麻疹方，惟是升发清凉解利，兹竞有若此不治者，因不知麻疹中有痧也。盖麻疹乘虚而发，若秽气暑气，时行不正
之气，亦可乘病而感。苟犯痧者，但先治痧胀，麻疹自发自散。盖麻疹兼痧胀，痧胀为难，麻疹反隐而难现，不可不辨
也。
治验∶
一金权可，二月间，犯时行麻疹，心胸烦闷。延余治之，脉症不合。放痧后用宝花散并活血顺气消食之剂，俱调黑
糖，侯稍冷冻饮料之，复刮痧讫，如前二剂，乃安。
一潘质黄子犯麻疹，脉微，放腿弯痧二针，血流紫色，又放指上痧三十余针，付圆红散并清凉至宝饮合红花汤，俱
微冷冻饮料之即愈。
一余弟骧武子八岁，正月间犯麻疹，胸腹胀闷，烦躁热渴，咳嗽气急，面赤身热，脉不洪大反见细数，放腿弯痧二
针，付圆红散、沉香丸，用荆芥薄荷汤合枳实大黄汤，俱微冷冻饮料之，麻疹即发透随散而愈。其时一仆妇亦咳嗽烦闷，同
犯麻疹，如上治而痊。
一王日斯女，壮热咳嗽，麻疹初现，气急面赤，脉症不合。放指上痧二十余针，付圆红散加沉香末，调黑糖汤，稍
冷冻饮料之，用清气化痰饮合蒲黄饮，均微冷冻饮料之，即发透随散而愈。
伤风咳嗽烦闷，为麻疹之候，然亦有麻疹未发，或触秽气，或感暑气，或吸时行不正之气，当即痧胀，或心痛腹痛，
或胀闷喘急，或遍身疼痛，或发晕昏沉。一似麻疹不发，内攻心腹，痛及周身，使止认为麻疹之候，升发之，势必危殆。
不知伤风咳嗽烦闷，虽有麻疹，发于日后，其痧胀内攻，即麻疹有现形者，因之反隐，更助痧胀为祸，况麻疹未形，痧
胀沉重可不先救痧胀乎。
治验∶
一陆迪恩内人，发热咳嗽，胸腹疼痛，叫喊非常，脉症不合，令其仆妇放腿弯痧未愈。先以宝花散、阿魏丸清茶稍
冷冻饮料之，付必胜汤减大黄加枳实，连翘、卜子二剂，微冷冻饮料之，疼痛稍已。次日如前剂减五灵脂加荆芥、黄芩微温饮之，
疼痛乃止。麻疹即发，再剂而痊。
一沈端肱女，咳嗽发热，胀闷不已，六脉弦紧，或时歇指，放指头痧二十余针，未愈。用宝花散加沉香末，稍冷冻饮料
之，付防风胜金汤加红花、荆芥治之，麻疹随发，用荆芥汤减川芎加黄芩、玄参、金银花微温饮二剂而瘳。
一陈弘甫，伤风发热，咳嗽烦闷，脉左沉右洪。放乳上痧二针，用紫朴汤冷冻饮料，麻疹渐现。次日为秽气所触，复隐
隐不发，刮两臂肩背痧，用荆芥汤减川芎加黄芩、银花、红花、沙参、乌药微冷冻饮料之，麻疹即发，再剂而愈。
一高子良弟，四岁，正月间，伤风咳嗽烦闷，有以麻疹治之，不发，反吐血，发晕昏沉。延余，脉症不合，放舌下
痧二针，付紫朴汤加黄芩，微冷冻饮料之，麻疹始现。次日稍饮温茶半钟，麻疹复隐。余曰∶“痧胀余毒，复发内攻，故麻疹
随之而隐。”又刮痧毕，服必胜汤减大黄、五灵脂，贝母加黄芩饮之，麻疹即透，后惟清凉解毒而痊。
The treatment of measles (Ma Zhen) focuses on ascending and diffusing, clearing heat, and resolving toxicity. Yet today there are cases that are deemed incurable because the practitioner fails to recognize the presence of Sha Zhang (Sand Swelling/Poison) within the measles. Generally, measles erupts when pathogenic factors take advantage of deficiency. If foul air, summerheat, or epidemic abnormal qi invades while the disease is present, it can complicate the condition. If Sha Zhang is involved, one must first treat Sha Zhang, after which the measles will naturally erupt and dissipate. When measles is complicated by Sha Zhang, Sha Zhang is the more difficult aspect; the measles may become hidden and difficult to manifest, a distinction that must not be overlooked.
Clinical Records:
Jin Quanke contracted epidemic measles in February, suffering from vexation and oppression in the chest and heart. Upon my consultation, the pulse and symptoms were inconsistent. After performing bloodletting for Sha Zhang, Baohua San (Precious Flower Powder) along with formulas to invigorate blood, regulate qi, and digest food were administered, all mixed with brown sugar and taken cool. Subsequently, scraping therapy was performed. Using the previous two types of prescriptions, the patient stabilized.
