Library

(Bear Yingxiong notes: Ma, Sha, and Zhen are different local terms for the same condition. Why separate Zhen into two chapters is inappropriate; now they are combined into one category.)

Sun Wenyuan treated Sun Shou, the son of his servant, who suffered from measles (also known as Douzi). The symptoms included cough without phlegm, swelling of the upper lip, body edema with fever, dry stool, hoarseness, indicating damage by dryness-fire. He prescribed Maidong (Ophiopogonis Radix), Zhimu (Anemarrhenae Rhizoma), Gualou (Trichosanthis Fructus), Gancao (Glycyrrhizae Radix et Rhizoma), Baishao (Paeoniae Radix Alba), Sangpiao (Morus Cortex) [For this condition, Baishao and Sangpiao should be removed and Niubangzi (Arctii Fructus) and Jiegeng (Platycodonis Radix) added], Digupi (Lycii Cortex), Shihu (Dendrobii Caulis), and Zhike (Aurantii Fructus). After taking the medicine, the cough decreased by seventy percent. Then Gualou and Zhike were removed because the stool had become loose. Shengdi (Rehmanniae Radix), Danggui (Angelicae Sinensis Radix), and Yiren (Coicis Semen) were added for conditioning, leading to recovery. (Whether adding Shengdi is appropriate for this case should be considered carefully.)

The son of Mr. Cheng was seven years old when he contracted measles (called Douzi in Xiwu and Shazi in Gusu). More than a month later, he still had fever, cough with hoarseness, emaciation with visible bones, and total hair loss. Doctors were at a loss. Sun Wenyuan examined him and said, "If you say this child cannot be cured, this is deficiency-heat turning into Gan syndrome after measles. Give him Da Lushui Wan, and he can be completely cured." The family initially ignored my advice, thinking I was not a pediatric specialist, unaware that this is merely a supplementary skill for general practitioners. (One may adapt Han Yu's poem to say 'pediatrics is a side task.' However, those proficient in internal medicine but ignorant of pediatrics are certainly not good doctors.) I prepared the medicine for him, and he recovered before finishing the dose.

Lu Dongzhuang treated the son of the Qian family, aged five, who suffered from measles complicated by diarrhea. Pediatricians claimed that diarrhea was suitable for measles and did not hesitate, prioritizing clearing fire and administering cold-cooling medicines excessively, which aggravated the condition. Lu observed redness on the child's malar eminences (floating deficient yang), teeth grinding and rapid breathing (excess above), severe thirst with continuous drinking (deficiency of yin fluids), and a pulse that was large and slow like that of a healthy adult. He said, "The spleen is in acute danger. Quickly administer Renshen (Ginseng Radix et Rhizoma), Danggui, Huangqi (Astragali Radix), Chenpi (Citri Reticulatae Pericarpium), Gancao, Fuling (Poria), and Muxiang (Aucklandiae Radix) to save him. After one dose, he felt better." Someone objected, saying, "Wrong. Pediatrics has its own specialists; how can a scholar treat this? I have heard that measles treatment focuses on dispersing, cooling, and detoxifying. Now half the body has rashes, tidal fever persists, yet you use warming tonification. It will surely fail." (Those without true knowledge interfering can mislead people; experts should be cautious.) The family feared and stopped the medication. Three days later, the father returned, saying all symptoms recurred. Lu asked if it was a joke. The father explained he hadn't taken the medicine. Lu said, "Go home quickly; the child's Tianzhu bone (neck/spine) has collapsed." Upon arriving, the father confirmed this. Lu advised taking the previous formula again, stating, "The previous formula treated deficiency; now cold has intensified. Only Guizhi (Cinnamomi Ramulus) and Fuzi (Aconiti Lateralis Radix Praeparata) can reverse this." The father questioned why heat symptoms were called deficiency-cold. Lu explained, "Yin is exhausted internally, Yang scatters externally, and cold medicines forced it further. Yang has no place to return, resulting in true cold inside and false heat outside. This elucidates the subtle meaning of the Neijing by Xue Lizhai; only those who deeply understand can believe it." The family took the medicine against others' advice. After one dose, the neck straightened; after two doses, wheezing and thirst stopped; after three doses, he walked and played outdoors. (This specific prescription resulted from excessive bitter-cold usage and is not applicable to all children.)

