三拗汤 治风寒伤肺而咳,误行敛肺而壅嗽喘急。
麻黄(不去节) 甘草(生) 杏仁(连皮尖)
更加荆芥、桔梗,名加味三拗汤。
嚏 麻疹初起而多嚏者,是内火因风邪激搏而然。正出时有嚏者,其候必轻。如没后尚有嚏者,邪热尽解,
可无余患矣。如嚏而多涕者,浊壅得泄,肺气自清,最为吉兆。若无嚏而鼻塞不通,必有风邪留滞,宜辛凉之
剂以透达者。
呕吐 麻之初起,吐泻交作者顺,干霍乱者逆,欲吐不吐者危。呕吐是胃中热邪不得发泄而作,葛根解肌
汤(方见前)。正出及正没时见者,消毒饮(方见前)加枳实、黄连。多痰者更加贝母、栝蒌根。若没后而呕
者,脾胃虚而热滞也,石斛清胃散。其有呕而吐蛔者,胃中痰热胶固,虫无所养而上窜也,能食即定。如蛔出
多而不能食,为胃败不治。
石斛清胃散 治麻后呕吐,胃虚不食热滞。
石斛 茯苓 橘皮 生姜(一片) 葱白(一茎)
水煎,温服。血热者加紫草、连翘。
泄泻 泄泻为麻疹之常候,热邪得以开泄也。发热时,泻而黄赤稠粘,小水短涩者,属热,四苓散加木通、
滑石。已出,人参白虎汤(方见前)去知母易麦冬。其证必多发渴,渴甚不止,热甚不退,虽数剂无妨。如泻
下清稀白沫,腹疼喜得温按者,属寒,胃苓汤去苍术加煨姜。泻利窘迫而腹痛胀满,或嗳气如败卵者,为饮食
停滞,枳壳汤加楂、檗、木通。大抵麻疹泄泻属热者多,属寒
者少。辨治宜早,不可令其泻久,泻久则正气下陷,或成肿满,或变下利,并宜枳实、理中之类,以理脾胃为
主。麻后泻利不止,口渴目闭,四肢不温者不治。呕吐不食,洞泄不知者不治。
四苓散 治小便赤涩胀痛,及温热时行烦渴。
白术(生) 茯苓 猪苓(各二钱) 泽泻(三钱)
水煎服。
胃苓汤 治饮食停积,浮肿泄泻,脉证俱实者。
浓朴(去皮,姜汁炒) 苍术(泔浸,去皮,麻油拌,炒黄) 茯苓 猪苓 甘草(炙) 白术(生)
陈皮(泡去浮白) 泽泻 桂
平胃本平胃气之墩阜,若因脾土之虚不能消运,又须稍借参苓,如养胃之类。然复有土衰不能分利而成肿
胀,且气雍不胜参术,难合理中者,乃合五苓以健运水土,与正气散之假苏、藿以散客邪,两不移易之定例也。
枳壳汤 治痘疹误服参 ,腹胀喘急。
枳壳 浓朴(去皮,姜沙炒) 陈皮(泡去浮白) 甘草(炙)
水煎服。
目 麻疹发热之时,眼光如水而多眵泪,或白睛微红,此正候也。若没后犹见红赤,为肺经风热未尽,泻白
散加荆芥、薄荷、玄参、牛蒡。闭不欲开,更加连翘、木通。赤而肿痛者,风热上壅也,导赤散加荆、蒡、玄
参。若为风热所侵,而眼眶赤烂者,柴胡饮子。急须治之,否则为终身痼疾。
泻白散 治肺热咳,手足心热。
桑根皮(姜汁和蜜炙) 地骨皮(各一两) 甘草(炙,五钱)
为散,每服四五钱,入粳米百粒,竹叶一把,水煎服。加橘红、桔梗名加味泻白散。有热更加知母、黄芩。
如有客邪禁用。或问∶地骨皮三焦气分药,泻白用之何义?答言∶三焦属肾,实则泻其子也。
导赤散 治小肠实热,小便赤涩。
生地黄(五钱) 木通 甘草梢(生,各一钱) 竹叶(一握)
上四味水煎,热服。溺血加辰砂五分。(一方多灯草,一方多车前。)
柴胡饮子 治风热眼眶赤烂。
柴胡 羌活 赤芍药 桔梗 荆芥 生地(各一钱) 甘草(炙,五分)
水煎,热服。
发不出 初起发热咳嗽,浑身胀痛,有似伤寒之候。惟干咳连声,目赤多泪,呕恶便溏,确为麻疹之验。
若将发之际,或为风寒暴袭,或因肢体坦露,寒郁热邪不能外出,此全盛之势未萌,与出后没早不同。如气粗喘
促,腹中胀痛,烦扰不宁,而不得出,急与麻杏甘石汤或越脾汤(方见前)去枣,重用石膏。轻则升麻汤,以
升发之。若因触犯雾露风寒,隐现不能发出,以新猪矢冲汤,隔簟蒸之,冷则更添滚者。并取猪矢烧灰,葱白
汤下二三钱。乃痘疮黑陷,用烧人矢之变法。即烧人矢亦能发之。仍不出者,神丹不能复图矣。
麻杏甘石汤 治发汗后,汗出而喘,无大热者。
麻黄(去节) 杏仁(泡,去皮尖,捣碎) 甘草 石膏
此麻黄汤去桂而兼越脾之意,专去上焦湿热痰气。与苓桂术甘汤互发。彼借苓术,专祛心下之支饮;此借
石膏,专祛膈上之湿热也。
升麻汤(一名升麻葛根汤) 治阳明经邪发热及痘疹初起。
升麻(一钱) 葛根 白芍(各钱半) 甘草(炙,八分)
上四味,水煎温服。
升葛为阳明经之向导,阳明专主肌肉,恐开泄太过,即以白芍敛护营血,甘草调和中气,所以解利本经邪
热,及时行痘疹,皆为专药。然在起胀后禁用。
透表 麻疹无问尖大细小,必得透表可无后患。其有一种匾阔 赤成块,块上复有小粒,平塌不起者;
亦有一片如风毒,偏高
红肿,但头粒不尖。二者虽透,其中必有热邪留伏,防有他变,并宜用竹叶石膏汤(方见前)去半夏以滋
化之。纵有余热,从此涣散矣。
不透表 麻出而皮肤干燥,毛窍疏栗不能透表者,风寒郁遏也,越脾汤(方见前)、葛根解肌汤(方见前)
随轻重取用。其有表虚不胜疏透者,一味葱白浓煎,时时与之,但得微汗即解。若头粒隐隐,红紫一片而不透
表者,火毒炽盛也,白虎汤(方见前)加荆芥、玄参。如肌肤不燥,唇色淡白,二便如常而不透者,中气本虚
也,消毒饮(方见前)加连翘、木通、车前、茯苓。虽有蕴热,不可轻用寒凉。即用峻剂升发,亦必不能复透。
但当解利,使之内化为主。亦有胸背腰腹暖处起发而红,头面手足乍有乍无,此证必缠绵难已。且有没后五七
日,复发如前,二三次而愈者,此气候之异,当非不透之比。只宜辛凉透表,渐次向安。欲求速效,转增危殆。
没早 麻出未经三日,或为风寒外郁,或热邪内陷,或误食酸收之物,一日半日即没,周身暖处绝无红影,
终变危候。若虽没早,肌肤暖处尚未全没,急需透表。发之不起,即当审其所触,而与内解。如外为风寒所遏,
邪反内攻而没早者,消毒饮(方见前)加葱头,热服,复透者吉。甚则加麻黄、穿山甲,或越脾、三拗选用。
若不急治,必喘胀而死。亦有遍身青紫热肿,喘胀气急,此毒滞血凝,半匿肌表,急投凉膈散(方见前)去芒
硝,加麻黄、石膏,以发越之。若腹胀喘促,溺涩脐突者,凉膈散加葶苈,或可救一二。若内夹痰热,火毒亢
剧而伏匿烦躁,或腹胀喘急,不省人事者,白虎汤(方见前)加玄参、竹叶。若误食酸醋收敛之物,伏匿壮热,
