Library

Yan Shizhai stated: For pregnant women suffering from measles (Rash), treatment should be based on Siwu Tang (Four Substances Decoction) with modifications, adding Huangqin (Scutellariae Radix) and Aiyè (Artemisiae Argyi Folium) to primarily stabilize the fetus and clear heat. In this way, the fetal qi will remain stable, and the measles will naturally erupt. However, heat-toxin steaming the fetus often causes fetal injury; although the fetus may be damaged, the mother usually remains unharmed. This is because measles differ from smallpox (Variola). Smallpox requires internal solidity because its pathogenic factors should resolve from the exterior; thus, if the fetus is lost, toxic vapors attack inward through deficiency, leading to the mother's death. Measles, conversely, require internal emptiness because its pathogenic factors should resolve from within; thus, if the fetus is lost, heat-toxin exits downward with the fetus, allowing the mother to survive. Nevertheless, it is better for both mother and child to survive than for the mother to survive at the cost of the fetus. Moreover, ancients only knew to use heat-clearing methods to stabilize the fetus, failing to realize that clearing heat before the rash has erupted makes it difficult for the rash to emerge and deepens internal heat. Thus, attempting to protect the fetus inadvertently harms it. One should employ light, ascending, and dispersing methods to support the eruption of the rash, so that as the rash emerges, the heat clears spontaneously. Subsequently, using yin-nourishing and heat-clearing methods ensures neither the rash nor the fetus is hindered; without explicitly stabilizing the fetus, the fetal qi stabilizes itself. If the rash fails to erupt smoothly, combine Baihu Tang (White Tiger Decoction) with Shengma Gegen Tang (Cimicifugae et Puerariae Decoction), heavily increasing Xuanshen (Scrophulariae Radix) and Niubangzi (Arctii Fructus). If fetal qi rushes upward, urgently decoct Zhugen (Bambusae Caulis Interjointis) and Aiyè (Artemisiae Argyi Folium), grind Binglang (Arecae Semen) into the soup, administer it, and then advance Siwu Tang (Four Substances Decoction). If abdominal pain and lower back soreness occur, one knows the fetus is destined to abort; if abortion occurs, treat according to obstetric protocols.

Shengma Gegen Tang (Cimicifugae et Puerariae Decoction): This is a formula for resolving the exterior and inducing sweating. When exterior heat is vigorous and pathogens are excess in the exterior, the Classics state: "Light substances can remove excess." Therefore, Shengma (Cimicifugae Rhizoma) and Gegen (Puerariae Lobatae Radix) are used to vent the exterior. The reason is that Shengma (Cimicifugae Rhizoma) resolves epidemic toxins and raises yang qi from beneath extreme yin, assisting the generating qi; Gegen (Puerariae Lobatae Radix) resolves heat-toxins and simultaneously vents Ying and Wei, guiding the mechanism of rash eruption. Besides these two herbs, Gancao (Glycyrrhizae Radix et Rhizoma) is added to harmonize the qi in the exterior, and Shaoyao (Paeoniae Radix Alba) is added to harmonize the Ying blood in the interior. By removing excess pathogens and harmonizing Ying and Wei, wind-cold resolves spontaneously, and the measles erupt naturally.

For women who experience smallpox or measles about half a month after delivery, there is no burden of a fetus, but Qi and Blood are still deficient. Treatment should primarily focus on greatly tonifying Ying and Wei. If the eruption is profuse, add Lianqiao (Forsythiae Fructus) and Niubangzi (Arctii Fructus); otherwise, treat according to standard protocols without excessive doubt to avoid further errors.