（雄按∶麻也，痧也，疹也， 也，各处方言不同也，其实一也。何以分 疹为两篇，殊属未当，今归并作一类。）
孙文垣治仆子孙守，以麻（即 子。）咳嗽无痰，上唇浓，体肿热，大便燥，声哑，燥火为患。以麦冬、知母、
栝蒌、甘草、白芍、桑皮、（是症宜去白芍、桑皮，入牛蒡、桔梗。）地骨皮、石斛、枳壳，服后嗽减其七，乃去栝蒌、
枳壳。以其大便已溏，加生地、当归、苡仁，调理而安。（此症加生地，合否当酌之。）
程氏子七岁中麻，（西吴呼为 子，姑苏呼为痧子。）一月余矣，发热如故，咳嗽声哑，肌削骨立，头发尽秃，众
医束手。孙见之曰∶若谓此儿不可治耶，此麻后虚热成疳，以大芦荟丸与之，可万全也。病家初不余问者，谓非幼
科专门也，不知此特大方家余事耳。（可改韩诗曰，余事作儿科。然方脉不知儿科者，必非良手。）为制药与之，未尽服
而瘳。
吕东庄治钱氏子，五岁，病 泄泻。儿医谓 最宜于泻，不复顾忌，以清火为急，寒凉纵进，（着眼在纵字。）
病势殊剧。吕视之，面色两观刺红，（虚阳上浮。）时切牙喘急，（上盛。）口渴甚，饮水不绝，（阴虚液燥。）脉洪缓
如平壮人。曰∶脾急矣，速投人参、当归、黄 、陈皮、甘草、茯苓、木香以救之，一剂觉安。或阻之曰∶误矣，小
儿有专门，岂可令腐儒治之。吾所闻 病，以发散清凉解毒为主，今半身 ，潮热未退，而用温补，必不救矣。（无
真知而参未议，最能误人，知者慎之。）其家惧，遂不敢再服。间三日，其父复来见曰∶诸症复如故，如何？吕曰∶
岂有是理哉，君戏我耳。曰∶日来实不服君药，乃述其故。吕曰∶君试急归，儿天柱骨倒矣。别去，顷之驰至，曰∶
果如公言，奈何？急服前方何如？吕曰∶前方救虚也，今加寒矣，非桂、附不能挽也。曰∶颧红口渴，喘急饮
水，俱是热症，而公独云虚寒何也？曰∶阴竭于内，阳散于外，而寒凉复逼之也。阳无所归，内真寒而外假热，
此立斋所发《内经》微旨，非深究精蕴者，不能信也。乃归而违众服之，一剂而天柱直，二剂而喘渴止，三剂
起行，嬉戏户外。（此由苦寒过剂，故处方如是，非一切小儿皆可桂、附也。）
冯楚瞻治沈氏儿，发热数日见麻疹，才一日，面上尽没，神气困极，蛔从口出，不一而足，数日不食，下
泻上喘，唇口焦裂，五心壮热，手足指尖皆冷，脉细数无伦，两尺更弱。咸谓疹毒归脏，胃热故蛔连出也。不
知神气欲脱，五脏俱困，脾虚不能纳谷，虫无所食，又兼虚火熏蒸，脏腑燥热，虫不安而出耳。况诸斑疹，多
由内伤失调，脾胃不足以荣，是以阳气逆行，阴覆于外。血盛气壮，则色红而 发，血虚气弱，则色白而隐伏，
有何毒之轻重乎？面上退缩者，阳虚不能升发也。喘促者，气难续也。唇焦者，脾津耗竭也。五心壮热者，阴
亏火烁也。泄泻不食者，真火衰而脾不运也。寸关细数，尺弱者，气虚血虚，虚火上浮而不藏也。急则治标，
缓则治本，今者之急，本气欲脱也。倘谓麻疹余毒，解利清托，恐神气先尽矣。乃以熟地六钱，丹皮一钱，麦
冬三钱，牛膝二钱，制附六分，一剂假热全消，真虚毕露，神气更倦。此阴已少复，当补气以助其发生。前方
另煎人参二钱冲服，神气渐复，喘促全安。饮粥微呕，乃胃气久虚之故也，再用前方，加炒黄白术二钱，去丹
参，参汤冲服，四剂全愈。
愚按∶此与吕症大同小异，要是百中一二，未可执为程法也。大抵麻疹之发，本诸肺胃，治之但宜松透，
一切寒燥寒热之剂，不可入也。余尝遇表散过甚，绵延不已者，一以生地、杞子、地骨、麦冬、蒌仁、沙
参等味三四剂，必嗽止热退而安。
高士宗长男六岁，次男三岁，于元旦次日发热见疹，即用以清解透发之剂，次日略增十数点，究不畅。心
以长男七月而生，先天怯弱，问其胸腹宽否？曰∶饥甚。口味何如？曰∶淡甚。因知其虚，遂投 、术、参、
草、桂枝、红花一二剂。次日透发遍身，热稍退，而性情犹烦躁，夜发热，频咳嗽，至一月而安。由见点之
初，过服表剂，虚其经脉故也。（由此成疳劳者多矣。）次男幼稚，致问不能，以上冬痰喘，服麻、杏、桂
枝、石膏一
剂而愈，谓其禀质略强，知其疹必不寒凝毒甚。因其苏、麻、前、杏、黄芩、石膏药，（大错。）红点不增，又与紫
苏、葱、姜、芫荽等温之熨之，疹总不出。（所谓不知经候，混攻混表是也。）同道俱云∶舍透法，并无别
法。（如此等药，岂但透发而已。）至五六日，吐蛔。或曰∶此热极生虫，可服牛黄散，牛黄散即大黄末也。一服
而痰喘止，神气稍平，却自是不能言矣。计无所施，针百会穴开其 门，服牛黄分许，及诸单方。观其形症，
（急则乱投药饵。）实不能生。友人张卫生曰∶此大虚大寒症也，今既无言，又不能食，恐无济矣。勉投参、
附，究无挽回。经曰∶一逆尚引日，再逆促命期。为医者可不鉴诸？
汪氏子出 已三日，服前胡、杏仁、麻黄、石膏药一二剂，疹出二十余点，不能再增，心胸烦闷，乞高诊。
高曰∶若再攻发则败矣。急与芎、归、 、术、桂、苓、红花一剂，而热退身安。凡治疹，调其气血，和其经
络，寒凉攻发，概致不用，则屡试屡效也。（亦非定论，盖鉴前车而矫枉过正也。）
吴题先子甫二岁，出 ，儿医攻发不透。高视之，知其虚也。曰∶若但发 ， 断不出，必至不保。惟有
温补之剂，益其脏腑，安其肠胃，助其气血方可。（语无筋节，则胸无滚动条可知。）遂与 、术、姜、桂、
归、芍、苓、银花、红花诸味，一剂而安。次日，即用原方加人参一钱，又连服独参汤而愈。
夏氏子出 ，色点俱紫，神气不宁。高曰∶此症大凶，治须得法。连看二次，皆用温散药。次早，其家人
走告曰∶口吐涎虫，另有药否？曰∶昨二剂俱服否？曰∶尚存一剂。因与附子八分，令加入煎服，自此遂无音
耗。（心窃惑之。）越三载，至其家，（犹怀鬼胎。）见其子长大，因问昔年出 吐蛔，何由得愈？曰∶服药后，
