而出，为肾经痘，虽有良医，不能挽回。若疹则其根源在于肌腠皮肤，肤腠之血根于胞中血海，肤腠寒而胞血
稽迟，则有疹毒之证。得其源而活法以治，或听其自然而不加妄治，百无一死也。
霖按∶痧疹阳毒，治宜清解。间有赋质孱弱，或为苦寒
过剂，不得不用温托，作补偏救弊计，然亦千百中仅见一二。知此法以处变则可，泥此法以杀人则不可。致谓
根源是血，因寒凝涩，滞于肤腠之间，散而为疹，设此论为概用温补地步，贻误后学，尤属大谬。士宗与张隐
庵同负盛名，观此其两人优劣可见。
张石顽曰∶麻疹者，手足太阴阳明二经蕴热所发，小儿居多，大人亦时有之，是亦时气传染之类。其发热
时多咳嗽，多嚏多呕，眼中如泪，面浮腮赤，多泻，多痰，多热，多渴，多烦闷，甚则躁乱，咽痛唇焦，神昏。
通身红赤，起而成粒，匀净而小，斜目视之，隐隐皮肤之下，以手摸之，磊磊肌肉之间，其形若疥，其色若丹。
以其阳气从上，故头面愈多者为顺。法当清凉发散为主药，用辛散以升发之，凉润以清解之，切忌酸收。凡动
气燥悍，及一切温补之药，慎不可犯，误用祸不旋踵。辛散如荆芥、薄荷、前胡、葛根、麻黄、石膏、鼠粘子，
凉润如玄参、栝蒌根、葳蕤、麦冬、生甘草、芩、连、贝母、连翘、竹叶，皆应用之药。又当随所发月时，量
儿大小及见证轻重而为制剂。若渐出渐收者，其势虽轻，而热尚未平，须防喘急。若连绵三四日者，其势虽盛，
而热已发泄，必无他变，宜大青汤，或消毒饮加玄参、石膏、麦冬、竹叶。若发热时遍身汗出或衄血者，此毒
解也，勿遽止之。若汗出太多，血流不止，当以清肺汤去款冬、杏仁，加麻黄根以敛汗，犀角地黄汤以止血。
迟则气虚神耗，为难治也。若发热时，或呕吐，或自利者，此火邪内逼，毒瓦斯上下行也，俱宜清热解毒利小便，
切勿止涩。大凡疹症，发热时未有不渴者，但当与绿豆、灯芯煎汤，勿与冷冻饮料，致成水蓄，多生变幻也。即荤
腥酒面、生冷水果，咸须禁之。麻疹多有热痰在肺，初发时必咳嗽，宜清热透表，不得止嗽。麻后咳嗽，切忌
辛温酸涩，但用清咽滋肺汤以清余热，痰壅自愈。多喘者，热邪壅肺也，切勿定喘，惟应大剂竹叶石膏汤去半
夏加贝母、玄参、薄
荷。如冬天寒甚，麻毒为寒郁于内，不得透出而喘，加蜜酒炒麻黄一剂立止。夏月热势甚者，即用白虎汤加竹
叶。忌用升麻，误服必喘。然喘为肺气壅遏，故喘必兼嗽，而张口抬肩者，肺窍不通，不治也。故谚有喘而咳
嗽者可疗，喘而不嗽者难医之语。又其证多泄泻，慎勿止涩，惟宜芩、连、葛根，则泻自止。疹家不忌泻，泻
则阳明之邪热得解，是亦表里分消之义。又有疹收之后，饮食如常，卒然心腹绞痛，遍身冷汗如冰者，此元气
虚弱而中恶气也，朝发夕死，勿妄治之。凡麻疹以鲜明似锦为吉，黑晦如煤最凶，头面不出者重，红紫黯惨者
重，咽喉肿痛不食者重。黑黯干枯，一出即没者不治；鼻煽张目无神者不治；鼻青粪黑者不治；牙疳臭烂者不
治。疹之牙疳最为难治，外用无比散吹之；内服加味清胃散，更加荆芥，石膏，缓则不救，疹中诸患，不宜根据
证施治，惟当治本。本者，手太阴、足阳明二经之邪热也，解其邪热，则诸证自退矣。有夹痘而出者，此毒瓦斯
太盛，故一齐涌出，不必治疹，但当托痘为主。然治痘宜温，治疹宜凉，此又不可不审。大人男妇出疹，当与
外感并治，惟清凉解表，随天时寒暑施治。凡麻痘并作，脏腑风热交患也。麻乃风邪外感，豆为胎毒内发，二
者相杂，赤晕发 。多有误认痘出太密而委之不救，殊不知其为疹夹痘也，当与化斑汤续续频进，麻毒解而痘
自起矣。
大青汤 治斑子热毒。
石膏（生） 知母 大青 玄参 生地 甘草（炙） 木通 荆芥 竹叶
水煎服。
消毒饮 治痘疹咽痛而起发迟。
鼠粘子（研，钱半） 甘草（五分） 荆芥（一钱）
水煎，日二服。
清肺汤 治痘疹肺热，喘嗽吐痰
桔梗 甘草 麦门冬 款冬花 杏仁 贝母 牛蒡子
水煎服。
犀角地黄汤 治伤寒温病，一应发汗而不得汗，内蓄血，及鼻衄、吐血不尽，内余瘀血，大便血，面黄
或中脘作痛。
犀角 生地黄（酒浸，另捣） 牡丹皮 白芍（等分）
上四味水煎去滓，入地黄再煎数沸，滤清服。喜妄如狂，加大黄、黄芩。脉大来迟，腹不满而自言满者，
加当归，肉桂。吐衄加藕汁、侧柏、童便。
清咽滋肺汤 治麻后余热咳嗽声喑。
玄参 荆芥 葳蕤 鼠粘子 麦门冬 贝母（去心） 枳壳 桔梗 栝蒌根 马兜铃 藿香 丹皮 扁豆
赤芍（等分） 甘草（减半）
为散，每服三四钱，加生姜一片，水煎服。
竹叶石膏汤 治大病后烦热作渴。
竹叶 人参 甘草（炙） 石膏（生用，碎） 粳米 半夏 麦门冬
水煎温服。
白虎汤 治热病壮热烦渴，及中 烦热而渴。
石膏（八钱，生用，碎） 知母（三钱） 甘草（一钱，炙） 粳米（半合）
水煎，温分三服，一日尽饮之。
无比散 治麻后牙疳腐烂。
取黄牛粪 存性，入龙脑少许，研细吹之。
加味清胃散 治斑疹口舌生疮，齿龈腐烂。
生地黄 升麻 当归 牡丹皮 川连（酒蒸） 犀角 连翘 生甘草
为散，水煎去滓，细细呷之，半日再服。
化斑汤 治痘与斑夹出，用此消斑起痘。
鼠粘子（一钱） 玄参（二钱） 柴胡（八分） 荆芥（六分） 生甘草（四分） 连翘（七分） 防风
（六分） 木通（八分） 淡竹叶（十五片） 枳壳（七分） 蝉蜕（五分） 灯芯（二十茎）
水煎，温，日二三服。
有种行浆疹子，极似痘，最难看。然痘则必有顶盘，疹虽有浆，而头粒必不坚，根盘必无红晕也。疹后痘不
结痂，乃元气亏损，当大补脾胃为主，不可误认邪热未尽，复与清热退火之药。
麻疹俗名痧子，浙人呼为 子，麻病风热，人或未知。痧之与 ，字学不收，皆土音，习俗之讹耳。原其证
之轻重，今昔悬殊。吾吴水土濡弱之乡，生气最易萌动，故麻疹之发，自始至终，不过二三日即安。从古迄今，
