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Although measles originates from fetal toxin (Tai Du, inherent pathogenic factors), it often carries epidemic qi (Shi Xing, seasonal pathogenic factors). It is caused by abnormal climatic changes of cold and warmth, leading to transmission between males and females. Its onset resembles smallpox (Dou Zhen); however, its variations are more severe than those of smallpox. Ignorant people often regard it as an ordinary disease, attributing life or death to fate. They do not know that the toxin arises from the Stomach (Wei) and heat flows into the Heart (Xin). Throughout the course of the disease, there are no specific symptoms in the Kidney (Shen); among the zang-fu organs, the Lung (Fei) suffers the most damage. Asking for directions with doors closed is inferior to going out to find a path; stopping boiling water by stirring is inferior to removing the firewood from under the pot.

In the initial stage, fever occurs, resembling Cold Damage (Shang Han). Tears flow continuously from the eyes, and nasal discharge does not dry up. Coughing is severe, accompanied by irritability and restlessness. When illuminated by fire, the rash appears faintly beneath the skin; when touched by hand, it stands out clearly within the muscles. Its shape resembles scabies, and its color resembles cinnabar; it appears and disappears intermittently. If the base is swollen, it is measles combined with urticaria (Yin Zhen); if the skin is red, it is measles accompanied by macules/papules (Ban). If the rash is bright like brocade, nine out of ten cases are auspicious; if it is black like coal, hardly one in a hundred recovers.

The measles toxin is heaviest, so the treatment methods differ. Mild sweating allows the heat to dissipate without lingering; normal bowel movements ensure the toxin circulates without obstruction. If the pores are closed and stagnant, dispersing and venting methods should be used immediately; if the intestines and stomach are constipated, urgent unblocking and purging are required. If the pulse appears large but feels thin inside, one must fear that auspicious signs may turn into ominous ones. Therefore, epistaxis (nosebleed) need not cause worry, as the pathogen resolves through bleeding; dysentery with blood need not be stopped forcibly, as the toxin is relieved through purgation. What is pleasing is the coolness of the body; what is feared is swelling and pain in the throat. Constant thirst requires methods to generate fluids and nourish blood; reduced appetite necessitates formulas to clear the stomach and harmonize the middle jiao.

Furthermore, if eruption is too delayed, releasing the exterior is paramount; if eruption is excessive, clearing toxicity is appropriate. Do not disrupt the harmony of Heaven and Human (Tian He), but always observe the annual climate. If the cold is biting, the toxin becomes stagnant and fails to emerge; if the heat is blazing, the pathogen takes advantage to cause epidemics. One may apply warming and tonifying methods, but do not assist the pathogen; one may use cooling and purging methods, but do not injure the stomach. Moderating excess aims only at balance; suppressing violence aims at restoring righteousness. Avoiding both cold and heat depends on the imbalance of yin and yang; addressing excess or deficiency depends on the individual's constitutional strength.

Once measles have erupted, nursing care is particularly difficult. Sitting and lying should be kept warm, and diet should be bland. If wind-cold invades, it causes swelling and heat; intolerance to salty or sour foods leads to cough and asthma. Even if affected by other pathogens, variable syndromes should be considered. Frequent pus and blood in stool indicates heat in the spleen and stomach blood; copious phlegm and foam in cough indicates cold damaging the lung (Hua Gai, metaphor for lungs). Mouth ulcers and cracked lips indicate that heart fire has not subsided; scorched skin and withered hair indicate that nutritive (Ying) and defensive (Wei) qi are about to dry up. Without detailed examination during clinical practice, how can one demonstrate mastery of medicine?