麻疹已出贵透彻，细密红润始为良，若不透彻须分晰，风寒毒热气虚详，
风寒升葛汤加味，毒热三黄石膏汤，气虚人参败毒散，托里透疹效非常。
[注]
麻疹见形贵乎透彻，出后细密红润，则为佳美，
有不透彻者，须察所困，
如风寒闭塞，必有身热无汗，头疼呕恶，疹色淡红而黯之证，
宜用升麻葛根汤，加苏叶，川芎，牛蒡子，
因毒壅滞者，必面赤身热，谵语烦渴，疹色赤紫滞黯，宜用三黄石膏汤，
又有正气虚弱，不能送毒外出者，必面色□白，身微热，精神倦怠，
疹色白而不红，以人参败毒散主之。
(升麻葛根汤) 方见痘门发热证治。
(三黄石膏汤) 麻黄 石膏 淡豆豉 黄蘖 黄连 栀子 黄芩 水煎服。
(方歌)
疹出不透因毒热，三黄石膏汤急寻，麻黄石膏淡豆豉，黄蘖黄连栀子芩。
(人参败毒散) 人参 川芎 羌活 独活 前胡 枳壳麸炒 桔梗
柴胡 生甘草 赤苓 引用生姜水煎服。
(方歌)
疹因气虚出难透，人参败毒有奇功，参芎羌独前枳桔，柴胡甘草赤茯苓。
%
疹出三日当收没，不疾不徐始无虞，收没太速毒攻内，当散不散虚热医，
毒盛荆防解毒治，外用胡荽酒法宜，虚热柴胡四物剂，应证而施病渐离。
[注]
麻疹见形三日之后，当渐次没落，不疾不徐，始为无病，
若一二日疹即收没，此为太速，
因调摄不谨，或为风寒所袭，或为邪秽所触，以致毒反内攻，
轻则烦渴谵狂，重则神昏闷乱，急宜内服荆防解毒汤，
外用胡荽酒熏其衣被，使疹透出，方保无虞，
当散不散者，内有虚热留滞于肌表也，
其证潮热烦渴，口燥咽干，切不可纯用寒凉之剂，
以柴胡四物汤治之，便血分和畅，余热悉除，疹即没矣。
(荆防解毒汤) 薄荷叶 连翘去心 荆芥穗 防风 黄芩 黄连 牛蒡子炒研
大青叶 犀角 人中黄 引用灯心芦根水煎服。
(方歌)
收没太速毒内攻，荆防解毒治最灵，薄翘荆防芩连蒡，大青犀角共人中。
(胡荽酒) 方见痘门水泡证治。
(柴胡四物汤) 白芍炒 当归 川芎 生地 人参 柴胡 淡竹叶 地骨皮
知母炒 黄芩 麦冬去心 引加生姜红枣水煎服。
(方歌)
当散不散因虚热，柴胡四物芍归芎，生地人参柴竹叶，地骨知母芩麦冬。
%
The eruption of measles should be thorough; fine, dense, and rosy-red rashes indicate a favorable prognosis. If the eruption is not thorough, one must differentiate between wind-cold, toxic-heat, or qi-deficiency patterns. For wind-cold, use Shengma Gegen Tang (Cinnamon Twig and Rhizoma Cimicifugae Decoction) with modifications; for toxic-heat, use Sanhuang Shigao Tang (Three-Yellow and Gypsum Decoction); for qi-deficiency, use Renshen Baidu San (Ginseng Detoxification Powder). These methods effectively support the interior and promote the eruption of rashes with remarkable efficacy.
[Note]
In the manifestation stage of measles, thoroughness is paramount. Fine, dense, and rosy-red rashes after eruption are auspicious signs.
If the eruption is incomplete, one must investigate the obstructing factors.
If caused by wind-cold obstruction, symptoms necessarily include fever without sweating, headache, nausea, vomiting, pale red but dull rash color.
Shengma Gegen Tang (Cinnamon Twig and Rhizoma Cimicifugae Decoction), added with Perilla Leaf (Perillae Folium), Ligusticum Chuanxiong Rhizome (Chuanxiong Rhizoma), and Arisaema Cum Bile (Baihezi, here referring to Arctii Fructus/Niubangzi), is appropriate.
If caused by toxic stagnation, symptoms necessarily include facial flushing, body heat, delirious speech, irritability, thirst, and dark purple, stagnant, and dull rash color. Sanhuang Shigao Tang (Three-Yellow and Gypsum Decoction) is appropriate.
In cases of deficient healthy qi unable to expel toxins outward, symptoms necessarily include sallow white complexion, slight body heat, mental fatigue,
and white, non-rosy rash color. Renshen Baidu San (Ginseng Detoxification Powder) is the primary treatment.
(Shengma Gegen Tang) See the section on Fever in the Smallpox Chapter for the formula details.
