痘疹咽痛亦是常候，乃火毒上熏而然也，勿以喉痹同论，妄用针刺。盖此非喉痹痈肿，原无恶
血可去也。痘疹喉病，只是咽干作痛，宜廿桔汤加牛蒡子，或射干鼠粘子汤，细细咽之，更以玉钥
匙吹之。
凡出疹之先，或有胃火，及出疹之后，余毒不散，此热毒收于牙龈上下，故并唇口生疮。遇有
此证，每日
用温米泔水洗十余吹，急用解毒之药治之。若或失治，多变走马疳也。
凡疹初热一日至五六日之间，多有腹痛之证。此大肠之火郁于皮窍之中，故作腹痛。俱不可认
作伤食，用消导之药，或以手揉，俱能致害。但解疹毒，毒散则腹痛自止，最宜慎之。
凡疹后余毒未尽，随当解之。若停留日久不解，则必致喘嗽，或喉中痰响，或为四肢冷痹，或
目无光彩，面色青白，或鼻孔如烟筒，或嗽声不出。若右手一指脉轻取散乱，重按全无，则成难治
之证矣。
一、疹子收后身有微热者，此虚热也，不须治之，待血气和畅，其热自退。苦热势太甚，或日
久不减，宜用柴胡麦门冬散；甚则黄连解毒汤，或合人参白虎汤。
一、疹后热不退，而发枯毛竖，肉消骨立，渐渐羸瘦，为骨蒸劳瘵之证者，宜万氏柴胡四物汤
主之，或芦荟肥儿丸加当归、连翘治之。迟则变证，为睡则露睛，口鼻气冷，手足厥逆，遂成慢脾
风螈 ，不治之证矣。
一、疹后热不除忽作搐者，不可以急惊风同论，宜导赤散加人参、麦门冬，送七味安神丸。小便
清者可治，短少者难治。如见多痰，或用抱龙丸，或以四物汤加麦门冬、枣仁、淡竹叶、甘草、龙
胆草、黄连、茯苓、辰砂、石菖蒲之类治之，或以此药为末，用蒸饼、猪心血为丸服亦可。
一、疹退后多有咳嗽之证。若微嗽不已者，此余毒未尽也，用清肺饮加生甘草、牛蒡子主之。
苦嗽甚气逆，发而不已者，此肺中伏火，金虚叶焦也，宜清肺饮，或清肺汤合人参白虎汤、六一散
之类主之。若身热顿嗽，甚至饮食俱呛出，或咳出血，皆热毒乘肺而然，宜多用门冬清肺汤，或加
连翘，或清金降火汤主之。若咳甚而面浮目肿，胸高喘急，血退场门鼻，面色青赤，昏躁摇头者，死
证也。又有肺气本虚，为毒所逼而发喘不已，但
无嗽血呛会等证者，宜用清肺饮倍加人参治之。不可拘于肺热之说，而纯用清肺解毒之药也。
一、疹后余热未尽，或热甚而失血者，四物汤加茵陈、木通、犀角以利小便，使热气下行则愈。
若血在上者去川芍。
一、疹后余毒入胃，久而不散，以致牙龈黑烂，肉腐血出，臭气冲人者，名为走马疳，用马鸣
散主之；甚者急用人中白、芦荟、使君子、龙胆草、黄连、五灵脂，浸蒸饼为丸，滚水服之，以清
胃火。若面颊浮肿，环口青黑，齿脱唇崩鼻坏者，死证也。
一、疹退之后，饮食如常，动止如故，乃卒然心腹绞痛，遍身汗出如水者，此因元气虚弱，失
于补养，外虽无病，里实虚损，偶然为恶气所中，谓之中恶。此朝发夕死之证。
痘疹引起的咽痛也是常见症状，这是由于火毒向上熏蒸所致，不应将其与喉痹混为一谈，切忌妄用针刺治疗。因为痘疹并非喉痹或痈肿，原本就没有恶血可以排出。对于痘疹引起的咽喉疾病，通常只是咽干疼痛，适宜服用廿桔汤加牛蒡子，或者射干鼠粘子汤，细细吞咽，并配合使用玉钥匙散吹入咽喉。
凡是出疹之前，可能有胃火；以及出疹之后，余毒未能消散，这些热毒积聚在牙龈上下，导致嘴唇和口腔生疮。遇到这种情况，每天用温热的米泔水清洗十余次，并立即使用解毒药物进行治疗。如果延误治疗，很容易转变为走马疳。
凡是疹子初起发热一天到五六天之间，常出现腹痛的症状。这是因为大肠的火气郁结在皮肤毛孔之中，从而引起腹痛。都不应误认为是伤食，而使用消导药物，或用手法揉按，这些做法都会造成伤害。只要解除疹毒，毒气消散，腹痛自然停止，这一点务必谨慎对待。
凡是疹后余毒未尽，应当及时清除。如果停留日久不解除，必然会导致气喘咳嗽，或者喉咙中有痰鸣声，或者四肢寒冷麻木，或者眼睛无神光彩，面色青白，或者鼻孔周围像烟筒一样发黑，或者咳嗽声音发不出。如果右手寸口脉轻取时散乱，重按时完全摸不到，这就成了难以治疗的证候了。
其一，疹子消退后身体有轻微发热的，这是虚热，不需要特别治疗，等待气血调和通畅，热度自然会退去。如果热势过于严重，或者日久不退，适宜使用柴胡麦门冬散；严重时可用黄连解毒汤，或者合用人参白虎汤。
其二，疹后热度不退，且头发干枯竖起，肌肉消瘦骨骼显露，逐渐变得瘦弱，属于骨蒸劳瘵的证候，适宜以万氏柴胡四物汤为主方，或者用芦荟肥儿丸加当归、连翘治疗。如果拖延不治，病情变化，会出现睡觉时眼睛睁开（露睛），口鼻气息冰冷，手足厥冷逆乱，最终形成慢脾风抽搐，这是不治之症。
其三，疹后热度未除突然发生抽搐的，不能与急惊风混为一谈，适宜用导赤散加人参、麦门冬，送服七味安神丸。小便清长的可以治愈，小便短少的难治。如果见到痰多，可以使用抱龙丸，或者用四物汤加麦门冬、枣仁、淡竹叶、甘草、龙胆草、黄连、茯苓、辰砂、石菖蒲等药物治疗，或者将这些药研成粉末，用蒸饼和猪心血制成丸剂服用也可以。
