今夫血阴物也，有质而凝，寒则凝，热则行，热毒之气内外不得分消，内闭结，外无汗，营家失所，奔
窜妄行，传注督脉，必从鼻软关而出。《经》云∶毒从衄散不必止之。若从口来犯胃，
难治，急用犀角地黄汤。或溺血者，加山栀、车前、石苇、木通、
升麻、槐花（各二钱），或大便下血者，加黄芩（四钱）、槐角（三钱）、黄柏（二钱）、升麻（二钱）。血属阴本静，因
相火所逼，故越出上窍，耳鼻衄出者加山栀（二钱）、防风（二钱）、荆芥（八分）。若九窍出血者不治。若吐蛔，泻蛔。
蛔者，嘈食虫也。不食而出者，胃火实也。见食而出者，胃中虚寒也。气虚不食而吐蛔者死，泻蛔亦然。不食，虫
无存养之所，故出。虫畏胃火，不安其身，亦出，宜重用石膏。
疹虽出齐，天庭不明，手足尖不至，而时师误降者，或自回者，于降药中加发散开提之药，如大黄、钩
丁、薄荷、蝉衣之类。或用青龙汤不可迟延，生甘草、知母、薄荷、黄芩、栝蒌仁、胆草、大青、红花、忍
冬花、通草、谷精草、西瓜汁、升麻、砂仁、竹沥、僵蚕、槐花。
咽者，胃脘水谷之道路，主纳而不出；喉者，肺经呼吸之往来，主出而不入。咽喉系一身之橐 ，使毒
火上炎，不得发越，锁于咽喉，或燥或破，或呛或噎，或痛或肿，甚至水入则吐，食入则呕，音哑，言语
不明，无论火毒重轻，即以甘桔汤加大力、荆芥、玄参、复花、前胡、芍药，消火毒，清咽喉为要。回后加
豆根、麝干、麦冬、防风、石膏、苦参。《经》云∶切要解炎并
清喉痹。咽痛甚，毒火灼，只恐一朝封管， 锁杀声，哑却徒劳。
血属于阴，是有形质的物质，遇寒则凝结，遇热则流动。如果热毒之气在体内和体外都无法消散，就会在内闭结，在外无汗，导致营气失去正常的居所，四处奔窜妄行，传导至督脉，必然从鼻部的软关窍而出。《内经》说：毒邪通过鼻衄（鼻出血）散发出来，不必强行止血。如果血液从口部涌出并侵犯胃腑，难以治疗，应立即使用犀角地黄汤。如果是尿血者，加入山栀、车前子、石韦、木通、升麻、槐花（各二钱）；如果是大便下血者，加入黄芩（四钱）、槐角（三钱）、黄柏（二钱）、升麻（二钱）。血本属阴而安静，因为受到相火的逼迫，所以向上溢出七窍。对于耳鼻出血者，加入山栀（二钱）、防风（二钱）、荆芥（八分）。如果九窍全部出血，则无法治愈。如果出现吐蛔虫或泻蛔虫的情况，蛔虫就是引起嘈杂感的食虫。如果不吃东西却吐出蛔虫，是胃火实证的表现；看到食物才吐出蛔虫，是胃中虚寒的表现。气虚不想进食而吐出蛔虫的，预后不良会死亡，泻出蛔虫的情况也是如此。不吃东西，虫子就没有赖以生存的地方，所以跑出来。虫子畏惧胃火，身体不安宁，也会出来，应当重用石膏。
麻疹虽然已经出齐，但天庭（额头）部位色泽不明亮，手足指尖没有到达，而当时的医生错误地使用了降逆药物，或者疹毒自行内陷回退的，应当在降逆药中加入发散开提的药物，如大黄、钩藤、薄荷、蝉蜕之类。或者使用青龙汤，不可拖延，方剂组成包括生甘草、知母、薄荷、黄芩、瓜蒌仁、龙胆草、大青叶、红花、忍冬花、通草、谷精草、西瓜汁、升麻、砂仁、竹沥、僵蚕、槐花。
咽部，是胃脘中水谷通行的道路，主要功能是接纳食物而不排出；喉部，是肺经呼吸气息往来的通道，主要功能是呼出而不吸入。咽喉是人体全身气的囊袋（橐龠），如果使毒火上炎，不能发散透达，锁结在咽喉部位，就会出现干燥或破裂，或者呛咳或噎塞，或者疼痛或肿胀，甚至喝水就吐，吃饭就呕，声音嘶哑，言语不清。无论火毒轻重，都应以甘桔汤为基础，加入大力子（牛蒡子）、荆芥、玄参、复花（旋覆花）、前胡、芍药，以消除火毒，清利咽喉为关键。疹毒消退后，加入豆根、麝香干品、麦冬、防风、石膏、苦参。《内经》说：关键在于解表清热并清除喉痹。咽喉疼痛剧烈，毒火灼烧，只担心一旦气管封闭，锁住声音，导致失语，那就徒劳无功了。
Blood is a Yin substance, possessing form and coagulating nature; it coagulates in cold and flows in heat. If the pathogenic heat-toxin cannot be dispersed both internally and externally, it will close inward without inducing sweat, causing Ying-Qi (Nutritive Qi) to lose its proper residence, rushing wildly and transmitting through the Du Meridian (Governing Vessel), inevitably exiting from the soft gate of the nose. The *Classic* states: "When toxin dissipates via nasal bleeding (Xue Bi), there is no need to stop it forcibly." If blood emerges from the mouth and invades the Stomach, it is difficult to treat; immediately use Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction). For cases of hematuria, add Zhizi (Gardeniae Fructus), Cheqiancao (Plantaginis Herba), Shiwei (Pyrosiae Folium), Mutong (Akebiae Caulis), Shengma (Cimicifugae Rhizoma), and Huaihua (Sophorae Flos) (each 2 qian). For cases of lower gastrointestinal bleeding, add Huangqin (Scutellariae Radix) (4 qian), Huaijiao (Gleditsiae Sinensis Fructus Spina), Huangbai (Phellodendri Cortex) (2 qian), and Shengma (2 qian). Blood belongs to Yin and is inherently still; driven by Ministerial Fire, it overflows upward through the orifices. For epistaxis and otorrhagia, add Zhizi (2 qian), Fangfeng (Saposhnikoviae Radix), and Jingjie (Schizonepetae Spica) (8 fen). If bleeding occurs from