疹。天行时毒之气也。亦禀受胎毒之气也。出于痘前者。名奶疹子。出于痘后者。名正
疹子
。要亦生人必不能免之数也。初发热时。咳嗽喷嚏。鼻流清涕。面浮腮赤。两目胞肿。眼泪
汪汪。有如醉状。或呕恶。或泄利。或手掏眉目鼻面。是即出疹之候也。然必发热五七
日。或多至十一二日。始见疹子者。宜徐徐升托表邪。俾疹毒出尽。则儿无事矣。切忌妄汗
妄下。若妄汗。则增其热。为鼻衄。为咳血。为口疮咽痛。为目赤痛。为烦躁。为大小便不
通。妄下。则虚其里。为滑泄。为下痢赤白。为隐伏。为喘逆。多至不救。慎之慎之。主治
之法。轻者。宜升麻葛根汤。透邪煎。柴归饮之类主之。重者。宜金沸草散主之。兼泄利者
。合升麻葛根汤。去葛根。加白芷主之。若发热至六七日。明是疹子。却不见出。此皮肤坚
浓。腠理闭密。又或为风寒外袭。或会有吐利。乃伏也。宜急用麻黄汤。调柽叶散发之。外
用胡荽酒。麻蘸戛之。如一向未更衣者。此毒甚于里也。以七物升麻丸解之。若咳嗽不止。
上气喘急。面浮目胞肿者。宜甘桔汤。消毒散。泻白散。三方合用。若更兼热盛烦渴。加石
膏知母黄芩天花粉之类主之。若自汗出。或鼻衄者。不须止之。但不可太过。如汗太多。人
参
白虎汤。或黄连汤之类主之。若衄太多。元参地黄汤。或茅花汤之类主之。若吐甚者。黄
芩汤
。加茅根芦根枇杷叶主之。若利甚者。黄芩汤吞香连丸主之。若咽候肿痛者。甘桔汤。加元
参
牛蒡连翘。或射干鼠粘子汤之类主之。既见疹后。色贵通红。必以三日周身普遍而渐没者为
轻。若色淡白者。此心血不足也。养血化 汤主之。若色太殷红。或微紫者。此血分有热也
。大青汤主之。疹收之后。清涕复来。始为正候。若疹既收后。身有微热。不须施治。若身
热太甚。或日久不减者。柴胡麦门冬散主之。若发枯毛竖。肉消骨立。渐见羸瘦者。柴胡四
物
汤主之。若疹后发热不除。忽作搐者。导赤散加人参麦门冬。兼安神丸主之。若疹后咳嗽者
。泻白散。合消毒散主之。若咳甚气喘。甚至饮食汤水俱呛出者。门冬清肺汤。加枇杷叶。
见血。加茅根汁。阿胶珠主之。若疹后下痢赤白。里急后重。日夜无度者。黄芩汤。兼香连
丸主之。虚者。加人参。滑者。加椿根白皮。俱于丸药内加之。大抵疹属阳邪。用药最宜
养
阴。然亦有属虚寒者。但当合色脉形证以治之。始无贻误。若果热甚气粗。渴而饮冷。便秘
溺涩。脉象洪数有力。悉宜按上法治之。若神气怠惰。渴而饮汤。二便调和。脉象虚数。即
宜用归芍养阴。略加表托之品矧泻痢气喘。尤多虚症乎。断不可泥为疹毒。而不敢用补剂也
。慎之慎之。
附方
透邪煎 凡麻疹初热未出之时。惟恐误药。故云未出之先。不宜用药。然解利得宜。则
毒必易散。而势自轻减。欲求妥当。当先用此方为主。
当归（二三钱） 白芍（酒炒一二钱） 防风（七八分） 荆芥（一钱） 甘草（炙七分） 升麻（三分）
水一钟半。煎服。如热甚脉洪滑者。加柴胡一钱。此外凡有杂症。俱可随宜加减。
加味金沸草散
旋复花（去梗） 麻黄（去节水煮去沫晒干） 前胡（去芦各七钱） 荆芥穗（一两）
半夏（汤泡七次芦汁拌炒） 赤芍（各五钱） 鼠粘子（炒） 浮萍（各七钱）
上为末。每服三钱。生姜二片。薄荷叶三五片。煎。
麻黄汤
麻黄（去根节水煮去沫晒干） 升麻 牛蒡子（炒）
蝉蜕（洗净去翅足） 甘草（各一钱）
上加腊茶叶一钱。为细末。每服二三钱。水一盏。煎七分。去渣服。烦渴加石膏末四钱
柽叶散
柽。亦名西河柳。亦名垂丝柳。青茂时。采叶晒干。为末。每服一二钱。茅根煎汤调下。
胡荽酒 辟秽气。使痘疹出快。
胡荽（一把） 好酒（二盏）