因无力相延，仗天覆庇，得以渐愈。（语亦虚活。）以上皆医药真传，高案。
徐仲光治一儿，身热喘胀，以内伤外感治之不效。视其背，隐隐赤色，乃疹也。以疹黄汤表发，虽出而头
面不足，随没而死。（雄按∶此证未始不由初治所误。）
一儿疹，身热似痘候，遍身报点。沈虚明、黄锦云皆以为虚也。时黄绮芸年十二岁，未知医，往视，独以
为疹。其父诟之，绮芸曰∶儿闻父言，疹为肺胃风热，今两鼻流涕，已非疹乎？已而果然。后长，遂为明医，
是以鼻涕作疹者，则早得其要领也。
一儿疹出紫色，便嗽哕泻不食，用解毒饮，挑痧法治之而后愈。（雄按∶识见之超，本乎天分。）
一儿疹出紫色，便秘溺涩，烦躁闷乱，急以大柴胡汤利之而愈。
一儿疹不易透，知为风寒所遏，用桂枝汤加葛根、麻黄、前胡升发之，又浓用被裹之，再以大剂防风汤，
熏于床下而愈。此亦可用芫荽防风汤，浴头面手足，又苎蘸芫荽酒戛之。（疹证以照顾咽喉为要务，麻
黄、葛根、升麻等药，最宜慎用。）
一儿身热，头痛骨痛，咳嗽气急，呕哕不食，乃伤寒而兼出疹也。以百祥散、十神解毒汤治之愈。若此
症治之少缓，疹虽透，必变紫黑闷乱喘胀而死。
一儿疹出，腹饱便秘，乃内伤所发也，乃承气汤下之愈。
一儿疹正出，而恣食停滞，腹饱便秘，壮热谵语，急以大黄、栝蒌、枳实、浓朴、黄连、甘草等药利之。
而尚喘嗽、脉迟肢冷，以附子理中汤，又归芍六君汤治之而愈。
一儿表散后疹出，隐隐肌肉间成片，又为风热所郁，浑身变青紫，烦躁闷乱，喘胀，欲出不出，急用麻黄
桂枝汤加葛根以升发之，得冷汗微出而愈。
一儿疹半出，壮热烦躁，喘胀闷乱，乃出不透而内攻也。急以麻黄、甘草、桔梗、前胡、葛根、荆芥、牛
蒡、枳壳升发之，疹出二三番，得尽透而愈。
一儿疹隐不振，头面不出，面色青白，喘胀闷乱，右寸脉微，此正气虚也，不能升毒。急用麻黄桂枝汤，
加人参一钱，防风芫荽汤浴，治之而愈。
一儿疹尽出，壮热秘结，喘胀谵语，此毒壅犹不尽透也。急以黄连、栝蒌、枳壳、石膏、桑皮、知母、人
中黄等药治之愈。
一儿汗出疹透，犹喘不止，亦邪壅也。急以炒黑麻黄加石膏、杏仁、甘草治之而愈。
一儿疹时，咳嗽喘急，用大小无比散五分至一钱，即喘定而睡，醒后神安，此热从小便而解也。
一儿仲春出疹，用凉药，食生梨，寒郁而没，喘闷，面青肢冷，声哑昏晕。急以麻黄葛根汤，葛根、柴胡、
甘草、桔梗、紫苏、生姜等发之，再复以被，取汗而愈。
一儿疹发不出，喘嗽，烦躁闷乱。缪仲淳治，西河柳五钱，麦冬三钱五分，牛蒡三钱五分，蝉蜕、荆芥、
薄荷、知母各一钱，竹叶三十片，甚者加石膏五钱，冬米或三黄等，治之而愈。
一兄疹虽出而喘反甚，乃骤用麻黄燥烈之药，火甚而肺火热也。宜清金润肺，以甘草、桔梗、前胡、牛蒡、
杏仁、元参、知母、黄芩、花粉，治之而愈。
贺知忍少子，疹不透，极重。其家不知，尚以肉饭与之。仲淳急以西河柳两许，石膏一两五钱，知母五钱，
元参、贝母各三钱，竹叶七十片，作二剂服，而疹尽现，遍身皆赤。连服四服，疹尽出，而烦躁犹不止，再以
石膏三两，知母、西河柳各二两，麦冬三两，黄芩、黄柏、黄连各五钱，竹叶三十片，浓煎与服，遂定而瘥。
（雄按∶叶天士、吴鞠通皆言西河柳非 疹所宜，而缪氏每与石膏并用，则不嫌其温升太过矣，殆即仲圣以麻
黄与石膏同用之意也。）
一儿寒月出疹不透，喘胀闷乱，躁烦，用去节麻黄，蜜和酒拌炒一钱，葛根、麦冬、贝母、前胡、知母、
荆芥、元参、甘草、西河柳，一服而疹立透，随愈。
一新婚出疹，痰嗽不已，咸谓余毒。用清解而痰愈多，午后咳甚，此阴虚火炽而潮热也。用六味地黄丸，
加知母、麦冬治之愈。
一新婚妇出疹，其症如前，用六味地黄丸料加当归，治之而愈。
一孕妇疹不出，极热，闷乱喘胀，用清热安胎药，而热愈甚，危剧，子母难全。此怀胎内热，故法当下其
胎，则疹热解而母命可保矣。以表散兼堕胎药，治之而愈。（此种治，实原谬妄，疹不过肺胃之热，喘胀亦
肺家本症，何必下其胎
而始可治乎？）
一孕妇出疹，小腹痛而漏血，此热甚动胎。以升麻葛根汤加荆芥、紫苏、黄芩、当归、白术、川芎、砂仁、
橘红、阿胶治之，血止而安。
一孕妇出疹，触动其胎，胎堕而去血过多，疹虽没而烦躁，闷闷昏绝，乃血脱故也。当兼益气，用理中汤
而苏。又用人参一两，当归、阿胶、炮姜、荆芥、艾叶，治之而愈。（既知血脱，却偏要益气，古人此种甚
多，实不可解。）
一孕妇出疹，热极，堕胎而难产。用鱼胶三寸烧存性，麝香一分，共酒服，立产。遇此症最为难治。更有
横生者，用鱼胶一尺，如前法治，虽疹而子不活。
一产妇，疹不易出，热甚而去血不止，乃血气不足，不能逐毒出外也。用麻黄葛根汤加人参、荆芥、白芷、
当归、阿胶，治之而愈。
一妇疹后轻咳，朝凉暮热，面色少神，肌瘦唇赤，咸以气血不足，用八珍汤治之。细讯其夫，知其不慎房
室，用六味地黄丸合生脉散与服，又嘱绝欲百日而瘳。（此亦影响揣摩之谈，大抵疹后肺阴大伤，水绝上源，
故显此候。得六味滋润之力，故遂愈。以非正治肺家之药，故取效迟也。）
柴屿青治候补汪某，年二十余，因感时气出疹，过服石膏等剂，身热泄泻，两耳皆聋，绝不思食。脉之，
两尺微弱，舌上干燥，毫无津液。本属阴亏，况大寒之剂，不但伤阳，亦且伤阴。用麦冬五钱，滋阴以清虚
热，陈皮以和胃气，加西河柳一钱，以清疹毒。次日，热微泻止，舌亦觉润。惟左寸脉微洪，加小生地二钱，
木通一钱，菊叶一钱，三日，热退思食。因是月应选，身软耳聋，虑不能过堂掣签，谓已平复，十九日当投补
剂，定可痊愈。后果如言，竟得赴选。（此案可法，盖灼知病源，故不以八珍十全笼统塞责也。）
