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Women suffering from smallpox (or measles, here referring to 'Ma' which generally implies severe exanthematous diseases like smallpox or measles in historical contexts, often translated as Smallpox/Measles depending on specific era interpretation, but WHO standard for 麻 is often Measles or Smallpox. Given "麻科活人全书" is a classic text on Smallpox/Measles differentiation, and modern context often leans towards Measles for general 'Ma', but historically distinct. However, strictly following WHO terminology where possible: *Ma* is often mapped to Measles (*Rubeola*) or Smallpox (*Variola*). In this specific text "麻科", it covers both. I will use "Measles/Smallpox" or generic "Exanthematous disease" if ambiguous, but usually *Ma* = Measles in simplified TCM English unless specified as *Da Ma* (Smallpox). Let's stick to **Measles** as the primary translation for *Ma* in many modern TCM contexts, or specify **Smallpox** if the text implies severity. Actually, *Ma Ke Huo Ren Quan Shu* deals with both. I will use **Measles** for simplicity as per common WHO mapping for *Ma*, but note that historically it included Smallpox. To be precise with WHO: *Ma* -> Measles.

Women suffering from measles are the most difficult to treat. The female constitution has always been prone to blood deficiency. When the time comes for the rash to erupt, there is fear that menstruation may be occurring at that very moment.

If fever occurs alongside menstruation outside the normal cycle, it indicates that fire pathogen is forcing blood to circulate rapidly and recklessly. It is imperative to urgently employ methods to cool the blood and stop bleeding; otherwise, waiting until the middle jiao becomes deficient will make regret come too late.

The *Zheng Li Lun* states: Infants and women should benefit from nourishing Yin fluids. Because women possess a Yin constitution, their blood is often insufficient. In cases of measles, if blood is insufficient, various complications may arise. Therefore, for women after the age of fourteen who contract measles, one must often worry that menstruation is occurring normally, leading to blood loss and Qi deficiency, resulting in the internal collapse of the measles eruption. It is appropriate to use Yang Yin Tang (Nourishing Yin Decoction) [see Article 32], removing Bai Shao (Radix Paeoniae Alba), Chuan Xiong (Rhizoma Chuanxiong), and Shu Di Huang (Prepared Radix Rehmanniae), and adding Sheng Di Huang (Raw Radix Rehmanniae) as the principal treatment.

If a woman develops measles during fever and menstruation suddenly begins, yet this is not the normal time for her period, this is due to internal accumulation of toxic heat disturbing the Sea of Blood, forcing blood to flow recklessly, thus causing menstruation to occur irregularly. It is appropriate to use Liang Xue Yin Zi (Cooling Blood Drink) [see Article 45], removing Chi Shao (Radix Paeoniae Rubra) and Mu Tong (Caulis Akebiae); or Liang Xue Di Huang Tang (Cooling Blood Rehmannia Decoction) [see Article 45], removing Gan Cao (Radix Glycyrrhizae); or Yuan Shen Di Huang Tang (Scrophularia and Rehmannia Decoction) [see Article 58], removing Sheng Ma (Rhizoma Cimicifugae), Bai Shao, and Gan Cao. All these formulas should be administered with Jing Jie (Herba Schizonepetae), Lian Qiao (Fructus Forsythiae), and Niu Bang Zi (Fructus Arctii) as principal ingredients. Alternatively, the ancient formula Huang Lian Jie Du Tang (Coptis Decoction for Resolving Toxicity) [see Article 35] can be used, added with Sheng Di Huang, Dang Gui (Radix Angelicae Sinensis), Chao Jing Jie (Stir-fried Herba Schizonepetae), Lian Qiao, and Niu Bang Zi. The general principle is to focus on cooling the blood; optimal results are achieved only after menstruation ceases. If menstruation does not stop despite medication, prolonged duration will lead to deficiency of the middle jiao and weakness of Qi and Blood, causing the measles to become hidden and unable to erupt.

If postpartum women encounter measles, since the fetus has been expelled, there is no need for worry or panic. Relying solely on tonifying and benefiting methods is most effective; do not commit the error of using cold and cooling herbs, which would damage the vitalizing Qi.

When an infant is still in the mother’s womb, the epidemic measles pathogen attacks the body directly. High fever steaming upwards causes fetal expulsion. The treatment method must not be the same as that for postpartum conditions.

Women’s blood is naturally insufficient, and it becomes even more depleted after childbirth. If a woman contracts measles postpartum, she must nourish the blood while slightly incorporating detoxifying agents. Use Si Wu Tang (Four Substances Decoction) [see Article 25] with a small addition of Jing Jie and Niu Bang Zi as the principal treatment. Do not recklessly use cold and cooling herbs, lest they damage the generating Qi. Some practitioners use Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) as the principal treatment, but the Bai Shao and Rou Gui (Cortex Cinnamomi) within the formula require careful consideration. If used, they should all be stir-fried with wine to dispel stasis and generate new blood. Bai Zhu (Rhizoma Atractylodis Macrocephalae) should be replaced by Qian Shi Mi (Seed of Euryale). If a pregnant woman contracts measles and high heat causes fetal expulsion, regardless of whether the measles rash has appeared or not, directly use Si Wu Tang [see Article 25] added with Sheng Pu Huang (Raw Sparganium Pollen), Niu Bang Zi, Huang Lian (Rhizoma Coptidis), Huang Qin (Radix Scutellariae), Lian Qiao, and Chao Jing Jie. This removes old impurities, generates new blood, resolves toxicity, and clears heat, thereby achieving miraculous effects. At this stage, one should not rigidly adhere to postpartum protocols that emphasize merely tonifying Qi and Blood.

Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction)
Ren Shen (Radix Ginseng), Bai Zhu (Rhizoma Atractylodis Macrocephalae), Fu Ling (Poria), Gan Cao (Radix Glycyrrhizae), Chuan Xiong (Rhizoma Chuanxiong), Shu Di Huang (Prepared Radix Rehmanniae), Dang Gui (Radix Angelicae Sinensis), Bai Shao (Radix Paeoniae Alba), Huang Qi (Radix Astragali) (each 1 qian), Rou Gui (Cortex Cinnamomi) (0.3 qian), Sheng Jiang (Rhizoma Zingiberis Recens) (3 slices), Hong Zao (Fructus Jujubae) (1 piece) as a guide. Decoct in water and take orally.