喘咳烦闷,以猪胆汁制甘草煎成,续续与之,得吐微汗为效。或苦瓠、生甘草煎汤灌之,亦能取吐,吐中便有
发越之义。误食豕肉,喘胀气急,枳壳汤(方见前)加山楂、芒硝以下夺之。误食核桃,喘咳声喑,消毒饮(方
见前)加石膏、马兜铃。若得热退身安,气息渐调者,方可无虑。或大病之后,或洞泄不止,中气
本虚,不能发越而没早,惟当健运中气,略兼解表清热。若没后遍身瘙痒者,露风早也,消风散以疏解之。
消风散 治风热咳嗽,遍身疥瘰,小儿疮疹余热。
川芎 羌活 防风 荆芥穗 藿香 人参 茯苓 僵蚕 蝉蜕(等分) 甘草(炙) 陈皮 浓朴(姜
制,减半)
上十二味为散,每服三四钱,茶清调下。或用五钱,水煎,去滓服。如久病头风目翳,每日三服效。此方
妙用全在浓朴、人参。当知肌表之疾,无不由胃而发,故用浓朴清理其内,即以人参助诸风药,消解风热于外,
则羌防荆芥辈方始得力耳。
难没 西北水土刚劲,禀质亦浓,麻必五七日乃没。东南风气柔弱,麻出不过二三日即化。迩来地运变迁,
未有不绵延数日者,当非难没之比。若三四日后,点燥色白,隐隐于肌腠而难没者,此必卫气素微,不能 发。
或衣被单薄,阻其发越之机,以致绵延多日。法当辛散透达,不可遽用寒凉,蔽其开泄之路也。
渴 渴若乃肺胃热盛之候,唇口必红。二便秘涩者,麦冬甘露饮。若二便清利,唇色不红而但渴者,此必
寒凉太过,脾虚不生津液而作渴也,七味白术散去木香,加粳米。渴而烦躁者,是热邪凌轹心包,宜白虎汤
(方见前)加麦冬、竹叶。正没时,竹叶石膏汤(方见前)去半夏。渴而腹胀者,本虚实滞,为难治也。
麦冬甘露饮 治麻疹热甚而渴。
麦冬(二钱,去心) 玄参 黄芩 栝蒌根 连翘(各一钱) 生甘草(五分) 灯芯(二十茎) 竹
叶(二十片)
水煎,温服。
七味白术散(即钱氏白术散) 治胃虚津气不行而渴。
人参(一钱至三钱) 白术(炒黄,一钱至二钱) 茯苓(一钱至一钱半) 甘草(炙,六分至一钱)
煨葛根 藿香 木香
为散,每服三四钱,水煎,日三服。
喘 喘者热邪壅遏肺窍,气道阻塞而然。其证有虚实之分,
虚者难治,实者易调。虚则小便清利,大便溏泄,身无大热,虽清痰润肺,多难获效,实则大便坚燥,小便赤
涩,身发壮热,竹叶石膏汤(方见前)去半夏加栝蒌仁、贝母,冬月量加蜜炙麻黄,随手而应。若喘而无涕,兼
之鼻煽者,不治。大抵未出而喘者易治,没后喘者难治。初发之时喘者,三拗汤(方见前)加石膏、芽茶。喘
而鼻干口燥者,白虎汤(方见前)最捷。若见于麻后,又宜清咽滋肺汤(方见前)以滋肺胃,白虎汤又为切禁。
故曰医不执方,治法在人耳。
气促 气促多缘肺热不清所致。初发正出时见之,清热透肌汤(方见前)。在正没、没后,清咽滋肺汤
(方见前)。如喉中有痰, 而鸣者,热邪阻逆,不得发越也,见于初发正出之间,除热清肺汤。正没、
没后见者,必邪热未透,或露风没早,余热内攻,而肺气受伤也,难治。
除热清肺汤 治麻疹尽透而壮热咳嗽,大便秘结。
石膏(三钱) 玄参(一钱) 生地黄(一钱) 麦冬(去芯,一钱半) 赤芍 栝蒌根 贝母(各一钱)
甘草(五分)
水煎,温服。
喑 肺胃热邪为风寒所袭,不能尽达于表,咳盛咽伤,故喑,宜清咽滋肺汤(见前方)。若喑而肿痛者,射
干消毒饮。然喑为麻疹之常,不可与痘喑比例。
射干消毒饮 治麻疹咳嗽声喑,咽喉肿痛。
射干 玄参 连翘 鼠粘子 荆芥(等分) 甘草(减半)
水煎,温服。
搐 搐为痰热聚于心包,见于初发未透之时,清热透肌汤(方见前)加栝蒌仁、竹叶。没后见者难治,只宜
轻清之剂调之,不可误用金石。痰诞壅盛者,一味栝蒌涌吐之。若搐无痰鸣,或自啮指者,非真搐也。此为正
虚,不能主持,必死不治。
衄 衄者火邪炽盛,血随火载,上行而溢于鼻。麻疹初起是为顺候,其热得以开泄,不治自己。若衄之不止,
或失血者,犀
角地黄汤(方见前)加荆芥穗。正没及没之后仍不止者,四物汤(方见前)加茅根、麦冬,以滋降之。
谵妄 谵妄是热邪炽盛于心包。若发热正出时见者,为火邪内伏,不得透表而致,白虎汤(方见前)加荆
芥、鼠粘子,甚则加麻黄以发越之。在正没、没后,并宜竹叶石膏汤(方见前)去半夏加生地黄以清解之。
切牙 痘证切牙有寒热之分。麻疹切牙皆为热例,乃阳陷于阴,故多发渴而手足热,喜饮冷者,麦门冬汤
加丹皮;若手足不热,而反厥冷,喜饮热汤,此为热邪内亢,后必下血,咽喉作痛,痰鸣而死。即与白虎汤
(方见前),多不可救。
麦门冬汤 治痘疹便实而渴。
麦门冬(二钱) 当归身(一钱) 白芍(钱半) 生地(二钱)
水煎,温服。
唇燥 唇燥多属脾胃之热。淡而燥者,其热轻;赤而燥者,其热深;紫黑而燥者,热剧而重也。随轻重以清
润之。
唇舌破裂 唇舌破裂者,心脾之火上冲也,其色必多深赤。初发、正出时见之,白虎汤(方见前)加芩、连、
玄参、荆芥、薄荷。若正没、没后见者,为心脾俱绝,及紫黑枯燥,而血不活者,皆难治也。
口气 口气秽浊,乃热邪蕴隆于胃,清胃散加石膏、连翘、生甘草。其有臭不可闻者,此胃败也,不治。
若其人本有是证,不在此例。
清胃散 治胃中蕴热,中脘作痛,痛后火气发泄,必作寒热乃止。及齿龈肿痛出血,痛引头脑。
生地黄(四钱)升麻(钱半) 牡丹皮(五钱) 当归 川连(酒蒸,各三钱)
为散,分三服,水煎去渣,细细呷之,半日再服。
犀角地黄汤专以散瘀为主,故用犀、芍。此则开提胃热,故用升、连。其后加味清胃,则兼二方之制,但
少芍药耳。
舌胎 舌者心之苗,麻本火候,心属于火,故舌多有胎。白为肺热,黄为胃热,但当清解疏利,更参外证
而为施治。纯黑为心绝。黑而湿者,热淫血分;黑而燥者,热淫气分,皆为危候。并宜白虎汤(方见前),湿
三拗汤:治疗因风寒损伤肺脏引起的咳嗽,若错误使用收敛肺气的方法,会导致痰液壅滞、咳嗽加剧且呼吸急促。
麻黄(不去节) 甘草(生用) 杏仁(保留皮和尖端)
再加入荆芥、桔梗,称为加味三拗汤。