万密斋治吴道松，四肢病疹。或治之三日，疹不出，烦躁甚，欲用荆防败毒散。曰∶此皆发热之药，无解
毒之用，况天大热，又无时令之药一二味在内，则阳愈胜，阴愈亏，阴阳不和，此疹之所以不出也。以东垣凉
膈散，加元参、升麻，一服疹出，三日起。（议论极是，但凉膈重剂，非热毒甚，亦难轻用。至用升麻于凉膈
剂中，则有相济之妙，而无过升之弊矣。）
甘氏子发热，疹三日不出，身凉神倦，坐卧不宁。此毒不外出，毒火内伏也，故烦而坐卧不安。用升麻葛
根汤加麻黄、石膏以发之。一服，疹尽出，色白不红，此血虚也。用四物汤加防风，一服色红而愈。
（熊应雄按：麻、痧、疹，各地叫法不同，其实是一回事。为什么要把疹单独分成两篇讨论，这很不恰当，现在把它们归为一类。）
孙文垣治疗仆人的儿子孙守，患麻疹（即痘子），咳嗽无痰，上唇肿胀，身体浮肿发热，大便干燥，声音嘶哑，这是燥火为害。用麦冬、知母、栝蒌、甘草、白芍、桑白皮（此症应当去掉白芍和桑白皮，加入牛蒡子和桔梗）、地骨皮、石斛、枳壳，服用后咳嗽减少了七成，于是去掉栝蒌和枳壳。因为大便已经变稀，加入生地、当归、薏苡仁，调理后痊愈。（此症加生地是否合适，应当斟酌。）
程氏的儿子七岁出麻疹，（西吴地区称为痘子，姑苏地区称为痧子。）一个月多了，仍然发热，咳嗽声音嘶哑，肌肉消瘦，骨头突出，头发全部脱落，众医生束手无策。孙文垣看了说：“如果说这孩子不可治，这是麻疹后的虚热变成了疳积，给他吃大芦荟丸，可以完全治愈。”病家起初不听从我的建议，认为我不是儿科专家，不知道这只是大方脉医生的余事罢了。（可以改韩愈的诗句为“余事作儿科”，然而精通内科却不懂儿科的医生，一定不是好手。）为他制药服用，药没吃完病就好了。
吕东庄治疗钱家的儿子，五岁，患麻疹并发泄泻。儿科医生说麻疹最适宜于腹泻，不再顾忌，把清火作为急务，大量使用寒凉药物，病情非常严重。吕东庄看诊，发现孩子面色颧骨处刺红（虚阳上浮），不时咬牙喘急（上盛），口渴厉害，喝水不停（阴虚液燥），脉象洪缓如同健康的壮年人。说：“脾脏危急了，迅速投用人参、当归、黄芪、陈皮、甘草、茯苓、木香来救治，一剂药后感觉安稳。”有人阻止说：“错了，小儿有专门的医术，怎么能让腐儒来治？我听说麻疹的治疗，以发散清凉解毒为主，现在半身出疹，潮热未退，却用温补，必定救不了。”（没有真知灼见而随意发表议论，最能误人，懂的人要谨慎。）这家人害怕，就不敢再服药。过了三天，孩子的父亲又来见他说：“各种症状又恢复了，怎么办？”吕东庄说：“哪有这种事呢，你在开玩笑吧。”父亲说：“这几天确实没服你的药，是陈述原因。”吕东庄说：“你试着赶紧回去，孩子的天柱骨已经倒了。”告别离开，一会儿骑马赶去，说：“果然像您说的，怎么办？”吕东庄说：“赶快服用前面的方子怎么样？”吕东庄说：“前面的方子是救虚证的，现在寒气加重了，不用桂枝、附子不能挽回。”父亲说：“颧红口渴，喘急饮水，都是热症，为什么您独独说是虚寒呢？”吕东庄说：“阴液在内枯竭，阳气在外散失，而寒凉药物又逼迫它。阳气无处回归，内里是真寒而外表是假热，这是薛立斋阐发《内经》的精微旨意，不深入探究精义的人，是不能相信的。”于是回家违背众人的意见服用了药，一剂后天柱骨挺直，二剂后喘渴停止，三剂后能起来行走，在户外嬉戏。（这是因为苦寒药物过量，所以处方如此，并非所有小儿都可以用桂枝、附子。）
冯楚瞻治疗沈家的儿子，发热数天后出现麻疹，才一天，脸上的疹子全部隐没，神气极度困倦，蛔虫从口中吐出，不止一次，几天不吃饭，下泻上喘，嘴唇口角焦裂，五心（手心、脚心、胸口）壮热，手足指尖都冷，脉象细数无比，两尺脉更弱。大家都认为是疹毒归入脏腑，胃热导致蛔虫连出。却不知道神气快要脱失，五脏都困乏，脾虚不能纳谷，虫子没有食物，再加上虚火熏蒸，脏腑燥热，虫子不安而出。况且各种斑疹，多由内伤失调，脾胃不足以滋养，所以阳气逆行，阴气覆盖于外。血盛气壮，则颜色红而透发；血虚气弱，则颜色白而隐伏，有什么毒性的轻重之分呢？脸上退缩的，是阳虚不能升发。喘促的，是气难接续。嘴唇焦的，是脾津耗竭。五心壮热的，是阴亏火烁。泄泻不食的，是真火衰而脾不运化。寸关脉细数，尺脉弱的，是气虚血虚，虚火上浮而不潜藏。急则治标，缓则治本，现在的急务是本气欲脱。如果说是麻疹余毒，用解利清托的方法，恐怕神气先耗尽。于是用熟地黄六钱，牡丹皮一钱，麦冬三钱，牛膝二钱，制附子六分，一剂药后假热全消，真虚毕露，神气更加疲倦。这说明阴液已稍恢复，应当补气以助其发生。前方另煎人参二钱冲服，神气逐渐恢复，喘促全安。喝粥微呕，是胃气久虚的缘故，再用前方，加炒黄白术二钱，去掉丹参，用人参汤冲服，四剂后全愈。
我按语：这与吕东庄的病例大同小异，但确实是百中无一二的情况，不可固执地作为常规法则。大抵麻疹的发生，根源在肺胃，治疗只宜松透，一切寒燥、寒热之剂，不可使用。我曾遇到表散过度，绵延不断的，只用生地、枸杞、地骨皮、麦冬、栝楼仁、沙参等味，三四剂后，必咳嗽止、热退而安。
