寒热头疼兼背强。遍身痛楚苦难当。更有头项俱肿者。都缘毒火未清降。
麻症本类伤寒。倘或不避风寒。未经清解。邪火内迫。毒攻于里。症生多端。或有伤寒并作。
头疼背强。或头面颈项浮肿。或脉强火盛。大热作渴。或麻收之后。发热而遍身疼痛。种种症候。
在所不免。急宜清火解毒。如寒热并作。头疼背强者。当用表散。以宣毒发表汤（见第五条）去升
麻、桔梗、甘草。略加白芷治之。（有加羌活者。大非所宜。）头面颈项肿者。以宣毒发表汤。（见
第五条）去升麻、白桔梗、甘草。加葶苈主之。脉强火炽。热盛作渴者。则以白虎解毒汤（见二十
六条）主之。如麻出稠密。遍身疼痛烦躁者。以凉血饮子（见四十五条）去赤芍。加连翘、牛蒡子主
之。如麻收后。遍身疼痛者。以古方黄连解毒汤。（见三十五条）加葛根、前胡、白芷、防风治之。
（有加升麻羌活者。亦非所宜。）
朱曰 时医不敢用表散。盖慎之也。惟麻证则必须表散。如项肿遍身痛。以及腹肿腹痛
证。皆毒邪闭塞。证虽凶猛。用清热解毒。佐以表散。无不奏效如神。
腹痛原因毒内攻。首尾治法不相同。清解通利消饮食。更分虚实莫朦胧。
腹痛之症不一。总由火毒内郁。而不能出。或为风寒壅滞遏抑。或因饮食停滞不化。而皆能
致痛。若见于初热正出之间。风寒壅遏。毒反内攻。而腹痛者。急与疏表。麻出透而痛自止。以宣
毒发表汤（见第五条）去升麻、桔梗、甘草、淡竹叶。或葛根解肌汤（见第五条）去赤芍、甘草。加枳
壳。或葛根疏邪汤（见三十三条）治之。若饮食过伤。腹满胀痛者。以枳实导滞化毒汤去山楂、
浓朴、槟榔、甘草治之。（有用平胃散。加神曲、山楂、麦芽、枳壳、木通治之者。治腹痛满固当。而
治麻腹痛亦非所宜。方仍附收。）大便秘者。加丑牛、或大黄以利之。小便赤涩不通者。加猪苓、泽
泻以导之。若于正收及收未尽之时而腹痛者。乃外邪未尽。而复入里所致。宜兼清中外。法当疏
托。佐以清解。使毒复出。而痛自止。以清热透肌汤（见二十五条）加枳壳。木通、黄芩治之。如
麻全敛之后而腹痛者。治宜清凉解毒。佐以风药。兼分利余热。使毒内消、而痛自愈。以化毒清表
汤（见十六条）去知母、花粉、桔梗、甘草。加枳壳治之。又须验其有无他症。分别属虚属实而治。
若邪热内结而腹痛者。以通利大便为主。以河间凉膈散（见二十六条）去甘草治之。如麻后脾气
不调而致腹痛面目四肢浮肿者。以分利小便为主。以导赤散（见二十六条）治之。腹疼而小便不
通者。以导赤散（见二十六条）加芍药治之。若麻症毒重。腹痛烦躁潮热者。以连翘败毒散。去赤
芍、甘草治之。倘腹痛不止。加黄连、麦冬治之。若麻症首尾肚痛者。此皆由毒火内蕴而然。宜先
发散。以防风败毒散（见第五条）去桔梗、甘草治之。后以山楂肉煎汤与服。至若元气大虚。阴阳
不能升降。小水不利。遍身浮肿。喘促兼见者。则难治矣。
枳实导滞化毒汤
枳实 青皮 麦芽 木通 连翘 赤苓 牛蒡子 山楂肉 槟榔 浓朴 甘草 灯心引。水煎服。
连翘败毒散
连翘 防风 牛蒡子 荆芥 木通 赤芍 甘草 水煎服。
平胃散 治胃中宿食不化。藜藿之人宜之。
浓朴（去皮姜汁炒） 苍术（米泔水浸去皮麻油拌炒黄色各四钱） 陈皮（去白） 炙甘草（各
二钱） 姜引。水煎服。
Alternating chills and fever, headache accompanied by stiffness of the neck and back, and unbearable pain throughout the body. If swelling occurs in both the head and neck, it is all due to the failure of toxic fire to clear and descend.
