大热经日不退休。将出出尽实可忧。正出之时逢壮热。此为顺候不须愁。
麻本火候。非热不出。故最喜有热。如热势甚者。以白虎汤去炙甘草、粳米。加西河柳、连翘、
牛蒡子、木通、枳壳、葛根主之。然治麻大法。总以解毒为主。若麻初热时。有毒火不退而热甚者。
宜以解毒汤去桔梗主之。若发大热而经日不退。是为壮热。初起发热间即发壮热。直至出时而不
退者。其症必重。以清热透肌肠（见第二十五条）去甘草。加地骨皮、生地黄、黄连、黄芩主之。有
咳甚者。加贝母。大便结滞加火麻仁、枳壳。小便赤涩加赤茯苓、木通治之。或用宣毒发表汤（见
第五条）去升麻、桔梗、甘草。加枯黄芩、生地黄、地骨皮、黄连、栀仁治之。若先热轻。正出现之
时其热方甚者。此为顺候。出尽而壮热不退者。又不宜也。急宜用凉解疏托之剂。以化毒清表汤
（见十六条）去桔梗、甘草。加麦冬、熟石膏治之。大便闭者。加丑牛以通之。小便赤涩者。合导赤
散去甘草。加车前子以利之。或以竹叶石膏汤去人参、半夏、炙甘草、粳米。加荆芥、元参、地骨皮
治之亦可。收后而壮热不退者。更不宜也。急宜凉解为上。以化毒清表汤（见十六条）去甘草、
桔梗。加生地黄、山豆根治之。或以河间凉膈散去炙甘草、芒硝治之。收后而壮热兼大渴者。以白
虎解毒汤加元参、黄柏治之。
白虎汤 清肺金。泻胃火实热。小便赤者宜之。小便白者慎用。
石膏（八钱） 知母（三钱） 炙甘草（二钱） 粳米（半合） 水煎服。
解毒汤 治麻热甚。火毒不退。初出亦宜。
黄连 黄芩 栀仁 木通 桔梗 水煎服。一方有贝母。无桔梗。
导赤散 治心热发搐。及小肠实热、小便赤涩。
生地黄（五钱） 川木通 生甘草梢（各一钱） 淡竹叶（一握） 灯心引。
一方有车前子。溺血者加辰砂（五分）
竹叶石膏汤 治大病后烦热作渴。伤寒解后呕渴少气。
生石膏 淡竹叶 麦冬 人参 半夏 炙甘草 粳米 有渴者去半夏。姜引。水煎服。
河间凉膈散 治瘟疫时行。表里实热。及心火亢盛。目赤便闭。胃热发斑。
大黄（酒浸二两） 芒硝 连翘 黄芩（各一两） 栀仁（八钱） 薄荷（七钱） 炙甘草（六
钱） 淡竹叶十五片。生蜜五匙引。水煎。日三服。夜二服。得下热退为度。一书姜三片、
枣三枚、葱白一根引。易老去大黄、芒硝。加淡竹叶、桔梗。治胸膈与六经之热。以手少阳三焦、
足少阳胆腑、俱在胸膈。同相火游行一身之表。乃至高之分。故用桔梗舟楫之药。浮而上之。以去
胸膈六经之热也。症重者用河间方。轻者用此方。
白虎解毒汤
石膏（四钱） 知母 天花粉 黄连 黄芩 栀仁（各一钱） 麦冬 生地黄（各二钱） 淡竹叶（十片）
水二钟。煎至一钟。去滓。入犀角汁于药内。俟病患要汤水饮时。以此药与之。代茶服。
High fever persists for many days without receding. It is indeed worrying if high fever continues when the rash is about to fully emerge. However, encountering high fever at the time when the rash is just beginning to erupt is a favorable prognosis (Shun Hou), so there is no need to worry.
The measles toxin inherently relies on fire heat (Re Shi) to be vented out; without heat, it cannot emerge. Therefore, the presence of fever is most desirable. If the heat intensity is excessive, treat with Baihu Tang (White Tiger Decoction), removing Zhi Gancao (Honey-fried Licorice Root) and Jingmi (Rice Grain), and adding Xihe Liu (Tamarix Twig), Lianqiao (Forsythia Fruit), Niubangzi (Arctium Fruit), Mutong (Akebia Stem), Zhike (Bitter Orange Fruit), and Gegen (Kudzu Root).