高士宗的长子六岁，次子三岁，在元旦次日发热出疹，立即用清解透发的药剂，次日略增十几点，终究不畅。我心里想长子七月出生，先天怯弱，问他们胸腹宽否？回答说：“很饿。”口味如何？回答说：“很淡。”因此知道是虚证，于是投用黄芪、白术、人参、甘草、桂枝、红花一二剂。次日透发遍身，热稍退，但性情仍烦躁，夜间发热，频繁咳嗽，到一个月才安。这是由于见点之初，过服表药，使经脉虚弱所致。（由此变成疳劳病的很多。）次子年幼，无法询问，以上午痰喘，服用麻黄、杏仁、桂枝、石膏一剂而愈，认为他禀赋体质略强，知道他的疹子必定不会寒凝毒甚。因为他之前用了苏叶、麻黄、前胡、杏仁、黄芩、石膏的药，（大错。）红点不增加，又用紫苏、葱、姜、芫荽等温热之物熨烫，疹子总不出。（这就是所说的不知经络时令，混攻混表。）同道都说：除了透发法，别无他法。（像这样的药，岂止是透发而已。）到了五六天，吐蛔虫。有人说：这是热极生虫，可服牛黄散，牛黄散就是大黄末。一服后痰喘止，神气稍平，却不能说话了。计无所施，针刺百会穴开通窍门，服牛黄少许，以及各方单方。观察其形症，（急乱投药饵。）实在不能生还。友人张卫生说：这是大虚大寒症，现在已经不能说话，又不能进食，恐怕无济于事。勉强投用参、附，终究无法挽回。经书说：一逆尚引日，再逆促命期。做医生的能不以此为鉴吗？
汪家的儿子出疹已三天，服用前胡、杏仁、麻黄、石膏药一二剂，疹出二十余点，不能再增加，心胸烦闷，请求高斗魁诊治。高斗魁说：“如果再攻发就败坏了。”急忙给予川芎、当归、黄芪、白术、桂枝、茯苓、红花一剂，热退身安。凡是治疗疹子，调和气血，和解经络，寒凉攻发，一概不用，则屡试屡效。（这也非定论，大概是鉴于前车之鉴而矫枉过正。）
吴题的先父两岁时出疹，儿科医生攻发不透。高斗魁看诊，知道他是虚证。说：“如果只发疹，疹断然出不来，必然保不住性命。只有温补的药剂，益其脏腑，安其肠胃，助其气血才可以。”（话语没有条理，可知胸中无主见。）于是给予黄芪、白术、干姜、桂枝、当归、白芍、茯苓、银花、红花诸味，一剂后安稳。次日，即用原方加人参一钱，又连服独参汤而愈。
夏家的儿子出疹，色点俱紫，神气不宁。高斗魁说：“此症大凶，治疗须得法。”连看两次，都用温散药。第二天早上，其家人跑来说：“口吐涎虫，另有药吗？”高斗魁说：“昨天两剂都服了吗？”家人说：“还剩一剂。”于是给附子八分，令加入煎服，从此就没有音讯。（心里暗自疑惑。）过了三年，到他家，（还怀着鬼胎。）看见他的儿子长大了，于是问当年出疹吐蛔，怎么好的？家人说：“服药后，因无力拖延，仗赖上天庇护，得以渐愈。”（话语也虚浮不实。）以上皆是医药真传，高斗魁的医案。
徐仲光治疗一个儿子，身热喘胀，以内伤外感治疗无效。看他的背部，隐隐赤色，原来是疹子。用疹黄汤表发，虽然出了但头面不足，随即隐没而死。（熊应雄按：此证未始不是由于初治所误。）
一个儿子出疹，身热似痘候，遍身报点。沈虚明、黄锦云都认为是虚证。当时黄绮芸十二岁，不懂医，前往看视，唯独认为是疹子。其父责骂他，黄绮芸说：“儿子听父亲说，疹是肺胃风热，现在两鼻流涕，难道不是疹吗？”后来果然如此。长大后，成为名医，所以把鼻涕当作疹子的征兆，就能早得其要领。
一个儿子出疹紫色，便嗽哕泻不食，用解毒饮，挑痧法治好后痊愈。（熊应雄按：见识超群，本乎天赋。）
一个儿子出疹紫色，便秘溺涩，烦躁闷乱，急以大柴胡汤利下而愈。
一个儿子疹不易透，知道被风寒遏制，用桂枝汤加葛根、麻黄、前胡升发，又浓盖被子包裹，再以大剂防风汤，熏于床下而愈。这也可用芫荽防风汤，浴头面手足，或用苎麻蘸芫荽酒擦之。（疹证以照顾咽喉为要务，麻黄、葛根、升麻等药，最宜慎用。）
一个儿子身热，头痛骨痛，咳嗽气急，呕哕不食，这是伤寒兼出疹。用百祥散、十神解毒汤治好。如果此症治疗稍缓，疹虽透，必变紫黑闷乱喘胀而死。
一个儿子疹正出，而恣食停滞，腹饱便秘，壮热谵语，急以大黄、栝蒌、枳实、厚朴、黄连、甘草等药利下。而尚喘嗽、脉迟肢冷，用附子理中汤，又归芍六君汤治好。
一个儿子表散后疹出，隐隐肌肉间成片，又为风热所郁，浑身变青紫，烦躁闷乱，喘胀，欲出不出，急用麻黄桂枝汤加葛根以升发，得冷汗微出而愈。
一个儿子疹半出，壮热烦躁，喘胀闷乱，是不透而内攻。急以麻黄、甘草、桔梗、前胡、葛根、荆芥、牛蒡、枳壳升发，疹出二三番，得尽透而愈。
一个儿子疹隐不振，头面不出，面色青白，喘胀闷乱，右寸脉微，这是正气虚，不能升毒。急用麻黄桂枝汤，加人参一钱，防风芫荽汤浴，治好。
一个儿子疹尽出，壮热秘结，喘胀谵语，这是毒壅犹不尽透。急以黄连、栝蒌、枳壳、石膏、桑皮、知母、人中黄等药治好。
一个儿子汗出疹透，犹喘不止，也是邪壅。急以炒黑麻黄加石膏、杏仁、甘草治好。
一个儿子出疹时，咳嗽喘急，用大小无比散五分至一钱，即喘定而睡，醒后神安，这是热从小便而解。
一个儿子仲春出疹，用凉药，食生梨，寒郁而没，喘闷，面青肢冷，声哑昏晕。急以麻黄葛根汤，葛根、柴胡、甘草、桔梗、紫苏、生姜等发之，再复以被，取汗而愈。
一个儿子疹发不出，喘嗽，烦躁闷乱。缪仲淳治疗，用西河柳五钱，麦冬三钱五分，牛蒡三钱五分，蝉蜕、荆芥、薄荷、知母各一钱，竹叶三十片，甚者加石膏五钱，冬米或三黄等，治好。
一个哥哥疹虽出而喘反甚，是骤用麻黄燥烈之药，火甚而肺火热。宜清金润肺，以甘草、桔梗、前胡、牛蒡、杏仁、元参、知母、黄芩、花粉，治好。
贺知忍的小儿子，疹不透，极重。其家不知，还用肉饭给他吃。缪仲淳急以西河柳两许，石膏一两五钱，知母五钱，元参、贝母各三钱，竹叶七十片，作二剂服，而疹尽现，遍身皆赤。连服四服，疹尽出，而烦躁犹不止，再以石膏三两，知母、西河柳各二两，麦冬三两，黄芩、黄柏、黄连各五钱，竹叶三十片，浓煎与服，遂定而瘥。（熊应雄按：叶天士、吴鞠通都说西河柳不适合疹，而缪氏每与石膏并用，则不嫌其温升太过，大概即是仲景以麻黄与石膏同用的意思。）
一个儿子寒月出疹不透，喘胀闷乱，躁烦，用去节麻黄，蜜和酒拌炒一钱，葛根、麦冬、贝母、前胡、知母、荆芥、元参、甘草、西河柳，一服而疹立透，随愈。
