痘之外有疹，疹子外又有麻疹。麻疹者，亦疹之类，即斑疹也。但正疹则热至五六日而后一齐
涌出，出皆粒粒成疮，非若麻疹之皮红成片也。且麻疹之出，则不拘三四日，以火照之，遍身涂朱
之状，此将出之兆。出则细碎，皮红成片，如蚊蚤之迹者，即麻疹也。亦或有六日始出，出而又没
，没而又出，不过一周时许。世俗谓一日三出，三日九出，后方齐出透彻。然亦有不拘者，只三日
间，从面至胸背手足，虽随出随没，然只要出透，以遢身红润者为美。重者遍身膨胀，眼亦封闭。
色有赤白微黄不同，只要红活，最嫌黑陷，及面目胸腹稠密，缠锁咽喉者为逆，发不出而喘者即死
。所谓麻者，以遍身细碎如麻，无有空处故也。然又有遍身但红而绝无斑点者，是又谓之火丹，亦
其类也。故痘家有夹疹、夹麻、夹丹等证，总皆热毒所致，俱当详辨也。
一、麻疹初起，呵欠发热，恶寒咳嗽，嚏喷流涕，宜升麻葛根汤加苏叶、葱白以解肌，切忌大汗
。若潮热甚者，加芩、连、地骨皮。谵语者，调辰砂益元散。咳嗽加麻黄、杏仁、麦门冬、石膏。
咳甚热甚者，用凉膈散加桔梗、地骨皮。泄泻者，宜四苓散。便红合犀角地黄汤。吐血衄血，用犀
角地黄汤加山栀。小便赤加木通。
寒热似疟，小柴胡汤。
一、麻疹已出，烦躁作渴者，解毒汤合白虎汤。喘而便闭者，前胡根壳汤加五味子。便秘甚者
，小承气汤。谵语溺闭者，导赤散。小便如泔者，四苓散加车前、木通。谵语如狂者，解毒汤调辰
砂益元散。大小便血者，犀角地黄汤合解毒汤。吐血衄血，解毒汤加炒山栀、童便。泄泻，解毒汤
或四苓散。喘兼泄泻，溺赤涩者，柴苓汤。烦热大渴作泻者，白虎汤加苍术、猪苓。热盛干呕者，
解毒汤。伤食呕吐，四君子汤。夏月因热作呕，四苓散加人参。
一、麻证初起，及已出已没，一切杂证俱与痘疹大同，但始终药宜清凉。虽曰麻喜清凉，痘喜
温暖，不易常道，然虚则补，实则泻，寒则温，热则凉，方是医家玄妙。故治麻亦有血虚而用四物
汤，气虚而用四君子汤，伤冷则温中、理中之药，皆当因证而用也。
一、麻证收后，余毒内改，凡寻衣摸床，谵言妄语，神昏志乱者死。如热轻而余毒未除，必先
见诸气色，若有所见，须预防之，始终以升麻葛根汤为主，或四味消毒饮，或六味消毒饮、解毒汤
，随证选用，仍忌鱼腥葱蒜等物。
痘疹之外有疹，疹子外面又有麻疹。所谓麻疹，也是疹的一种，也就是斑疹。但是典型的疹子是等到热邪发展到第五六天之后才一齐涌出，出来的时候每一颗都形成疮疡，不像麻疹那样皮肤发红连成一片。而且麻疹发出的时候，不拘泥于第三四天，用火照看它，全身像涂了朱砂一样的状态，这是将要发出的征兆。发出来时细碎，皮肤红成片，像蚊子蚤子叮咬的痕迹，这就是麻疹。也有等到第六天才发出的，发出后又隐没，隐没后又发出，不过大约一周的时间。世俗说法是一天出三次，三天出九次，后来才全部透彻地发出。然而也有不拘泥于此的，只要在三天之间，从面部到胸背手足，虽然随出随没，但只要出得透彻，以全身红润为美。病情重的则全身肿胀，眼睛也封闭。颜色有赤、白、微黄的不同，只要红润鲜活最好，最忌讳黑陷，以及面目胸腹稠密，缠绕锁住咽喉的为逆证，发不出来而喘息的立即死亡。所谓的“麻”，是因为遍身细碎如麻，没有空隙的缘故。然而又有遍身只是红而没有斑点的，这又叫做火丹，也是属于这一类。所以痘科医生有夹疹、夹麻、夹丹等证候，总都是热毒所致，都应当详细辨别。
一、麻疹初起，出现呵欠、发热、恶寒、咳嗽、打喷嚏、流鼻涕等症状，宜用升麻葛根汤加紫苏叶、葱白来解肌发表，切忌大汗淋漓。如果潮热严重的，加黄芩、黄连、地骨皮。出现胡言乱语的，用辰砂益元散调服。咳嗽加麻黄、杏仁、麦门冬、石膏。咳嗽剧烈且热势盛的，用凉膈散加桔梗、地骨皮。泄泻的，宜用四苓散。大便带血的合用犀角地黄汤。吐血、鼻出血，用犀角地黄汤加山栀。小便赤涩加木通。
一、麻疹已经发出，出现烦躁、口渴症状的，用解毒汤合白虎汤。喘息且大便闭结的，用前胡根壳汤加五味子。便秘严重的，用小承气汤。胡言乱语且小便闭结的，用导赤散。小便浑浊像米泔水的，用四苓散加车前子、木通。胡言乱语像发狂的，用解毒汤调服辰砂益元散。大小便出血的，犀角地黄汤合解毒汤。吐血、鼻出血，解毒汤加炒山栀、童便。泄泻，用解毒汤或四苓散。喘息兼泄泻，小便赤涩的，用柴苓汤。烦热大渴并伴有泄泻的，白虎汤加苍术、猪苓。热盛导致干呕的，用解毒汤。伤食导致的呕吐，用四君子汤。夏季因热导致的呕吐，用四苓散加人参。
一、麻疹证候在初起，以及已出已没阶段，一切杂证都与痘疹大同小异，但始终用药宜清凉。虽然说麻疹喜欢清凉，痘疹喜欢温暖，但这并非固定不变的道理，然而虚证则补，实证则泻，寒证则温，热证则凉，这才是医家的玄妙之处。所以治疗麻疹也有血虚而使用四物汤，气虚而使用四君子汤，受冷则用温中、理中的药物，都应当根据证候来使用。
一、麻疹消退后，余毒内攻，凡是寻衣摸床、胡言乱语、神志昏迷意识混乱的预后不良（死证）。如果热势轻而余毒未除，必须先观察面色气色，如果有异常表现，须提前预防，始终以升麻葛根汤为主方，或者四味消毒饮，或者六味消毒饮、解毒汤，根据证候选用，仍然忌食鱼腥、葱蒜等物。
