（治法）余所以略述西医关于麻疹及猩红热之病状及鉴别者，并非希望医者尽以西法治疗此二症。实以此：二症，尤其猩红热一症，在大流行时，害人最速，必兼白喉．小儿尤危。往往不及治疗，已濒危险，此时唯一特效方法，即为预防注射，万不可偏信中医．致罹传染，此二症．在真正之西医，固不难诊断明确，施一切防疫方法及治疗方法。若在穷乡僻壤，缺乏高明医者，或只读中医书，缺乏西医常识之中医，一遇此症。治疗上纵有最效之方法，此症既病之后，中医治法，奇妙灵活，较之西医之血清疗法或有过之，病家亦不可偏信西医也。然村十—一切之预防上，实无丝毫设备，危险眯甚。故余希望中医．具此新识，深信预防注射，可以根本减少灾疠之流行。遇此时机．中西医务须合力唤醒人民，施行预防注射。不幸发现此症，务宜实行患者隔离，各尽各心，拯救病者。并非强中医以注射，强西医用汤剂也，然中药治此症之奇效，则不得不详细说明，愿高明西医一研究之。至于注射疫苗及血清等，系属西医专门学问．本不正在此书内叙述，兹为补充中医新识起见，谨将血清及疫苗注射大意略述千下：1.血清，血清者即血液中之水样成分也，有免疫血清、健康动物血清、健康入血清、自家血清等。通常贩卖之血清，皆为免疫血清，系用各种毒素，注入于健康之马或牛等大动物之体内，使此大动物之体内，发生抗毒素（注入某种毒素。即得某种抗毒素血清，再采取之。血清即以此采取之血清，注入某种病人体内，则发生抗毒之力量，例如以大量猩红热血清，注射于患此症之人体内，则此人之抵抗病毒之力加强，是谓治疗血清。盖以此种大量血清，注入病人体内．则其体内游离之毒素，即为此种血清所中和，而制止其毒性也。若以小量血清，注入病人体内．以增高其抵抗力，而预防疾病之发生者，名曰预防血清。此不过仅为中医介绍血清原理，故约略述之，至于应用血清之各要点，（例如血清病及过敏性等）属于专门注射之西医，无庸多赘。
2，疫苗，或称浆苗，或称疫苗，译名伐克辛或译为万克醒等名词。系以各种之病原菌或毒素，拣选培养育质完善后．再醉死之，而制成之品。其疗法，在免疫学上，与血清相反，盖血清疗法，系被免疫，而菌苗疗法？系自免疫也。详言之，即血清疗法，系先将动物免疫，而后采其血清，再注射于病人体内，是用已经成立之免疫体。若菌苗疗法，则以已经培养成之病原菌或毒素，醉死之，直接注入患者之体内，以督促细胞，使其自己发生免疫体，以防止各种传染病菌之侵入，而成此敌毒体，其已病之人，亦能制止病毒之增加，而收治疗之效果，此菌苗之原理也。菌苗分类，有混合菌苗及单独菌苗之分，与血清亦不同，兹从略。
3．疫苗内精，系为细菌之取出物，既非细菌亦非其生长之培养基，故较其他抗体原少含蛋白质而又无毒素之制品也。（此种系先由培养基内取出活菌，再用生理食盐水混合，而事先提取之液体）4．腓啦克金，系含有无数微菌之排泻物之流质。此种液质，并不含有菌之本体，与伐克辛及血清均不同，乃用灭生流动物质之含有微菌废物，由人工微菌育质之培养法，所产出者也。
以上四种，皆供应注射用者，但除预防注射外，治疗上之地位，亦非百发百中，病势危笃，血清治疗，有时反不及中医中药之灵效，此余所历验而得之认识，病家不可不知，医者不可不知也。
（治法）名医治疹大法，以清凉宣透四字为秘诀，此四字加以解释，则清凉药味，多用清轻芳香解毒之类，例如连翘、金银花、绿豆皮、竹叶等药是也。宣字之义，最含妙谛，盖疹之发生，肺此肺字，不可仅作呼吸器解，须参照肺主皮毛等义。必先病，内外上下之经络，完全为瘟毒蕴酿，一种毒秽热浊之气体，含育混合于营卫血脉三焦经络之间，积不能容。因气侯之诱因所渭四时不正之气及自己体内之排除力，而欲使其向体外全身皮肤及粘膜外，口内、眼内、鼻内，以及腹腔、内脏、肠内，均有粘膜，即俗所谓嫩皮是也（此粘膜外三字，系余杜撰。），排除之。在余之理想，可谓瘟毒在体内，全部颇似欲酵之物质，若治疗得宜，因势利导宣透使其发酵完成，绝不致有危险。先医创此宣透二字，实为治疹唯一妙法。盖此症第一治法，初起即须使室内温暖，不可透风，更必须令患者绝对避风寒侵袭，避忌凉饮冷食，在发热一、二日后，皮肤红胀，疹将发现之时，尤应避忌。此即与治温症不同之点，疹一见红点，绝对禁止见风及生冷饮食，一犯此禁，疹点立即回隐，热毒内陷，危险立至。常见有发面蒸馒头者，酵母水分，配合停妥，温度合宜，势将发起矣，此时忽被冷气一吹，则此面食立时收缩，酵母失其作用，此后无论如何加热蒸气绝难宣发，医者能明此理，即可明厂治疹要诀，亦可见避风寒三字之关系重大，余此说虽甚鄙俚，然能罕譬而喻也。初起所用之药，既有类似之表证，头痛、恶寒、身热、身痛故宜于清轻芳香解毒药中，略参加一、二味清凉解肌之品，不可发汗，发汗过当，则体温下降，血管收缩，疹不易出，反成逆症，盖体温不高．疹不能出透澈也。使患者之皮肤毛孔，仅仅松动，津津然若有汗意蒸润，但并非出汗，此际最宜避风。例如薄荷、葛根、芥穗，均为适用，但亦不用大量，自三分至一钱，视年令为定。以仅仅达到宣透目的为标准。但宣透二宇不可仅作解肌讲，内外宣透、上下宣透，医者思想要极灵活，是以解肌之外，其次即应注意患者之大便，如有一、二日不大便，或大便不爽、恶臭或干燥，即是上下不宣透，即应稍稍与以缓下之药。