麻为胎毒发于心。肺与相连热毒侵。咳嗽鼻中清涕出。更兼两目泪盈盈。
麻疹之证面必红。呵欠咳嗽鼻流浓。汪汪眼泪频频嚏。休作伤寒别证攻。
麻疹初潮。未现标时。必身热憎寒。头疼咳嗽。或吐。或干呕。或泻。或腹痛。或鼻塞。或鼻流
清涕。喷嚏呵欠。眼胞浮肿。目泪汪汪。腮赤体疼。烦躁不宁。夫麻乃胎毒所发。毒者火也。麻疹小
而色红碎密。其行于皮肤之间者。属手少阴心经。君火也。五脏心肺相连。肺位乎上。心经火旺。
则肺受之。故麻之发。惟肺受毒最重。其咳嗽者。肺因心火炎上。而肺叶焦举也。鼻流清涕者。鼻
为肺之窍。以火烁金而液自流也。目中泪出者。肺热则移于肝。肝之窍在目也。肝属木。木能生
风。故有呵欠也。吐与干呕者。心火流入于胃也。肺与大肠为表里。肺热流于大肠。故眼胞浮肿。
腹痛而泄泻也。腮赤烦躁。心火旺也。喷嚏。肺经火邪也。或手掐眉目唇鼻及面者。肺热证也。
然麻虽胎毒。未有不因时气冒感而发者。故其证与伤寒相似。而身热憎寒头疼体痛也。但治麻者
莫作伤寒施治。当先以肺为主。总宜泻火清金。而泻火当用黄连、黄柏、栀仁、大青、元参、连翘之
类。清金当用黄芩、知母、贝母、麦冬、石膏、天花粉、牛蒡子、地骨皮、桑白皮、杏仁之类。夫麻初
起。既与伤寒相似。而认麻须细看两耳根下颈项连耳之间。以及背脊之下至于腰间。必有三五红
点。此即麻之报标。如无红点以为证佐。则当以别证施治。此屡试屡验者也。若果有红点及现有
前证相符。则是麻候。宜用宣毒发表汤去升麻、桔梗、甘草。或少加苏叶。或少加胡荽。或并去
淡竹叶主之。或用葛根解肌汤去赤芍、甘草。加防风。或更加苏叶、枳壳主之。或用防风败毒散
去桔梗、甘草、石膏、知母。或并去淡竹叶。加前胡、葛根主之。俱以灯心为引与服。以疏风解
肌。托之出外。可以坐享平安。虽有吐泻。亦不必拘泥。麻出而吐泻自止。盖麻属热候。热冲胃则
吐。热冲大肠则泻。此麻之常候。麻出热解。吐泻之证。不治自止。不必更忧吐泻之不止而妄治
也。
朱曰 认麻法凡二十九字。于认麻时注意及之。自无错误。
热冲胃与大肠。有吐泻二证。自是经验之谈。且不治自止。有小儿者。知此可少解忧虑。
宣毒发表汤 治麻发热欲出未出时。各证并宜。凡地方麻疹发作之时。初潮之际。未明是否麻
证。当以此方主之。纵非麻候。即是冒感伤寒。用之无碍。并附加减法于方尾。
薄荷叶（八分） 葛根 防风 荆芥穗 连翘 牛蒡子（炒） 木通 枳壳 淡竹叶（各一钱） 升麻
桔梗 甘草 灯心引。（勿用生姜姜皮） 冬天寒月。可加苏叶。（八分） 又加葱白为引。暑月炎天。可加
生黄芩。一钱总除升麻、甘草、桔梗不用。初潮无咳者。宜用留白陈皮以甚其咳。有咳切勿
再加。初起往来潮热者。除淡竹叶。免解肤热。致麻难透表。在寒月仍宜加苏叶、葱白以疏表
之。初潮潮热太甚者。加赤茯苓、生地黄。并可加生黄芩。不必拘麻初用寒凉毒伏麻不得出
之说。正当用之。以保肺受火克之虞。但春冬寒月。黄芩等分。宜略少耳。初潮无汗。加葱
白以发之。更略加衣被穿盖。以取其汗。使毒透。切不可遽用胡荽酒 之法。免助邪火内攻。
肺金重受其克。药中略加胡荽作引。稍可。初潮不食。不必治之。盖热毒内蕴。自必不食。热
毒一解。自然能食。切勿加进食开胃之药。初潮即见喘促。加黄芩、葶苈、栝蒌仁。以清肺开
胸。或更加姜汁炒白芥子、家苏子、莱菔子以降之。初潮呕吐。加竹茹、柿霜。（如无柿霜。用
柿饼亦可。）初潮呃逆。加枇杷叶、竹茹。初潮鼻衄。加鲜茅根。初潮即现咽喉痛者。加射干。
倍用牛蒡子。初潮即现唇干、齿燥、舌胎枯黄、口渴等候。加麦冬、花粉、黄芩。甚则加黄连、
黄柏、栀仁等味。以预解之。初潮热甚。大便坚实者。加火麻仁二、三钱以润之。用枳实以导
之。免至闭塞。而热毒不得发越。致变紫黑。如便不通者。加生黑白丑牛末以利之。如利之
不通者。必生气喘鼻扇逆证。即用黄连解毒汤加大黄、牛蒡子、连翘、地骨皮、桑白皮以通
