一问曰。麻之初出。何以知其发于肺胃二经。答曰。肺主一身之皮毛。胃乃主纳五谷。若皮肤
坚浓。腠理闭密。而麻难现。毛孔开豁。毒从里出。而麻易透。胃火壅滞。故不能食。火邪清消。而
口能餐。是以知也。所以治麻之法。初时专以发散解表清胃火为主。宜用加减参苏饮。去桔梗、甘
草。加连翘、牛蒡子、荆芥、防风、石膏治之。又问曰。假如用加减参苏饮。发散不出。何以治之。答
曰。以麻黄散发之。或以三仙散发之即出。
加减参苏饮
紫苏叶 前胡 粉葛 茯苓 枳壳 桔梗 甘草 生姜 葱白引。水煎服。
麻黄散
麻黄（蜜同酒炒黑） 枳壳 赤茯苓 木通 苏叶 前胡 葛根 连翘 牛蒡子 蝉蜕 红花
葱白引。水煎热服。
三仙散
红花 牛蒡子（炒） 穿山甲（炒成珠） 水煎热服。
二问曰。麻证忌用人参、半夏、升麻。而痘证又用升麻代犀角以补其气。何以辨。答曰。麻乃
肺胃蕴积热毒而发。不宜内实。又不宜温补。而最喜清凉。夫麻出于六腑。所以先动阳气。阴血多
亏。阳者气也。故不浆。升麻能升动阳气上冲。是以麻证最忌。痘出于五脏。宜内实。最喜温补而助
脓。其以升麻代犀角者。乃生犀地黄汤（见八十二条）中。用升麻以引生地黄。而入足阳明胃经耳。
朱曰 麻出六腑。最喜清凉。痘出五脏。最喜温补。此条发明用升麻代犀角之法。
三问曰。麻疹初出。咳嗽。何以治之。答曰。麻初出咳嗽。宜用加减泻白散。去人参、甘草、糯
米。合三味消毒散。去甘草。或用白虎汤。除去甘草、粳米。合三味消毒散。去甘草。或以三拗汤治
之。如或不效。用加味五仙散。去桔梗、芽茶、加牛蒡子、麦冬主之。
朱曰 此条发明初出咳嗽治法。
加减泻白散 治肺炎喘嗽。
桑白皮（蜜炒） 地骨皮 炒甘草 人参 白茯苓 肥知母 枯黄芩 粳米一撮引。
三味消毒散
牛蒡子（炒二两） 荆芥（二钱五分） 每用三钱。水煎服。（按原刻遗甘草一味）
白虎汤 清肺金，泻胃火。
石膏 知母 炙甘草 粳米一撮引。
三拗汤 治风寒伤肺而咳。误行敛肺而壅。咳嗽喘急。
麻黄（不去节三钱） 杏仁（连皮尖用二十粒） 生甘草（一钱） 水煎服。
加味五仙散 治咳嗽不止。
知母 贝母（各二钱） 款冬花（四钱） 桑白皮（七） 桔梗（七钱） 芽茶（五钱） 为末
。每用一钱。杏仁煎汤下。
四问曰。麻证发热。五六日。欲出不出。或作惊候。吐泻交攻。何以治之。答曰。发热而麻欲出
不出。乃淫火之毒。内相攻搏。以致胃家受火邪之毒而作吐泻。急宜分利。而兼清胃泻火。以加味
导赤散主之。兼惊者。加辰砂滑石粉、调服。万无一失。或以麻黄散、去升麻。济生散等剂治之。
朱曰 此条发明欲作惊候。吐泻交攻治法。
加味导赤散 治心胃。利小便。止惊泄。
薄荷叶（四钱） 生地黄（酒洗） 木通 元参 车前子 连翘 淡竹叶（各七钱） 黄连（三钱）
灯心、石膏引。
麻黄散
麻黄（去根节水煮打去绿汁，尽用酒蜜拌炒如煤用） 升麻（酒炒） 人中黄（瓦盛火 ） 牛
蒡子（炒） 蝉蜕（去头足） 水煎服。
济生散 治麻欲出不出。而生杂证。入口即效。
紫草茸 梅蕊 凤尾草 郁金（各一钱） 牛黄（一分） 穿山甲（五分） 蝉蜕（去头足一钱
）为末。麦冬煎汤下一钱。