喷嚏:麻疹初起时频繁打喷嚏,是因为体内火气被风邪激惹搏结所致。在疹子正发出时有喷嚏,病情必然较轻。如果疹子消退后仍有喷嚏,说明邪热已完全解除,可以没有遗留病患。如果打喷嚏并伴有大量鼻涕,说明浊邪得以宣泄,肺气自然清利,这是最吉祥的征兆。如果没有喷嚏且鼻塞不通,必定有风邪留滞,适宜用辛凉性质的药剂来透达发散。
呕吐:麻疹刚起时,呕吐与腹泻交替发作属于顺证;干霍乱(欲吐不得吐,欲泻不得泻)属于逆证;想吐却吐不出来属于危重证候。呕吐是由于胃中热邪无法发泄而引发的,可用葛根解肌汤(方剂见前文)。在疹子正发出及正消退时出现呕吐,用消毒饮(方剂见前)加入枳实、黄连。痰多者再加贝母、栝蒌根。如果在疹子消退后出现呕吐,是脾胃虚弱且有热邪停滞,用石斛清胃散。如果有呕吐并吐出蛔虫,是胃中痰热胶结固着,蛔虫无处滋养而上窜,如果能进食则病势可定。如果蛔虫排出很多且不能进食,属于胃气败绝,无法治愈。
石斛清胃散:治疗麻疹后呕吐,胃虚不能进食且有热邪停滞。
石斛 茯苓 橘皮 生姜(一片) 葱白(一茎)
用水煎煮,温服。血热者加紫草、连翘。
泄泻:泄泻是麻疹的常见症状,说明热邪得以开泄散发。发热时,大便黄赤稠粘,小便短少涩痛,属于热证,用四苓散加木通、滑石。疹子已发出,用人参白虎汤(方剂见前)去掉知母,改用麦冬。此证必然多发口渴,如果口渴严重不止,热势甚高不退,即使服用多剂药也无妨。如果大便清稀呈白色泡沫状,腹痛且喜欢温热按压,属于寒证,用胃苓汤去掉苍术加煨姜。如果腹泻急迫窘迫且腹痛胀满,或者打嗝有腐败卵臭味,是饮食停滞,用枳壳汤加山楂、黄柏、木通。大抵麻疹泄泻属热的居多,属寒的较少。辨证治疗宜早,不可让腹泻时间过长,腹泻久了正气下陷,可能形成肿胀满闷,或变为下痢,都适宜用枳实、理中丸之类,以调理脾胃为主。麻疹后腹泻不止,口渴、眼睛闭合、四肢不温的,无法治愈。呕吐不食,洞泄(水样直下)不知人事的,无法治愈。
四苓散:治疗小便赤红涩痛胀痛,以及温热流行病引起的烦渴。
白术(生用) 茯苓 猪苓(各二钱) 泽泻(三钱)
用水煎服。
胃苓汤:治疗饮食停积,浮肿泄泻,脉象和症状都表现为实证的患者。
浓朴(去皮,用姜汁炒) 苍术(用淘米水浸泡,去皮,拌麻油,炒至黄色) 茯苓 猪苓 甘草(炙) 白术(生用)
陈皮(泡去浮白) 泽泻 桂枝
平胃散本是平和胃气厚实的方子,如果因为脾土虚弱不能消化运化,又须稍微借用参、苓等药,如养胃汤之类。然而又有土气衰弱不能分利水湿而成肿胀,且气机雍塞不能耐受参、术补益,难以配合理中丸治疗的,才合用五苓散来健运水土,配合正气散的假苏(藿香)、藿香来疏散客邪,这是两个不可更改的定例。
枳壳汤:治疗痘疹误服人参等补药,导致腹胀喘急。
枳壳 浓朴(去皮,用姜沙炒) 陈皮(泡去浮白) 甘草(炙)
用水煎服。
眼部症状:麻疹发热时,眼光如水且多眼屎眼泪,或白眼球微红,这是正常征候。如果疹子消退后仍然见红赤,是肺经风热未尽,用泻白散加荆芥、薄荷、玄参、牛蒡子。眼睛紧闭不想睁开,再加连翘、木通。红肿疼痛的,是风热上壅,用导赤散加荆芥、牛蒡子、玄参。如果是被风热侵袭,眼眶赤烂的,用柴胡饮子。必须紧急治疗,否则会成为终身顽疾。
泻白散:治疗肺热咳嗽,手足心发热。
桑根皮(用姜汁和蜜炙) 地骨皮(各一两) 甘草(炙,五钱)
研为散,每次服用四五钱,加入粳米一百粒,竹叶一把,用水煎服。加入橘红、桔梗称为加味泻白散。有热再加知母、黄芩。如果有外感客邪禁用。有人问:地骨皮是三焦气分的药,泻白散用它有什么意义?回答说:三焦属于肾,这里是“实则泻其子”的道理。
导赤散:治疗小肠实热,小便赤红涩痛。
生地黄(五钱) 木通 甘草梢(生用,各一钱) 竹叶(一握)
以上四味用水煎,热服。尿血加辰砂五分。(另一方案多加灯芯草,另一方案多加车前子。)
柴胡饮子:治疗风热导致的眼眶赤烂。
柴胡 羌活 赤芍药 桔梗 荆芥 生地(各一钱) 甘草(炙,五分)
用水煎,热服。
发不出:初起时发热咳嗽,浑身胀痛,类似伤寒的症状。只有干咳连声,眼睛红多泪,呕吐恶心大便溏稀,确是麻疹的验证。如果在将要发出之际,或被风寒突然袭击,或因肢体暴露,寒气郁遏热邪不能外出,此时全盛之势尚未萌动,与发出后过早消退不同。如果气粗喘促,腹部胀痛,烦躁不安,却无法发出,急忙给予麻杏甘石汤或越脾汤(方剂见前)去掉大枣,重用石膏。轻症用升麻汤,以升发透疹。如果是因触犯雾露风寒,疹点隐现不能发出,用新猪粪冲调的汤,隔着竹席蒸熏,冷了再添加滚热的。同时取猪粪烧成灰,用葱白汤送服二三钱。这是痘疮黑陷时的变法。即使用烧成人粪便也能起到透发作用。仍然出不来的,神仙丹药也无法挽救了。
麻杏甘石汤:治疗发汗后,出汗且气喘,没有大热的情况。
麻黄(去节) 杏仁(泡,去皮尖,捣碎) 甘草 石膏
这是麻黄汤去掉桂枝而兼有越脾汤的意思,专门去除上焦的湿热痰气。与苓桂术甘汤相互发明。前者借茯苓、白术,专门祛除心下的支饮;这里借石膏,专门祛除膈上的湿热。
升麻汤(一名升麻葛根汤):治疗阳明经邪气发热及痘疹初起。
升麻(一钱) 葛根 白芍(各钱半) 甘草(炙,八分)
以上四味,用水煎温服。
升麻、葛根是阳明经的向导,阳明经主管肌肉,担心开泄太过,就用白芍收敛保护营血,甘草调和中间之气,所以能解利本经邪热,以及及时行痘疹,都是专用药物。然而在起胀之后禁用。
透表:麻疹无论大小,必须得透表才能没有后患。有一种匾阔赤色成片,片上又有小粒,平坦塌陷不起的;也有一片像风毒,偏高红肿,但头部颗粒不尖的。这两种虽然透出,但其中必有热邪留伏,防止发生其他变化,都适宜用竹叶石膏汤(方剂见前)去掉半夏来滋阴化解。纵然有余热,从此也会涣散消散。
不透表:麻疹发出但皮肤干燥,毛孔疏栗不能透表的,是风寒郁遏,用越脾汤(方剂见前)、葛根解肌汤(方剂见前)根据轻重选用。有表虚不胜疏透的,一味葱白浓煎,时时喂服,只要得到微汗就解除了。如果头部颗粒隐隐约约,红紫一片而不透表的,是火毒炽盛,用白虎汤(方剂见前)加荆芥、玄参。如果肌肤不干燥,唇色淡白,二便正常而不透表的,是中气本来虚弱,用消毒饮(方剂见前)加连翘、木通、车前子、茯苓。虽然有蕴热,不可轻易用寒凉药。即用峻猛药剂升发,也一定不能重新透出。只应当解利,以内化为原则。也有胸背腰腹温暖处起发发红,头面手足疹点乍有乍无的,此证必然缠绵难愈。而且有疹子消退后五七天,再次复发像以前一样,两三次后才痊愈的,这是气候差异,应当不属于不透发的情况。只适宜辛凉透表,逐渐趋向安宁。想要追求速效,反而增加危险。
