疹发最怕毒火盛，热昏心神谵妄生。未出三黄石膏治，已出黄连解毒灵。
注∶谵妄一证乃毒火太盛，热昏心神而然也。疹未出而谵妄者，三黄石膏汤主之；疹已出而谵妄者，黄连解毒汤主
之。
三黄石膏汤（方见前）
黄连解毒汤
黄连 黄芩 栀子 黄柏
加味∶丹皮生地黄生甘草金银花连翘（去心）
引加灯心水煎服。
方歌∶麻疹已出谵妄烧，毒郁热结未曾消，黄连解毒芩栀柏，加丹生地草银翘。
疹初无汗作喘急，宣发麻杏石甘宜；毒热内攻金受克，保肺清气化毒医。
注∶喘为恶候，麻疹尤忌之。如初出未透无汗喘急者，此表实拂郁其毒也，宜用麻杏石
甘汤发之。疹已出胸满喘急，此毒瓦斯内攻，肺金受克，宜用清气化毒饮清之。若迟延失治，以致肺叶焦举，则难救矣。
麻杏石甘汤
石膏（ ） 麻黄（蜜炒） 杏仁（去皮尖炒） 生甘草
引用生姜水煎服。
方歌∶喘用麻杏石甘汤，石膏火 合麻黄，杏仁去尖须微炒，甘草相配引生姜。
清气化毒饮
前胡 桔梗 栝蒌仁 连翘（去心） 桑皮（炙） 杏仁（炒去皮尖） 黄芩 黄连 元参 生甘草 麦冬（去心）
引用芦根水煎服。
方歌∶毒热内攻肺喘满，清气化毒饮最灵，前桔栝蒌翘桑杏，芩连元参草麦冬。
疹子发出后，最害怕的是毒火炽盛，导致热邪扰乱心神而出现谵妄（神志不清，胡言乱语）。在疹子尚未发出时出现谵妄，用三黄石膏汤治疗；在疹子已经发出后出现谵妄，用黄连解毒汤治疗。
注释：谵妄这一证候，是由于毒火过于旺盛，热邪昏蒙心神所致。疹子未出而见谵妄的，以三黄石膏汤为主方；疹子已出而见谵妄的，以黄连解毒汤为主方。
三黄石膏汤（方剂见前文）
黄连解毒汤
组成：黄连、黄芩、栀子、黄柏
加味：牡丹皮、生地黄、生甘草、金银花、连翘（去心）
引药：灯心草，用水煎服。
方歌：麻疹已出谵妄烧，毒郁热结未曾消，黄连解毒芩栀柏，加丹生地草银翘。
疹子初起无汗并伴有喘急，宜用宣发之法，选用麻杏石甘汤；若毒热内攻克制肺金，则需用保肺清气化毒饮来医治。
注释：喘是恶候，患麻疹尤其忌讳。如果疹子刚出未透且无汗而喘急，这是表实郁闭导致毒邪不得外泄，宜用麻杏石甘汤发散。疹子已出但胸满喘急，这是毒气内攻，肺金受克，宜用清气化毒饮清解。如果延误时机失治，导致肺叶焦枯上举，那就难以救治了。
麻杏石甘汤
组成：石膏、麻黄（蜜炒）、杏仁（去皮尖炒）、生甘草
引用：生姜，用水煎服。
方歌：喘用麻杏石甘汤，石膏火 合麻黄，杏仁去尖须微炒，甘草相配引生姜。
清气化毒饮
组成：前胡、桔梗、栝蒌仁、连翘（去心）、桑白皮（炙）、杏仁（炒去皮尖）、黄芩、黄连、元参、生甘草、麦冬（去心）
引用：芦根，用水煎服。
方歌：毒热内攻肺喘满，清气化毒饮最灵，前桔栝蒌翘桑杏，芩连元参草麦冬。
The emergence of rashes is most feared when the toxic fire is excessive, leading to heat confusing the heart-mind and causing delirium (mental confusion with incoherent speech). If delirium occurs before the rash erupts, Sanhuang Shigao Tang (Three-Yellow Gypsum Decoction) is used for treatment; if it occurs after the rash has erupted, Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity) is used.
