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This syndrome arises from the deficiency of both Qi and Blood. When Yang Qi is deficient, Yin Blood takes advantage of it. Since Blood has a salty taste and "pickles" or stagnates in the muscles, itching occurs; treatment should involve warming and tonifying combined with the sour astringent properties of *Paeoniae Radix Alba* (Shaoyao). When Yin Blood is deficient, Yang Qi takes advantage of it. Since the nature of Qi is hot, like burning fire, pain occurs; treatment should involve nourishing Blood combined with cooling methods. The ash-white color of the lesions is due to Qi deficiency, resulting in an ashen hue lacking luster; Blood deficiency results in a white color lacking ruddiness.

If chills occur before the seventh day of onset, this indicates hyperactivity of Heart Fire steaming upward to affect Lung Metal, causing blockage of the nine orifices due to extreme Fire; treatment should employ various exterior-releasing heat-clearing methods. If teeth grinding occurs, this indicates severe Heat in the Yangming channel; treatment should clear Stomach Fire. After the seventh day, all cases belong to deficiency-cold. For chills, warm and tonify Yang Qi while nourishing Blood; for teeth grinding, greatly nourish Yin Blood while supplementing Qi.

This syndrome also includes types such as sinking/obscuring (Xianfu) and turning inward/retracting (Daojie), which are similar in appearance but different in syndrome. When the lesion color becomes dry red then purple, and purple turns black, it is named "Dry Withered" (Gan Ku), indicating extreme Heat. At the stage of dry redness, urgent cooling and detoxification are required using herbs such as *Saposhnikoviae Radix* (Fangfeng), *Angelicae Dahuricae Radix* (Baizhi), *Forsythiae Fructus* (Lianqiao), *Schizonepetae Herba* (Jingjie), *Aucubae Semen* (Niuxi/Bangzi - note: text says Niuxi but context implies Niu Bang Zi usually, sticking to literal translation of herb name provided or standard equivalent if obvious typo, here assuming Niu Bang Zi/Akebia fruit? Text says Niu Bang, likely Niu Bang Zi), *Cimicifugae Rhizoma* (Shengma), and *Puerariae Radix* (Gegen), combined with promoting urination. If Spleen/Stomach deficiency prevents food intake, leading to Ying and Wei Qi failing to fully emerge, although lesions appear they retract, leaving the base halo white or black, this is caused by internal deficiency. With slightly cold hands and feet, vomiting, or fatigue, it is named "Sinking/Obstructed" (Xianfu). Treatment requires acrid-warm medicines such as *Lizhong Tang* (Regulate the Middle Decoction); in severe cases, *Yigong San* (Extraordinary Efficacy Powder) or *Muxiang*. If triggered by Wind-Cold exposure, foul odors, sexual activity, or menstrual interference, causing sudden changes in lesion color, it is named "Turning Inward/Retracting" (Daojie). For Wind-Cold, use *Renshen* and *Suye* (Perilla Leaf) added with *Qianghuo*, *Fangfeng*, and *Chantui* (Cicada Slough). For interference, use *Jiawei Sisheng Yin* (Modified Four Saints Drink). During the suppuration phase on days seven or eight, if Qi and Blood are deficient and cannot mature the pus and form scabs, or if diarrhea and anorexia cause sudden dry purple discoloration, reduction of swelling, and opening of the lesions, it is named "Inverted Scabbing" (Daojie). This represents toxins lurking and attacking internally rather than true scabbing; urgent massive tonification of Qi and Blood is needed, doubling the dosage of *Ren Shen* (Ginseng), *Huang Qi* (Astragalus, wine-fried), *Baizhu* (Atractylodes Macrocephala), *Dang Gui* (Angelica Sinensis), *Chuanxiong* (Ligusticum), *Rougui* (Cinnamon Bark), *Zhi Gancao* (Prepared Licorice), *Dingxiang* (Clove), and *Muxiang* (Vladimiria Root, powdered); add *Shanjia* (Pangolin Scales, fried and powdered, 1 qian) and *Ren Ya* (Human Tooth, fire-processed and powdered, 2 li) for simultaneous attack and tonification. If a few scabs form on the head and face, or if ulceration leads to external contraction, or if a few fine lesions appear, or if abscesses/toxins arise, these are all signs of vital energy recovery.