脉多沉伏。或细而散。或绝无。滑伯仁曰。脉者血之波澜。故发斑者。血散于肌肤。故
脉伏。脉阳浮而数。阴实而大。火盛在表。故阳脉浮数。下焦实热。故阴脉实大。
夫斑。有色点而无头粒者是也。疹浮小有头粒者。随出随收。收则又出者是也。非若斑
之无
头粒者。当明辨之。若斑发赤红。为胃热。若紫而不赤者。为热甚。如紫黑者。为胃烂。故
赤者半生半死。黑色者九死一生。大抵鲜红起发稀朗者吉。紫黑者难治。杂黑斑烂者死也。
凡斑欲出未出之际。宜先以升麻汤透其毒。脉虚。加人参。食少而大便不实。加白术。斑已
出不宜再发者。斑不可汗。斑烂者不宜下。如脉洪数。热甚烦渴者。人参化斑汤。
一论阳毒赤斑。口出狂言。吐脓血。乃热毒蕴于胸中而发斑。宜以
升麻汤
升麻（二钱） 犀牛角屑 射干 人参 生甘草（各一钱）
上锉一剂。水煎。温服。
一论只因内热发出。皮肤如蚊虫之啮。不宜汗下。但清热降火凉血气为要。若斑黑为不
治之症。宜用
人参化斑汤
人参（三钱） 石膏（一两） 知母（二钱五分） 当归 紫草茸 白茯苓（去皮） 甘草（各
三钱）
上锉一剂。水煎服。
一论气分有热发斑者。宜用
柴胡汤
柴胡（三钱） 黄芩（二钱） 半夏（姜炒二钱） 人参（一钱） 紫草（二钱） 黄连（二钱） 茯苓（二钱） 甘
草（二钱）
上锉一剂。生姜煎服。
一论血分有热发斑者。宜
当归散
当归（三钱） 赤芍（二钱） 生地黄（三钱） 黄连（六分） 红花（八分） 石膏（二钱）
上锉一剂。水煎服。
一论瘾疹。因风热客于肌腠。气血积阻而成也。宜
加味败毒散
羌活 独活 前胡 柴胡 当归 川芎 枳壳（去穣） 桔梗 茯苓 人参（各五分）
薄荷 甘草 白术 防风 荆芥 苍术（米泔水浸） 赤芍 生地黄（各五分）
上锉一剂。姜、枣。水煎。温服。此因感冒风湿。以致发斑者。服之良验。
一论斑者。如胭脂点而不起粒者是也。红斑可治。紫斑十活其一。黑斑十无一生。如有
斑见。宜服
解毒化斑汤
牡丹皮 生地黄 木通 归尾 远志（甘草汤泡去心） 犀角（以乳汁磨下一二钱） 紫
草茸 知母 牛蒡子 茜根 甘草（生带梢者） 穿山甲（炒成珠研末一钱）
上用水煎药。调下山甲末并犀角汁同服。
脉象多表现为沉伏。或者细弱而散乱，或者完全摸不到。滑伯仁说：脉是血液运行的波澜表现，所以发斑疹时，血液散溢于肌肤之间，因此脉象伏匿。如果脉象阳部浮数，阴部实大，说明火邪盛于体表，所以阳脉浮数；下焦有实热，所以阴脉实大。
所谓“斑”，是有颜色斑点但没有颗粒头粒的皮疹。“疹”则是浮起、较小且有颗粒头粒的皮疹，它们随出随收，收起后又重新发出，不像斑那样没有头粒，应当明确辨别这两者。如果斑发出呈赤红色，属于胃热；如果呈紫色而不红，说明热毒极盛；如果呈紫黑色，说明胃腑腐烂。因此，赤色的斑疹一半生一半死；黑色的斑疹九死一生。大体上，鲜红色、起发稀疏明朗的是吉兆；紫黑色的难以治疗；夹杂黑色且腐烂的斑疹则会导致死亡。
凡是斑疹将要发出但尚未发出的时候，适宜先用升麻汤来透发毒邪。如果脉象虚弱，加入人参；如果食欲少且大便不成形，加入白术。斑疹已经发出后不宜再次发汗，因为斑疹不可用汗法；斑疹腐烂者不宜用泻下法。如果脉象洪数，热盛且烦渴，宜用人参化斑汤。
一篇论述阳毒引起的赤色斑疹，患者口出狂言，呕吐脓血，这是热毒蕴结在胸中而引发的斑疹，适宜用升麻汤。
升麻（二钱） 犀牛角屑 射干 人参 生甘草（各一钱）
以上药材锉碎为一剂，用水煎煮，温服。
一篇论述只因内热引发，皮肤感觉像蚊虫叮咬一样，不宜用汗法和下法，只有清热、降火、凉血气才是关键。如果斑疹变黑，属于不治之症，适宜用人参化斑汤。
人参（三钱） 石膏（一两） 知母（二钱五分） 当归 紫草茸 白茯苓（去皮） 甘草（各三钱）
以上药材锉碎为一剂，用水煎煮服用。
一篇论述气分有热引发斑疹的，适宜用柴胡汤。
柴胡（三钱） 黄芩（二钱） 半夏（姜炒二钱） 人参（一钱） 紫草（二钱） 黄连（二钱） 茯苓（二钱） 甘草（二钱）
以上药材锉碎为一剂，用生姜煎煮服用。
一篇论述血分有热引发斑疹的，适宜用当归散。
当归（三钱） 赤芍（二钱） 生地黄（三钱） 黄连（六分） 红花（八分） 石膏（二钱）
以上药材锉碎为一剂，用水煎煮服用。
一篇论述瘾疹，是因为风热客居于肌腠之间，气血积聚阻滞而成。适宜用加味败毒散。
羌活 独活 前胡 柴胡 当归 川芎 枳壳（去瓤） 桔梗 茯苓 人参（各五分）
薄荷 甘草 白术 防风 荆芥 苍术（米泔水浸泡） 赤芍 生地黄（各五分）
以上药材锉碎为一剂，用姜、枣，水煎煮，温服。这是因为感冒风湿，导致发斑疹，服用此方效果良好。
一篇论述斑疹，像胭脂点染而没有颗粒头粒的就是斑。红斑可以治疗，紫斑十人中能活一个，黑斑十人中没有能活的。如果有斑疹出现，适宜服用解毒化斑汤。
牡丹皮 生地黄 木通 归尾 远志（甘草汤浸泡去心） 犀角（用乳汁磨下一二钱） 紫草茸 知母 牛蒡子 茜根 甘草（生带梢者） 穿山甲（炒成珠研末一钱）
以上用水煎药，调下山甲末和犀角汁一同服用。
