发热数日热便退。再隔数日热又来。时热时凉为乍热。用心调理免受灾。
热而又退退又热。初潮正出此为逆。收尽乍热毒未尽。病后治本免疏失。
乍热有二。一则热数日而止。过数日热又作者。一则一日之间。有早发热而午凉。午发热而
夜止者。此二者皆谓之乍热也。若未出之间见乍热。名曰毒未得透。药宜疏散。以宣毒发表汤（见
第五条）去升麻、桔梗、甘草。或葛根解肌汤（见第五条）去赤芍、甘草。加赤茯苓主之。正出之际。
甚不宜见乍热。见之则为逆候。此由毒出而邪热未解。复有内攻之意。必须疏托。以化毒清表汤
（见十六条）去天花粉、桔梗、甘草。或清热透肌汤去甘草。加生地黄、地骨皮主之。又有因大病之
后。中气虚甚而然者。以治本为要。药宜温补。以四物汤加连翘、元参。临症斟酌而用之。若收
后及未收之间见乍热者。皆为毒瓦斯未尽。急宜凉解分利。如清热透肌汤去甘草。加黄连、黄芩、生
地黄、地骨皮。宣毒发表汤（见第五条）去升麻、甘草、桔梗。加黄连、黄芩、生地黄、地骨皮。俱可
施治。
清热透肌汤 治麻未透。热甚而咳。
元参 石膏 牛蒡子 荆芥 防风 前胡 葛根 杏仁（各八分） 生甘草（四分） 水煎热服。
四物汤 治一切血虚。凡血症通宜。
当归（酒洗） 生地黄（酒洗各三钱） 白芍药（酒炒二钱） 川芎（酒炒一钱五分）
凉心血加酒炒黄连。凉肝血加酒炒条黄芩。凉肺血加酒炒枯黄芩。凉大肠血加酒炒子实黄
芩。凉肾、膀胱血加黄柏。凉脾血多用酒洗生地黄。凉胃血加酒蒸大黄。凉三焦血加酒洗鲜
地骨皮。凉心胞络血加酒蒸牡丹皮。凉小肠血加炒栀仁、川木通。清心与胞络气加麦冬。清
肺气加炒枳壳。清肝气加酒炒柴胡、醋炒青皮。清脾加酒炒白芍。清胃加干葛、石膏。清小
肠加赤茯苓。清大肠气、三焦气加连翘。清膀胱加滑石、琥珀。血虚加龟版。血燥加乳汁。瘀
血加桃仁、红花、韭菜汁、童便、行之。暴血加薄荷叶、酒洗元参。血不止加炒蒲黄、京墨。
加黄柏、知母、元参名滋阴降火汤（治阴虚有火。）。加酒炒黄连、酒炒胡连名二连四物汤
（治虚劳血虚。五心烦热。热入血室。夜分发热。）。加黄柏、黄芩、甘草名三黄四物汤（治阴
虚潮热。）。加桃仁、红花名元戎四物汤（治脏结便闭。扑损瘀血。）。加羌活、防风（一方用
北秦艽）名治风六合汤（治风虚眩晕。风秘便难。）。加木香、槟榔名治风六合汤（治血海虚
滞。或血气上冲。）。本方去白芍药。加防风名防风当归散（治发汗过多而成痉症。宜去风养血。）。
After fever persists for several days, the heat subsides. After a few more days, the fever returns. Alternating hot and cold states are termed "Zha Re" (Intermittent Fever). Careful management is required to avoid disaster.
The fever subsides only to return again. If this occurs when the measles rash is just beginning to erupt, it is considered a "Ni Zheng" (Adverse Syndrome). If the rash has fully receded but intermittent fever persists, it indicates that the pathogenic toxin is not yet exhausted. Post-illness treatment must focus on addressing the root cause to avoid negligence.
