Library

The measles rash emerges tall and moist, with distinct spots. At this time, if clearing and resolving methods are applied heavily again, the Lung will be free from danger. The pathogenic factor gradually recedes from the exterior to the interior; when no scar marks remain on the skin, it is called "Lian" (resolution/absorption).

If the measles rash resolves immediately after one day of emergence, it is either due to exposure to wind-cold or concurrent heat pathogens. Ingestion of sour foods can also cause this condition. The etiological sources of these three situations are distinguishable.

When the rash emerges and quickly resolves, the disease condition is mild; when it lingers continuously and fails to resolve, the pathological trend is alarming. One should employ Huaban Jiedu Tang (Spot-Transforming Detoxification Decoction) to eliminate the pathogen, preventing residual evil from accumulating in the body.

The emergence and resolution of measles conform to Yin-Yang laws: emergence requires gentleness, while resolution requires coolness. Continuous emergence without resolution indicates excessive Yang Qi; intermittent and delayed emergence indicates strong Yin.

The emergence and resolution of measles are typically measured by the twelve two-hour periods (Shichen). For instance, if emerging after Zi hour, it resolves at Wu hour; if emerging in the afternoon, it resolves at Zi hour. This is the natural number of creation where Yang generates and Yin grows, Yin generates and Yang completes. Cases of such rapid emergence and resolution belong to "Yi Shou" (Easy Resolution), with mild symptoms. However, for measles to be easily resolved, certain prerequisites must be met first: the rash spots must stand high, with granular tips that are pale red and moist. This is because the toxin is light and superficial, making the muscle layer easy to clear, and the Lungs do not suffer aggravated coughing, thus facilitating easy resolution. Another scenario exists where, although the Fire-Toxin is heavy, repeated application of clearing and resolving methods causes the Fire-Evil in the Lungs and Stomach to retreat completely, leading to easy resolution. However, this must occur within three days, gradually receding from the muscle layer to the interior, or completely resolving within three days, leaving no trace or shadow of sores on the skin. Only then is it considered Easy Resolution. The practitioner must examine carefully.

If the measles resolves after only one day of emergence, it is due to premature exposure to wind, struck by wind-cold. The measles toxin attacks inwardly and has not cleared smoothly; this is not Easy Resolution. Urgent treatment is required. If not treated early, it will inevitably lead to rotting of the Stomach and death. Ge Gen Shu Xie Tang (Kudzu Root Decoction for Dispersing Evil) (see Article 33) should be used as the primary formula. Even if it does not re-emerge, there will be no sequelae. Even if the measles has clearly resolved after three days, if there is an attack by wind-cold, this formula is still appropriate. "Zao Shou" (Early Resolution) differs from "Yi Shou". Zao Shou refers to the measles resolving completely before three days have passed, or within one to two days, or even half a day. In cases of Zao Shou, the warm areas of the body's skin show absolutely no red shadows. This ultimately transforms into a critical condition. If, although resolving early before three days, the warm areas of the skin have not fully resolved, and the toxin is incomplete but attacking inwardly, urgent detoxification, muscle-releasing, and surface-penetrating measures are needed to save the patient. Jiedu Kuaiban Tang (Detoxifying Rapid Spot-Transforming Decoction) should be used, removing Hawthorn Flesh (Zha Rou), Raw Licorice (Sheng Gan Cao), Chuanxiong (Chuanxiong Rhizome), Platycodon (Jie Geng), and Arnebia (Zicao Rong), and adding Gypsum (Shi Gao), Anemarrhena (Zhi Mu), and Scrophularia (Yuan Shen).