靡不皆然。迩来风气变迁，有似北方气候，即寻常麻疹，必六七日乃化消。若热势未尽，或触风寒，或犯饮食，
变证百出，其危有甚于痘者。因遍考方书，从无麻疹专学，间有一二及此，无非附见痘疹之未，一皆简略不详。
何怪儿科之莫能举措，且以痘方混治。曷知麻属阳，阳从阴化，故外出内没而不浆；痘属阴，阴从阳化，当外
疏内托以助脓。二者相去天渊，乌可不辨。然皆为婴孺说也。但今不特婴孺，少壮每多患此，虽当参详诊切，
仍不能舍此绳墨。而临证之机，活法在乎心手，绳墨又不可拘也。
霖按∶《正字通》∶“麻，风热病。本作 。”《玉篇》∶“隐疹，皮外小起也。”是痘疹、痧疹、麻疹，
皆指其形似而言。若拘牵字学，则专治或出或不出之风热时麻，而转将人人不免之伏气痧疹置之不问。因字害义，
石顽老人未免疏漏矣。
发热 麻痘之初必由发热，但痘热不过二三日即出，麻热有六七日或半月乃出，或乍凉乍热，或壮热经日
不退。始热之际，必见面赤眼肿，多涕泪，咳嗽连声，是其候也。热甚经日不退曰壮热，惟正出时为正候。若初
发壮热，至已出而热不少衰者，其证必重，清热透肌汤。出尽而壮热不退者，竹叶石膏汤（方见前）去半夏加荆
芥、玄参。没后而壮热不退者危急，需凉解为主。其有热数日止而复作者，有早热而暮退者。在初发时为热邪末
透，葛根解肌汤。正出之际，而烦热转甚，乃邪热未解而复内攻也，清热透肌
汤。没后见者，为余邪未尽，四物汤换生地、赤芍，加连翘、玄参。亦有麻退身凉，越六七日而复热者，非余
热未清，即复感风邪，当以意消息。或因大病之后，中气虚而然者，治本为要。临病之机，不可不审也。
清热透肌汤 治麻疹未透，热甚而咳。
玄参 石膏 鼠粘子 荆芥 防风 前胡 葛根 杏仁（等分） 生甘草（减半）
水煎，热服。
葛根解肌汤 治麻疹初起，发热咳嗽，或乍凉乍热。
葛根 前胡 鼠粘子 荆芥 连翘 赤芍 蝉蜕 木通（等分） 生甘草（减半）
水煎，热服。
四物汤 治营血虚热。
熟地黄（二钱） 当归身（一钱） 白芍（钱半） 川芎（八分）
上四味，水煎温服。肥盛多湿痰，及呕逆少食便清者禁用。
部位 麻属腑候，发则先动阳分，而后归阴经。一身之中，阳部宜多，阴部宜少。阳部宜透，阴部即不透，
亦可无虑。若阴部多，而阳部反少不透者为险，防有他变。阳部者，头面、背、四肢向外者，皆为阳。阴部者，
胸、腹、腰、四肢向内者，皆为阴也。凡发自头至足为齐，头面多者为顺。先从胸腹暖处起，渐发四肢者顺。
如从手足起，渐发胸腹背者逆。
形色 色贵红润，形贵尖耸。若色虽红润而不起，二便艰涩者，清热透肌汤（方见前）。如色淡不起，二
便如常，此属本虚，兼当培养气血。亦有色黯不起，大便秘结，唇舌燥赤者，为火邪内郁，白虎汤（方见前）
加玄参、荆芥。其有色白，不分肉地，惟点粒高耸， 时即没者，邪热本轻也。然有表气本虚而色白者，调护
温暖，一二日自变红活也。若正出时为风寒所遏，而色白如肤，必毛窍悚栗，葛根解肌汤（方见前）。或麻出
成片，一被风寒，便变为白，身
不发热而反内攻，烦躁腹痛，痰喘气急者，危。如毒攻于胃，则呕吐清水。攻于脾，则腹胀不食。攻于肺，则鼻
塞喘促。攻于心包，则唇舌焦燥，不省人事，摇头掣手。攻于肾肝，则变黑而不救也。若色紫赤而黯，是火毒
炽盛，顶粒起者可治，宜凉血饮子。 语烦躁者，黄连解毒汤（方见前万氏论中）调益元散，枯燥不起者难治。
若顶粒焦者，无论红淡，皆为热剧之候，并宜白虎汤（方见前），重用石膏。干燥无汗，加麻黄以汗之；大便秘
者，凉膈散下之。亦有麻发如云头大片，其形有二∶一者大片 赤，一者大片之上复有小红点粒，皆火邪炽盛
所致，白虎汤加玄参、竹叶。若麻出斑斓如锦纹，或出脓血腥臭不干，心胸烦闷，呕吐清水，身温热者，白虎
汤加黄芩、茅术。若初发时有似斑屑者，乃风寒在表而成隐疹，只宜疏解。俟麻一透，其疹自退。切勿认为斑，
而与苦寒之剂，致麻内陷而难救也。
凉血饮子 治麻疹火毒炽盛，紫赤而黯。
黄连（五分） 黄芩（一钱） 大生地（钱半） 荆芥（一钱） 玄参（一钱） 赤芍药（八分） 红
花（三分） 木通（七分） 牡丹皮（八分）
水煎，温服。
益元散（一名天水散，一名六一散） 治暑月小便不利。
滑石（水飞，六两） 甘草（炙六钱，生四钱）
为散，清水调服二三钱。发散温病、热病，加葱白五七茎，香豉四合，水煎温服。老人、虚人及病后伤津，
小便不利，禁用此方。加葱豉煎服，则兼散表邪。加吴茱萸，则治白痢。加红曲，则治血痢。加炮姜，则兼消饮
食。加朱砂，则兼退心火。加青黛，则散肝火。加薄荷，则清肺热。加石膏，则除胃热。其入通圣、双解、解
毒等方，随证配合，未遑枚举。
凉膈散 治温热时行，表里实热，及心火亢盛，目赤便秘，胃热发斑。
大黄（酒浸，二两） 芒硝（一两） 连翘（一两） 黄芩（一两） 甘草（炙，六钱）
山栀（八钱） 薄荷（七钱）
为散，每服四五钱，加竹叶十五片，水煎温，日三夜二服，得下热退为度。（世本无竹叶，有姜一片，枣一
枚，葱一茎。）
硝黄得枳朴之重着，则下热承之而顺下；得芩栀翘薄之轻扬，则上热抑之而下清。此承气、凉膈之所攸分
也。用甘草者，即调胃承气之义也。《局方》专主温热时行，故用竹叶。若治感冒之证，从世本用葱白姜枣可
也。
咳嗽 麻疹干咳连声不断，是火邪凌烁肺金所致。然咳则毛窍开而麻易出。故未出之先最喜咳甚，发透其
咳自己。若出尽及没后而咳仍不止者，清咽滋肺汤（方见前）。咳嗽多痰，去麦冬，加橘皮、茯苓。其有感触
风寒，咳嗽烦闷，呕逆清水，眼赤咽痛，口舌生疮者，甘桔汤加芩连。没后见者，人参白虎汤去知母易麦冬，
以滋化之。
甘桔汤 治麻疹咽痛，口舌生疮。
甘草 桔梗 山豆根 玄参 鼠粘子 荆芥（等分） 麦门冬（倍用）
水煎，温服。
人参白虎汤 治热病舌干大渴，发热背寒。
