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[Wang] Predecessors stated that children's constitutions vary in deficiency and excess, so one cannot rigidly adhere to the number of days. Some develop rashes after three days of fever, some after six or seven days, and even some after more than ten days; as long as red spots appear on the feet, it is considered fully erupted. After full eruption, blood blisters form. After seven days of blood blisters, they should form pustular scabs. If red spots are still interspersed within the blood blisters, then one cannot rigidly adhere to the number of days; one must wait until all become blood blisters to consider it complete. Blood blisters forming pustular scabs after seven days indicates harmonious Ying (Nutritive) and Wei (Defensive) Qi, with no external pathogenic invasions, allowing the process to proceed as scheduled. Moreover, during the formation of blood blisters, if weather conditions such as cold, heat, dryness, dampness, and wind are irregular, causing abnormal climate variations that lead to disorderly speed of eruption, one cannot rigidly adhere to the number of days. One should only consider the day when all red spots have turned into blood blisters as the completion point. If after seven days of blood blisters, the patient has deficient Qi and some red spots have not yet formed blood blisters, this is due to excessive toxic vapors that fail to consolidate. Urgently apply Zhuwei Gao (Pig Tail Ointment), and scabs will form promptly. [Wan] Popular belief holds that there are specific days for fever, appearance, development, pus formation, and crusting. These are merely generalizations. Rashes vary in density, toxins vary in severity, and constitutions vary in deficiency and excess. How can one rigidly adhere to a fixed number of days? For instance, if rashes are originally sparse, the toxin is mild, the patient has solid Middle Jiao Qi, and can eat, eruption and crusting will naturally be easy, not requiring ten days. If rashes are originally dense, the toxin is severe, but the patient has solid Middle Jiao Qi, can eat, and has harmonious Ying and Wei Qi without internal or external invasions, crusting can occur on schedule by the twelfth or thirteenth day. However, if the patient has deficient Middle Jiao Qi, poor appetite, previous internal or external invasions, or encounters abnormal climate changes, making crusting difficult, how can one rigidly adhere to the number of days?

Wenren Shi said: Those with robust constitution endure summer heat without much fear and winter cold without much fear. Those with weak constitution easily catch cold or heat; in cold rainy weather, they suffer from damp diarrhea due to cold-damp invasion; in slightly hot weather, they suffer from latent heat and heatstroke. Therefore, those who understand seasonal changes can distinguish the prosperity and decline of Yin-Yang and cold-heat. The Classic states: Those with Yang excess endure winter but not summer; those with Yin excess endure summer but not winter. This also reflects different constitutional endowments. Furthermore, from Lixia (Start of Summer), the climate becomes purely Yang, and all things flourish. Physicians using hot herbs should avoid heat (i.e., use caution with strongly heating herbs in summer); for herbs like Guizhi Tang (Cinnamon Twig Decoction) and Mahuang Tang (Ephedra Decoction), one must add Zhimu (Anemarrhena Rhizome), Shengma (Cimicifugae Rhizome), and Shigao (Gypsum Fibrosum). At Lidong (Start of Winter), the climate aligns with pure Yin. Physicians using cold herbs should avoid cold (i.e., use caution with strongly cooling herbs in winter); when using cooling formulas, stop once the disease is addressed, do not necessarily finish the dose. Also, in warm winters, those with deficiency are comfortable while those with excess get sick; in cool summers, those with excess are comfortable while those with deficiency get sick. Warm winters and cool summers are abnormal climatic energies, arriving violently and departing quickly; it depends on how people regulate themselves. In extreme cold, cover warmly to prevent cold invasion, lest toxic vapors be blocked by cold and fail to erupt. In extreme heat, avoid over-covering; keep cool to prevent external heat combining with toxin, causing agitation and ulceration. During sudden storms or heavy rains, be cautious with curtains, add covers, and burn incense to dispel malodorous air. Sleeping areas should be windless yet bright, never dark. Keep lights on at night, have relatives watch closely to ensure food/drink availability and provide massage for itching/pain, as others may not care as diligently.

Wenren Shi said: Wood withers with Guizhi (Cinnamomi Ramulus), realgar turns black with Hufen (Lead Carbonate), citrus rots with dried meat. Things repel each other thus. Rashes fear foul and mixed airs similarly. Avoid: sexual odors, menstrual blood odor, fox sweat/armpit odor, alcohol and greasy food odors, sulfur and mosquito repellent odors, moldy humid air, burnt oil/hair odors, feces/urine splashes, frying oil/eggs odors, all fishy/foul odors, five pungent spices odors, and odors from travel. These must be strictly avoided. Guard doors, prevent strangers from entering, do not sweep rooms, do not disturb drains, do not open latrines, do not burn strong aromatics like Naozhang (Borneol) and Shexiang (Musk). Zhang Zhongjing said: When rashes are about to erupt, burn Cangzhu (Atractylodis Rhizoma) and Zhujia (Porcis Cutis Corneum). Hang Huyuan (Coriandri Fructus) around the bed, spray with wine, or burn Rushiang (Olibanum) is excellent, as fragrance accelerates Ying and Wei Qi circulation, helping toxin erupt. If precautions fail, disaster follows: eruptions fail, existing ones become necrotic patches, severe cases turn black and depressed, rotting and smelling foul, causing pain like knife wounds, delirium, and death. Even survivors may have permanent black scars or eczema. Must beware. Upon initial eruption, forbid sexual activity, burn dispelling-incense continuously, and heat hard stones with water. If touched, causing color change or itching, treat with Yinchen Moxibustion method.