Note: The syndrome of delirium arises from excessive toxic fire that confuses the heart-mind due to heat. For delirium preceding the eruption of the rash, Sanhuang Shigao Tang is the primary formula; for delirium following the eruption, Huanglian Jiedu Tang is the primary formula.
Sanhuang Shigao Tang (Formula see previous section)
Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity)
Ingredients: Coptidis Rhizoma (Huanglian), Scutellariae Radix (Huangqin), Gardeniae Fructus (Zhizi), Phellodendri Cortex (Huangbai)
Additions: Moutan Cortex (Danpi), Rehmanniae Radix Recens (Shengdihuang), Glycyrrhizae Radix et Rhizoma (Shenggancao), Lonicerae Flos (Jinyinhua), Forsythiae Fructum (Lianqiao) [remove heart]
Guiding herb: Juncus effusus (Dengxincao), decocted in water.
Rhyme verse: When measles have erupted and delirium burns, toxic stagnation and heat accumulation remain unresolved; Huanglian Jiedu uses Huangqin, Zhizi, and Huangbai; add Danpi, Shengdi, Gancao, Jinyinhua, and Lianqiao.
When the rash first appears without sweat accompanied by wheezing and urgency, the method of dispersing and venting should be employed, selecting Maxing Shigan Tang (Ephedra, Apricot Kernel, Gypsum, and Licorice Decoction); if toxic heat attacks internally and overcomes Lung Metal, Baofei Qingqi Huadu Yin (Preserve-Lung Clear-Qi Detoxifying Drink) is used for treatment.
Note: Wheezing is an ominous sign, particularly taboo in measles. If the rash has just begun to emerge but not fully penetrated, with no sweat and wheezing/urgency, this indicates exterior excess and constraint causing toxic pathogenic factors to be trapped; Maxing Shigan Tang should be used to disperse them. If the rash has emerged but there is chest fullness and wheezing/urgency, this indicates toxic qi attacking internally and overcoming Lung Metal; Qingqi Huadu Yin should be used to clear it. If treatment is delayed, leading to the lungs becoming scorched and elevated, rescue will be difficult.
Maxing Shigan Tang (Ephedra, Apricot Kernel, Gypsum, and Licorice Decoction)
Ingredients: Gypsum Fibrosum (Shigao), Ephedrae Herba (Mahuang) [honey-fried], Armeniacae Semen Amarum (Xingren) [skin and tip removed, fried], Glycyrrhizae Radix et Rhizoma (Shenggancao)
Guiding ingredient: Zingiberis Rhizoma Recens (Shengjiang), decocted in water.
Rhyme verse: For wheezing use Maxing Shigan Tang, mix gypsum and fire with Ma Huang, Xingren tip removed must be lightly fried, Gancao paired guides with Sheng Jiang.
Qingqi Huadu Yin (Clear-Qi Detoxifying Drink)
Ingredients: Peucedani Radix (Qianhu), Platycodonis Radix (Jiegeng), Trichosanthis Fructus Semen (Gualouren), Forsythiae Fructum (Lianqiao) [remove heart], Mori Cortex (Sangpi) [stir-baked], Armeniacae Semen Amarum (Xingren) [fried, skin and tip removed], Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), Scrophulariae Radix (Yuan Shen), Glycyrrhizae Radix et Rhizoma (Shenggancao), Ophiopogonis Tuber (Maidong) [remove heart]
Guiding ingredient: Phragmitis Rhizoma (Lugen), decocted in water.
Rhyme verse: Toxic heat attacking internally causes lung wheezing and fullness, Qingqi Huadu Yin is most effective; Qian, Jie, Gualou, Lianqiao, Sang, Xing, Huangqin, Huanglian, Yuan Shen, Gancao, Maidong.