rash is about to recede; Heat moves down the Hand-Yangming channel causing diarrhea. This is common in macule/rash cases. It will stop soon." Indeed, after two days, cough and diarrhea ceased, body cooled, and rash faded. Although manifestations differ, treatment principles are similar. In the Dingwei year, Wet Earth governed the Heaven, causing extreme drought in spring/summer, lingering from the previous year's Dry Metal. Thus, initial treatment requires Cooling-Resolving, not Warming-Dispersing; subsequent treatment requires Cold-Moistening, not Warming-Tonifying. Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) seems suitable but is rich/heavy, failing to reach the exterior and trapping pathogens. It is only reasonable when residual heat lingers after rash fades. Using it at the onset of fever/cough is nourishing harm, not Yin. Converting pills to decoctions deviates from ancient intent. Blind application ignores pathological changes. Even Xue Lizhai, master of Liuwei, would sigh if he saw modern misuse.

Chai Yuqing's Medical Case Record: Candidate Wang, 20s, contracted seasonal qi and developed rash. Overuse of Shigao (Gypsum Fibrosum) caused fever, diarrhea, deafness, anorexia, weak Chi pulses, and dry tongue. Originally Yin deficiency, aggravated by Cold herbs damaging both Yang and Yin. I used Maidong (Ophiopogonis Radix) 5 qian to nourish Yin and clear deficient heat, Chenpi (Citri Reticulatae Pericarpium) to harmonize Stomach Qi, and Xihe Liu (Tamarici Cacumen) 1 qian to clear rash toxin. Next day, fever subsided, diarrhea stopped, tongue moistened. Left Cun pulse became slightly surging; I added Xiaoshengdi (Rehmanniae Radix) 2 qian, Mutong (Akebiae Caulis) 1 qian, and Juye (Chrysanthemi Indici Folium) 1 qian. Fever resolved, appetite returned in three days. Concerned about failing the selection exam due to weakness/deafness, I waited until day 19 of recovery to prescribe tonics. He recovered fully and passed the exam.

Feng Chuzhan's Medical Case Record: Shen's son had fever for days. Rash appeared for one day, then vanished from the face. Spirit was exhausted, roundworms vomited, anorexia for days, diarrhea below, asthma above, cracked lips/mouth, five-center high fever, cold fingertips, fine/rapid pulse without order, weaker Chi pulses. Others thought rash toxin entered organs and Stomach heat caused worms. I knew spirit was collapsing, five Zang were distressed, Spleen deficiency prevented grain intake, worms starved, and deficient Fire steamed organs, causing worms to exit. Most rashes stem from internal injury and Spleen/Stomach weakness. Yang rebels, Yin covers the exterior. Strong Blood/Qi yields red rash; Weak Blood/QI yields white/faint rash. Where is the difference in toxicity? Facial retraction indicates Yang deficiency failing to ascend; Asthma indicates Qi exhaustion; Cracked lips indicate Spleen fluid depletion; Five-center fever indicates Yin deficiency with Fire scorching; Diarrhea/anorexia indicates True Fire decline and Spleen failure; Fine/rapid Cun/Guan and weak Chi indicate Qi/Blood deficiency with floating deficient Fire. Treat acute symptoms first, root later. Current urgency is collapsing Zheng Qi. Clearing toxins might exhaust spirit further. I used Shudi (Rehmanniae Radix Preparata) 6 qian, Danpi (Moutan Cortex) 1 qian, Maidong (Ophiopogonis Radix) 3 qian, Niuxi (Achyranthis Bidentatae Radix) 2 qian, and Zhi Fuzi (Prepared Aconiti Lateralis Radix) 6 fen. One dose eliminated false heat, revealing true deficiency; spirit grew more tired. Yin had slightly recovered; now tonify Qi to aid generation. Added Renshen (Ginseng Radix et Rhizoma) 2 qian decocted separately to the previous formula. Spirit gradually recovered, asthma resolved. Mild vomiting after drinking porridge indicated long-term Stomach Qi deficiency. I added Chao Huang Baizhu (Fried Atractylodis Macrocephalae Rhizoma) 2 qian, removed Danpi (Moutan Cortex), continued Renshen (Ginseng Radix et Rhizoma) decoction. Four doses cured.