之。如兼口渴者。并加麦冬、天花粉。初潮大便溏者。方内之枳壳等分减用。以为开泄之路。
庶可免便闭之患。初潮溏泄而有微汗。除薄荷、竹叶。不可兼用止汗止泄之品。以堵其发越
之门。初潮泄泻者。除枳壳。初潮洞泄者。除枳壳。加猪苓、泽泻、以分利之。不可止泄。以
塞其舒畅之机。初潮小便赤者。除薄荷叶。加赤茯苓。或更加车前子以利之。初潮小便不通
者。合导赤散（方见二十六条）。除甘草。加车前子以通之。初潮溺血者。如生地黄、黄连、黄
柏、黄芩、栀仁。俱可随意加入。更加牡丹皮以去其滞血。免使留而为殃。冬月寒天。无汗
不咳者。量加蜜汁、和酒炒麻黄二、三分。其余诸证。不能备悉。宜因所见之证。加减而用。至
于等分之轻重。须量人之大小。若月内半周婴儿。只宜以杯许与服。当令乳母代服。使药性
流入乳中。儿食母乳。如同服药。
葛根解肌汤 治麻初起。发热咳嗽。或乍冷乍热。已现麻路。并宜初潮未明是否麻证。加减同宣
毒发表汤。并附已现麻路加减于尾。（总除赤芍、甘草不用。）
葛根 前胡 荆芥穗 牛蒡子 连翘（去子） 蝉蜕（各八分） 木通（七分） 赤芍 甘草 灯心引
桑白皮（蜜蒸） 贝母（去心姜汁蒸） 随意加入后药。已现潮热大甚者。加生地黄、地骨皮、赤苓。更可
加黄芩。已现口渴者。加麦冬、天花粉。已现无咳者。不妨少加留白陈皮。已现无汗者。加
葱白。已现气喘。加葶苈、栝蒌霜。喘甚者。加白芥子、苏子、萝卜子。（俱姜汁炒。）已现呕吐
者。加柿霜、竹茹。已现鼻衄者。加茅根。衄甚者。更加黄芩、黄连。（俱生用。）已现大便坚
者。加枳实、火麻仁。已现大便闭者。加丑牛。已现大便闭。用丑牛仍不通者。加生大黄、黄
连、黄芩。已现大便溏者。加赤苓、泽泻。洞泄者。亦如之。已现小便赤涩者。加赤苓、泽泻。已
现小便闭塞不通者。加车前子。并加枳壳。
防风败毒散 加减照前二方酌用。（总除甘、桔二味不用。）
防风 荆芥穗 连翘 牛蒡子 石膏 知母 木通 薄荷 枳壳 淡竹叶 桔硬 甘草 灯心引。
Measles originates from fetal toxin manifesting in the Heart. The Lungs are connected to the Heart, and heat-toxin invades them. Symptoms include coughing, clear nasal discharge, and eyes brimming with tears.
In measles cases, the face must be red. There is yawning, coughing, and thick nasal discharge. Tears flow freely, and sneezing occurs frequently. Do not treat it as Wind-Cold (Shanghan) or other distinct patterns.
During the initial stage of measles, before the rash appears, there will inevitably be fever, aversion to cold, headache, and coughing. There may also be vomiting, dry retching, diarrhea, abdominal pain, nasal congestion, or clear nasal discharge. Other symptoms include sneezing, yawning, swollen eyelids, watery eyes, reddened cheeks, body aches, and restlessness.
