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The fetal toxin (inherited pathogenic factors) and wind-heat pathogens contend with each other. At the same time, seasonal pestilential qi (highly contagious external pathogens) spreads. If a person contracts this pathogen, warm maculopapular rashes (a type of exanthematous disease similar to measles but with heat characteristics) will erupt. If the treatment is improper, the condition will manifest in various complicated ways.

"Wen Ma" (Warm Measles) arises from fetal toxin combined with wind-heat infection, compounded by the prevalence of pestilential qi during the season. In both cities and villages, transmission occurs at an exceptionally rapid pace. If the therapeutic approach is incorrect, pathological changes will occur immediately. During the initial fever stage and when the rash is about to emerge but has not yet fully appeared, it is appropriate to use Xuan Du Fa Biao Tang (Dispel Toxin and Release the Exterior Decoction) (see Article 5), removing Shengma (Cimicifugae Rhizoma), Jiegeng (Platycodonis Radix), and Gancao (Glycyrrhizae Radix et Rhizoma) as the principal formula. If the rash has already emerged and is severely red and swollen, use Hua Du Qing Biao Tang (Transform Toxin and Clear the Exterior Decoction), removing Jiegeng (Platycodonis Radix) and Gancao (Glycyrrhizae Radix et Rhizoma) as the principal formula. If the rash emerges completely but residual toxins flow downward causing dysentery-like symptoms, use Qing Re Dao Zhi Tang (Clear Heat and Guide Out Accumulation Decoction) (see Article 72) as the principal formula. These three formulas, when modified appropriately, yield remarkable effects whether for Zheng Ma (Standard Measles) or Wen Ma (Warm Measles). However, once a person has contracted Standard Measles, they will not contract Warm Measles subsequently.

Hua Du Qing Biao Tang (Transform Toxin and Clear the Exterior Decoction): Treats cases where measles have erupted with severe redness and swelling; it is the main formula for manifested measles. Modifications are listed at the end of the prescription. (General rule: Do not use Gancao [Glycyrrhizae Radix et Rhizoma] and Jiegeng [Platycodonis Radix].)

Qianhu (Peucedani Radix), Gange (Puerariae Radix), Zhimu (Anemarrhenae Rhizoma), Lianqiao (Forsythiae Fructus), Jiegeng (Platycodonis Radix) (each 0.7 qian), Niubangzi (Arctii Fructus, stir-fried 0.7 qian), Mutong (Akebiae Caulis) (0.6 qian), Xuanshen (Scrophulariae Radix) (1 qian), Huanglian (Coptidis Rhizoma, wine-fried), Fangfeng (Saposhnikoviae Radix), Zhiren (Gardeniae Fructus, charred black, each 0.3 qian), Bohe (Menthae Haplocalycis Herba), Huangqin (Scutellariae Radix, wine-fried, each 0.5 qian), Tianhuafen (Trichosanthis Radix), Digupi (Lycii Cortex) (each 0.8 qian), Danzhuye (Lophatheri Herba) (1 qian), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma, peeled 0.3 qian). Use Dengxin (Junci Medulla) 50 cun as a guide, adding Sheng Xijiao (Rhinocerotis Cornu, raw) (0.3 qian) is better.

If tidal fever is mild, remove Danzhuye (Lophatheri Herba), Zhiren (Gardeniae Fructus), Huanglian (Coptidis Rhizoma), and Bohe (Menthae Haplocalycis Herba). If tidal fever is severe, add Sheng Dihuang (Rehmanniae Radix), Digupi (Lycii Cortex), Chiling (Poria Cocos with Red Core), Zhike (Aurantii Fructus), Huanglian (Coptidis Rhizoma), and Huangqin (Scutellariae Radix), all used raw. If thirsty, add Maidong (Ophiopogonis Radix) and Shushigao (Calcitum, calcined). If not thirsty, remove Zhimu (Anemarrhenae Rhizoma) and Tianhuafen (Trichosanthis Radix). If stool is dry and difficult, add Chaohuomaren (Hemp Seed, stir-fried) and Zhike (Aurantii Fructus). If constipated, add Zhike (Aurantii Fructus), Chaobaishouli (White Morning Glory Seed, stir-fried), and Chaheishouli (Black Morning Glory Seed, stir-fried). If no bowel movement after two to three days, add Dahuang (Rhei Radix et Rhizoma). If urine is red and scanty/painful, add Mutong (Akebiae Caulis) and Zexie (Alismatis Rhizoma) in equal proportions. If urination is obstructed, add Cheqianzi (Plantaginis Semen). If there is no cough, add Liubai Chenpi (Tangerine Peel with white pith retained). If there is no sweating, add Congbai (Allii Fistulosi Bulbus). If the rash color is purple, add Zicaorong (Arnebiae Radix et Rhizoma) and Honghua (Carthami Flos). If the rash color is bright red, add Mudanpi (Moutan Cortex) and Dangguiwei (Angelicae Sinensis Radix tip). If mixed with red-purple spots, add Zicaorong (Arnebiae Radix et Rhizoma) and Mudanpi (Moutan Cortex). If high heat persists without abating, remove Fangfeng (Saposhnikoviae Radix) and Bohe (Menthae Haplocalycis Herba), add Sheng Dihuang (Rehmanniae Radix) and Chuanbeimu (Fritillariae Cirrhosae Bulbus). If throat pain occurs, add Shegan (Belamcandae Rhizoma), Shandougen (Sophorae Tonkinensis Radix), and Maidong (Ophiopogonis Radix). If delirium occurs, add Sheng Dihuang (Rehmanniae Radix) and Mutong (Akebiae Caulis). If wheezing with phlegm occurs, add Gualou (Trichosanthis Fructus) and Tinglizi (Descurainiae Semen seu Lepidii Semen), while removing Tianhuafen (Trichosanthis Radix), Danzhuye (Lophatheri Herba), and Bohe (Menthae Haplocalycis Herba). If shortness of breath occurs, add Su Zi (Perillae Fructus) and Laifuzi (Radish Seed), while removing Tianhuafen (Trichosanthis Radix), Danzhuye (Lophatheri Herba), and Bohe (Menthae Haplocalycis Herba). If hiccups occur, add Zhuru (Bambusae Caulis in Taenia), Shishuang (Diospyri Fructus Frost), and Pipaye (Loquat Leaf); this is also suitable for vomiting.