痧疹俗呼麻子。盖因火热熏蒸。遍身红点朱砂形。发自心脾二经。最忌黑斑死证。极宜赤似
朱纹。大抵治法喜凉清。不可辛甘犯禁。
麻子如何辨认。分明证似伤寒。此多咳嗽有红斑。喷嚏眼中水现。或见腹中疼痛。或者吐泻
相兼。疹家吐泻不须煎。正要毒除热散。
麻与痘疮异治。二家不可同方。痘宜温解疹清凉。又要现形为上。若受风寒不出。其间凶险
难当。急宜发散保平康。切忌神昏腹胀。
麻证因何咳嗽。只因肺与心通。肺金被火苦熬煎。以致咳嗽气喘。治当清金降火。不宜误用
辛甘。譬如包子蒸笼然。只要气松火暖。
凡遇麻子出现。详看天令如何。假如叶暖又风和。荆防败毒差可。若是时行疫疠。芩连消毒
宜多。用心调理救沉 。莫学观天井坐。
且说荆防败毒散。此为发散仙方。防风荆芥生地黄。酒炒黄芩黄连二样。赤苓干葛灯草。连
翘枳壳牛蒡子。元参杏仁实为良。淡竹叶水煎停当。
又有芩连消毒饮。清金散火尤佳。黄芩黄连防风及栀仁黄柏。枳壳骨皮共把。石膏干葛知
母。连翘牛蒡子天花粉。引用淡竹叶要多加。只个方儿值价。
若是发散不出。令人真个忧疑。麻黄酒蜜炒如煤。栀仁 黄柏 黄芩 黄连一例
。更加大黄酒炒。连翘牛蒡子相随。石膏蝉蜕红花子。不效命离尘世。
如见出时紫黑。这般证候多凶。急求人粪路旁东。火 存性取用。细研酒调吞服。须臾紫黑
变红。若还依旧黑朦胧。管取黄粱一梦。
麻子现形发热。寻常只用化斑汤。石膏栀仁及元参。枳壳连翘牛蒡子灵验。若是毒多热甚。
芩连消毒为先。大便秘结丑牛添。务使微溏数遍。
麻证频多咽痛。火邪熏灼无他。连翘豆根要多加。射干牛蒡子煎罢。外用十宣妙散（见八十
八条）。吹喉休要吁嗟。假如见效莫争差。芩连消毒饮堪夸。
咳嗽声声气促。只消降火清金。黄芩栀子赤茯苓。葶苈石膏一定。知母贝母元参地骨皮。栝
蒌仁麦冬杏仁。连翘牛蒡子妙如神。淡竹叶将来作引（一书有黄连）。
麻证若兼泻痢。预先用药调医。泻时须用三苓散（见三十七条）宜。加上车前子滑石。如见痢
兼赤白。加减黄芩汤（见七十二条）相随。大都痢止便为奇。不效令人疑忌。
麻后须防四证。不治常致误人。遍身余热欠清宁（证一）。咳嗽连声牵引（证二）。牙齿疳生走
马（证三）。痢下赤白难禁（证四）。各求方法细论评。才是麻科医圣。
问甚身间壮热。只因余毒留连。金华丸子是灵丹。栀仁黄芩黄连龙胆草。郁金雄黄解毒。灯
芯地骨皮汤吞。若还脾弱热绵延。集圣丸胃芩渴任选。
集圣丸当归川芎。芦荟五灵脂夜明砂。砂仁青皮莪术加。黄连酒炙虾蟆（即蛤蜊）。猪胆粟米
粉糊丸。清晨米饮吞下。治疳肥儿功最大。这个丸儿堪夸。
平胃散五苓散相合。方儿名曰胃苓汤。苍术茯苓肉桂与猪苓。陈皮浓朴泽泻分明。白术须宜
生用。去肉桂甘草煎成。浮肿泄泻食积停。人口效应如神。
咳嗽频频不止。为因不禁酸咸。又加火毒肺家炎。尤恐胸高气喘。体实却用葶苈丸。神虚清
肺神丹。如斯调理保平安。莫向风波弄险。
葶苈丸除肺热。杏仁葶苈防己。牵牛莱菔子相随。红枣肉捣成为剂。清肺神丹降气。盐水煮
焙陈皮。黄芩黄连栀仁黄柏杏仁泥。苏子稀糊丸易。
口齿生疮臭烂。此名走马牙疳。金华丸子内求安。外用除疳妙散。先取桶中尿白。火缎白色
如盐。五倍子铜绿蜕壳蚕（即蚕蜕纸）。再加硼砂冰片。
赤痢下成鲜血。黄连柏叶槐花。枳壳荆芥穗同加。痢止血除才罢。白痢茱萸滑石。樗根枳壳
升麻。乌梅取肉作丸佳。赤白香连丸可下。
香连丸又名香橘。五钱木香陈皮。石莲子取肉半数宜（等分用止一半）。一两黄连另制。外将
茱萸五钱。同黄连炒而用之。炒后去茱萸勿同施。神曲糊丸吞饵。
痘后麻疹即现。治法从未讲究。专用清肺是妙手。发散与补俱谬。药用黄芩桑白皮。贝母牛
蒡子同俦。更宜倍入西河柳。特为后学指授。
麻后如变疟疾。清凉健脾为佳。麦冬薏苡仁粉干葛。白茯苓陈皮鳖甲。柴胡白芍淡竹叶。知
母贝母山楂。渴甚再把石膏加。不渴知母并罢。
更防四种死证。临时休得殊差。毒多体热瘦如麻（证一）。咳嗽面青声哑（证二）。走马（牙疳）
唇齿肉落（证三）。痢疾噤口吁嗟（证四）。这般即是死冤家。不可骑牛觅马。
妇人出麻时候。天癸正当临期。血走气虚难支持。伏陷恐成在斯。药忌辛酸升发。养阴汤（见
三十二条）加减最宜。用心调理莫待迟。临危法无可施。
妇人麻初发热。经行非期何因。毒火内迫血离经。元参地黄汤进。或将解毒汤四物汤。二方
合用调停。服后天癸依然行。定变伏陷逆证。
元参地黄汤神方。丹皮生地元参。炒黑蒲黄栀仁添。水煎入口灵验。四物汤除去川芎白芍。
解毒汤栀仁黄柏黄芩黄连。服后经止立便痊。不应中虚证交。
妊娠如逢出疹。热蒸胎必坠伤。热甚儿坠母安康。轻或两全无恙。初潮宜用参苏饮。减去半
夏木香。或已现麻须更方。安胎饮用停当。