没早:疹子发出未满三天,或因风寒外郁,或热邪内陷,或误食酸收之物,一日半日即消退,周身温暖处绝无红影,最终变成危重证候。如果虽然没早,但肌肤温暖处尚未完全消退,急需透表。发不起来,就应当审查所触病因,进行内解。如果外被风寒遏制,邪气反内攻而没早的,用消毒饮(方剂见前)加葱头,热服,若能重新透出为吉。严重时加麻黄、穿山甲,或越脾汤、三拗汤选用。如果不紧急治疗,必因喘胀而死。也有遍身青紫热肿,喘胀气急,这是毒滞血凝,半隐匿于肌表,急忙投予凉膈散(方剂见前)去掉芒硝,加麻黄、石膏,以发越之。如果腹胀喘促,小便涩脐突起的,凉膈散加葶苈子,或许能救一二。如果内夹痰热,火毒亢盛剧烈而伏匿烦躁,或腹胀喘急,不省人事的,用白虎汤(方剂见前)加玄参、竹叶。如果误食酸醋收敛之物,伏匿壮热,喘咳烦闷,用猪胆汁制甘草煎成,连续喂服,得到呕吐微汗为有效。或用苦瓠、生甘草煎汤灌服,也能引起呕吐,吐中便有发越的意义。误食猪肉,喘胀气急,用枳壳汤(方剂见前)加山楂、芒硝以下夺之。误食核桃,喘咳声音嘶哑,用消毒饮(方剂见前)加石膏、马兜铃。如果得到热退身安,气息逐渐调和的,才可以无忧虑。或大病之后,或洞泄不止,中气本来虚弱,不能发越而没早,只应当健运中气,略微兼解表清热。如果疹子消退后遍身瘙痒的,是露风没早,用消风散以疏解之。
消风散:治疗风热咳嗽,遍身疥瘰,小儿疮疹余热。
川芎 羌活 防风 荆芥穗 藿香 人参 茯苓 僵蚕 蝉蜕(等分) 甘草(炙) 陈皮 浓朴(姜制,减半)
以上十二味研为散,每次服用三四钱,茶清调下。或用五钱,水煎,去渣服。如果久病头风目翳,每日三服有效。此方妙用全在浓朴、人参。应当知道肌表之疾,无不由胃而发,故用浓朴清理其内,即以人参助诸风药,消解风热于外,则羌活、防风、荆芥等方才得力。
难没:西北水土刚劲,禀赋体质也浓厚,麻疹必五七日才消退。东南风气柔弱,麻疹发出不过二三日即化解。近来地运变迁,没有不绵延数日的,应当不属于难没的情况。如果三四日后,疹点干燥色白,隐隐于肌腠而难消退的,这必定是卫气素来微弱,不能透发。或衣被单薄,阻碍其发越之机,以致绵延多日。治法当用辛散透达,不可急于用寒凉药,遮蔽其开泄之路。
口渴:口渴乃是肺胃热盛的征候,嘴唇口角必红。二便秘涩的,用麦冬甘露饮。如果二便清利,唇色不红但口渴的,这必定是寒凉太过,脾虚不能生津液而作渴,用七味白术散去木香,加粳米。口渴且烦躁的,是热邪凌轹心包,宜用白虎汤(方剂见前)加麦冬、竹叶。正消退时,用竹叶石膏汤(方剂见前)去掉半夏。口渴且腹胀的,是本虚标实停滞,为难治。
麦冬甘露饮:治疗麻疹热甚而口渴。
麦冬(二钱,去心) 玄参 黄芩 栝蒌根 连翘(各一钱) 生甘草(五分) 灯芯(二十茎) 竹叶(二十片)
用水煎,温服。
七味白术散(即钱氏白术散):治疗胃虚津气不行而口渴。
人参(一钱至三钱) 白术(炒黄,一钱至二钱) 茯苓(一钱至一钱半) 甘草(炙,六分至一钱)
煨葛根 藿香 木香
研为散,每次服用三四钱,水煎,日服三次。
喘:喘是热邪壅遏肺窍,气道阻塞所致。此证有虚实之分,虚者难治,实者易调。虚证则小便清利,大便溏泄,身体无大热,虽清痰润肺,多难获效;实证则大便坚燥,小便赤涩,身体发壮热,用竹叶石膏汤(方剂见前)去掉半夏加栝蒌仁、贝母,冬季酌情加蜜炙麻黄,随手应验。如果喘而无鼻涕,兼之鼻翼煽动的,无法治愈。大抵未发出而喘的易治,消退后喘的难治。初发之时喘的,用三拗汤(方剂见前)加石膏、芽茶。喘而鼻干口燥的,用白虎汤(方剂见前)最快捷。如果见于麻疹后,又宜用清咽滋肺汤(方剂见前)以滋肺胃,白虎汤又是切禁。所以说医生不固执于方剂,治疗方法在于人。
气促:气促多缘肺热不清所致。初发正出时见到,用清热透肌汤(方剂见前)。在正消退、消退后见到,用清咽滋肺汤(方剂见前)。如果喉中有痰,喘息鸣响的,是热邪阻逆,不得发越,见于初发正出之间,用除热清肺汤。正消退、消退后见到的,必是邪热未透,或露风没早,余热内攻,而肺气受伤,难治。
除热清肺汤:治疗麻疹尽透而壮热咳嗽,大便秘结。
石膏(三钱) 玄参(一钱) 生地黄(一钱) 麦冬(去芯,一钱半) 赤芍 栝蒌根 贝母(各一钱)
甘草(五分)
用水煎,温服。
喑(失音):肺胃热邪被风寒所袭,不能尽达于表,咳嗽剧烈咽喉受伤,故失音,宜用清咽滋肺汤(见前方)。如果失音且肿痛,用射干消毒饮。然而失音是麻疹的常症,不可与痘疹失音相提并论。
射干消毒饮:治疗麻疹咳嗽声哑,咽喉肿痛。
射干 玄参 连翘 鼠粘子(牛蒡子) 荆芥(等分) 甘草(减半)
用水煎,温服。
搐(抽搐):搐是痰热聚于心包,见于初发未透之时,用清热透肌汤(方剂见前)加栝蒌仁、竹叶。消退后见到的难治,只宜轻清之剂调理,不可误用金石类药物。痰诞壅盛的,一味栝蒌涌吐之。如果抽搐无痰鸣,或自咬手指的,不是真抽搐。这是正气虚弱,不能主持,必死不治。
衄(鼻出血):衄是火邪炽盛,血随火载,上行而溢于鼻。麻疹初起是为顺证,其热得以开泄,不治自己会好。如果衄血不止,或失血的,用犀角地黄汤(方剂见前)加荆芥穗。正消退及消退之后仍不止的,用四物汤(方剂见前)加茅根、麦冬,以滋阴降火。
谵妄:谵妄是热邪炽盛于心包。如果发热正出时见到,是火邪内伏,不得透表而致,用白虎汤(方剂见前)加荆芥、鼠粘子,严重时加麻黄以发越之。在正消退、消退后,并宜用竹叶石膏汤(方剂见前)去掉半夏加生地黄以清解之。
切牙(磨牙):痘证切牙有寒热之分。麻疹切牙皆为热证,乃阳陷于阴,故多发渴而手足热,喜饮冷者,用麦门冬汤加丹皮;如果手足不热,反而厥冷,喜饮热汤,此为热邪内亢,后必下血,咽喉作痛,痰鸣而死。即给予白虎汤(方剂见前),大多不可救。
麦门冬汤:治疗痘疹便实而口渴。
麦门冬(二钱) 当归身(一钱) 白芍(钱半) 生地(二钱)
