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At the initial stage of fever, there is alternating chills and fever (Han Re Wang Lai), coughing, sneezing, nasal congestion with heavy voice, and clear runny nose; these symptoms are indistinguishable from Taiyang disease (Taiyang Bing, a syndrome caused by pathogenic factors attacking the Taiyang meridian). However, in measles, the eyelids are slightly swollen, eyes are watery, face is puffy with red cheeks, nausea and dry heaving occur; this is the difference. If these symptoms are seen, it must be measles. One must strictly avoid wind and cold, regulate diet, avoid foul odors, abstain from meat and alcohol, and avoid pungent and hot foods. Medication should be used to release the exterior (Biao San), making the skin smooth and pores open. If there is slight sweating, the pathogenic factor will be resolved through sweat, and the toxin will be easily expelled. By the third day of fever, the rash should appear. On the first day, it appears three times; on the third day, nine times; by the sixth day, it should be fully erupted. When the rash reaches the feet and the head/face begins to recede, the heat subsides at the sites of recession. As the rash gradually recedes, the heat also gradually subsides. By the eighth or ninth day, the measles completely recede, and the heat fully dissipates. If it fails to erupt, it is critical; if it does not erupt completely, it is dangerous; if it erupts and then immediately recedes, it is even more dangerous. How can treatment be delayed!

If the fever fluctuates without other severe symptoms, the condition is mild. If the head and face do not show the rash, the condition is mild. If the rash is fully erupted for three days before gradually receding, the condition is mild. If the rash is bright red, lively, moist, evenly distributed on the face, and abundant, the condition is mild. If the rash is dark red/purple, dull, dry, scorched, and unmoistened, the condition is severe. If heat transfers to the Large Intestine causing dysentery, the condition is severe. If the rash is dark/black, dry, and vanishes immediately upon appearing, it is difficult to treat. If the nose is blue and stool is black, it is difficult to treat. If there is nasal flaring, mouth breathing, and lack of spirit in the eyes, it is difficult to treat. If the chest is high and distended with panting and precordial pulsation, it is difficult to treat.

If the whites of the eyes are red, voice is hoarse, lips are swollen, heart is vexed and thirsty, waist and abdomen hurt, bleeding occurs from mouth and nose, consciousness is unclear, urination and defecation are blocked, restlessness and mania occur, tongue coating is yellow/black, and breath is fishy/foul, this is called Bi Syndrome (Closed Syndrome). Toxin is stagnant inside and cannot exit, about to attack the interior organs; this is the most critical prognosis. Urgently use Qing Du Jie Biao Tang (Clear Toxin Release Exterior Decoction) as the main formula. If the rash can erupt, it is salvageable; if it cannot erupt, it is unsalvageable. Formula: Sheng Ma (Cimicifugae Rhizoma), Fang Feng (Saposhnikoviae Radix), Jing Jie (Schizonepetae Spica), Ma Huang (Ephedrae Herba), Lian Qiao (Forsythiae Fructus), Niu Bang Zi (Arctii Fructus), Jie Geng (Platycodonis Radix), Shi Gao (Gypsum Fibrosum), Zhi Mu (Anemarrhenae Rhizoma), Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Chan Tui (Cicadae Periostracum), Mai Dong (Ophiopogonis Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma). Decoct in water and take orally.

Measles patients with epistaxis have heavy toxin; those with oral bleeding have even heavier toxin. Bleeding from mouth and nose need not be stopped forcibly; blood loss allows heat and toxin to disperse. If palms and soles feel like burning fire at the onset, the toxin is also heavy. If early clearing and resolving are neglected, heat accumulates in the Stomach, causing foul breath from mouth/nose, inevitably leading to Ya Gan (dental gangrene/gum ulceration). Toxin entering the Large Intestine leads to chronic dysentery. Over-releasing the exterior damages Yuan Qi (Primary Qi), leading to Gan Ji (infantile malnutrition/digestive disorder). Neglect in the early stage inevitably causes trouble later. Although one clarifies the severity at onset, one must consider survival later. Since measles are detailed regarding the early stage, how can one ignore the aftermath?

When measles are triggered by Wind-Heat, commonly called Piao Ma (Floating Measles), this is a minor skin ailment that does not endanger life; simply dispersing wind and clearing heat leads to recovery.

When an infant develops measles within the first month after birth, commonly called Tai Ma (Fetal Measles), it can heal without medication.