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Whenever measles erupts, it is crucial for the eruption to be thorough. One should initially use methods to release the exterior and induce sweating, so that the pathogenic toxins are completely delivered to the muscle and skin surface. If cold-cooling herbs are overused, causing the heat-toxin to be "ice-locked" (suppressed by excessive cold), the eruption will inevitably fail to be thorough.
This often leads to the pathogenic qi attacking inwardly, resulting in wheezing, chest oppression, and death. As for cases where the eruption has already become thorough, one should then use clearing and draining agents to ensure there is no residual heat internally, thereby avoiding various post-measles syndromes.
Moreover, measles belongs to the Yang category; severe heat damages the Yin aspect, and blood is consumed by it. Therefore, after the rash subsides, treatment must focus primarily on nourishing the blood to ensure complete safety. This constitutes the general principle for treating measles from beginning to end. Regarding temporary flexibility and adaptation, one must rely on divine perception and clear understanding.

Lian's Commentary: The general principles of treatment are summarized by three aspects: releasing the exterior, clearing/draining, and nourishing blood. This is an undeniable truth. Even if Zhang Zhongjing were resurrected, he could not alter these words. If one prescribes medication according to this method, how could there be critical conditions? However, this is merely the general principle. While releasing the exterior generally contraindicates early use of clearing/draining methods, there are cases of "Fire Closure" (heat-toxin stagnation) where cooling herbs are suitable as adjuncts; cases of "Food Closure" (food stagnation obstruction) where digestive-promoting herbs are suitable; and cases of "Phlegm Closure" (phlegm turbidity obstruction) where phlegm-resolving herbs are suitable. Although nourishing blood is appropriate after the rash subsides, there are cases where pathogens are concealed in the exterior, requiring dispersing herbs as adjuncts; cases of Fire Stagnation requiring cooling herbs; cases of Food Accumulation requiring digestive herbs; and cases of Phlegm Obstruction requiring phlegm-resolving herbs. Furthermore, there are cases where the primordial Qi is inherently deficient, requiring simultaneous tonification of Qi and Blood at the initial stage, or warm tonification after the rash subsides; and cases where Qi and Blood are tonified initially, but cooling herbs are used after the rash subsides. Measles presents with myriad changes, and physicians must also respond with myriad adaptations. Initially, Xie's seventy-two syndromes cannot exhaustively cover them. Hence, it is said that temporary flexibility relies on divine perception. These words are profound! It lies in the reader to understand the intent and extend its application.

Measles as a syndrome does not erupt without heat; thus, when it is about to erupt, the body first becomes hot. If there is no pathogen in the interior or exterior, the fever will be mild and harmonious, the pathogenic qi will loosen, making eruption easy and thorough. If accompanied by wind-cold, food stagnation, or excess heat syndromes, the fever will be vigorous, the pathogenic qi will be stagnant and closed, making eruption difficult and incomplete. Treatment utilizes Xuandu Fabiao Tang (Toxin-Releasing Exterior-Release Decoction). If there are mixed symptoms in between, they should also be treated with modifications of this formula according to the syndrome.

Xuandu Fabiao Tang (Toxin-Releasing Exterior-Release Decoction): Treats measles that are about to erupt but have not yet appeared.
Shengma (Cimicifugae Rhizoma), Gegen (Puerariae Lobatae Radix), Qianhu (Peucedani Radix), Jiegeng (Platycodonis Radix), Zhike (Aurantii Fructus Immaturus), Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Bohe (Menthae Haplocalycis Herba), Mutong (Akebiae Caulis), Lianqiao (Forsythiae Fructum), Niu Bang Zi (Arctii Fructus), Dan Zhu Ye (Lophatheri Herba), Gancao (Glycyrrhizae Radix et Rhizoma).
Add Yuanxi (Coriandri Fructus) as a guide, decoct in water and take orally. For those affected by cold pathogens, add Mahuang (Ephedrae Herba); do not use in summer. For food stagnation, add Nan Shan Zha (Crataegi Fructus). For internal heat, add Huangqin (Scutellariae Radix). For rapid breathing, remove Shengma and add Suye (Perillae Folium) and Congbai (Allii Fistulosi Bulbus). In severe cases, also remove Jiegeng. For pregnant women, follow the previous method but additionally remove Mutong.