于清瘟解毒药中，加入少许之熟大黄，或于服中药之后，再隔八，九点钟，视其年龄大小与以一至二支甘汞锭，此指大人用量（一锭含量0．2克）或于中药内加以瓜蒌仁，若大便显然有（肠炎）之症象时，尤须参照肠热治法，格外注意。但疹初发时，不可任意与以大量之泻药，以免毒反内陷也。盖宣透二字之义，不但外表宣透，使疹毒易于发出，即内腑亦宜通透，不使疹热在血管内留有馀毒，内外上下，均有出路，血液得以干净，毒质排净，即是治疹成功。所以解肌之药、缓下之药、清瘟解毒之药，必须相辅而行也。惟疹出齐后，约在六、七日至八、九日热甫减退，患者往往骤觉轻快，任意饮食，或出户外游戏，一经劳动，热又复起，体温上升此时更为危险，急以葛根一味，加入连壳、桑叶、丹皮等酌量以前病情药中，速服一、二剂，葛根一味，三岁儿可服五分至一钱馀类推。退热有奇效。若有他项续发症，应以类加药，例如肾炎加木通等。但疹正初发时，注意初字万不可服西药之退热剂例如安基比林、撒曹药类及中药之发汗、例如麻黄、桂枝等升提、例如柴胡等滋补例如生地、元参、山药、百合等等药，如犯此禁，必致危险也。常见有普通人发热，往往白服阿斯比林等退热药片或泻药等，最为害事，疹病初起，尤为大患，不可不知。疹毒内陷，或疹隐太早，此际皮肤毛孔，早已闭锁，内毒无路可出，势必倒转入内，逼迫逆流，危险万状，最为棘手。患者神昏气喘，毒炎熏灼，津液将枯，有肠溃、胃腐、肺炎、肾炎之危，此时挽回生命，非清淡药品所能奏功。第一犀角为必需之品，次则黄芩、黄柏、黄连、山栀大苦大寒之药及石膏、生地，此二药在初病最忌用。一切大凉之药均可选用，或可挽救生命于万一，服凉药之后若得鼻衄，尚有希望，于此有一要诀，即无论如何，处方中始终必须佐以连翘、金银花等败毒之品且须重量方为周密。此症始终治法与温病相似，而实不同，看护上更不同，兹一列举如下：①温病不忌凉，此则格外避忌寒冷，切不可饮冷水，及恣啖水果等。②温病室内宜凉爽？此症室内则宜略温暖，且室内宜暗，空气宜湿润。③温病愈后，即可户外运动，不致再发，此症则自疹退后，在四星期内，必须室内静养。以肺炎、肾炎等危症，多发于不知不觉之二、四星期后也。若一大意小儿尤甚往往续发他症，十之八九，因而致命，而时常注意患者之大便，尤为要着，此症看护，最关重要，不可不知也。
疹子初起，不论有无咽疼及白喉嫌疑，均应每日用盐剥水方列后含漱，使口内清洁，以预防白喉之并发。即巳发白喉，亦极有效。但含漱药，不可下咽，小孩在六岁以下，不易使用此法，必须设法用盐剥水试其口内，先以盐剥水吸入于皮球内（洗涤用）令小孩面向下抱之，令其啼哭，即利用其哭时口开，再以筷子一根，裹以消毒白布，置撑小孩口内，而后以注有盐剥水之皮球嘴，对准小孩之口，激射之，刚小孩不能闭口，（有筷子撑住）可以洗涤口内，较之以布或笔蘸药水涂布拂试之法为良，可试用之。再盐剥水漱口治疗白喉大效．一日一夜可漱十馀次，连漱三、五日亦无妨，此法辅中药之（内服药）不及，最有奇效也。总以设法用之为宜。以疹兼白喉之症颇多，内服中药例如连翘、银花、牛蒡子等，（六神丸有大效）恐力缓，凡口内—切炎症，例如痄腮等，亦疹病中常有之症，皆奇效。故余治此症，恒外用漱口西药，而内用中药，百不失一也。
（医验）余治此症，何止干百，此种医案甚多，录不牲录，兹举最近较重之麻疹及猩红热各—‘例于下，以资参考。李涤厂年廿四岁，住北京崇文门外雷家胡同九号，于民国二十七年三月初八日患疹。初觉身体倦怠，一、二日后．恶寒战栗，身痛，遂不能起床，继则呕吐，咽痛甚剧，体温上升，脉实数，头痛、口渴，一日之间，并发白喉极剧，舌苔绛赤，发热约三日，密丛之疹，即发现自头部以下，遍及全身弥漫而为红斑，疹内含有浆液浓汁。中间曾延西医临诊，认为猩红热病，嘱其速住传染病院，并未与药。此症自初，延余诊治，即认为猩红热，并发白喉，处方如下：第一次方（第一日）硫苦一○·○重曹一·○顿服。此时倦怠，尚未发热（询其在外饮食油腻太重，故先与此方）又方盐剥一○·○蒸馏水四○○．○含漱。不拘次数，此方自初病，共用六利，约七、八日未断。
第二次方（第二日）绿豆皮六钱连翘八钱桑叶四钱竹叶四钱薄荷一钱菊花二钱金银花四钱花粉四钱丹皮四钱牛蒡子二钱鲜苇根三钱引煎服。此方在疹太发之前，尚有恶寒、头痛各症，眼药后（得病第三日）疹即发现遍身奇痒，如疿含脓，喉头义膜白色甚大，且蔓延极速，嘱令频频以盐剥水漱口。（延清西医临诊，即在此时期，然并未开方）第三次方绿豆皮八钱连翘八钱竹叶二钱桑叶四钱薄荷一钱金银花八钱；花粉四钱丹皮四钱牛蒡子二钱熟军二钱鲜苇根三钱引煎服。此第四日方疹已出齐，喉症稍减，唯已四日未大便，故于原方加熟军微利之，以防未然。第四次方照前方减去薄荷一钱、熟军二钱，馀同前方，服第三方得大便一次，一切症状都轻减，只以清瘟解毒为治，此方连服五剂，病已痊愈。嘱其慎防疹后续发各症，不可早出户外，约在室内静养四星期，完全恢复健康矣。此症初起，用硫苦、重曹轻泻，系因患者连日在外酬应，困于酒食，为此症诱因，故起首施以缓下，俾肠胃清楚，易于施治，奉为对此君特殊疗法。若在普通疹病患者，未见大便燥实，万不可先与泻剂，以免流弊。盖此症虽以泻下为宜，然亦不可冒然从事，若在小儿，更不可轻率也。又此症中间因喉症甚险，除用盐剥水含漱外，于服汤剂后，曾令兼服六神丸四次，一日二次，合并志之。
