麻疹收完幸平复。动止如常饮食足。心腹绞痛忽然亡。此是气虚中恶毒。
麻疹收完之后。动止饮食如常。忽然心腹绞痛而死者。此是元气虚弱。兼之偶中疫疠之气。
正不胜邪。邪伏于中。外若无病。内已亏损。故一中即死。谓之中恶。
痰热聚于心胞络。喉中哈哈发惊搐。未透之时反为吉。慎勿妄投金石药。
麻毒流连为壮热。烦躁不宁时搐掣。养血散火清心肝。神爽身凉生可决。
发热无休神渐昏。忽然螈 似堪惊。莫将疯痫同调治。小便通利即安宁。
麻之发搐。不同常论。乃痰热聚于心胞络中所致。若见于发热初出未透之时。俱为无害而反
吉。治法宜以疏散之剂。少加清凉之药治之。以清热透肌汤(见二十五条)去生甘草、杏仁。加栝
蒌霜、淡竹叶治之。若收后而发搐者。则为难治。法当消痰清上焦之火。兼利小便。只宜用轻清之
剂调之。不可误用镇惊金石之药。以加味导赤散(见四十九条)去薄荷、石膏。加贝母、栝蒌霜主
之。如痰壅甚者。以栝蒌仁一味煎汤与服。以涌吐之。如麻后浑身壮热不除。未至羸瘦。但多搐
掣、烦躁不宁者。此乃热在心肝二经。然不可与急惊同治。以当归养血汤去川芎、甘草。加酒炒黄
连、地骨皮。与黄连安神丸相间而服。或以安神丸去冰片、甘草。或导赤散(见二十六条)去甘草。
加人参、麦冬。煎汁送下治之。小便清长者可治。小便短少者不可治。宜以抱龙丸与服。若搐而喉
中无痰鸣。或自吃指者。是非麻之发搐。乃正虚不能主持之候也。必死不治。
朱曰 以栝蒌仁一味煎汤取吐。为吐法另立一法。
当归养血汤
当归 川芎 生地黄 麦冬 木通 栀仁 甘草 淡竹叶 灯心引。
黄连安神丸
黄连 当归 龙胆草 朱砂(各二钱) 全蝎(水洗糯米拌炒干七只) 石菖蒲(姜汤泡去
毛姜汁蒸) 白茯神(各一钱五分) 为末。滚水和作饼。蒸熟。以 猪心血同捣为丸。以朱砂为衣
。黍米大。灯心汤下十丸。
安神丸
黄连 当归身 麦冬 白茯苓 甘草(各五钱) 朱砂(一钱) 冰片(二分五厘) 为末
。滚水和丸。蒸熟。以 猪心血同捣合丸。黍米大。灯心汤下十丸。
抱龙丸
琥珀 天竺黄 白檀香 人参(各一两五钱) 白茯苓(一两五钱) 甘草(去节三两) 枳壳
(麸炒) 枳实(麸炒各一两) 辰砂(五钱) 金箔(一百张) 山药(去黑皮炒熟一两) 牛胆
南星(一两) 为末。每药一两。取新汲井水一两。同入乳钵内捣匀为丸。如皂子大。勿见日。阴干。
晒则燥烈。每用一丸。薄荷叶煎汤化下。
After the measles rash has subsided and the condition has fortunately stabilized, the child's movements and diet return to normal. If sudden severe pain in the heart and abdomen occurs leading to death, this is due to Qi deficiency causing an attack by malignant toxins (Zhong'e).
After the measles rash has resolved, if the child's movements and diet remain normal but they suddenly die from severe pain in the heart and abdomen, this is because of deficient Yuan Qi (Original Qi) combined with a casual infection by epidemic pestilential Qi (Yili Zhi Qi). The righteous Qi cannot overcome the pathogenic factor, so the pathogen lies latent within. Externally there appears to be no disease, but internally there is already depletion. Therefore, once attacked, death follows immediately; this is termed "Zhong'e" (Sudden Collapse/Malignant Attack).
Phlegm-heat accumulates in the Pericardium Collateral (Xin Bao Luo), causing a rattling sound in the throat and convulsions/tremors (Fa Chu). If this occurs while the measles have not yet fully erupted, it is actually auspicious. Do not recklessly administer mineral-based sedatives (Jin Shi Yao).
If the measles toxin lingers causing high fever, restlessness, and frequent convulsions/tremors (Chu Che), treatment should nourish blood, dissipate fire, and clear heat from the Heart and Liver. If the spirit becomes clear and the body cools, recovery can be determined.
If fever persists without cessation and the spirit gradually becomes confused, sudden convulsions (Yu) may occur, which is alarming. Do not treat this as epilepsy (Feng Xian). If urination becomes smooth and profuse, peace will ensue.