人参（一钱） 石膏（八钱，生用，碎） 知母（三钱） 粳米（半合） 甘草（一钱，炙）
水煎，温，分三服，一日尽饮之。
汗 麻发之际，常宜微汗，微汗则肌腠疏豁而邪易透。不可复用升发，升发恐汗大泄，不无亡阳之虑。其
有隐陷不透之坏证，用权升发得大汗而解者，此特语其变也。若壮热无汗而皮肤干燥者，必风寒壅滞难出，多
（痧疹）透发而出，若属肾经痘证，虽有良医，也无法挽回。若是疹子，其根源在于肌腠皮肤，肤腠之血根源于胞中血海，若肤腠受寒导致胞中血液运行迟滞，就会出现疹毒的证候。找到病源并运用灵活的方法治疗，或者顺应其自然规律而不妄加干预，百人中也不会有一个人死亡。
叶霖按语：痧疹属于阳毒，治疗应当以清热解毒为主。偶尔遇到体质孱弱的人，或因苦寒药物使用过量，不得不采用温补托毒的方法，作为纠正偏颇、补救弊端的权宜之计，但这在千百例中也仅见一二。知晓这种方法来处理变证是可以的，但拘泥于此法而致人死亡则不可取。那种认为根源是血，因寒凝涩滞于肤腠之间，散开而形成疹子的说法，如果将其作为普遍使用温补的依据，贻误后学，更是大错特错。士宗与张隐庵都享有盛名，从这一点可以看出两人的优劣。
张石顽说：麻疹是由手足太阴、阳明二经蕴积的热邪所引发，多见于小儿，成人也有时发病，这也属于时气传染的一类。发热时多伴有咳嗽、打喷嚏、呕吐，眼中流泪，面部浮肿、腮部发红，多腹泻，多痰，多热，多口渴，多烦闷，严重时躁动不安，咽喉疼痛，嘴唇焦裂，神志昏迷。全身红赤，起疹成粒，均匀细密，斜视可见隐隐在皮肤之下，用手触摸感觉颗粒感在肌肉之间，形状像疥疮，颜色像丹砂。因为阳气向上走，所以头面部出疹多的为顺证。治疗方法当以清凉发散为主药，用辛散药物来升发，用凉润药物来清解，切忌使用酸收类药物。凡是性质动气燥悍，以及一切温补的药物，务必谨慎，不可触犯，误用则灾祸立至。辛散药物如荆芥、薄荷、前胡、葛根、麻黄、石膏、牛蒡子；凉润药物如玄参、天花粉、玉竹、麦冬、生甘草、黄芩、黄连、贝母、连翘、竹叶，都是应当应用的药物。又应根据发病的月份，衡量患儿的大小及见证的轻重来制定方剂。如果疹子渐渐发出又渐渐消退，虽然病情较轻，但热势尚未平息，须防止出现喘急。如果连绵三四天，虽然病情看似严重，但热邪已经发泄，必然不会有其他变故，适宜用大青汤，或消毒饮加玄参、石膏、麦冬、竹叶。如果发热时遍身出汗或流鼻血，这是毒邪解除的表现，不要急于止住。如果汗出太多，血流不止，应当用清肺汤去掉款冬花、杏仁，加入麻黄根以收敛汗液，犀角地黄汤以止血。拖延久了会导致气虚神耗，就难以治疗了。如果发热时，出现呕吐或自发性腹泻，这是火邪内逼，毒气上下行走，都应当清热解毒利小便，切勿使用止涩药物。大凡疹症，发热时没有不口渴的，只应当给予绿豆、灯芯煎汤，不要给冷冻饮料，以免形成水蓄积，产生更多变幻。即使是荤腥酒面、生冷水果，都必须禁止食用。麻疹多有热痰在肺，初发时必定咳嗽，应当清热透表，不能强行止咳。麻疹后的咳嗽，切忌使用辛温酸涩药物，只用清咽滋肺汤清除余热，痰壅自然痊愈。多喘的，是热邪壅塞肺部，切勿强行定喘，只应大剂量使用竹叶石膏汤去掉半夏，加入贝母、玄参、薄荷。如果是冬天寒气很重，麻毒被寒邪郁闭在内，不能透出而导致喘息，加蜜酒炒制的麻黄，一剂即可停止。夏天热势严重的，直接用白虎汤加竹叶。忌用升麻，误服必然导致喘息。然而喘息是因为肺气壅遏，所以喘息必定兼有咳嗽，如果出现张口抬肩的症状，说明肺窍不通，是无法治疗的。所以谚语说：“喘而咳嗽的可以治疗，喘而不咳嗽的难医。”另外这种病症多伴有泄泻，千万不要止涩，只宜用黄芩、黄连、葛根，腹泻自然停止。患疹的人不忌讳腹泻，腹泻则阳明经的邪热得以解除，这也是表里分消的道理。又有疹子收没之后，饮食如常，突然心腹绞痛，遍身冷汗如冰的，这是元气虚弱而中了恶气，早晨发作晚上就会死亡，不要妄加治疗。大凡麻疹以色泽鲜明似锦缎为吉兆，黑晦暗如煤炭最凶险，头面部不出疹的重症，红紫黯惨的重症。黑黯干枯，一出即消失的不治；鼻翼煽动、眼睛无神的；鼻子发青、大便黑色的；牙疳臭烂的不治。疹子的牙疳最为难治，外用无比散吹敷；内服加味清胃散，再加荆芥、石膏，迟缓则无法挽救。疹中的各种病患，不宜根据具体症状施治，只应当治本。本，就是手太阴、足阳明二经的邪热，解除了邪热，各种证候自然消退。有夹带痘疹一起出的，这是因为毒气太盛，所以一齐涌出，不必治疹，只应当以托痘为主。然而治痘适宜温补，治疹适宜清凉，这又不可不仔细审察。成年男女出疹，应当与外感病并治，只是用清凉解表的方法，随天时寒暑施治。凡是麻痘并发，是脏腑风热交相为患。麻是风邪外感，痘是胎毒内发，二者混杂，赤晕发生。常有误认痘出得太密而放弃救治的，殊不知这是疹夹痘，应当连续频进化斑汤，麻毒解除而痘自然发出。
大青汤 治疗斑子热毒。
石膏（生用） 知母 大青 玄参 生地 甘草（炙） 木通 荆芥 竹叶
水煎服。
消毒饮 治疗痘疹咽痛且起发迟缓。
鼠粘子（研碎，一钱半） 甘草（五分） 荆芥（一钱）
水煎，每日服两次。
清肺汤 治疗痘疹肺热，气喘咳嗽吐痰。
桔梗 甘草 麦门冬 款冬花 杏仁 贝母 牛蒡子
水煎服。
犀角地黄汤 治疗伤寒温病，所有发汗而不得汗，体内蓄血，以及鼻衄、吐血不尽，体内残留瘀血，大便出血，面色黄或中脘作痛。
犀角 生地黄（酒浸，另捣） 牡丹皮 白芍（等分）
以上四味水煎去渣，放入地黄再煎数沸，滤清服用。出现谵语狂乱，加大黄、黄芩。脉象大而来迟，腹部不胀满却自称胀满的，加当归、肉桂。吐血衄血加藕汁、侧柏叶、童便。
清咽滋肺汤 治疗麻疹后余热咳嗽声音嘶哑。
玄参 荆芥 葳蕤 鼠粘子 麦门冬 贝母（去心） 枳壳 桔梗 栝蒌根 马兜铃 藿香 丹皮 扁豆 赤芍（等分） 甘草（减半）