女孙惟静，未周岁，（七个月）乙亥夏，北京麻疹大流行，殇幼孩极多，率因合并症，肠炎、肾炎、及肺炎，致命余之两女孙，一男孙，均罹此症，而惟静年最幼，病且最重，均得治愈。兹录惟静一例于下：初病倦怠不乐，吐乳，发热，旋复平温，越二日又发热，此是疹前一定热型，所谓第二次热也。呕吐，喷嚏，咳嗽，流泪，所谓加答儿症状是也哭泣。与下方：第一方连翘二钱花粉五分丹皮五分葛根五发竹叶一钱薄荷三分绿豆皮二钱杏仁五分贝母五分鲜茅根一钱引，煎妥分服，一日三次。此第二次发热后之方服后疹渐出，仍服此方又二剂全出，四日热仍不退，且喘咳，胸高神昏、不乳、又加腹泻，日十馀次（稀水）至下午热更高，四肢厥逆，角弓反张，二目天吊，几至气绝，似无生望，曾经注射沃母纳丁一次，无效，不得已，（已移置地上）乃与第二方。
第二方云茯苓一钱生白芍一钱杏仁一钱连翘二钱浙贝一钱桑皮一钱水煎服。仍分三次与服，乃服药后，竟有奇效。咳喘减轻，且能稳睡，是好现象，乃就原方加山药五分，去桑皮，服后病又加，急又恢复原方与服，立效，（分量均加一半）神即清醒，咳喘亦大减，收效竟出意料之外，于是仍照原方，再服二剂，泻亦渐止，又眼两剂，原方未改动，竞庆更生。此症第二方，应与咳嗽（肺炎）门医验参看，此疹病并发肺炎、肠炎之重症也。
(Treatment Methods) The reason I briefly described the symptoms and differential diagnosis of measles and scarlet fever according to Western medicine is not to suggest that physicians should treat these two conditions entirely with Western methods. In fact, it is because: these two diseases, especially scarlet fever, spread most rapidly during epidemics and often complicate with diphtheria, posing a particular danger to children. Often, before treatment can be administered, patients are already in a critical state; at this time, the only specific effective method is prophylactic injection. One must absolutely not rely solely on Traditional Chinese Medicine (TCM), lest one contract the infection. For genuine Western physicians, diagnosing these two conditions clearly and implementing various preventive and therapeutic measures is indeed not difficult. However, in remote rural areas lacking skilled physicians, or among TCM practitioners who have only studied TCM texts but lack basic knowledge of Western medicine, when encountering such cases, although TCM treatments can be ingenious and flexible—perhaps even surpassing Western serum therapy once the disease has set in—patients should also not blindly trust Western medicine alone. Yet, in terms of preventive measures in villages, there is truly no equipment whatsoever, making the danger extremely high. Therefore, I hope TCM practitioners acquire this new knowledge and firmly believe that prophylactic injections can fundamentally reduce the prevalence of plagues. When