麻出有阴阳部位多寡之分，自头而背及四肢向外处为阳部，宜多出起顶，向内处为
阴部，宜稀少。若见阳部稀疏而不起顶，纵阴部多出起发是阴阳相反，必有后患，当预
防之。又云∶自耳后项上腰腿先见，其顶尖而不长，其形小而匀净者吉也，勿药有喜。大
凡疹子只要出得尽，则毒邪散，正气自得和平。如拂拂发热，烦闷不安，如蛇在灰，如
蚓在尘，或呕吐注泻，皆毒邪壅遏，尚未尽出，急用托里散表之剂，或用麻黄汤，去杏
仁加蝉蜕、升麻，外用胡荽酒之类。
一疹出色白，由于脾胃气馁，血不充肌，不可专主于清热，宜助益脾气，或养营汤，或
人参败毒散主之。
一风寒外闭，欲出不出，热重无汗，内外有不可解之势，速用羌活内托散。若见隐
影紫色，热甚气喘，宜清热黄芩汤。
一麻出紫黑，晦暗不透，宜黄连解毒汤。若紫红干燥色晦，是火毒炽盛，宜滋阴凉血
汤，或大青汤，或元参汤选用。
一麻出不透，热极目红，发痰作喘，此毒未尽出，气因热逼，宜用柴连解毒汤。
一麻出热不退，渴不止，遍身如锦纹者，宜化斑汤，毒甚烦躁不眠，紫滞不红活者，宜
疏风解毒饮。夹痰烦渴者，宜人参白虎汤。
一麻出夹斑，无他杂症，宜小柴胡汤。若蕴毒发斑者，宜黄芩橘皮汤。疹出色黑，热
毒亢极，乃不治之症，姑用加味化斑汤，或凉血解毒汤。
一麻出紫赤，内热极也，但得形色光润，颗粒尖耸者可治，速宜清凉解毒，佐以清痰
定喘，便得安痊。若枯燥无起色者不治。又有见暖则红活，不暖则枯燥，是为风寒所折，
虽宜凉解，不可太过。如见疹色鲜红，光泽有艳，头粒离肉者轻，头顶平塌不起者重。
一麻出如云一片红肿，又有细碎红点，见于红肿大片之上，此毒火炽盛，宜清解分利。
一疹已透表而粒焦者，无分红淡，皆属热重，急当清解肺胃之热，分利小便。如大
便闭者，佐以凉血润下之品，甚则投以承气汤，失治则变紫黑，难以救疗。
一暑月出疹，发自阳明，古人治暑，以白虎汤主之。盖以暑必兼湿，非用甘寒，不
足以彻其热。若疹毒内发，暑湿外侵，烦渴神不安者，宜却暑丹，佐以化毒。
一咳嗽气喘，口干心烦者，乃毒在心肺发未尽也，宜泻白散。
一咽喉肿痛，不能食者，乃毒火抑郁上熏，宜甘桔汤加味，或以千金散少许，用竹
管吹入喉中，或玉锁匙亦可。
一疹出即没，烦渴躁甚者，宜白虎汤加桔梗，连进二三服，若疹出后，热不退，连
绵三四日不收者，此毒火太甚，外发未尽，内有余邪，宜化斑汤，或消毒饮，加元参、石
膏、桔梗。倘遍身既出，而犹烦热，频作呕吐，此毒邪留于肺胃，亦宜化斑汤。如大便
闭结者，少加大黄微利之。
麻疹的发出有阴阳、部位多寡的区别。从头部到背部以及四肢向外扩散的部位属于阳部，适宜多发且疹顶隆起；向内收敛的部位属于阴部，适宜稀少。如果在阳部皮疹稀疏且疹顶不起，即使阴部多发且发出，这也是阴阳相反的表现，必然会有后患，应当提前预防。又说：如果皮疹先从耳后、颈部、腰部、腿部出现，疹顶尖耸但不拉长，形态小而均匀洁净，这是吉兆，甚至不需要用药即可痊愈。大凡麻疹只要出得透彻，毒邪就能消散，正气自然恢复平和。如果出现轻微发热、烦闷不安，像蛇在灰中蠕动、蚯蚓在尘土中挣扎的样子，或者呕吐、腹泻，这都是毒邪壅滞遏阻、尚未完全发出的表现，急需使用托里散表的方剂，或者使用麻黄汤，去掉杏仁，加入蝉蜕、升麻，外用胡荽酒等擦拭。
一种情况是疹出色白，这是由于脾胃之气虚弱，血液不能充盈肌肤所致，不可单纯主张清热，应当补助脾气，可以使用助益脾气的方剂，或者用人参败毒散主治。
一种情况是风寒外闭，导致疹子欲出不出，热势重且无汗，内外呈现无法解散的局面，应迅速使用羌活内托散。如果见到疹色隐现紫色，热势极盛且气喘，宜用清热黄芩汤。
一种情况是麻疹发出呈紫黑色，晦暗不透亮，宜用黄连解毒汤。如果疹色紫红但干燥晦暗，这是火毒炽盛的表现，宜选用滋阴凉血汤，或者大青汤，或者元参汤。
一种情况是麻疹出不透，热势极盛导致眼睛发红，生痰并引发气喘，这是因为毒邪未尽发出，气机因热邪逼迫所致，宜用柴连解毒汤。
一种情况是麻疹发出后热势不退，口渴不止，全身如锦纹般分布，宜用化斑汤。如果毒邪严重导致烦躁不眠，疹色紫滞且不红润鲜活，宜用疏风解毒饮。如果夹杂痰湿且有烦渴症状，宜用人参白虎汤。
一种情况是麻疹发出夹杂斑疹，没有其他杂症，宜用小柴胡汤。如果是蕴积的毒邪发为斑疹，宜用黄芩橘皮汤。如果疹出色黑，热毒亢盛到了极点，这是不治之症，姑且使用加味化斑汤，或者凉血解毒汤。
一种情况是麻疹发出呈紫红色，说明内热极盛。但只要形色光润，颗粒尖耸，就可以治愈，应迅速采用清凉解毒的方法，佐以清痰定喘的药物，便能痊愈。如果枯燥无起色则无法治愈。又有见到遇暖则红活，不暖则枯燥的情况，这是被风寒所遏制，虽然宜用凉解之法，但不可太过。如果见到疹色鲜红，光泽艳丽，疹头颗粒离肉者病情轻；疹头顶平塌不起者病情重。
一种情况是麻疹发出如云片状红肿，又有细碎红点见于大片红肿之上，这是毒火炽盛，宜用清解分利之法。
一种情况是疹已透出体表但颗粒焦枯，无论颜色红淡，都属于热势沉重，急当清解肺胃之热，分利小便。如果大便闭塞，佐以凉血润下的药物，严重时投用承气汤，若失治则变为紫黑色，难以救治。
一种情况是暑月出疹，病发于阳明经。古人治疗暑病，以白虎汤为主。因为暑邪必定兼夹湿气，非用甘寒之药，不足以彻底清除其热。如果疹毒内发，暑湿外侵，导致烦渴神志不安，宜用却暑丹，佐以化毒。
一种情况是咳嗽气喘，口干心烦，这是毒邪在心肺未发尽的表现，宜用泻白散。
