麻疹发热之初，与伤寒相似，惟疹子则面颊赤，咳嗽喷嚏，鼻流清涕，目中有泪，呵欠喜睡，
或吐泻，或手掐眉目，面赤为异耳。但见此候，即是疹子，便宜谨避风寒，戒荤腥浓味。古法用升
麻葛根汤以表散毒邪，余制透邪煎代之更佳，或柴归饮亦妙。但使皮肤通畅，腠理开豁，则疹毒易
出，不可作伤寒，妄加汗下也。妄汗则增热而为衄血咳血，为口疮咽痛，为目赤肿，为烦躁干渴，
为大小便不通。妄下则里虚，为滑泄，为滞下。经曰∶必先岁气，母伐天和。言不可妄汗妄下也。
凡疹初热疑似之间，切不可轻易用药。总有他证，必待五日，腮下见疹，方可用升表之剂。嗽
多、连打嚏喷，鼻流清涕，或流鼻血，饮食减少，好饮凉水，只宜调理饮食，戒面食荤腥。
一、疹子初发热时，未见出现，咳嗽百十余声不已，上气喘急，面目胞肿，时卧时起，此火毒内
蒸，肺叶焦举，宜甘桔汤合白虎汤加牛蒡子、薄荷主之。如疹出之时，咳嗽口干，心烦者，此毒在
心肺，发未尽也，泻白散加天花、连翘、玄参、黄连主之。
一、疹子欲出未出之时，宜早为发散以解其毒，则无余患。若不预解，使之尽出，多致毒蓄于中
，或为壮热，日久枯瘁，或成惊痫，成为泻痢，或为咳血喘促，或作疳蚀而死。此虽一时戾气之染
，然未有不由于人事之未尽也。
麻疹发热初期，症状与伤寒相似，但麻疹患者面部两颊发红，伴有咳嗽、打喷嚏、流清鼻涕、眼睛流泪、打哈欠且嗜睡，有时出现呕吐或腹泻，或者用手抓挠眉目部位，以面赤为其特征。只要见到这些征候，即可诊断为麻疹，此时应谨慎避免风寒，忌食荤腥及味道浓烈的食物。古代方法使用升麻葛根汤来发散毒邪，我（张介宾）创制的透邪煎替代此方效果更佳，或者使用柴归饮也很巧妙。只要使皮肤通畅，腠理开泄，则疹毒容易透出，不可将其当作伤寒，胡乱使用发汗或攻下法。胡乱发汗会导致热势加重，进而引起鼻出血、咳血、口疮咽痛、眼睛红肿、烦躁干渴、大小便不通。胡乱攻下则导致里气虚弱，引起滑泄不止或痢疾。《内经》说：“必须先顺应岁气，不要损伤天和。”意思是不可胡乱发汗和攻下。凡是麻疹初起发热，症状疑似难辨时，切不可轻易用药。即使有其他证候，也必须等到第五天，腮部下方出现疹子后，才可以使用发表透疹的药剂。如果咳嗽多、连续打喷嚏、流清鼻涕，或者流鼻血，饮食减少，喜欢喝凉水，只宜调理饮食，忌食面食和荤腥。
一、麻疹初起发热时，疹点尚未发出，咳嗽一百多次不停止，上气喘急，面目眼睑浮肿，时而躺卧时而起身，这是火毒内蒸，导致肺叶焦枯上举，适宜用甘桔汤合白虎汤加牛蒡子、薄荷主治。如果在疹子发出之时，出现咳嗽、口干、心烦的症状，这是毒邪在心肺，疹毒未能完全透发，适宜用泻白散加天花粉、连翘、玄参、黄连主治。
一、麻疹欲出未出之时，应当尽早发散以解除其毒邪，这样就不会留下后患。如果不预先解毒，使其全部发出，大多会导致毒邪蓄积在体内，或者出现高热，日久身体干枯憔悴，或者形成惊痫，演变为泻痢，或者出现咳血喘促，或者因疳蚀而死。这虽然是一时戾气感染所致，然而没有不是因为人事处理不当造成的。
At the initial stage of fever in measles, the symptoms are similar to those of Shanghan (Cold Damage), but patients with measles present with redness on the cheeks, coughing, sneezing, runny nose with clear discharge, tearing eyes, yawning and drowsiness, sometimes accompanied by vomiting or diarrhea, or scratching the eyebrows and eyes. Redness of the face is a distinctive feature. Upon observing these signs, it can be diagnosed as measles; at this time, one should carefully avoid wind and cold, and abstain from meat, fish, and strongly flavored foods. Ancient methods used Shengma Gegen Tang (Cimicifugae Rhizoma and Puerariae Radix Decoction) to disperse toxic pathogens. I (Zhang Jiebin) created Touxie Jian (Toxin-Dispersing Decoction) as a superior alternative, or Chaiyin Yin (Bupleurum and Angelica Decoction) is also excellent. As long as the skin remains unobstructed and the Couli (pores/skin texture) are open, the measles toxin will easily emerge. It must not be treated as Shanghan, nor should sweating or purging methods be applied recklessly. Reckless sweating will exacerbate heat, leading to epistaxis, hemoptysis, mouth ulcers, sore throat, red and swollen eyes, restlessness, dry thirst, and obstruction of urination and defecation. Reckless purging will weaken the interior, leading to incontinence or dysentery. The Classics state: "One must first accord with the Qi of the year and not violate the Harmony of Heaven." This means that sweating and purging should not be performed indiscriminately. Whenever there is doubt between initial fever of measles and other conditions, medication should never be administered lightly. Even if other syndromes exist, one must wait until the fifth day when rashes appear below the cheeks before using exterior-releasing agents. If there is excessive coughing, continuous sneezing, clear nasal discharge, or epistaxis, along with reduced appetite and a preference for cold water, only dietary regulation is appropriate, avoiding wheat products and meat/fish.
1. When measles initially presents with fever but the rash has not yet emerged, accompanied by incessant coughing (over a hundred times), rapid breathing, swelling of the face and eyelids, and alternating lying down and getting up, this indicates internal steaming of fire-toxin causing the lung lobes to become scorched and elevated. Ganjie Tang (Licorice and Platycodon Decoction) combined with Baihu Tang (White Tiger Decoction) plus Niubangzi (Arctii Fructus) and Bohe (Menthae Haplocalycis Herba) should be used. If during the emergence of the rash, symptoms include cough, dry mouth, and irritability, this indicates toxin residing in the Heart and Lung, with incomplete eruption. Xiebai San (Draining White Powder) plus Tianhuafen (Trichosanthis Radix), Lianqiao (Forsythiae Fructus), Xuanshen (Scrophulariae Radix), and Huanglian (Coptidis Rhizoma) should be used.
1. When the measles rash is about to emerge but has not yet done so, early dispersal is required to resolve the toxin, thereby preventing sequelae. If the toxin is not resolved in advance and allowed to fully erupt, the toxin may accumulate internally, leading to high fever, prolonged emaciation, convulsions and epilepsy, dysentery, hemoptysis with panting, or death due to gan erosion (nutritional deficiency/gangrene). Although this is caused by the infection of a specific pathogenic factor (Li Qi), it invariably results from inadequate human management/care.