研为散，每次服三到四钱，加生姜一片，水煎服。
竹叶石膏汤 治疗大病后烦热口渴。
竹叶 人参 甘草（炙） 石膏（生用，碎） 粳米 半夏 麦门冬
水煎温服。
白虎汤 治疗热病壮热烦渴，以及中暑烦热而渴。
石膏（八钱，生用，碎） 知母（三钱） 甘草（一钱，炙） 粳米（半合）
水煎，分三次温服，一天喝完。
无比散 治疗麻疹后牙疳腐烂。
取黄牛粪煅存性，加入少许龙脑，研细吹入患处。
加味清胃散 治疗斑疹口舌生疮，齿龈腐烂。
生地黄 升麻 当归 牡丹皮 川连（酒蒸） 犀角 连翘 生甘草
研为散，水煎去渣，细细呷服，半天后再服。
化斑汤 治疗痘与斑夹杂而出，用此方消除斑疹促使痘发出。
鼠粘子（一钱） 玄参（二钱） 柴胡（八分） 荆芥（六分） 生甘草（四分） 连翘（七分） 防风（六分） 木通（八分） 淡竹叶（十五片） 枳壳（七分） 蝉蜕（五分） 灯芯（二十茎）
水煎，温服，每日两到三次。
有种行浆疹子，极像痘，最难诊治。然而痘必有顶盘，疹虽然有浆，但头部颗粒必定不坚硬，根部也没有红晕。疹后痘不结痂，是元气亏损，应当以大补脾胃为主，不可误认为邪热未尽，再次给予清热退火的药物。
麻疹俗名痧子，浙江人呼为“沙”子，麻病风热，人们或许不知道。痧与沙，字书不收，都是土音，是习俗的错误。推究其证候的轻重，今昔悬殊。我们吴地水土柔弱的地方，生气最容易萌动，所以麻疹的发生，从头到尾，不过两三天就平安了。从古至今，无不如此。近来风气变迁，有点像北方气候，即使是寻常麻疹，也必须六七天才能化消。如果热势未尽，或触犯风寒，或犯饮食，变证百出，其危险甚至有甚于痘的。于是遍考方书，从无麻疹专学，间有一二提及此事的，无非附见于痘疹之前，一概简略不详。难怪儿科医生不能举措得当，且用治痘的方子混治。怎知麻属阳，阳从阴化，所以外出内陷而不化浆；痘属阴，阴从阳化，应当外疏内托以助脓。二者相差天壤，怎能不辨别。这都是针对婴幼儿说的。但现在不仅婴幼儿，少壮之人也多患此病，虽然应当详细诊切，仍不能舍弃这些准则。然而临证的机变，活法在于心手，准则又不可拘泥。
叶霖按语：《正字通》说：“麻，风热病。本作‘沙’。”《玉篇》说：“隐疹，皮外小起也。”因此痘疹、痧疹、麻疹，都是指其形态相似而言。如果拘牵于字学，则专门治疗或出或不出之风热时麻，反而将人人不免的伏气痧疹置之不问。因字害义，石顽老人未免疏漏了。
发热 麻痘之初必定由发热引起，但痘热不过两三天就发出，麻热有六七天或半个月才发出，或乍凉乍热，或壮热整天不退。开始发热之际，必定见面赤眼肿，多涕泪，咳嗽连声，这是其征候。热势很盛整天不退叫壮热，只有正当发出时为正候。如果初发壮热，等到已经发出而热势不少衰减的，其证必重，用清热透肌汤。出尽而壮热不退的，用竹叶石膏汤（方见前）去掉半夏加入荆芥、玄参。疹没后而壮热不退的危急，需要以凉解为主。有的热势几天停止后又复发的，有早热而暮退的。在初发时为热邪未透，用葛根解肌汤。正当发出之际，而烦热转甚，是邪热未解而复内攻，用清热透肌汤。疹没后见到的，为余邪未尽，用四物汤换生地、赤芍，加连翘、玄参。也有麻退身凉，过了六七天又复热的，不是余热未清，就是复感风邪，应当凭心意斟酌。或因大病之后，中气虚而导致的，治本是关键。临病的机变，不可不审慎。
清热透肌汤 治疗麻疹未透，热甚而咳。
玄参 石膏 鼠粘子 荆芥 防风 前胡 葛根 杏仁（等分） 生甘草（减半）
水煎，热服。
葛根解肌汤 治疗麻疹初起，发热咳嗽，或乍凉乍热。
葛根 前胡 鼠粘子 荆芥 连翘 赤芍 蝉蜕 木通（等分） 生甘草（减半）
水煎，热服。
四物汤 治疗营血虚热。
熟地黄（二钱） 当归身（一钱） 白芍（钱半） 川芎（八分）
以上四味，水煎温服。肥胖多湿痰，及呕逆少食便溏者禁用。
部位 麻属腑候，发出则先动阳分，而后归阴经。一身之中，阳部宜多，阴部宜少。阳部宜透，阴部即不透，也可以无忧虑。如果阴部多，而阳部反而少不透的为险证，防备有其他变故。阳部，指头面、背、四肢向外者，皆为阳。阴部，指胸、腹、腰、四肢向内者，皆为阴也。凡是发自头至足为齐，头面多者为顺。先从胸腹暖处起，渐发四肢者为顺。如从手足起，渐发胸腹背者为逆。
形色 颜色贵红润，形状贵尖耸。如果颜色虽红润但不起来，二便艰涩的，用清热透肌汤（方见前）。如果色淡不起，二便如常，这属于本虚，兼当培养气血。也有色黯不起，大便秘结，唇舌燥赤的，为火邪内郁，用白虎汤（方见前）加玄参、荆芥。其有色白，不分肉地，惟点粒高耸，刚出来就消失的，邪热本来轻浅。然而有表气本虚而色白的，调护温暖，一两天自然变红活。如果正当发出时被风寒所遏，而色白如皮肤，必定毛窍悚栗，用葛根解肌汤（方见前）。或麻出成片，一被风寒，便变为白色，身体不发热反而内攻，烦躁腹痛，痰喘气急的，危。如果毒攻于胃，则呕吐清水。攻于脾，则腹胀不食。攻于肺，则鼻塞喘促。攻于心包，则唇舌焦燥，不省人事，摇头掣手。攻于肾肝，则变黑而不救。如果色紫赤而黯，是火毒炽盛，顶粒起的可治，宜用凉血饮子。谵语烦躁的，用黄连解毒汤（方见前万氏论中）调益元散，枯燥不起的难治。如果顶粒焦枯的，无论红淡，都是热剧的征候，并用白虎汤（方见前），重用石膏。干燥无汗，加麻黄以发汗；大便秘结的，用凉膈散下之。也有麻发如云头大片，其形有二：一者大片赤红，一者大片之上复有小红点粒，都是火邪炽盛所致，用白虎汤加玄参、竹叶。如果麻出斑斓如锦纹，或出脓血腥臭不干，心胸烦闷，呕吐清水，身温热者，用白虎汤加黄芩、茅术。如果初发时有似斑屑的，乃风寒在表而成隐疹，只宜疏解。等麻一透，其疹自退。切勿认为是斑，而与苦寒之剂，致使麻内陷而难救。
凉血饮子 治疗麻疹火毒炽盛，紫赤而黯。
