疹初咳嗽风邪郁，加味升麻葛根良，毒热熏蒸金受制，清金宁嗽自堪尝。
【注】麻疹发自脾、肺，故多咳嗽。若咳嗽太甚者，当分初、没治之。初起咳嗽，此
为风邪所郁，以升麻葛根汤加前胡、桔梗、苏叶、杏仁治之；已出咳嗽，乃肺为火灼，以
清金宁嗽汤主之。
升麻葛根汤（方见痘门发热证治）
清金宁嗽汤
橘红 前胡 生甘草 杏仁（去皮、尖，炒） 桑皮（蜜炙） 川连 栝蒌仁
桔梗 浙贝母（去心）
引用生姜、红枣，水煎服。
【方歌】嗽用清金宁嗽汤，橘红前草杏仁桑，川连栝蒌桔贝母，引用红枣共生姜。
疹毒热甚上攻喉，肿痛难堪实可忧，表邪元参升麻用，里热凉膈消毒求。
【注】疹毒热盛，上攻咽喉，轻则肿痛，甚则汤水难下，最为可虑，表邪郁遏，疹毒
不能发舒于外，致咽喉作痛者，元参升麻汤主之；里热壅盛，或疹已发于外，而咽喉作
痛，以凉膈消毒饮主之。
元参升麻汤
荆芥 防风 升麻 牛蒡子（炒、研） 元参 生甘草
水煎服。
【方歌】表郁疹毒喉肿痛，急服元参升麻汤，荆芥防风升麻蒡，元参甘草水煎尝。
凉膈消毒饮
荆芥穗 防风 连翘（去心） 薄荷叶 黄芩 生栀子 生甘草 牛蒡子（炒、研） 芒硝 大黄（生）
引用灯心，水煎服。
【方歌】里热喉痛苦难当，凉膈消毒饮最良，荆防翘薄芩栀草，牛蒡芒硝生大黄。
Cough at the initial stage of rash is caused by the constraint of wind-pathogen; the modified Shengma Gegen Tang (Cinnamon Twig and Pueraria Decoction) is effective. If toxic heat steams upward and constrains the Metal (Lung), Qingjin Ningsou Tang (Clear Metal and Calm Cough Decoction) should be used to clear the Lung and stop coughing, which proves to be efficacious.
[Note] Measles originates from the Spleen and Lung, so cough is a common symptom. If the cough is excessively severe, treatment should be differentiated according to whether it occurs during the initial eruption or the resolution phase. Cough appearing at the onset is due to wind-pathogen constraint; it can be treated with Shengma Gegen Tang (Cinnamon Twig and Pueraria Decoction) added with Qianhu (Peucedani Radix), Jiegeng (Platycodonis Radix), Ziye (Perillae Folium), and Xingren (Armeniacae Semen Amarum). Cough occurring after the rash has erupted is due to the Lung being scorched by fire; Qingjin Ningsou Tang (Clear Metal and Calm Cough Decoction) should be administered as the principal formula.
Shengma Gegen Tang (See the section on Fever in the Smallpox Chapter for the formula)
Qingjin Ningsou Tang (Clear Metal and Calm Cough Decoction)
Juhong (Citri Reticulatae Pericarpium Rubrum), Qianhu (Peucedani Radix), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), Xingren (Armeniacae Semen Amarum, peeled, tips removed, stir-fried), Sangbai pi (Morus alba Cortex, honey-fried), Chuanlian (Coptidis Rhizoma), Gualou ren (Trichosanthis Semen), Jiegeng (Platocodonis Radix), Zhebeimu (Fritillariae Thunbergii Bulbus, heart removed).
Decoct with fresh ginger and red dates in water.
[Formula Song] For cough, use Qingjin Ningsou Tang, containing Juhong, Qianhu, Gancao, Xingren, and Sangbai pi; Chuanlian, Gualou, Jiegeng, and Beimu are included; decoct together with red dates and fresh ginger.
When measles toxin-heat is excessive and attacks the throat upwards, causing severe swelling and pain that is unbearable, it is indeed a cause for concern. If the pathogen is in the exterior, Yuanshen Shengma Tang (Scrophulariae Radix and Cimicifugae Rhizoma Decoction) should be used; if there is excess heat in the interior, Liangge Xiaodu Yin (Cool the Diaphragm and Detoxify Decoction) should be sought.
[Note] When measles toxin-heat is vigorous and attacks the throat upwards, mild cases present with swelling and pain, while severe cases may result in difficulty swallowing even liquids, which is most worrying. If the throat pain is caused by exterior pathogen constraint preventing the measles toxin from venting outward, Yuanshen Shengma Tang (Scrophulariae Radix and Cimicifugae Rhizoma Decoction) is the principal formula. If the throat pain persists due to excess interior heat, or even after the rash has erupted externally, Liangge Xiaodu Yin (Cool the Diaphragm and Detoxify Decoction) is the principal formula.
Yuanshen Shengma Tang (Scrophulariae Radix and Cimicifugae Rhizoma Decoction)
Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Shengma (Cimicifugae Rhizoma), Niubangzi (Arctii Fructus, stir-fried and crushed), Yuanshen (Scrophulariae Radix), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma).
Decoct in water.
[Formula Song] For exterior constraint with measles toxin attacking the throat causing swelling and pain, urgently take Yuanshen Shengma Tang; Jingjie, Fangfeng, Shengma, and Niubangzi are key, along with Yuanshen and Gancao, decocted in water.
Liangge Xiaodu Yin (Cool the Diaphragm and Detoxify Decoction)
Jingjiesui (Schizonepetae Spica), Fangfeng (Saposhnikoviae Radix), Lianqiao (Forsythiae Fructus, heart removed), Boheye (Menthae Haplocalycis Folium), Huangqin (Scutellariae Radix), Sheng Zhizi (Gardeniae Fructus), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), Niubangzi (Arctii Fructus, stir-fried and crushed), Mangxiao (Natrii Sulfas), Dahuang (Rhei Radix et Rhizoma, raw).
Decoct with Dengxincao (Junci Medulla) in water.
[Formula Song] Interior heat causes unbearable throat pain; Liangge Xiaodu Yin (Cool the Diaphragm and Detoxify Decoction) is most effective. It contains Jingjie, Fangfeng, Lianqiao, Bohe, Huangqin, Zhizi, and Gancao, along with Niubangzi, Mangxiao, and raw Dahuang.