such opportunities arise, both Eastern and Western medical personnel must work together to awaken the public to undergo prophylactic injections. If these diseases are unfortunately discovered, patient isolation must be strictly implemented, and everyone should do their utmost to save the sick. This does not mean forcing TCM doctors to perform injections, nor forcing Western doctors to use herbal decoctions; rather, the miraculous efficacy of Chinese herbs in treating these conditions deserves detailed explanation, which I hope brilliant Western physicians will study. As for vaccines and serums, these belong to specialized Western medical knowledge and were not originally intended to be discussed in this book. Now, to supplement the new knowledge of TCM practitioners, I briefly outline the general principles of serum and vaccine injections as follows:
1. Serum, or blood serum, refers to the watery component of blood, including immune serum, healthy animal serum, healthy human serum, and autologous serum. Commercially available serums are typically immune serums. They are produced by injecting various toxins into healthy large animals like horses or cows, stimulating the production of antitoxins within these animals (injecting a specific toxin yields a specific antitoxin serum, which is then harvested). Injecting this harvested serum into a patient's body induces an anti-toxic effect. For example, injecting a large amount of scarlet fever serum into a patient strengthens their resistance to the virus, known as therapeutic serum. By injecting such a large volume of serum into the patient's body, the free toxins circulating in the body are neutralized by the serum, thereby inhibiting their toxicity. If a small amount of serum is injected to enhance resistance and prevent disease occurrence, it is called prophylactic serum. Here, I am merely introducing the principle of serum to TCM practitioners, so the description is brief. Specific points regarding serum application (such as serum sickness and allergies) fall under the domain of specialized Western injection practices and need not be elaborated further.