黄连（五分） 黄芩（一钱） 大生地（钱半） 荆芥（一钱） 玄参（一钱） 赤芍药（八分） 红花（三分） 木通（七分） 牡丹皮（八分）
水煎，温服。
益元散（一名天水散，一名六一散） 治疗暑月小便不利。
滑石（水飞，六两） 甘草（炙六钱，生四钱）
研为散，清水调服二三钱。发散温病、热病，加葱白五七茎，香豉四合，水煎温服。老人、虚人及病后伤津，小便不利，禁用此方。加葱豉煎服，则兼散表邪。加吴茱萸，则治白痢。加红曲，则治血痢。加炮姜，则兼消饮食。加朱砂，则兼退心火。加青黛，则散肝火。加薄荷，则清肺热。加石膏，则除胃热。其入通圣、双解、解毒等方，随证配合，来不及枚举。
凉膈散 治疗温热时行，表里实热，及心火亢盛，目赤便秘，胃热发斑。
大黄（酒浸，二两） 芒硝（一两） 连翘（一两） 黄芩（一两） 甘草（炙，六钱）
山栀（八钱） 薄荷（七钱）
研为散，每次服四五钱，加竹叶十五片，水煎温，日三夜二服，得下热退为度。（世传本无竹叶，有姜一片，枣一枚，葱一茎。）
硝黄得枳朴之重着，则下热承之而顺下；得芩栀翘薄之轻扬，则上热抑之而下清。这是承气、凉膈之所区别。用甘草者，即调胃承气之义。《局方》专主温热时行，故用竹叶。若治感冒之证，从世传本用葱白姜枣即可。
咳嗽 麻疹干咳连声不断，是火邪凌烁肺金所致。然而咳则毛窍开而麻易出。所以在未出之先最喜咳甚，发透其咳自己会停。如果出尽及没后而咳仍不止的，用清咽滋肺汤（方见前）。咳嗽多痰，去掉麦冬，加橘皮、茯苓。其有感触风寒，咳嗽烦闷，呕逆清水，眼赤咽痛，口舌生疮的，用甘桔汤加芩连。疹没后见到的，用人参白虎汤去掉知母换麦冬，以滋化之。
甘桔汤 治疗麻疹咽痛，口舌生疮。
甘草 桔梗 山豆根 玄参 鼠粘子 荆芥（等分） 麦门冬（倍用）
水煎，温服。
人参白虎汤 治疗热病舌干大渴，发热背寒。
人参（一钱） 石膏（八钱，生用，碎） 知母（三钱） 粳米（半合） 甘草（一钱，炙）
水煎，温，分三服，一天喝完。
汗 麻发之际，常宜微汗，微汗则肌腠疏豁而邪易透。不可复用升发，升发恐汗大泄，不无亡阳之虑。其有隐陷不透之坏证，用权宜升发得大汗而解的，这只是告诉其变证。如果壮热无汗而皮肤干燥的，必定风寒壅滞难出，多……
(Erythema) erupts outward. If it is a case of kidney meridian smallpox, even with excellent physicians, it cannot be saved. However, if it is erythema (measles/rash), its root lies in the muscle-coupling and skin. The blood of the muscle-coupling originates from the Chong Mai (Penetrating Vessel) and Blood Sea. If cold in the muscle-coupling causes stasis in the uterine blood, symptoms of erythema toxin will appear. By identifying the source and applying flexible treatment methods, or by allowing nature to take its course without reckless intervention, fewer than one in a hundred will die.
Ye Lin's Note: Sha Zhen (toxic rash) belongs to Yang toxins; treatment should focus on clearing heat and resolving toxicity. Occasionally, for patients with weak constitutions or those who have overdosed on bitter-cold herbs, warm-tonifying and pushing-out methods must be used as a remedy for deviation and correction of defects. However, such cases are rare, perhaps only one or two in a thousand. Knowing this method to handle variations is acceptable, but adhering rigidly to it leading to death is unacceptable. The theory that the root is blood, congealed by cold and stagnating between the muscle-couplings, dispersing to form rashes, if used as a basis for universal warm-tonification, misleads future generations and is a major error. Shizong and Zhang Yin'an were both renowned; comparing them based on this reveals their differences in quality.