上煎一两沸。令乳母每含一两口。喷儿遍身。或喷头面。房中须烧胡荽香。以辟除秽气
。能
使痘疹出快。煎过胡荽悬房门上。更妙。按此酒惟未出之前。及初报之时宜用之。若起胀之
后。则宜避酒气。亦忌发散。皆不可用也。
七物升麻丸
升麻 犀角 黄芩 朴硝 栀子仁 大黄各二两 淡豉（二升微炒）
上共为末。蜜丸如黍米大。凡觉四肢大热。大便秘者。少服十余粒。取微利为止。
消毒散 治痘疮六七日间。身壮热。不大便。其脉紧盛者。用此药微利之。
荆芥穗 甘草（炙各一两） 牛蒡子（四两并炒）
上共为粗散。每用二三钱。水一盏。煎七分服。
人参白虎汤
人参 甘草（各一钱） 知母（三钱） 石膏（五钱） 粳米（一合）
上量儿大小。水煎。待米熟。去渣温服。
黄连汤
黄连 麦冬（去心） 当归 黄柏 黄芩 生地 黄
上分量随宜。水煎去渣。调败蒲扇灰服之。
茅花汤
茅花 真郁金 生地黄 栀子仁 黄芩
上水煎。调百草霜服。
香连丸 治热泻痢疾。赤白脓血。湿热侵脾。里急后重。
黄连（净十两切如豆大） 吴茱萸（净五两）
上二味。用热水拌和一处。入瓷罐内。置热汤中。顿一日。取起同炒。至黄连紫黄色为
度。
去茱萸不用。每制净黄连一两。加木香二钱五分。共为细末。醋糊丸。桐子大。每服一二十
粒。量大小增减。空心米饮下。
射干鼠粘子汤 治痘疹后痈疽疮毒。
鼠粘子（二钱） 升麻 甘草 射干（各五分）
上锉散。水一盏。煎六分。量大小服。忌鱼腥葱蒜。
养血化 汤
当归 生地黄 红花 蝉蜕 人参（各等分）
上锉细。水一盏。生姜一片。煎六分去渣。温服无时。
大青汤
大青 元参 生地黄 石膏 知母 木通 甘草 地骨皮 荆芥穗（各等分）
上锉细。水一盏。淡竹叶十二片。煎七分去渣。量大小温服。
柴胡麦门冬散
柴胡（五分） 龙胆草（三分） 麦门冬（八分） 甘草（二分） 人参 元参（各五分）
上锉细。水煎服
柴胡四物汤
柴胡 人参 当归身 黄芩 川芎 生地黄 白芍 地骨皮 知母 麦门冬 淡竹叶
上锉细。水一盏。煎七分去渣。量大小温服。
安神丸
黄连 当归身 麦门冬 白茯神 甘草（各五钱） 朱砂（一两） 龙脑（二分半）
上为极细末。汤浸蒸饼。和 猪心血捣匀。丸和黍米大。每服十丸。灯心汤下。
门冬清肺汤
天门冬（去心） 麦门冬（去心） 知母 贝母 桔梗 款冬花 甘草 牛蒡子
杏仁（去皮尖研） 马兜铃 桑白皮 地骨皮（各等分）。
上锉细。水一盏。煎七分去渣。量大小食后温服。
升麻葛根汤（方见痘论）
柴归饮（方见辨惊风之误论）
甘桔汤（方见痘论）
泻白散（方见热论）
元参地黄汤（方见痘论）
黄芩汤（方见痘论）
导赤散（方见实论）
Measles (Rash) is caused by the pathogenic qi of seasonal epidemics and toxic influences, and it also stems from the congenital fetal toxin. When it appears before smallpox, it is called "Milk Measles" (Nai Zhen Zi); when it appears after smallpox, it is called "True Measles" (Zheng Zhen Zi). This is essentially an inevitable stage in human development.