其四，疹退后多有咳嗽的症状。如果是轻微咳嗽不止，这是余毒未尽，用清肺饮加生甘草、牛蒡子为主方。如果咳嗽剧烈气逆，皮疹发出后咳嗽不停，这是肺中伏火，肺气虚弱如叶焦枯，适宜用清肺饮，或者清肺汤合人参白虎汤、六一散等为主方。如果身体发热突然咳嗽，甚至饮食都呛出，或者咳出血来，都是热毒乘袭肺部所致，适宜多用门冬清肺汤，或者加连翘，或者用清金降火汤为主方。如果咳嗽剧烈且面部浮肿眼睛肿胀，胸部高耸呼吸急促，大便带血肛门出血，面色青赤，昏乱烦躁摇头的，是死证。又有肺气本虚，被毒邪逼迫而喘息不止，但没有咳血呛食等证的，适宜用清肺饮倍加人参治疗。不可拘泥于肺热的说法，而单纯使用清肺解毒的药物。
其五，疹后余热未尽，或者热势严重导致失血的，用四物汤加茵陈、木通、犀角以利小便，使热气下行则痊愈。如果出血部位在上部，去掉川芎。
其六，疹后余毒进入胃部，日久不散，导致牙龈黑烂，肌肉腐烂出血，臭气冲人的，名为走马疳，用马鸣散为主方；严重的紧急使用中人白、芦荟、使君子、龙胆草、黄连、五灵脂，浸泡蒸饼制成丸剂，用滚水送服，以清胃火。如果面颊浮肿，口周青黑，牙齿脱落嘴唇崩坏鼻子坏死的，是死证。
其七，疹退之后，饮食正常，行动如常，却突然心腹绞痛，全身出汗如水样的，这是因为元气虚弱，失去补养，外表虽无病，体内实则虚损，偶然被恶气所中，称为中恶。这是早晨发作晚上死亡的危重证候。
Sore throat caused by smallpox and measles is also a common manifestation, resulting from the upward薰 (fuming/burning) of fire-toxin. It should not be equated with Hou Bi (sore throat/obstruction), and blind use of acupuncture needles is prohibited. This is because it is not Hou Bi or carbuncle/swelling, and originally there is no evil blood to be expelled. For throat diseases associated with smallpox and measles, presenting merely as dryness and pain in the pharynx, Nian Jie Tang (Twenty-Seed Decoction) added with Niubangzi (Arctii Fructus) is suitable, or Shegan Niuzi Tang (Belamcanda and Arctii Decoction), which should be swallowed slowly. Additionally, Yuyao Chi (Jade Key Powder) can be blown into the throat.
Before the eruption of measles, there may be Stomach Fire; and after the eruption, residual toxins may fail to dissipate. When this heat-toxin accumulates above and below the gums, sores appear on the lips and mouth. In such cases, wash with warm rice water more than ten times daily, and urgently treat with detoxifying herbs. If treatment is delayed, it often transforms into Zou Ma Gan (Funky Mouth/Noma).