The pulse is mostly deep and hidden (Chen Fu). It may be fine and scattered (Xi San), or completely imperceptible. Hua Bo-ren stated: "The pulse is the ripple of blood." Therefore, when macules erupt, blood scatters into the skin and muscles, causing the pulse to become hidden. If the pulse is floating and rapid in the Yang position, and solid and large in the Yin position, it indicates excessive fire on the exterior, hence the Yang pulse is floating and rapid; excess heat in the Lower Jiao causes the Yin pulse to be solid and large.
"Ban" (Macules) are characterized by colored spots without granular heads. "Zhen" (Papules/Rash) are raised, small, and have granular heads; they appear and disappear quickly, reappearing after receding, unlike Ban which lacks granular heads. These must be clearly distinguished. If the macules are bright red, it indicates Stomach Heat. If purple but not red, it indicates extreme heat. If purple-black, it indicates rotting of the Stomach. Thus, red macules indicate a prognosis of half survival and half death; black macules indicate nine deaths for every one survivor. Generally, fresh red macules that emerge sparsely and clearly are auspicious; purple-black ones are difficult to treat; those mixed with black and rotting are fatal.
When macules are about to emerge but have not yet appeared, it is appropriate to first use Shengma Tang (Cimicifugae Decoction) to vent the toxicity. If the pulse is deficient, add Renshen (Ginseng Radix et Rhizoma); if appetite is poor and stools are loose, add Baizhu (Atractylodis Macrocephalae Rhizoma). Once macules have emerged, further sweating is contraindicated as macules should not be treated with diaphoresis; if macules are ulcerated, purgation is contraindicated. If the pulse is flooding and rapid, with severe heat, restlessness, and thirst, Renshen Huaban Tang (Ginseng Macule-Transforming Decoction) is indicated.
One discussion addresses Yang Toxicity causing red macules, with delirious speech and vomiting of pus and blood. This results from heat-toxin accumulating in the chest and erupting as macules. Shengma Tang (Cimicifugae Decoction) is indicated.
Shengma (Cimicifugae Rhizoma, 2 qian) Xijiaojiao Xi (Rhinoceros Horn Chips) Shegan (Belamcandae Rhizoma) Renshen (Ginseng Radix et Rhizoma) Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma, 1 qian each)
Crush these ingredients for one dose. Decoct in water and take warm.
