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At the initial stage of fever in measles, the symptoms are similar to those of Shanghan (Cold Damage), but patients with measles present with redness on the cheeks, coughing, sneezing, runny nose with clear discharge, tearing eyes, yawning and drowsiness, sometimes accompanied by vomiting or diarrhea, or scratching the eyebrows and eyes. Redness of the face is a distinctive feature. Upon observing these signs, it can be diagnosed as measles; at this time, one should carefully avoid wind and cold, and abstain from meat, fish, and strongly flavored foods. Ancient methods used Shengma Gegen Tang (Cimicifugae Rhizoma and Puerariae Radix Decoction) to disperse toxic pathogens. I (Zhang Jiebin) created Touxie Jian (Toxin-Dispersing Decoction) as a superior alternative, or Chaiyin Yin (Bupleurum and Angelica Decoction) is also excellent. As long as the skin remains unobstructed and the Couli (pores/skin texture) are open, the measles toxin will easily emerge. It must not be treated as Shanghan, nor should sweating or purging methods be applied recklessly. Reckless sweating will exacerbate heat, leading to epistaxis, hemoptysis, mouth ulcers, sore throat, red and swollen eyes, restlessness, dry thirst, and obstruction of urination and defecation. Reckless purging will weaken the interior, leading to incontinence or dysentery. The Classics state: "One must first accord with the Qi of the year and not violate the Harmony of Heaven." This means that sweating and purging should not be performed indiscriminately. Whenever there is doubt between initial fever of measles and other conditions, medication should never be administered lightly. Even if other syndromes exist, one must wait until the fifth day when rashes appear below the cheeks before using exterior-releasing agents. If there is excessive coughing, continuous sneezing, clear nasal discharge, or epistaxis, along with reduced appetite and a preference for cold water, only dietary regulation is appropriate, avoiding wheat products and meat/fish.

1. When measles initially presents with fever but the rash has not yet emerged, accompanied by incessant coughing (over a hundred times), rapid breathing, swelling of the face and eyelids, and alternating lying down and getting up, this indicates internal steaming of fire-toxin causing the lung lobes to become scorched and elevated. Ganjie Tang (Licorice and Platycodon Decoction) combined with Baihu Tang (White Tiger Decoction) plus Niubangzi (Arctii Fructus) and Bohe (Menthae Haplocalycis Herba) should be used. If during the emergence of the rash, symptoms include cough, dry mouth, and irritability, this indicates toxin residing in the Heart and Lung, with incomplete eruption. Xiebai San (Draining White Powder) plus Tianhuafen (Trichosanthis Radix), Lianqiao (Forsythiae Fructus), Xuanshen (Scrophulariae Radix), and Huanglian (Coptidis Rhizoma) should be used.

1. When the measles rash is about to emerge but has not yet done so, early dispersal is required to resolve the toxin, thereby preventing sequelae. If the toxin is not resolved in advance and allowed to fully erupt, the toxin may accumulate internally, leading to high fever, prolonged emaciation, convulsions and epilepsy, dysentery, hemoptysis with panting, or death due to gan erosion (nutritional deficiency/gangrene). Although this is caused by the infection of a specific pathogenic factor (Li Qi), it invariably results from inadequate human management/care.