Feng Chuzhan treated the son of the Shen family, who had fever for several days followed by measles. Within a day, the facial rash disappeared, spirit was extremely fatigued, roundworms vomited repeatedly, no food intake for days, diarrhea with upper wheezing, cracked and scorched lips/chin, intense heat in the five centers (palms, soles, chest), cold fingertips, and a fine, rapid pulse, weaker at both Chi positions. Everyone believed the toxin entered the organs due to stomach heat causing worm vomiting. Feng knew the spirit was about to collapse, all five zang organs were distressed, spleen deficiency prevented grain assimilation, worms lacked food, and deficiency-fire steamed causing organ dryness, forcing worms out. Regarding macules/rashes, most stem from internal injury and imbalance, where spleen/stomach fail to nourish, causing Yang to reverse and Yin to cover the exterior. Abundant blood and strong Qi result in red, erupting rashes; deficient blood and weak Qi result in pale, hidden rashes. What difference in toxicity exists? Facial retraction indicates Yang deficiency failing to rise. Wheezing indicates difficult Qi continuation. Scorched lips indicate exhaustion of Spleen fluids. Intense heat in five centers indicates Yin deficiency and fire blazing. Diarrhea and anorexia indicate decline of True Fire and Spleen failure to transport. Fine/rapid Cun/Guan pulses with weak Chi indicate Qi/Blood deficiency and floating deficiency-fire. Acute cases treat the branch; chronic cases treat the root. The current urgency is impending collapse of Root Qi. If treated as residual measles toxin with clearing/descending methods, spirit might exhaust first. He used Shudi (Rehmanniae Radix Preparata) 6 qian, Mudanpi (Moutan Cortex) 1 qian, Maidong 3 qian, Niuxi (Achyranthis Bidentatae Radix) 2 qian, and Zhi Fuzi (Prepared Aconite) 0.6 fen. After one dose, false heat vanished, revealing true deficiency, and spirit became more tired. This indicated slight Yin recovery; thus, tonify Qi to aid generation. Add Ren Shen 2 qian decocted separately and mixed in. Spirit gradually recovered, wheezing ceased. Mild vomiting after drinking porridge indicated long-term Stomach Qi deficiency. Use the previous formula plus Chao Huang Baizhu (Stir-fried Atractylodis Macrocephalae Rhizoma) 2 qian, remove Danshen, mix with Ren Shen decoction. Four doses led to full recovery.

My note: This case is similar to Lu's but represents one in a hundred; do not rigidly apply it as a standard. Generally, measles originates in Lung and Stomach; treatment should only facilitate gentle eruption. All cold-dry or cold-hot agents should be avoided. I once encountered prolonged cases due to excessive diaphoresis; using Shengdi, Gouqi (Lycii Fructus), Digupi, Maidong, Gualouren (Trichosanthis Semen), and Shashen (Adenophorae Radix) for three to four doses invariably stopped cough and fever.

Gao Shizong's eldest son (six years old) and second son (three years old) developed fever and rash on the day after New Year's Day. Clearing and resolving formulas were used, but eruption was incomplete. Thinking the eldest was congenitally weak (born in July), Gao asked about chest/abdomen distension (answered: hungry) and taste (answered: bland). Diagnosing deficiency, he prescribed Huangqi, Baizhu, Renshen, Gancao, Guizhi, and Honghua for one to two doses. Eruption spread over the body, fever subsided slightly, but irritability, night fever, and frequent cough persisted until the first month ended. This was due to excessive exterior-releasing agents damaging meridians during early eruption. (Many such cases develop into Gan-Lao syndrome.) The younger son, too young to question, had morning phlegm-wheezing and recovered after one dose of Mahuang, Xingren, Guizhi, and Shigao, as his constitution was stronger, predicting no severe cold-toxin stagnation. However, prior use of Zisu, Mahuang, Qianhu, Xingren, Huangqin, and Shigao failed to increase red spots. Subsequent application of Zisu, Congbai, Jiang, and Yuanxu (warm moxibustion-like therapy) also failed. Colleagues insisted only eruption methods worked. By day five, roundworms appeared. Some suggested Niuhuang San (Rhei Radix et Rhizoma powder), which stopped wheezing but caused aphasia. Acupuncture at Baihui (GV20) and Niuhuang failed. Friend Zhang Weisheng diagnosed extreme deficiency-cold; Renshen and Fuzi could not save him. As the Classic states, one error delays death, two hasten it. Physicians must learn from this.

