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。
有人身体并不发热，但在胸胁部位发出红斑，就像一片深红色的云彩一样。人们以为是心火极盛所致，却不知这是胃火郁结到了极点。胃火本应炎上，为何会郁滞不宣？这是因为被风寒在外部束缚住了。火气想要向外发散，遇到寒邪遏制压抑，导致火无法外出而内藏。然而，火蕴结在胃中，终究不能一直隐藏，于是外现于皮肤，形成了发红云状的斑疹。此时如果逆用凉药治疗，就会违背热性的规律，使病情变为狂躁；如果用热药治疗，则会助长火势，使其更加猖獗。必须使用风药来和解才是得当的，但又不能完全只用风药。大抵火旺则水必衰，如果不补水，只疏散火邪，那么胃中的燥热如何能解除呢？没有水的制约，火只会随风更猛烈地扬起。如果在滋阴水中疏散火邪，则火得到水的制约，水借助风的力量平息炎症，斑疹自然会在无形中消失，绝不会因为发汗过多导致亡阳，从而造成不可救治的病症。方剂用消红汤：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。
这个方子通过补阴来制约火邪，凉血来化解斑疹，只是用散法而不用寒凉直折，只是用和解而不用猛攻，自然郁结得宣、热势减退，水旺燥除，斑疹哪有不完全消退的道理？
此症用散云汤也有效。
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。两剂痊愈。
有人满身发斑，不是大块的红赤，而是细小的斑疹，密密麻麻排列着，斑上的皮肤时而发痒，时而疼痛。人们认为是肺火旺盛，却不知是肺火郁结。肺主皮毛，肺气运行则皮毛开泄，肺气郁结则皮毛闭塞。之所以郁结，是因为心火克制肺金（火刑金），外部又遭遇寒风侵袭，肺火不能通达于皮毛，所以斑疹才显现出来。既然肺生斑疹，仍是内热的缘故，治法仍宜泻火。然而火郁结在皮毛，如果不解表，而突然使用泻火的药物，反而能遏制火气，使其不能向外发散，反而向内攻伐，势必导致表证转变为里证，这就更加令人担忧了。因此必须在解散表邪的同时，辅以消除火邪的药物，这样消散斑疹自然迅速。方剂用散斑饮：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。一剂斑疹消退，两剂完全消退。
这个方子发散多于清解，因为清火会导致火更郁结，气机不畅；发散风邪则风邪尽解，火邪也随之平息。
此症也可以用苏叶解斑汤：
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。两剂痊愈。
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.