Zhang Shiwen said: Measles are caused by accumulated heat in the Hand-Taiyin, Foot-Taiyin, and Foot-Yangming meridians. They occur mostly in children, but adults also get them occasionally; this is also a type of seasonal epidemic contagion. During fever, there is often coughing, sneezing, vomiting, tearing eyes, facial swelling, reddish cheeks, diarrhea, phlegm, heat, thirst, irritability, and in severe cases, restlessness, sore throat, cracked lips, and coma. The whole body becomes red, raising into granules, uniform and small. Viewed obliquely, they are faintly visible under the skin; touched by hand, they feel like grains among the muscles. Their shape resembles scabies, and their color resembles cinnabar. Because Yang Qi moves upward, having more eruptions on the head and face indicates a favorable prognosis. The treatment method should primarily use cool and dispersing drugs, using acrid-dispersing agents to ascend and diffuse, and cool-moistening agents to clear and resolve. Sour-astringent drugs must be strictly avoided. Any drugs with moving, dry, and fierce properties, as well as all warm-tonifying drugs, must be handled with caution and not violated; misuse leads to immediate disaster. Acrid-dispersing drugs include Jingjie (Schizonepetae Herba), Bohe (Menthae Haplocalycis Herba), Qianhu (Peucedani Radix), Gegen (Puerariae Lobatae Radix), Mahuang (Ephedrae Herba), Shigao (Gypsum Fibrosum), and Niubangzi (Arctii Fructus). Cool-moistening drugs include Xuanshen (Scrophulariae Radix), Gualougen (Trichosanthis Radix), Weirui (Polygonati Odorati Rhizoma), Maidong (Ophiopogonis Radix), Sheng Gancao (Glycyrrhizae Radix et Rhizoma), Huangqin (Scutellariae Radix), Lianlian (Coptidis Rhizoma), Beimu (Fritillariae Bulbus), Lianqiao (Forsythiae Fructus), and Zhuye (Bambusae Folium); these are all applicable drugs. Furthermore, prescriptions should be adjusted according to the month of onset, considering the child's size and the severity of symptoms. If the rash emerges gradually and recedes gradually, although the condition is mild, the heat has not yet subsided, so one must guard against wheezing urgency. If it persists for three to four days, although the condition seems severe, the heat has been vented, and no other changes are likely; Daqing Tang (Great Blue Decoction) or Xiaodu Yin (Detoxification Drink) added with Xuanshen, Shigao, Maidong, and Zhuye is suitable. If sweating over the whole body or epistaxis occurs during fever, this indicates the resolution of toxin; do not hastily stop it. If sweating is excessive and bleeding does not stop, Qingfei Tang (Clear Lung Decoction) should be used, removing Kuandonghua (Adenophorae Radix) and Xingren (Armeniacae Semen Amarum), adding Mahuang Gen (Ephedrae Radix et Rhizoma) to arrest sweating, and Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) to stop bleeding. Delay leads to Qi deficiency and spirit exhaustion, making it difficult to treat. If vomiting or spontaneous diarrhea occurs during fever, this is fire pathogen forcing inward, with toxin qi moving up and down; all cases should be treated with clearing heat, detoxifying, and promoting urination. Astringents must absolutely not be used. Generally, in rash syndromes, thirst is inevitable during fever; only Mung Bean and Lampwick decoction should be given. Frozen drinks must be avoided to prevent water accumulation and further complications. Meat, alcohol, noodles, and raw/cold fruits must also be prohibited. Measles often involve hot phlegm in the lungs; coughing is inevitable at the initial stage. Treatment should clear heat and vent the exterior; cough should not be suppressed. For post-measles cough, acrid-warm and sour-astringent drugs must be avoided. Only Qingyan Zipfei Tang (Clear Throat and Nourish Lung Decoction) should be used to clear residual heat, after which phlegm obstruction will resolve spontaneously. Wheezing is due to heat pathogen obstructing the lungs; do not forcibly stop wheezing. Instead, a large dose of Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) should be used, removing Banxia (Pinelliae Rhizoma), and adding Beimu, Xuanshen, and Bohe. In winter, if cold is severe and measles toxin is depressed internally by cold, preventing eruption and causing wheezing, add honey-fried Mahuang; one dose will stop it immediately. In summer, if heat is severe, use Baihu Tang (White Tiger Decoction) with added Zhuye. Shengma (Cimicifugae Rhizoma) must be avoided; misuse inevitably causes wheezing. Wheezing is due to lung Qi obstruction, so wheezing must be accompanied by cough. Opening mouth and lifting shoulders indicates blocked lung orifices, which is untreatable. Hence the proverb: "Wheezing with cough can be treated; wheezing without cough is hard to cure." Additionally, this syndrome often involves diarrhea; do not use astringents. Use Huangqin, Lianlian, and Gegen, and diarrhea will stop naturally. Rash patients do not fear diarrhea; diarrhea resolves Yangming heat pathogen, embodying the principle of distributing elimination between interior and exterior. After the rash subsides, if diet is normal but sudden heart/abdominal colic and icy cold sweat occur, this is Yuanqi (Original Qi) deficiency with evil qi invasion; morning onset means evening death; do not treat recklessly. Generally, bright and brocade-like measles are auspicious; black, dull, coal-like ones are most ominous. Absence on head/face is serious; dark purple/red is serious. Black/dry/withered disappearing immediately upon eruption is untreatable; flaring nostrils and spiritless eyes are untreatable; blue nose and black stool are untreatable; foul rotting gums are untreatable. Gum rot in measles is the hardest to treat; externally apply Wubi San (Peerless Powder); internally administer Jiawei Qingwei San (Modified Stomach-Clearing Powder) with added Jingjie and Shigao. Delay means no rescue. Various complications in measles should not be treated symptomatically but by addressing the root. The root is the heat pathogen in the Hand-Taiyin and Foot-Yangming meridians. Resolving this heat clears all symptoms. Cases with concurrent smallpox occur when toxin qi is too abundant, erupting simultaneously. There is no need to treat the rash; focus on supporting the smallpox. However, treating smallpox requires warmth, while treating measles requires cooling; this distinction must be carefully examined. Adult men and women with measles should be treated alongside exterior syndromes, using cool-clearing and exterior-resolving methods adjusted for seasonal cold/heat. Concurrent measles and smallpox indicate wind-heat affecting the Zang-Fu. Measles is external wind pathogen; smallpox is internal fetal toxin. Mixed together, red halos appear. Often, dense smallpox is mistaken for hopeless cases, unaware it is measles complicating smallpox. Continuously administer Huaban Tang (Spot-Resolving Decoction); once measles toxin resolves, smallpox will rise.
Daqing Tang treats macule heat toxin.
Shigao (Raw), Zhimu (Anemarrhenae Rhizoma), Daqing (Isatidis Folium), Xuanshen, Shengdi (Rehmanniae Radix), Gancao (Honey-fried), Mutong (Akebiae Caulis), Jingjie (Schizonepetae Spica), Zhuye. Decoct in water and take.
Xiaodu Yin treats smallpox/measles with sore throat and delayed eruption.
Niubangzi (Crushed, 1.5 qian), Gancao (0.5 qian), Jingjie (1 qian). Decoct in water, take twice daily.
Qingfei Tang treats smallpox/measles lung heat, wheezing, cough, and expectoration.
Jiegeng (Platycodonis Radix), Gancao, Maidong, Kuandonghua (Adenophorae Flos), Xingren, Beimu, Niubangzi. Decoct in water and take.
Xijiao Dihuang Tang treats Shanghan (Cold Damage) and Wenbing (Warm Diseases) where sweating fails to induce perspiration, internal blood stasis, incomplete epistaxis/hematemesis, remaining intra-abdominal blood stasis, hematochezia, yellow complexion, or epigastric pain.
Xijiao (Rhinocerotis Cornu - *Note: Substitute with Water Buffalo Horn/Shuiniujiao in modern practice*), Shengdihuang (Soaked in wine, separately pounded), Mudanpi (Moutan Cortex), Baishao (Paeoniae Radix Alba) in equal parts.
Decoct the first three ingredients, remove dregs, add Dihuagn, boil briefly, filter, and take. For delirium/manic behavior, add Dahuang (Rhei Radix et Rhizoma) and Huangqin. For pulse large but slow, abdominal fullness sensation despite no distension, add Danggui (Angelicae Sinensis Radix) and Rougui (Cinnamomi Cortex). For hematemesis/epistaxis, add Lotus Root Juice, Ce Bai Ye (Biota Tops), and Tongbian (Child's Urine).
