或谓余曰∶“痧胀之发，即麻疹也。子于痧胀，特多放痧之法尔，不知所放之痧，即放麻疹之胀气也。安得云麻疹非
痧胀之标，痧胀非麻疹之本欤？余曰∶“我见麻疹从伤风咳嗽而发者，有矣，未闻有感秽气发麻疹，感热天暑气发麻疹者。
岂非麻疹自有麻疹病，痧胀自有痧胀病乎。况痧胀既云即麻疹，何以有麻疹因秽气暑气所乘兼痧胀麻疹即隐而不发，必
俟放刮后麻疹始发乎。乃知麻疹不与痧胀同。故刮者放者各痧胀，虽有刮出之痧，不可即认为麻疹，其痧胀亦不与麻疹
同。必因伤风所发，始为麻疹实不同也。乃兹有痧胀不因伤风发热咳嗽所起。尝见刮放用药后，发出遍身形影如麻疹者，
虽形似麻疹，实非麻疹，故名之为类麻疹焉。”或曰∶“讵有非麻疹而形可同于麻疹者？”曰∶“此亦犹痧毒发为肿毒，发
为紫 之类尔，何疑乎。”
治验∶
一闻德音内人，腹中疼痛，右脉微而弦，左脉细而涩。令其婢放腿弯痧三针，血流紫黑色，未愈。用宝花散，救苦
丹清茶稍冷冻饮料之，付以和脾宣化饮加茜草、桃仁微冷冻饮料之，发出一身类麻疹者，余用防风散痧汤减细辛加连翘、红花、
金银花、桃仁治之，而痊。
一施均季孙女，发热咳嗽，腹胀昏沉，微有麻疹形影，大便泻黄水有用升发之药，不效。延余治之，脉上盛而下虚，
乃知发热咳嗽，虽本伤风实非因伤风而有麻疹形影也。放指头痧二十余针，用圆红散调黑糖，微冷汤饮之，稍觉清爽用
独活红花汤加山楂、卜子、泽兰治之，连送二剂，大便下尽黑物，而愈。
─章涟漪三子，发热昏沉，腰胁间微有形影与麻疹相似，有用升发之剂，惟恐不透。次日，迎余，六脉歇指，余曰∶
“麻疹之病，何遽尔歇指耶？虽昏沉气喘，喉无痰声，脉不合症，斯痧胀之类麻疹者欤。”放头顶痧兼放左太阳及乳上痧
三针，未愈。用荆芥汤加山棱、蓬术、白蒺藜微冷冻饮料之，发一身类麻疹者，遂安。
一薛思高，发热迷闷，气不得舒，胸腹头面有麻疹形。余诊之，两关俱芤，此痧胀之类麻疹也。放痧十余针，又刮
痧讫，用沉香郁金散，清茶稍冷冻饮料之，而痊。
一张省原子，胸腹饱闷，昏沉不醒、痧筋不现，但微有麻疹形。脉左寸关沉细如无，右寸亦伏。余思，麻疹脉不若
是。令其家人，用灯心蘸菜油点火 之，即醒。但饱闷未解，用宝花散加沉香、蒲黄清茶微冷冻饮料之，付奏 和解饮减山
药、人参、甘草加桃仁、红花治之，而愈。
有人对我说：“痧胀的发作，就是麻疹。您对于痧胀，特别多用放痧的方法，却不知道所放的痧，就是放出麻疹的胀气。怎么能说麻疹不是痧胀的表现，而痧胀不是麻疹的根本呢？”我说：“我见过麻疹因伤风咳嗽而发作的，却从未听说过因感受秽浊之气或热天暑气而引发麻疹的。这难道不是说明麻疹自有其病症，痧胀也自有其病症吗？况且如果痧胀就是麻疹，为什么会有麻疹因为秽浊之气和暑气侵袭，导致痧胀和麻疹同时潜伏而不发作，必须等到放痧或刮痧之后，麻疹才发出来呢？由此可知麻疹与痧胀并不相同。所以，无论是刮痧还是放痧治疗的各类痧胀，即使刮出了痧象，也不能立即认为是麻疹，它们的痧胀也不与麻疹相同。只有因伤风引起的，始为真正的麻疹，这是完全不同的。然而现在有一种痧胀，并非因伤风发热咳嗽而起。我曾见到经过刮痧、放痧及用药后，身上发出遍布全身的疹子，形状像麻疹一样，虽然形态相似，实际上并不是麻疹，所以称之为‘类麻疹’。”那人问：“难道有不是麻疹但形态却与麻疹相同的吗？”我说：“这也就像痧毒发作成为肿毒，或者变成紫斑之类的情况罢了，有什么可怀疑的呢。”
治疗案例：
一位皇室内眷属，腹部疼痛，右脉微弱而弦，左脉细涩。命令她的婢女在腿弯处放痧三针，流出紫黑色的血，病未痊愈。使用宝花散，配合救苦丹，用清茶稍微冷冻后饮用，并开具和脾宣化饮加入茜草、桃仁，稍微冷冻后饮用，结果发出一身类似麻疹的疹子。我随后使用防风散痧汤，减去细辛，加入连翘、红花、金银花、桃仁进行治疗，最终痊愈。
施均季的孙女，发热咳嗽，腹胀昏沉，微有麻疹的形影，大便泻下黄水。之前有用升提发散的药物，无效。请我诊治，脉象上部盛而下部虚，才知道发热咳嗽，虽然本于伤风，但实际上并非因伤风而有麻疹形影。在手指头处放痧二十多针，用圆红散调黑糖，用微冷的汤水送服，稍觉清爽后，使用独活红花汤加入山楂、莱菔子（卜子）、泽兰进行治疗，连续服用两剂，大便排尽黑色物质，于是痊愈。
章涟漪的第三个儿子，发热昏沉，腰胁间微有形影与麻疹相似，之前有用升提透发的药剂，只是担心不能透发。第二天，迎接我去诊治，六脉出现歇止（间歇），我说：“麻疹的病，怎么会突然脉象歇止呢？虽然昏沉气喘，喉间无痰声，脉象与症状不符，这大概是痧胀中的类麻疹吧。”在头顶放痧，兼且在左侧太阳穴及乳房上方放痧三针，病未愈。使用荆芥汤加入三棱、莪术、白蒺藜，稍微冷冻后饮用，发出一身类似麻疹的疹子，于是安定下来。
