疹有发水泡者,此因火毒太甚,迫于肌肤而不能透表,故发水泡,此症多于见点之
时,亦有于未见点之时,皆为不治,故不立法。
疹之有气促者,由肺不清而致,当分先后。若见于正出未出之时,宜疏托。若见于
已出正没之时,宜降火清痰之药。
疹有眼闭者,常于没后见之,皆因脾火旺盛,致目肿而闭,但宜清上焦之药,兼以
利水,使热退而眼自开矣。又有白珠者,又有赤红者,俱属肺气,宜清肺火,兼以风药佐之。
疹有啮牙者,是阳陷于阴,热火相搏,故啮牙耳。其口必多渴,手足俱热,喜食冷物,
治宜滋阴降火,不可食辛辣之物。若误食之,后必下血,痰响而死。
疹前吐蛔者,毒火上冲,胃难安养,蛔从上出。若初出发热之时不妨,待热退身凉,
自然不吐,亦宜清胃,用生地、当归、丹皮、连翘、石膏、升麻,庶无他症。如已出回时
而有此症,用使君子、黄芩、川连、花粉、胡连、川椒为主。如蛔死者,毒火猖獗,胃气
将绝,死期立至。有泻蛔者,不必过治,清解自愈。如泻死蛔者亦重。
疹有呕吐者,毒火冲胃,未经发泄,不必过治。若出齐回后有此症,宜用清凉解毒之药。
疹有泄泻者,其色黄而有沫,小便赤涩,口干唇燥,此因肺经热甚,未出与当出之时
而泻者,不必服药。经云毒以痢松,但不宜久,若回后有此泄者,是积热移于大肠,治
宜四苓散,猪苓、茯苓、白术、泽泻,加黄芩、黄连、木通、栝蒌仁霜。如下有红紫色,
总因热毒留连,药宜赤芍、大黄,行一二次,毒尽自愈,不宜多下。切不可因其泄泻,用
诃、蔻以止之,恐其腹胀喘急而死。如首尾水泻,小便短赤,用木通、车前利水之剂,佐以升提可也。
疹子出现水泡的,这是因为火毒过于严重,逼迫于肌肤而不能透发至体表,所以形成水泡。这种症状多出现在疹点刚显现的时候,也有在疹点尚未显现时就出现的,都属于不治之症,因此不制定专门的治疗法则。
疹子伴有呼吸急促的,是由于肺脏不清爽所致,应当区分发病的先后阶段。如果出现在疹子正要发出或尚未发出的时候,适宜使用疏风托毒的方法;如果出现在疹子已经发出、正要消退的时候,适宜使用降火清痰的药物。
疹子出现眼睛闭合的,通常在疹子消退后见到,都是因为脾火旺盛,导致眼睛肿胀而闭合,只宜使用清上焦热邪的药物,兼用利水药,使热邪退去,眼睛自然就会睁开。又有眼白部分发白的,又有眼白部分赤红的,这些都归属于肺气的问题,适宜清泻肺火,并兼用祛风药物辅助治疗。
疹子出现磨牙咬齿的,这是阳气陷入阴分,火热之邪相互搏结,所以出现磨牙的现象。患者口中一定多渴,手足都发热,喜欢食用冷物,治疗适宜滋阴降火,不可食用辛辣食物。如果误食辛辣之物,后来必然会出现便血,因痰鸣作响而死。
出疹前吐出蛔虫的,是毒火上冲,胃难以安宁滋养,蛔虫从上面排出。如果在初起发热的时候出现这种情况不要紧,等到热退身凉,自然会停止吐蛔,也适宜清胃,使用生地、当归、丹皮、连翘、石膏、升麻,这样才不会产生其他病症。如果是在疹子发出后又回退时出现此症,使用使君子、黄芩、川黄连、花粉、胡黄连、川椒作为主药。如果是吐出死蛔,说明毒火猖獗,胃气即将断绝,死亡期立刻到来。有排出蛔虫的,不必过度治疗,清热解表自愈。如果是排出死蛔的情况也比较严重。
疹子出现呕吐的,是毒火冲犯胃腑,邪气尚未发泄,不必过度治疗。如果是在疹子出齐回退后出现此症,适宜使用清凉解毒的药物。
疹子出现泄泻的,大便颜色黄且有泡沫,小便赤红涩痛,口干唇燥,这是因为肺经热邪严重,在疹子未出与正当要出的时候发生腹泻,不必服药。医经说“毒随痢松”,但腹泻不宜持久,如果是在疹子回退后出现这种泄泻,是积热转移到大肠,治疗适宜用四苓散(猪苓、茯苓、白术、泽泻),加入黄芩、黄连、木通、栝蒌仁霜。如果大便中有红紫色物质,总因热毒留恋,用药适宜赤芍、大黄,服用一两次,毒尽则自愈,不宜过多攻下。切不可因为泄泻,使用诃子、豆蔻来止泻,恐怕会导致腹胀喘急而死。如果是从头到尾都是水样腹泻,小便短少赤红,使用木通、车前子等利水的药剂,佐以升提药物即可。
Cases of measles presenting with blisters occur because the fire-toxin is excessively severe, forcing its way into the skin and muscle layers but failing to vent through the exterior, thus forming blisters. This condition mostly appears when the rash spots are just emerging, or sometimes before they appear at all; both scenarios are considered intractable, hence no specific treatment protocol is established.
