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Although measles (Ma Zhen) originates from fetal toxin, it is often accompanied by epidemic climate pathogens. It is transmitted through warm and hot weather. Its onset is similar to smallpox (Dou Zhen), but its pathological changes are more severe than those of smallpox. The pathogen initially arises in the Yang aspect and later returns to the Yin aspect; the toxin is abundant in the Spleen, and heat flows into the Heart. Among the Zang-Fu organs, the Lung is particularly severely injured, while the Kidney shows no specific symptoms throughout the course of the disease. Initially, there is fever, resembling Taiyang syndrome (Taiyang Bing). The eyelids are difficult to lift due to fatigue, and clear nasal discharge flows without dryness. There is coughing, loss of appetite, irritability, thirst, and restlessness. When viewed obliquely, the rash is faintly visible under the skin; when touched with hand, it feels granular between the muscles. The shape resembles scabies, and the color resembles cinnabar. After appearing for three days, gradual fading indicates safety; if the rash appears and disappears simultaneously, one must guard against sudden panting and urgency. If the base of the rash is swollen, it is a rash combined with wind-urticaria (Yin Zhen); if the skin becomes redder, it is a rash complicated by macules (Ban). If the rash is bright and clear like brocade, it may heal without medication; if it is black and dull like coal, almost none will survive.

Once measles has erupted, nursing care is very difficult. The patient should keep warm when sitting or lying down, and the diet should be bland. If there is coughing up of saliva and phlegm, sour and salty foods cannot be tolerated; sudden panting and urgency indicate that the Lung has been invaded by wind-cold; burning fire in the Heart and Spleen causes sores on the mouth and tongue; accumulated heat in the Lung and Stomach leads to constant dryness of body fluids. For these complications, treatment methods differ: inducing slight sweating resolves the toxin and reduces heat severity; clear and regulated urination and defecation ensure smooth Qi movement without obstruction. If the pores are closed and stagnant, dispersing and releasing the exterior is required; if the intestines and stomach are constipated, urgent unblocking and dredging are needed. Epistaxis does not require worry as the pathogen resolves through bleeding; spontaneous diarrhea does not need immediate stopping as the toxin loosens through evacuation. Post-measles diarrhea often occurs because heat-toxin shifts to the Large Intestine; cough and sore throat result from phlegm and Qi stagnating in the chest and heart. Thirst and irritability require methods to generate fluids and nourish Yin; reduced appetite requires regulating the Stomach and harmonizing the Middle Jiao. Other symptoms vary and require flexible adaptation. This is the general principle of measles; its subtle application lies in the physician's mind.

If fever subsides or recurs for five to six days before eruption, the condition is mild. If the rash is pale red and moist, evenly distributed on the head and face, and abundant, the condition is mild. If the rash fully erupts for three days and then gradually fades, the condition is mild. If the head and face do not show rash, the condition is severe; if the color is dark red/purple and dry, the condition is severe; if there is sore throat swelling and inability to eat, the condition is severe; if exposure to wind causes early disappearance of the rash, the condition is severe; if heat shifts to the Large Intestine causing dysentery, the condition is severe. Dark, dry, and black rash that disappears immediately upon appearance is incurable; flaring nostrils, open mouth breathing, and spiritless eyes are incurable; cyanosis of the nose bridge and black stool are incurable; panting with suction at the precordium is incurable; foul-smelling and rotting gums after measles (Ya Gan) are incurable. Xu Shixiangcun said: Measles is as dangerous as smallpox. However, since they appear simultaneously and have similar manifestations, physicians treat smallpox strictly but neglect measles. They do not realize that smallpox has a broader pathological scope; even when extremely dangerous, there is time for calm treatment. Measles has a rapid progression, with changes occurring in an instant, often leaving no time for rescue. Therefore, prevention is essential. Prevention for families involves keeping warm during rest and maintaining a bland diet. For physicians, it involves being cautious about using exterior-releasing methods. Regarding caution in exterior release: First, for children with strong constitutions and excessive fire-toxin, over-release can cause heat to congest upward, leading to rough breathing and asthma closure. Physicians seeing this might administer more exterior-releasing drugs, causing heat to rise uncontrollably and potentially death. Consider ancient formulas: Shengma Gegen Tang uses Shaoyao to harmonize Yin; Mahuang Shigao Tang releases exterior while descending heat. Second, for children with weak constitutions, eruption is often delayed. Mild dispersal already floats the Yuan Qi. Physicians thinking the rash is not fully erupted may use stronger dispersants. Although the rash emerges, the True Yang Qi is exhausted, and without Yin to anchor it, asthma collapse may occur. I used Liuwei Dihuang Tang plus Renshen to guide Qi back to its source and saved a few cases. I told colleagues: Whenever seeing weak children, those with open fontanelles, pale faces, spiritless eyes, orphaned/malnourished children, or those recovering from major illnesses/malaria/dysentery, even if eruption is slow, one must protect Yuan Qi and absolutely avoid excessive exterior release. Regarding general eruption patterns and severe/incurable signs, adhering to these principles is highly effective. Except for distinguishing deficiency and excess, all other rules should be followed strictly. Despite myriad variations, the core remains unchanged.