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The pathogenesis of measles originates from the six fu-organs, first disturbing the yang aspect, and then returning to the yin meridians. Therefore, its manifestation is attributed to yin, while its root is attributed to yang. The fever must be severe; because the blood aspect is scorched by heat, the blood is largely depleted. Thus, treatment from beginning to end should primarily focus on nourishing yin and replenishing blood. One must absolutely avoid any medications that move qi, and treatment should proceed slowly. Therefore, harsh and drying agents such as Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), and Banxia (Pinelliae Rhizoma), as well as those that raise yang qi, which cause yang qi to rush upward, are all contraindicated. Furthermore, since there is often excessive internal heat, Siwu Tang (Four Substances Decoction) should be added with Huanglian (Coptidis Rhizome), Fangfeng (Saposhnikoviae Radix), and Lianqiao (Forsythiae Fructus) to cool the interior and dissipate the yang heat.

1. If symptoms such as fever, aversion to cold, high fever, runny clear nose, body pain, vomiting, and diarrhea occur, and it is unclear whether the syndrome is indeed measles, one may administer Suge Tang (Perilla and Kudzu Decoction), removing Sharen (Amomi Fructus) and Chenpi (Citri Reticulatae Pericarpium). If abdominal pain is present, a method of thickly covering with clothes and blankets to induce sweating can also be used. When sweat gradually disperses from head to foot, removing the cover allows the skin to become unobstructed and the couli (skin pores and interstices) to open, causing the measles rash to emerge. Even if it does not immediately appear, one must not induce sweating again, lest it lead to the collapse of yang (Yang Collapse). Instead, one should frequently drink Congbai Tang (Scallion White Decoction); the measles will naturally emerge, and this method prevents convulsions and spasms.

2. During the febrile stage, after surface-releasing treatments, one must strictly avoid wind-cold, cold water, and raw fruits. Violating these prohibitions causes the skin and hair pores to close, making it difficult for toxic factors to excrete, leading to a transformation into purple-black discoloration and death. If extreme thirst occurs and the patient desires water, only small sips should be taken, using Congbai Tang to moisten the thirst. It is necessary to maintain a slight perspiration in the hair pores, keeping them moist but not excessive. One must also avoid plums, plums (prunes), fish, alcohol, honey, and pungent or fresh-smelling foods, as these may provoke ascension of gi worms (parasitic infestations associated with malnutrition).

3. When the measles rash has emerged, if the color is red-purple, dry, dark, and dull, this indicates excessive fire and intense toxicity. One should urgently use Liuyi San (Six-to-One Powder) to resolve it, or use Siwu Tang (Four Substances Decoction) without Dihuang (Rehmanniae Radix Praeparata), adding Honghua (Carthami Flos) and Chao Huangqin (Scutellariae Radix stir-fried).

4. After the measles rash emerges, if it fails to fade after three days, it is due to excessive internal heat. It is appropriate to administer Siwu Tang (Four Substances Decoction). If accompanied by hemorrhagic syndromes, add Xijiao Zhi (Rhinocerotis Cornu Juice) to resolve toxicity.

5. Before and after the emergence of the measles rash, if fever persists without abating, these syndromes belong to blood deficiency and blood heat. One should only adjust Siwu Tang (Four Substances Decoction) according to standard methods based on specific symptoms. For thirst, add Maidong (Ophiopogonis Radix) and Xijiao Zhi (Rhinocerotis Cornu Juice); for cough, add Gualou Shuang (Trichosanthis Fructus Frost); for phlegm, add Beimu (Fritillariae Bulbus) and remove the white part of Chenpi (Citri Reticulatae Pericarpium). One must strictly avoid Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), and Banxia (Pinelliae Rhizoma). Misuse of these herbs causes significant harm and must be guarded against. Since measles belongs to yang syndromes and involves substantial blood depletion, nourishing yin and replenishing blood naturally eliminates the heat. This embodies the principle of "nourishing yin to retreat yang."

6. After the measles recede, if gum rotting and epistaxis (nosebleed) occur, these are hemorrhagic syndromes. One should urgently take Siwu Tang (Four Substances Decoction) added with Yichen (Artemisiae Scopariae Herba), Mutong (Akebiae Caulis), and Sheng Xijiao (Fresh Rhinocerotis Cornu) to promote urination and direct heat downward. If white gi sores appear, this indicates stomach rot, which is an incurable condition.

7. Diarrhea caused by measles must be differentiated by duration (new vs. old) and nature (cold vs. heat). For new-onset or heat-type diarrhea, Siling San (Four-Ingredient Powder) added with Mutong (Akebiae Caulis) is suitable. Cold-type diarrhea is rare; however, if caused by food stagnation or cold exposure necessitating treatment, one dose of Lizhong Tang (Regulate the Middle Decoction) will stop it. For chronic diarrhea, only Doukou Wan (Cardamom Pill) or Wubeizi (Chebulae Fructus) and Susuke (Poppies Capsule) burned to ash and mixed for oral administration to astringe should be used.

8. After the measles recede, one must avoid wind-cold and water-dampness. Negligence leads to lifelong cough and ulcerative conditions with no hope of cure.

9. Before and after the emergence of the measles rash, pork, fish, alcohol, and eggs are strictly taboo, as they may provoke lifelong cough. Only old chicken fat and lean meat boiled for consumption are permitted to slightly enhance flavor.

10. During the active eruption of measles, even if food intake is absent, there is no harm provided the rash is light red and moist. This is because the heat toxin is unresolved and excess internal heat exists, making food unnecessary. After recession, if appetite is lost, administering Siwu Tang (Four Substances Decoction) with Shenqu (Massa Medicata Fermentata) and Sharen (Amomi Fructus) for one to two doses will restore eating ability. If stomach qi is weak, reduce the dosage of Dihuang (Rehmanniae Radix Praeparata).

11. If the measles rash disappears after one day of emergence, it is due to wind-cold impact and internal attack by measles toxin. Without treatment, stomach rot and death ensue. One dose of Xiaodu Yin (Detoxification Decoction), taken hot, brings peace. If the rash appears for three days and then recedes, and wind-exposure symptoms are present, Xiaodu Yin (Detoxification Decoction) is also effective.

In my experience, the initial onset of measles resembles headache, cough, high fever, red eyes, and flushed cheeks caused by wind-cold injury. Eruption within one to two days indicates a mild case requiring surface release. Contact with wind-cold, fishy odors, and strong flavors must be avoided; violation may generate phlegm-cough and transform into convulsions and spasms, becoming untreatable. Simultaneous vomiting and diarrhea at onset is a favorable sign (Shun); Gan Huoluan (Dry Cholera-like syndrome with inability to vomit or defecate) is an adverse sign (Ni); failure to erupt despite signs suggests imminent danger and death.