Measles is caused by the manifestation of fetal toxin. This "toxin" is essentially Fire. The measles rash is small, red, fragmented, and dense, moving within the skin, belonging to the Hand-Shaoyin Heart Meridian, which governs Ministerial Fire (Jun Huo). The Zang-Fu organs Heart and Lung are connected; the Lung resides superiorly. When Heart Fire flares up, the Lung is affected. Therefore, upon the onset of measles, the Lung suffers the heaviest toxicity. Coughing occurs because Heart Fire flares upward, scorching the Lung tissue. Clear nasal discharge happens because the nose is the orifice of the Lung; fire scorches Metal (Lung), causing fluids to flow out. Tears from the eyes occur because Lung heat transfers to the Liver, whose orifice is the eye. The Liver belongs to Wood, and Wood generates Wind, hence the yawning. Vomiting and dry retching result from Heart Fire flowing into the Stomach. The Lung and Large Intestine are exterior-interior pairs; Lung heat flows into the Large Intestine, causing swollen eyelids, abdominal pain, and diarrhea. Reddened cheeks and restlessness indicate strong Heart Fire. Sneezing indicates Fire pathogenic factors in the Lung Meridian. If the child scratches their eyebrows, eyes, lips, nose, and face, this is a sign of Lung heat.
However, although measles stems from fetal toxin, it invariably erupts after contracting seasonal qi (epidemic climate pathogens). Thus, its symptoms resemble Wind-Cold, including fever, aversion to cold, headache, and body pain. However, those treating measles must not apply Wind-Cold treatment protocols. One should first focus on the Lung, generally employing methods to purge Fire and clear Metal (clear Lung heat). To purge Fire, use herbs such as Huanglian (Coptis Rhizome), Huangbai (Phellodendron Bark), Zhiren (Gardenia Seed), Daqingye (Isatis Leaf), Xuanshen (Scrophularia Root), and Lianqiao (Forsythia Fruit). To clear Metal, use herbs such as Huangqin (Scutellaria Root), Zhimu (Anemarrhena Rhizome), Beimu (Fritillaria Bulb), Maidong (Ophiopogon Tuber), Shigao (Gypsum Fibrosum), Tianhuafen (Trichosanthes Root), Niubangzi (Arctii Fructus), Digupi (Lycium Cortex), Sangbaipi (Morus Root Bark), and Xingren (Prunus Seed).
Although the early stage of measles resembles Wind-Cold, identifying measles requires careful observation of the area below the roots of both ears, the neck connecting to the ears, and the lower back down to the waist. There must appear three to five red spots; these are the herald signs (Biao Biao) of measles. If no red spots are present as evidence, treat according to other distinct patterns. This has been repeatedly verified. If red spots are indeed present and match the aforementioned symptoms, it is a measles pattern. Use Xuan Du Fa Biao Tang (Toxin-Releasing and Exterior-Resolving Decoction), removing Shengma (Cimicifugae Rhizoma), Jiegeng (Platycodon Radix), and Gancao (Glycyrrhizae Radix et Rhizoma). Alternatively, add a small amount of Ziye (Perilla Folium) or Huyi (Coriandri Fructus), or remove Danzhuyeqian (Lophatheri Herba). Or use Gegen Jie Ji Tang (Puerariae Radix Muscle-Relieving Decoction), removing Chishao (Paeoniae Radix Rubra) and Gancao, adding Fangfeng (Saposhnikoviae Radix). Or add Ziye and Zhike (Aurantii Fructus). Or use Fangfeng Bai Du San (Saposhnikoviae Powder for Overcoming Toxicity), removing Jiegeng, Gancao, Shigao, and Zhimu, or removing Danzhuyeqian, adding Qianhu (Peucedani Radix) and Gegen (Puerariae Radix). All these formulas should be taken with Dengxincao (Junci Medulla) as a guiding herb to disperse Wind and relieve the muscle layer, pushing the toxin outward, ensuring peace and safety. Even if vomiting or diarrhea occurs, do not be constrained by them. Once the measles erupts, vomiting and diarrhea will cease naturally. Measles is a Heat pattern; Heat rushing to the Stomach causes vomiting, and Heat rushing to the Large Intestine causes diarrhea. This is a common presentation of measles. Once the measles erupts and heat resolves, vomiting and diarrhea stop without specific treatment. There is no need to worry about persistent vomiting/diarrhea and treat recklessly.
Zhu stated: The method for identifying measles consists of twenty-seven characters. Pay attention to these points when identifying measles, and errors will be avoided.