However, the general principle for treating measles always prioritizes detoxification. If during the initial fever stage of measles, toxic fire does not subside and the heat is severe, use Jiedu Tang (Detoxification Decoction), removing Jiegeng (Platycodon Root). If high fever occurs and persists for many days without receding, this is termed Zhuang Re (Intense Fever). If intense fever appears immediately upon the onset of initial fever and does not recede until the rash emerges, the condition must be severe. Treat with Qingre Tou Ji Chang (Clear Heat and Vent Muscle Layer Formula) [see Article 25], removing Gancao (Licorice Root), and adding Digupi (Cortex Lycii Radicis), Sheng Dihuang (Raw Rehmannia Root), Huanglian (Coptis Rhizome), and Huangqin (Scutellaria Root). For severe cough, add Beimu (Fritillaria Bulb). For constipation and stagnation, add Huomaren (Hemp Seed) and Zhike (Bitter Orange Fruit). For red and scanty urine, add Chifuling (Red Poria) and Mutong (Akebia Stem). Alternatively, use Xuandu Fabiao Tang (Vent Toxins and Release Exterior Decoction) [see Article 5], removing Shengma (Cimicifuga Rhizome), Jiegeng (Platycodon Root), and Gancao (Licorice Root), and adding Ku Huangqin (Dried Scutellaria Root), Sheng Dihuang (Raw Rehmannia Root), Digupi (Cortex Lycii Radicis), Huanglian (Coptis Rhizome), and Zhiren (Gardenia Seed).
If the initial fever was mild, but becomes severe precisely when the rash is emerging, this is a favorable prognosis. However, if intense fever persists after the rash has fully emerged, this is unfavorable. Urgently apply cooling, resolving, and supporting formulas. Use Huadu Qingbiao Tang (Transform Toxin and Clear Exterior Decoction) [see Article 16], removing Jiegeng (Platycodon Root) and Gancao (Licorice Root), and adding Maidong (Ophiopogon Tuber) and Shu Shigao (Calcined Gypsum). For fecal impaction, add Niuxi (Achyranthes Root) or Qiuniu (Morning Glory Seed) to promote bowel movement. For red and scanty urine, combine with Daochi San (Guide Out Red Powder), removing Gancao (Licorice Root), and adding Cheqianzi (Plantago Seed) to promote urination. Alternatively, use Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction), removing Renshen (Ginseng Root), Banxia (Pinellia Tuber), Zhi Gancao (Honey-fried Licorice Root), and Jingmi (Rice Grain), and adding Jingjie (Schizonepeta Spike) and Yuan Shen (Scrophularia Root). This is also acceptable.
If intense fever persists after the rash has retracted (Shou Hou), this is even more unfavorable. Urgently prioritize cooling and resolving. Use Huadu Qingbiao Tang (Transform Toxin and Clear Exterior Decoction) [see Article 16], removing Gancao (Licorice Root) and Jiegeng (Platycodon Root), and adding Sheng Dihuang (Raw Rehmannia Root) and Shandougen (Sophora Tonkinensis Root). Alternatively, use Hejian Liangge San (He Jian's Cooling Chest Powder), removing Zhi Gancao (Honey-fried Licorice Root) and Mangxiao (Mirabilite). If intense fever accompanies extreme thirst after retraction, use Baihu Jiedu Tang (White Tiger Detoxification Decoction) with added Yuan Shen (Scrophularia Root) and Huangbai (Phellodendron Bark).
Baihu Tang (White Tiger Decoction): Clears Lung Metal Qi and drains excess heat from the Stomach. Suitable for cases with red urine. Use cautiously in cases with clear urine.
Shigao (Gypsum Fibrosum) (8 qian) Zhimu (Anemarrhena Rhizome) (3 qian) Zhi Gancao (Honey-fried Licorice Root) (2 qian) Jingmi (Rice Grain) (0.5 he) Decoct in water and take orally.