Wang's son had been erupting for three days. Prior use of Qianhu, Xingren, Mahuang, and Shigao yielded only twenty spots with chest distress. Gao Doukui warned against further attacking/dispersing. He prescribed Xiong (Chuanxiong Rhizoma), Danggui, Huangqi, Baizhu, Guizhi, Fuling, and Honghua. One dose resolved fever and restored comfort. Treating measles requires harmonizing Qi/Blood and collaterals, avoiding cold/dispersing attacks. (This is not an absolute rule but corrects past excesses.)

Wu Ti's ancestor, aged two, had measles that failed to erupt due to pediatricians' aggressive dispersal. Gao diagnosed deficiency. He stated that mere dispersal would fail and endanger life; only warming tonification benefiting organs, calming intestines, and assisting Qi/Blood would work. He prescribed Huangqi, Baizhu, Jiang, Guizhi, Danggui, Baishao, Fuling, Yinhua, and Honghua. One dose stabilized. Next day, add Renshen 1 qian to original formula, followed by Du Shen Tang (Single Ginseng Decoction) until recovery.

Xia's son had purple-rash points and restless spirit. Gao deemed it critical and used warming dispersants twice. The next morning, the family reported vomiting saliva/worms. Gao asked if the previous two doses were taken; one remained. He added Fuzi 0.8 fen to the remaining dose. No news followed for three years. Visiting later, Gao saw the boy grown and asked how he recovered. The family attributed it to heaven's protection after the medicine. (These accounts contain exaggerations.) These are authentic medical records from Gao.

Xu Zhongguang treated a boy with fever, wheezing, and distension. Internal/external injury treatments failed. Back showed faint redness—measles. Using Zhen Huang Tang to release exterior, eruption occurred but was insufficient on head/face, followed by disappearance and death. (Bear notes: Likely due to initial mismanagement.)

Another boy had fever resembling smallpox with widespread spots. Shen Xuming and Huang Jinyun thought it was deficiency. Huang Qiyun, age twelve and untrained, identified it as measles because nasal discharge indicated Lung/Stomach wind-heat. It proved correct. Huang later became a renowned physician, recognizing nasal discharge as a key sign of measles.

A boy with purple rash, cough, hiccups, diarrhea, and anorexia recovered using Jiedu Yin and Tiao Sha (scraping) therapy. (Bear notes: Superior insight stems from natural talent.)

A boy with purple rash, constipation, dysuria, irritability, and confusion recovered urgently using Da Chaihu Tang to purge.

A boy with difficult eruption due to wind-cold obstruction recovered using Guizhi Tang plus Gegen (Puerariae Lobatae Radix), Mahuang, and Qianhu (Peucedani Radix) for ascending/dispersing, wrapped in thick blankets, and fumigated with Fangfeng Tang under the bed. Alternatively, Yuanxu/Fangfeng bath or Yuanxu wine rub could be used. (Care for throat is crucial; Mahuang, Gegen, Shengma should be used cautiously.)

A boy with fever, headache, bone pain, cough, wheezing, vomiting, and anorexia had cold damage complicated by measles. Recovered with Baixiang San and Shishen Jiedu Tang. Delayed treatment would lead to purple-black rash, confusion, wheezing, distension, and death.

A boy with abdominal fullness and constipation during eruption had internal injury origin. Recovered with Chengqi Tang purgation.

A boy with sudden food stagnation during eruption, abdominal fullness, constipation, high fever, and delirium recovered urgently with Dahuang (Rhei Radix et Rhizoma), Gualou, Zhishi (Aurantii Fructus Immaturus), Houpo (Magnoliae Officinalis Cortex), Huanglian (Coptidis Rhizoma), and Gancao. Subsequent wheezing, slow pulse, and cold limbs were treated with Fuzi Lizhong Tang and Guishao Liujun Tang.

A boy with faint rash after exterior release, covered in patches,郁 by wind-heat, turning blue-purple with irritability and wheezing, recovered urgently with Mahuang Guizhi Tang plus Gegen for ascending, inducing slight cold sweat.