Between one to five or six days after the initial fever of measles, abdominal pain is common. This occurs because the fire of the Large Intestine is constrained within the skin pores, causing abdominal pain. One must not mistake this for food stagnation and use digestive-promoting herbs, nor rub the abdomen with hands, as these actions can cause harm. Only by resolving the measles toxin, once the toxin disperses, will the abdominal pain cease naturally. This requires utmost caution.
If residual toxins remain after measles, they should be resolved promptly. If left unresolved for a long time, it will inevitably lead to wheezing and coughing, rattling of phlegm in the throat, coldness and numbness of the four limbs, lackluster eyes, blue-white complexion, blackening around the nostrils resembling a chimney, or inability to produce a cough sound. If the pulse at the Cun position of the right hand is scattered when lightly palpated and completely absent when heavily pressed, it becomes a difficult-to-treat condition.
First, slight fever remaining after the resolution of measles indicates Deficient Heat. No specific treatment is needed; wait for the Qi and Blood to harmonize and flow smoothly, and the fever will subside spontaneously. If the heat is severe or persists for a long time, Chai Hu Mai Men Dong San (Bupleurum and Ophiopogon Powder) is suitable; if severe, Huang Lian Jie Du Tang (Coptis Decoction for Resolving Toxicity) or Ren Shen Bai Hu Tang (Ginseng White Tiger Decoction) may be used.
Second, if fever persists after measles, accompanied by dry and erect hair, emaciation with visible bones, and gradual wasting, it constitutes Gu Zheng Lao Zhai (Bone-stealing Consumption Disease). Wan Shi Chai Hu Si Wu Tang (Wan's Bupleurum Four Substances Decoction) is the primary formula, or Lu Hui Fei Er Wan (Aloe Vera Pill for Enriching the Spleen) added with Dang Gui (Angelicae Sinensis Radix) and Lian Qiao (Forsythiae Fructus). Delay leads to transformation: sleeping with eyes open, cold breath from mouth and nose, cold and inverted extremities, eventually forming Man Pi Feng (Slow Spleen Wind) with convulsions, which is incurable.