The measles syndrome is originally similar to Shanghan (Cold Damage). If one fails to avoid wind-cold, or if it has not been cleared and resolved, evil fire presses inward, and toxins attack the interior, resulting in a variety of symptoms. Sometimes, Shanghan may occur concurrently.
Headache with stiffness of the neck and back, or swelling of the face, head, and neck; or a strong pulse with excessive fire, high fever, and thirst; or fever and body pain after the measles have receded—all these manifestations are inevitable. At this point, it is urgent to clear heat, purge fire, and detoxify. If chills and fever occur together with headache and neck/back stiffness, a releasing method should be used. Use Xuandu Fabiao Decoction (see Article 5), removing Shengma (Cimicifugae Rhizoma), Jiegeng (Platycodonis Radix), and Gancao (Glycyrrhizae Radix et Rhizoma), and slightly adding Baizhi (Angelicae Dahuricae Radix) for treatment. (Adding Qianghuo (Notopterygii Rhizoma et Radix) is highly inappropriate.) For swelling of the face, head, and neck, use Xuandu Fabiao Decoction (see Article 5), removing Shengma, Baiejiegeng (Platycodonis Radix), and Gancao, and adding Tingli (Descurainiae Semen seu Lepidii Semen) as the main treatment. For a strong pulse, blazing fire, intense heat, and thirst, use Baihu Jiedu Decoction (see Article 26) as the main treatment. If the measles appear dense, accompanied by body pain and irritability, use Liangxue Yinzi (see Article 45), removing Chishao (Paeoniae Radix Rubra), and adding Lianqiao (Forsythiae Fructus) and Niubangzi (Arctii Fructus) as the main treatment. If body pain persists after the measles have receded, use the ancient formula Huanglian Jiedu Decoction (see Article 35), adding Gegen (Puerariae Lobatae Radix), Qianhu (Peucedani Radix), Baizhi, and Fangfeng (Saposhnikoviae Radix) for treatment. (Adding Shengma and Qianghuo is also inappropriate.)
Zhu stated: Contemporary physicians dare not use releasing methods, out of caution. However, for measles syndromes, releasing methods are essential. In cases such as neck swelling with body pain, or abdominal swelling and pain, the cause is blockage by toxic pathogens. Although the syndrome appears fierce, using heat-clearing and detoxifying methods combined with releasing methods yields miraculous results without exception.
Abdominal pain is caused by internal attack of toxins. The treatment methods at the beginning and end of the disease differ. One must clear, resolve, unblock, promote urination, and digest food stagnation, while distinguishing between deficiency and excess to avoid ambiguity.
Symptoms of abdominal pain vary, but generally stem from internal depression of fire-toxins that cannot vent outward, or from obstruction and suppression by wind-cold, or from food stagnation and indigestion, all of which can cause pain. If abdominal pain occurs during the initial fever and eruption phase due to wind-cold obstruction causing toxins to retreat inward, emergency release of the exterior is required. Once the measles erupt thoroughly, the pain will cease spontaneously. This can be treated with Xuandu Fabiao Decoction (see Article 5), removing Shengma, Jiegeng, Gancao, and Danzhuye (Lophatheri Herba); or Gegen Jiexi Decoction (see Article 5), removing Chishao and Gancao, and adding Zhike (Aurantii Fructus Immaturus); or Gegen Shuxie Decoction (see Article 33). If abdominal fullness and distending pain result from dietary overindulgence, use Zhishi Daoli Huadu Decoction, removing Shanzha (Crataegi Fructus), Houpo (Magnoliae Officinalis Cortex), Binglang (Arecae Semen), and Gancao. (Some use Pingwei San, adding Shenqu (Megaspermi Fermentatus), Shanzha, Maiya (Hordei Fructus Germinatus), Zhike, and Mutong (Akebiae Caulis), which is suitable for general abdominal fullness but inappropriate for measles-related abdominal pain; the formula is still appended here.) For constipation, add