五问曰。麻出一日而又收。腹中作胀喘急者。何也。答曰。出而又收。乃为风寒所触。腹中作
胀。乃是麻毒内攻。喘急者。乃是麻毒攻胃。急宜早治。若迟。则传三经而难治矣。当以葛根疏邪
汤。加栝蒌仁、石膏、枳实、主之。或以回生清毒散治之。使麻毒内解。则无后患矣。
朱曰 此条发明麻出又收。腹胀喘急治法。
葛根疏邪汤
葛根 防风 荆芥 苏叶 牛蒡子 连翘 地骨皮 前胡 赤茯苓 枳壳 木通 水煎服。
回生消毒散 治麻出而又收。腹胀喘急。
牛蒡子 蟾酥（二钱） 地龙（即蚯蚓晒干去土各二钱） 僵蚕 贝母 防风 荆芥（各一钱
）为末。以淡竹叶煎汤下末一钱。
六问曰。麻证服发散解毒之剂。麻不出而发斑。何以治之。答曰。麻证服发散解毒药。麻不出
而发斑。乃心经君火盛而毒内攻也。当用通利之剂。名为釜底抽薪。使内热一解。则麻易出。纵不
出亦不为害。以化斑解毒汤去升麻主之。或以清宁散加减治之亦可。
朱曰 此条发明麻变斑证治法。
化斑解毒汤
元参 知母 石膏 牛蒡子 连翘 升麻 人中黄（火 另研用） 大黄（酒蒸） 淡竹叶 水煎。调
人中黄服。
清宁散 主泻心肝。（即泻青丸。以蜜合丸。淡竹叶煎汤下。治同。）
大黄（酒蒸一两） 羌活 栀仁（炒黑） 川芎 龙胆草 防风 当归（酒洗各五钱） 为末。蜜水调下。
七问曰。麻后作吐泻。不食发热。多有难救者。何也。答曰。麻收后吐泻不食。乃脾胃二经之
证。脾虚则泻。胃虚则吐。治法当以理脾安胃为主。不可遂用人参、白术。只宜用六仙散治之。若
热不退。则以四物汤（见二十五条）调六仙散治之。倘用人参、白术。则助虚气作喘而死。
朱曰 此条发明麻后吐泻不食发热治法。
六仙散 治麻后、吐泻、不食、发热。
蚂蚁花（ 灰二钱） 薏苡仁（二钱） 藕节（一两） 莲肉（二钱） KT 石斛 陈早米（炒各五
钱） 为末。米汤送下三钱。
八问曰。麻后鼻干黑燥。昏沉不睡。又有喘急咳嗽。多有用白虎汤而死者。何也。答曰。麻后
鼻干黑燥。乃火邪刑金。作喘急。乃胃气虚也。初出而见此候。乃肺胃火邪盛。用白虎汤（见二十
六条）以清肺经之金而泻胃火。实为得宜。麻证日久胃虚。收后而见此证。用白虎汤。则更有伤
胃气。不死何为。只宜以消毒清肺饮。去桔梗、甘草。加栝蒌仁、葶苈主之。可保无虞。倘服消毒清
肺饮而不应。可用复元散除罂粟壳、桔梗。加栝蒌仁、葶苈。一二服则安。或用补肺阿胶散、更妙。
朱曰 此条发明麻证鼻干黑燥喘急咳嗽等证。在收后不宜用白虎汤。另出治法。
消毒清肺饮 治麻后喘嗽。鼻如烟煤。
防风 荆芥 牛蒡子 连翘 桑皮 知母 贝母 陈皮 赤茯苓 百合 桔梗 甘草水煎服。
复元散 治麻后喘急。鼻孔干黑如煤。
贝母 百合 阿胶（炒） 枇杷叶（蜜炙去毛） 桔梗 罂粟壳（炒各一钱） 为末。用桑白皮
煎汤下一钱。
补肺阿胶散（治法加减详五十一条）
阿胶（蛤粉炒） 马兜铃 牛蒡子（炒香） 糯米 炙甘草（各一两） 杏仁（去皮尖七粒） 水煎服。
九问曰。麻后牙疳。多致不治者何也。答曰。麻后牙疳。乃失血证。是热留足阳明胃经。余毒
上攻所致。而有五不治之候。须要看证明白。自外延入内者不治。无脓血者不治。通龈白色者不