2. Vaccine, also referred to as "jiang miao" or simply vaccine, translated as "Vaccine" or "Wangke Xing," etc. It is prepared by selecting and culturing various pathogens or toxins, and then killing them to create the product. In immunology, its therapeutic mechanism is opposite to that of serum: serum therapy involves passive immunity, whereas vaccine therapy involves active immunity. Specifically, serum therapy first immunizes an animal, harvests its serum, and then injects it into a patient, utilizing an already established immune system. In contrast, vaccine therapy takes cultured pathogens or toxins, kills them, and directly injects them into the patient's body to stimulate cells to produce their own immune bodies, preventing invasion by various infectious bacteria and forming anti-toxic bodies. Even in already infected individuals, it can inhibit viral proliferation and achieve therapeutic effects. This is the principle of vaccines. Vaccines are classified into mixed and single vaccines, differing from serums, which will not be detailed here.
3. Vaccine essence (Bacterial Extract), derived from bacteria, is neither the bacteria itself nor its culture medium. Thus, it contains less protein than other antigens and is non-toxic. (This substance is obtained by extracting live bacteria from the culture medium, mixing them with physiological saline, and pre-extracting the liquid.)
4. Pfeiffer's fluid (Phlegmakin), a liquid containing excretions of countless microorganisms. This fluid does not contain the bacterial body itself, differing from vaccines and serums. It is produced using artificial microbial culture methods involving sterile flowing substances containing microbial waste.
The above four types are all supplied for injection. However, apart from prophylactic injections, their status in treatment is not infallible. In critical conditions, serum therapy is sometimes less effective than TCM herbal medicine, a realization gained through my personal experience. Patients and physicians must be aware of this.
(Treatment Principles) The grand principle of famous doctors in treating rashes is encapsulated in the four characters: "Cooling and Ventilation" (Qingliang Xuantou). Explaining these four characters: cooling agents mostly consist of light, aromatic, and detoxifying herbs, such as Forsythiae Fructus (Lianqiao, 连翘), Lonicerae Japonicae Flos (Jinyinhua, 金银花), Vigna radiata testa (Lv dou pi, 绿豆皮), and Phragmitis Caulis (Zhuye, 竹叶). The meaning of "Ventilation" (Xuan) holds profound truth. The emergence of rashes relates to the Lung; this "Lung" cannot be interpreted merely as a respiratory organ but must refer to concepts like "the Lung governs the skin and hair." Initially, the meridians inside and outside, above and below, are completely brewed with epidemic toxins—a mixture of toxic, filthy, hot, and turbid gases contained within the Ying-Wei (Nutritive and Defensive), blood vessels, Sanjiao (Triple Burner), and meridians. Accumulating beyond capacity, driven by climatic triggers (abnormal Qi of the four seasons) and the body's internal elimination force, the toxins seek to expel themselves outward through the whole-body skin and mucous membranes (inside the mouth, eyes, nose, abdominal cavity, internal organs, intestines—all having mucous membranes, commonly known as tender skin [Note: "outside mucous membrane" is my coined term]). In my view, epidemic toxins inside the body resemble substances ready to ferment. With proper treatment, guiding the situation to facilitate ventilation and completion of fermentation ensures no danger. The pioneers who coined "Ventilation and Permeation" created the unique miracle method for treating rashes. The primary treatment rule at the onset is to keep the room warm, avoid drafts, and absolutely protect the patient from wind-cold invasion, avoiding cold drinks and food. Especially one or two days after fever begins, when the skin becomes red and swollen and rashes are about to appear, this avoidance is crucial. This differs from treating Warm Diseases (Wen Bing). Once red spots appear, exposure to wind and raw/cold food is strictly prohibited. Violating this causes rashes to retract immediately, leading to internal entrapment of heat-toxins and immediate danger. Consider steaming mantou (steamed buns): yeast and moisture are well-mixed, temperature is suitable, and rising is imminent. If suddenly exposed to cold air, the dough contracts, yeast loses function, and no matter how much steam is applied later, expansion becomes impossible. Physicians understanding this logic grasp the key to treating rashes and