Lv Yonghui's Medical Case Record: Qian Du's five-year-old son had rash with diarrhea. Pediatricians claimed toxins should be purged, prioritizing clearing Fire with Cold herbs, worsening the condition. I saw tender red cheeks, teeth grinding, rapid asthma, severe thirst, continuous drinking, and洪缓 (surging-slow) pulse like a healthy adult. I said, "Spleen is critical." Urgently prescribed Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Danggui (Angelicae Sinensis Radix), Huangqi (Astragali Membranacei Radix), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma), Fuling (Poria), and Muxiang (Aucklandiae Radix). One dose brought relief. Next day, neighbors warned against treating a child with "rotten scholar" herbs, claiming rash requires dispersing/cooling/detoxifying, and warming-tonics would fail. Family feared and stopped medication. Two days later, Qian Du returned, symptoms relapsed. I predicted "Heavenly Pillar has fallen" (severe collapse). He rushed back confirming my words. I advised taking the previous tonic. He asked why I called it Deficient-Cold when cheeks were red and thirst existed. I explained: "Yin exhausted internally, Yang scattered externally. Cold herbs forced Yang without refuge, creating Internal True Cold and External False Heat. This reveals the subtle meaning of the Neijing by Mr. Lizhai,可信 only to those who deeply investigate." Qian Du defied others, took the medicine. Heavenly Pill straightened in one dose; asthma/thirst stopped in two; walking/playing in three.

Shu Chi Yuan's Medical Case Record: Lao Geng, 27, had summer rash with slight head/body heat, pale-red spots, severe sore throat. Doctors mistakenly used Chaihu (Bupleuri Radix), Gegen (Puerariae Lobatae Radix), Niubangzi (Arctii Fructus), Gancao (Glycyrrhizae Radix et Rhizoma), Jiegeng (Platycodonis Radix), causing diarrhea. After several episodes of severe diarrhea, rash sank/vanished, throat closed, mutism, confusion, near-fainting. Tian You was present. I told Tian You, "This is pure Yin-Cold inside. Standard rash drugs will kill him." Tian You asked why. I said, "If internal Fire existed, spots would be purple-red, not pale-red. Throat pain without redness/swelling, no thirst/aversion to heat, clearly indicates Kidney Deficient-Cold with Yin Fire attacking. Yang harmony ensures health. Rash is Yang; only Pure Yang allows eruption. At appearance, like sprouts, encountering Yin/Killing Qi destroys them. With rampant Yin Evil burying True Yang, survival is rare. We must abruptly administer Fuzi (Aconiti Lateralis Radix Preparata), Ganjiang (Zingiberis Rhizoma), Banxia (Pinelliae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Rougui (Cinnamomi Cortex), and Huangqi (Astragali Membranacei Radix) to warm-tonify, expel Yin, restore Yang, and return chaos to harmony. Dangerous yet subtle!"

Lin's Commentary: These three cases are similar, representing 1 in 1000. Do not take them as standard rules. Generally, rash affects Lung/Stomach; treatment should loosen/penetrate. All warming-drying/tonifying/astringent herbs are contraindicated. Though not standard treatment, they are preserved as alternative patterns.

Another record states: Cousin Jingqian, 30, had rash. Initial fever caused mental irritability and abdominal burning pain. He asked if Sandou Tang (Three Bean Decoction) could be taken. I said, "Decoct and drink urgently." Heart/abdominal heat resolved, but spots did not appear, dizziness ensued, cough/asthma increased, nasal flaring observed. Detailed examination revealed Heat-Toxin blocking Lungs; Lung blockage prevents fluid flow and pore opening, hence no spots. I used Huangqin (Scutellariae Radix) to clear interior heat, Ejiao (Colla Corii Asini) and Maidong (Ophiopogonis Radix) to moisten Lung dryness, Jiegeng (Platycodonis Radix) to raise Lung Qi, and Chaihu (Bupleuri Radix), Gegen (Puerariae Lobatae Radix)...