If the eruption fails to rise, one must investigate the cause and combine it with internal resolution methods. Why? There are three causes for Early Resolution. The first cause occurs when the rash is emerging but not yet penetrating, and wind-cold is contracted. The measles is constrained by wind-cold, causing the evil to counter-attack inwardly, resulting in early resolution. Ge Gen Shu Xie Tang (see Article 33) with Scallion White (Cong Bai) should be given hot. Alternatively, Xiaodu Yin (Detoxification Drink) (see Article 22) without Licorice, plus Scallion White and Kudzu Root, should be given hot. If the rash penetrates after administration, it is auspicious. If not, Xiaodu Yin (see Article 22) without Licorice, plus Ephedra (Ma Huang) fried with wine and honey, should be used. Some add Pangolin Scales (Chuanshanjia); the dosage should be adjusted accordingly. Failure to treat urgently will lead to wheezing and distension death. Another presentation involves generalized cyanosis, hot swelling, wheezing, and shortness of breath, indicating stagnant toxin and coagulated blood, half-hidden in the muscle layer. Hejian Liangge San (He Jian's Cooling Pagoda Powder) (see Article 26) should be used urgently, removing Rhubarb (Da Huang), Mirabilite (Mang Xiao), and Licorice, adding Scrophularia, Arnebia, Morning Glory Seed (Qiuniu), Ephedra fried with honey, and Gypsum to disperse and vent. If abdominal distension, panting, clear urination, and umbilical protrusion occur, use Hejian Liangge San (see Article 26) removing Rhubarb and Mirabilite, adding Morning Glory Seed, Lepidium Fruit (Tingli), and Mustard Seed (Jiezi) to treat. This may save one or two patients. The second cause is internal accumulation of Phlegm-Heat, where Fire-Toxin is severe and latent, causing restlessness, abdominal distension, panting, and unconsciousness. Baihu Jiedu Tang (White Tiger Detoxification Decoction) (see Article 26) should be used, removing Trichosanthes Root (Tianhuafen) and Bamboo Leaf (Danzhuye), adding Scrophularia, Butterfly Bush Seed (Niubangzi), Forsythia (Lianqiao), and Trichosanthes Peel (Gualou Shuang). The third cause is ingestion of sour/astringent substances like vinegar, causing Lung obstruction, closed pores, and latent toxin, presenting with high fever, panting, cough, and stifling sensation. Decoct Licorice in Pig Bile water and administer slowly. Or decoct bitter bottle gourd (Ku Hu) with Raw Licorice into a thick soup for gastric lavage to induce vomiting. Vomiting contains the meaning of venting the toxin. However, dispersing and supporting is still necessary; use Xiaodu Yin (see Article 22) without Licorice. If pork was ingested mistakenly, causing panting and shortness of breath, use Xiaodu Yin (see Article 22) without Licorice, adding Citrus Aurantium (Zhike), Morning Glory Seed, and Hawthorn Flesh to purge stagnation. Some use Zhike Tang removing Magnolia Bark (Houpo) and Licorice, adding Medicated Leaven (Shenqu) and Malt (Maiya), but this is indeed ineffective. If raw fruits like plums and peaches were ingested, causing panting, cough, and hoarseness, use Xiaodu Yin (see Article 22) adding Akebia (Mutong), Citrus Aurantium, Gypsum, and Aristolochia (Madou Ling), removing Raw Licorice. If heat subsides, the body feels comfortable, and breathing regulates, there is no cause for worry.

There are also cases where measles emerge after severe or chronic illness, where Middle Qi is depleted, preventing toxin venting and causing early resolution. Or cases where diarrhea persists long during the initial fever stage, or severe diarrhea occurred before fever onset, damaging Middle Qi, causing measles to resolve immediately after full emergence. In these cases, although dispersing and supporting herbs are used, the toxin is difficult to fully vent. One must strengthen and transport Middle Qi, slightly combining exterior-dispersing and heat-clearing agents. Xiangsha Liujun Tang (Fragrant and Amomum Six Gentlemen Decoction) without Pinellia, using small doses of equal parts Atractylodes Macrocephala (Baizhu), Aucklandia (Muxiang), and Amomum (Sharen), added with Ophiopogon (Maidong), Forsythia, Butterfly Bush Seed, Coptis (Huanglian) fried with wine, Scutellaria (Huangqin) fried with wine, Schizonepeta (Jingjie), Saposhnikovia (Fangfeng), and Kudzu Root can be applied. (My opinion suggests replacing Ginseng with Glehnia (Shashen), Atractylodes with Coix Seed (Yiyiren), removing Aucklandia and Amomum, and adding Fritillaria (Beimu).) Merely adjusting the gateways, one should immediately continue using detoxifying agents like Xiaodu Yin (see Article 22). Do not delay, lest Lung and Stomach decay become incurable.