see the great importance of avoiding wind-cold. Though my analogy may seem crude, it illustrates the point. Initial medications, presenting similar exterior symptoms like headache, aversion to cold, fever, and body ache, should include one or two cooling muscle-relaxing herbs among the light, aromatic, detoxifying ones. Sweating (Fa Han, 发汗) must be avoided; excessive sweating lowers body temperature and constricts blood vessels, making rashes difficult to erupt and causing adverse conditions, as insufficient body temperature prevents thorough eruption. The goal is to slightly loosen skin pores, creating a moist sensation without actual sweating, while avoiding wind. Herbs like Menthae Haplocalycis Herba (Bohe, 薄荷), Puerariae Radix (Gegen, 葛根), and Schizonepetae Spica (Jiesui, 芥穗) are suitable but used in small doses (3 fen to 1 qian, depending on age), aiming solely for ventilation. "Ventilation" implies more than just relaxing muscles; it means ventilating internally/externally and upwards/downwards, requiring flexible thinking. Besides muscle-relaxing herbs, attention must be paid to bowel movements. If constipation persists for one or two days, or stools are uncomfortable, foul-smelling, or dry, it indicates blocked ventilation up and down. Mild laxatives should be added to Qingwen Jiedu (Clear Epidemic and Detoxify) formulas, such as cooked Rhubarb (Shu Dahuang, 熟大黄), or Calomel tablets (Gan Hong Ding, 甘汞锭 - adult dose 0.2g per tablet) given 8-9 hours after herbal medicine, or Trichosanthis Semen (Gualou Ren, 瓜蒌仁) added to herbs. If intestinal inflammation signs are obvious, follow Intestinal Heat treatment methods carefully. However, during initial rash eruption, massive laxatives must not be given arbitrarily to avoid driving toxins inward. The meaning of "Ventilation and Permeation" extends beyond external eruption facilitating toxin release; internal organs must also be permeable, ensuring no residual heat-toxin remains in blood vessels. With outlets for inside/outside and up/down, blood cleanses, and toxins are expelled, marking successful treatment. Thus, muscle-relaxing, mild laxative, and clearing/detoxifying herbs must work synergistically. After rashes fully emerge, around day 6-7 to 8-9 when fever subsides, patients often feel suddenly better, eating freely or playing outdoors. Physical exertion can cause fever recurrence and temperature rise, which is dangerous. Urgently administer Puerariae Radix (Gegen, 葛根) combined with Forsythiae Fructus (Lianqiao, 连翘), Morus Folium (Sangye, 桑叶), and Moutan Cortex (Danpi, 丹皮) based on previous condition, taken quickly for 1-2 doses. For a three-year-old, 5 fen to over 1 qian of Gegen is appropriate. It has miraculous fever-reducing effects. For secondary complications, add corresponding herbs (e.g., Akebiae Caulis (Mutong, 木通) for nephritis). However, at the very beginning of rash eruption, absolutely avoid Western antipyretics (e.g., Aminopyrine, Saccharin-type drugs) and TCM herbs that induce sweating (e.g., Ephedrae Herba (Mahuang, 麻黄), Cinnamomi Ramulus (Guizhi, 桂枝)), ascend (e.g., Bupleuri Radix (Chaihu, 柴胡)), or tonify (e.g., Rehmanniae Radix Preparata (Shengdi, 生地), Scrophulariae Radix (Yuanshen, 元参), Dioscoreae Rhizoma (Shanyao, 山药), Lilii Bulbus (Baihe, 百合)). Violating these prohibitions leads to danger. Common people taking aspirin or laxatives for fever causes harm; this is especially critical in early rash stages. If toxins sink inward or rashes retract too early, skin pores close, internal toxins have no exit, forcing reverse flow inward, creating extreme danger and difficulty. Patients suffer coma, panting, burning inflammation, drying fluids, risking intestinal ulceration, gastric corruption, pneumonia, and nephritis. Saving life at this stage requires more than mild medicines. Rhinoceros Horn (Xijiao, 犀角) is essential, followed by Scutellariae Radix (Huangqin, 黄芩), Phellodendri Cortex (Huangbai, 黄柏), Coptidis Rhizoma (Huanglian, 黄连), Gardeniae Fructus (Shanzhi, 山栀), Gypsum Fibrosum (Shigao, 石膏), and Rehmanniae Radix (Shengdi, 生地)—though the latter two are taboo initially. All strong cooling herbs can be selected to potentially save lives. Nasal bleeding after taking cooling herbs indicates hope. A key principle is that prescriptions must always include heavy doses of detoxifying herbs like Forsythiae Fructus (Lianqiao, 连翘) and Lonicerae Japonicae Flos (Jinyinhua, 金银花). Treatment resembles Warm Diseases but differs significantly, especially in nursing care:
1. Warm Diseases do not forbid cooling; this condition strictly forbids cold. Do not drink cold water or eat fruits excessively.
