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Vomiting caused by measles is due to the internal pressure of fire pathogen, leading to rebellious Qi of the Stomach. One should use Zhuru Shigao Tang (Bamboo Shavings and Gypsum Decoction) to harmonize the Middle Jiao and clear heat; the vomiting will stop naturally.

Zhuru Shigao Tang (Bamboo Shavings and Gypsum Decoction)
Fa Banxia (Pinelliae Rhizoma Preparatum), Chiling (Poria Cocos with Red Dye), Guangpi (Exocarpium Citri Reticulatae), Zhuru (Bambusae Caulis in Taeniam), Gancao (Glycyrrhizae Radix et Rhizoma), Shigao (Gypsum Fibrosum) [dosage not specified], add fresh ginger.

Commentary by Lian: Liu Hejian stated that excessive heat in the Stomach and Diaphragm leads to vomiting, which is a manifestation of Fire Qi flaring upward. Shengma (Cimicifugae Rhizoma) should be avoided, as its use will inevitably cause asthma/wheezing. One should use Zhuru (Bambusae Caulis in Taeniam), Gegen (Puerariae Lobatae Radix), Xihe Liu (Salicis Tomentosae Ramulus), Chenpi (Citri Reticulatae Pericarpium), Shigao (Gypsum Fibrosum), Gancao (Glycyrrhizae Radix et Rhizoma), and Huanglian (Coptidis Rhizoma) stir-fried with ginger. If phlegm is expectorated in silk-like strands, or if clear saliva forming clumps with white foam is vomited, treatment should primarily focus on clearing the Lung, resolving phlegm, and descending Fire. Zhu Danxi stated that for medications treating vomiting, one should avoid Gualou Ren (Trichosanthis Semen), Xingren (Armeniacae Semen Amarum), Shanzhi (Gardeniae Fructus), and Luobozhi (Raphani Semen). Furthermore, although it is appropriate to release the exterior at the initial stage, one must not overuse lifting/astringent herbs. Regarding vomiting after the eruption of measles, there are excess patterns and deficiency patterns. The Classic states: "Deficiency of the Stomach leads to vomiting." For Stomach Excess, digestion-promoting and fire-clearing methods are suitable; for Stomach Deficiency, Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder) or Lizhong Tang (Regulate the Middle Decoction) are used.

Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder)
Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried), Fuling (Poria Cocos), Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma), Muxiang (Aucklandiae Radix), Huoxiang (Agastaches Herba), Gegen (Puerariae Lobatae Radix).

Lizhong Tang (Regulate the Middle Decoction)
Renshen (Ginseng Radix et Rhizoma), Jiaoshu (Fried Atractylodis Rhizoma), Paojiang (Prepared Ginger Rhizome), Zhi Cao (Honey-fried Licorice Root).
In severe cases, add Fuzi (Aconiti Lateralis Radix Praeparata).

Diarrhea caused by measles occurs when toxic heat shifts into the Intestines and Stomach, disrupting their transportation and transformation functions. The practitioner must absolutely avoid using warm and hot formulas. When diarrhea occurs at the initial stage of rash eruption, treat with Shengma Gegen Tang (Cimicifuga and Kudzu Root Decoction) added with Chiling (Poria Cocos with Red Dye), Zhuling (Polyporus Umbellatus), and Zexie (Alismatis Rhizoma). When diarrhea occurs after the rash has fully erupted, treat with Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity) added with Chiling (Poria Cocos with Red Dye) and Mutong (Akebiae Caulis).

Shengma Gegen Tang (Cimicifuga and Kudzu Root Decoction) (See previous section)
Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity) (See previous section)

Dysentery accompanying measles is called "Measles-complicated Dysentery" (Jia Zhen Li). It is caused by unresolved toxic heat shifting to the Large Intestine. Symptoms include abdominal pain with an urge to defecate, and stools may be red, white, or mixed red and white. All such cases should be treated primarily with Qingre Daozhi Tang (Clear Heat and Guide Out Stagnation Decoction). Do not lightly administer astringent agents.