If measles emerge and then retract (some use Danggui Honghua Yin plus Scallion White, Butterfly Bush Seed, Forsythia, Kudzu Root; this is highly inappropriate, recorded here to show error), or emerge incompletely with palpitations and incessant crying, it is extremely critical, with death imminent. Or if accompanied by dysentery and abdominal pain (some use Scutellaria and Paeonia Lactiflora; this is inappropriate), use Jiedu Kuaiban Tang removing Platycodon, Licorice, Hawthorn Flesh, Arnebia, and Chuanxiong, adding Citrus Aurantium and Red Poria (Chi Fuling), modified according to symptoms. Generally, if measles appear to gradually resolve after the third or fourth day, it is a favorable sign. However, resolution can only occur when the muscle layer becomes cool. If measles fail to resolve after three to four days, or five to seven days, the skin will surely be hot, indicating a Difficult Resolution syndrome. Use muscle-releasing and blood-cooling agents assisted by diuretics. Liangxue Yinzi (Blood-Cooling Infusion) (see Article 45) without Red Peony Root (Chishao), adding Akebia, Red Poria, Citrus Aurantium, and Kudzu Root should be used. If lingering unresolved for four to five days, this indicates extreme Yang-Toxin. Huaban Jiedu Tang should be used, removing Cimicifuga (Shengma) and Rhubarb, adding Scutellaria, Scrophularia, Rehmannia (Shengdihuang), and Groundsel Root (Digupi) to resolve. If constipation with abdominal pain occurs, use Rhubarb to purge. Or use Mimben Daqing Tang (Secret Big Blue Decoction) (see Article 40) removing Cimicifuga and Platycodon, adding Scutellaria, Groundsel Root, Scrophularia, and Rehmannia to resolve. If constipation and abdominal pain persist, add Morning Glory Seed to purge. Resolve the toxin so it vents outward, ensuring no residual evil remains internally, avoiding sequelae. If, after resolution, the rash still hesitates to emerge, it is due to external wind-cold binding and closed skin. Ge Gen Shu Xie Tang (see Article 33) plus Mint (Bohe) and Groundsel Root should be used. If the measles spots have a white, dry color, faintly visible between the muscles, appearing to resolve but actually not, this is likely due to wind-cold hindering penetration, not Difficult Resolution. Urgently use dispersing and supporting agents assisted by cooling herbs. Ge Gen Jieji Tang (Kudzu Root Muscle-Releasing Decoction) (see Article 5) without Red Peony Root and Licorice, adding Saposhnikovia and Scutellaria should be used. If no spots are seen on the skin, only flat patches, it is Easy Resolution that is incomplete. Use muscle-releasing herbs, specifically Ge Gen Jieji Tang (see Article 5) without Red Peony Root and Licorice, modified according to symptoms. If internal heat signs are present, clear the internal heat. If internal heat is not removed, complete resolution is often hindered. Shengdi Gupi Tang (Rehmannia and Groundsel Root Decoction) (see Article 30) without Licorice, the ancient Fang Huang Lian Jiedu Tang (Coptis Detoxification Decoction) (see Article 35), and Jiawei Daochi San (Modified Guiding Outward Red Powder) are all selectable options, applied with modifications.

Mr. Zhang Lu stated: The water and soil in the Northwest are rigid, and people's constitution is dense; measles take five to seven days to resolve. The wind and qi in the Southeast are soft; measles resolve in two to three days. Recently, geographical changes have occurred; regardless of North/South, constitutions are weak, and none resolve without lingering for a long time. These do not fall under Difficult Resolution. If after three to four days, measles spots are dry and white, faintly visible in the skin and difficult to resolve, this is due to inherent weakness of Wei Qi (Defensive Qi) failing to lift, or thin clothing causing wind-cold exposure, blocking the venting mechanism, leading to prolonged duration. The method should use acrid-dispersing and surface-penetrating agents like Schizonepeta, Kudzu Root, Peucedanum (Qianhu), Butterfly Bush Seed, Tamarix (Xihe Liu), and Ephedra to disperse them; Bamboo Leaf, Scrophularia, Mint, and Cicada Slough to penetrate the muscle. Cold and cool herbs must never be used hastily to close the opening and venting pathways. This instruction can serve as the great principle for treating measles for generations.