One discussion addresses eruptions caused solely by internal heat, where the skin feels like insect bites. Sweating and purging are inappropriate; clearing heat, reducing fire, and cooling blood and Qi are essential. If macules turn black, it is an untreatable condition. Renshen Huaban Tang (Ginseng Macule-Transforming Decoction) is indicated.
Renshen (Ginseng Radix et Rhizoma, 3 qian) Shigao (Gypsum Fibrosum, 1 liang) Zhimu (Anemarrhenae Rhizoma, 2.5 qian) Danggui (Angelicae Sinensis Radix) Zicao Rong (Arnebiae Radix) Baifuling (Poria Cocos, peeled) Gancao (Licorice Root, 3 qian each)
Crush these ingredients for one dose. Decoct in water and take.
One discussion addresses macules caused by heat in the Qi level. Chaihu Tang (Bupleuri Decoction) is indicated.
Chaihu (Bupleuri Radix, 3 qian) Huangqin (Scutellariae Radix, 2 qian) Banxia (Pinelliae Tuber, stir-fried with ginger, 2 qian) Renshen (Ginseng Radix et Rhizoma, 1 qian) Zicao (Arnebiae Radix, 2 qian) Huanglian (Coptidis Rhizoma, 2 qian) Fuling (Poria Cocos, 2 qian) Gancao (Licorice Root, 2 qian)
Crush these ingredients for one dose. Decoct with fresh ginger and take.
One discussion addresses macules caused by heat in the Blood level. Danggui San (Angelica Powder) is indicated.
Danggui (Angelicae Sinensis Radix, 3 qian) Chishao (Paeoniae Radix Rubra, 2 qian) Sheng Dihuang (Rehmanniae Radix Recens, 3 qian) Huanglian (Coptidis Rhizoma, 6 fen) Honghua (Carthami Flos, 8 fen) Shigao (Gypsum Fibrosum, 2 qian)
Crush these ingredients for one dose. Decoct in water and take.
One discussion addresses Urticaria (Yinzhen), caused by wind-heat invading the muscle interstices, leading to accumulation and obstruction of Qi and Blood. Jiawei Baidu San (Modified Detoxifying Powder) is indicated.
Qianghuo (Notopterygii Rhizoma et Radix) Duhuo (Angelicae Pubescentis Radix) Qianhu (Peucedani Radix) Chaihu (Bupleuri Radix) Danggui (Angelicae Sinensis Radix) Chuanxiong (Ligustici Chuanxiong Rhizoma) Zhike (Aurantii Fructus, pith removed) Jiegeng (Platycodonis Radix) Fuling (Poria Cocos) Renshen (Ginseng Radix et Rhizoma, 5 fen each)
Bohe (Menthae Haplocalycis Herba) Gancao (Licorice Root) Baizhu (Atractylodis Macrocephalae Rhizoma) Fangfeng (Saposhnikoviae Radix) Jingjie (Schizonepetae Spica) Cangzhu (Atractylodis Rhizoma, soaked in rice water) Chishao (Paeoniae Radix Rubra) Sheng Dihuang (Rehmanniae Radix Recens, 5 fen each)
Crush these ingredients for one dose. Decoct with ginger and jujube in water, and take warm. This formula is effective for macules caused by cold-dampness invasion.
One discussion defines Ban (Macules) as resembling rouge spots without granular heads. Red macules are treatable; purple macules have a one-in-ten survival rate; black macules have zero survival. If macules appear, Jiedu Huaban Tang (Detoxifying Macule-Transforming Decoction) is indicated.
Mudanpi (Moutan Cortex) Sheng Dihuang (Rehmanniae Radix Recens) Mutong (Akebiae Caulis) Guiwei (Angelicae Sinensis Radix tail) Yuanzhi (Polygalae Radix, soaked in licorice decoction, heart removed) Xijiao (Rhinoceros Horn, ground with milk juice, 1-2 qian) Zicao Rong (Arnebiae Radix) Zhimu (Anemarrhenae Rhizoma) Niubangzi (Arctii Fructus) Qiangengen (Rubiae Radix) Gancao (Licorice Root, raw with tips) Chuanshanjia (Manis Squama, stir-fried until popping, ground to powder, 1 qian)
Decoct these ingredients in water. Mix in the Chuanshanjia powder and Xijiao juice, and take together.