麻疹浮小而有头粒，随出即收，不结脓 ，北人谓之糠疮，南人谓之麸疮，吴人谓之痧，越人谓之喑，古所谓麻，
闻人氏所谓肤疹是也。与前所谓脾为疹者不同。小儿有出一二次者，出轻而日数少者名奶疹子，出稍重而日数
稍多者名正疹子，又，出于痘前者名奶疹子，出于痘后者名正疹子。初出亦与痘疮相似，但痘发于脏，
麻发于腑，脏属阴，其病本深，故难出难收，而药于温平为宜。腑属阳，其病本浅，
故易出易收，而药于清凉为宜。万氏云∶痘大而 肿者，少阳三焦火也，阳道常饶，故大而肿。疹小而碎者，
少阴心火也，阴道常乏，故小而密。三焦水谷之道路，脾胃主纳水谷，治痘专以脾胃为主。心肺属阳，而位乎上，
心火旺则肺受之，治疹专以肺为主。观其咳嗽者，火炎则肺叶焦举也。鼻流清涕者，鼻为肺之窍，以火烁
金而液自流也。目中泪出，肺热则移于肝，肝之窍在目也。或手掐眉目唇鼻及面者，肺热证也。按∶既是
心火刑肺金，即是贼邪，其证当重，何反轻于痘，余每治麻疹，但据见证以泻白散加减，大剂投之，即至危困
之证无不愈者，其他时师用苦寒降火，辛温发表，而阽于危亡者不可胜数，安在其为心火刑肺也。春温、夏
暑、秋清、冬寒，此四时之正气也，冬应寒而反温，阳气暴泄，火令早行，人感之者，至于来春必发疮疥，未出
痘疹者，必感而出，虽曰胎毒，未有不由天行者，故一时传染，大小相似，但见疹痘之出，即宜先服三豆汤、
代天宣化丸（二方俱见前预防）以预解之。麻疹初出，全类伤风发热，咳嗽鼻塞，面肿涕唾稠粘，全是肺经之证，
有末传泄利者，有一起即兼泄利者，肺与大肠相表里，表里俱病也，惟不可触冒风
寒，及于正蒸热时啖食，能变轻为重，不可不慎。麻疹形证亦同，有如发风疹疙瘩，拥起如云头，色赤成 ，
随见随没者。有如粟米头糠，三番俱见而不没，至三日后方收渐没者。然皆谓之麻疹，其于欲出未出之际，
当用发表之药发之，则易出易愈也。麻疹，有发热至十余日始见者，大抵主在发散肺经之热毒者、始事也，
调理补养病后之元气者、终事也，其间或兼风，或兼痰，或伤食，并随宜加对证之药，其有变证，即随病用对
证之药，要不乱投汤剂，则儿无事矣。疹喜清凉，痘喜温暖，此法人皆知之，然疹子初出，亦须和暖则易出，
所以发苗之初，只要发出得尽，则毒便解，非若痘必苗而秀，秀而实，而后毒解也，痘子成实之时，若大温
热，则反溃烂不收，是痘之后，亦喜清凉也，故治痘疹者，无过热，无过寒，温凉适宜，阴阳自和，是为得之。
【初热】痘疹发热之初，多似伤寒，惟麻疹则咳嗽喷嚏，鼻流清涕，眼胞肿，其泪汪汪，面浮腮赤，或
呕恶，或泄利，或手掐眉目鼻面，此为异耳。轻者以泻白散合三味消毒散主之，重者以金沸草散主之，兼泄
利者，合升麻葛根汤，以白芷代葛根。此余创立治法，用之无不效者，即十分危证，守而勿失，终于必济，
每见诸书
所定方，类皆苦寒辛凉发表之剂，不尽对证对经，恐有诛罚无过之失，用者详之。大抵疹欲出已出之际，虽寒
勿用桂枝。虽虚勿用参术。虽呕而有痰勿用半夏、南星。大忌认作伤寒，妄汗妄下，汗之则增其热，为鼻衄，
为咳血，为口疮咽痛，为目赤痛，为烦躁，为大小便不通。下之则虚其里，为滑泄，为滞下，多至不救，慎之慎
之。〔万〕如手足稍微冷，恶寒而无汗，面色青惨而不舒，左额有青纹者，伤寒之热也。手足稍微温，发热有
汗，面赤而光者，伤风之热也，并宜惺惺散（痘初热）发散之。目胞肿而右颊有青筋，发热而头额腹肚最甚，或
兼呕吐腹疼者，伤食之热也，备急丸（痘初热）下之。面色青红，额正中有纹，手掌心有汗，时作惊惕，手络
脉微动而发热者，此惊热也，泻青丸（肝）、牛黄清心丸（痘烦躁）主之。身热而倍能食，唇红颊赤，大小便
秘，胁下汗者，此风热也，宣风散主之（痘发热）。以上诸热，久而不去，内外感发，则所蕴疮疹之毒，亦能乘
间而出矣。疹子只怕不能得出，若出尽，则便毒解，故治疹子者，发热之时，当察时令寒暄，以药发之，如时
太寒，以桂枝葛根汤发之。太热，以升麻葛根汤（俱痘初热）合人参白虎汤发之（痘渴）。不寒不热，以荆防败
毒散发之（痘夹疹）。如兼疫疠之气，以人参败毒散发之（痘初热）。如尽一剂不出，再作本汤发之，外用胡荽
酒（见形）以苎麻蘸酒遍身忧之，务令亟出。如三四作更不出，加腹中胀痛，气上喘促，昏闷谵妄者，必死证也。
泻白消毒散
桑白皮 地骨皮（二味、自采鲜者，各三钱） 牛蒡子（炒研） 荆芥穗（各一钱半） 桔梗 甘草（各一
钱） 浮萍（晒干，二钱）
上为粗末。每服三五钱，水一盏，煎六分，滤清服。
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） 甘草
（炙） 半夏（汤泡七次，姜汁拌炒） 赤芍药（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。
防风解毒汤（如温暖之时，以此辛凉之药发之）
防风 薄荷 荆芥 石膏 知母 桔梗 甘草 牛蒡子 连翘 木通 枳壳 淡竹叶
黄连解毒汤（如暄热之时，以此辛寒之药、发之）