用水煎,温服。
唇燥:唇燥多属脾胃之热。淡而燥的,其热轻;赤而燥的,其热深;紫黑而燥的,热剧而重也。根据轻重以清润之。
唇舌破裂:唇舌破裂者,心脾之火上冲也,其色必多深赤。初发、正出时见到,用白虎汤(方剂见前)加黄芩、黄连、玄参、荆芥、薄荷。如果正消退、消退后见到,为心脾俱绝,及紫黑枯燥,而血不活的,皆难治。
口气:口气秽浊,乃热邪蕴隆于胃,用清胃散加石膏、连翘、生甘草。其有臭不可闻的,这是胃败,无法治愈。如果其人本来有此证,不在此例。
清胃散:治疗胃中蕴热,中脘作痛,痛后火气发泄,必作寒热乃止。及齿龈肿痛出血,痛引头脑。
生地黄(四钱) 升麻(钱半) 牡丹皮(五钱) 当归 川连(酒蒸,各三钱)
研为散,分三服,水煎去渣,细细呷之,半日再服。
犀角地黄汤专以散瘀为主,故用犀角、芍药。此方则开提胃热,故用升麻、黄连。其后加味清胃,则兼二方之制,但少芍药耳。
舌胎:舌是心之苗,麻疹本乎火候,心属于火,故舌多有胎。白为肺热,黄为胃热,但当清解疏利,更参外证而为施治。纯黑为心绝。黑而湿的,热淫血分;黑而燥的,热淫气分,皆为危候。并宜用白虎汤(方剂见前),湿...
San'ao Decoction: Treats cough caused by wind-cold damaging the lungs. If lung-astringent methods are mistakenly used, it leads to phlegm obstruction, aggravated coughing, and rapid breathing.
Ephedrae Herba (Mahuang, 麻黄) [without removing joints] Licorice Radix et Rhizoma (Gancao, 甘草) [raw] Apricot Seed (Xingren, 杏仁) [with skin and tip]
Adding Schizonepetae Herba (Jingjie, 荆芥) and Platycodonis Radix (Jiegeng, 桔梗), it is named Modified San'ao Decoction.
Sneezing: Frequent sneezing at the initial stage of measles indicates that internal fire is agitated and contended by wind-pathogen. Sneezing during the eruption phase suggests a mild condition. Sneezing after the rash has subsided indicates that pathogenic heat has been completely resolved, with no residual illness. Sneezing accompanied by abundant nasal discharge indicates that turbid pathogens are being discharged, and lung qi becomes clear; this is an auspicious sign. Absence of sneezing and nasal congestion indicates lingering wind-pathogen, requiring acrid-cool formulas to diffuse and release.
Vomiting: Vomiting alternating with diarrhea at the onset of measles is a favorable progression (Shun). Dry Huoluan (inability to vomit or defecate) is unfavorable (Ni). The urge to vomit without success is critical. Vomiting occurs when stomach heat cannot be vented; use Gegen Jieji Decoction (see previous section). During active eruption or subsidence, use Xiaodu Yin (see previous section) added with Aurantii Fructus (Zhishi, 枳实) and Coptidis Rhizoma (Huanglian, 黄连). For excessive phlegm, add Fritillariae Bulbus (Beimu, 贝母) and Trichosanthis Radix (Gualougen, 栝蒌根). Vomiting after rash subsidence indicates spleen-stomach deficiency with stagnant heat; use Shihu Qingwei San. Vomiting with expulsion of roundworms indicates sticky phlegm-heat in the stomach causing worms to migrate upward; if the patient can eat, the condition stabilizes. Profuse worm expulsion with inability to eat indicates stomach qi failure and is incurable.
