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The therapeutic methods for treating measles are the most extensive. One must thoroughly investigate whether tonification or purgation is indicated. Incorrectly combining clearing, resolving, tonifying, and astringent methods can kill a patient as quickly as flipping one's hand.

When measles first begin to erupt, patients often suffer from incessant diarrhea. In this stage, the pathogenic heat-toxin is reduced through the discharge of stool, which poses no harm. However, if red and yellow stools appear after the measles have fully erupted, it indicates latent heat within the interior. For such cases, as well as those with severe diarrhea, Jiawei Sanling San (Modified Three-Portulaca Powder) should be administered; recovery typically occurs after a single dose. One must absolutely avoid using tonifying and astringent agents containing Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), He Zi (Terminalia Chebulae Fructus), and Dou Kou (Cardamomi Fructus Rotundus) in an attempt to stop the diarrhea rapidly.

If physicians fail to recognize these contraindications and do not study them carefully, upon seeing diarrhea, they immediately employ astringent treatments, justifying themselves by saying, "I am adding small doses of Ren Shen, Bai Zhu, He Zi, and Dou Kou to my clearing and resolving formulas; what harm could that do?" When no effect is seen after one dose, instead of changing the prescription, they might say, "The dosage of Ren Shen, Bai Zhu, He Zi, and Dou Kou was too light, hence the lack of efficacy." Consequently, they increase the dosages of these herbs and administer them again, leading to complicated measles syndromes. Severe cases may result in abdominal distension, wheezing, and chest fullness that are incurable; milder cases may transform into Xiu Xi Li (Resting Dysentery), characterized by chronic, lingering symptoms.

Furthermore, it is not only inappropriate to combine tonifying and astringent herbs when red-yellow stools appear after the measles have fully erupted, but also when yellow-red diarrhea occurs after the measles have subsided. In such instances, Jiawei Sanling San should still be used. Combining tonifying and astringent herbs is inadvisable; using them exclusively would lead to death even more swiftly than flipping a hand. Practitioners of this art must surely exercise caution.

**Jiawei Sanling San (Modified Three-Portulaca Powder):**
Zhu Ling (Polypori Umbellati Sclerotium), Mu Tong (Akebiae Caulis), Che Qian Zi (Plantaginis Semen), Chi Fu Ling (Poria Cocos with Red Mycelium) (each 0.7 fen); Ze Xie (Alismatis Rhizoma) (0.8 fen); Huang Qin (Scutellariae Radix) (prepared with wine); Niu Bang Zi (Arctii Fructus) (stir-fried and crushed) (each 0.5 fen); Huang Lian (Coptidis Rhizoma) (prepared with wine) (0.2 fen). Decoct with Deng Xin Cao (Junci Medullia, 50 cun) as a guide. Take after meals.

Lifting, clearing, and detoxifying constitute the major principles for treating measles. Their application requires strict adherence to sequence. The order has been established over time and cannot be confused.

While lifting, clearing, and detoxifying are appropriate methods for measles, they must be applied in a specific sequence, not mixed indiscriminately. Why? When measles first present with fever, there is a risk that the rash will fail to penetrate the exterior. Therefore, formulas that lift and release the exterior while releasing the muscle layer should be used to facilitate eruption. After the initial signs appear, but before the rash is fully transparent, methods that release the exterior combined with clearing heat should be employed to cool the blood and open the skin pores, allowing the measles to emerge clearly. Once the measles cover the entire body uniformly, appearing as a continuous red mass with beads-like granularity extending equally to the extremities without gaps, this indicates complete eruption. At this stage, clearing heat and detoxifying formulas should be used, without the need for exterior-releasing drugs; resolution follows quickly.

If cold and cooling detoxifying agents are used prematurely during the initial fever or early eruption phase, Qi stagnation and blood coagulation will occur, causing the skin and muscles to become closed and dense, preventing penetration. This leads to failure of eruption and numerous critical conditions. Therefore, during the initial fever before eruption and during the early eruption phase, only acrid-dispersing herbs such as Jing Jie (Schizonepetae Herba), Ge Gen (Puerariae Lobatae Radix), Bo He (Menthae Haplocalycis Herba), Qian Hu (Peucedani Radix), Niu Bang Zi (Arctii Fructus), Fang Feng (Saposhnikoviae Radix), Su Ye (Perillae Folium), Dan Zhu Ye (Lophatheri Herba), and Shi Gao (Gypsum Fibrosum) should be used. Even Ma Huang (Ephedrae Herba) should be used cautiously according to the syndrome to facilitate penetration. During the receding phase and after recesion, cold and cooling detoxifying herbs such as Yuan Shen (Scrophulariae Radix), Qing Dai (Indicum), Mai Dong (Ophiopogonis Tuber), Huang Bo (Phellodendri Cortex), Gua Lou Gen (Trichosanthis Radix), Huang Lian (Coptidis Rhizoma), Huang Qin (Scutellariae Radix), Lian Qiao (Forsythiae Fructus), Bei Mu (Fritillariae Bulbus), Zhi Mu (Anemarrhenae Rhizoma), Zhi Ren (Gardeniae Semen), Shan Dou Gen (Sophorae Tonkinensis Radix), and Dan Zhu Ye (Lophatheri Herba) should be employed to facilitate the dissipation of heat-toxins, ensuring no future complications.

Mr. Zhu asked: When should exterior-releasing and muscle-releasing formulas be used? When should exterior-releasing and heat-clearing formulas be used? When should heat-clearing and detoxifying formulas be used? The author provides detailed guidance, speaking with earnest care.