防风 黄芩 黄连 荆芥穗 知母 石膏 黄柏（酒炒） 栀子仁 大青 玄参 甘草 桔梗 木通
桂枝解毒汤（如大寒之时，以此辛温热之药、发之）
桂枝 麻黄（酒炒） 赤芍药 防风 荆芥 羌活 甘草 桔梗 人参 川芎 牛蒡子 生姜
升麻解毒汤（如时暖时寒，以此辛平之药、发之）
升麻 干葛 荆芥穗 人参 柴胡 前胡 牛蒡子 桔梗 防风 羌活 赤芍药 淡竹叶 连翘 甘草
上方，虽曰因时制宜，亦不可拘泥，如冬月亦有不宜麻桂而宜石膏者，正当以脉证为主耳，若株守而不
知通变，必有失，不如用首二方之为妥当也。
发热六七日以后，明是疹子，却不见出，此皮肤坚浓，腠理闭密，又或为风寒袭之，曾有吐利，乃伏也，
急用托里发表之剂，麻黄汤调柽叶散发之，外用胡荽酒（见形）蘸麻刮之。如一向未更衣者，毒甚于里，伏而
不出也，以七物升麻丸解之，发之解之再不出者，死证也。
麻黄汤
麻黄（去根节，制过） 升麻 牛蒡子（炒） 蝉壳（洗净，去足翅） 甘草（各一钱）
烦渴，加石膏末四钱。
上锉细。加腊茶叶一钱，水一盏，煎七分，去滓服。
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。
疹子初发热时，未见出现，咳嗽百十声不止，上气喘急，面浮目胞肿，宜甘桔汤、消毒散、泻白散
三方合用，内桑白皮，采鲜者多用，热盛烦渴，加石膏末、知母、黄芩、天花粉。
疹子发热，或自汗出，或鼻衄者，不须止之，亦发散之义，汗则毒从汗散，衄则毒从衄解，但不可太过，
如汗太多，人参白虎汤（痘渴）合黄连解毒汤（痘烦躁），或黄连汤主之。衄太多，玄参地黄汤（失血）
茅花汤主之。
黄连汤
黄连 麦门冬 当归 黄柏 黄芩 生地黄 黄
水煎，去滓，调败蒲扇灰服之。
茅花汤
茅花 真郁金 生地黄 栀子仁 黄芩
水煎，调百草霜服。
疹子发热吐利，乃火邪内迫，纯是热证，不可作寒论。上焦多吐，宜黄芩汤（痘泄利）加茅根、芦根、枇杷
叶。下焦多利，宜黄芩汤送下香连丸（大科泄泻）。中焦吐利俱多，宜黄芩汤多加芦根、茅根煎调六一散
（痘初热）。自利甚，则里急后重而为滞下，宜加味黄芩汤调六一散。大抵疹家吐利滞下，宜于疹家求之，
不可作吐利滞下而治。
加味黄芩汤
黄连 黄芩（各一钱半） 白芍药（三钱） 甘草（七分） 滑石末（三钱）
水煎服。若滑石不煎、调服，止于一钱。血痢，加地榆二钱。
铜璧山人黄芩汤
黄芩 黄连 赤芍药 生地黄 木通 枳壳 甘草 当归梢 人参
水煎，去滓，调天水散服之。初加酒大黄微利之。
疹出之时咽喉肿痛者，乃毒火上熏而然，勿作喉痹治法，妄用针刺，喉痹、内作痈肿，故宜决去恶血。
痘疹只是咽干作痛，宜甘桔汤加玄参、牛蒡、连翘，或射干鼠粘子汤细细咽之，钱氏甘露饮子（俱咽喉）亦
可。外用十全散、玉锁匙点之。
十全散
黄连 黄芩 黄柏（各一钱） 苦参 孩儿茶 雄黄（各五分） 硼砂 玄明粉（各三分） 乳香
（一分） 片脑（少许，临时入）
共为极细末。每用五厘吹之。
疹子渴喜饮水，纯是火邪，肺焦胃干，心火内亢故也。初发热渴者，前发散药中多加石膏、天花粉，或葛
根麦门冬散。疹子出见渴者，人参白虎汤（痘渴）加天花粉、麦门冬，渴甚者，白虎汤合黄连解毒汤主之。
葛根麦门冬散
干葛 麦门冬（各一钱） 石膏 升麻 赤芍药 甘草 茯苓 人参（各五分）
上锉细。加淡竹叶七片，水一盏，煎七分，去滓温服。
白虎合解毒汤
石膏（研粗末，四钱） 知母 天花粉 黄芩 黄连 山栀仁（各一钱） 生地黄 麦门冬（各二钱
）入淡竹叶十片，水二钟，煎一钟，更磨入犀角汁，索汤水则与之。觉胃热渴，甚宜以此方多与之，胃清乃止，
庶免牙疳之害，直至疳成，而后清胃凉血解毒，往往噬肤无及，慈亲仁人，宜早为之所，毋事姑息。
【见形】痘疮，贵三四次出，谓出匀。麻疹，贵一齐涌出，谓出尽。麻疹只要得出，便轻减，以火照之，
遍身如涂朱之状，此将出之状，出形细密，与痘疮密者相似，但疹子随出随没，非若痘子之以渐长大也。出形
鲜红与伤寒发 相似，但疹子粒粒成疮，非若 之皮红成片，如蚊蚤之迹也。
疹痘之色不可同论，大抵痘子怕太红，皮嫩易破，必生瘙痒。疹子喜通红，疹发于心，红者火之正色也。
若色淡白者，心血不足，养血化 汤主之。色太红殷，或微紫者，血热也，或出太甚者，并宜大青汤主之。黑
者，死证也。
养血化 汤
当归身 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，去滓温服，无时。
大青汤
大青 玄参 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，去滓温服。
疹子出没，常以六时为准，假如子后出者，午时即收，午后出者，子时即收，乃阳生阴成，阴生阳成，造
化自然之数也。凡此旋出旋收者轻。若一出连绵，三四日不收者，乃阳毒太甚，宜大青汤解之，逡巡不出者，
乃风外束，皮肤闭密也，宜荆防败毒散主之（夹疹）。
疮疹非热不出，疹子欲出，则遍身发热，或烦躁，或头眩，或身拘急，及既出，则身便凉，诸病悉解，此