治。牙齿落者不治。口臭者不治。除此五证。内服犀角消毒饮。或加味清胃散。外用药方搽之。毒
消自愈。
朱曰 此条发明麻后牙疳。有不治及可治法。
犀角消毒饮
牛蒡子（炒研一钱五分） 荆芥 黄芩 防风 犀角 甘草（各一钱） 水煎。日二服。
加味清胃散 治口舌生疮。牙龈腐烂。
生地黄 升麻 连翘 丹皮 当归 黄连 犀角 生甘草 水煎服。
搽牙药方 治麻后走马牙疳。
人中白（ ） 鸡肫皮（各一钱） 乳香（熨） 没药（熨） 儿茶 朱砂（各五分） 血
竭五倍子（各三分） 赤石脂（ ） 海螵蛸 明矾（ 各七分） 麝香 冰片（各二分）为末。用
粟壳煎汤洗净。搽之。要速效。须加牛黄（二分） 珍珠末（二分） 和匀搽之。
又搽牙药方
红褐子（烧灰） 人中白（ 各二分） 白梅（烧灰五分） 麝香（二分） 冰片（一分） 五
谷虫（炒一钱） 为末。先以韭菜煎汤洗患处。搽之。
十问曰。麻证又有发斑红。而麻反不红者。何也。答曰。麻出于胃。斑亦发于胃。斑是火大盛。
而麻纵不红。亦无大害。只宜以清热消毒治之。用犀角消毒饮（见九问）可也。或以犀角一味磨汁
与服亦可。若发紫斑。则为胃烂。不治。
朱曰 此条发明麻证发红斑。而麻反不红之由与治法。
十一问曰。麻初出。四肢浮肿。何以治之。答曰。四肢浮肿。乃是湿热流于四肢也。以五皮饮
加葶苈治之。如不应。用木通散与之。一二服即愈。
朱曰 此条发明麻初出四肢浮肿治法。
五皮饮
大腹皮 茯苓皮 陈皮 五加皮 姜皮 水煎服。
木通散
地龙（晒干烧灰一钱） 通草（焙焦） 木通（焙干各五钱） 为末。用米汤调下一钱。
问：麻疹初起时，如何判断其病位在肺经和胃经？
答：肺主一身之皮毛，胃主受纳五谷。如果皮肤坚实致密，腠理（皮肤纹理及汗孔）闭阻，则麻疹难以透出；如果毛孔开张，毒邪从体内向外透发，则麻疹容易透发。若胃火壅滞，则导致不能进食；待火邪消退，口舌便能正常饮食。据此即可判断。因此，治疗麻疹的方法，初期主要以发散解表、清泻胃火为主。适宜使用加减参苏饮，去掉桔梗、甘草，加入连翘、牛蒡子、荆芥、防风、石膏来治疗。
又问：假如使用加减参苏饮，麻疹仍发散不出，该如何治疗？
答：使用麻黄散来发散透疹，或者使用三仙散，麻疹即可透出。
加减参苏饮
紫苏叶 前胡 粉葛 茯苓 枳壳 桔梗 甘草 生姜 葱白为引，水煎服。
麻黄散
麻黄（与蜂蜜同用酒炒至黑色） 枳壳 赤茯苓 木通 苏叶 前胡 葛根 连翘 牛蒡子 蝉蜕 红花
葱白为引，水煎后热服。
问：麻疹证候忌用人参、半夏、升麻，而痘疹证候却用升麻代替犀角以补气，如何辨别？
答：麻疹是由于肺胃蕴积热毒而发作，不宜内实，也不宜温补，最喜欢清凉之药。麻疹出于六腑，所以先触动阳气，阴血多亏损，阳指气，所以麻疹灌浆期往往不足。升麻能升动阳气上冲，因此麻疹证候最忌用升麻。痘疹出于五脏，宜内实，最喜欢温补以助脓液生成。其中用升麻代替犀角的情况，是在生犀地黄汤（见八十二条）中，使用升麻是为了引导生地黄进入足阳明胃经罢了。
朱氏评注：麻疹出于六腑，最喜欢清凉；痘疹出于五脏，最喜欢温补。此条阐明了用升麻代替犀角的原理。
