人有身不发热，胸胁之间发出红斑，不啻如绛云一片，人以为心火热极，谁知胃火之
郁极乎。夫胃火本宜炎上，何郁滞不宣？盖风寒外束之也。火欲外出，遇寒
遏抑之则火不得出而内藏。然而火蕴结于胃中，终不能藏之也，于是外现于皮肤，发红云之
斑矣。此时以凉药逆投之，则拂其热之性，而变为狂；以热药治之，则助其火之势，而增其
横。必须以风药和解之为得，又不可竟用风药也。大约火旺者水必衰，不补其水，仅散其火，
则胃中燥热何以解氛，不得风而愈扬乎。诚于水中散其火，则火得水而有制，水佐风而息炎，
斑且消灭于乌有，断不至发汗亡阳，以成不可救之症也。方用消红汤∶
干葛（二钱） 玄参（一两） 当归（一两） 芍药（五钱） 升麻（一钱） 生地（
一两） 麦冬（一两） 甘草（一钱） 天花粉（二钱）水煎服。
此方补阴以制火，凉血以化斑，但用散而不用寒，但用和而不用战，自然郁宣而热减，
水旺燥除，何斑之不尽消哉。
此症用散云汤亦神。
葛根（三钱） 青蒿（五钱） 生地（一两） 玄参（一两） 升麻（一钱） 贝母（三
钱） 麦冬（五钱）水煎服。二剂愈。
人有满身发斑，非大块之红赤，不过细小之斑，密密排列，斑上皮肤时而作痒，时而
作痛，人以肺火之盛也，谁知肺火之郁乎。盖肺主皮毛，肺气行而皮毛开，肺
气郁而皮毛闭。其所以郁者，以心火刑金，外遇寒风之吹，肺火不得达于皮毛，而斑乃
现矣。然则肺之生斑，仍是内热之故，治法仍宜泻火。然火郁于皮毛，不用解表，而骤用泻火
之品，反能遏抑火气，不向外达反致内攻，势必至表症变为里症，尤可虞也。故必须散表
之中，佐以消火，则散斑自速也。方用散斑饮∶
玄参（五钱） 升麻（二钱） 白芷（一钱） 荆芥（二钱） 甘草（一钱） 麦冬（
五钱） 生地（一两） 黄连（一钱） 天花粉（三钱）水煎服。一剂斑消，二剂全消。
此方散多于清者，以清火则火愈郁，而气不宣，散风则风尽解，而火亦息也。
此症亦可用苏叶解斑汤∶
苏叶（三钱） 生地（三钱） 麦冬（五钱） 甘草（一钱） 桔梗（二钱） 升麻（
一钱） 贝母（二钱） 当归（五钱）水煎服。二剂愈。
There are cases where a person does not have a fever, but red macules appear between the chest and hypochondrium, resembling a patch of crimson clouds. People assume this is due to extreme Heart Fire (Xin Huo), yet they do not realize it is actually Stomach Fire (Wei Huo) that has become extremely stagnant. Stomach Fire naturally tends to flare upwards; why does it stagnate and fail to disperse? This is because it is constrained externally by Wind-Cold (Feng Han). When Fire attempts to move outward, if it is suppressed by Cold, it cannot exit and remains hidden internally. However, Fire accumulated in the Stomach cannot remain hidden indefinitely; thus, it manifests externally on the skin as red, cloud-like macules. At this stage, if cooling herbs are administered contrary to the nature of the heat, it will violate the thermal property and lead to mania; if heating herbs are used, they will assist the Fire's momentum and increase its destructiveness. The appropriate method is to use Wind-dispelling herbs (Feng Yao) for harmonization, but one must not rely solely on them. Generally, when Fire is excessive, Water (Yin fluids) must be deficient. If Water is not supplemented and only Fire is dispersed, how can the dry-heat in the Stomach be resolved? Without Water to restrain it, Fire will rise more vigorously with the Wind. By dispersing Fire within the context of nourishing Water, Fire is controlled by Water, and Water assists Wind in extinguishing inflammation. The macules will vanish into nothingness, and there will be no danger of sweating leading to Yang collapse (Wang Yang), resulting in an incurable condition. The prescription is Xiao Hong Tang (Eliminate Red Decoction): Ge Gen (Puerariae Lobatae Radix, 2 qian), Xuan Shen (Scrophulariae Radix, 1 liang), Dang Gui (Angelicae Sinensis Radix, 1 liang), Shao Yao (Paeoniae Radix Alba, 5 qian), Sheng Ma (Cimicifugae Rhizoma, 1 qian), Sheng Di Huang (Rehmanniae Radix, 1 liang), Mai Dong (Ophiopogonis Radix, 1 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian), Tian Hua Fen (Trichosanthis Radix, 2 qian). Decoct in water and take orally.
