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If the rash on the head, face, and both cheeks is difficult to erupt, the condition is severe; if wind-cold was contracted and treatment was delayed, the condition is severe; if the rash on both cheeks appears purple and in patches, the condition is severe; if macules are mixed with papules and there is rebellious Qi, the condition is severe; if the rash is red-purple, dark, and dry, the condition is severe; if there is soreness and swelling of the throat with inability to eat, the condition is severe; if heat transfers to the Large Intestine causing dysentery, the condition is severe.

If the rash is dark, black, and dry, disappearing immediately upon eruption, it is incurable. If the nostrils are flaring, the mouth is open, and the eyes lack spirit, it is incurable. If the nose is cyanotic and the stool is black, it is incurable. If extreme heat causes panting and chest distension, high chest, shoulder breathing (using accessory muscles), delirium, epistaxis, hand clenching, head shaking, picking at bedclothes, hiccups, aversion to food, constipation, and breath smelling like feces, it is incurable. If panting occurs with suction at the precordium, it is incurable. If no rash appears on the head and face, it is incurable.

For post-rash gingival gangrene (Ya Gan), there are five incurable conditions: foul rotting odor is incurable; pathogen moving from exterior to interior is incurable; absence of pus and blood is incurable; white teeth indicate stomach tissue decay and are incurable; falling teeth indicate kidney failure and are incurable. Once righteous Qi is insufficient to expel pathogens outward, toxins remain latent inside, leading to death from panting and chest distension; this condition is called "Men Sha" (Stifling Miasma).

Measles stem from fetal toxin originating in the Heart, connected to the Lung, where heat-toxin invades, causing coughing, clear nasal discharge, and watery eyes.
When diagnosing macules and papules, one must first understand the annual climate (Sui Qi); do not lightly use sweating or purging methods as for Taiyang disease (Shang Han). Observe the patient's deficiency or excess to apply appropriate methods, and do not violate the Harmony of Heaven, damaging longevity.
Measles prefers coolness, while smallpox prefers warmth; knowing their differences is crucial. Measles lesions are superficial, smallpox lesions are substantial; the Zang-Fu organs and Yin-Yang are distinct.
If overdue and not erupting, the course drags on, and toxins trapped within are hard to release. Urgently use methods to vent the skin; do not neglect, lest the Zang-Fu suffer torment.
With steaming fever and frequent coughing, swollen and floating eyes, rising Qi, restlessness, and scanty phlegm, the Lung leaves are scorched due to heat-toxin invasion.
Intense heat steams, moistening the body with sweat; pathogens force blood into the meridians. Excessive sweat disperses Wei-level pathogens; loss of blood reduces Ying-level toxicity.
Smallpox lesions are also vibrant, requiring nourishment to attack; measles lesions are bright red, allowing toxins to loosen easily. White measles due to Blood deficiency can still be treated; black macules indicate a dire prognosis, avoid encountering them.
The emergence and disappearance of measles conform to Yin and Yang. Eruption should be treated with mild methods, disappearance with cool methods. Continuous eruption without receding indicates excessive Yang; slow, intermittent eruption indicates strong Yin.