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Whenever a patient with measles presents with halitosis, it is due to the accumulation of fire-toxin in the stomach and intestines. If the person has had this condition habitually, it is not discussed here; one should merely clear the stomach and descend fire, and the halitosis will naturally subside. If cracks are seen on the lips and mouth, it indicates that heat-toxin from the Heart and Spleen meridians is rushing upward. In the early stage, if the color is red and the blood circulation is active, using cooling herbs combined with dispersing and supporting methods can still resolve the pathogen. If the color appears purple-black and dry, it signifies that the blood has stagnated, making it difficult to treat. If this occurs after the rash has subsided, it indicates that the Heart and Spleen functions have failed, inevitably leading to critical danger. If sores appear on the lips, it also belongs to stomach heat; washing with warm rice water (Mi Gan Shui) more than ten times daily will gradually resolve it. The tongue is the sprout of the Heart; a thin coating indicates mild heat, while a thick coating indicates severe heat. Sores resembling mushrooms, white debris, swelling, and pain all result from blazing Heart-fire, which should be treated with cooling and draining methods. Only when the coating is black, dry, and prickly does it indicate excessive fire accompanied by fluid exhaustion, signifying the failure of Stomach Qi. Before the eruption of measles, there may be stomach fire; after the eruption, if residual toxin remains unresolved and heat-toxin accumulates in the gums, failing to detoxify early often leads to the transformation into Gangrene of the Running Horse (Zou Ma Gan). Severe teeth-grinding caused by heavy heat indicates yang-heat hidden within yin, accompanied by thirst, hot hands and feet, and a preference for cold water; this requires nourishing yin and descending fire. Consuming spicy and heat-assisting foods will inevitably lead to hematochezia, sore throat, and death due to rattling phlegm, as heat-toxin attacks the throat upwards. Mild cases present with swelling and pain, while severe cases make swallowing liquids difficult, which is most concerning. When exterior pathogens constrain the measles toxin, preventing its outward release, resulting in throat swelling and pain, Yuanshen Shengma Tang (Scrophulariae Radix and Cimicifugae Rhizoma Decoction) is the primary formula. When interior heat is congested and abundant, and the rash has erupted externally but the throat still hurts, Liangge Xiaodu Yin (Cool the Diaphragm Detoxification Drink) is indicated. If heat-toxin blocks the lung orifices causing aphonia, use Yuanshen Shengma Tang during the initial eruption, Jiajian Liangge San (Modified Powder to Cool the Diaphragm) after eruption, and Ercha San (Terra Rubra Powder) after resolution.

The most favorable sign in measles is sweating; sweating opens the couli (pores), allowing toxin to resolve through sweat, but excessive sweating must be avoided. If sweating is too profuse, Renshen Baizhu Tang (Ginseng and White Tiger Decoction) or a combination with Huanglian Jiedu Tang (Coptis Decoction to Relieve Toxicity) should be used. If the skin is dry without sweat, causing obstruction and difficulty in eruption, or leading to internal attack manifesting as abdominal distension and rapid breathing, treatment differs. If constrained by wind-cold, use light agents to ventilate the muscle layer in summer and autumn, and heavy agents to ascend and disperse cold pathogens in spring and winter. If it is indeed heat-fire causing closure and anhidrosis, characterized by red cracked lips, constipation of stool and urine, whole-body distension and pain, often leading to panting and phlegm rattle, cold and cool herbs must be used urgently to clear the lungs and descend fire. This allows the muscle layer to penetrate and produce sweat, so the rash emerges completely with the sweat, leaving no residual toxin; otherwise, it becomes a fatal syndrome. Therefore, slight sweating is always auspicious in measles.