一个新婚男子出疹，痰嗽不已，大家都说是余毒。用清解而痰愈多，午后咳甚，这是阴虚火炽而潮热。用六味地黄丸，加知母、麦冬治好。
一个孕妇疹不出，极热，闷乱喘胀，用清热安胎药，而热愈甚，危剧，子母难全。这是怀胎内热，所以法当下其胎，则疹热解而母命可保。用表散兼堕胎药，治好。（这种治法，实在原谬妄，疹不过是肺胃之热，喘胀也是肺家本症，何必下其胎才可治呢？）
一个孕妇出疹，小腹痛而漏血，这是热甚动胎。用升麻葛根汤加荆芥、紫苏、黄芩、当归、白术、川芎、砂仁、橘红、阿胶治好，血止而安。
一个孕妇出疹，触动其胎，胎堕而去血过多，疹虽没而烦躁，闷闷昏绝，这是血脱。当兼益气，用理中汤苏醒。又用人参一两，当归、阿胶、炮姜、荆芥、艾叶，治好。（既然知道血脱，却偏要益气，古人此种很多，实在不可解。）
一个孕妇出疹，热极，堕胎而难产。用鱼胶三寸烧存性，麝香一分，共酒服，立产。遇此症最为难治。更有横生的，用鱼胶一尺，如前法治，虽疹而子不活。
一个产妇，疹不易出，热甚而去血不止，这是血气不足，不能逐毒出外。用麻黄葛根汤加人参、荆芥、白芷、当归、阿胶，治好。
一个妇人疹后轻咳，朝凉暮热，面色少神，肌瘦唇赤，大家都认为是气血不足，用八珍汤治疗。仔细询问其夫，知道其不慎房室，用六味地黄丸合生脉散与服，又嘱绝欲百日而愈。（这也是推测之谈，大抵疹后肺阴大伤，水绝上源，故显此候。得六味滋润之力，故遂愈。因非正治肺家之药，故取效迟也。）
柴屿青治疗候补官员汪某，年二十余，因感时气出疹，过服石膏等剂，身热泄泻，两耳皆聋，绝不思食。诊脉，两尺微弱，舌上干燥，毫无津液。本属阴亏，况大寒之剂，不但伤阳，亦且伤阴。用麦冬五钱，滋阴以清虚热，陈皮以和胃气，加西河柳一钱，以清疹毒。次日，热微泻止，舌亦觉润。惟左寸脉微洪，加小生地二钱，木通一钱，菊叶一钱，三日，热退思食。因是月应选，身软耳聋，虑不能过堂掣签，谓已平复，十九日当投补剂，定可痊愈。后果如言，竟得赴选。（此案可法，盖灼知病源，故不以八珍十全笼统塞责也。）
万密斋治疗吴道松，四肢病疹。有人治疗三日，疹不出，烦躁甚，想用荆防败毒散。万密斋说：“这都是发热的药，无解毒之用，况天大热，又无时令之药一二味在内，则阳愈胜，阴愈亏，阴阳不和，此疹之所以不出也。”用东垣凉膈散，加元参、升麻，一服疹出，三日起。（议论极是，但凉膈重剂，非热毒甚，亦难轻用。至用升麻于凉膈剂中，则有相济之妙，而无过升之弊矣。）
甘家的儿子发热，疹三日不出，身凉神倦，坐卧不宁。这是毒不外出，毒火内伏，故烦而坐卧不安。用升麻葛根汤加麻黄、石膏以发之。一服，疹尽出，色白不红，这是血虚。用四物汤加防风，一服色红而愈。
(Bear Yingxiong notes: Ma, Sha, and Zhen are different local terms for the same condition. Why separate Zhen into two chapters is inappropriate; now they are combined into one category.)
Sun Wenyuan treated Sun Shou, the son of his servant, who suffered from measles (also known as Douzi). The symptoms included cough without phlegm, swelling of the upper lip, body edema with fever, dry stool, hoarseness, indicating damage by dryness-fire. He prescribed Maidong (Ophiopogonis Radix), Zhimu (Anemarrhenae Rhizoma), Gualou (Trichosanthis Fructus), Gancao (Glycyrrhizae Radix et Rhizoma), Baishao (Paeoniae Radix Alba), Sangpiao (Morus Cortex) [For this condition, Baishao and Sangpiao should be removed and Niubangzi (Arctii Fructus) and Jiegeng (Platycodonis Radix) added], Digupi (Lycii Cortex), Shihu (Dendrobii Caulis), and Zhike (Aurantii Fructus). After taking the medicine, the cough decreased by seventy percent. Then Gualou and Zhike were removed because the stool had become loose. Shengdi (Rehmanniae Radix), Danggui (Angelicae Sinensis Radix), and Yiren (Coicis Semen) were added for conditioning, leading to recovery. (Whether adding Shengdi is appropriate for this case should be considered carefully.)
