发热之初，憎寒壮热，鼻流清涕，呕吐泄泻，咳嗽气急，腮红眼倦，即当解表。得微汗则
皮肤通畅，腠理开豁，麻疹易出。宁有闭闷、腹胀、喘急之患哉？初起全似伤寒，但面赤、中指
冷为异。
主方 （次剂根据后加减） 升麻 葛根 防风 荆芥 桔梗 枳壳 前胡 桑皮 杏仁
（等分） 甘草（减半） 加连须、葱头，水煎服。
暄热加黄芩、黄连、栀子、玄参、木通、石膏、知母，减升麻、葛根，入淡竹叶、灯心煎。
和暖加石膏、知母、牛蒡、薄荷、连翘、木通，减升麻、葛根、灯心十枝，水煎。
时暖时寒加羌活、牛蒡、连翘、赤芍，减枳壳。水煎服。
大寒加麻黄（酒炒、） 羌活、川芎（少加桂枝，） 去升麻、葛根。水煎服。
四方加桑皮、杏仁。
凡吐泻不食，不必治。惟发散表，疹出透，诸证自安。如大便秘加大黄五、七分，以通为度
。
疹之初出，多于耳后，项上及腰腿先见。其顶尖而不长、其形小而匀净者吉。既出之时，色
宜淡红、疏朗，如深红紫色，兼火化也。若紫红干燥，昏暗无光，乃火盛毒炽也。服表药后，纸
捻照之，红影出于肌肤，成片而将起。切戒风寒、生冷及诸禁忌。一有触犯即反收没，多致不救
。遇此急宜表出，如不出，猛加发药，外用擦法。若毒内攻，则致痒塌，难救。或皮肤闭塞，毒
气壅滞，遂变为浑身青紫，烦躁腹痛，喘急闷乱而死。若自利不止，或小便频数，虽为恶候，如
疹稠密，深红紫色，则又无妨。但至三日后，热不退、疹不收者，毒火太盛，余邪未尽也。宜服
清火解毒之药，自收。根据后方∶
轻∶或热或退，五、六日后出疹，色淡红滋润，头面匀净而多，根据时发透，三日渐收。
重∶头面不出，红紫黯燥，咽喉肿痛，不能食，冒风寒没早，移热变痢。
主方 防风 前胡 川芎 枳壳 桔梗 桑皮 杏仁 陈皮（等分） 甘草（减半） 水煎
服。
发未透加升麻、麻黄，夏少用。出透加连翘、牛蒡。毒火、渴甚加石膏、知母、玄参、黄连
、黄芩、栀子。喘嗽加苏子、栝蒌仁、萝卜子。 火闭加大黄。色白加红花（酒炒）、赤芍药（酒炒）。
疹色深红而渴∶石膏（二钱） 知母（一钱） 牛蒡 连翘 升麻 地骨皮 淡竹叶 甘草
（各七分） 上加糯米（百粒，）水煎服。
天热、大渴引饮不止加栀子、麦冬、天粉，与绿豆灯心汤饮。
风寒闭塞，疹出不透∶麻黄（酒洗，一钱或二钱。发为度） 升麻（酒洗，一钱） 人中黄
（如无，用童便拌甘草） 蝉蜕 牛蒡子（各一钱）
姜、葱煎服。外用胡荽同酒糟蒸热，于无风暖处，周身头至足擦，令热汗出为度。
紫赤干燥∶川芎 生地 红花（酒洗） 干葛 黄芩 连翘 牛蒡子 上水煎成，调六一散
服。
将出复没∶麻黄（酒洗，二钱） 升麻 葛根 羌活 防风 荆芥 牛蒡子 前胡 桔梗
甘草 水煎服。
孕妇出疹∶主方加川芎、生地、条芩、艾叶，安胎为主，兼解毒药，宜多服。如胎气上冲，
急用苎根、艾叶煎汤，磨生槟榔服。
热毒蒸胎∶胎多受伤，内服药，外用护胎法保全。倘失治胎坠，母可无恙。盖痘宜内实，胎
落母亡；疹宜内虚，故母可安（必宜母子俱生。）
护胎法∶靛青 灶心土 井底泥研匀，涂脐腹寸浓，频敷。
不治证∶黑黯焦枯，忽见紫点，一出即没，鼻扇口张，目直无神，鼻青粪黑，气喘前心吸
，疹后牙疳臭烂。
发热初期，出现怕冷且高热、流清鼻涕、呕吐腹泻、咳嗽气促、腮部发红眼睛疲倦等症状时，应当立即采用解表法治疗。若能微微出汗，则皮肤通畅，腠理（皮肤纹理及毛孔）开泄，麻疹容易透发。这样怎么还会有胸闷腹胀、气喘急促的祸患呢？发病初期症状完全类似伤寒，但面部潮红、中指发凉是其不同之处。
主方（次剂根据后文加减）：升麻、葛根、防风、荆芥、桔梗、枳壳、前胡、桑白皮、杏仁（各等分），甘草（减半量）。加入带须的葱和葱头，用水煎服。
天气暄热时，加黄芩、黄连、栀子、玄参、木通、石膏、知母，减少升麻、葛根，加入淡竹叶、灯心草煎服。
天气温和时，加石膏、知母、牛蒡子、薄荷、连翘、木通，减少升麻、葛根、灯心草十枝，用水煎服。
时暖时寒时，加羌活、牛蒡子、连翘、赤芍，减少枳壳。用水煎服。
大寒时，加麻黄（酒炒）、羌活、川芎（少加桂枝），去掉升麻、葛根。用水煎服。
以上四方均加桑白皮、杏仁。
凡是出现呕吐腹泻不能进食的情况，不必专门治疗止泻止吐。只需发散表邪，待疹子透出，各种症状自然安宁。如果大便秘结，加大黄五到七分，以大便通畅为度。
疹子初出时，多先在耳后、颈部以及腰腿部显现。疹点尖端不尖锐且不长、形状小而均匀洁净的，预后良好。疹子发出时，颜色宜呈淡红色、分布稀疏明朗；如果是深红紫色，兼有火化现象。若是紫红色且干燥，昏暗无光泽，则是火盛毒炽的表现。服用解表药后，用纸捻照看，若看到红色影子出现在肌肤之下，成片即将隆起。务必戒除风寒、生冷食物及各种禁忌。一旦触犯禁忌，疹子就会反向收敛内陷，大多导致无法救治。遇到这种情况，急宜用发汗法使疹子透出，如仍不透，猛加发汗药物，并配合外用擦拭法。如果毒气内攻，则会导致瘙痒塌陷，难以救治。或者因皮肤闭塞，毒气壅滞，最终变为全身青紫，烦躁腹痛，气喘胸闷混乱而死。如果是自利不止，或小便频数，虽然属于恶候，但如果疹子稠密，呈深红紫色，则又没有妨碍。但是到了第三天后，热度不退、疹子不收敛的，是毒火太盛，余邪未尽。适宜服用清火解毒的药物，疹子自然会收敛。根据后方：
轻症：或热或退，五、六日后出疹，颜色淡红滋润，头面部均匀洁净且较多，按时透发，三日后逐渐收敛。
重症：头面部不出疹，颜色红紫暗燥，咽喉肿痛，不能进食，冒受风寒导致疹子早没，移热变生痢疾。
主方：防风、前胡、川芎、枳壳、桔梗、桑白皮、杏仁、陈皮（各等分），甘草（减半量）。用水煎服。
疹子未透发，加升麻、麻黄，夏季少用。疹子已透发，加连翘、牛蒡子。毒火旺盛、口渴严重，加石膏、知母、玄参、黄连、黄芩、栀子。气喘咳嗽，加苏子、栝楼仁、萝卜子。火闭证，加大黄。疹色发白，加红花（酒炒）、赤芍药（酒炒）。