A boy with half-erupted rash, high fever, irritability, wheezing, and confusion (failure to erupt leading to internal attack) recovered urgently with Mahuang, Gancao, Jiegeng, Qianhu, Gegen, Jingjie (Schizonepetae Herba), Niubangzi, and Zhike for ascending. Rash erupted fully after two or three cycles.

A boy with suppressed rash, absent on face/head, blue-white complexion, wheezing, confusion, and faint Right Cun pulse had righteous Qi deficiency failing to raise toxin. Urgently treated with Mahuang Guizhi Tang plus Renshen 1 qian, and Fengfang Yuanxu Tang bath.

A boy with fully erupted rash, high fever, constipation, wheezing, and delirium had lingering toxin obstruction. Treated urgently with Huanglian, Gualou, Zhike, Shigao, Sangpiao, Zhimu, and Renzhonghuang.

A boy with sweating, erupted rash, but persistent wheezing had pathogen obstruction. Treated with Chao Hei Mahuang (charred Ephedra) plus Shigao, Xingren, and Gancao.

A boy with measles-related cough and wheezing recovered after 0.5-1 qian of Daxiao Wubi San, settling wheezing and allowing sleep, indicating heat resolving via urination.

A boy in mid-spring with measles took cooling medicine and raw pear, causing cold-stagnation suppression, wheezing, cyanosis, cold limbs, hoarseness, and syncope. Urgently treated with Mahuang Gegen Tang plus Gegen, Chaihu (Bupleuri Radix), Gancao, Jiegeng, Zisu, and Shengjiang (Zingiberis Rhizoma Freshus), wrapped in blankets to induce sweating.

A boy with non-erupting rash, wheezing, and irritability was treated by Miao Zhongchun using Xihe Liu (Tamarisci Ramulus) 5 qian, Maidong 3.5 qian, Niubangzi 3.5 qian, Chanthui (Bombyx Batryticatus), Jingjie, Bohe (Menthae Haplocalycis Herba), Zhimu each 1 qian, Zhu Ye (Phyllostachydis Folium) 30 slices. Severe cases added Shigao 5 qian, Dongmi (Winter Rice) or Sanhuang. Recovered.

An elder brother with rash but worsening wheezing due to abrupt use of drying/hot Mahuang had lung-fire heat. Treated with Qingjin Runfei method using Gancao, Jiegeng, Qianhu, Niubangzi, Xingren, Yuanshen (Scrophulariae Radix), Zhimu, Huangqin (Scutellariae Radix), and Huafen (Paeoflorae Radix). Recovered.

He Zhiren's youngest son had severe, non-erupting measles. Family fed meat rice. Miao urgently prescribed Xihe Liu 2 liang, Shigao 1.5 liang, Zhimu 5 qian, Yuanshen and Beimu (Fritillariae Thunbergii Bulbus) each 3 qian, Zhu Ye 70 slices, divided into two doses. Rash appeared fully, body red. Continued four doses for full eruption. Persistent irritability required Shigao 3 liang, Zhimu and Xihe Liu each 2 liang, Maidong 3 liang, Huangqin, Huangbai (Phellodendri Chinensis Cortex), Huanglian each 5 qian, Zhu Ye 30 slices, decocted strongly. Settled and recovered. (Bear notes: Ye Tianshi and Wu Jutong advised against Xihe Liu for measles, but Miao combined it with Shigao to avoid excessive warming ascent, akin to Zhang Zhongjing combining Mahuang and Shigao.)

A boy in cold month with non-erupting rash, wheezing, confusion, and irritability recovered after one dose of Qujie Mahuang (Ephedra without joints) honey-wine fried 1 qian, Gegen, Maidong, Beimu, Qianhu, Zhimu, Jingjie, Yuanshen, Gancao, and Xihe Liu.

A newlywed man with persistent cough/phlegm post-measles (misdiagnosed as residual toxin) worsened with clearing/resolving meds. Afternoon cough indicated Yin deficiency with blazing fire/tidal fever. Treated with Liuwei Dihuang Wan plus Zhimu and Maidong. Recovered.

A newlywed woman with similar symptoms recovered with Liuwei Dihuang Wan material plus Danggui.