The son of Mr. Cheng was seven years old when he contracted measles (called Douzi in Xiwu and Shazi in Gusu). More than a month later, he still had fever, cough with hoarseness, emaciation with visible bones, and total hair loss. Doctors were at a loss. Sun Wenyuan examined him and said, "If you say this child cannot be cured, this is deficiency-heat turning into Gan syndrome after measles. Give him Da Lushui Wan, and he can be completely cured." The family initially ignored my advice, thinking I was not a pediatric specialist, unaware that this is merely a supplementary skill for general practitioners. (One may adapt Han Yu's poem to say 'pediatrics is a side task.' However, those proficient in internal medicine but ignorant of pediatrics are certainly not good doctors.) I prepared the medicine for him, and he recovered before finishing the dose.
Lu Dongzhuang treated the son of the Qian family, aged five, who suffered from measles complicated by diarrhea. Pediatricians claimed that diarrhea was suitable for measles and did not hesitate, prioritizing clearing fire and administering cold-cooling medicines excessively, which aggravated the condition. Lu observed redness on the child's malar eminences (floating deficient yang), teeth grinding and rapid breathing (excess above), severe thirst with continuous drinking (deficiency of yin fluids), and a pulse that was large and slow like that of a healthy adult. He said, "The spleen is in acute danger. Quickly administer Renshen (Ginseng Radix et Rhizoma), Danggui, Huangqi (Astragali Radix), Chenpi (Citri Reticulatae Pericarpium), Gancao, Fuling (Poria), and Muxiang (Aucklandiae Radix) to save him. After one dose, he felt better." Someone objected, saying, "Wrong. Pediatrics has its own specialists; how can a scholar treat this? I have heard that measles treatment focuses on dispersing, cooling, and detoxifying. Now half the body has rashes, tidal fever persists, yet you use warming tonification. It will surely fail." (Those without true knowledge interfering can mislead people; experts should be cautious.) The family feared and stopped the medication. Three days later, the father returned, saying all symptoms recurred. Lu asked if it was a joke. The father explained he hadn't taken the medicine. Lu said, "Go home quickly; the child's Tianzhu bone (neck/spine) has collapsed." Upon arriving, the father confirmed this. Lu advised taking the previous formula again, stating, "The previous formula treated deficiency; now cold has intensified. Only Guizhi (Cinnamomi Ramulus) and Fuzi (Aconiti Lateralis Radix Praeparata) can reverse this." The father questioned why heat symptoms were called deficiency-cold. Lu explained, "Yin is exhausted internally, Yang scatters externally, and cold medicines forced it further. Yang has no place to return, resulting in true cold inside and false heat outside. This elucidates the subtle meaning of the Neijing by Xue Lizhai; only those who deeply understand can believe it." The family took the medicine against others' advice. After one dose, the neck straightened; after two doses, wheezing and thirst stopped; after three doses, he walked and played outdoors. (This specific prescription resulted from excessive bitter-cold usage and is not applicable to all children.)
Feng Chuzhan treated the son of the Shen family, who had fever for several days followed by measles. Within a day, the facial rash disappeared, spirit was extremely fatigued, roundworms vomited repeatedly, no food intake for days, diarrhea with upper wheezing, cracked and scorched lips/chin, intense heat in the five centers (palms, soles, chest), cold fingertips, and a fine, rapid pulse, weaker at both Chi positions. Everyone believed the toxin entered the organs due to stomach heat causing worm vomiting. Feng knew the spirit was about to collapse, all five zang organs were distressed, spleen deficiency prevented grain assimilation, worms lacked food, and deficiency-fire steamed causing organ dryness, forcing worms out. Regarding macules/rashes, most stem from internal injury and imbalance, where spleen/stomach fail to nourish, causing Yang to reverse and Yin to cover the exterior. Abundant blood and strong Qi result in red, erupting rashes; deficient blood and weak Qi result in pale, hidden rashes. What difference in toxicity exists? Facial retraction indicates Yang deficiency failing to rise. Wheezing indicates difficult Qi continuation. Scorched lips indicate exhaustion of Spleen fluids. Intense heat in five centers indicates Yin deficiency and fire blazing. Diarrhea and anorexia indicate decline of True Fire and Spleen failure to transport. Fine/rapid Cun/Guan pulses with weak Chi indicate Qi/Blood deficiency and floating deficiency-fire. Acute cases treat the branch; chronic cases treat the root. The current urgency is impending collapse of Root Qi. If treated as residual measles toxin with clearing/descending methods, spirit might exhaust first. He used Shudi (Rehmanniae Radix Preparata) 6 qian, Mudanpi (Moutan Cortex) 1 qian, Maidong 3 qian, Niuxi (Achyranthis Bidentatae Radix) 2 qian, and Zhi Fuzi (Prepared Aconite) 0.6 fen. After one dose, false heat vanished, revealing true deficiency, and spirit became more tired. This indicated slight Yin recovery; thus, tonify Qi to aid generation. Add Ren Shen 2 qian decocted separately and mixed in. Spirit gradually recovered, wheezing ceased. Mild vomiting after drinking porridge indicated long-term Stomach Qi deficiency. Use the previous formula plus Chao Huang Baizhu (Stir-fried Atractylodis Macrocephalae Rhizoma) 2 qian, remove Danshen, mix with Ren Shen decoction. Four doses led to full recovery.
My note: This case is similar to Lu's but represents one in a hundred; do not rigidly apply it as a standard. Generally, measles originates in Lung and Stomach; treatment should only facilitate gentle eruption. All cold-dry or cold-hot agents should be avoided. I once encountered prolonged cases due to excessive diaphoresis; using Shengdi, Gouqi (Lycii Fructus), Digupi, Maidong, Gualouren (Trichosanthis Semen), and Shashen (Adenophorae Radix) for three to four doses invariably stopped cough and fever.