薛思高，发热迷闷，气息不得舒展，胸腹头面有麻疹的形影。我诊察他的脉象，两手关脉都呈现芤脉（中空如葱管），这是痧胀中的类麻疹。放痧十余针，又刮痧完毕，使用沉香郁金散，用清茶稍微冷冻后饮用，于是痊愈。
张省元的儿子，胸腹饱闷，昏沉不醒，痧筋不显现，仅微有麻疹的形影。脉象左寸关沉细得几乎摸不到，右寸脉也伏匿不见。我思考，麻疹的脉象不会是这样。让他的家人用灯心草蘸菜油点火熏灸鼻窍，患者立刻苏醒。但饱闷仍未解除，使用宝花散加入沉香、蒲黄，用清茶稍微冷冻后饮用，并开具和解饮，减去山药、人参、甘草，加入桃仁、红花进行治疗，于是痊愈。
A person said to me, "The onset of Sha Zhang (Sha Distension) is precisely Measles. You employ the method of bloodletting (Fang Sha) extensively for Sha Zhang, unaware that the 'Sha' released is merely the distending Qi of Measles. How can you claim that Measles is not a manifestation of Sha Zhang, nor that Sha Zhang is not the root of Measles?" I replied, "I have seen Measles arising from Wind-Cold injury accompanied by coughing, but I have never heard of Measles being caused by inhaling foul odors or summer-heat. Does this not prove that Measles has its own distinct pathology, and Sha Zhang has its own? Moreover, if Sha Zhang were identical to Measles, why would Measles remain latent due to invasion by foul odors and summer-heat, only erupting after bloodletting or scraping? This indicates that Measles and Sha Zhang are not the same. Therefore, in various types of Sha Zhang treated by scraping or bloodletting, even if Sha spots appear, they cannot be immediately identified as Measles; their pathology differs from Measles. Only those arising from Wind-Cold constitute true Measles, which is fundamentally different. However, there exists a type of Sha Zhang that arises without Wind-Cold, fever, or cough. I have observed cases where, after scraping, bloodletting, and medication, rashes resembling Measles appeared all over the body. Although similar in appearance, they are not true Measles; hence, they are termed 'Measles-like Rashes'." The person asked, "Are there conditions other than Measles that present with a morphology similar to Measles?" I said, "This is akin to Sha toxins manifesting as abscesses or purple macules; what is there to doubt?"