2. Warm Disease rooms should be cool; this condition's room should be slightly warm, dim, and humid.
3. After recovering from Warm Diseases, outdoor exercise is fine; after rash subsides, bed rest indoors for four weeks is mandatory to prevent late-onset pneumonia or nephritis. Negligence, especially in children, often leads to fatal complications. Monitoring bowel movements is crucial. Nursing is vital and must not be ignored.
At the onset of rashes, regardless of sore throat or suspected diphtheria, gargle daily with Salt Borax Water (Yan Peng Shui, 盐硼水) listed below to keep the mouth clean and prevent diphtheria complications. It is also highly effective if diphtheria has already developed. Do not swallow the gargle solution. Children under six find this difficult; use a rubber bulb (for washing) filled with Salt Borax Water. Hold the child face down, make them cry to open the mouth, insert a chopstick wrapped in sterile white cloth to prop the mouth open, then spray the solution into the mouth. Since the mouth is held open, cleaning is effective, superior to wiping with cloth or brush. Try this method. Gargling with Salt Borax Water is highly effective for diphtheria; gargling 10+ times a day for 3-5 days is safe. This external method complements internal TCM (e.g., Forsythiae Fructus (Lianqiao, 连翘), Lonicerae Japonicae Flos (Jinyinhua, 金银花), Arctii Fructus (Niubangzi, 牛蒡子); Liushen Wan (Six Divine Pills) is effective) which may act slowly. It is also effective for oral inflammations like mumps, common in rash diseases. Thus, I often combine external Western gargles with internal TCM, achieving near-perfect results.
(Clinical Cases) I have treated thousands of such cases; records are too numerous to list. Here are recent severe cases of measles and scarlet fever for reference.
Li Dichang, male, 24 years old, residing at No. 9 Leijia Hutong, Chongwenmen Outer Street, Beijing. On March 8, Republic of China Year 27, he contracted a rash. Initially felt fatigue; one to two days later, experienced chills, tremors, body pain, unable to get out of bed. Subsequently vomited, severe sore throat, elevated temperature, solid and rapid pulse, headache, thirst. Within one day, severe diphtheria complicated the condition. Tongue coating was crimson-red. Fever lasted about three days. Dense rashes appeared from head to toe, spreading diffusely as erythema, containing serous pus. A Western doctor consulted, diagnosed Scarlet Fever, advised hospitalization, provided no medication. From the start, I diagnosed Scarlet Fever complicated with Diphtheria. Prescriptions:
First Prescription (Day 1): Sodium Sulfate (Liuku, 硫苦) 10.0g, Sodium Bicarbonate (Zhongcao, 重曹) 1.0g, taken at once. At this time, fatigue existed but no fever yet (Inquired: heavy oily diet outside caused this trigger, hence this prescription). Another prescription: Salt Borax (Yanpeng, 盐硼) 10.0g, Distilled Water 400.0ml, for gargling. Frequency unrestricted. This formula was used continuously for about 6-8 days.
Second Prescription (Day 2): Vigna radiata testa (Lv dou pi, 绿豆皮) 6 qian, Forsythiae Fructus (Lianqiao, 连翘) 8 qian, Morus Folium (Sangye, 桑叶) 4 qian, Phragmitis Caulis (Zhuye, 竹叶) 4 qian, Menthae Haplocalycis Herba (Bohe, 薄荷) 1 qian, Chrysanthemi Flos (Juhua, 菊花) 2 qian, Lonicerae Japonicae Flos (Jinyinhua, 金银花) 4 qian, Angelicae Dahuricae Radix (Baifen, 花粉) 4 qian, Moutan Cortex (Danpi, 丹皮) 4 qian, Arctii Fructus (Niubangzi, 牛蒡子) 2 qian, Fresh Reed Rhizome (Xian Weigen, 鲜苇根) 3 qian. Decoct and take. Before full eruption, chills and headache persisted. After taking medicine (Day 3 of illness), rashes erupted all over body with intense itching, resembling pustules. White membrane in throat was large and spread rapidly. Advised frequent gargling with Salt Borax Water. (A Qing Western doctor consulted here but prescribed nothing).
