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During the course of measles, one must avoid exposure to wind and cold. Failure to do so results in dry and rough skin. The couli (pores and interstitial spaces) become closed and dense, making it difficult for the measles toxin to erupt. Consequently, thousands of critical syndromes may arise.

Wind and cold pathogens originate from external invasion. Throughout the entire course of measles, from onset to resolution, it is most appropriate to promptly avoid wind and cold. If one is not careful and neglects these precautions, once exposed to wind and cold, it will cause the skin and muscles to become dry and the couli to close tightly. This prevents the measles toxin from dispersing and erupting, making it difficult for the rash to appear. During the initial fever stage, if precautions are taken, the measles will erupt easily, and the toxin will resolve, leaving no aftereffects. However, during the critical phase of eruption, if precautions are neglected, the measles may be triggered by wind and cold, causing the rash to retract after appearing. This leads to the accumulation of toxins internally without resolution, resulting in complicated syndromes. After the measles have subsided, strict avoidance is essential. Neglecting this leaves residual toxins that are difficult to eliminate, leading to endless complications. Mild cases may result in prolonged illness with lifelong cough and phlegm disorders; severe cases inevitably progress to critical conditions that are difficult to save. Therefore, after the measles have subsided, one must wait until fourteen days later, when the fever has receded, the body is cool, there is no phlegm or cough, appetite is normal, and spirit has recovered, before relaxation of precautions is permissible. Exercise utmost caution.

Measles belongs to fire; the pathological heat causes irritability and thirst. Patients often desire cold foods. However, consumption must be prohibited during the initial fever stage before eruption. Indulging in raw and cold foods causes the pores to close tightly.

While the use of cold-natured herbs is suitable for treating measles, one must carefully assess the timing and pathogenesis. Sudden use of major cold herbs in the early stage hinders the eruption of measles. The fault for internal attack by toxins lies with the physician.

Measles inherently involves fire pathology. From the onset of fever until full eruption, symptoms such as thirst and irritability are inevitable, leading patients to prefer cold foods. Although measles pathology is fire-related, suggesting cold food might seem harmless, raw and cold foods should be contraindicated throughout the entire course of measles. Why? Because the primary goal in measles treatment is to promote eruption through the exterior. Warm dietary intake is appropriate to facilitate this process. If raw and cold foods are consumed during the initial fever stage before eruption, they act like ice subduing fire, closing the pores and preventing the toxic heat from erupting. Even after eruption, raw and cold foods remain contraindicated. Only dried persimmon, autumn white pear, lotus root, and water chestnut may be used sparingly. Peaches, plums, plums (ume), citrus fruits, pomegranates, and water caltrops are strictly forbidden. Moreover, it is not only the patient who must avoid raw and cold foods; physicians must also refrain from suddenly using cold-natured drugs. In the initial febrile stage of measles, cold-natured substances are most contraindicated because they risk freezing the measles toxin, causing qi and toxins to stagnate and fail to erupt, leading to internal attack. Ancients stated that in hot weather, pungent-cool flavors should be used, such as Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity). However, they failed to realize that atmospheric heat cannot be resolved merely by cold medicines. Today, sudden use of cold medicines may fail to resolve external heat and instead obstruct internal heat, preventing its release. I once treated a one-year-old child with measles who developed convulsions during fever but before the appearance of spots. The physician misdiagnosed this as acute convulsion syndrome and administered cold-natured drugs to purge heat. This caused the measles toxin to remain hidden within the skin, unable to reach the exterior. A subsequent physician attempted to treat with yin-nourishing formulas, such as Siwu Tang (Four Substance Decoction), without success. The child died several days later due to irritability and hoarseness. This illustrates the harm of suddenly using cold substances to freeze the measles toxin. Today, some rigidly adhere to seasonal theories and suddenly use cold medicines due to hot weather; this is illogical. Therefore, when treating measles at the initial eruption stage, even if symptoms such as fever and irritability/thirst are present, Xian Du Fa Biao Tang (Toxin-Releasing Exterior-Dispersing Decoction) should be used, removing Gancao (Licorice Root), Jiegeng (Platycodon Root), and Shengma (Cimicifuga Rhizome), and adding a small amount (3-5 fen) of wine-fried Huangqin (Scutellaria Root) to clear heat. One must absolutely avoid immediately administering Huanglian (Coptis Rhizome), Huangbai (Phellodendron Bark), or Zhiren (Gardenia Seed), lest they freeze the toxin internally and prevent outward eruption. Later attempts to disperse the exterior would fail, and the measles would never erupt. How can one not fear this?

Zhu stated: The previous section on avoiding wind and cold and this section on avoiding raw and cold foods are errors most easily committed by patients' families. Complicated syndromes arising midway are often caused by these mistakes. Therefore, regarding these two sections, physicians must repeatedly admonish the patients' families.