麻疹非热不出。若既出透。其热当减。倘仍大热者。此毒盛壅遏也。宜用化毒清表汤治之。
疹已没落而身热者。此余热留于肌表也。宜柴胡清热饮治之。
化毒清表汤 治麻既出透而身犹大热者
粉葛 薄荷 地骨皮 粘子(炒研) 连翘(去心) 防风 黄芩 黄连 元参 知母
木通 甘草 桔梗 加灯心
柴胡清热饮 治没后身热。
柴胡 黄芩 赤芍 生地 麦冬
地骨皮 知母 甘草 加灯心
廉按此亦言其大略也。身热而兼他症者。宜随症加减治之。合下并看自见。且益见前收没条
所云当散不散为虚热之止言常法也。然而此条亦当合前条观之。倘有虚症。不至过于寒凉
矣。
凡出麻疹烦渴者。乃毒热壅盛也。盖心为热扰则烦。胃为热郁则渴。当未出时。宜升麻葛根
汤加麦冬花粉。已出者。宜白虎汤。没后烦渴者。用竹叶石膏汤。
升麻葛根汤（见前）
白虎汤（见前）
竹叶石膏汤
人参 麦冬 石膏
知母 淡竹叶 甘草
廉按烦渴而兼他症。当随症加减治之。或他症重于烦渴。当以他症为主烦渴为兼。此当统前
后而观也。亦有火毒内蕴而不烦渴者。
谵妄一证。乃毒火太盛。热昏心神而然也。疹未出而谵妄者。宜三黄石膏汤主之。疹已出而
谵妄者。黄连解毒汤主之。
三黄石膏汤（见前）
黄连解毒汤
黄连 黄芩 黄柏 栀子(炒) 加灯心
廉按云主之者。必有辅之者也。病至谵妄。必不止谵妄一疹矣。如风寒痰食。以及诸变症
。
各宜随症用药辅之。故金鉴下一字宜细细揣摩。不同他书之一条止一事。所谓言简而该也。
麻疹并非依靠热势不能透发出来。如果疹子已经出得透彻，其发热应当减轻。倘若仍然高热不退，这是毒邪炽盛、壅滞遏伏的表现。适宜使用化毒清表汤来治疗。
疹子已经消退隐没后身体仍有发热的，这是余热留存在肌表所致。适宜用柴胡清热饮来治疗。
化毒清表汤：治疗麻疹已经出透但身体仍然高热的情况。
粉葛、薄荷、地骨皮、粘子（炒熟研碎）、连翘（去除心）、防风、黄芩、黄连、元参、知母、木通、甘草，加灯心草。
柴胡清热饮：治疗疹子消退后身体发热的情况。
柴胡、黄芩、赤芍、生地、麦冬、地骨皮、知母、甘草，加灯心草。
廉按语：这里也是大概地论述。如果身热兼有其他症状的，应当根据具体症状进行加减治疗。结合下文一起看自然明白。而且更能体现前面关于疹子收没条文中所说的“应当发散而未发散导致虚热”只是常法而言。然而这一条也应当结合前一条来看待。如果有虚证，就不会过于使用寒凉药物了。
凡是出现麻疹并伴有烦躁口渴的，是毒热壅盛的表现。因为心被热邪扰乱所以烦躁，胃被热邪郁结所以口渴。在疹子尚未发出时，适宜用升麻葛根汤加入麦冬、花粉。疹子已经发出的，适宜用白虎汤。疹子消退后出现烦躁口渴的，用竹叶石膏汤。
升麻葛根汤（见前文）
白虎汤（见前文）
竹叶石膏汤：人参、麦冬、石膏、知母、淡竹叶、甘草。
廉按语：烦躁口渴兼有其他症状的，应当根据症状加减治疗。或者如果其他症状重于烦躁口渴，应当以其他症状为主，烦躁口渴为兼症。这应当综合前后文来看待。也有火毒内蕴但不出现烦躁口渴的情况。
谵妄这一证候，是由于毒火太盛，热邪昏蒙心神而导致的。疹子尚未发出而出现谵妄的，适宜以三黄石膏汤为主治。疹子已经发出而出现谵妄的，适宜以黄连解毒汤为主治。
三黄石膏汤（见前文）
黄连解毒汤：黄连、黄芩、黄柏、栀子（炒）、加灯心草。
廉按语：说“主之”，意味着必须有辅助治疗的措施。病发展到谵妄阶段，必然不止有谵妄这一个症状。如风寒、痰食以及诸种变症，各自适宜根据症状用药辅助治疗。所以《医宗金鉴》中用的“宜”字需要细细揣摩，不同于其他书籍的一条只对应一件事，这就是所谓的言语简练而涵盖全面。
Measles cannot be expelled without heat. If the rash has erupted thoroughly, the fever should subside. However, if high fever persists, this indicates that the pathogenic toxin is abundant and obstructing stagnation. It is appropriate to treat with Huadu Qingbiao Decoction (Toxin-Resolving Surface-Clearing Decoction).