疹色深红且口渴：石膏（二钱）、知母（一钱）、牛蒡子、连翘、升麻、地骨皮、淡竹叶、甘草（各七分）。上面加上糯米（一百粒），用水煎服。
天气炎热、大渴引饮不止，加栀子、麦冬、天花粉，与绿豆灯心草汤饮用。
风寒闭塞，疹子出不透：麻黄（酒洗，一钱或二钱，以发汗为度）、升麻（酒洗，一钱）、人中黄（如无，用童便拌甘草）、蝉蜕、牛蒡子（各一钱）。用姜、葱煎服。外用胡荽同酒糟蒸热，在无风温暖处，从周身头部擦至足部，令其出微汗为度。
疹色紫赤干燥：川芎、生地、红花（酒洗）、干葛、黄芩、连翘、牛蒡子。用水煎成，调服六一散。
疹子将出又隐没：麻黄（酒洗，二钱）、升麻、葛根、羌活、防风、荆芥、牛蒡子、前胡、桔梗、甘草。用水煎服。
孕妇出疹：主方加川芎、生地、黄芩、艾叶，以安胎为主，兼用解毒药，宜多服。如果胎气上冲，急用苎麻根、艾叶煎汤，磨碎生槟榔服用。
热毒蒸伤胎儿：胎儿多会受伤，内服药配合外用护胎法保全。倘若失治导致胎坠，母亲可以安然无恙。因为痘疮宜内实，胎落则母亡；麻疹宜内虚，所以母亲可以平安（必须确保母子俱生）。
护胎法：靛青、灶心土、井底泥研匀，涂抹于脐腹部，厚度一寸，频繁敷贴。
不治之证：疹色黑黯焦枯，忽见紫点，一出即没，鼻翼扇动口张，眼睛直视无神，鼻梁青色粪便黑色，气喘前胸凹陷吸气，疹后牙疳臭烂。
At the initial stage of fever, when symptoms such as aversion to cold with high fever (Zenghan Zhuangre), runny nose with clear mucus, vomiting and diarrhea, cough with rapid breathing, red cheeks, and tired eyes appear, the exterior should be resolved immediately. If a slight sweat is achieved, the skin becomes unobstructed, the couli (skin pores and texture) open up, and the measles rash easily emerges. How could there then be worries of chest tightness, abdominal distension, or rapid breathing? The initial presentation resembles Taiyang disease (Shanghan), but facial flushing and coldness in the middle finger are distinguishing features.
Main Formula (subsequent doses adjusted according to modifications below): Shengma (Cimicifugae Rhizoma), Gegen (Puerariae Radix), Fangfeng (Saposhnikoviae Radix), Jingjie (Schizonepetae Spica), Jiegeng (Platycodonis Radix), Zhike (Aurantii Fructus Immaturus), Qianhu (Peucedani Radix), Sangbaipi (Mori Cortex), Xingren (Armeniacae Semen Amarum) (equal parts); Gancao (Glycyrrhizae Radix et Rhizoma) (half dose). Add scallions with roots and scallion heads, decoct in water and take orally.
In warm/hot weather: Add Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Zhizi (Gardeniae Fructus), Xuanshen (Scrophulariae Radix), Mutong (Akebiae Caulis), Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma); reduce Shengma and Gegen; add Danzhuyez (Lophatheri Herba) and Dengxincao (Junci Medulla), decoct in water.
In mild/warm weather: Add Shigao, Zhimu, Niubangzi (Arctii Fructus), Bohe (Menthae Haplocalycis Herba), Lianqiao (Forsythiae Fructus), Mutong; reduce Shengma, Gegen, and Dengxincao (ten stalks); decoct in water.
When alternating warmth and cold: Add Qianghuo (Notopterygii Rhizoma et Radix), Niubangzi, Lianqiao, Chishao (Paeoniae Radix Rubra); reduce Zhike. Decoct in water and take orally.