一层疹子随收矣。如疹子既出，热甚不减，此毒壅遏，宜大青汤解其表。便涩者，以黄连解毒汤（痘烦躁）合
白虎汤（发热）解其里。大便不通者，四顺清凉饮主之（发热）。
加味地骨皮散 治疹出，发热不退，饮食不进。
地骨皮（鲜者，三钱） 桑白皮（鲜者，二钱） 麦门冬（二钱） 银柴胡 赤芍药 干葛（各一钱
）甘草 生犀屑（各五分）
水煎，调大小无比散五七分（方见痘初热）。亦治喘急不止。
凡疹子，只要出得尽，则毒邪解散，正气和平。如拂拂发热，烦闷不宁，如蛇在灰，如蚓在尘之状，或呕
吐，或注泄，此毒邪壅遏，尚未出尽。烦热者，黄连解毒汤（烦躁）。呕泄者，柴胡橘皮汤。并外用胡荽酒
（见形）以苎麻蘸酒遍身戛之。待疹子出尽，则烦热自去，呕泄自止矣。俱可用大小无比散兼服。
柴胡橘皮汤
柴胡 橘皮 黄芩 半夏 人参 白茯苓（各等分）
上锉细。加竹茹一团，生姜三片，水一盏，煎七分，去滓温服，不拘时。
疹子欲出未出之时，宜早发散，以解其毒，则无余灾。若不预解使之尽出，以致毒蓄于中，或为壮热，日久
枯瘁，或成惊痫，或为泻痢，或咳血喘促，或作疳 而死，此虽一时戾气之染，未有不由于人事之未尽者。
【收后】疹子收后，身有微热者，此虚热也，不须施治，待气血和畅，自然退去。
若热太甚，或日久不减，以柴胡麦门冬散。甚则以黄连解毒汤（烦躁）合人参白虎汤（痘渴），与前方相间
服之。如发枯毛竖，肉消骨立，渐渐羸瘦者，柴胡四物汤主之。
疹子初起，多泻不妨，惟愈后最忌重热，此不可不调治者。盖疹子发热，多至十一二日，少亦不下五七日，
热久元气虚矣，加之疹出饮食不进，而复重热，阴阳耗竭，不死何待。故再热者必大补气血可也。余见忽
以为常，而死者屡矣。
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 玄参（各半钱）
上锉细。水煎服。
柴胡四物汤
Measles rash appears small and superficial with distinct granules, emerging and receding quickly without forming pus or scabs. In northern regions it is called "Kang Chuang" (Bran Sore), in southern regions "Fu Chuang" (Bran Sore), in the Wu region "Sha", and in the Yue region "Yin". This is what the ancients referred to as "Ma" (Measles), and what Wenren Shi described as "Fu Zhen" (Skin Rash). It differs from the rashes previously mentioned as originating from the Spleen.
Some children may have one or two outbreaks; those that are mild and last for a few days are called "Nai Zhen Zi" (Milk Measles); those that are slightly more severe and last longer are called "Zheng Zhen Zi" (True Measles). Additionally, measles appearing before variola (smallpox) are called "Nai Zhen Zi", while those appearing after variola are called "Zheng Zhen Zi". Initially, they resemble variola, but variola originates from the Zang organs (Solid Organs), whereas measles originate from the Fu organs (Hollow Organs). The Zang organs belong to Yin, so the disease root is deep, making it difficult to emerge and recede; thus, medication should be warm and neutral. The Fu organs belong to Yang, so the disease root is shallow, making it easy to emerge and recede; thus, medication should be cool and clear.
