斑疹二字，非以色言，以形言也。故发斑有红紫黑色之殊，而皆以斑名。点与
皮平，绝不高起。其曰蚊迹者，状红斑之成点者也。曰锦纹者，状红斑之成片者也。疹则其形高
出皮肤之上，大者若北方之高粮米，小者若小米，亦有红紫二色，而黑者殊少，较之发斑稍轻。
又有白疹发于卫分，形如苋种，色白，破之，中有清水。凡发此者，最吉，是邪从疹散也。斑疹
形色已尽于斯。先以斑论，总因邪毒不解，留于血分所致。如当汗不汗，则表邪不解；当下不下，
则里邪不解；下之早，则邪陷不解；当清不清，则火盛不解；当补不补，则无力不解。（瘟疫少见。）
或阳症而误温补，则阳亢不解；阴症而误寒凉，则阴凝不解。（瘟疫无此。）不解则直入阴分，
郁而成热，以致液涸血枯而发，乃营卫俱剧之症。凡汗下温清俱不解，及足冷、耳聋、烦闷、咳
呕者，便是发斑之候。鲜红者，吉；紫者，五死一生；黑则十死一生。并忌稠密成片。凡斑既出，
脉洪数有力，身温足暖者，易治。脉沉小，足冷，元气弱者，难治。凡已出未出时，切忌妄投寒
剂，并忌饮冷，恐伤胃气作呕吐。又忌香臭薰触，又不可妄发汗、妄攻下，虚其表里之气，其害尤
甚。若脉弱者，或先有房事，要在审问之。凡治瘟斑，必细审人之虚实，症之表里，脉之有神无
神为要。吴又可发斑条，只有下之一法，奚足以尽其变哉！成氏言发斑者戒发汗，而张景岳则以邪自
外入者，仍自内出。凡脉数无汗，表症俱在者，必须仍从汗解，以犀角地黄汤为治斑要药，而以
成氏不可汗之说为非。愚意成氏之所谓不可汗者，指麻桂紫苏而言，
非指犀角地黄汤也。
“斑”和“疹”这两个字，不是从颜色来定义的，而是从形态来定义的。所以发斑有红色、紫色、黑色等不同，但都称为斑。斑点是平的，与皮肤齐平，完全不隆起。所谓“蚊迹”，是指红斑形成点状的样子。所谓“锦纹”，是指红斑成片状的样子。疹的形态则高出皮肤表面，大的像北方的高粱米，小的像小米，也有红、紫两种颜色，黑色的很少，比发斑的症状稍轻。又有白疹发于卫分（体表浅层），形状像苋菜种子，颜色白色，破溃后里面有清亮的水液。凡是出现这种白疹的，最为吉利，这是邪气随疹而散的表现。关于斑疹的形色特点已经全部阐述完毕。先论述斑，总的原因是邪毒未能解除，滞留于血分所致。比如应当发汗而没有发汗，则表邪不能解除；应当攻下而没有攻下，则里邪不能解除；攻下过早，则邪气内陷而不能解除；应当清热而没有清热，则火热亢盛不能解除；应当补益而没有补益，则因正气无力而无法解除。（瘟疫病中少见这种情况。）或者阳证误用温补，则阳气亢盛不能解除；阴证误用寒凉，则阴寒凝滞不能解除。（瘟疫病没有这种情况。）邪气不解就会直接深入阴分，郁结而生热，导致津液枯竭、血液干涸而发病，这是营气和卫气都严重受损的病证。凡是经过汗法、下法、温法、清法治疗都无效的，以及出现脚冷、耳聋、心烦胸闷、咳嗽呕吐等症状的，就是发斑的征兆。斑色鲜红的，预后良好；紫色的，十死一生；黑色的，十死一生。并且忌讳斑点稠密成片。凡是斑已经发出或尚未发出时，脉象洪大数急且有力，身体温暖、双脚温暖的，容易治疗。脉象沉细，脚冷，元气虚弱的，难以治疗。凡是斑已发出或未发出时，切忌乱投寒凉药物，并忌讳喝冷饮，恐怕损伤胃气导致呕吐。又忌讳香臭气味熏染刺激，又不可妄自发汗、妄自攻下，以免耗伤体表的里的气机，其危害尤其严重。如果脉象虚弱，或者之前有过房事，一定要仔细询问。凡是治疗瘟疫发斑，必须详细审察病人的虚实状况、病症的表里位置、脉象有神无神，这是关键。吴又可关于发斑的论述，只有攻下一法，哪里足以穷尽其变化呢！成无己说发斑者禁止发汗，而张景岳则认为邪气从外侵入，仍应从内部向外透发。凡是脉数无汗，表证都在的，必须仍然从汗法解表，以犀角地黄汤作为治疗斑的要药，并认为成无己所说的不可发汗的观点是错误的。我认为成无己所说的不可发汗，指的是麻黄、桂枝、紫苏这类药物，而不是指犀角地黄汤。
The terms "ban" (macules) and "zhen" (papules/urticaria) are defined not by color, but by morphology. Therefore, macules may appear red, purple, or black, yet all are termed "ban". Macules are flat, level with the skin surface, and do not protrude at all. The term "mosquito bites" refers to the appearance of macules forming as discrete spots. The term "brocade patterns" refers to macules appearing as confluent patches. Papules ("zhen"), however, protrude above the skin surface; large ones resemble sorghum grains common in the north, while small ones resemble millet seeds. They also present in red or purple colors, with black being rare, and are generally milder than macules. There is also a condition called "white papules" occurring in the Wei division (the superficial defensive layer), shaped like amaranth seeds, white in color, which, when ruptured, release clear fluid. The occurrence of such white papules is considered highly auspicious, indicating that pathogenic factors are dispersing along with the eruption. The morphological characteristics of macules and papules have been fully described. Discussing macules first, the general cause is the failure to resolve pathogenic toxins, which remain stagnant in the Blood division. For instance, if sweating should have been induced but was not, exterior pathogens remain unresolved; if purgation should have been applied but was not, interior pathogens remain unresolved; if purgation is applied too early, pathogens sink inward and