Third Prescription (Day 4): Vigna radiata testa (Lv dou pi, 绿豆皮) 8 qian, Forsythiae Fructus (Lianqiao, 连翘) 8 qian, Phragmitis Caulis (Zhuye, 竹叶) 2 qian, Morus Folium (Sangye, 桑叶) 4 qian, Menthae Haplocalycis Herba (Bohe, 薄荷) 1 qian, Lonicerae Japonicae Flos (Jinyinhua, 金银花) 8 qian, Angelicae Dahuricae Radix (Baifen, 花粉) 4 qian, Moutan Cortex (Danpi, 丹pi) 4 qian, Arctii Fructus (Niubangzi, 牛蒡子) 2 qian, Cooked Rhubarb (Shu Jun, 熟军) 2 qian, Fresh Reed Rhizome (Xian Weigen, 鲜苇根) 3 qian. Decoct and take. Rashes fully emerged, throat symptoms slightly reduced, but no bowel movement for four days. Added cooked Rhubarb to promote mild evacuation to prevent issues.
Fourth Prescription: Same as previous, minus Menthae Haplocalycis Herba (Bohe, 薄荷) 1 qian and Cooked Rhubarb (Shu Jun, 熟军) 2 qian. After third prescription, had one bowel movement, all symptoms lightened. Focus shifted to clearing epidemic and detoxifying. Took this formula for five doses, recovered completely. Advised caution against post-rash complications, avoid going outdoors early, rest indoors for four weeks. Fully recovered health. Initial use of Sodium Sulfate and Sodium Bicarbonate for mild purgation was due to patient's social engagements and rich diet triggering the illness. Gentle purgation clears intestines/stomach for easier treatment, considered special therapy for this individual. For ordinary rash patients without dry stool, laxatives must not be given first to avoid adverse effects. Although purgation is suitable here, it must not be done rashly, especially in children. Due to dangerous throat symptoms, besides gargling, Six Divine Pills (Liushen Wan, 六神丸) were administered orally twice daily for four times total.
Granddaughter Wei Jing, under one year old (7 months). Summer of Yihai year, major measles epidemic in Beijing, many infants died from complications like enteritis, nephritis, and pneumonia. My two granddaughters and one grandson contracted it. Wei Jing was youngest and sickest but recovered. Record of Wei Jing: Initial fatigue, unhappiness, vomiting milk, fever, then temperature normalized. Two days later, fever returned (pre-rash fever pattern, second fever). Vomiting, sneezing, coughing, tearing (catarrhal symptoms). Prescription:
First Prescription: Forsythiae Fructus (Lianqiao, 连翘) 2 qian, Angelicae Dahuricae Radix (Baifen, 花粉) 5 fen, Moutan Cortex (Danpi, 丹皮) 5 fen, Puerariae Radix (Gegen, 葛根) 5 fen, Phragmitis Caulis (Zhuye, 竹叶) 1 qian, Menthae Haplocalycis Herba (Bohe, 薄荷) 3 fen, Vigna radiata testa (Lv dou pi, 绿豆皮) 2 qian, Armeniacae Semen Amarum (Xingren, 杏仁) 5 fen, Fritillariae Thunbergii Bulbus (Beimu, 贝母) 5 fen, Fresh Imperata Rhizome (Xian Maogen, 鲜茅根) 1 qian. Decoct, divide, take three times daily. After second fever, rashes gradually emerged. Continued this formula for two more doses until fully erupted. Day 4 fever persisted, plus panting, cough, chest distension, coma, refusal to nurse, diarrhea (>10 times/day, watery). Afternoon fever higher, limbs cold, opisthotonos, eyes rolling back, near death. Injection of Vomina Ding (likely Vitamin B complex or similar supportive agent) ineffective. Desperate, placed on ground, gave Second Prescription.
Second Prescription: Poria (Fuling, 茯苓) 1 qian, Raw White Peony Root (Sheng Baishao, 生白芍) 1 qian, Armeniacae Semen Amarum (Xingren, 杏仁) 1 qian, Forsythiae Fructus (Lianqiao, 连qiao) 2 qian, Zhejiang Fritillaria Bulb (Zhe Bei, 浙贝) 1 qian, Mulberry Bark (Sangpi, 桑皮) 1 qian. Decoct in water, divide into three doses. Miraculous effect after taking. Cough/panting reduced, stable sleep possible (good sign). Added Dioscoreae Rhizoma (Shanyao, 山药) 5 fen, removed Mulberry Bark (Sangpi, 桑皮). Condition worsened again; urgently reverted to original formula with increased dosage (half increase). Consciousness cleared, cough/panting greatly reduced, unexpected efficacy. Continued original formula for two more doses, diarrhea stopped. Took two more doses unchanged, celebrated recovery. This Second Prescription should be cross-referenced with Cough (Pneumonia) clinical cases, representing severe rash complicated by pneumonia and enteritis.