At the initial stage of fever, symptoms include coughing, sneezing, clear nasal discharge, facial edema, reddening of the cheeks, swelling of the eyelids, excessive tearing, and a demeanor resembling intoxication. There may also be nausea and vomiting, diarrhea, or the infant scratching the eyebrows, eyes, nose, and face. These are signs that the rash is about to erupt. Typically, one must wait for five to seven days of fever, or even up to eleven or twelve days, before the rash becomes visible. At this stage, gentle lifting and supporting methods should be used to release the exterior pathogens, allowing the measles toxin to fully emerge, thereby ensuring the child's safety. It is strictly forbidden to use indiscriminate sweating or purging methods. Indiscriminate sweating will exacerbate the heat, leading to epistaxis (nosebleed), hemoptysis (coughing blood), mouth ulcers and sore throat, red and painful eyes, restlessness, and obstruction of urination and defecation. Indiscriminate purging will damage the interior qi, leading to incontinence, dysentery with red and white pus and blood, internal retention of the toxin, wheezing and counterflow qi, which can often prove fatal. Exercise utmost caution.
The primary treatment principles are as follows: For mild cases, formulas such as Shengma Gegen Tang (Cinnamon Twig and Pueraria Decoction), Touxie Jian (Decoction to Expel Pathogens), and Chai Gui Yin (Bupleurum and Angelica Drink) should be used. For severe cases, Jin Fei Cao San (Golden Whorlwort Powder) is indicated. If accompanied by diarrhea, combine Shengma Gegen Tang, remove Ge Gen (Puerariae Radix), and add Bai Zhi (Angelicae Dahuricae Radix). If fever persists for six to seven days and the rash is clearly present but has not erupted, it is due to thick and dense skin, closed pores, external invasion by wind-cold, or preceding vomiting and diarrhea causing the toxin to become latent. In such cases, Ma Huang Tang (Ephedra Decoction) combined with Xi He Liu Ye San (Tamarisk Leaf Powder) should be urgently administered to induce sweating and expel the rash. Externally, Hu Sui Jiu (Coriander Wine) can be applied by dipping and wiping the body. If there has been no bowel movement for some time, indicating deep accumulation of toxin in the interior, Qi Wu Shengma Wan (Seven-Ingredient Cinnabar Root Pill) should be used. If coughing persists, accompanied by upper airway wheezing, facial edema, and swollen eyelids, combine Gan Jie Tang (Licorice and Platycodon Decoction), Xiao Du San (Detoxification Powder), and Xie Bai San (Draining White Powder). If accompanied by intense heat, irritability, and thirst, add Shi Gao (Gypsum), Zhi Mu (Anemarrhenae Rhizoma), Huang Qin (Scutellariae Radix), and Tian Hua Fen (Trichosanthis Radix). If spontaneous sweating or epistaxis occurs, do not forcibly stop it, but ensure it does not become excessive. If sweating is profuse, Ren Shen Bai Hu Tang (Ginseng and White Tiger Decoction) or Huang Lian Tang (Coptis Decoction) may be used. If epistaxis is severe, Yuan Shen Di Huang Tang (Scrophulariae and Rehmanniae Decoction) or Mao Hua Tang (Sedge Flower Decoction) is indicated. For severe vomiting, Huang Qin Tang (Scutellaria Decoction) with Mao Gen (Imperatae Rhizoma), Lu Gen (Phragmitis Rhizoma), and Pi Pa Ye (Loquat Leaf) should be used. For severe diarrhea, Huang Qin Tang taken with Xiang Lian Wan (Fragrant Coptis Pill) is appropriate. For sore and swollen throat, Gan Jie Tang supplemented with Yuan Shen (Scrophulariae Radix), Niu Bang Zi (Arctii Fructus), and Lian Qiao (Forsythiae Fructus), or She Gan Niu Bang Zi Tang (Belamcanda and Arctii Decoction) may be used.