In severe cold: Add Mahuang (Ephedrae Herba) (wine-fried), Qianghuo, Chuanxiong (Ligustici Chuanxiong Rhizoma) (add a small amount of Guizhi (Cinnamomi Ramulus)); remove Shengma and Gegen. Decoct in water and take orally.
All four formulas above add Sangbaipi and Xingren.
For cases with vomiting, diarrhea, and inability to eat, no specific treatment for these symptoms is needed. Only resolve the exterior pathogen; once the rash emerges fully, all other symptoms will naturally settle. If constipation occurs, add Dahuang (Rhei Radix et Rhizoma) 5-7 fen, stopping when bowel movement is unobstructed.
When the rash first appears, it usually shows first behind the ears, on the neck, waist, and legs. It is auspicious if the papules have pointed tips but do not elongate, and are small and uniform/clean. At the time of emergence, the color should be pale red and sparse/clear. Deep red or purple indicates transformation into fire. If purple-red and dry, dark and lusterless, it signifies excessive fire and intense toxin. After taking exterior-resolving medicine, shine a paper torch upon the skin; if red shadows appear under the skin, forming patches ready to rise, proceed. Strictly avoid wind, cold, raw/cold foods, and various taboos. Any violation may cause the rash to retract inward, often leading to untreatable conditions. In such emergencies, urgently promote eruption via sweating methods; if still not emerging, vigorously increase diaphoretic herbs, and apply external rubbing methods. If toxins attack internally, itching and collapse may occur, making rescue difficult. Or, due to closed skin and stagnation of toxic qi, it may turn into whole-body cyanosis, restlessness, abdominal pain, rapid breathing, chest tightness, confusion, and death. If spontaneous diarrhea persists or urination is frequent, although these are ominous signs, if the rash is dense and deep red/purple, they are not necessarily detrimental. However, if after three days the fever does not subside and the rash does not recede/converge, it means the toxic fire is too strong and residual pathogens remain. It is appropriate to take heat-clearing and detoxifying medicines, which will allow the rash to converge. According to subsequent formulas:
Mild case: Fever fluctuates; rash appears after five to six days, pale red and moist, uniform and clean on head and face, abundant, erupts on schedule, and converges after three days.