Dispelling Incense (for Pus-filling stage) Yinchen Moxibustion Method (for Development stage)

[Yuan] Formula for Treating Rashes Turning Purple upon Contact
If rashes turn purple suddenly with panting, seek loofah skin immediately, powder it, mix with honey for application. Gancao Dihuang Tang (Licorice and Rehmannia Decoction) taken once promotes eruption. If irritability/thirst occurs, grind Xijiao (Rhinocerotis Cornu) in water decoction. This applies to days 4-5. Treatment for contact should be as above. By days 7-8, if empty shells are contacted, death is certain. If half-filled blisters are contacted, verify carefully. (Loofah skin should be harvested before veins form, dried, and only skin/stem powdered for use.)

Formula for Treating Ash-White Rashes after Contact
If rashes turn ash-white with unbearable itching, Fuzi (Aconiti Lateralis Radix Praeparata) tight and yellow, the more used, the better the effect. Supporting herbs are prepared previously; details need not be exhaustive. Use your ingenuity as in battle. (Examine the base; if original redness exists, it can be saved; if no true root, do not treat.)

Formula for Treating Rashes Touched by Menstrual Blood
When rashes are erupting and filling, coinciding with menstruation, lack of cleanliness leads to regression. Use Honghua (Carthami Flos) monthly, decoct branches and leaves in wine. Tender tips decocted in wine restore normalcy quickly, regardless of menstrual blood contact.

Formula for Treating Itching Caused by Musk Contact
Musk causes unbearable itching with black specks. Immediately decoct Shengma (Cimicifugae Rhizoma) and Cang'er Cao (Xanthii Fructus) for slow bathing to improve condition. Internally support Wei Qi with Renshen (Ginseng Radix), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix), Shengdi Huang (Rehmanniae Radix), Fangfeng (Saposhnikoviae Radix), Chan Tui (Cicadae Periostracum), Honghua (Carthami Flos), and Chidou (Phaseoli Semen Rubrum). (Note: Chidou refers to wild coarse flat red beans, not domesticated small red beans. Substitute with large red soybeans if unavailable.)

Formula for Treating Rashes Affected by Corpse Oppression
Corpse touch causes eye deviation and sinking rashes with foaming. Quickly burn Yuan Sui (Coriandri Fructus) and Zao Ai (Jujubae Fructus with Artemisia Argyi) in a tube to fumigate. Externally, boil Chen Sha (Cinnabar) with ginger wine to sip frequently to lift rashes. Although corpse oppression does not kill the rash, this treatment restores beauty. (I treat this with Yuan Sui, Chen Sha, and ginger wine internally, and burn the medicine externally. Chen Sha is heavy and settling, good for lifting rashes, but should not be taken in large amounts.)

Formula for Treating Rashes Affected by Guest Wu (Fright from Strangers)
Guest Wu invasion resembles fright, with crying and blue face. Use finely knotted loofah with flowers, dew-harvested, steamed, and baked into powder. Mix with honey and dose according to age. Do not say loofah is cheap; an inch of loofah is worth an inch of gold.

Formula for Treating Rashes Shrinking from Animal Fright
On days 5-6, during pus-filling, if frightened by cats/dogs, rashes shrink, turn slanted, or sink. This is because Heart loses mastery, blood fails to assist, and Qi fails to support. Urgently take Wulong San (Black Dragon Powder).

Wulong San Formula
Wulong San treats fright in rashes caused by pigs, cats, dogs, horses. Use Yuanzhi (Polygalae Radix) and Changpu (Acori Tatarinowii Rhizoma), wash Chan Tui (Cicadae Periostracum) clean. Boil with sweet wine, remove Yuanzhi and Changpu, leave Chan Tui, powder it, mix with brown sugar, and swallow with wine.
Clean Yuanzhi 1 liang, fine Changpu 1 liang, boil in wine, remove herbs, bake Chan Tui to powder, administer with medicinal wine, then give Jiming San. All recover beautifully.

Qian Yi said: For all rashes, wet nurses must guard their diet, avoiding hunger and cold/wind exposure. Wenren Shi said: A person fasting for a day gets hungry; touching cold/wind causes illness. How much more so for infants with rashes relying on grain Qi internally and needing protection from wind/cold externally? If grain Qi is deficient and wind/cold invades, consequences are dire. Infants nursing should have mothers with sufficient diet and wind-free living. Older children should be watched by experienced adults. Balance is key; avoiding hunger/cold should not lead to overfeeding/overheating, which harms rather than helps. Families should know this. Chen Shi said: For feverish rashes with unrelenting thirst, absolutely do not give water, nor cold foods like honey, persimmons, watermelon, or oranges. (If pulse is excess with internal heat, cold foods are not forbidden.) Between crusting stages, if crusting stops, with abdominal distension and thirst, do not give water/honey/cold foods. If head is warm but toes cold, or with diarrhea/thirst/rapid breathing, do not give them. On days 12-13, after scabs fall, if scars are dark or uneven, and skin tender, do not bathe, nor eat roasted/spicy/pungent/toxic foods, fearing heat-toxin steaming the diaphragm and causing eye opacities. Hai Zang said: People often love too much, believing customs over medicine, worrying only when illness is advanced. They rub gently and obey everything, not knowing that excessive love harms and excessive pity abandons. Delaying treatment leads to incomplete cure, death, and wasted effort, then blaming the doctor. Alas, their plan is flawed!