(Sanhuang Shigao Tang) Composition: Ephedrae Herba (Mahuang), Gypsum Fibrosum (Shigao), Fermented Soybean (Douchi), Phellodendri Cortex (Huangbai), Coptidis Rhizoma (Huanglian), Gardeniae Fructus (Zhizi), Scutellariae Radix (Huangqin). Decoct in water and take orally.
(Formula Song)
Rashes fail to erupt due to toxic heat, seek Sanhuang Shigao Tang urgently;
Ephedrae Herba, Gypsum Fibrosum, Fermented Soybean,
Phellodendri Cortex, Coptidis Rhizoma, Gardeniae Fructus, Scutellariae Radix.
(Renshen Baidu San) Composition: Ginseng Radix et Rhizoma (Renshen), Ligusticum Chuanxiong Rhizoma (Chuanxiong), Notopterygii Rhizoma et Radix (Qianghuo), Angelicae Dahuricae Radix (Duqu), Peucedani Radix (Qianhu), Aurantii Fructus Immaturus stirfried with bran (Zhike), Platycodonis Radix (Jiegeng), Bupleuri Radix (Chaihu), Glycyrrhizae Radix et Rhizoma raw (Gancao), Poria (Fuling). Add fresh ginger as an adjuvant, decoct in water and take orally.
(Formula Song)
Rashes difficult to erupt due to qi deficiency, Renshen Baidu San has miraculous merit;
Ginseng, Ligusticum, Notopterygium, Angelica, Peucedani, Aurantium, Platycodon,
Bupleuri, Glycyrrhiza, Poria.
%
By the third day of eruption, the rashes should begin to recede; neither too fast nor too slow ensures safety. Receding too quickly allows toxins to attack inward; failing to recede when it should requires treating residual heat from deficiency.
For excessive toxin, treat with Jingfang Jiedu Tang (Schizonepeta and Saposhnikovia Detoxification Decoction); externally, Huisu Jiu (Coriander Wine) method is suitable.
For residual heat from deficiency, treat with Chaihu Siwu Tang (Bupleurum and Four Substances Decoction). Apply treatments according to the syndrome, and the disease will gradually resolve.
[Note]
After three days of the manifestation stage, the rashes should gradually disappear at a moderate pace, indicating health.
If the rashes recede within one or two days, this is too rapid.
This results from improper care, invasion by wind-cold, or contact with pathogenic filth, causing toxins to counter-attack inward.
Mild cases present with irritability, thirst, delirium, and mania; severe cases present with coma, confusion, and restlessness. Urgently administer Jingfang Jiedu Tang (Schizonepeta and Saposhnikovia Detoxification Decoction) internally.
Externally, fumigate clothing and bedding with Huisu Jiu (Coriander Wine) to induce the rashes to re-emerge, ensuring safety.
When rashes fail to recede when they should, it is because deficient heat lingers in the muscle layer.
Symptoms include tidal fever, irritability, thirst, dry mouth, and dry throat. One must absolutely avoid using purely cold-natured medications.
Treat with Chaihu Siwu Tang (Bupleurum and Four Substances Decoction) to harmonize the blood level, eliminate residual heat completely, and allow the rashes to subside naturally.
(Jingfang Jiedu Tang) Composition: Menthae Haplocalycis Herba (Boheye), Forsythiae Fructus decentered (Lianqiao), Schizonepetae Spica (Jingjie), Saposhnikoviae Radix (Fangfeng), Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), Arctii Fructus fried and ground (Niubangzi), Isatidis Folium (Daqingye), Rhinocerotis Cornu (Xijiao), Indentis Pulvis (Renzhonghuang). Add Centelli Herba (Dengxincao) and Phragmitis Rhizoma (Lugen) as adjuvants, decoct in water and take orally.
(Formula Song)
Receding too quickly causes toxins to attack inward, Jingfang Jiedu Tang treats most effectively;
Mint, Forsythia, Schizonepeta, Saposhnikovia, Scutellaria, Coptis, Arctium,
Isatis, Rhinoceros Horn, together with Indentis Pulvis.
(Huisu Jiu) See the section on Vesicles in the Smallpox Chapter for the formula details.
(Chaihu Siwu Tang) Composition: Paeoniae Radix Alba stirfried (Baishao), Angelicae Sinensis Radix (Danggui), Ligusticum Chuanxiong Rhizoma (Chuanxiong), Rehmanniae Radix Preparata (Shengdi), Ginseng Radix et Rhizoma (Renshen), Bupleuri Radix (Chaihu), Lophatheri Herba (Danzhuye), Cortex Lycii (Digupi), Anemarrhenae Rhizoma stirfried (Zhimu), Scutellariae Radix (Huangqin), Ophiopogonis Radix decentered (Maidong). Add fresh ginger and Ziziphi Jujubae Fructus (Hongzao) as adjuvants, decoct in water and take orally.
(Formula Song)
Failing to recede due to deficient heat, Chaihu Siwu Tang contains Baishao, Danggui, Chuanxiong;
Shengdi, Renshen, Chaihu, Danzhu Ye,
Digupi, Zhimu, Huangqin, Maidong.