一种情况是咽喉肿痛，不能进食，这是毒火抑郁上熏所致，宜用甘桔汤加味，或者取少许千金散，用竹管吹入喉中，或者玉锁匙也可。
一种情况是疹出即没，烦渴躁动严重的，宜用白虎汤加桔梗，连续服用二三剂。如果疹出之后，热势不退，连绵三四日不消退，这是毒火太甚，外发未尽，体内有余邪，宜用化斑汤，或者消毒饮，加入元参、石膏、桔梗。倘若遍身既已出齐，仍然烦热，频繁呕吐，这是毒邪留滞于肺胃，也宜用化斑汤。如果大便闭结，少量加大黄使其轻微通下。
The eruption of measles (Mazhen) is distinguished by Yin and Yang aspects, as well as the abundance or scarcity in different body regions. Areas extending from the head to the back and limbs outwardly are considered Yang regions (Yang Bu), where abundant eruption with prominent papules is appropriate. Areas converging inwardly are considered Yin regions (Yin Bu), where sparse eruption is appropriate. If the eruption is sparse and the papules do not rise in the Yang regions, even if it is abundant in the Yin regions, this represents a contradiction between Yin and Yang and will inevitably lead to subsequent complications; preventive measures should be taken in advance. It is also stated: If the rash first appears behind the ears, on the neck, waist, and legs, and the papules are pointed but not elongated, with a small, uniform, and clean appearance, this is an auspicious sign, and recovery may occur without medication. Generally speaking, as long as the measles erupt thoroughly, the pathogenic toxins will dissipate, and the healthy Qi (Zheng Qi) will naturally return to harmony. If there is slight fever, restlessness, and discomfort, resembling a snake wriggling in ash or an earthworm struggling in dust, accompanied by vomiting or diarrhea, these indicate that the pathogenic toxins are stagnant and obstructed, and have not yet fully erupted. Urgent treatment with formulas that support the interior and release the exterior is required, such as Mahuang Tang (Ephedra Decoction), with Xingren (Apricot Seed) removed and Chan Tui (Cicada Slough) and Sheng Ma (Cimicifugae Rhizoma) added. Externally, Hu Su Jiu (Coriander Wine) can be used.
In one scenario, the rash appears white due to deficiency of Spleen and Stomach Qi and blood failing to nourish the muscles. Treatment should not focus solely on clearing heat; instead, it should aid the Spleen Qi. Formulas such as those benefiting the Spleen or Renshen Baidu San (Ginseng Detoxification Powder) should be used.