Severe case: Rash does not appear on head/face, color is red-purple, dark, dry; sore throat and swelling, inability to eat, rash retracts early due to wind-cold exposure, heat shifts causing dysentery.
Main Formula: Fangfeng, Qianhu, Chuanxiong, Zhike, Jiegeng, Sangbaipi, Xingren, Chenpi (Tangerine Peel) (equal parts); Gancao (half dose). Decoct in water and take orally.
If rash has not emerged fully: Add Shengma, Mahuang; use sparingly in summer.
If rash has emerged fully: Add Lianqiao, Niubangzi.
If toxic fire is strong and thirst is severe: Add Shigao, Zhimu, Xuanshen, Huanglian, Huangqin, Zhizi.
If wheezing and coughing: Add Su Zi (Perillae Fructus), Gualou Ren (Trichosanthis Semen), Luobo Zi (Raphani Semen).
If fire closure: Add Dahuang.
If rash color is white: Add Honghua (Carthami Flos) (wine-fried), Chishao (wine-fried).
Deep red rash with thirst: Shigao (2 qian), Zhimu (1 qian), Niubangzi, Lianqiao, Shengma, Digupi (Bark of Lycium Root), Danzhuye, Gancao (each 7 fen). Add Nuomi (Glutinous Rice) (100 grains), decoct in water and take orally.
Hot weather, extreme thirst with continuous drinking: Add Zhizi, Maidong (Ophiopogonis Radix), Tianfen (Tianhuafen/Trichosanthis Radix); drink with Menglü Dengxin Tang (Mung Bean and Juncus Decoction).
Wind-cold closure, rash not emerging fully: Mahuang (wine-washed, 1 or 2 qian, until sweating occurs), Shengma (wine-washed, 1 qian), Renzhonghuang (Human Waste Charcoal) (if unavailable, use Gancao mixed with child's urine), Chantui (Cicada Slough), Niubangzi (each 1 qian). Decoct with Jiang (Ginger) and Cong (Scallion) and take orally. Externally: Steam Huisu (Coriander) with wine lees until hot; rub over the whole body from head to feet in a wind-free, warm place, until slight sweat appears.
Purple-red and dry rash: Chuanxiong, Shengdi (Rehmanniae Radix Preparata), Honghua (wine-washed), Gange (Gegen), Huangqin, Lianqiao, Niubangzi. Decoct in water, mix with Liuyisan (Six-to-One Powder) and take orally.
Rash about to emerge but retracts: Mahuang (wine-washed, 2 qian), Shengma, Gegen, Qianghuo, Fangfeng, Jingjie, Niubangzi, Qianhu, Jiegeng, Gancao. Decoct in water and take orally.
Pregnant woman with measles: Main formula adds Chuanxiong, Shengdi, Tiaohuangqin (Scutellariae Radix), Aiye (Artemisiae Argyi Folium). Focus on calming the fetus, combined with detoxifying herbs; take generously. If fetal qi rushes upward, urgently decoct Zhugen (Radix Boehmeriae Niveae) and Aiye, grind Shengbinglang (Arecae Semen) and take.
Heat-toxin steaming the fetus: The fetus is often injured; internal medication combined with external fetal-protection methods ensures safety. If untreated and the fetus aborts, the mother may remain safe. This is because variola (smallpox) requires interior excess (leading to maternal death if fetus drops), whereas measles requires interior deficiency (allowing maternal safety). (Must ensure both mother and child survive.)
Fetal protection method: Dianqing (Indigo Naturalis), Zaoxintu (Caoline), Jingdini (Mud from bottom of well) ground uniformly; apply to umbilicus and abdomen, thickness of one cun, apply frequently.
Untreatable signs: Black, dark, scorched, and withered appearance; sudden appearance of purple spots that disappear immediately; flaring nostrils, open mouth, staring eyes without spirit, blue nasal bridge, black stool; rapid breathing with anterior chest retraction; foul-smelling rotting gums after rash.