Library

Diseases such as smallpox (Tianhuang), measles-like rashes (Zhen), and miasma-rash (Masha) are all named based on their morphological characteristics. However, the syndrome of Masha is unpredictable and ever-changing; historically, there have been no specialized monographs on it. Ancient medical maxims regarding this condition are mostly scattered within texts dedicated to smallpox treatment. Furthermore, patients often regard it as a trivial matter, considering wind-rash (Fengsha) a mild condition, leading to frequent neglect and carelessness. By the time ominous internal collapse occurs and life is in danger, rescue becomes impossible, making regret futile. Even if attributed to destiny, the root cause ultimately lies in human efforts being insufficient. I respectfully read from the Imperially Compiled *Yizong Jinjian* (Golden Mirror of Medical Tradition): "Measles require careful management and treatment; one must not be negligent even slightly from beginning to end. Although slightly milder than smallpox, its changes occur in an instant." These are profound words of admonition. Therefore, presuming upon my own shallow knowledge, I have carefully compiled ancient and modern treatments for Masha syndromes into a manuscript, divided into four sections: "Chongzheng" (Upholding Orthodoxy), "Shugu" (Narrating Antiquity), "Zhengjin" (Verifying the Present), with an appendix of established prescriptions titled "Fanglun" (Discourse on Prescriptions), totaling six volumes. May future scholars, by tracing origins and investigating thoroughly, progressing step by step, save the people from suffering, realize that medicine is indeed not a minor art.

Written by hand on the 15th day of the first month in the Gengyin year of the 16th year of Guangxu (1890 AD), Bingchen day, coinciding with Lichun (Start of Spring), by Ling De Zhe'an of Gui'an.

Measles belong to the category of true rashes (Zhengzhen) and are also caused by fetal toxin (Tai Du). The toxin lies dormant in the Six Fu Organs and manifests upon contracting external pathogens. The initial presentation resembles smallpox, but the lesions are pointed, gradually become dense, yet do not form pustules. Careful nursing and treatment are required throughout; although milder than smallpox, the changes are rapid.

Annotation: Rashes are not a single entity; there are pruritic rashes (Saozhen), urticaria-like rashes (Yinzhen), and warm rashes (Wenzhen); thus, neither smallpox nor general rashes constitute "true rashes." Only measles (Ma Zhen) is considered a true rash. It arises from fetal toxin latent in the Six Fu Organs, triggered by pathogenic yang and excessive fire qi from heaven and earth, emerging through the Lung and Spleen. Consequently, symptoms often include coughing, sneezing, clear nasal discharge, watery eyes, and swollen eyelids. After two or three days, or sometimes four or five days of fever, spots appear on the skin. They resemble hemp seeds in shape and peach blossoms in color, occasionally resembling large smallpox lesions; this characterizes the initial eruption of measles. The lesions are pointed, initially sparse then becoming dense, possessing granular texture without roots or halos, slightly elevated and erythematous but without pus formation. This appearance after manifestation differs significantly from smallpox. Careful treatment is essential, with no negligence allowed at any stage. Although slightly milder than smallpox, its rapid changes occur in an instant.