After the rash appears, a bright red color is preferred. A case where the rash covers the whole body within three days and gradually fades is considered mild. If the color is pale white, it indicates insufficiency of Heart Blood; Yang Xue Hua Tang (Blood-Nourishing Transformation Decoction) should be used. If the color is too dark red or slightly purple, it indicates heat in the Blood level; Da Qing Tang (Isatidis Decoction) is indicated. After the rash subsides, the return of clear nasal discharge is a normal sign. If slight fever persists after the rash subsides, no treatment is needed. If the fever is high or persists for a long time, Chai Hu Mai Men Dong San (Bupleurum and Ophiopogon Powder) should be used. If hair becomes dry and stands on end, muscles waste away, and emaciation sets in, Chai Hu Si Wu Tang (Bupleurum Four Substances Decoction) is indicated. If fever persists after measles and sudden convulsions occur, Dao Chi San (Guide Out Redness Powder) with Ren Shen (Ginseng) and Mai Men Dong (Ophiopogonis Radix), combined with An Shen Wan (Calming Spirit Pill), should be used. For post-measles cough, Xie Bai San combined with Xiao Du San is appropriate. For severe coughing with wheezing, even causing aspiration of food and fluids, Men Dong Qing Fei Tang (Ophiopogon Lung-Clearing Decoction) with Pi Pa Ye, Mao Gen Zhi (Sedge Juice), and E Jiao Zhu (Processed Donkey-Hide Gelatin) should be used. For post-measles dysentery with red and white stool, tenesmus, and frequent episodes day and night, Huang Qin Tang combined with Xiang Lian Wan is indicated. For deficiency patterns, add Ren Shen; for slippery/diarrheal patterns, add Chun Gen Bai Pi (Toona Bark); these should be added to the pill form.
Generally, measles belongs to Yang pathogens, so medication should prioritize nourishing Yin. However, there are also deficiency-cold patterns; treatment must be based on a combination of complexion, pulse, physical condition, and symptoms to avoid errors. If there is indeed intense heat, coarse breathing, thirst for cold drinks, constipation, difficult urination, and a surging, rapid, and forceful pulse, follow the aforementioned treatments. If spirit is lethargic, thirst is for warm drinks, excretions are normal, and the pulse is deficient and rapid, use Gui Shao (Angelica and Paeonia) to nourish Yin, adding slight exterior-releasing agents. Moreover, dysentery and wheezing are often deficiency patterns. One must absolutely not rigidly attribute everything to measles toxin and refuse to use tonifying agents. Exercise utmost caution.
Attached Formulas:
Touxie Jian (Decoction to Expel Pathogens): Used when measles fever begins but the rash has not yet emerged. Although it is said that medication should be avoided before emergence, proper resolution helps dissipate the toxin and reduce severity. Use this formula as the main treatment.
Dang Gui (2-3 qian), Bai Shao (1-2 qian, wine-fried), Fang Feng (7-8 fen), Jing Jie (1 qian), Zhi Gan Cao (7 fen), Sheng Ma (3 fen).