Wan Quan stated: Variola that is large and swollen is due to Fire of the Shaoyang Sanjiao (Triple Burner). The Yang path is often abundant, hence large and swollen. Measles that are small and fragmented are due to Heart Fire of the Shaoyin. The Yin path is often deficient, hence small and dense. The Sanjiao is the pathway for water and grain; the Spleen and Stomach govern the reception of water and grain, so treating variola focuses primarily on the Spleen and Stomach. The Heart and Lungs belong to Yang and reside in the upper Jiao. When Heart Fire is excessive, it affects the Lung. Therefore, treating measles focuses primarily on the Lung. Observing cough indicates that fire blazing causes the lung lobes to become dry and elevated. Clear nasal discharge occurs because the nose is the opening of the Lung; fire scorches Metal (Lung), causing fluids to flow freely. Tears from the eyes indicate Lung heat transferring to the Liver, as the Liver opens into the eyes. Scratching the eyebrows, eyes, lips, nose, and face indicates Lung heat.
Note: Since this is Heart Fire punishing Lung Metal, it constitutes a "Thief Evil" (pathogenic factor that overacts), so the syndrome should be severe. Why is it milder than variola? Whenever I treat measles, I base my treatment on the manifestations using Xie Bai San (Drain White Powder) with modifications, administered in large doses. Even critically severe cases recover without exception. Other contemporary physicians use bitter-cold herbs to descend fire and acrid-warm herbs to release the exterior, leading to numerous fatal outcomes. How can this be considered Heart Fire punishing Lung Metal?
Spring warmth, summer heat, autumn clarity, and winter cold are the correct Qi of the four seasons. If winter should be cold but is instead warm, Yang Qi leaks violently, and the Fire mandate acts early. Those who contract this will inevitably develop sores and boils in the following spring. Those not yet having developed variola or measles will certainly contract them. Although termed "fetal toxin," none arise without transmission via epidemic qi. Thus, during an outbreak, symptoms are similar across ages and severities. Upon seeing the emergence of measles or variola, one should first administer Sandou Tang (Three Bean Decoction) and Daitian Xuanhua Wan (Heaven's Proxy Transformation Pill) [both formulas seen in the Prevention section] to preemptively resolve the toxin.
The initial stage of measles closely resembles wind-cold attack with fever, cough, nasal congestion, facial swelling, red cheeks, thick sticky sputum, and nasal discharge—all signs of the Lung channel. Some later develop diarrhea, while others present with diarrhea simultaneously. The Lung and Large Intestine are interior-exteriorly related, so both the exterior and interior channels are affected. One must avoid exposure to wind-cold and eating during the peak febrile phase, lest mild cases become severe. Exercise caution.
The morphology and signs of measles vary. Some resemble urticaria wheals, rising like cloud heads, red in color, appearing and disappearing rapidly. Others resemble millet grains or bran, visible through three stages without disappearing, only gradually receding after three days. All are termed measles. During the period when the rash is about to emerge but has not yet appeared, use diaphoretic agents to promote eruption, facilitating easier emergence and recovery.
In some cases, fever persists for ten-plus days before the rash appears. Generally, the primary task at the beginning is to dissipate Heat-Toxin from the Lung channel; the final task is to regulate and tonify the post-illness Yuan Qi. If complicated by Wind, Phlegm, or food stagnation, add appropriate herbs accordingly. For any altered syndromes, use targeted herbs based on the pathology. As long as decoctions are not indiscriminately prescribed, the child will remain safe.
Measles prefer coolness, while variola prefers warmth—a principle known to all. However, initially, measles also require mild warmth to facilitate eruption. Once the rash emerges completely, the toxin resolves. Unlike variola, which requires maturation ("seedling," "flowering," "fruiting") before toxin resolution, measles resolve upon complete eruption. For variola, excessive heat during maturation causes ulceration and failure to heal; thus, variola also benefits from coolness in its later stages. Therefore, in treating both, avoid excessive heat or cold. Maintain moderate warmth and coolness so that Yin and Yang harmonize naturally. This is the correct approach.
[Initial Fever] The initial fever of variola and measles often resembles Taiyang syndrome (Cold Damage). However, measles are distinguished by cough, sneezing, clear nasal discharge, swollen eyelids, watery eyes, facial puffiness, red cheeks, vomiting, diarrhea, or scratching the face/eyes/nose. Mild cases are treated with Xie Bai San combined with Sanwei Xiaodu San (Three-Ingredient Toxin-Resolving Powder). Severe cases are treated with Jin Fei Cao San (Golden Whorlwort Decoction). If accompanied by diarrhea, combine with Shengma Gegen Tang (Cimicifuga and Kudzu Decoction), replacing Gegen with Baizhi. This is my established method, which has proven effective even in critical cases. Many classical formulas rely on bitter-cold and acrid-cool diaphoretics, which may not always match the specific channel or syndrome, risking unjust punishment of healthy Qi. Users should consider this carefully.
Generally, during the emergence of measles, do not use Guizhi (Cinnamon Twig) even if cold signs are present. Do not use Renshen (Ginseng) and Baizhu (Atractylodes Macrocephala Rhizome) even if deficiency is present. Do not use Banxia (Pinellia Tuber) and Tianxing (Arisaema Rhizome) if vomiting is accompanied by phlegm. Most importantly, avoid misdiagnosing measles as Cold Damage and prescribing inappropriate sweating or purging methods. Sweating increases heat, leading to epistaxis, hemoptysis, mouth ulcers, sore throat, red painful eyes, restlessness, and urinary/fecal retention. Purging empties the interior, leading to incontinence or dysentery, often resulting in death. Be extremely cautious.