Qiuniu (Pharbitidis Semen) or Dahuang (Rhei Radix et Rhizoma) to promote bowel movement. For red, scanty, or obstructed urination, add Zhuling (Polyporus) and Zexie (Alismatis Rhizoma) to guide out dampness. If abdominal pain occurs during the proper contraction phase or when contraction is incomplete, it indicates that external pathogens remain and have re-entered the interior. Treatment should simultaneously clear the interior and exterior, employing a dispersing and supporting method assisted by heat-clearing and detoxification to force the toxins out again, thereby stopping the pain. Use Qingre Touji Decoction (see Article 25), adding Zhike, Mutong, and Huangqin (Scutellariae Radix) for treatment. If abdominal pain occurs after the measles have completely receded, treatment should focus on cooling, clearing, and detoxifying, assisted by wind-dispelling herbs, and promoting diuresis to clear residual heat, allowing toxins to dissipate internally and pain to heal spontaneously. Use Huadu Qingbiao Decoction (see Article 16), removing Zhimu (Anemarrhenae Rhizoma), Huafen (Trichosanthis Radix), Jiegeng, and Gancao, and adding Zhike for treatment. One must also examine for other symptoms to distinguish between deficiency and excess patterns. If abdominal pain is caused by internal binding of evil heat, the primary approach is to unblock and promote bowel movements, using Hejian Liangge San (see Article 26), removing Gancao. If abdominal pain and edema of the face, eyes, and limbs result from spleen-qi dysfunction after measles, the primary approach is to promote diuresis, using Daochi San (see Article 26) for treatment. For abdominal pain accompanied by obstructed urination, use Daochi San (see Article 26), adding Shaoyao (Paeoniae Radix Alba) for treatment. If measles toxicity is severe, presenting with abdominal pain, irritability, and tidal fever, use Lianqiao Baidu San, removing Chishao and Gancao for treatment. If abdominal pain persists, add Huanglian (Coptidis Rhizoma) and Maidong (Ophiopogonis Radix). If abdominal pain persists from the beginning to the end of the measles course, it is due to internal accumulation of toxic fire. Initial treatment should involve dispersion using Fangfeng Baidu San (see Article 5), removing Jiegeng and Gancao. Subsequently, administer decoction made from Shanzha Rou (Crataegi Fructus) for drinking. As for cases of significant yuan-qi deficiency, where yin and yang fail to ascend and descend, accompanied by difficult urination, generalized edema, and panting, the condition is difficult to treat.
Zhishi Daoli Huadu Decoction
Ingredients: Zhishi (Aurantii Fructus Immaturus), Qingpi (Citri Reticulatae Pericarpium Viride), Maiya (Hordei Fructus Germinatus), Mutong (Akebiae Caulis), Lianqiao (Forsythiae Fructus), Chiling (Polyporus), Niubangzi (Arctii Fructus), Shanzha Rou (Crataegi Fructus), Binglang (Arecae Semen), Houpo (Magnoliae Officinalis Cortex), Gancao (Glycyrrhizae Radix et Rhizoma). Usage: Use Dengxincao (Junci Medullia) as a guiding herb, decoct in water, and take orally.
Lianqiao Baidu San
Ingredients: Lianqiao (Forsythiae Fructus), Fangfeng (Saposhnikoviae Radix), Niubangzi (Arctii Fructus), Jingjie (Schizonepetae Spica), Mutong (Akebiae Caulis), Chishao (Paeoniae Radix Rubra), Gancao (Glycyrrhizae Radix et Rhizoma). Usage: Decoct in water and take orally.
Pingwei San
Indication: Treats retained food stagnation in the stomach; suitable for individuals consuming coarse grains.
Ingredients: Houpo (Magnoliae Officinalis Cortex) (peeled, stir-fried with ginger juice), Cangzhu (Atractylodis Rhizoma) (soaked in rice wash water, peeled, stir-fried with sesame oil until yellow, each 4 qian), Chenpi (Citri Reticulatae Pericarpium) (remove white pith), Zhi Gancao (Glycyrrhizae Radix et Rhizoma) (each 2 qian). Usage: Use Shengjiang (Zingiberis Rhizoma Recens) as a guiding herb, decoct in water, and take orally.