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If the measles rash fails to erupt after the expected time, it indicates that the toxic pathogen has invaded the Zang-Fu organs. If the pores are closed and the skin is dry, the situation is alarming. It is imperative to ensure the eruption of the measles within a specified timeframe; Mahuang San (Ephedra Powder) is an efficacious formula.

If the measles fails to erupt after the expected time and the condition lingers, the toxic pathogen is blocked internally, making eruption difficult. One must urgently employ strategies to vent the pathogen through the muscle layer without delay or negligence; otherwise, the Zang-Fu organs will suffer from internal torment.

After six or seven days of fever, it is clearly a case of measles, yet the eruption is delayed. This occurs because the couli (pores and interstices) are dense, all pores are closed, and the skin is dry and hard, causing the toxic qi to stagnate internally. Alternatively, the patient may have been attacked by wind-cold pathogens, or previously suffered from vomiting and diarrhea, leading to the latent retention of the pathogen and delayed eruption. In such cases, one should urgently use formulas that support the interior and induce dispersion. Use Mahuang San (Ephedra Powder), removing Shengma (Cimicifugae Rhizoma), and add Hushizi (Coriandri Fructus) to induce dispersion. Alternatively, use Dusheng San (Single Holy Powder) with added Hushizi (Coriandri Fructus), Niubangzi (Arctii Fructus), and Lianqiao (Forsythiae Fructus). During the cold months of spring and winter, additionally add Mahuang (Ephedrae Herba) stir-fried with honey and wine to induce dispersion. For treating measles that desire to erupt but fail to do so, Xiaodu San (Detoxification Powder) with added Mahuang (Ephedrae Herba) and Chuanshanjia (Pangolin Scales) can be used. However, this approach seems too potent. A better alternative is to use Xiaodu San (Detoxification Powder), removing Jiangcan (Bombyx Batryticatus) and Chansu (Toad Venom), and adding Hushu (Coriandrum Sativum), Congbai (Allii Fistulosi Bulbus), Gegen (Puerariae Lobatae Radix), and Chantui (Cicadae Periostracum). During the cold months of spring and winter, additionally add Mahuang (Ephedrae Herba) stir-fried with honey and wine to induce dispersion. Externally, one may apply Huixu Jiu (Coriander Wine) by dipping Zhuma (Ramie Fiber) and rubbing it on the body. If the rash should erupt but does not, and there are no other symptoms, Ge Gen Shu Xie Tang (Kudzu Root Decoction for Dispersing Pathogens) (see Article 33) should be administered. If it still does not erupt, urgently obtain dog feces from a dog facing east, burn it to ash while preserving its properties, mix with water, and administer orally; the rash will then appear. If the rash should erupt but appears unevenly, consume black sesame seeds ground in cold water. If the rash should erupt but fails to do so after the expected time, accompanied by restlessness, confusion, abdominal distension, panting, and cold hands and feet, the condition is incurable. If the patient has not had a bowel movement for some time, this indicates excessive toxicity in the interior with latent retention. Hejian Liang Ge San (Liangge Powder from Liu Wansu) (see Article 26), with Gancao (Glycyrrhizae Radix et Rhizoma) removed and Niubangzi (Arctii Fructus) added, should be used. Alternatively, as a provisional treatment, Qi Wu Shengma Wan (Seven-Ingredient Cimicifuge Pills) can be used to resolve and disperse. If resolution and dispersion fail to produce eruption, it is a fatal sign.

Secret Formula for Mahuang San:
Mahuang (Ephedrae Herba) (Remove roots and joints, filter out all dark juice, stir-fry with sand mixed with wine and honey.) Renzhonghuang (Human Waste Yellow) (Fire-calcine in a tile vessel.) Niubangzi (Arctii Fructus) (Stir-fry.) Chantui (Cicadae Periostracum) (Remove head and feet.) Shengma (Cimicifugae Rhizoma) (Stir-fry with wine.)
Decoct in water and take orally.

Zhu stated: Mahuang (Ephedrae Herba) is a drug for treating excess conditions. Ancient methods required removing joints and pre-decocting to remove foam. Stir-frying with honey and wine are later innovations driven by personal preference and are not worthy of emulation.

Dusheng San, also known as Chengye San:
Xihe Liu (Tamarix Chinensis Twig), also called Guanyin Liu, Chuisi Liu, or Cheng Liu. It has small, weak stems and fine, thread-like leaves. The flower spikes are three to four inches long, water-red in color, resembling Polygonum flowers, and open upon contact with rain. Grind into powder. Decoct Mugen (Imperatae Rhizoma) in water, take three to four qian of the powder with the decoction. Taking with plain water is also acceptable.

Xiaodu San:
Niubangzi (Arctii Fructus) Dilong (Earthworm) (Dry and grind into powder, two qian each.) Jiangcan (Bombyx Batryticatus) Beimu (Fritillariae Bulbus) (Remove heart.) Fangfeng (Saposhnikoviae Radix) Jingjie (Schizonepetae Spica) (One qian each.) Chansu (Toad Venom) (Two qian.) Grind into powder. Take one qian with a decoction of Dan Zhuye (Phyllostachys Viridis Folium).

Qi Wu Shengma Wan:
Whenever one feels intense heat in the four limbs, experiences difficulty in defecation, or has not had a bowel movement for two or three days, take this pill to induce mild diarrhea. If diarrhea does not occur, take another dose. (Gengyi refers to having a bowel movement.)
Shengma (Cimicifugae Rhizoma) Xijiao (Rhinocerotis Cornu) Huangqin (Scutellariae Radix) Poxiao (Natrii Sulfas) Dahuang (Rhei Radix et Rhizoma) (Two liang each.) Danshichu (Fermented Soybean) (Lightly stir-fry, two sheng.) Zhiren (Gardeniae Fructus) (Two liang.) Grind into powder. Make pills with honey, size of Setaria italica seeds. Take five to six fen with warm water.