[Wan Quan] If hands and feet are slightly cold, with aversion to cold, no sweat, bluish-pale complexion, and blue veins on the left forehead, it is Heat from Cold Damage. If hands and feet are slightly warm, with fever, sweat, and bright red face, it is Heat from Wind Strike. Both should be treated with Xingxing San (Xingxing Decoction) [for initial variola fever] to release the exterior. If eyelids are swollen with blue veins on the right cheek, fever most severe on head, forehead, abdomen, and belly, possibly with vomiting and abdominal pain, it is Heat from Food Stagnation. Treat with Beijji Wan (Emergency Preparation Pill) [for initial variola fever] to purge. If the complexion is greenish-red with a line on the center of the forehead, sweat on palms, frequent startles, slight tremors in hand collaterals, and fever, it is Heat from Fright. Treat with Xie Qing Wan (Drain Green Pill) [Liver] and Niuhuang Qingxin Wan (Calvescent Horn Clearing Heart Pill) [for variola irritability]. If body heat is accompanied by increased appetite, red lips and cheeks, constipation, and sweat under the ribs, it is Wind-Heat. Treat with Xuanfeng San (Dispel Wind Powder) [for variola fever]. If these various heats persist, internal and external pathogens interact, allowing the accumulated toxin of sores and rashes to emerge.
The main concern with measles is whether they can erupt. If they erupt completely, the toxin resolves. Therefore, during the febrile stage, observe the seasonal climate and use herbs to induce eruption. If too cold, use Guizhi Gegen Tang (Cinnamon Twig and Kudzu Decoction). If too hot, use Shengma Gegen Tang combined with Renshen Baitu Tang (Ginseng White Tiger Decoction) [for thirst]. If neither cold nor hot, use Jingfang Baidu San (Schizonepeta and Saposhnikovia Detoxifying Powder) [measles complication]. If epidemic qi is involved, use Renshen Baidu San [initial variola fever]. If one dose fails to produce eruption, repeat the same decoction. Externally, apply Huisu Jiu (Coriander Wine) [appearance stage] soaked in ramie cloth to rub the entire body, ensuring rapid eruption. If after three or four attempts the rash still does not appear, accompanied by abdominal distension/pain, panting, confusion, and delirium, it is a fatal sign.
Xie Bai Xiaodu San (Drain White Toxin-Resolving Powder)
Sangbaipi (Mulberry Root Bark), Digupi (Groundcherry Root Bark) [freshly harvested, 3 qian each], Niubangzi (Arctii Fructus, fried and ground), Jingjie Sui (Schizonepeta Spikelet, 1.5 qian each), Jiegeng (Platycodon Root), Gancao (Licorice Root, 1 qian each), Fuping (Azolla Herba, dried, 2 qian).
Grind into coarse powder. Take 3–5 qian per dose, boil in one cup of water until reduced to 0.6 cups, filter, and drink.
Jiawei Jin Fei Cao San (Modified Golden Whorlwort Decoction)
Xuanfuhua (Inulae Flos, remove stem), Mahuang (Ephedrae Herba, remove joints, boil to remove foam, dry), Qianhu (Peucedani Radix, remove rhizome, 7 qian each), Jingjie Sui (Schizonepeta Spikelet, 1 liang), Gancao (Licorice Root, honey-fried), Banxia (Pinelliae Rhizoma, soak in boiling water seven times, stir-fry with ginger juice), Chishao (Paeoniae Radix Rubra, 5 qian each), Shuniuzi (Arctii Fructus, fried), Fuping (Azolla Herba, 7 qian each).
Grind into powder. Take 3 qian per dose with 2 slices of fresh ginger and 3–5 mint leaves, decoct and drink.
Fangfeng Jiedu Tang (Saposhnikovia Toxin-Resolving Decoction) [Use this acrid-cool formula for warm weather]
Fangfeng (Saposhnikoviae Radix), Bohe (Menthae Haplocalycis Herba), Jingjie (Schizonepetae Herba), Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), Jiegeng (Platycodon Root), Gancao (Licorice Root), Niubangzi (Arctii Fructus), Lianqiao (Forsythiae Fructus), Mutong (Akebiae Caulis), Zhike (Aurantii Fructus), Danzhuye (Lophatheri Herba).
Huanglian Jiedu Tang (Coptis Toxin-Resolving Decoction) [Use this acrid-cold formula for hot weather]
Fangfeng (Saposhnikoviae Radix), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Jingjie Sui (Schizonepeta Spikelet), Zhimu (Anemarrhenae Rhizoma), Shigao (Gypsum Fibrosum), Huangbai (Phellodendri Cortex, wine-fried), Zhizi Ren (Gardeniae Semen), Daqing (Isatidis Folium), Xuanshen (Scrophulariae Radix), Gancao (Licorice Root), Jiegeng (Platycodon Root), Mutong (Akebiae Caulis).
Guizhi Jiedu Tang (Cinnamon Twig Toxin-Resolving Decoction) [Use this acrid-warm-hot formula for severe cold]
Guizhi (Cinnamomi Ramulus), Mahuang (Ephedrae Herba, wine-fried), Chishao (Paeoniae Radix Rubra), Fangfeng (Saposhnikoviae Radix), Jingjie (Schizonepetae Herba), Qianghuo (Notopterygii Rhizoma et Radix), Gancao (Licorice Root), Jiegeng (Platycodon Root), Renshen (Ginseng Radix), Chuanxiong (Chuanxiong Rhizoma), Niubangzi (Arctii Fructus), Shengjiang (Zingiberis Rhizoma Recens).