Shihu Qingwei San: Treats post-measles vomiting due to stomach deficiency, anorexia, and stagnant heat.
Dendrobii Caulis (Shihu, 石斛) Poria (Fuling, 茯苓) Tangerine Peel (Chenpi, 橘皮) Ginger Tuber (Shengjiang, 生姜) [one slice] Scallion White (Congbai, 葱白) [one stalk]
Decoct in water and take warm. Add Lithospermi Radix (Zicao, 紫草) and Forsythiae Fructum (Lianqiao, 连翘) for blood heat.
Diarrhea: Diarrhea is a common symptom of measles, indicating the release of heat pathogens. During fever, yellow-brown, thick, sticky stool with scanty, painful urination indicates heat syndrome; use Siling San added with Akebiae Caulis (Mutong, 木通) and Talcum (Huashi, 滑石). After eruption, use Renshen Baibu Tang (see previous section), removing Anemarrhenae Rhizoma (Zhimu, 知母) and replacing it with Ophiopogonis Radix (Maidong, 麦冬). This condition involves intense thirst; even if multiple doses are needed, it is acceptable. Clear, white, frothy stool with abdominal pain relieved by warmth indicates cold syndrome; use Weiling Tang removing Atractylodis Rhizoma (Cangzhu, 苍术) and adding Prepared Ginger (Weijiang, 煨姜). Urgent diarrhea with abdominal distension or belching with rotten egg odor indicates food stagnation; use Zhike Tang added with Crataegi Fructus (Zha, 楂), Phellodendri Cortex (Bo, 檗), and Mutong. Generally, measles diarrhea is mostly heat-related, rarely cold. Early differentiation and treatment are crucial to prevent prolonged diarrhea, which causes sinking of healthy qi, leading to swelling or dysentery. Zhi Shi and Lizhong Wan-type formulas should be used to regulate the spleen and stomach. Post-measles persistent diarrhea with thirst, closed eyes, and cold limbs is incurable. Vomiting with anorexia and profuse watery diarrhea with loss of consciousness is incurable.
Siling San: Treats red, scanty, painful urination, and irritability/thirst in warm-heat epidemics.
Atractylodis Macrocephalae Rhizoma (Baizhu, 白术) [raw] Poria (Fuling, 茯苓) Polyporus (Zhuling, 猪苓) [2 qian each] Alisma Rhizoma (Zexie, 泽泻) [3 qian]
Decoct in water and take.
Weiling Tang: Treats food stagnation, edema, diarrhea, and excess pulse/symptoms.
Magnoliae Officinalis Cortex (N Houpo, 浓朴) [peeled, stir-fried with ginger juice] Atractylodis Rhizoma (Cangzhu, 苍术) [soaked in rice water, peeled, mixed with sesame oil, fried yellow] Poria (Fuling, 茯苓) Polyporus (Zhuling, 猪苓) Licorice Root (Gancao, 甘草) [roasted] Atractylodis Macrocephalae Rhizoma (Baizhu, 白术) [raw] Tangerine Peel (Chenpi, 陈皮) [soaked to remove white pith] Alisma Rhizoma (Zexie, 泽泻) Cinnamon Twig (Gui, 桂)
Pingwei San originally balances stomach qi. If spleen-earth deficiency prevents digestion, Ginseng and Poria may be added, as in Yangwei Tang. However, if earth weakness fails to separate fluids causing swelling, and qi stagnation cannot tolerate tonics like Ginseng/Atractylodes, making Lizhong Tang unsuitable, then Wuling San is combined to strengthen earth/water transport, along with Zhengqi San's Perilla Leaf (Jiasu/Huo, 假苏/藿) to disperse external pathogens. These are fixed principles.
Zhike Tang: Treats acne/measles complicated by abdominal distension and rapid breathing due to mistaken use of tonics like Ginseng.
Aurantii Fructus (Zhike, 枳壳) Magnoliae Officinalis Cortex (N Houpo, 浓朴) [peeled, stir-fried with ginger sand] Tangerine Peel (Chenpi, 陈皮) [soaked to remove white pith] Licorice Root (Gancao, 甘草) [roasted]
Decoct in water and take.
Eye Symptoms: During measles fever, watery eyes with excessive discharge or slightly red sclera are normal signs. Redness persisting after rash subsidence indicates unresolved wind-heat in the lung meridian; use Xiebai San added with Jingjie, Bohe, Xuanshen, and Niubangzi. Eyes tightly shut indicate need for Lianqiao and Mutong. Red, swollen, painful eyes indicate upward congestion of wind-heat; use Daochi San added with Jingjie, Niubangzi, and Xuanshen. Red, ulcerated eye orbits from wind-heat require Chaihu Yinzi. Urgent treatment is necessary to prevent chronic disease.
Xiebai San: Treats lung-heat cough and heat in palms/soles.
Morus Alba Bark (Sangbaipi, 桑根皮) [stir-fried with ginger juice and honey] Lycii Cortex (Digupi, 地骨皮) [1 liang each] Licorice Root (Gancao, 甘草) [roasted, 5 qian]
Grind into powder. Take 4-5 qian per dose with 100 grains of Rice (Jingshi, 粳米) and a handful of Bamboo Leaves (Zhuye, 竹叶). Decoct in water. Adding Ju Hong and Jiegeng makes Modified Xiebai San. Add Zhimu and Huangqin for heat. Contraindicated for external pathogens. Question: Why use Digupi (Sanjiao qi-point drug) in Xiebai San? Answer: Sanjiao belongs to Kidney; this applies "draining the son" principle.
Daochi San: Treats small intestine excess heat and red, scanty urination.
Rehmanniae Radix (Shengdihuang, 生地黄) [5 qian] Mutong (木通) Licorice Root Tip (Gancao Shao, 甘草梢) [raw, 1 qian each] Bamboo Leaves (Zhuye, 竹叶) [a handful]
Decoct four ingredients, take hot. Add Cinnabar (Chensha, 辰砂) 0.5 fen for hematuria. (Alternative: add Dengcao or Cheqianzi.)
Chaihu Yinzi: Treats red, ulcerated eye orbits due to wind-heat.
Bupleuri Radix (Chaihu, 柴胡) Notopterygii Rhizoma et Radix (Qianghuo, 羌活) Red Peony Root (Chishao, 赤芍药) Platycodonis Radix (Jiegeng, 桔梗) Schizonepetae Herba (Jingjie, 荆芥) Rehmanniae Radix (Shengdi, 生地) [1 qian each] Licorice Root (Gancao, 甘草) [roasted, 0.5 fen]
Decoct in water, take hot.
Failure to Erupt: Initial fever, cough, body ache resembles cold damage. Persistent dry cough, red eyes with tears, nausea, and loose stools confirm measles. If eruption is blocked by sudden wind-cold or exposure, preventing heat release, the peak momentum has not yet formed. Rapid breathing, abdominal pain/distension, and restlessness without eruption require immediate Mahuang Xinggan Shigao Tang or Yuemi Tang (see previous section) removing Dazao, with heavy Shigao. Mild cases use Shengma Tang to raise and erupt. If blocked by fog/dew/cold-wind, use fresh pig manure infusion, steaming over bamboo mat, replenishing with hot liquid. Pig manure ash taken with scallion decoction (2-3 qian) is a method for black sunken pox. Human feces ash also works. If still unerupted, no medicine can save.
