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The eruption of measles (Mazhen) is distinguished by Yin and Yang aspects, as well as the abundance or scarcity in different body regions. Areas extending from the head to the back and limbs outwardly are considered Yang regions (Yang Bu), where abundant eruption with prominent papules is appropriate. Areas converging inwardly are considered Yin regions (Yin Bu), where sparse eruption is appropriate. If the eruption is sparse and the papules do not rise in the Yang regions, even if it is abundant in the Yin regions, this represents a contradiction between Yin and Yang and will inevitably lead to subsequent complications; preventive measures should be taken in advance. It is also stated: If the rash first appears behind the ears, on the neck, waist, and legs, and the papules are pointed but not elongated, with a small, uniform, and clean appearance, this is an auspicious sign, and recovery may occur without medication. Generally speaking, as long as the measles erupt thoroughly, the pathogenic toxins will dissipate, and the healthy Qi (Zheng Qi) will naturally return to harmony. If there is slight fever, restlessness, and discomfort, resembling a snake wriggling in ash or an earthworm struggling in dust, accompanied by vomiting or diarrhea, these indicate that the pathogenic toxins are stagnant and obstructed, and have not yet fully erupted. Urgent treatment with formulas that support the interior and release the exterior is required, such as Mahuang Tang (Ephedra Decoction), with Xingren (Apricot Seed) removed and Chan Tui (Cicada Slough) and Sheng Ma (Cimicifugae Rhizoma) added. Externally, Hu Su Jiu (Coriander Wine) can be used.

In one scenario, the rash appears white due to deficiency of Spleen and Stomach Qi and blood failing to nourish the muscles. Treatment should not focus solely on clearing heat; instead, it should aid the Spleen Qi. Formulas such as those benefiting the Spleen or Renshen Baidu San (Ginseng Detoxification Powder) should be used.

In another scenario, external closure by Wind-Cold causes the rash to desire eruption but fail to emerge, with severe heat and absence of sweating, creating a situation where internal and external pathogens cannot be resolved. Qianghuo Neituo San (Notopterygium Interior-Supporting Powder) should be administered rapidly. If the rash appears hidden and purple, with severe heat and panting, Qingre Huangqin Tang (Heat-Clearing Scutellaria Decoction) is indicated.

In a case where the measles erupt in purple-black color, appearing dull and blocked, Huanglian Jiedu Tang (Coptis Detoxification Decoction) is suitable. If the color is purple-red, dry, and dull, this indicates blazing Fire-Toxin; Ziyin Liangxue Tang (Nourishing Yin and Cooling Blood Decoction), Daqing Tang (Isatidis Decoction), or Yuanshen Tang (Scrophulariae Decoction) should be selected.

If the measles do not erupt thoroughly, with extreme heat causing red eyes, phlegm production, and panting, this is because the toxin has not fully emerged, and Qi is forced by heat. Chailian Jiedu Tang (Bupleurum and Coptis Detoxification Decoction) should be used.

If heat persists after eruption, thirst does not cease, and the body resembles brocade patterns, Huaban Tang (Spot-Transforming Decoction) is indicated. If severe toxicity causes irritability and insomnia, and the rash is purple-stagnant and lacks vitality, Shufeng Jiedu Yin (Wind-Dispersing and Toxin-Resolving Drink) is appropriate. If accompanied by phlegm, irritability, and thirst, Renshen Baihu Tang (Ginseng White Tiger Decoction) is suitable.

If the measles eruption includes macules without other mixed symptoms, Xiaochaihu Tang (Minor Bupleurum Decoction) is indicated. If accumulated toxins cause macules, Huangqin Jupi Tang (Scutellaria and Tangerine Peel Decoction) should be used. If the rash turns black with hyperactive Heat-Toxin, it is an incurable condition; however, Jiawei Huaban Tang (Modified Spot-Transforming Decoction) or Liangxue Jiedu Tang (Cooling Blood and Detoxifying Decoction) may be tentatively employed.

If the measles appear purple-red, indicating extreme internal heat, but the form and color are lustrous and the papules are pointed and erect, the condition is treatable. Rapid cooling and detoxification, assisted by phlegm-resolving and pantle-suppressing agents, will lead to recovery. If the skin is dry and shows no improvement, it is incurable. Additionally, if the rash becomes red and active when warm but dry when cold, it is constrained by Wind-Cold. Although cooling and resolving methods are appropriate, they must not be excessive. Fresh red color with luster and distinct papules indicates mild disease; flat, non-rising papules indicate severe disease.

If the measles erupt like a cloud patch of red swelling, with fine red dots appearing on large swollen areas, this indicates blazing Fire-Toxin. Clearing, resolving, and separating/drainage methods should be used.

If the rash has penetrated the exterior but the papules are scorched, regardless of whether the color is red or pale, it belongs to heavy heat. Urgently clear the Heat of the Lung and Stomach and promote diuresis. If constipation occurs, add blood-cooling and moistening purgatives; in severe cases, Chengqi Tang (Chengqi Decoction) may be used. Failure to treat properly leads to purple-black discoloration, which is difficult to rescue.

Measles occurring in summer originate from the Yangming channel. Ancients treated summerheat primarily with Baihu Tang (White Tiger Decoction). Since summerheat invariably combines with dampness, only sweet-cold herbs can thoroughly eliminate the heat. If measles toxins erupt internally while summer-dampness invades externally, causing irritability, thirst, and mental unrest, Queshu Dan (Summerheat-Repelling Pill) with toxin-resolving assistants is indicated.

Cough, panting, dry mouth, and heart irritability indicate that toxins in the Heart and Lung have not fully erupted. Xiebai San (Draining White Powder) is suitable.

Sore throat and swelling preventing eating indicate suppressed Fire-Toxin steaming upward. Ganjie Tang (Licorice and Platycodon Decoction) with modifications, or a small amount of Qianjin San (Thousand Gold Powder) blown into the throat via a bamboo tube, or Yusuoshi (Jade Lock Key), may be used.

If the rash disappears immediately upon appearing, with severe irritability, thirst, and restlessness, Baihu Tang (White Tiger Decoction) with Jiegeng (Platycodon Root) should be administered continuously for two or three doses. If heat persists for three to four days after eruption without subsiding, this indicates excessive Fire-Toxin, incomplete external eruption, and residual internal pathogens. Huaban Tang (Spot-Transforming Decoction) or Xiaodu Yin (Detoxifying Drink) with Yuanshen (Scrophulariae Radix), Shigao (Gypsum Fibrosum), and Jiegeng (Platycodon Radix) should be used. If the body is fully erupted but still febrile with frequent vomiting, this indicates pathogenic toxins lingering in the Lung and Stomach; Huaban Tang is also appropriate. If constipation is present, add a small amount of Dahuang (Rhei Radix et Rhizoma) to induce mild purgation.