Outside of variola (smallpox) there is exanthema, and outside of exanthema there is measles. Measles is also a type of exanthema, namely maculopapular rash. However, typical exanthema erupts all at once after the heat pathogen reaches the fifth or sixth day, with each lesion forming a pustule; this is unlike measles, where the skin becomes red and confluent. Furthermore, the eruption of measles is not restricted to the third or fourth day. When illuminated by fire, the body appears as if coated with cinnabar, which is a sign that it is about to erupt. Once erupted, the lesions are fine and scattered, with the skin red and confluent, resembling marks left by mosquito or flea bites; this is measles. There are cases where eruption occurs only on the sixth day, appearing and disappearing repeatedly within approximately one week. Secular belief holds that it erupts three times in one day, nine times in three days, and finally erupts thoroughly. However, some cases do not follow this pattern; as long as within three days, from the face to the chest, back, hands, and feet, although they appear and disappear, if they erupt thoroughly and the whole body is ruddy and vibrant, it is considered auspicious. In severe cases, the whole body swells, and the eyes are closed. The color may vary between red, white, and slightly yellow; ruddy and vibrant is best, while black depression is most abhorrent. Confluent lesions on the face, eyes, chest, and abdomen, or those obstructing the throat, are adverse signs. Failure to erupt accompanied by wheezing indicates death. The term "measles" refers to the fact that the body is covered with fine, scattered spots like hemp seeds, leaving no empty space. However, there are cases where the body is merely red without any spots; this is called "fire carbuncle" (huo dan), which also belongs to this category. Therefore, in variology, there are conditions such as variola complicated with exanthema, variola complicated with measles, and variola complicated with fire carbuncle. All are caused by heat-toxin and must be carefully differentiated.