Jiedu Tang (Detoxification Decoction): Treats severe measles fever where toxic fire does not subside. Also suitable for early eruption stages.
Huanglian (Coptis Rhizome) Huangqin (Scutellaria Root) Zhiren (Gardenia Seed) Mutong (Akebia Stem) Jiegeng (Platycodon Root) Decoct in water and take orally. Another prescription includes Beimu (Fritillaria Bulb) and excludes Jiegeng (Platycodon Root).
Daochi San (Guide Out Red Powder): Treats convulsions due to Heart heat, as well as excess heat in the Small Intestine and red, scanty urine.
Sheng Dihuang (Raw Rehmannia Root) (5 qian) Chuan Mutong (Akebia Stem) Sheng Gancao Shao (Tip of Raw Licorice Root) (each 1 qian) Dan Zhuye (Light Bamboo Leaf) (a handful) Use Dengxin Cao (Juncus Effusus Pith) as an guide.
Another prescription includes Cheqianzi (Plantago Seed). For hematuria, add Chen Sha (Cinnabar) (0.5 fen).
Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction): Treats irritability, fever, and thirst after serious illness. Also treats vomiting, thirst, and shortness of qi after the resolution of Shanghan (Cold Damage).
Sheng Shigao (Raw Gypsum) Dan Zhuye (Light Bamboo Leaf) Maidong (Ophiopogon Tuber) Renshen (Ginseng Root) Banxia (Pinellia Tuber) Zhi Gancao (Honey-fried Licorice Root) Jingmi (Rice Grain) Remove Banxia (Pinellia Tuber) if thirst is present. Use Shengjiang (Fresh Ginger) as a guide. Decoct in water and take orally.
Hejian Liangge San (He Jian's Cooling Chest Powder): Treats epidemic plagues, excess heat in both interior and exterior, hyperactivity of Heart fire, red eyes, constipation, and macules due to Stomach heat.
Dahuang (Rhubarb Root and Rhizome) (soaked in wine, 2 liang) Mangxiao (Mirabilite) Lianqiao (Forsythia Fruit) Huangqin (Scutellaria Root) (each 1 liang) Zhiren (Gardenia Seed) (8 qian) Bohe (Mint Herb) (7 qian) Zhi Gancao (Honey-fried Licorice Root) (6 qian) Dan Zhuye (Light Bamboo Leaf) (15 leaves) Use raw honey (5 spoons) as a guide. Decoct in water. Take three times daily and twice at night. Continue until bowel movement occurs and heat subsides. Another text suggests using Shengjiang (Fresh Ginger) (3 slices), Dazao (Jujube Fruit) (3 pieces), and Congbai (Green Onion White) (1 root) as guides. For elderly or frail patients, remove Dahuang (Rhubarb Root and Rhizome) and Mangxiao (Mirabilite), and add Dan Zhuye (Light Bamboo Leaf) and Jiegeng (Platycodon Root). This treats heat in the chest/diaphragm and the Six Meridians. Since the Hand-Shaoyang Sanjiao (Triple Burner) and Foot-Shaoyang Gallbladder are located in the chest/diaphragm region, and together with Ministerial Fire circulate on the exterior of the body, reaching the highest parts, Jiegeng (Platycodon Root), acting as a boat/pilot herb, is used to float upwards to clear heat from the chest/diaphragm and Six Meridians. For severe cases, use the original formula by He Jian. For mild cases, use this modified formula.
Baihu Jiedu Tang (White Tiger Detoxification Decoction)
Shigao (Gypsum Fibrosum) (4 qian) Zhimu (Anemarrhena Rhizome) Tianhuafen (Trichosanthes Root) Huanglian (Coptis Rhizome) Huangqin (Scutellaria Root) Zhiren (Gardenia Seed) (each 1 qian) Maidong (Ophiopogon Tuber) Sheng Dihuang (Raw Rehmannia Root) (each 2 qian) Dan Zhuye (Light Bamboo Leaf) (10 leaves) Use two zhong of water. Decoct until one zhong remains. Strain the dregs. Add Xijiao (Rhinoceros Horn) juice into the decoction. When the patient desires fluids, administer this medicine. Take it as tea substitute.