Clinical Cases:
1. A female member of the imperial household suffered abdominal pain. Her right pulse was faint and wiry, while her left pulse was fine and choppy. Her maid performed bloodletting at three points on the popliteal fossa, releasing dark purple-black blood, but she did not recover. She was administered Baohua San (Precious Flower Powder) and Jiuku Dan (Bitterness-Saving Pill), taken with slightly chilled clear tea. Additionally, Heping Xuanhua Yin (Spleen-Harmonizing and Transformation-Decoction) was prescribed with added Qiancao (Rubia cordifolia Root) and Taoren (Peach Seed), also taken slightly chilled. Subsequently, a Measles-like rash erupted all over her body. I then treated her with Fangfeng Sansha Tang (Saposhnikovia Decoction for Dispersing Sha), modifying it by removing Xixin (Asarum) and adding Lianqiao (Forsythia Fruit), Honghua (Carthamus Flower), Jinyinhua (Lonicera Flower), and Taoren (Peach Seed). She recovered.
2. The granddaughter of Shi Junji presented with fever, cough, abdominal distension, and lethargy, showing slight signs of Measles. She had diarrhea with yellow watery stools. Previous treatments using ascending and dispersing herbs were ineffective. Upon my examination, the pulse was excess in the upper position and deficient in the lower position. I determined that although the fever and cough originated from Wind-Cold, the Measles-like signs were not truly due to Wind-Cold. Bloodletting was performed at more than twenty points on the fingertips. Yuanhong San (Round Red Powder) was mixed with brown sugar and administered with slightly cool water. After feeling somewhat refreshed, Duhuo Honghua Tang (Angelica Pubescens and Carthamus Decoction) was prescribed with added Shanzha (Hawthorn Fruit), Boluoz (Radish Seed), and Zelan (Lycopus Herb). Two doses were given consecutively. Black material was passed in the stool, and she recovered.
3. The third son of Zhang Lianyi suffered from fever, lethargy, and slight rash-like shadows on the waist and hypochondrium resembling Measles. Previous treatments used ascending and penetrating agents, but there was concern that the pathogen might not fully emerge. On the following day, he summoned me. His six pulses exhibited intermittent pauses (Xi Zhi). I stated, "Why should the pulse of Measles suddenly show such pauses? Although he is lethargic and panting, there is no phlegm sound in the throat, and the pulse does not match the symptoms. This must be a case of Sha Zhang presenting as Measles-like rash." Bloodletting was performed on the vertex, along with three points on the left Taiyang (Bladder Meridian) point and above the breast. The condition did not improve initially. Jingjie Tang (Schizonepeta Decoction) was prescribed with added Sanleng (Sparganium Rhizome), Pengzhu (Curcuma Rhizome), and Baijili (Tribulus Fruit), taken slightly chilled. A Measles-like rash erupted all over the body, and he stabilized.
4. Xue Sigao presented with fever, mental confusion, stifled Qi, and rash-like shadows on the chest, abdomen, head, and face. Palpation revealed both Guan positions of the pulses were Kou (hollow, like a scallion stalk). This indicated Sha Zhang presenting as Measles-like rash. More than ten points were bled, followed by scraping. Chenxiang Yujin San (Agarwood and Curcuma Powder) was administered with slightly chilled clear tea. He recovered.
5. The son of Zhang Shengyuan suffered from chest and abdominal fullness and oppression, lethargy, and unconsciousness. Sha veins were not visible, though slight Measles-like shadows were present. The Cun and Guan positions of the left hand were deep and fine, almost imperceptible, and the Cun position of the right hand was hidden (Fu). I reasoned that the pulse of Measles would not present this way. His family members lit a lamp wick dipped in vegetable oil and cauterized his nose, upon which he regained consciousness. However, the fullness and oppression remained unresolved. Baohua San (Precious Flower Powder) was administered with added Chenxiang (Agarwood) and Puhuang (Tamarix Pollen), taken with slightly chilled clear tea. Heehjie Yin (Harmonizing and Resolving Decoction) was prescribed, modifying it by removing Shanyao (Dioscorea Rhizome), Renshen (Ginseng Root), and Gancao (Licorice Root), and adding Taoren (Peach Seed) and Honghua (Carthamus Flower). He recovered.