A pregnant woman with non-erupting rash, extreme heat, confusion, and wheezing worsened with fetal-calming cooling meds. Pregnancy heat required aborting fetus to resolve measles heat and save mother. Exterior-releasing and abortive meds were used. (Bear notes: This treatment is flawed. Measles is Lung/Stomach heat; wheezing is Lung symptom. Aborting fetus is unnecessary.)

A pregnant woman with lower abdominal pain and bleeding during measles had heat disturbing fetus. Treated with Shengma Gegen Tang plus Jingjie, Zisu, Huangqin, Danggui, Baizhu, Chuanxiong, Sharen (Amomi Fructus), Juhong (Citri Reticulatae Pericarpium Rubrum), and Ejiao (Colla Corii Asini). Bleeding stopped, condition stabilized.

A pregnant woman whose fetus aborted due to measles heat lost excessive blood. Rash disappeared, but irritability and coma ensued due to blood loss. Tonifying Qi was needed. Lizhong Tang revived her. Followed by Renshen 1 liang, Danggui, Ejiao, Paojiang (Zingiberis Rhizoma Preparatum), Jingjie, and Aiye (Artemisiae Argyi Folium). Recovered. (Bear notes: Tonifying Qi for blood loss seems contradictory, though common in ancient texts.)

A pregnant woman with extreme heat aborted and had dystocia. Yujiao (Fish Maw) 3 cun calcined with Shexiang (Moschus) 1 fen taken with wine induced immediate delivery. Difficult case. Breech presentation treated with 1 chi Yujiao similarly; fetus died despite maternal survival.

A postpartum woman with difficult eruption, high fever, and continuous bleeding had Qi/Blood deficiency failing to expel toxin. Treated with Mahuang Gegen Tang plus Renshen, Jingjie, Baizhi (Angelicae Dahuricae Radix), Danggui, and Ejiao. Recovered.

A woman with mild cough, morning coolness/evening fever, dull complexion, emaciation, and red lips post-measles was treated with Bazhen Tang for Qi/Blood deficiency. Inquiry revealed sexual indiscretion. Treated with Liuwei Dihuang Wan combined with Shengmai San, advised celibacy for 100 days. Recovered. (Bear notes: Speculative. Post-measles Lung Yin damage causes these signs. Liuwei provided moistening effect, hence delayed recovery as it doesn't directly treat Lung.)

Chai Yuqing treated Wang, a candidate officer, aged twenty-something, who developed measles from seasonal qi, took excessive Shigao, resulting in fever, diarrhea, deafness, and anorexia. Pulse: weak Chi. Tongue: dry, no fluids. Diagnosis: Yin deficiency exacerbated by cold medicines damaging Yang and Yin. Prescribed Maidong 5 qian to nourish Yin/clear deficiency heat, Chenpi to harmonize Stomach, and Xihe Liu 1 qian to clear measles toxin. Next day, fever/subside, stool stopped, tongue moistened. Left Cun pulse slightly large; added Xiaoshengdi 2 qian, Mutong (Akebiae Caulis), and Juye (Chrysanthemi Indici Folium). Three days later, fever subsided, appetite returned. Expected selection that month; worried about weakness/deafness affecting examination. Predicted recovery by 19th with tonics. Outcome matched prediction. (Bear notes: Exemplary case due to accurate diagnosis, avoiding generic Bazhen/Shiquan.)

Wan Mixai treated Wu Daosong with limb measles. After three days of ineffective treatment with fever-inducing herbs (Jingfang Baidu San), irritability increased. Wan noted these herbs lack detoxification, especially in hot weather without seasonal herbs, worsening Yang excess and Yin deficiency, preventing eruption. Used Dongyuan Liangge San plus Yuanshen and Shengma. One dose erupted rash; recovered in three days. (Bear notes: Sound reasoning, but Liangge San is heavy; use caution unless heat-toxin is severe. Combining Shengma with Liangge San balances ascending and clearing effectively.)

Gan's son had fever, rash not erupting for three days, cool body, fatigue, restlessness. Toxin trapped internally, fire lurking, causing irritability. Used Shengma Gegen Tang plus Mahuang and Shigao to erupt. One dose, rash fully erupted, white/pale (Blood deficiency). Used Siwu Tang plus Fangfeng. One dose, color turned red, recovered.