Shengma Jiedu Tang (Cimicifugae Toxin-Resolving Decoction) [Use this acrid-neutral formula for fluctuating temperatures]
Shengma (Cimicifugae Rhizoma), Gange (Puerariae Lobatae Radix), Jingjie Sui (Schizonepeta Spikelet), Renshen (Ginseng Radix), Chaihu (Bupleuri Radix), Qianhu (Peucedani Radix), Niubangzi (Arctii Fructus), Jiegeng (Platycodon Root), Fangfeng (Saposhnikoviae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Chishao (Paeoniae Radix Rubra), Danzhuye (Lophatheri Herba), Lianqiao (Forsythiae Fructus), Gancao (Licorice Root).
Although these formulas aim to adapt to seasonal conditions, do not adhere rigidly. For example, in winter, Shigao may be preferred over Mahuang and Guizhi. Prioritize pulse and syndrome differentiation. Stubborn adherence without flexibility leads to error; the first two formulas are generally safer.
If fever persists for six to seven days and measles are evident but not erupting, it may be due to thick skin and closed pores, or invasion by wind-cold, or prior vomiting/diarrhea indicating latent toxin. Urgently use a formula to support the interior and release the exterior. Use Mahuang Tang (Ephedra Decoction) mixed with Chengye San (Tomentose Willow Leaf Powder) to induce eruption. Externally, rub with Huisu Jiu (Coriander Wine) [appearance stage] soaked in hemp. If there has been no bowel movement, the toxin is severe in the interior and latent. Resolve with Qiwu Shengma Wan (Seven-Ingredient Cimicifuge Pill). If eruption and resolution fail repeatedly, it is a fatal sign.
Mahuang Tang (Ephedra Decoction)
Mahuang (Ephedrae Herba, remove roots/joints, processed), Shengma (Cimicifugae Rhizoma), Niubangzi (Arctii Fructus, fried), Chanqiao (Cicadae Periostracum, cleaned, legs/wings removed), Gancao (Licorice Root, 1 qian each).
For irritability and thirst, add 4 qian of Shigao powder.
Cut finely. Add 1 qian of aged tea leaves, boil in one cup of water until reduced to 0.7 cups, strain, and drink.
Chengye San (Tomentose Willow Leaf Powder)
Cheng (Tomentose Willow Leaf), also known as Xihe Liu or Chuisi Liu. Harvest leaves when lush, dry, and grind into powder. Take 1–2 qian per dose, mixed with Mugen (Imperatae Rhizoma) decoction.
When measles initially present with fever but no eruption, accompanied by incessant coughing (hundreds of times),急促 breathing, facial puffiness, and swollen eyelids, combine Ganjie Tang (Licorice and Platycodon Decoction), Xiaodu San (Toxin-Resolving Powder), and Xie Bai San (Drain White Powder). Use more fresh Sangbaipi (Mulberry Root Bark). For intense heat, irritability, and thirst, add Shigao powder, Zhimu, Huangqin, and Tianhuafen.
If measles fever presents with spontaneous sweating or epistaxis, do not stop it; this is part of the dispersing mechanism. Sweat allows toxin to exit via perspiration; epistaxis allows toxin to exit via bleeding. However, do not allow excessive loss. If sweating is excessive, use Renshen Baitu Tang (Ginseng White Tiger Decoction) combined with Huanglian Jiedu Tang (Coptis Toxin-Resolving Decoction), or Huanglian Tang (Coptis Decoction). If epistaxis is excessive, use Xuanshen Dihuang Tang (Scrophularia and Rehmannia Decoction) [for hemorrhage] or Maohua Tang (Miscanthus Flower Decoction).
Huanglian Tang (Coptis Decoction)
Huanglian (Coptidis Rhizoma), Maidong (Ophiopogonis Tuber), Danggui (Angelicae Sinensis Radix), Huangbai (Phellodendri Cortex), Huangqin (Scutellariae Radix), Shengdihuang (Rehmanniae Radix Recens), Huangbai (Phellodendri Cortex).
Decoct in water, strain, and mix with powdered ash from a discarded palm fan.
Maohua Tang (Miscanthus Flower Decoction)
Maohua (Miscanthi Floris Summitas), Zhen Yujin (Curcumae Radix), Shengdihuang (Rehmanniae Radix Recens), Zhizi Ren (Gardeniae Semen), Huangqin (Scutellariae Radix).
Decoct in water, strain, and mix with Baicaoshuang (Carbonized Grass Ash).
Vomiting and diarrhea with measles fever indicate internal pressure from Fire-Pathogen; it is purely a Heat syndrome, not Cold. Upper Jiao vomiting: use Huangqin Tang (Scutellaria Decoction) [variola diarrhea] plus Mugen, Lugen (Reed Rhizome), and Pipaye (Loquat Leaf). Lower Jiao diarrhea: take Huangqin Tang with Xianglian Wan (Costus and Coptis Pill) [general diarrhea]. Middle Jiao vomiting and diarrhea: use Huangqin Tang with added Lugen and Mugen, decocted and mixed with Liuyi San (Six-to-One Powder) [initial variola fever]. Severe self-directed diarrhea with tenesmus and dysentery: use Jiawei Huangqin Tang (Modified Scutellaria Decoction) mixed with Liuyi San. Generally, for vomiting, diarrhea, and dysentery in measles patients, seek the cause within the measles pathology, not as independent gastrointestinal disorders.