Qingyan Zipfei Tang treats post-measles residual heat, cough, and hoarseness.
Xuanshen, Jingjie, Weirui, Niubangzi, Maidong, Beimu (Heart removed), Zhike (Aurantii Fructus), Jiegeng, Gualougen, Madouling (Aristolochiae Radix), Huoxiang (Agastaches Herba), Danpi, Bidou (Dolichoris Semen), Baishao (Equal parts), Gancao (Half dose).
Grind into powder. Take 3-4 qian per dose with one slice of Shengjiang (Zingiberis Rhizoma), decoct in water.
Zhuye Shigao Tang treats irritability and thirst after severe illness.
Zhuye, Renshen (Ginseng Radix et Rhizoma), Gancao (Honey-fried), Shigao (Raw, crushed), Jingmi (Oryza Sativa), Banxia (Pinelliae Rhizoma), Maidong. Decoct in water and take warm.
Baihu Tang treats febrile disease with high fever, irritability, and thirst, as well as Summerheat irritability and thirst.
Shigao (8 qian, Raw, crushed), Zhimu (3 qian), Gancao (1 qian, Honey-fried), Jingmi (0.5 he).
Decoct in water, divide into three warm doses, consume within one day.
Wubi San treats post-measles gum rot.
Take cow dung, calcine until carbonized, add a little Longnao (Borneolum Syntheticum), grind fine, and insufflate.
Jiawei Qingwei San treats macules/rashes with oral ulcers and gum rot.
Shengdihuang, Shengma, Danggui, Mudanpi, Chuanlian (Steamed with wine), Xijiao, Lianqiao, Sheng Gancao.
Grind into powder, decoct in water, remove dregs, sip slowly, repeat after half a day.
Huaban Tang treats concurrent smallpox and macules; use to resolve macules and promote smallpox eruption.
Niubangzi (1 qian), Xuanshen (2 qian), Chaihu (Bupleuri Radix, 0.8 qian), Jingjie (0.6 qian), Sheng Gancao (0.4 qian), Lianqiao (0.7 qian), Fangfeng (Saposhnikoviae Radix, 0.6 qian), Mutong (0.8 qian), Dan Zhuye (15 leaves), Zhike (0.7 qian), Chantui (Cicadae Periostracum, 0.5 qian), Dengxin (Junci Medulla, 20 stems).
Decoct in water, take warm, 2-3 times daily.
There is a type of vesicular rash resembling smallpox, very difficult to diagnose. Smallpox always has a distinct crown/base; although rashes may have fluid, the head/granule is never firm, and the base lacks a red halo. If smallpox fails to crust after rash, it is due to Yuanqi deficiency; treat by strongly tonifying Spleen and Stomach. Do not mistake this for lingering heat pathogen and administer heat-clearing/fire-reducing drugs again.
Measles is commonly called Shazi; Zhejiang people call it "Sha" zi. Measles involves wind-heat, though people may not know this. "Sha" and "Sha" are not in standard dictionaries; they are local dialects, errors of custom. Comparing the severity of symptoms then and now shows great disparity. Our Wu region has soft/water-rich soil where Shengqi (Vital Energy) easily stirs, so measles usually resolves within 2-3 days from start to finish. This has been true since ancient times. Recently, climate has changed, resembling the North. Even common measles now takes 6-7 days to resolve. If heat is not fully cleared, or if exposed to wind/cold or improper diet, myriad complications arise, potentially more dangerous than smallpox. Having reviewed medical texts, there is no specialized study on measles; mentions are brief appendices to smallpox chapters, lacking detail. No wonder pediatricians struggle and confuse smallpox formulas with measles. Know that Measles is Yang, transforming via Yin, thus erupting outward or sinking inward without forming pus; Smallpox is Yin, transforming via Yang, requiring exterior dispersion and interior support to aid pus formation. The difference is vast; how can they not be distinguished? This applies to infants. Now, however, young and strong adults also suffer. Although detailed diagnosis is needed, one cannot abandon principles. Yet clinical flexibility lies in mind and hand; principles should not be rigidly bound.
Ye Lin's Note: "Zhengzitong" states: "Ma [Measles] is a wind-heat disease. Originally written as 'Sha'." "Yupian" states: "Yinzhen [Hidden Rash] refers to small bumps on the skin surface." Thus, Douzhen (Smallpox/Rash), Shazhen (Sha Rash), and Mazhen (Measles) all refer to morphological similarity. Adhering strictly to philology would lead to treating only specific wind-heat epidemics with variable eruption, ignoring the latent Qi Sha Zhen that everyone is susceptible to. Letting characters harm meaning, Shiwen Laoren was somewhat negligent.
Fever: Both measles and smallpox begin with fever. Smallpox fever lasts 2-3 days before eruption; measles fever may last 6-7 days or half a month, or fluctuate, or remain high continuously. Initial fever presents with red face, swollen eyes, runny nose/tears, continuous cough. High fever lasting days is called Zhuang Re (Intense Heat), occurring mainly during active eruption. If intense heat persists after eruption without abating, the condition is severe; use Qingre Touji Tang (Heat-Clearing and Skin-Venting Decoction). If intense heat persists after complete eruption, use Zhuye Shigao Tang (formula above) removing Banxia, adding Jingjie and Xuanshen. If intense heat persists after resolution, it is critical; prioritize cooling and resolving. Some fevers stop for days then recur; some are early heat fading at dusk. At initial stage, if heat pathogen is not fully penetrated, use Gegen Jieji Tang (Kudzu Muscle-Relieving Decoction). During active eruption, if irritability worsens, heat pathogen has not resolved and is attacking inward; use Qingre Touji Tang. After resolution, if seen, residual pathogen remains; use Siwu Tang replacing Shengdi with Chishao, adding Lianqiao and Xuanshen. Sometimes rash fades, body cools, then fever returns after 6-7 days; this is either unresolved residual heat or new wind pathogen invasion; judge accordingly. Or it results from Middle Qi deficiency after severe illness; treating the root is key. Clinical judgment must be prudent.
Qingre Touji Tang treats measles not fully erupted, with intense heat and cough.
Xuanshen, Shigao, Niubangzi, Jingjie, Fangfeng, Qianhu, Gegen, Xingren (Equal parts), Sheng Gancao (Half dose).
Decoct in water, take hot.
Gegen Jieji Tang treats early measles with fever, cough, or alternating chills/fever.
Gegen, Qianhu, Niubangzi, Jingjie, Lianqiao, Chishao, Chantui, Mutong (Equal parts), Sheng Gancao (Half dose).
Decoct in water, take hot.
Siwu Tang treats Ying-Blood deficiency heat.
Shudihuang (2 qian), Dangguishen (1 qian), Baishao (1.5 qian), Chuanxiong (0.8 qian).
Decoct the four ingredients in water, take warm. Contraindicated for obese individuals with damp-phlegm, or those with nausea, poor appetite, and loose stools.