1. At the initial stage of measles, characterized by yawning, fever, aversion to cold, cough, sneezing, and runny nose, Shengma Gegen Tang (Ephedra and Pueraria Decoction) should be used with Perilla Leaf (Zi Su Ye) and Scallion White (Cong Bai) to release the muscle layer. Profuse sweating must be strictly avoided. If tidal fever is severe, add Huang Qin (Scutellaria Root), Lian Zi (Coptis Rhizome), and Di Gu Pi (Lycium Bark). For delirium, Chen Sha Yi Yuan San (Cinnabar and Yuan Zhi Powder) should be administered. For cough, add Ma Huang (Ephedra Herb), Xing Ren (Apricot Seed), Mai Men Dong (Ophiopogon Tuber), and Shi Gao (Gypsum Fibrosum). For severe cough and high fever, Liang Ge San (Cool the Upper Jiao Powder) should be used with Jie Geng (Platycodon Root) and Di Gu Pi. For diarrhea, Si Ling San (Four-Poria Powder) is appropriate. For blood in stool, Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) should be combined. For hematemesis and epistaxis, Xi Jiao Di Huang Tang should be used with Shan Zhi (Gardenia Fruit). For dark urine, Mu Tong (Akebia Stem) should be added.
For chills and fever alternating like malaria, Xiao Chai Hu Tang (Minor Bupleurum Decoction) is indicated.
1. After the eruption of measles, if irritability and thirst occur, Jiedu Tang (Detoxification Decoction) combined with Bai Hu Tang (White Tiger Decoction) should be used. For wheezing with constipation, Qian Hu Gen Ke Tang (Peucedanum Root and Shell Decoction) with Wu Wei Zi (Schisandra Berry) should be administered. For severe constipation, Xiao Cheng Qi Tang (Minor Order the Qi Decoction) is indicated. For delirium with urinary retention, Dao Chi San (Guide Out the Red Powder) should be used. For turbid urine resembling rice water, Si Ling San should be used with Che Qian Zi (Plantago Seed) and Mu Tong. For delirium resembling mania, Jiedu Tang should be taken with Chen Sha Yi Yuan San. For bleeding from both large and small bowels, Xi Jiao Di Huang Tang combined with Jiedu Tang should be used. For hematemesis and epistaxis, Jiedu Tang should be used with fried Shan Zhi and Tong Bian (Child's Urine). For diarrhea, Jiedu Tang or Si Ling San should be used. For wheezing accompanied by diarrhea and dark, painful urination, Chai Ling Tang (Bupleurum and Poria Decoction) is indicated. For irritability, heat, intense thirst, and diarrhea, Bai Hu Tang should be used with Cang Zhu (Atractylodes Rhizome) and Zhu Ling (Polyporus). For dry retching due to excessive heat, Jiedu Tang should be used. For vomiting due to food stagnation, Si Jun Zi Tang (Four Gentlemen Decoction) is indicated. For vomiting due to heat in summer, Si Ling San should be used with Ren Shen (Ginseng Root).
1. The initial stage of measles, as well as the stages after eruption and resolution, present miscellaneous symptoms largely similar to those of variola and exanthema. However, the medication throughout should generally be cooling. Although it is said that measles prefers cooling and variola prefers warming, these are not fixed rules. Rather, deficiency should be tonified, excess should be purged, cold should be warmed, and heat should be cooled; this is the profound art of medicine. Therefore, in treating measles, Si Wu Tang (Four Substances Decoction) may be used for blood deficiency, Si Jun Zi Tang for qi deficiency, and warming and regulating middle-jiao herbs for cold injury; all should be applied according to the specific syndrome.
1. After the resolution of measles, if residual toxins invade internally, leading to picking at clothes and beds, delirious speech, confusion of spirit, and disordered consciousness, the prognosis is fatal. If the heat is mild but residual toxins remain, one must first observe the complexion and qi color. If abnormalities are seen, preventive measures must be taken. The treatment should primarily rely on Shengma Gegen Tang, or Si Wei Xiaodu Yin (Four-Ingredient Detoxification Drink), Liu Wei Xiaodu Yin (Six-Ingredient Detoxification Drink), or Jiedu Tang, selected according to the syndrome. Foods such as fish, seafood, scallions, and garlic should still be avoided.