remain unresolved; if clearing heat should be employed but is not, excessive fire remains unresolved; if tonification should be used but is not, weakness prevents resolution. (This scenario is rare in plague diseases.) Alternatively, if Yang syndromes are mistakenly treated with warming and tonifying methods, Yang hyperactivity remains unresolved; if Yin syndromes are mistakenly treated with cold and cooling methods, Yin stagnation remains unresolved. (These scenarios do not occur in plague diseases.) If pathogens remain unresolved, they penetrate directly into the Yin division, stagnate and generate heat, leading to depletion of fluids and exhaustion of blood, resulting in disease. This represents a severe condition affecting both Ying (nutritive) and Wei (defensive) qi. When treatments involving sweating, purging, warming, and clearing fail, and symptoms such as cold feet, deafness, mental restlessness, cough, and vomiting appear, these are signs of macule eruption. Fresh red macules indicate a favorable prognosis; purple macules indicate a mortality rate of five out of six; black macules indicate a mortality rate of ten out of eleven. Densely packed, confluent macules are strictly contraindicated. Whether macules have erupted or not, if the pulse is surging, rapid, and forceful, and the body is warm with warm feet, the condition is easy to treat. If the pulse is deep and fine, feet are cold, and Yuan Qi (original qi) is weak, the condition is difficult to treat. During the period before or after eruption, one must strictly avoid indiscriminately administering cold-natured medicines and drinking cold liquids, lest this damage Stomach Qi and induce vomiting. One must also avoid exposure to strong fragrances or odors, and must not recklessly induce sweating or apply purgatives, as this would deplete the Qi of both the exterior and interior, causing even greater harm. If the pulse is weak, or if there has been recent sexual intercourse, careful inquiry is essential. In treating plague-related macule eruptions, it is crucial to carefully assess the patient's deficiency or excess, the location of the syndrome as exterior or interior, and whether the pulse exhibits Shen (spirit/vitality). Wu Keyi’s discussion on macule eruption mentions only purgation as a method, which is insufficient to cover its variations. Cheng Wuji stated that patients with macule eruptions should not be treated with sweating methods, whereas Zhang Jingyue argued that pathogens entering from the exterior should still exit from the interior. For cases where the pulse is rapid without sweat and exterior symptoms persist, treatment must still follow the sweating method to resolve the exterior. Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) is the primary formula for treating macules, and thus Cheng Wuji’s assertion against sweating is considered incorrect. It is my opinion that Cheng Wuji’s prohibition against sweating referred specifically to herbs like Mahuang (Ephedrae Herba), Guizhi (Cinnamomi Ramulus), and Zisu (Perillae Folium), rather than to Xijiao Dihuang Tang.