Boil in 1.5 zhong of water. If heat is intense and pulse is surging and slippery, add Chai Hu (1 qian). Other miscellaneous conditions can be adjusted accordingly.
Jia Wei Jin Fei Cao San (Modified Golden Whorlwort Powder):
Xuan Fu Hua (remove stem), Ma Huang (remove roots/joints, boil, skim foam, dry), Qian Hu (remove rhizome, 7 qian each), Jing Jie Sui (1 liang), Ban Xia (soak in hot water seven times, stir-fry with reed juice), Chi Shao (5 qian each), Niu Bang Zi (fried), Fu Ping (7 qian each).
Grind into powder. Take 3 qian per dose with 2 slices of fresh ginger and 3-5 mint leaves, decocted in water.
Ma Huang Tang (Ephedra Decoction):
Ma Huang (processed as above), Sheng Ma, Niu Bang Zi (fried), Chan Tui (cleaned, wings/legs removed), Gan Cao (1 qian each).
Add La Cha Ye (wax tea leaf, 1 qian), grind to fine powder. Take 2-3 qian per dose, decoct in 1 zhong of water until reduced to 0.7 zhong, strain and take. For irritability and thirst, add Shi Gao Mo (4 qian).
Xi He Liu Ye San (Tamarisk Leaf Powder):
Xi He Liu (also known as West River Willow or Weeping Willow). Harvest leaves when green and lush, dry them, and grind into powder. Take 1-2 qian per dose, mixed with decoction of Mao Gen (Imperatae Rhizoma).
Hu Sui Jiu (Coriander Wine): Dispels turbid qi, facilitating faster eruption of rashes.
Hu Sui (1 bunch), Good Wine (2 zhan).
Boil briefly. The nursing mother should hold a mouthful and spray it over the infant's body or head/face. Burn coriander incense in the room to dispel turbidity. This promotes faster eruption. Hanging the boiled coriander on the door is also effective. Note: This wine is only suitable before eruption or at the very beginning. After the rash rises/blisters, avoid alcohol and dispersing methods.
Qi Wu Sheng Ma Wan (Seven-Ingredient Cinnabar Root Pill):
Sheng Ma, Xi Jiao (Rhinoceros Horn - *Note: Modern substitutes like Buffalo Horn are used*), Huang Qin, Po Xiao, Zhi Zi Ren, Da Huang (2 liang each), Dan Chi (2 sheng, lightly fried).
Grind into powder, make honey pills the size of millet seeds. For intense limb heat and constipation, take a few pills (approx. 10) until mild laxation occurs.
Xiao Du San (Detoxification Powder): Treats smallpox/measles around day 6-7 with high fever, constipation, and tight/full pulse. Induces mild laxation.
Jing Jie Sui, Zhi Gan Cao (1 liang each), Niu Bang Zi (4 liangs, fried).
Grind into coarse powder. Take 2-3 qian, decoct in 1 zhong of water until reduced to 0.7 zhong.
Ren Shen Bai Hu Tang (Ginseng and White Tiger Decoction):
Ren Shen, Gan Cao (1 qian each), Zhi Mu (3 qian), Shi Gao (5 qian), Jing Mi (1 he).
Adjust dosage based on infant size. Boil in water until rice is cooked, strain, and take warm.
Huang Lian Tang (Coptis Decoction):
Huang Lian, Mai Dong (remove heart), Dang Gui, Huang Bo, Huang Qin, Sheng Di, Huang (likely Huang Lian or another yellow herb, text implies combination).
Adjust proportions. Decoct, strain, and mix with Baidu Shan Hui (Ash of Withered Lotus Fan).
Mao Hua Tang (Sedge Flower Decoction):
Mao Hua, Zhen Yu Jin, Sheng Di Huang, Zhi Zi Ren, Huang Qin.
Decoct in water, mix with Bai Cao Shuang (Soot from burning various herbs).