初潮宜用参苏饮。加减全凭神医。枳壳前胡与苏叶。除去甘草桔梗陈皮。葛根白茯苓同煎。
人参半夏木香须忌。加入连翘牛蒡子贝母宜。勿学庸工执泥。
出现宜用安胎饮。川芎白芍当归身。苏叶甘草条子芩。大腹皮乌豆水浸。陈皮姜汤泡去白。
姜汁炒连壳砂仁。人参白术用时须当斟。糯米一撮为引。（白芍。出现时须当并除）
【附秘本妊娠出麻括】孕妇如逢出疹。须防热甚胎伤。川芎当归白芍生地黄是主方。蕲艾条
子芩多放。砂仁连壳姜汁炒。安胎清热最良。用心调理莫仓皇。务保子母无恙。
产后如遇出麻。用药休使寒凉。四君子汤（见七十二条）四物汤（见二十五条）十全大补汤。
补养气血为上。绵 肉桂因人施用。全在良师审详。若泥寒凉生气伤。好似雪上加霜。
且说十全大补汤。八珍汤加味成方。川芎当归身生地黄。人参白苓白术甘草相将。肉桂白芍
俱用酒炒。黄 蜜拌炙为良。水煎浓汁与之尝。加减听凭酌量。
Sha zhen (Rubeola/Measles), commonly known as Ma zi, is caused by the steaming and薰蒸 of fire-heat. It manifests as red spots resembling cinnabar dots all over the body. The pathology originates from the Heart Meridian and Spleen Meridian. The most feared sign is black macules indicating a fatal condition; ideally, the rash should appear bright red like vermilion patterns. Generally, the treatment principle favors cooling and clearing, avoiding acrid-sweet warm-drying herbs to prevent contraindications.
How to identify measles? The symptoms clearly resemble Taiyang Cold Damage (Shanghan), but are accompanied by coughing, red macules, sneezing, watery eyes, or abdominal pain, or simultaneous vomiting and diarrhea. For patients with measles, vomiting and diarrhea need not be forcibly stopped; rather, they help expel toxins and dissipate heat.
The treatment for measles differs from that for smallpox; they cannot share the same formula. Smallpox requires warm dispersal, while measles requires cooling and clearing, with successful eruption being paramount. If wind-cold prevents eruption, the situation becomes perilous. Urgent dispersal is needed to ensure safety, strictly avoiding coma and abdominal distension.
Why does measles cause coughing? Because the Lung connects with the Heart. Lung Metal is tormented by fire-heat, leading to cough and asthma. Treatment should clear Lung Qi and descend fire, avoiding acrid-sweet tonics. It is like steaming buns: only smooth Qi flow and moderate heat are required.