Zhu said: I treat measles requiring six to seven days to resolve, never three days. Reading Mr. Zhang Shiwen's instruction, I suddenly understand.

Jiedu Kuaiban Tang (Detoxifying Rapid Spot-Transforming Decoction): Suitable for measles showing form for one to two days.
Lianqiao (Forsythia Fructus), Niubangzi (Arctii Fructus), Fangfeng (Saposhnikoviae Radix), Jingjie Sui (Schizonepetae Spica), Danggui Wei (Angelicae Sinensis Radix caudex), Jiegeng (Platycodonis Radix) (each 7 fen); Shengdihuang (Rehmanniae Radix), Zha Rou (Crataegi Fructus) (each 8 fen); Chantui (Cicadae Periostracum, remove head and feet, 7 pieces); Huangqin (Scutellariae Radix), Zicao Rong (Arnebiae Radix) (each 6 fen); Qian Ge (Puerariae Lobatae Radix) (1 qian); Xihe Liu (Tamaricis Cacumen) (5 fen); Chuanxiong (Ligustici Chuanxiong Rhizoma) (5 fen); Sheng Gancao (Glycyrrhizae Radix et Rhizoma, peeled, 3 fen). Decoct in water, mix with Rhinoceros Horn (Xijiao) ground juice for administration.

Zhike Tang (Citrus Aurantium Decoction):
Houpo (Magnoliae Officinalis Cortex, peeled, stir-fried with ginger juice), Chenpi (Citri Reticulatae Pericarpium, soaked in ginger water, pith removed, each 3 qian), Zhike (Aurantii Fructus, bran-fried, 4 qian), Zhi Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, 3 qian). Decoct in water and take.

Xiangsha Liujun Tang (Fragrant and Amomum Six Gentlemen Decoction): Treats Qi deficiency with Phlegm stagnation, Food stagnation, Qi stagnation, etc.
Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Baifuling (Poria), Zhi Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma), Muxiang (Aucklandiae Radix), Sharen (Amomi Fructus), Hongzao (Jujubae Fructus), Ginger as guide.

Danggui Honghua Yin (Angelica and Safflower Infusion): Treats measles that emerge and then retract. (Backup formula)
Danggui (Angelicae Sinensis Radix, wine-fried), Honghua (Carthami Flos), Ge Gen (Puerariae Lobatae Radix), Lianqiao (Forsythiae Fructus), Niubangzi (Arctii Fructus), Gancao (Glycyrrhizae Radix et Rhizoma). Decoct in water and take. One book lists Shengma (Cimicifugae Rhizoma); another lists Sheng Baishao (Paeoniae Radix Alba) and Jiegeng (Platycodonis Radix).

Huaban Jiedu Tang (Spot-Transforming Detoxification Decoction):
Yuan Shen (Scrophulariae Radix), Zhi Mu (Anemarrhenae Rhizoma), Shi Gao (Gypsum Fibrosum), Niubangzi (Arctii Fructus), Lianqiao (Forsythiae Fructus), Dahuang (Rhei Radix et Rhizoma, wine-steamed), Renzhonghuang (Human Manure Ash, fire-treated, separately ground), Danzhuye (Phyllostachydis Folium), Shengma (Cimicifugae Rhizoma). Decoct in water, mix with Renzhonghuang for administration.

Jiawei Daochi San (Modified Guiding Outward Red Powder):
Bohe Ye (Menthae Haplocalycis Herba) (4 fen), Shengdihuang (Rehmanniae Radix, wine-rinsed), Mutong (Akebiae Caulis), Yuan Shen (Scrophulariae Radix), Cheqianzi (Plantaginis Semen, fried and ground), Danzhuye (Phyllostachydis Folium) (each 7 fen), Lianqiao (Forsythiae Fructus) (6 fen), Huanglian (Coptidis Rhizoma) (2 fen). Jixin (Centaurii Herba) and Shi Gao (Gypsum Fibrosum) as guides.