Heat rushing to the Stomach and Large Intestine causes vomiting and diarrhea. This is indeed empirical knowledge, and these conditions resolve spontaneously. Parents of young children can find relief from anxiety knowing this.
Xuan Du Fa Biao Tang (Toxin-Releasing and Exterior-Resolving Decoction): Treats various patterns during measles fever when the rash is wanting but not yet erupted. It is suitable whenever measles outbreaks occur locally, especially in the initial stage when it is unclear if the condition is measles. Use this formula as the primary treatment. Even if it is not measles but rather contracted Wind-Cold, using this formula is harmless. Additions and subtractions are listed at the end of the formula.
Boheye (Menthae Haplocalycis Herba) (8 fen), Gegen (Puerariae Radix), Fangfeng (Saposhnikoviae Radix), Jingjiesui (Schizonepetae Spica), Lianqiao (Forsythiae Fructus), Niubangzi (Arctii Fructus, stir-fried), Mutong (Akebiae Caulis), Zhike (Aurantii Fructus), Danzhuyeqian (Lophatheri Herba) (1 qian each), Shengma (Cimicifugae Rhizoma), Jiegeng (Platycodon Radix), Gancao (Glycyrrhizae Radix et Rhizoma). Use Dengxincao (Junci Medulla) as a guide. (Do not use Shengjiang [Zingiberis Rhizoma Recens] or Jiangpi [Zingiberis Pericarpium]). In cold winter months, add Ziye (Perillae Folium) (8 fen) and Congbai (Allii Fistulosi Bulbus) as a guide. In hot summer months, add Sheng Huangqin (Scutellariae Radix) 1 qian. Generally, remove Shengma, Gancao, and Jiegeng. If there is no cough in the initial stage, use Liubai Chenpi (Citri Reticulatae Pericarpium retained white pith) to promote coughing; if coughing is already present, do not add more. If there is alternating tidal fever in the initial stage, remove Danzhuyeqian to avoid resolving skin heat, which might hinder the eruption of measles. In cold months, still add Ziye and Congbai to disperse the exterior. If tidal fever is severe in the initial stage, add Chifuling (Poria with Red Host) and Shengdihuang (Rehmanniae Radix), and possibly Sheng Huangqin. Do not adhere to the theory that using cold/cool herbs initially traps the toxin and prevents eruption; they should be used to protect the Lung from being overcome by Fire. However, in spring and winter cold months, reduce the dosage of Huangqin etc. If there is no sweat in the initial stage, add Congbai to induce sweating, and slightly increase clothing/bedding to obtain sweat, allowing the toxin to penetrate. Do not immediately use Huyi wine methods, lest they assist evil fire to attack inward, severely overcoming Lung Metal. Adding a small amount of Huyi as a guide is acceptable. If there is loss of appetite in the initial stage, do not treat it; internal heat-toxin naturally suppresses appetite. Once heat-toxin resolves, appetite returns. Do not add digestive/appetite-stimulating drugs. If wheezing/dyspnea appears in the initial stage, add Huangqin, Tinglizi (Descurainiae Semen seu Lepidii Semen), and Gualouren (Trichosanthis Semen) to clear the Lung and open the chest. Or add Jiangzhi chao Baijiezi (Sinapis Semen), Jiazisu (Perillae Folium), and Laizizi (Raphani Semen) to descend Qi. If vomiting occurs in the initial stage, add Zhuru (Bambusae Caulis in Taenia) and Shishuang (Diospyri Fructus Frost); if Shishuang is unavailable, use Shibing (Diospyri Fructus). If hiccups occur, add Pipaye (Loquat Folium) and Zhuru. If epistaxis occurs, add Xian Maogen (Imperatae Rhizoma). If sore throat appears, add Yeyan (Belamcandae Rhizoma) and double the dose of Niubangzi. If dry lips, dry teeth, withered yellow tongue coating, and thirst appear, add Maidong, Hua Fen (Trichosanthis Radix), and Huangqin. Severe cases add Huanglian, Huangbai, and Zhiren to preemptively resolve. If heat is intense and stool is firm in the initial stage, add Huomaren (Cannabis Semen) 2-3 qian to moisten, and Zhishi (Aurantii Fructus Immaturus) to guide, preventing blockage where heat-toxin cannot vent, leading to purple-black discoloration. If stool is blocked, add Sheng Heibai Chouniu (Morning Glory Seed) powder to purge. If purgation fails, causing