Location: Measles belongs to Fu organ manifestations; eruption first affects Yang divisions, then Yin meridians. In the body, Yang areas should have more eruptions, Yin areas fewer. Yang areas should vent; if Yin areas do not vent, it is not worrying. If Yin areas have many eruptions while Yang areas have few/unvented, it is dangerous; watch for complications. Yang areas: Head, face, back, extensor surfaces of limbs. Yin areas: Chest, abdomen, waist, flexor surfaces of limbs. Eruption from head to foot evenly is complete; more on head/face is favorable. Starting from warm chest/abdomen spreading to limbs is favorable. Starting from hands/feet spreading to chest/abdomen/back is unfavorable.
Color and Shape: Color should be rosy/red; shape should be pointed/upright. If rosy but flat, with difficult urination/bowel movements, use Qingre Touji Tang. If pale and flat, with normal excretion, this is Root Deficiency; nourish Qi and Blood. If dark and flat, with constipation and dry red lips/tongue, this is internal Fire depression; use Baihu Tang adding Xuanshen and Jingjie. If white, indistinct, with only raised dots that disappear quickly, the heat pathogen is light. However, if Wei Qi is deficient and color is white, keep warm; it will turn red/active in 1-2 days. If venting is blocked by wind-cold, turning skin-white with shivering, use Gegen Jieji Tang. If measles merge into patches, turning white upon wind-cold exposure, without fever but with internal attack, irritability, abdominal pain, phlegm-wheezing, it is critical. Toxin attacking Stomach causes vomiting clear water; attacking Spleen causes abdominal distension/anorexia; attacking Lungs causes nasal congestion/wheezing; attacking Pericardium causes dry scorched lips/tongue, unconsciousness, head shaking/hand twitching; attacking Kidney/Liver turns black and is untreatable. Purple-dark red indicates intense Fire toxin; if granules rise, it is treatable; use Liangxue Yinzi (Cool Blood Decoction). Delirium/irritability: Use Huanglian Jiedu Tang mixed with Yiyuan San. Dry/flattened is hard to treat. Scorched granules, regardless of color, indicate extreme heat; use Baihu Tang with heavy Shigao. Dry/no sweat: Add Mahuang to induce sweating. Constipation: Use Liangge San to purge. Large cloud-like patches: Either large red patches or small red dots on large patches; both indicate intense Fire toxin; use Baihu Tang adding Xuanshen and Zhuye. Brocade-like patterns or purulent bloody foul-smelling discharge with chest oppression, vomiting clear water, and warmth: Use Baihu Tang adding Huangqin and Maoyu Zhu (Imperata Rhizoma - *Text says Mao Zhu, likely Imperata or similar*). Early eruption resembling macules/scabs is wind-cold in exterior causing hidden rash; only disperse. Once measles vent, rash retreats. Do not mistake for macules and use bitter-cold drugs, causing measles to sink inward and become untreatable.
Liangxue Yinzi treats measles with intense Fire toxin, purple-dark red.
Huanglian (0.5 qian), Huangqin (1 qian), Da Shengdi (1.5 qian), Jingjie (1 qian), Xuanshen (1 qian), Chishao Yao (0.8 qian), Honghua (Carthami Flos, 0.3 qian), Mutong (0.7 qian), Mudanpi (0.8 qian).
Decoct in water, take warm.
Yiyuan San (also known as Tianshui San, Liuyi San) treats difficult urination in summer.
Huashi (Talcum, water-flowered, 6 liang), Gancao (Honey-fried 6 qian, Raw 4 qian).
Grind into powder, mix with clear water, take 2-3 qian. For dispersing Wenbing/Febrile disease, add 5-7 Congbai (Allii Fistulosi Bulbus) and 4 he Xiangchi (Fermented Soybean), decoct and take warm. Contraindicated for elderly, deficient persons, and post-illness Yin depletion with difficult urination. Adding Congchi decocts disperses exterior pathogens. Adding Wuzhuyu treats white dysentery. Adding Hongqu treats bloody dysentery. Adding Paojiang eliminates fluid retention. Adding Zhusha clears Heart fire. Adding Qingdai disperses Liver fire. Adding Bohe clears Lung heat. Adding Shigao removes Stomach heat. Combined with Tongsheng, Shuangjie, Jiedu formulas as needed.
Liangge San treats warm-heat epidemics, exterior-interior excess heat, Hyperactive Heart Fire, red eyes, constipation, Stomach heat causing macules.
Dahuang (Wine-soaked, 2 liang), Mangxiao (Natrii Sulfas, 1 liang), Lianqiao (1 liang), Huangqin (1 liang), Gancao (Honey-fried, 6 qian), Shanzhi (Gardeniae Fructus, 8 qian), Bohe (Menthae Haplocalycis Herba, 7 qian).
Grind into powder. Take 4-5 qian per dose with 15 Zhuye, decoct warm. Take 3 times day, 2 times night. Stop when heat resolves and bowels move. (Modern versions lack Zhuye, adding Ginger, Jujube, Scallion).
Mangxiao and Dahuang, aided by Zhi/Po's heaviness, guide lower heat downward smoothly; aided by Qin/Zhi/Qiao's lightness, they suppress upper heat while clearing below. This distinguishes Chengqi from Liangge. Gancao reflects the intent of Tiaowei Chengqi Tang. "Ju Fang" focuses on warm-heat epidemics, hence Zhuye. For common cold, follow modern version with Congbai, Ginger, Jujube.
Cough: Continuous dry cough in measles is caused by Fire pathogen scorching Lung Metal. Copening pores facilitates measles eruption. Thus, vigorous coughing before eruption is desirable; eruption stops the cough. If cough persists after eruption/resolution, use Qingyan Zipfei Tang. For cough with much phlegm, remove Maidong, add Chenpi (Citri Reticulatae Pericarpium) and Fuling (Poria). For wind-cold invasion with cough, irritability, vomiting clear water, red eyes, sore throat, oral ulcers, use Ganjie Tang adding Huangqin/Huanglian. Post-resolution: Ren Shen Baihu Tang removing Zhimu, substituting Maidong to nourish.
Ganjie Tang treats measles sore throat and oral ulcers.
Gancao, Jiegeng, Shandougen (Toosendan Fructus), Xuanshen, Niubangzi, Jingjie (Equal parts), Maidong (Double dose).
Decoct in water, take warm.
Renshen Baihu Tang treats febrile disease with dry tongue/thirst, fever, and chills in back.
Renshen (1 qian), Shigao (8 qian, Raw, crushed), Zhimu (3 qian), Jingmi (0.5 he), Gancao (1 qian, Honey-fried).
Decoct in water, take warm, divide into three doses, consume within one day.
Sweat: During measles eruption, slight sweating is ideal; it opens muscle-couplings, facilitating pathogen exit. Do not use ascending/dispersing drugs again, as excessive sweating risks Yang collapse. For sunk/unvented bad cases, using ascending/dispersing drugs to induce heavy sweat is a special variation. If high fever with no sweat and dry skin, wind-cold obstruction prevents eruption, often...