Xiang Lian Wan (Fragrant Coptis Pill): Treats heat-type dysentery with red/white pus/blood, damp-heat invading Spleen, tenesmus.
Jing Huang Lian (10 liangs, cut bean-sized), Wu Zhu Yu (5 liangs).
Mix with hot water, place in ceramic jar, sit in hot water bath for one day. Stir-fry together until Huang Lian turns purple-yellow. Remove Wu Zhu Yu. For every 1 liang of processed Huang Lian, add Mu Xiang (2.5 qian). Grind to fine powder, make pills with vinegar paste, size of sesame seeds. Take 10-20 pills, adjusted by size, on an empty stomach with rice water.
She Gan Niu Bang Zi Tang (Belamcanda and Arctii Decoction): Treats carbuncles and sores after measles/smallpox.
Niu Bang Zi (2 qian), Sheng Ma, Gan Cao, She Gan (5 fen each).
Cut into pieces, decoct in 1 zhong of water until reduced to 0.6 zhong. Avoid fish, garlic, and scallions.
Yang Xue Hua Tang (Blood-Nourishing Transformation Decoction):
Dang Gui, Sheng Di Huang, Hong Hua, Chan Tui, Ren Shen (equal parts).
Cut finely, decoct in 1 zhong of water with 1 slice of ginger until reduced to 0.6 zhong. Strain and take warm at any time.
Da Qing Tang (Isatidis Decoction):
Da Qing, Yuan Shen, Sheng Di Huang, Shi Gao, Zhi Mu, Mu Tong, Gan Cao, Di Gu Pi, Jing Jie Sui (equal parts).
Cut finely, decoct in 1 zhong of water with 12 leaves of Dan Zhu Ye until reduced to 0.7 zhong. Strain and take warm, adjusted by size.
Chai Hu Mai Men Dong San (Bupleurum and Ophiopogon Powder):
Chai Hu (5 fen), Long Dan Cao (3 fen), Mai Men Dong (8 fen), Gan Cao (2 fen), Ren Shen, Yuan Shen (5 fen each).
Cut finely, decoct in water.
Chai Hu Si Wu Tang (Bupleurum Four Substances Decoction):
Chai Hu, Ren Shen, Dang Gui Shen, Huang Qin, Chuan Xiong, Sheng Di Huang, Bai Shao, Di Gu Pi, Zhi Mu, Mai Men Dong, Dan Zhu Ye.
Cut finely, decoct in 1 zhong of water until reduced to 0.7 zhong. Strain and take warm, adjusted by size.
An Shen Wan (Calming Spirit Pill):
Huang Lian, Dang Gui Shen, Mai Men Dong, Bai Fu Shen, Gan Cao (5 qian each), Zhu Sha (1 liang), Long Nao (2.5 fen).
Grind to extremely fine powder. Soak steamed dough in water, mix with Pig Heart Blood, knead well, and make pills the size of millet seeds. Take 10 pills with Deng Xin Tang (Juncus Decoction).
Men Dong Qing Fei Tang (Ophiopogon Lung-Clearing Decoction):
Tian Men Dong (remove heart), Mai Men Dong (remove heart), Zhi Mu, Bei Mu, Jie Geng, Kuan Dong Hua, Gan Cao, Niu Bang Zi, Xing Ren (skin/kernel removed, ground), Ma Dou Ling, Sang Bai Pi, Di Gu Pi (equal parts).
Cut finely, decoct in 1 zhong of water until reduced to 0.7 zhong. Strain and take warm after meals, adjusted by size.
Shengma Gegen Tang (See Smallpox Theory)
Chai Gui Yin (See Discussion on Errors in Treating Convulsions)
Gan Jie Tang (See Smallpox Theory)
Xie Bai San (See Heat Theory)
Yuan Shen Di Huang Tang (See Smallpox Theory)
Huang Qin Tang (See Smallpox Theory)
Dao Chi San (See Excess Theory)