all nine orifices, the condition is incurable. If vomiting or passing roundworms (Hui Chong) occurs: Roundworms are parasites that cause gastric discomfort (Cao Za). Vomiting worms without eating indicates Excess Stomach Fire; vomiting worms upon seeing food indicates Deficiency-Cold in the Stomach. Vomiting worms due to Qi deficiency and anorexia leads to death, as does passing them. Without food intake, there is no sustenance for the worms, so they exit. Fearing Stomach Fire and feeling unsettled, they also emerge; thus, Shigao (Gypsum Fibrosum) should be heavily used.
Although the measles rash has fully erupted, if the forehead (Tian Ting) lacks luster and the fingertips do not reach full extension, and the physician erroneously uses descending/restraining herbs, or if the rash retreats spontaneously, descending herbs should be combined with dispersing and lifting agents such as Dahuang (Rhei Radix et Rhizoma), Gouding (Uncariae Ramulus cum Uncis), Bohe (Menthae Haplocalycis Herba), and Chenyi (Bombyx Batryticatus). Alternatively, Qinglong Tang (Azure Dragon Decoction) may be used without delay. The formula consists of Sheng Gancao (Glycyrrhizae Radix et Rhizoma), Zhimu (Anemarrhenae Rhizoma), Bohe, Huangqin, Gualouren (Trichosanthis Semen), Danshen (not listed, likely Dan Cao/Gentianae Scabrae Radix based on context "Dan Cao"), Daqingye (Isatidis Folium), Honghua (Carthami Flos), Rendonghua (Lonicerae Flos), Tongcao (Tetrapanacis Medulla), Gujingcao (Eriobotryae Folium), Xiguazhi (Citrulli Lanati Juice), Shengma, Sharen (Amomi Fructus), Zhuli (Bambusae Caulis in Taenia), Jiangcan (Bombyx Batryticatus), and Huaihua.
The Pharynx (Yan) is the pathway for water and food in the Stomach region, primarily for ingestion and not excretion; the Larynx (Hou) is the passage for respiratory Qi in the Lung Meridian, primarily for exhalation and not inhalation. The throat serves as the bellows (Tu Yue) of the whole body. If toxic fire flares upward and cannot vent, locking in the throat, symptoms include dryness or ulceration, choking or obstruction, pain or swelling, even regurgitation of fluids and vomiting of solids, hoarseness, and unclear speech. Regardless of the severity of the fire-toxin, Ganjie Tang (Licorice and Platycodon Decoction) should be modified with Niuxibangzi (Arctii Fructus), Jingjie, Xuanshen (Scrophulariae Radix), Fuhua (Inulae Flos), Qianhu (Peucedani Radix), and Shaoyao (Paeoniae Radix) to eliminate fire-toxin and clear the throat. After the rash subsides, Dougen (Millettiae Speciosae Radix), Shegan (Moschus), Maidong (Ophiopogonis Tuber), Fangfeng, Shigao, and Kushen (Sophorae Flavescentis Radix) are added. The *Classic* states: "The crucial point is to resolve inflammation and clear Hou Bi (throat obstruction)." Severe throat pain with burning toxic fire raises the fear of sudden airway closure leading to aphasia, which would render treatment futile.