There are two types of "Zha Re" (Intermittent Fever): one type involves fever lasting several days then stopping, followed by recurrence after a few days; the other type involves fever in the morning with coolness at noon, and fever at noon with cessation at night. Both are referred to as "Zha Re" (Intermittent Fever). If "Zha Re" (Intermittent Fever) appears before the rash erupts, it is named "Du Wei De Tou" (Toxin unable to penetrate/extrude). Medication should promote dispersion, using Xuan Du Fa Biao Tang (Disperse Toxin and Release the Exterior Decoction) (see Article 5), removing Sheng Ma (Cimicifugae Rhizoma), Jie Geng (Platycodonis Radix), and Gan Cao (Glycyrrhizae Radix et Rhizoma); or alternatively, Ge Gen Jie Ji Tang (Puerariae Radix Relieving Muscle Tension Decoction) (see Article 5), removing Chi Shao (Paeoniae Radix Rubra) and Gan Cao (Glycyrrhizae Radix et Rhizoma), adding Chi Fu Ling (Poria Cocos with Red Core). This is the primary treatment. During the peak eruption of the rash, the appearance of "Zha Re" (Intermittent Fever) is highly inadvisable; its presence indicates an adverse prognosis. This arises because the toxin is emerging while pathogenic heat remains unresolved, with a tendency to attack internally. One must employ dispersing and supporting methods, using Hua Du Qing Biao Tang (Transform Toxin and Clear Exterior Decoction) (see Article 16), removing Tian Hua Fen (Trichosanthis Radix), Jie Geng (Platycodonis Radix), and Gan Cao (Glycyrrhizae Radix et Rhizoma); or alternatively, Qing Re Tou Ji Tang (Clear Heat and Penetrate Muscle Decoction), removing Gan Cao (Glycyrrhizae Radix et Rhizoma), adding Sheng Di Huang (Rehmanniae Radix) and Di Gu Pi (Lycii Cortex). This is the primary treatment. Another cause is extreme deficiency of Middle Qi (Spleen and Stomach Qi) following a severe illness; treating the root is essential, and medication should be warming and tonifying. Use Si Wu Tang (Four Substances Decoction) added with Lian Qiao (Forsythiae Fructus) and Yuan Shen (Scrophulariae Radix), adjusted according to clinical presentation. If "Zha Re" (Intermittent Fever) appears during or after the recession phase of the rash, it indicates that toxic vapors are not yet exhausted. Urgent cooling, resolution, and separation/drainage are needed. For example, Qing Re Tou Ji Tang (Clear Heat and Penetrate Muscle Decoction) without Gan Cao (Glycyrrhizae Radix et Rhizoma), added with Huang Lian (Coptidis Rhizoma), Huang Qin (Scutellariae Radix), Sheng Di Huang (Rehmanniae Radix), and Di Gu Pi (Lycii Cortex); or Xuan Du Fa Biao Tang (Disperse Toxin and Release the Exterior Decoction) (see Article 5) without Sheng Ma (Cimicifugae Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), and Jie Geng (Platycodonis Radix), added with Huang Lian (Coptidis Rhizoma), Huang Qin (Scutellariae Radix), Sheng Di Huang (Rehmanniae Radix), and Di Gu Pi (Lycii Cortex). Both can be applied.
Qing Re Tou Ji Tang (Clear Heat and Penetrate Muscle Decoction): Treats measles that have not yet erupted, with severe heat and cough.
Ingredients: Yuan Shen (Scrophulariae Radix), Shi Gao (Gypsum Fibrosum), Niu Bang Zi (Arctii Fructus), Jing Jie (Schizonepetae Herba), Fang Feng (Saposhnikoviae Radix), Qian Hu (Peucedani Radix), Ge Gen (Puerariae Radix), Xing Ren (Armeniacae Semen Amarum) (each 8 fen), Sheng Gan Cao (Raw Glycyrrhizae Radix et Rhizoma) (4 fen). Decoct in water and take warm.
Si Wu Tang (Four Substances Decoction): Treats all forms of Blood Deficiency; generally suitable for all Blood disorders.
Ingredients: Dang Gui (Angelicae Sinensis Radix) (washed with wine), Sheng Di Huang (Rehmanniae Radix) (washed with wine, each 3 qian), Bai Shao Yao (Paeoniae Radix Alba) (stir-fried with wine, 2 qian), Chuan Xiong (Ligustici Chuanxiong Rhizoma) (stir-fried with wine, 1.5 qian).
