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Measles (Dòuzhěn) originates from congenital predisposition and erupts according to seasonal changes; Sha syndrome (Shāzhèng, acute toxic heat condition) is also caused by contracting epidemic pathogens, and the toxins in the fetal origin are thereby fully released. Whenever Sha distension occurs before the measles spots appear, there must be restlessness, phlegm-saliva accumulation, and even coma, heaviness, and loss of consciousness; this is its clinical presentation. The pulse of children is slippery and rapid, resembling the pulse of Sha syndrome where there is trembling due to syncope. Although it may seem ambiguous and difficult to distinguish, "Sha veins" (visible subcutaneous veins indicating Sha toxin) can be identified. Acupuncture should not be used here; instead, only herbal medicine should be used for clearing. It is appropriate to use Mu Formula 1 (Mù Fāng Yī), which both resolves Sha toxin and promotes the eruption of measles. The Sha toxin will naturally recede, and the measles will naturally rise. If the measles spots have already formed but remain hidden due to contact with filth, various measles treatment texts have their own detailed explanations.

After measles, when Qi deficiency prevails, special care and protection are especially necessary. There have been cases where a child's scabs had healed and crusted over, appearing safe and sound, but upon encountering summer heat or filth, Sha distension suddenly developed, leading to abrupt complications. People often mistakenly attribute this to malignant measles toxins, which is a great error.
A seven-year-old boy had his scabs fall off, leaving smooth skin, with diet and movement returning to normal. On the morning of the twenty-fifth day, he suddenly cried out with dizziness. His pulse was minute, fine, and deep-hidden. If this were a sign of residual toxins from malignant measles transforming, the pulse would be deep, tight, and forceful. However, the pulse and symptoms do not match; the Sha veins are clearly visible and countable. After using Zhu Formula 2 (Zhú Fāng Èr) and Zhu Formula 4 (Zhú Fāng Sì), he immediately regained consciousness. Later, he suffered from lower abdominal pain and dysentery. He was treated with five qian of Danggui (Angelicae Sinensis Radix), one qian of Shanzha (Crataegi Fructus), and five fen of Shujun (Prepared Rhizoma Rhei), taken warm with infant urine. He recovered immediately.
When Sha veins are seen before or after measles, only herbal medication should be used; acupuncture is strictly prohibited.

Soreness and pain in sores are caused by Heart fire and blood heat. Pain from abscesses develops gradually, unlike the sudden and frightening onset associated with concurrent Sha syndrome. Moreover, the pulse for sores is typically surging and rapid, which is definitely different from the pulse of concurrent Sha; observing the Sha veins provides further verification.
A woman suffered from a sore for half a year. One day, after drinking alcohol, her blood became hot, and she consumed chicken and goose meat. Her purulent sore became severe. After administering herbs to cool the blood and resolve toxicity, she felt even more comatose and bloated. Her pulse was no longer surging and rapid but became deep and minute. This was undoubtedly caused by Sha. One needle was inserted into the top of the head, and several needles into the tips of the fingers. She felt slightly refreshed but still experienced bloating. She was cured using Mu Formula 2 (Mù Fāng Èr) and Mu Formula 3 (Mù Fāng Sān).

When Sha toxins stagnate in the interstices (Còulǐ, pores and muscle interspaces), they form swellings and toxic masses. It is appropriate to first perform Sha release (Fàngshā, pricking to bleed), then use detoxifying and Sha-resolving herbs to eliminate the root cause. Subsequently, examine the twelve meridians and zang-fu organs, differentiate yin and yang, cold and heat, and treat accordingly. For mild cases, dissipate the pathogen; for severe cases, expel the toxin outward; for deficiency patterns, tonify; for excess patterns, purge. Severe redness and swelling belong to Yang patterns, treated with Mu Formula 3 (Mù Fāng Sān). White, flat swelling that does not rise belongs to Yin patterns, treated with Mu Formula 4 (Mù Fāng Sì). Toxins with mixed Yang-Yin characteristics are treated with Mu Formula 2 (Mù Fāng Èr). After ulceration, apply Taiyi Plaster (Tàiyǐ Gāo). If there is no pus but only toxic fluid flows, or if there is little pus and much blood, crush a small amount of Feilong Duoming Dan (Fēilóng Duómìng Dān, Flying Dragon Life-Grabbing Pill) and mix it into the Taiyi Plaster. After extracting the toxic fluid, pus, and blood, apply the plaster alone. If the toxic wound is difficult to close, sprinkle Hongyu San (Hóngyù Sān, Red Jade Powder) (i.e., Mu Formula 4 and Mu Formula 5).
A person suffered from body-wide pain and developed a toxic mass on the back, which turned black, rotted, and caused severe pain. His pulse was deep and minute, his fingertips were black, yet he disliked hot drinks. This was Sha transforming into malignant toxin, complicated by the use of cold compress wraps, resulting in a carbuncle on the back. He was instructed to remove the compress wraps, undergo Sha release, and wait until the Sha qi subsided. Then, Mu Formula 4 (Mù Fāng Sì) was used to warm and support the expulsion of toxins. External application followed the previous method, with Mu Formula 5 (Mù Fāng Wǔ) available as an alternative selection.
Appendix: Methods for post-Sha recovery and regulation are discussed in Mu Formulas 6, 7, and 8 below.