wheezing, nasal flaring, and counterflow Qi, use Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity) plus Dahuang (Rhei Radix et Rhizoma), Niubangzi, Lianqiao, Digupi, and Sangbaipi to unblock. If accompanied by thirst, add Maidong and Tianhuafen. If stool is loose in the initial stage, reduce the dosage of Zhike etc. in the formula to allow drainage, avoiding constipation. If loose stool with slight sweating occurs, remove Boheye and Zhuye, and do not use antidiarrheal or antiperspirant agents, to avoid blocking the venting pathway. If diarrhea occurs, remove Zhike. If profuse watery diarrhea occurs, remove Zhike and add Zhuling (Poria) and Zexie (Alismatis Rhizoma) to separate clear and turbid via urination; do not stop diarrhea, to avoid obstructing the free flow mechanism. If urine is red in the initial stage, remove Boheye and add Chifuling. Or add Cheqianzi (Plantaginis Semen) to promote urination. If urinary retention occurs, combine Dao Chi San (Guide Out Redness Powder) (see Article 26), remove Gancao, and add Cheqianzi to unblock. If hematuria occurs, add Shengdihuang, Huanglian, Huangbai, Huangqin, and Zhiren as appropriate. Add Mudanpi (Moutan Cortex) to remove stagnant blood and prevent lingering harm. In winter cold weather, if there is no sweat and no cough, add Mijie (Honey-processed) and Jiuchao Mahuang (Ephedrae Herba stir-fried with wine) 2-3 fen. For other patterns not fully listed, adjust based on observed symptoms. Dosage strength must be weighed against the patient's size. For infants under half a year old, only a cupful should be given; have the nursing mother take it so the medicinal properties enter the milk, and the infant receives the medicine through breastfeeding.
Gegen Jie Ji Tang (Puerariae Radix Muscle-Relieving Decoction): Treats early measles with fever, coughing, or alternating chills and fever, when the measles pathway is already showing. Suitable for initial stages where measles diagnosis is unclear; additions/subtractions follow Xuan Du Fa Biao Tang. Additions for evident measles pathways are listed at the end. (Generally remove Chishao and Gancao.)
Gegen (Puerariae Radix), Qianhu (Peucedani Radix), Jingjiesui (Schizonepetae Spica), Niubangzi (Arctii Fructus), Lianqiao (Forsythiae Fructus, remove seeds), Chantui (Cicadae Periostracum) (8 fen each), Mutong (Akebiae Caulis) (7 fen), Chishao (Paeoniae Radix Rubra), Gancao (Glycyrrhizae Radix et Rhizoma), Dengxincao (Junci Medulla) as guide. Sangbaipi (Morus Root Bark, honey-steamed), Beimu (Fritillaria Bulb, remove heart, steam with ginger juice). Add subsequent herbs as needed: If tidal fever is severe, add Shengdihuang, Digupi, and Chifuling. Can further add Huangqin. If thirst is evident, add Maidong and Tianhuafen. If no cough is evident, add a little Liubai Chenpi. If no sweat is evident, add Congbai. If wheezing is evident, add Tinglizi and Gualou Shuang (Trichosanthis Fruit Pulp). If wheezing is severe, add Baijiezi, Suzi, and Luobozi (all stir-fried with ginger juice). If vomiting is evident, add Shishuang and Zhuru. If epistaxis is evident, add Maogen. If bleeding is severe, add Huangqin and Huanglian (both raw). If stool is hard, add Zhishi and Huomaren. If stool is blocked, add Chouniu. If stool remains blocked after using Chouniu, add Sheng Dahuang, Huanglian, and Huangqin. If stool is loose, add Chifuling and Zexie. Profuse diarrhea is treated similarly. If urine is red and difficult, add Chifuling and Zexie. If urinary obstruction occurs, add Cheqianzi and Zhike.
Fangfeng Bai Du San (Saposhnikoviae Powder for Overcoming Toxicity): Adjustments refer to the previous two formulas. (Generally remove Gancao and Jiegeng.)
Fangfeng (Saposhnikoviae Radix), Jingjiesui (Schizonepetae Spica), Lianqiao (Forsythiae Fructus), Niubangzi (Arctii Fructus), Shigao (Gypsum Fibrosum), Zhimu (Anemarrhena Rhizoma), Mutong (Akebiae Caulis), Bohe (Menthae Haplocalycis Herba), Zhike (Aurantii Fructus), Danzhuyeqian (Lophatheri Herba), Jiegeng (Platycodon Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Dengxincao (Junci Medulla) as guide.