Modifications: To cool Heart Blood, add Huang Lian (Coptidis Rhizoma) stir-fried with wine. To cool Liver Blood, add Tiao Huang Qin (Scutellariae Radix) stir-fried with wine. To cool Lung Blood, add Ku Huang Qin (Scutellariae Radix) stir-fried with wine. To cool Large Intestine Blood, add Zi Shi Huang Qin (Scutellariae Radix) stir-fried with wine. To cool Kidney and Bladder Blood, add Huang Bo (Phellodendri Cortex). To cool Spleen Blood, use more Sheng Di Huang (Rehmanniae Radix) washed with wine. To cool Stomach Blood, add Da Huang (Rhei Radix et Rhizoma) steamed with wine. To cool San Jiao (Triple Burner) Blood, add Di Gu Pi (Lycii Cortex) washed with wine. To cool Pericardium Collateral Blood, add Mu Dan Pi (Moutan Cortex) steamed with wine. To cool Small Intestine Blood, add Zhi Ren (Gardeniae Semen) stir-fried and Chuan Mu Tong (Akebiae Caulis). To clear Heart and Pericardium Qi, add Mai Dong (Ophiopogonis Radix). To clear Lung Qi, add Zhi Zhi Ke (Aurantii Fructus) stir-fried. To clear Liver Qi, add Chai Hu (Bupleuri Radix) stir-fried with wine and Qing Pi (Citri Reticulatae Pericarpium Viride) vinegar-fried. To clear Spleen, add Bai Shao Yao (Paeoniae Radix Alba) stir-fried with wine. To clear Stomach, add Gan Ge (Puerariae Radix) and Shi Gao (Gypsum Fibrosum). To clear Small Intestine, add Chi Fu Ling (Poria Cocos with Red Core). To clear Large Intestine Qi and San Jiao (Triple Burner) Qi, add Lian Qiao (Forsythiae Fructus). To clear Bladder, add Hua Shi (Talcum) and Hu Po (Amber). For Blood Deficiency, add Gui Ban (Testudinis Carapax et Plastrum). For Dry Blood, add Ru Zhi (Milky Juice). For Stasis Blood, add Tao Ren (Persicae Semen), Hong Hua (Carthami Flos), Jiu Cai Zhi (Allii Tuberosi Juice), Tong Bian (Child's Urine), to promote circulation. For sudden bleeding, add Bo He Ye (Menthae Haplocalycis Folium) and Yuan Shen (Scrophulariae Radix) washed with wine. For unceasing bleeding, add Pu Huang (Typhae Pollen) stir-fried and Jing Mo (Chinese Ink).
Adding Huang Bo (Phellodendri Cortex), Zhi Mu (Anemarrhenae Rhizoma), and Yuan Shen (Scrophulariae Radix) is named Zi Yin Jiang Huo Tang (Nourish Yin and Descend Fire Decoction) (treats Yin Deficiency with Fire).
Adding Huang Lian (Coptidis Rhizoma) stir-fried with wine and Hu Lian (Coptidis Rhizoma) stir-fried with wine is named Er Lian Si Wu Tang (Two Coptis Four Substances Decoction) (treats Xu Lao Blood Deficiency, Five Centers Heat, Heat entering Blood Chamber, fever at midnight).
Adding Huang Bo (Phellodendri Cortex), Huang Qin (Scutellariae Radix), and Gan Cao (Glycyrrhizae Radix et Rhizoma) is named San Huang Si Wu Tang (Three Yellows Four Substances Decoction) (treats Yin Deficiency tidal fever).
Adding Tao Ren (Persicae Semen) and Hong Hua (Carthami Flos) is named Yuan Rong Si Wu Tang (Yuan Rong Four Substances Decoction) (treats Zang Jie constipation, traumatic stasis blood).
Adding Qiang Huo (Notopterygii Rhizoma et Radix) and Fang Feng (Saposhnikoviae Radix) (one formula uses Bei Qin Jiao (Gentianae Macrophyllae Radix)) is named Zhi Feng Liu He Tang (Wind-Curing Six-Harmony Decoction) (treats Wind Deficiency vertigo, Wind Bi constipation).
Adding Mu Xiang (Aucklandiae Radix) and Bing Lang (Arecae Semen) is named Zhi Feng Liu He Tang (Wind-Curing Six-Harmony Decoction) (treats Blood Sea deficiency stagnation, or Blood and Qi rushing upward).
Removing Bai Shao Yao (Paeoniae Radix Alba) from this formula and adding Fang Feng (Saposhnikoviae Radix) is named Fang Feng Dang Gui San (Saposhnikovia and Angelica Powder) (treats spasms caused by excessive sweating, suitable for dispelling wind and nourishing blood).