Third, sudden convulsions occurring while fever persists after measles should not be treated as Ji Jing Feng (Acute Convulsive Wind). Use Dao Chi San (Guide Out Redness Powder) added with Ren Shen (Ginseng Radix et Rhizoma) and Mai Men Dong (Ophiopogonis Tuber), administered with Qi Wei An Shen Wan (Seven-Ingredient Calming Spirit Pill). Clear urine indicates a treatable condition; scanty urine indicates difficulty. If excessive phlegm is present, Bao Long Wan (Embracing Dragon Pill) can be used, or Si Wu Tang (Four Substances Decoction) added with Mai Men Dong, Zao Ren (Ziziphi Spinosae Semen), Dan Zhu Ye (Lophatheri Herba), Gan Cao (Licorice Root), Long Dan Cao (Gentianae Radix), Huang Lian (Coptidis Rhizoma), Fu Ling (Poria), Chen Sha (Cinnabar), and Shi Chang Pu (Acori Tatarinowii Rhizoma). These can also be powdered and formed into pills with steamed dough and pig heart blood.
Fourth, coughing is common after measles resolve. Persistent mild cough indicates residual toxin; Qing Fei Yin (Clear Lung Infusion) added with Sheng Gan Cao (Raw Licorice) and Niu Bang Zi (Arctii Fructus) is indicated. Severe cough with rebellious Qi and persistent onset after eruption indicates latent fire in the Lung and deficiency of Metal leading to scorched leaves (Lung Yin deficiency); Qing Fei Yin, or Qing Fei Tang combined with Ren Shen Bai Hu Tang or Liu Yi San (Six-to-One Powder) is indicated. Sudden cough with body heat, even choking on food and drink, or hemoptysis, results from heat-toxin attacking the Lung; Duo Yong Men Dong Qing Fei Tang (Abundant Use of Ophiopogon Clearing Lung Decoction), possibly with Lian Qiao, or Qing Jin Jiang Huo Tang (Clear Metal Descend Fire Decoction) are indicated. Severe cough with facial edema, swollen eyes, high chest with rapid breathing, bleeding from anus and nose, blue-red complexion, delirium, irritability, and head shaking constitute a death syndrome. If Lung Qi is inherently deficient and forced by toxin to wheeze without hemoptysis or choking, Qing Fei Yin with doubled Ren Shen is indicated. Do not rigidly adhere to the theory of Lung Heat and use only clearing and detoxifying herbs.
Fifth, if residual heat remains after measles, or severe heat causes hemorrhage, Si Wu Tang added with Yin Chen (Artemisiae Scopariae Herba), Mu Tong (Akebiae Caulis), and Xi Jiao (Rhinocerotis Cornu - note: usually substituted in modern practice) promotes urination to direct heat downward for cure. If bleeding is located in the upper jiao, remove Chuan Xiong (Ligustici Chuanxiong Rhizoma).
Sixth, residual toxin entering the Stomach and failing to dissipate for a long time causes black rotting of gums, rotting flesh with bleeding, and foul odor, named Zou Ma Gan (Noma). Ma Ming San (Horse Cry Powder) is the primary formula. In severe cases, urgently use Zhong Ren Bai (Calcinata Os Humanis), Lu Hui (Aloe), Shi Jun Zi (Quisqualis Fructus), Long Dan Cao, Huang Lian, and Wu Ling Zhi (Trogopterori Faeces), soaked in steamed dough to form pills, taken with boiling water to clear Stomach Fire. Facial swelling, blue-black color around the mouth, tooth loss, lip collapse, and nasal destruction constitute a death syndrome.
Seventh, after measles resolve, if diet and movement are normal, but sudden severe colic occurs with profuse sweating like water, it is due to weak Yuan Qi (Original Qi) and lack of nourishment. Although there is no external disease, the interior is truly deficient. Accidental invasion by evil Qi is called Zhong E (Qi Stroke/Poisoning). This is a syndrome where morning onset leads to evening death.