If body heat remains after the rash has faded and disappeared, this signifies residual heat lingering in the muscle layer. It is appropriate to treat with Chaihu Qingre Yin (Bupleurum Heat-Clearing Drink).
Huadu Qingbiao Decoction: Treats cases where the measles have erupted thoroughly but high fever persists.
Puerariae Lobatae Radix (Fenge), Menthae Haplocalycis Herba (Bohe), Lycii Cortex (Digupi), Sesami Tici Semen (Nianzi, stir-fried and ground), Forsythiae Fructus (Lianqiao, heart removed), Saposhnikoviae Radix (Fangfeng), Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), Scrophulariae Radix (Yuan Shen), Anemarrhenae Rhizoma (Zhimu), Akebiae Caulis (Mutong), Glycyrrhizae Radix et Rhizoma (Gancao), add Junci Medulla (Dengxin).
Chaihu Qingre Yin: Treats body heat after the rash has faded.
Bupleuri Radix (Chaihu), Scutellariae Radix (Huangqin), Paeoniae Radix Rubra (Chishao), Rehmanniae Radix Preparata (Shengdi), Ophiopogonis Radix (Maidong), Lycii Cortex (Digupi), Anemarrhenae Rhizoma (Zhimu), Glycyrrhizae Radix et Rhizoma (Gancao), add Junci Medulla (Dengxin).
Comment by Lian: This discusses the general principles. If body heat is accompanied by other symptoms, modifications should be made according to the specific symptoms. Reading it together with the following text will make it clear. Furthermore, it highlights that the previous statement regarding "failure to disperse when dispersal was indicated, leading to deficiency heat," refers only to standard methods. However, this section should also be viewed in conjunction with the previous one. If there are deficiency patterns, overly cold and cooling treatments would not be used.
In cases of measles accompanied by irritability and thirst, this is due to abundant and obstructing toxic heat. The heart is disturbed by heat causing irritability, and the stomach is constrained by heat causing thirst. Before the eruption, Shengma Gegen Tang (Cimicifugae and Pueraria Decoction) added with Ophiopogonis Radix (Maidong) and Pseudostellariae Radix (Huafen) is appropriate. After eruption, Baihu Tang (White Tiger Decoction) is appropriate. After fading, Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) is used.
Shengma Gegen Tang (See previous)
Baihu Tang (See previous)
Zhuye Shigao Tang: Ginseng Radix et Rhizoma (Renshen), Ophiopogonis Radix (Maidong), Gypsum Fibrosum (Shigao), Anemarrhenae Rhizoma (Zhimu), Lophatheri Herba (Dan Zhuye), Glycyrrhizae Radix et Rhizoma (Gancao).
Comment by Lian: When irritability and thirst are accompanied by other symptoms, treatment should be modified accordingly. Or, if other symptoms are more severe than irritability and thirst, the primary focus should be on the other symptoms, treating irritability and thirst as secondary. This requires viewing the context comprehensively. There are also cases where internal accumulation of fire toxin does not present with irritability or thirst.
Delirium is a syndrome caused by excessive toxic fire, where heat confounds the mind and spirit. If delirium occurs before the eruption, Sanhuang Shigao Tang (Three Yellows and Gypsum Decoction) is the principal prescription. If delirium occurs after eruption, Huanglian Jiedu Tang (Coptis Detoxification Decoction) is the principal prescription.
Sanhuang Shigao Tang (See previous)
Huanglian Jiedu Tang: Coptidis Rhizoma (Huanglian), Scutellariae Radix (Huangqin), Phellodendri Cortex (Huangbai), Gardeniae Fructus (Zhizi, stir-fried), add Junci Medulla (Dengxin).
Comment by Lian: The term "principal" implies that auxiliary measures are necessary. By the time the disease progresses to delirium, it is certainly not limited to just delirium. Factors such as wind-cold, phlegm, food stagnation, and various complications must be addressed. Each should be treated with medications tailored to the symptoms as auxiliaries. Therefore, the word "appropriate" (yi) in *Yizong Jinjian* requires careful consideration, differing from other texts where one line addresses only one issue. This is what is meant by concise yet comprehensive expression.