Mahuang Xinggan Shigao Tang: Treats sweating, wheezing, and absence of high fever after diaphoresis.
Ephedrae Herba (Mahuang, 麻黄) [de-jointed] Apricot Seed (Xingren, 杏仁) [soaked, de-skinned, de-tipped, crushed] Licorice Root (Gancao, 甘草) Gypsum Fibrosum (Shigao, 石膏)
This is Mahuang Tang minus Guizhi, incorporating Yuemi intent, targeting upper jiao damp-heat/phlegm. Contrasts with Linggui Zhugan Tang: the latter uses Fuling/Baizhu for fluid retention under heart; this uses Shigao for damp-heat above diaphragm.
Shengma Tang (aka Shengma Gegen Tang): Treats Yangming meridian heat and early measles/pox.
Bupleuri Radix (Shengma, 升麻) [1 qian] Puerariae Lobatae Radix (Gegen, 葛根) White Peony Root (Baishao, 白芍) [1.5 qian each] Licorice Root (Gancao, 甘草) [roasted, 0.8 fen]
Decoct four ingredients, take warm.
Shengma/Gegen guide Yangming meridian (governs muscles). Baishao protects Ying-blood from excessive release; Gancao harmonizes middle qi. Specific for Yangming heat and epidemic pox. Contraindicated after swelling begins.
Diffusing Exterior: Measles must diffuse exteriorly to avoid sequelae. Flat, broad red patches with small granules, or flat/swollen patches resembling wind-toxin with non-pointed heads, indicate latent heat despite eruption. Use Zhuye Shigao Tang (see previous section) removing Banxia to nourish and resolve. Residual heat will dissipate.
Failure to Diffuse Exterior: Dry skin and sparse pores preventing eruption indicate wind-cold constraint; use Yuemi Tang or Gegen Jieji Tang based on severity. Surface deficiency unable to support diffusion requires strong Congbai decoction for mild sweat. Hidden, purple-red rash indicates fierce fire-toxin; use Baibu Tang added with Jingjie and Xuanshen. Non-dry skin, pale lips, normal bowels/bladder but no eruption indicates middle qi deficiency; use Xiaodu Yin added with Lianqiao, Mutong, Cheqianzi, Fuling. Avoid cold herbs despite latent heat. Strong uplifting agents will fail. Focus on resolving internally. Intermittent rash on warm areas or recurrence days later is climate-related, not true failure; treat with acrid-cool diffusers gradually. Seeking speed increases danger.
Early Subsidence: Rash vanishing within three days due to wind-cold constraint, internal heat sinking, or sour/astringent foods, leaving no redness in warm areas, leads to critical state. If partially remaining, urgent exterior diffusion is needed. If unable to erupt, investigate cause and resolve internally. Wind-cold constraint causing internal attack: Xiaodu Yin with Congtou, taken hot, for re-eruption (auspicious). Severe cases: add Mahuang, Shanjiacortex (Chuanshanjia, 穿山甲), or select Yuemi/San'ao. Untreated leads to death from wheezing/bloating. Blue-purple swollen rash with rapid breathing indicates toxic stasis; use Liangge San (see previous section) removing Mangxiao, adding Mahuang/Shigao to vent. Abdominal bloating, wheezing, scanty urine, protruding umbilicus: Liangge San with Tinglizi may save. Internal phlegm-heat with severe fire-toxin,烦躁, unconsciousness: Baibu Tang added with Xuanshen/Zhuye. Ingestion of sour/astringents causing hidden fever/cough: Licorice prepared with pig bile, administered continuously until vomiting/mild sweat occurs. Bitter gourd/Licorice decoction induces vomiting (venting mechanism). Pork ingestion causing bloating/wheezing: Zhike Tang added with Shanzha/Mangxiao to purge. Walnut ingestion causing hoarseness/cough: Xiaodu Yin added with Shigao/Madouling. Recovery requires normalized breath/temperature. Post-illness or profuse diarrhea with middle qi deficiency causing early subsidence: strengthen middle qi, mildly resolve exterior/heat. Itching after subsidence indicates wind-exposure early subsidence; use Xiaofeng San.
Xiaofeng San: Treats wind-heat cough, body sores/lumps, and residual heat in pediatric pox.
Chuanxiong Rhizome (Chuanxiong, 川芎) Notopterygii Rhizoma et Radix (Qianghuo, 羌活) Saposhnikoviae Radix (Fangfeng, 防风) Schizonepetae Spica (Jingjie Sui, 荆芥穗) Pogostemonis Herba (Huoxiang, 藿香) Ginseng Radix (Renshen, 人参) Poria (Fuling, 茯苓) Bombyx Batryticatus (Jiangcan, 僵蚕) Cicada Slough (Chantui, 蝉蜕) [equal parts] Licorice Root (Gancao, 甘草) [roasted] Tangerine Peel (Chenpi, 陈皮) Magnoliae Officinalis Cortex (N Houpo, 浓朴) [ginger-processed, half dose]
Grind twelve ingredients into powder. Take 3-4 qian with tea liquor, or 5 qian decocted. Effective for chronic headache/cataracts (3 doses/day). Key ingredients are Houpo and Renshen. Skin diseases originate from stomach; Houpo clears interior, Renshen aids wind-dispersing herbs to resolve wind-heat externally, enabling efficacy of Qianghuo/Fangfeng/Jingjie.
Difficulty Subsiding: Northwest rigid water/earth and strong constitution require 5-7 days for subsidence. Southeast soft wind allows 2-3 days. Recent climatic shifts prolong duration. Dry, white, hidden spots after 3-4 days indicate weak Wei qi failing to erupt. Thin clothing blocking eruption causes delay. Treatment: acrid dispersants to diffuse. Avoid cold herbs to preserve opening pathways.
Thirst: Thirst indicates lung/stomach excess heat with red lips/mouth. Constipation/scanty urine: Maidong Ganlu Yin. Normal bowels/bladder, pale lips, but thirst indicates excessive cold damaging spleen fluid production: Qiwei Baizhu San removing Muxiang, adding Jingshi. Thirst with irritability indicates heat harassing Pericardium: Baibu Tang added with Maidong/Zhuye. At subsidence: Zhuye Shigao Tang removing Banxia. Thirst with abdominal distension indicates deficiency-stagnation, difficult to treat.
Maidong Ganlu Yin: Treats measles with intense heat and thirst.
Ophiopogonis Radix (Maidong, 麦冬) [2 qian, de-heart] Scrophulariae Radix (Xuanshen, 玄参) Scutellariae Radix (Huangqin, 黄芩) Trichosanthis Radix (Gualougen, 栝蒌根) Forsythiae Fructum (Lianqiao, 连翘) [1 qian each] Raw Licorice Root (Sheng Gancao, 生甘草) [0.5 fen] Rush Pith (Dengxin, 灯芯) [20 stems] Bamboo Leaves (Zhuye, 竹叶) [20 leaves]
Decoct in water, take warm.