This formula nourishes Yin to control Fire and cools Blood to resolve macules. It employs dispersion rather than cold purgation, and harmonization rather than aggressive attack. Naturally, stagnation is relieved, heat decreases, Water becomes abundant, and dryness is eliminated. How could the macules fail to completely disappear?
For this syndrome, San Yun Tang (Disperse Clouds Decoction) is also effective:
Ge Gen (Puerariae Lobatae Radix, 3 qian), Qing Hao (Artemisiae Annuae Herba, 5 qian), Sheng Di Huang (Rehmanniae Radix, 1 liang), Xuan Shen (Scrophulariae Radix, 1 liang), Sheng Ma (Cimicifugae Rhizoma, 1 qian), Bei Mu (Fritillariae Cirrhosae Bulbus, 3 qian), Mai Dong (Ophiopogonis Radix, 5 qian). Decoct in water and take orally. Cure achieved in two doses.
In some cases, macules cover the entire body. They are not large patches of redness but small, densely arranged spots. The skin over the macules alternately itches and hurts. People attribute this to excessive Lung Fire (Fei Huo), yet it is actually Lung Fire stagnation. The Lung governs the skin and hair; when Lung Qi circulates, the skin pores open; when Lung Qi stagnates, the skin pores close. The cause of stagnation is Heart Fire insulting Metal (Xin Huo Xing Jin), combined with external exposure to Cold Wind. Consequently, Lung Fire cannot reach the skin and hair, causing macules to appear. Since the appearance of macules on the Lung surface is still due to internal heat, the treatment should involve purging Fire. However, since Fire is stagnated in the skin and hair, if one does not release the exterior but suddenly uses Fire-purging herbs, it may suppress the Fire further, preventing it from moving outward and instead driving it inward. This inevitably transforms an exterior syndrome into an interior syndrome, which is even more alarming. Therefore, one must scatter the exterior while assisting with Fire-resolving herbs, so that the macules dissipate rapidly. The prescription is San Ban Yin (Disperse Macules Drink): Xuan Shen (Scrophulariae Radix, 5 qian), Sheng Ma (Cimicifugae Rhizoma, 2 qian), Bai Zhi (Angelicae Dahuricae Radix, 1 qian), Jing Jie (Schizonepetae Spica, 2 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian), Mai Dong (Ophiopogonis Radix, 5 qian), Sheng Di Huang (Rehmanniae Radix, 1 liang), Huang Lian (Coptidis Rhizoma, 1 qian), Tian Hua Fen (Trichosanthis Radix, 3 qian). Decoct in water and take orally. Macules disappear after one dose and completely resolve after two doses.
This formula emphasizes dispersion over clearing. Clearing Fire causes further stagnation and Qi obstruction; dispersing Wind resolves the Wind, and consequently, the Fire subsides.
For this syndrome, Su Ye Jie Ban Tang (Perilla Leaf Macule-Resolving Decoction) can also be used:
Su Ye (Perillae Folium, 3 qian), Sheng Di Huang (Rehmanniae Radix, 3 qian), Mai Dong (Ophiopogonis Radix, 5 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian), Jie Geng (Platycodonis Radix, 2 qian), Sheng Ma (Cimicifugae Rhizoma, 1 qian), Bei Mu (Fritillariae Cirrhosae Bulbus, 2 qian), Dang Gui (Angelicae Sinensis Radix, 5 qian). Decoct in water and take orally. Cure achieved in two doses.