When measles appears, observe the seasonal climate. If the weather is warm and gentle, Jing Fang Bai Du San is suitable. If it is an epidemic season, Qin Lian Xiao Du Yin is preferred. Careful management saves critical patients; do not sit idly by.
Jing Fang Bai Du San is a miraculous formula for dispersal. It contains Fang Feng, Jing Jie, Sheng Di Huang, wine-fried Huang Qin, Huang Lian, Chi Fu Ling, Ge Gen, Deng Xin Cao, Lian Qiao, Zhi Ke, Niu Bang Zi, Yuan Shen, and Xing Ren. Decoct with Dan Zhu Ye.
Qin Lian Xiao Du Yin clears Lung Qi and scatters fire-heat excellently. It consists of Huang Qin, Huang Lian, Fang Feng, Zhi Zi Ren, Huang Bo, Zhi Ke, Gu Pi, Shi Gao, Ge Gen, Zhi Mu, Lian Qiao, Niu Bang Zi, and Tian Hua Fen. Use extra Dan Zhu Ye as a guide. This formula is highly valuable.
If eruption fails, causing anxiety, use Ma Huang fried with honey until coal-black, along with equal parts Zhi Zi Ren, Huang Bo, Huang Qin, and Huang Lian. Add Da Huang fried in wine, followed by Lian Qiao and Niu Bang Zi. Add Shi Gao, Chan Tui, and Hong Hua Zi. If ineffective, death is imminent.
If the rash turns purple-black, the prognosis is ominous. Seek roadside human feces, preserve its nature by calcination, grind finely, and take with wine. The color should turn red quickly. If it remains black, death is certain.
For fever during eruption, use Hua Ban Tang normally. It contains Shi Gao, Zhi Zi Ren, Yuan Shen, Zhi Ke, Lian Qiao, and Niu Bang Zi. If toxin load and heat are severe, prioritize Qin Lian Xiao Du Yin. For constipation, add Qiu Niu Zi to achieve mild loose stools several times.
Frequent sore throat in measles is due to fire-heat scorching. Increase Lian Qiao and Dou Gen, decoct with She Gan and Niu Bang Zi. Apply Shi Xuan Miao San externally to the throat. If effective, Qin Lian Xiao Du Yin is praiseworthy.
For persistent coughing and shortness of breath, descend fire and clear Lung. Use Huang Qin, Zhi Zi, Chi Fu Ling, Ting Li Zi, and Shi Gao. Combine Zhi Mu, Bei Mu, Yuan Shen, Di Gu Pi, Gua Lou Ren, Mai Dong, Xing Ren, Lian Qiao, and Niu Bang Zi. Use Dan Zhu Ye as a guide (some texts add Huang Lian).
If measles is complicated by diarrhea or dysentery, treat proactively. For diarrhea, use San Ling San plus Che Qian Zi and Hua Shi. For bloody/purulent dysentery, use modified Huang Qin Tang. Cessation of dysentery is a miracle; failure causes doubt.
After measles, guard against four conditions: residual heat (1), persistent cough (2), gan disease of teeth/mouth (3), and uncontrollable bloody dysentery (4). Evaluate methods carefully to become a master of measles treatment.
High fever is due to lingering residual toxin. Jin Hua Wan is a spiritual pill containing Zhi Zi Ren, Huang Qin, Huang Lian, Long Dan Cao, Yu Jin, and Xiong Huang. Take with Deng Xin and Di Gu Pi decoction. For weak Spleen with lingering heat, choose Ji Sheng Wan, Wei Qin Ke, or others.
Ji Sheng Wan contains Dang Gui, Chuan Xiong, Lu Hui, Wu Ling Zhi, Ye Ming Sha, Sha Ren, Qing Pi, E Zhu, wine-fried Huang Lian, and Toad (or Clam) liver. Form pills with Pig Gallbladder and Millet Flour. Take with rice water in the morning. It is best for treating gan disease and nourishing children.
Wei Ling Tang combines Ping Wei San and Wu Ling San. It contains Cang Zhu, Fu Ling, Rou Gui, Zhu Ling, Chen Pi, Hou Po, Ze Xie, raw Bai Zhu, and Gan Cao (remove Rou Gui). It treats edema, diarrhea, and food stagnation effectively.
Persistent cough is due to intolerance of sour/salty foods and lung fire-toxin, fearing chest fullness and asthma. For excess patterns, use Ting Li Wan; for deficiency patterns, use Qing Fei Shen Dan. Manage carefully to avoid danger.