Measles accompanied by shortness of breath results from the Lung not being clear. One must distinguish between early and late stages. If it occurs when the rash is about to emerge or has not yet emerged, dispersing and supporting methods should be used. If it occurs when the rash has fully emerged and is beginning to recede, herbs that descend fire and clear phlegm should be employed.
Measles presenting with closed eyes usually appear after the rash has receded. This is caused by excessive Spleen fire leading to eye swelling and closure. Treatment should focus on clearing heat from the Upper Jiao (upper burner) combined with diuretics, so that as the heat subsides, the eyes naturally open. Cases where the sclera appears white or reddish belong to Lung Qi disorders; clearing Lung fire and assisting with wind-dispelling herbs is appropriate.
Measles presenting with teeth grinding indicates Yang sinking into Yin, with hot and fire pathogens clashing. The mouth will likely be dry with excessive thirst, hands and feet will be hot, and the patient will crave cold foods. Treatment should nourish Yin and descend fire; spicy foods must be avoided. Ingestion of spicy food may lead to hematochezia later, followed by death due to rattling phlegm.
Vomiting froth is also caused by hyperactive Stomach fire; the primary treatment is clearing the Stomach and descending fire.
Expelling roundworms before the onset of measles is due to toxin-fire rushing upward, making the Stomach unable to maintain harmony, causing worms to exit upwards. If this occurs during the initial fever stage, it is not critical; once the fever subsides and the body cools, vomiting will cease naturally. Clearing the Stomach using Shengdi Huang (Rehmanniae Radix), Dang Gui (Angelicae Sinensis Radix), Dan Pi (Moutan Cortex), Lian Qiao (Forsythiae Fructus), Shi Gao (Gypsum Fibrosum), and Sheng Ma (Cimicifugae Rhizoma) prevents further complications. If this occurs when the rash is receding, use Shi Jun Zi (Quisqualis Fructus), Huang Qin (Scutellariae Radix), Chuan Lian (Coptidis Rhizoma), Hua Fen (Trichosanthis Radix), Hu Lian (Coptidis Rhizoma variant), and Chuan Jiao (Zanthoxyli Pericarpium) as main ingredients. Expelling dead roundworms indicates rampant toxin-fire and impending collapse of Stomach Qi, signaling imminent death. Passing live worms requires no excessive treatment; clearing and resolving will lead to self-healing. Passing dead worms is a serious condition.
Vomiting associated with measles is caused by toxin-fire attacking the Stomach, with pathogens not yet vented; excessive treatment is unnecessary. If vomiting occurs after the rash has fully emerged and is receding, cooling and detoxifying herbs should be used.
Diarrhea associated with measles presents with yellow stool containing foam, red and scanty urine, dry mouth, and chapped lips. This is due to severe heat in the Lung Meridian. Diarrhea occurring before or during the emergence of the rash does not require medication. The classics state that "toxin loosens with dysentery," but diarrhea should not persist. If diarrhea occurs after the rash recedes, it indicates accumulated heat transferring to the Large Intestine. Treatment should utilize Si Ling San (Four-Ingredient Powder for Draining Dampness: Zhu Ling (Polypori Sclerotium), Fu Ling (Poria), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Ze Xie (Alismatis Rhizoma)) added with Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Mu Tong (Akebiae Caulis), and Gua Lou Ren Frost (Trichosanthis Semen). If red or purple blood appears in the stool, it is due to lingering heat-toxin; Chi Shao (Paeoniae Radix Rubra) and Da Huang (Rhei Radix et Rhizoma) should be used to purge one or two times until the toxin is exhausted and health returns; over-purging should be avoided. Do not use He Zi (Terminalia Chebulae Fructus) and Dou Kou (Tsaoko Fructus) to stop diarrhea, as this may cause abdominal distension, wheezing, and death. If watery diarrhea persists from start to finish with short, red urine, use Mu Tong (Akebiae Caulis) and Che Qian Zi (Plantaginis Semen) to promote urination, assisted by lifting herbs.