Mr. Pan Zhihuang’s son suffered from measles with a faint pulse. Two needles were used for bloodletting at the popliteal fossa, yielding purple blood. More than thirty needle pricks were performed on the fingers. Yuanshong San (Round Red Powder) combined with Qingliang Zhibao Yin (Cooling Supreme Treasure Drink) and Honghua Tang (Safflower Decoction) were prescribed, all taken slightly cooled, resulting in a quick recovery.
My brother Xiangwu’s eight-year-old son contracted measles in January, presenting with chest and abdominal distension and oppression, restlessness, fever, thirst, cough, rapid breathing, red face, and body heat. The pulse was not surging but rather fine and rapid. Two needles were used for bloodletting at the popliteal fossa. Yuanshong San and Chenxiang Wan (Agarwood Pill) were given, along with Jingjie Bohe Tang (Schizonepeta and Mint Decoction) combined with Zhishi Dahuang Tang (Immature Bitter Orange and Rhubarb Decoction), all taken slightly cooled. The measles erupted fully and subsequently dissipated, leading to recovery. At that time, a female servant also suffered from cough and vexation due to measles; she was cured using the same method.
Ms. Wang Risi presented with high fever and cough, early signs of measles, rapid breathing, red face, and inconsistent pulse and symptoms. More than twenty needle pricks were performed on the fingers. Yuanshong San with added Chenxiang Mo (Agarwood Powder), mixed with brown sugar water and taken slightly cooled, was administered. Then, Qingqi Huatan Yin (Clear Qi and Resolve Phlegm Drink) combined with Puhuang Yin (Tiger Lily Pollen Drink) were given, both taken slightly cooled. The measles erupted fully and dissipated, leading to recovery.
Wind-cold injury causing cough and vexation is a prodromal sign of measles. However, before measles erupts, exposure to foul air, summerheat, or epidemic abnormal qi can immediately induce Sha Zhang, manifesting as heart pain, abdominal pain, distension, oppression, panting, general body pain, dizziness, or lethargy. This resembles measles failing to erupt, with internal attack on the heart and abdomen, and pain throughout the body. If mistaken merely for a measles prodrome and treated solely with ascending/diffusing methods, the situation will likely become critical. One must understand that even if wind-cold cough and vexation precede measles, the internal attack of Sha Zhang can cause existing measles rashes to recede, further exacerbating Sha Zhang pathology. Especially when measles has not yet formed and Sha Zhang is severe, should one not prioritize treating Sha Zhang?
Clinical Records:
Mrs. Lu Di’en suffered from fever, cough, chest and abdominal pain, and extreme screaming. Pulse and symptoms were inconsistent. Her maid attempted bloodletting at the popliteal fossa without success. First, Baohua San and Awai Wan (Asafoetida Pill) were given with clear tea, taken slightly cooled. Then, Bisheng Tang (Invincible Decoction) with Dahuang removed and Zhishi, Lianqiao, and Boluizi added were prescribed, taken slightly cooled over two doses, alleviating the pain. The next day, Wulingzhi was removed from the formula, and Jingjie and Huangqin were added, taken warm. The pain ceased. Measles then erupted, and after two more doses, she recovered.
Ms. Shen Duanheng suffered from cough, fever, and incessant distension and oppression. The six pulses were wiry and tight, sometimes intermittent. More than twenty needle pricks were performed on the fingertips without improvement. Baohua San with added Chenxiang Mo was given, taken slightly cooled. Fangfeng Shengjin Tang (Sapling Root Victory Gold Decoction) with Honghua and Jingjie was administered. Measles erupted subsequently. Jingjie Tang with Chuanxiong removed and Huangqin, Xuanshen, and Jinyinhua added was taken warm for two doses, leading to improvement.
Chen Hongfu suffered from wind-cold induced fever, cough, and vexation. The left pulse was deep, and the right pulse was surging. Two needles were used for bloodletting above the breast. Zipu Tang (Magnolia Bark Decoction) was taken cooled, and measles gradually appeared. The next day, exposure to foul air caused the measles to recede and fail to erupt. Scraping therapy was performed on both arms, shoulders, and back. Jingjie Tang with Chuanxiong removed and Huangqin, Yinhua, Honghua, Shashen, and Wuyao added was taken slightly cooled. Measles erupted, and after two doses, he recovered.
Gao Ziliang’s younger brother, four years old, suffered from wind-cold cough and vexation in January. He was treated for measles previously, which failed to erupt and instead resulted in hemoptysis, dizziness, and lethargy. Upon my consultation, pulse and symptoms were inconsistent. Two needles were used for bloodletting under the tongue. Zipu Tang with Huangqin added was given, taken slightly cooled, allowing measles to begin appearing. The next day, drinking half a cup of warm tea caused the measles to recede again. I stated, “This is the recurrence of residual Sha Zhang toxins attacking internally, causing the measles to recede.” After scraping therapy, Bisheng Tang with Dahuang and Wulingzhi removed, and Beimu added with Huangqin was administered. The measles erupted fully, and subsequent treatment with cooling and detoxifying methods led to recovery.