Jiawei Huangqin Tang (Modified Scutellaria Decoction)
Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix) [1.5 qian each], Baishao (Paeoniae Radix Alba, 3 qian), Gancao (Licorice Root, 0.7 qian), Huashi (Talcum Powder, 3 qian).
Decoct and drink. If Huashi is not decocted but mixed, limit to 1 qian. For bloody dysentery, add Diyü (Sanguisorbae Radix, 2 qian).
Tongbi Shanren Huangqin Tang (Bronze Wall Scholar Scutellaria Decoction)
Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Chishao (Paeoniae Radix Rubra), Shengdihuang (Rehmanniae Radix Recens), Mutong (Akebiae Caulis), Zhike (Aurantii Fructus), Gancao (Licorice Root), Danggui Shao (Angelicae Sinensis Radix tip), Renshen (Ginseng Radix).
Decoct, strain, and mix with Tianshui San (Heaven and Water Powder). Initially add Jiudahuang (Wine-processed Rheum Palmatum Rhizoma) to induce mild purgation.
Sore throat and swelling during measles eruption result from toxic fire steaming upward. Do not treat as Hou Bi (Throat Bi) or use needle pricking. Hou Bi involves internal abscesses requiring bloodletting. For simple dry/painful throat in variola/measles, use Ganjie Tang plus Xuanshen, Niubang, and Lianqiao, or Shegan Niubangzi Tang (Belamcanda and Arctii Decoction) to gargle slowly. Qian's Ganlu Yinzi (Sweet Dew Decoction) [throat conditions] is also suitable. Externally, apply Shiquan San (Ten-Complete Powder) or Yusuo Chi (Jade Lock Key) [topical powders].
Shiquan San (Ten-Complete Powder)
Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Huangbai (Phellodendri Cortex) [1 qian each], Kushen (Sophorae Flavescentis Radix), Haiercha (Camelliae Seed Tea), Xionghuang (Realgar) [0.5 fen each], Pengsha (Borax), Xuanmingfen (Mirabilite) [0.3 fen each], Rushxiang (Frankincense, 0.1 fen), Piannao (Borneolum Syntheticum, a little, add just before use).
Grind into ultra-fine powder. Apply 0.05 fen per application via insufflation.
Thirst and desire for water in measles indicate pure Fire-Pathogen, drying the Lung and Stomach, with hyperactive Heart Fire. For initial fever-thirst, add more Shigao and Tianhuafen to diaphoretic formulas, or use Gegen Maidong San (Kudzu and Ophiopogon Powder). For thirst upon eruption, use Renshen Baitu Tang plus Tianhuafen and Maidong. For severe thirst, use Baitu Tang combined with Huanglian Jiedu Tang.
Gegen Maidong San (Kudzu and Ophiopogon Powder)
Gange (Puerariae Lobatae Radix), Maidong (Ophiopogonis Tuber) [1 qian each], Shigao (Gypsum Fibrosum), Shengma (Cimicifugae Rhizoma), Chishao (Paeoniae Radix Rubra), Gancao (Licorice Root), Fuling (Poria), Renshen (Ginseng Radix) [0.5 fen each].
Cut finely. Add 7 leaves of Danzhuye, boil in one cup of water until reduced to 0.7 cups, strain, and drink warm.
Baitu He Jiedu Tang (White Tiger Combined with Toxin-Resolving Decoction)
Shigao (Gypsum Fibrosem, coarsely ground, 4 qian), Zhimu (Anemarrhenae Rhizoma), Tianhuafen (Trichosanthis Radix), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Shanzhiren (Gardeniae Semen) [1 qian each], Shengdihuang (Rehmanniae Radix Recens), Maidong (Ophiopogonis Tuber) [2 qian each]. Add 10 leaves of Danzhuye, boil in two cups of water until reduced to one cup. Grind in Xijiao (Rhinocerotis Cornu) juice. Provide soup/water as desired. For stomach heat/thirst, administer generously until the stomach clears to prevent Ya Gan (Gum Gangrene). Delaying treatment until gangrene forms renders remedies ineffective. Compassionate practitioners should act early, not indulge in hesitation.
[Appearance Stage] Variola ideally erupts in three to four batches evenly. Measles ideally erupt all at once completely. Measles are lighter if they erupt fully. Illuminating with fire reveals a crimson appearance, indicating imminent eruption. The rash is fine and dense, resembling dense variola, but measles appear and disappear rapidly, unlike variola which grows gradually. Bright red eruptions resemble Cold Damage macules, but measles form individual pustules, unlike macules which are confluent red patches resembling insect bites.
Colors of measles and variola differ. Variola fears excessive redness as thin skin breaks easily, causing itching. Measles prefer uniform redness, as they originate from the Heart; red is the true color of Fire. Pale white color indicates Heart Blood deficiency; treat with Yangxue Hua Ban Tang (Nourish Blood Transform Macule Decoction). Deep red or slightly purple indicates Blood Heat or excessive eruption; treat with Daqing Tang (Greater Isatis Decoction). Black indicates a fatal sign.