Qingre Daozhi Tang (Clear Heat and Guide Out Stagnation Decoction)
Shanzha (Crataegi Fructus), Houpo (Magnoliae Officinalis Cortex), Gancao (Glycyrrhizae Radix et Rhizoma), Zhike (Aurantii Fructus Immaturus), Binglang (Arecae Semen), Danggui (Angelicae Sinensis Radix), Jiushaoyao (White Peony Root processed with wine), Tiaoqin (Scutellariae Radix, wine-fried), Lianqiao (Forsythiae Fructus), Qianzi (Plantaginis Semen), Qingpi (Citri Reticulatae Pericarpium Viride), Huanglian (Coptidis Rhizoma, stir-fried with Evodiae Fructus), reference fresh ginger for decoction.

Commentary by Lian: For diarrhea, it is emphasized that warm/hot agents must strictly be avoided; for dysentery, it is emphasized that astringent agents should not be lightly administered. The intent of this earnest warning is profound. I have treated measles for decades and have never seen diarrhea or dysentery presenting as a deficiency pattern. However, I privately speculate that long after measles recovery, there might be cases of diarrhea/dysentery due to Spleen Deficiency. Such cases must present with weak pulse, pale lips, slippery white tongue coating, no purple-red hue on the tongue, no thirst, and mental fatigue. Only then can it be diagnosed as Spleen Deficiency. In such cases, Siling San (Four-Ingredient Powder), Sijunzi Tang (Four-Gentlemen Decoction), or Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) may be used, but selection must be cautious and well-considered. Zhang Yulu stated: Measles-induced diarrhea and dysentery are mostly heat patterns, but one must not allow prolonged diarrhea. Prolonged diarrhea leads to sinking of Middle Qi or results in distension/swelling. It is appropriate to use formulas like Zhike Lizhong Tang variants to regulate the Spleen and Stomach. There is also a condition where stool passes directly out like the rectum itself, expelling whatever was eaten immediately. This indicates Excessive Fire. Due to its rapid nature, the stool exits directly from the rectum. Using twenty Gardenia fruits (Shanzhi) decocted in water and taken frequently will lead to self-healing. In summary, dysentery is best treated with ascending and dispersing methods. At the onset, Dahuang (Rhei Radix et Rhizoma) can be used; if Fire is excessive, add Huangqin (Scutellariae Radix) and Huanglian (Coptidis Rhizoma), or Xijiao Wan (Rhino Horn Pill), all of which are applicable. If accumulated toxins are cleared but Yin is lost due to excessive purging, Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) can also be applied.

Siling San (Four-Ingredient Powder)
Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried), Fuling (Poria Cocos), Zhuling (Polyporus Umbellatus), Zexie (Alismatis Rhizoma).

Sijunzi Tang (Four-Gentlemen Decoction)
Renshen (Ginseng Radix et Rhizoma), Jiaoshu (Fried Atractylodis Rhizoma), Fuling (Poria Cocos), Zhi Cao (Honey-fried Licorice Root).

Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction)
Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), Jiaoshu (Fried Atractylodis Rhizoma), Danggui (Angelicae Sinensis Radix), Chaihu (Bupleuri Radix), Shengma (Cimicifugae Rhizoma), Zhi Cao (Honey-fried Licorice Root), Guangpi (Exocarpium Citri Reticulatae).

Lizhong Tang (Regulate the Middle Decoction) (See previous section)

Xijiao Wan (Rhino Horn Pill): *Qiansheng* states that for any dysentery, taking this pill ensures recovery.
Xijiao Xie (Rhino Horn Fragment), Huanglian (Coptidis Rhizoma), Kushen (Sophorae Flavescentis Radix), Huangbai (Phellodendri Cortex), Danggui (Angelicae Sinensis Radix).
Grind each into fine powder, mix equally. Take a dose the size of a square inch on an empty stomach, mixed with cooked glutinous rice porridge. Take twice daily. Avoid greasy and raw/cold foods.

Huanglian Wan (Coptis Pill)
Huanglian (Coptidis Rhizoma), Lingyangjiao (Saiga Tataricae Cornu), Huangbai (Phellodendri Cortex), Chiling (Poria Cocos with Red Dye) [each 1 liang 5 qian].
Grind into fine powder, form pills with honey the size of tung seeds. Take 20 pills per dose, washed down with ginger-honey water.

Liuwei Wan (Six-Ingredient Pill)
Shengdi (Rehmanniae Radix Preparata), Fuling (Poria Cocos), Huaiyao (Dioscoreae Rhizoma), Yurou (Corni Fructus), Danpi (Moutan Cortex), Zexie (Alismatis Rhizoma).