Ting Li Wan clears Lung heat with Xing Ren, Ting Li Zi, Fang Ji, Qian Niu, and Lai Fu Zi, formed into pills with Red Dates. Qing Fei Shen Dan descends Qi using Chen Pi, Huang Qin, Huang Lian, Zhi Zi Ren, Huang Bo, Xing Ren Ni, and Su Zi.
Bad breath and rotting gums indicate Zou Ma Ya Gan. Internally use Jin Hua Wan; externally apply Chu Gan Miao San. Use urine sediment calcined white, Wu Bei Zi, Tong Lv, Can Tui, Peng Sha, and Bing Pian.
For bloody dysentery, use Huang Lian, Bai Ye, Huai Hua, Zhi Ke, and Jing Jie Sui. For white dysentery, use Zhu Yu, Hua Shi, Chu Gen, Zhi Ke, Sheng Ma, and W Mei pills. For mixed red/white, use Xiang Lian Wan.
Xiang Lian Wan (also called Xiang Ju) contains Mu Xiang, Chen Pi, Shi Lian Zi, and Huang Lian. Stir-fry Zhu Yu with Huang Lian, remove Zhu Yu, and form pills with Shen Qu.
Measles appearing after smallpox requires clearing Lung; dispersal and tonification are wrong. Use Huang Qin, Sang Bai Pi, Bei Mu, Niu Bang Zi, and increased Xi He Liu. This guides students.
If measles transforms into malaria, cool and strengthen Spleen. Use Mai Dong, Yi Yi Ren, Ge Gen, Fu Ling, Chen Pi, Bie Jia, Chai Hu, Bai Shao, Dan Zhu Ye, Zhi Mu, Bei Mu, and Shan Zha. Add Shi Gao if thirsty; omit Zhi Mu if not.
Guard against four fatal signs: toxic heat with emaciation (1), cough with cyanotic face and hoarseness (2), gangrenous mouth/gums with tissue loss (3), and dysentery with inability to eat (4). These are fatal; do not seek remedies elsewhere.
During measles in women, if menstruation approaches, blood loss and Qi deficiency may cause collapse. Avoid acrid/warm dispersals. Use Yang Yin Tang modified. Manage carefully; late intervention is futile.
Early fever with abnormal menstruation is due to fire-toxin forcing blood out of channels. Use Yuan Shen Di Huang Tang, or combine Jie Du Tang and Si Wu Tang. This stabilizes the condition.
Yuan Shen Di Huang Tang contains Dan Pi, Sheng Di, Yuan Shen, charred Pu Huang, and Zhi Zi. Si Wu Tang removes Chuan Xiong and Bai Shao. Jie Du Tang contains Zhi Zi, Huang Bo, Huang Qin, and Huang Lian. Menstruation stops after taking these.
In pregnancy, measles heat threatens the fetus. Severe heat causes fetal loss but maternal survival; mild cases may save both. For early onset, use Shen Su Yin minus Ban Xia and Mu Xiang. If rash appears, switch to An Tai Yin.
Shen Su Yin modification uses Zhi Ke, Qian Hu, Su Ye, Ge Gen, and Fu Ling. Avoid Gan Cao, Jie Geng, Chen Pi, Ren Shen, Ban Xia, and Mu Xiang. Add Lian Qiao, Niu Bang Zi, and Bei Mu. Do not follow rigid practitioners.
An Tai Yin contains Chuan Xiong, Bai Shao, Dang Gui, Su Ye, Gan Cao, Huang Qin, Da Fu Pi, Wu Dou, Chen Pi, Sha Ren, Ren Shen, and Bai Zhu. Use Nu Mi as a guide. Remove Bai Shao when rash erupts.
[Secret Appendix on Measles in Pregnancy] Pregnant women with measles must fear fetal damage from heat. Main formula: Chuan Xiong, Dang Gui, Bai Shao, Sheng Di Huang. Add Qi Ai, Huang Qin, and Jiang Zhi fried Sha Ren. This clears heat and calms fetus safely.
Postpartum measles should not be treated with cold/bitter herbs. Use Si Jun Zi Tang, Si Wu Tang, and Shi Quan Da Bu Tang to tonify Qi and Blood. Use Mi Xian and Rou Gui based on individual constitution. Relying on cold herbs harms Qi like adding frost to snow.
Shi Quan Da Bu Tang is Ba Zhen Tang with added ingredients: Chuan Xiong, Dang Gui, Sheng Di, Ren Shen, Fu Ling, Bai Zhu, Gan Cao, wine-fried Rou Gui and Bai Shao, and honey-fried Huang Qi. Decoct thickly and adjust as needed.