Lian's Commentary: Wind Closure manifests as slightly bluish complexion, slightly white tongue coating, aversion to cold with shivering, erect hair follicles, nasal congestion, coarse breathing, wheezing and chest oppression with restlessness, even opisthotonos, limb spasms, cold feet, and clear loose stools. Heavily use Jingjie, Fangfeng, Bohe, Shengma, Fenge (Gegen), Qianhu, Jiegeng, Xingren (Pruni Semen), Chantui (Cicadae Periostracum), and Congbai to disperse. Use Mahuang in winter.
Fire Closure manifests as red face and eyes, scorched-hot skin, dry tongue and cracked lips, constipation or diarrhea, even wheezing, screaming, delirium, throwing hands and feet, preference for cold places. It is suitable to heavily use Shigao (Gypsum Fibrosum), Huangqin, Zhimu (Anemarrhenae Rhizoma) in the exterior-releasing formulas, or Xijiao (Rhinocerotis Cornu - note: substitute with Buffalo Horn in modern practice), Chuanlian (Coptidis Rhizoma), Zhizi (Gardeniae Fructum), etc. In severe cases, add Dahuang (Rhei Radix et Rhizoma).
Food Closure manifests as slightly yellow complexion, fatigue in limbs, acid regurgitation and belching of rotten food, body heat and dry mouth, thick yellow-white greasy tongue coating, chest and diaphragm fullness, even hard abdomen, lethargy, rapid breathing, and constipation. It is suitable to use Zhike, Houpo (Magnoliae Officinalis Cortex), Shan Zha (Crataegi Fructus), Mai Ya (Hordei Fructus Germinatus) in the exterior-dispersing drugs to digest the food. Bobzi (Raphani Semen) and Dahuang to open the obstruction. If food-fire disturbs the Heart, causing occasional delirium and cold extremities, it is named Food Jue (Syncope due to Food). Urgently use Huangqin, Chuanlian, Shigao, Lou Ren (Trichosanthis Semen), Dahuang, still assisting with dispersing drugs.
There is also Phlegm Closure, characterized by mouth full of salivary phlegm, sounds in the throat, rapid breathing and wheezing, inability to expectorate phlegm. It is suitable to heavily use Jiegeng, Xingren, Sangpi (Mori Cortex), Dansheng (Arisaematis Cum Bile), Lou Ren, Baijiezhi (Sinapis Semen), Zhuli (Bambusae Succus Liquidus), etc., still assisting with dispersing agents. The above four syndromes, if severe, are all called "Men Zhen" (Stifled Measles). One should examine the predominant cause and prescribe accordingly. If all four syndromes are present, Sanhuang Shigao Tang (Three-Yellow Gypsum Decoction) is suitable, adding wind-drugs, phlegm-drugs, and food-digesting drugs. Another method for Men Zhen with much phlegm and wheezing is to use bright Xionghuang (Realgar), place it in a bamboo tube, steam it seven times in rice, grind into powder, and take mixed with wine or liquid. Phlegm and wheezing will stop immediately.
The symptoms of Men Zhen include: fever for six or seven days without eruption; eruption appearing and then immediately disappearing; slight eruption on the head and face but none on the body; slight shadows on the body but none on the head, face, chest, or back; shadows inside but no visible form outside; faint purple-red skin; or widespread red-purple turning black in patches. These are all critical conditions with nine deaths for every one survival. However, if one accurately diagnoses the root cause and uses large doses of medication, rescue is possible. Do not abandon treatment. Whenever encountering Men Zhen, carefully inspect the crown of the head. If there are red veins or red nodules, puncture them to allow eruption. Or if there are ding (carbuncles) on the head, face, hands, or feet, puncture them with a silver needle to allow eruption. Or if there is a hair on the crown thicker than others with a yellow-red color, pluck it out until bleeding occurs, and eruption will follow.
It is also said that there are mixed syndromes, which should be treated with modifications according to the syndrome. This certainly includes more than just these four syndromes. Students should extend their understanding.

Sanhuang Shigao Tang (Three-Yellow Gypsum Decoction): Treats Men Zhen syndrome caused by stagnation of wind-cold and toxin-heat.
Mahuang (Ephedrae Herba), Shigao (Gypsum Fibrosum), Dan Zhu Ye (Lophatheri Herba), Huangbai (Phellodendri Cortex), Huanglian (Coptidis Rhizoma), Zhizi (Gardeniae Fructum), Huangqin (Scutellariae Radix).