Convulsions occurring during measles differ from general discussions. They are caused by phlegm-heat accumulating in the Pericardium Collateral. If seen when fever first begins and the rash has not yet penetrated, they are harmless and actually auspicious. The treatment method should use dispersing agents with a small addition of cooling herbs. Use Qing Re Tou Ji Tang (Heat-Clearing and Rash-Penetrating Decoction - see Article 25), removing Sheng Gan Cao (Raw Licorice Root) and Xing Ren (Apricot Seed), and adding Gua Lou Shuang (Trichosanthes Fruit Powder) and Dan Zhu Ye (Lophatherum Herb). If convulsions occur after the rash has resolved, it is difficult to treat. The method should eliminate phlegm, clear fire in the Upper Jiao, and promote urination. Only light and clear agents should be used for regulation. Do not mistakenly use heavy mineral sedatives, as this will worsen the condition. Use Jia Wei Dao Chi San (Modified Guide Out Red Powder - see Article 49), removing Bo He (Mint) and Shi Gao (Gypsum), and adding Bei Mu (Fritillaria Bulb) and Gua Lou Shuang (Trichosanthes Fruit Powder) as the main ingredients. If phlegm obstruction is severe, decoct a single herb of Gua Lou Ren (Trichosanthes Seed) and administer it to induce vomiting. If after measles the whole body remains hot without remission, without yet becoming emaciated, but with frequent convulsions and restlessness, this indicates heat in the Heart and Liver meridians. However, it must not be treated as acute convulsion (Ji Jing). Use Dang Gui Yang Xue Tang (Angelica Blood-Nourishing Decoction), removing Chuan Xiong (Szechwan Lovage Rhizome) and Gan Cao (Licorice Root), and adding Jiu Chao Huang Lian (Wine-fried Coptis Rhizome) and Di Gu Pi (Cortex Lycii). Administer alternately with Huang Lian An Shen Wan (Coptis Calming Spirit Pill). Alternatively, use An Shen Wan removing Bing Pian (Borneol) and Gan Cao (Licorice Root), or Dao Chi San (Guide Out Red Powder - see Article 26) removing Gan Cao (Licorice Root), adding Ren Shen (Ginseng Root) and Mai Dong (Ophiopogon Tuber), decocted to deliver the pill. If urine is clear and long, it is treatable; if urine is short, it is untreatable. It is suitable to administer Bao Long Wan (Embracing Dragon Pill). If convulsions occur without rattling sounds in the throat, or if the child sucks their fingers, this is not convulsion due to measles, but a sign that righteous Qi is too weak to maintain control. Death is inevitable and untreatable.
Zhu stated: Using only Trichosanthes Seed (Gua Lou Ren) decoction to induce vomiting establishes a separate method for emesis.
[Formula] Dang Gui Yang Xue Tang (Angelica Blood-Nourishing Decoction)
Composition: Dang Gui (Angelica Sinensis Radix), Chuan Xiong (Ligusticum Chuanxiong Rhizoma), Sheng Di Huang (Rehmanniae Radix Praeparata), Mai Dong (Ophiopogonis Tuber), Mu Tong (Akebiae Caulis), Zhi Ren (Gardeniae Semen), Gan Cao (Glycyrrhizae Radix et Rhizoma), with Dan Zhu Ye (Lophatheri Herba) and Deng Xin Cao (Junci Medullia) as guides.
[Formula] Huang Lian An Shen Wan (Coptis Calming Spirit Pill)
Composition: Huang Lian (Coptidis Rhizoma), Dang Gui (Angelicae Sinensis Radix), Long Dan Cao (Gentianae Radix), Zhu Sha (Cinnabaris, each 2 qian), Quan Xie (Scorpio, washed, stir-fried dry with glutinous rice, 7 pieces), Shi Chang Pu (Acori Tatarinowii Rhizoma, soaked in ginger juice to remove hairs, steamed), Bai Fu Shen (Poria cum Pinodia, each 1.5 qian). Pulverized into fine powder. Mixed with boiling water to form cakes, steamed until cooked. Pounded together with Pig Heart Blood to form pills, coated with Cinnabar. Size of millet seeds. Take 10 pills with Juniper Medulla Decoction.
[Formula] An Shen Wan (Calming Spirit Pill)
Composition: Huang Lian (Coptidis Rhizoma), Dang Gui Shen (Angelicae Sinensis Radix Core), Mai Dong (Ophiopogonis Tuber), Bai Fu Ling (Poria, each 5 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 5 qian), Zhu Sha (Cinnabaris, 1 qian), Bing Pian (Borneolum Syntheticum, 2.5 fen). Pulverized into fine powder. Mixed with boiling water to form pills, steamed until cooked. Pounded together with Pig Heart Blood to form pills. Size of millet seeds. Take 10 pills with Juniper Medulla Decoction.
[Formula] Bao Long Wan (Embracing Dragon Pill)
Composition: Hu Po (Amber), Tian Zhu Huang (Bambusae Concretio Silicea), Bai Tan Xiang (Santalum Album Lignum), Ren Shen (Ginseng Radix, each 1.5 liang), Bai Fu Ling (Poria, 1.5 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, deknotted, 3 liang), Zhi Ke (Aurantii Fructus, bran-fried), Zhi Shi (Aurantii Fructus Immaturus, bran-fried, each 1 liang), Chen Sha (Cinnabaris, 5 qian), Jin Bo (Folium Aureum, 100 sheets), Shan Yao (Dioscoreae Rhizoma, peeled and stir-fried, 1 liang), Niu Dan Nan Xing (Arisaema Cum Bile, 1 liang). Pulverized into fine powder. For every 1 liang of medicine, take 1 liang of fresh well water. Pound uniformly in a mortar to form pills, size of soap pods. Avoid sunlight; dry in shade. Sun-drying makes the drug overly acrid. Take one pill per dose, dissolved in Mint Leaf Decoction.