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Measles is pathologically associated with Fire, and the body should be warm. Now, the body is cold as ice; if this appears when the rash has not yet erupted or is in the process of erupting, it is the most ominous adverse sign (Ni Hou). If this occurs when the rash is about to resolve or has already resolved, it belongs to severe deficiency of Qi and Blood, with the Spleen and Stomach on the verge of collapse. One should employ warming and tonifying methods, and life might possibly be preserved.

During the eruption of measles, coughing is favorable. Frequent coughing opens the hair follicles (Mao Qiao), facilitating the eruption of the rash; therefore, coughing in the early stage is considered auspicious. If there is no cough during the first three days of fever, and still none by the fourth or fifth day, it is not a typical measles presentation. If coughing is scant initially, the Cou Li (pores) are closed, preventing the rash from emerging. In such cases, add Banxia (Pinelliae Rhizoma) to dispersing formulas to assist in inducing cough. There are also cases of dry cough with continuous, unceasing episodes; this indicates excessive Fire suppressing Lung Metal. It is necessary to clear the Lungs and descend Fire, assisted by ascending and diffusing agents. At the onset, use Shengma Gegen Tang (Cimicifugae and Puerariae Decoction) with added Qianhu (Peucedani Radix), Jiegeng (Platycodonis Radix), Sugeng (Perillae Caulis), and Xingren (Armeniacae Semen Amarum). After resolution, use Qingjin Ningsou Tang (Clear Metal and Calm Cough Decoction). However, within ten days after the rash subsides, some coughing should remain; this residual toxin must be dispersed through coughing, reflecting the pattern of sudden emergence and disappearance. One must absolutely avoid treating the cough merely because it is frequent.

Wheezing (Chuan) is an unfavorable sign and is unsuitable during measles. Wheezing is characterized by open-mouth breathing, elevation and stacking of the chest and ribs, and irregular respiratory rhythm. Treatment must differentiate between Deficiency and Excess patterns. The Deficiency pattern presents with clear and profuse urination, loose stools, pale lips, minimal body heat, absence of Fire signs, and no external pathogenic factors; this is necessarily a sign of Qi Collapse. This is not caused by the Six Qi (Six Pathogenic Factors); one must decoct Zhenyuan Yin (Zhenyuan Drink), otherwise death is inevitable. The Excess pattern presents with hard and constipated stool, red and scanty urine, persistent heavy heat, and initial eruption without penetration and sweating. Use Maxing Shigan Tang (Ephedra, Apricot Seed, Gypsum, and Licorice Decoction) for early eruption without full penetration; use Qingqi Huadu Yin (Clear Qi and Transform Toxin Drink) for fully erupted rashes. Rushen Dingchuan Tang (Rushen Calming Wheezing Decoction) is also excellent. Generally, wheezing before eruption is treatable, whereas wheezing after eruption or resolution is mostly incurable.

Urgent and rapid breathing, tight and disharmonious respiration, belongs to Lung disease. The Lung is the canopy of the five Zang organs, governing the entry and exit of Qi. Once scorched by toxic fire, it loses its clear and descending authority, leading to turbid Qi and resulting in急促 (rapid/urgent) breathing. When seen before or during eruption, treatment should focus on dispersing and supporting (Shu Tuo). If even stridor (Xiao Ming) is present, quickly clear phlegm and descend Fire; two or three out of ten may be saved. If seen during resolution or after resolution, one should also clear Fire and protect Lung Metal. If the rash retreats early due to Wind, with toxic fire attacking internally, accompanied by these critical signs, treatment is likely futile (do not treat).