Gao Shizong's eldest son (six years old) and second son (three years old) developed fever and rash on the day after New Year's Day. Clearing and resolving formulas were used, but eruption was incomplete. Thinking the eldest was congenitally weak (born in July), Gao asked about chest/abdomen distension (answered: hungry) and taste (answered: bland). Diagnosing deficiency, he prescribed Huangqi, Baizhu, Renshen, Gancao, Guizhi, and Honghua for one to two doses. Eruption spread over the body, fever subsided slightly, but irritability, night fever, and frequent cough persisted until the first month ended. This was due to excessive exterior-releasing agents damaging meridians during early eruption. (Many such cases develop into Gan-Lao syndrome.) The younger son, too young to question, had morning phlegm-wheezing and recovered after one dose of Mahuang, Xingren, Guizhi, and Shigao, as his constitution was stronger, predicting no severe cold-toxin stagnation. However, prior use of Zisu, Mahuang, Qianhu, Xingren, Huangqin, and Shigao failed to increase red spots. Subsequent application of Zisu, Congbai, Jiang, and Yuanxu (warm moxibustion-like therapy) also failed. Colleagues insisted only eruption methods worked. By day five, roundworms appeared. Some suggested Niuhuang San (Rhei Radix et Rhizoma powder), which stopped wheezing but caused aphasia. Acupuncture at Baihui (GV20) and Niuhuang failed. Friend Zhang Weisheng diagnosed extreme deficiency-cold; Renshen and Fuzi could not save him. As the Classic states, one error delays death, two hasten it. Physicians must learn from this.
Wang's son had been erupting for three days. Prior use of Qianhu, Xingren, Mahuang, and Shigao yielded only twenty spots with chest distress. Gao Doukui warned against further attacking/dispersing. He prescribed Xiong (Chuanxiong Rhizoma), Danggui, Huangqi, Baizhu, Guizhi, Fuling, and Honghua. One dose resolved fever and restored comfort. Treating measles requires harmonizing Qi/Blood and collaterals, avoiding cold/dispersing attacks. (This is not an absolute rule but corrects past excesses.)
Wu Ti's ancestor, aged two, had measles that failed to erupt due to pediatricians' aggressive dispersal. Gao diagnosed deficiency. He stated that mere dispersal would fail and endanger life; only warming tonification benefiting organs, calming intestines, and assisting Qi/Blood would work. He prescribed Huangqi, Baizhu, Jiang, Guizhi, Danggui, Baishao, Fuling, Yinhua, and Honghua. One dose stabilized. Next day, add Renshen 1 qian to original formula, followed by Du Shen Tang (Single Ginseng Decoction) until recovery.
Xia's son had purple-rash points and restless spirit. Gao deemed it critical and used warming dispersants twice. The next morning, the family reported vomiting saliva/worms. Gao asked if the previous two doses were taken; one remained. He added Fuzi 0.8 fen to the remaining dose. No news followed for three years. Visiting later, Gao saw the boy grown and asked how he recovered. The family attributed it to heaven's protection after the medicine. (These accounts contain exaggerations.) These are authentic medical records from Gao.
Xu Zhongguang treated a boy with fever, wheezing, and distension. Internal/external injury treatments failed. Back showed faint redness—measles. Using Zhen Huang Tang to release exterior, eruption occurred but was insufficient on head/face, followed by disappearance and death. (Bear notes: Likely due to initial mismanagement.)
Another boy had fever resembling smallpox with widespread spots. Shen Xuming and Huang Jinyun thought it was deficiency. Huang Qiyun, age twelve and untrained, identified it as measles because nasal discharge indicated Lung/Stomach wind-heat. It proved correct. Huang later became a renowned physician, recognizing nasal discharge as a key sign of measles.
A boy with purple rash, cough, hiccups, diarrhea, and anorexia recovered using Jiedu Yin and Tiao Sha (scraping) therapy. (Bear notes: Superior insight stems from natural talent.)
A boy with purple rash, constipation, dysuria, irritability, and confusion recovered urgently using Da Chaihu Tang to purge.
A boy with difficult eruption due to wind-cold obstruction recovered using Guizhi Tang plus Gegen (Puerariae Lobatae Radix), Mahuang, and Qianhu (Peucedani Radix) for ascending/dispersing, wrapped in thick blankets, and fumigated with Fangfeng Tang under the bed. Alternatively, Yuanxu/Fangfeng bath or Yuanxu wine rub could be used. (Care for throat is crucial; Mahuang, Gegen, Shengma should be used cautiously.)
A boy with fever, headache, bone pain, cough, wheezing, vomiting, and anorexia had cold damage complicated by measles. Recovered with Baixiang San and Shishen Jiedu Tang. Delayed treatment would lead to purple-black rash, confusion, wheezing, distension, and death.
A boy with abdominal fullness and constipation during eruption had internal injury origin. Recovered with Chengqi Tang purgation.
A boy with sudden food stagnation during eruption, abdominal fullness, constipation, high fever, and delirium recovered urgently with Dahuang (Rhei Radix et Rhizoma), Gualou, Zhishi (Aurantii Fructus Immaturus), Houpo (Magnoliae Officinalis Cortex), Huanglian (Coptidis Rhizoma), and Gancao. Subsequent wheezing, slow pulse, and cold limbs were treated with Fuzi Lizhong Tang and Guishao Liujun Tang.
A boy with faint rash after exterior release, covered in patches,郁 by wind-heat, turning blue-purple with irritability and wheezing, recovered urgently with Mahuang Guizhi Tang plus Gegen for ascending, inducing slight cold sweat.
A boy with half-erupted rash, high fever, irritability, wheezing, and confusion (failure to erupt leading to internal attack) recovered urgently with Mahuang, Gancao, Jiegeng, Qianhu, Gegen, Jingjie (Schizonepetae Herba), Niubangzi, and Zhike for ascending. Rash erupted fully after two or three cycles.
A boy with suppressed rash, absent on face/head, blue-white complexion, wheezing, confusion, and faint Right Cun pulse had righteous Qi deficiency failing to raise toxin. Urgently treated with Mahuang Guizhi Tang plus Renshen 1 qian, and Fengfang Yuanxu Tang bath.
A boy with fully erupted rash, high fever, constipation, wheezing, and delirium had lingering toxin obstruction. Treated urgently with Huanglian, Gualou, Zhike, Shigao, Sangpiao, Zhimu, and Renzhonghuang.
A boy with sweating, erupted rash, but persistent wheezing had pathogen obstruction. Treated with Chao Hei Mahuang (charred Ephedra) plus Shigao, Xingren, and Gancao.
A boy with measles-related cough and wheezing recovered after 0.5-1 qian of Daxiao Wubi San, settling wheezing and allowing sleep, indicating heat resolving via urination.
A boy in mid-spring with measles took cooling medicine and raw pear, causing cold-stagnation suppression, wheezing, cyanosis, cold limbs, hoarseness, and syncope. Urgently treated with Mahuang Gegen Tang plus Gegen, Chaihu (Bupleuri Radix), Gancao, Jiegeng, Zisu, and Shengjiang (Zingiberis Rhizoma Freshus), wrapped in blankets to induce sweating.