Qiwei Baizhu San (Qian's Baizhu San): Treats thirst due to stomach deficiency and obstructed fluid/qi.
Ginseng Radix (Renshen, 人参) [1-3 qian] Atractylodis Macrocephalae Rhizoma (Baizhu, 白术) [fried yellow, 1-2 qian] Poria (Fuling, 茯苓) [1-1.5 qian] Licorice Root (Gancao, 甘草) [roasted, 0.6-1 qian] Prepared Puerariae Lobatae Radix (Weigen, 煨葛根) Pogostemonis Herba (Huoxiang, 藿香) Aucklandiae Radix (Muxiang, 木香)
Grind into powder. Take 3-4 qian decocted, 3 times daily.
Wheezing: Wheezing results from heat obstructing lung orifices and airways. Differentiate deficiency/excess. Deficiency (clear urine, loose stool, no high fever) is hard to treat; lung-moistening often fails. Excess (hard stool, red scanty urine, high fever) responds to Zhuye Shigao Tang removing Banxia, adding Gualouren/Beimu. Winter: add honey-fried Mahuang. Wheezing with nasal flapping and no mucus is incurable. Pre-eruption wheezing is easier to treat than post-subsidence. Initial wheezing: San'ao Tang added with Shigao/Yechá. Wheezing with dry nose/mouth: Baibu Tang is fastest. Post-measles wheezing requires Qingyan Zipfei Tang; Baibu Tang is contraindicated. Medicine requires flexibility.
Shortness of Breath: Caused by unclear lung heat. Active eruption: Qingre Touji Tang (see previous). Subsidencing/post-subsidence: Qingyan Zipfei Tang (see previous). Phlegm rattling in throat during active eruption indicates heat obstruction; use Chure Qingfei Tang. Post-subsidence indicates unresolved heat, wind-exposure early subsidence, or residual heat damaging lung qi; difficult to treat.
Chure Qingfei Tang: Treats fully erupted measles with high fever, cough, and constipation.
Gypsum Fibrosum (Shigao, 石膏) [3 qian] Scrophulariae Radix (Xuanshen, 玄参) [1 qian] Rehmanniae Radix (Shengdihuang, 生地黄) [1 qian] Ophiopogonis Radix (Maidong, 麦冬) [1.5 qian, de-core] Red Peony Root (Chishao, 赤芍) Trichosanthis Radix (Gualougen, 栝蒌根) Fritillariae Bulbus (Beimu, 贝母) [1 qian each] Licorice Root (Gancao, 甘草) [0.5 fen]
Decoct in water, take warm.
Hoarseness: Lung/stomach heat attacked by wind-cold, unable to reach exterior, causes severe cough and throat injury leading to hoarseness; use Qingyan Zipfei Tang. Hoarseness with swelling/pain: Shegan Xiaodu Yin. Hoarseness is common in measles, distinct from pox hoarseness.
Shegan Xiaodu Yin: Treats measles cough, hoarseness, and sore throat.
Belamcandae Rhizoma (Shegan, 射干) Scrophulariae Radix (Xuanshen, 玄参) Forsythiae Fructum (Lianqiao, 连翘) Arctii Fructum (Niubangzi, 鼠粘子) Schizonepetae Herba (Jingjie, 荆芥) [equal parts] Licorice Root (Gancao, 甘草) [half dose]
Decoct in water, take warm.
Convulsions: Convulsions result from phlegm-heat gathering in Pericardium during pre-eruption. Use Qingre Touji Tang (see previous) added with Gualouren/Zhuye. Post-subsidence convulsions are difficult; use light/clearing agents. Avoid mineral drugs. Profuse phlegm: induce vomiting with Gualou alone. Convulsions without phlegm sound or self-biting indicate true deficiency, fatal.
Epistaxis: Epistaxis results from fierce fire carrying blood upward. Initial measles epistaxis is favorable, allowing heat release; resolves spontaneously. Uncontrolled bleeding: Xijiao Dihuang Tang added with Jingjie Sui. Persistent bleeding post-subsidence: Siwu Tang added with Mugen/Maidong to nourish and descend.
Delirium: Delirium indicates fierce heat in Pericardium. During active eruption, heat is trapped internally; use Baibu Tang added with Jingjie/Niubangzi, or Mahuang for severe cases. Post-subsidence: Zhuye Shigao Tang removing Banxia, adding Shengdihuang to clear/resolve.
Teeth Grinding: Pox teeth grinding varies by cold/heat. Measles teeth grinding is always heat, yang sinking into yin, causing thirst, hot extremities, preference for cold drinks; use Maimen Dong Tang added with Danpi. Cold extremities, preference for hot drinks, followed by bloody stool/sore throat/phlegm rattle indicates internal hyperactive heat, fatal even with Baibu Tang.
Maimen Dong Tang: Treats pox with constipation and thirst.
Ophiopogonis Radix (Maimendong, 麦门冬) [2 qian] Angelicae Sinensis Radix (Dangguishen, 当归身) [1 qian] White Peony Root (Baishao, 白芍) [1.5 qian] Rehmanniae Radix (Shengdi, 生地) [2 qian]
Decoct in water, take warm.
Dry Lips: Dry lips indicate stomach/spleen heat. Pale/dry: mild heat. Red/dry: deep heat. Purple-black/dry: severe heat. Treat with clearing/moistening based on severity.
Cracked Lips/Tongue: Cracking indicates heart/spleen fire rising, usually dark red. During eruption: Baibu Tang added with Huangqin/Huanglian/Xuanshen/Jingjie/Bohe. Post-subsidence cracking, purple-black/dry, inactive blood indicates heart/spleen exhaustion; difficult to treat.
Bad Breath: Foul breath indicates heat accumulation in stomach; use Qingwei San added with Shigao/Lianqiao/Sheng Gancao. Unbearable odor indicates stomach failure, incurable. Exception: pre-existing conditions.
Qingwei San: Treats stomach heat causing epigastric pain (relieved by寒热 alternating), gum swelling/bleeding, radiating head pain.
Rehmanniae Radix (Shengdihuang, 生地黄) [4 qian] Bupleuri Radix (Shengma, 升麻) [1.5 qian] Moutan Cortex (Mudanpi, 牡丹皮) [5 qian] Angelicae Sinensis Radix (Danggui, 当归) Coptidis Rhizoma (Chuanlian, 川连) [wine-steamed, 3 qian each]
Grind into powder, divide into three doses. Decoct, strain, sip slowly. Repeat in half day.
Xijiao Dihuang Tang focuses on dispelling stasis (uses Xijiao/Shao). Qingwei San lifts stomach heat (uses Shengma/Lian). Later modified Qingwei combines both, minus Shao.
Tongue Coating: Tongue is heart sprout; measles relates to fire/heart. Coatings vary: White=lung heat, Yellow=stomach heat. Clear/resolve based on exterior signs. Pure black=heart exhaustion. Black/wet=heat invading blood level; Black/dry=heat invading qi level. Both critical. Use Baibu Tang...