In another scenario, external closure by Wind-Cold causes the rash to desire eruption but fail to emerge, with severe heat and absence of sweating, creating a situation where internal and external pathogens cannot be resolved. Qianghuo Neituo San (Notopterygium Interior-Supporting Powder) should be administered rapidly. If the rash appears hidden and purple, with severe heat and panting, Qingre Huangqin Tang (Heat-Clearing Scutellaria Decoction) is indicated.
In a case where the measles erupt in purple-black color, appearing dull and blocked, Huanglian Jiedu Tang (Coptis Detoxification Decoction) is suitable. If the color is purple-red, dry, and dull, this indicates blazing Fire-Toxin; Ziyin Liangxue Tang (Nourishing Yin and Cooling Blood Decoction), Daqing Tang (Isatidis Decoction), or Yuanshen Tang (Scrophulariae Decoction) should be selected.
If the measles do not erupt thoroughly, with extreme heat causing red eyes, phlegm production, and panting, this is because the toxin has not fully emerged, and Qi is forced by heat. Chailian Jiedu Tang (Bupleurum and Coptis Detoxification Decoction) should be used.
If heat persists after eruption, thirst does not cease, and the body resembles brocade patterns, Huaban Tang (Spot-Transforming Decoction) is indicated. If severe toxicity causes irritability and insomnia, and the rash is purple-stagnant and lacks vitality, Shufeng Jiedu Yin (Wind-Dispersing and Toxin-Resolving Drink) is appropriate. If accompanied by phlegm, irritability, and thirst, Renshen Baihu Tang (Ginseng White Tiger Decoction) is suitable.
If the measles eruption includes macules without other mixed symptoms, Xiaochaihu Tang (Minor Bupleurum Decoction) is indicated. If accumulated toxins cause macules, Huangqin Jupi Tang (Scutellaria and Tangerine Peel Decoction) should be used. If the rash turns black with hyperactive Heat-Toxin, it is an incurable condition; however, Jiawei Huaban Tang (Modified Spot-Transforming Decoction) or Liangxue Jiedu Tang (Cooling Blood and Detoxifying Decoction) may be tentatively employed.
If the measles appear purple-red, indicating extreme internal heat, but the form and color are lustrous and the papules are pointed and erect, the condition is treatable. Rapid cooling and detoxification, assisted by phlegm-resolving and pantle-suppressing agents, will lead to recovery. If the skin is dry and shows no improvement, it is incurable. Additionally, if the rash becomes red and active when warm but dry when cold, it is constrained by Wind-Cold. Although cooling and resolving methods are appropriate, they must not be excessive. Fresh red color with luster and distinct papules indicates mild disease; flat, non-rising papules indicate severe disease.
If the measles erupt like a cloud patch of red swelling, with fine red dots appearing on large swollen areas, this indicates blazing Fire-Toxin. Clearing, resolving, and separating/drainage methods should be used.
If the rash has penetrated the exterior but the papules are scorched, regardless of whether the color is red or pale, it belongs to heavy heat. Urgently clear the Heat of the Lung and Stomach and promote diuresis. If constipation occurs, add blood-cooling and moistening purgatives; in severe cases, Chengqi Tang (Chengqi Decoction) may be used. Failure to treat properly leads to purple-black discoloration, which is difficult to rescue.
Measles occurring in summer originate from the Yangming channel. Ancients treated summerheat primarily with Baihu Tang (White Tiger Decoction). Since summerheat invariably combines with dampness, only sweet-cold herbs can thoroughly eliminate the heat. If measles toxins erupt internally while summer-dampness invades externally, causing irritability, thirst, and mental unrest, Queshu Dan (Summerheat-Repelling Pill) with toxin-resolving assistants is indicated.
Cough, panting, dry mouth, and heart irritability indicate that toxins in the Heart and Lung have not fully erupted. Xiebai San (Draining White Powder) is suitable.
Sore throat and swelling preventing eating indicate suppressed Fire-Toxin steaming upward. Ganjie Tang (Licorice and Platycodon Decoction) with modifications, or a small amount of Qianjin San (Thousand Gold Powder) blown into the throat via a bamboo tube, or Yusuoshi (Jade Lock Key), may be used.
If the rash disappears immediately upon appearing, with severe irritability, thirst, and restlessness, Baihu Tang (White Tiger Decoction) with Jiegeng (Platycodon Root) should be administered continuously for two or three doses. If heat persists for three to four days after eruption without subsiding, this indicates excessive Fire-Toxin, incomplete external eruption, and residual internal pathogens. Huaban Tang (Spot-Transforming Decoction) or Xiaodu Yin (Detoxifying Drink) with Yuanshen (Scrophulariae Radix), Shigao (Gypsum Fibrosum), and Jiegeng (Platycodon Radix) should be used. If the body is fully erupted but still febrile with frequent vomiting, this indicates pathogenic toxins lingering in the Lung and Stomach; Huaban Tang is also appropriate. If constipation is present, add a small amount of Dahuang (Rhei Radix et Rhizoma) to induce mild purgation.