A boy with non-erupting rash, wheezing, and irritability was treated by Miao Zhongchun using Xihe Liu (Tamarisci Ramulus) 5 qian, Maidong 3.5 qian, Niubangzi 3.5 qian, Chanthui (Bombyx Batryticatus), Jingjie, Bohe (Menthae Haplocalycis Herba), Zhimu each 1 qian, Zhu Ye (Phyllostachydis Folium) 30 slices. Severe cases added Shigao 5 qian, Dongmi (Winter Rice) or Sanhuang. Recovered.
An elder brother with rash but worsening wheezing due to abrupt use of drying/hot Mahuang had lung-fire heat. Treated with Qingjin Runfei method using Gancao, Jiegeng, Qianhu, Niubangzi, Xingren, Yuanshen (Scrophulariae Radix), Zhimu, Huangqin (Scutellariae Radix), and Huafen (Paeoflorae Radix). Recovered.
He Zhiren's youngest son had severe, non-erupting measles. Family fed meat rice. Miao urgently prescribed Xihe Liu 2 liang, Shigao 1.5 liang, Zhimu 5 qian, Yuanshen and Beimu (Fritillariae Thunbergii Bulbus) each 3 qian, Zhu Ye 70 slices, divided into two doses. Rash appeared fully, body red. Continued four doses for full eruption. Persistent irritability required Shigao 3 liang, Zhimu and Xihe Liu each 2 liang, Maidong 3 liang, Huangqin, Huangbai (Phellodendri Chinensis Cortex), Huanglian each 5 qian, Zhu Ye 30 slices, decocted strongly. Settled and recovered. (Bear notes: Ye Tianshi and Wu Jutong advised against Xihe Liu for measles, but Miao combined it with Shigao to avoid excessive warming ascent, akin to Zhang Zhongjing combining Mahuang and Shigao.)
A boy in cold month with non-erupting rash, wheezing, confusion, and irritability recovered after one dose of Qujie Mahuang (Ephedra without joints) honey-wine fried 1 qian, Gegen, Maidong, Beimu, Qianhu, Zhimu, Jingjie, Yuanshen, Gancao, and Xihe Liu.
A newlywed man with persistent cough/phlegm post-measles (misdiagnosed as residual toxin) worsened with clearing/resolving meds. Afternoon cough indicated Yin deficiency with blazing fire/tidal fever. Treated with Liuwei Dihuang Wan plus Zhimu and Maidong. Recovered.
A newlywed woman with similar symptoms recovered with Liuwei Dihuang Wan material plus Danggui.
A pregnant woman with non-erupting rash, extreme heat, confusion, and wheezing worsened with fetal-calming cooling meds. Pregnancy heat required aborting fetus to resolve measles heat and save mother. Exterior-releasing and abortive meds were used. (Bear notes: This treatment is flawed. Measles is Lung/Stomach heat; wheezing is Lung symptom. Aborting fetus is unnecessary.)
A pregnant woman with lower abdominal pain and bleeding during measles had heat disturbing fetus. Treated with Shengma Gegen Tang plus Jingjie, Zisu, Huangqin, Danggui, Baizhu, Chuanxiong, Sharen (Amomi Fructus), Juhong (Citri Reticulatae Pericarpium Rubrum), and Ejiao (Colla Corii Asini). Bleeding stopped, condition stabilized.
A pregnant woman whose fetus aborted due to measles heat lost excessive blood. Rash disappeared, but irritability and coma ensued due to blood loss. Tonifying Qi was needed. Lizhong Tang revived her. Followed by Renshen 1 liang, Danggui, Ejiao, Paojiang (Zingiberis Rhizoma Preparatum), Jingjie, and Aiye (Artemisiae Argyi Folium). Recovered. (Bear notes: Tonifying Qi for blood loss seems contradictory, though common in ancient texts.)
A pregnant woman with extreme heat aborted and had dystocia. Yujiao (Fish Maw) 3 cun calcined with Shexiang (Moschus) 1 fen taken with wine induced immediate delivery. Difficult case. Breech presentation treated with 1 chi Yujiao similarly; fetus died despite maternal survival.
A postpartum woman with difficult eruption, high fever, and continuous bleeding had Qi/Blood deficiency failing to expel toxin. Treated with Mahuang Gegen Tang plus Renshen, Jingjie, Baizhi (Angelicae Dahuricae Radix), Danggui, and Ejiao. Recovered.
A woman with mild cough, morning coolness/evening fever, dull complexion, emaciation, and red lips post-measles was treated with Bazhen Tang for Qi/Blood deficiency. Inquiry revealed sexual indiscretion. Treated with Liuwei Dihuang Wan combined with Shengmai San, advised celibacy for 100 days. Recovered. (Bear notes: Speculative. Post-measles Lung Yin damage causes these signs. Liuwei provided moistening effect, hence delayed recovery as it doesn't directly treat Lung.)
Chai Yuqing treated Wang, a candidate officer, aged twenty-something, who developed measles from seasonal qi, took excessive Shigao, resulting in fever, diarrhea, deafness, and anorexia. Pulse: weak Chi. Tongue: dry, no fluids. Diagnosis: Yin deficiency exacerbated by cold medicines damaging Yang and Yin. Prescribed Maidong 5 qian to nourish Yin/clear deficiency heat, Chenpi to harmonize Stomach, and Xihe Liu 1 qian to clear measles toxin. Next day, fever/subside, stool stopped, tongue moistened. Left Cun pulse slightly large; added Xiaoshengdi 2 qian, Mutong (Akebiae Caulis), and Juye (Chrysanthemi Indici Folium). Three days later, fever subsided, appetite returned. Expected selection that month; worried about weakness/deafness affecting examination. Predicted recovery by 19th with tonics. Outcome matched prediction. (Bear notes: Exemplary case due to accurate diagnosis, avoiding generic Bazhen/Shiquan.)
Wan Mixai treated Wu Daosong with limb measles. After three days of ineffective treatment with fever-inducing herbs (Jingfang Baidu San), irritability increased. Wan noted these herbs lack detoxification, especially in hot weather without seasonal herbs, worsening Yang excess and Yin deficiency, preventing eruption. Used Dongyuan Liangge San plus Yuanshen and Shengma. One dose erupted rash; recovered in three days. (Bear notes: Sound reasoning, but Liangge San is heavy; use caution unless heat-toxin is severe. Combining Shengma with Liangge San balances ascending and clearing effectively.)
Gan's son had fever, rash not erupting for three days, cool body, fatigue, restlessness. Toxin trapped internally, fire lurking, causing irritability. Used Shengma Gegen Tang plus Mahuang and Shigao to erupt. One dose, rash fully erupted, white/pale (Blood deficiency). Used Siwu Tang plus Fangfeng. One dose, color turned red, recovered.