Yangxue Hua Ban Tang (Nourish Blood Transform Macule Decoction)
Danggui Shen (Angelicae Sinensis Radix body), Shengdihuang (Rehmanniae Radix Recens), Honghua (Carthami Flos), Chantui (Cicadae Periostracum), Renshen (Ginseng Radix) [equal parts].
Cut finely. Boil in one cup of water with one slice of ginger until reduced to 0.6 cups, strain, and drink warm at any time.
Daqing Tang (Greater Isatis Decoction)
Daqing (Isatidis Folium), Xuanshen (Scrophulariae Radix), Shengdihuang (Rehmanniae Radix Recens), Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), Mutong (Akebiae Caulis), Gancao (Licorice Root), Digupi (Groundcherry Root Bark), Jingjie Sui (Schizonepeta Spikelet) [equal parts].
Cut finely. Boil in one cup of water with 12 leaves of Danzhuye until reduced to 0.7 cups, strain, and drink warm.
Measles emergence and recession follow a six-hour cycle. Eruption after Zi hour (11 PM–1 AM) recedes at Wu hour (11 AM–1 PM); eruption after Wu hour recedes at Zi hour. This reflects the natural generation of Yin from Yang and Yang from Yin. Rapid emergence and recession indicate mild disease. Continuous eruption lasting three to four days without recession indicates excessive Yang Toxicity; treat with Daqing Tang. Delayed eruption indicates external Wind binding and closed pores; treat with Jingfang Baidu San [measles complication].
Sores and rashes require Heat to emerge. Before eruption, the body may feel hot, irritable, dizzy, or stiff. After eruption, the body cools, and symptoms resolve, marking the recession phase. If fever persists after eruption, toxin is obstructed; treat the exterior with Daqing Tang. If urination is difficult, resolve the interior with Huanglian Jiedu Tang combined with Baitu Tang. If constipation occurs, use Sishun Qingliang Yin (Four-Obstruction Cooling Drink) [fever].
Jiawei Digupi San (Modified Groundcherry Powder) treats persistent fever and anorexia after measles eruption.
Digupi (Groundcherry Root Bark, fresh, 3 qian), Sangbaipi (Mulberry Root Bark, fresh, 2 qian), Maidong (Ophiopogonis Tuber, 2 qian), Yinchaihu (Cynanchi Stauntonii Radix), Chishao (Paeoniae Radix Rubra), Gange (Puerariae Lobatae Radix) [1 qian each], Gancao (Licorice Root), Sheng Xijiao (Fresh Rhino Horn, 0.5 fen each).
Decoct, mix with 0.5–0.7 portions of Daxiao Wubi San (Great and Small Extraordinary Powder) [initial variola fever]. Also treats persistent asthma.
As long as measles erupt completely, toxin disperses, and healthy Qi harmonizes. Symptoms like slight fever, restlessness, feeling like a snake in ashes or worm in dust, vomiting, or diarrhea indicate obstructed toxin not yet fully erupted. For irritability, use Huanglian Jiedu Tang. For vomiting/diarrhea, use Chaihu Jupi Tang. Externally, rub with Huisu Jiu [appearance stage] soaked in ramie cloth. Once erupted, symptoms cease. Daxiao Wubi San may be taken concurrently.
Chaihu Jupi Tang (Bupleurum and Tangerine Peel Decoction)
Chaihu (Bupleuri Radix), Jupi (Citri Reticulatae Pericarpium), Huangqin (Scutellariae Radix), Banxia (Pinelliae Rhizoma), Renshen (Ginseng Radix), Baifuling (Poria with Wood) [equal parts].
Cut finely. Add a ball of Zhuru (Bambusae Caulis in Taenia), 3 slices of ginger, boil in one cup of water until reduced to 0.7 cups, strain, and drink warm anytime.
During the pre-eruption phase, early dispersion resolves toxin and prevents disaster. Failure to resolve toxin leads to accumulation, causing high fever, wasting, convulsions, dysentery, hemoptysis, asthma, or death from malnutrition. Although caused by epidemic qi, outcomes depend on human intervention.
[Post-Recession] Slight fever after recession indicates Deficiency Heat; no treatment is needed. It resolves naturally as Qi and Blood harmonize.
If fever is severe or persistent, use Chaihu Maidong San. For severe cases, alternate Huanglian Jiedu Tang with Renshen Baitu Tang. If hair becomes brittle, muscles waste, bones show, and emaciation progresses, use Chaihu Siwu Tang (Bupleurum Four-Substance Decoction).
Diarrhea at onset is acceptable; however, recurrent heat after recovery is strictly contraindicated and requires treatment. Measles fever lasts 11–12 days, or at least 5–7 days. Prolonged heat depletes Yuan Qi. Poor diet during eruption plus recurrent heat exhausts Yin and Yang, leading to death. Recurrent heat requires major tonification of Qi and Blood. I have witnessed many deaths due to ignoring this.
Chaihu Maidong San (Bupleurum and Ophiopogon Decoction)
Chaihu (Bupleuri Radix, 0.5 fen), Longdancao (Gentianae Radix, 0.3 fen), Maidong (Ophiopogonis Tuber, 0.8 fen), Gancao (Licorice Root, 0.2 fen), Renshen (Ginseng Radix), Xuanshen (Scrophulariae Radix) [0.5 qian each].
Cut finely. Decoct and drink.
Chaihu Siwu Tang (Bupleurum Four-Substance Decoction)