问：麻疹初起时咳嗽，如何治疗？
答：麻疹初起咳嗽，适宜使用加减泻白散，去掉人参、甘草、糯米，合用三味消毒散，去掉甘草。或者使用白虎汤，去掉甘草、粳米，合用三味消毒散，去掉甘草。或者使用三拗汤治疗。如果无效，使用加味五仙散，去掉桔梗、芽茶，加入牛蒡子、麦冬主治。
朱氏评注：此条阐明了麻疹初起咳嗽的治疗方法。
加减泻白散 治疗肺炎喘嗽。
桑白皮（蜜炒） 地骨皮 炒甘草 人参 白茯苓 肥知母 枯黄芩 粳米一撮为引。
三味消毒散
牛蒡子（炒二两） 荆芥（二钱五分） 每次取三钱，水煎服。（按原刻本遗漏了甘草一味）
三拗汤 治疗风寒伤肺引起的咳嗽，误用敛肺药导致肺气壅滞，出现咳嗽喘急。
麻黄（不去节三钱） 杏仁（连皮尖用二十粒） 生甘草（一钱） 水煎服。
加味五仙散 治疗咳嗽不止。
知母 贝母（各二钱） 款冬花（四钱） 桑白皮（七钱） 桔梗（七钱） 芽茶（五钱） 研为末。每次取一钱，用杏仁煎汤送下。
问：麻疹证候发热，五六天欲出而未出，或出现惊厥征兆，吐泻交作，如何治疗？
答：发热而麻疹欲出不出，是淫火之毒在体内相互攻搏，导致胃家受到火邪毒气侵袭而发生吐泻。急需分利小便，兼清胃泻火，以加味导赤散主治。兼有惊厥者，加入辰砂滑石粉调服，万无一失。或者使用麻黄散，去掉升麻，配合济生散等方剂治疗。
朱氏评注：此条阐明了欲作惊厥、吐泻交作的治法。
加味导赤散 治疗心胃疾病，利小便，止惊泄。
薄荷叶（四钱） 生地黄（酒洗） 木通 元参 车前子 连翘 淡竹叶（各七钱） 黄连（三钱）
灯心草、石膏为引。
麻黄散
麻黄（去根节水煮打去绿汁，全部使用酒蜜拌炒如煤色） 升麻（酒炒） 人中黄（瓦器盛放火煨） 牛蒡子（炒） 蝉蜕（去头足）
水煎服。
济生散 治疗麻疹欲出不出而生杂证，入口即效。
紫草茸 梅蕊 凤尾草 郁金（各一钱） 牛黄（一分） 穿山甲（五分） 蝉蜕（去头足一钱） 研为末。用麦冬煎汤送下一钱。
问：麻疹出一天后又收回，腹部胀满喘急，是什么原因？
答：出了又收，是被风寒所触；腹部胀满是麻毒内攻；喘急是麻毒攻胃。急需早治，如果迟缓，则传变至三经就难治了。应当使用葛根疏邪汤，加入栝蒌仁、石膏、枳实主治。或者使用回生清毒散治疗，使麻毒在内化解，就没有后患了。
朱氏评注：此条阐明了麻疹出后又收、腹胀喘急的治法。
葛根疏邪汤
葛根 防风 荆芥 苏叶 牛蒡子 连翘 地骨皮 前胡 赤茯苓 枳壳 木通 水煎服。
回生消毒散 治疗麻疹出而又收，腹胀喘急。
牛蒡子 蟾酥（二钱） 地龙（即蚯蚓晒干去土各二钱） 僵蚕 贝母 防风 荆芥（各一钱） 研为末。用淡竹叶煎汤送下一钱末药。
问：麻疹证候服用发散解毒药剂，麻疹不出反而发斑，如何治疗？
答：麻疹证候服用发散解毒药，麻疹不出而发斑，是心经君火旺盛而毒邪内攻所致。应当使用通利药剂，名为釜底抽薪，使内热一解，则麻疹易出，即使不出也不为害。使用化斑解毒汤，去掉升麻主治。或者使用清宁散加减治疗也可以。
朱氏评注：此条阐明了麻疹变为斑证的治法。
化斑解毒汤
元参 知母 石膏 牛蒡子 连翘 升麻 人中黄（火煨另研用） 大黄（酒蒸） 淡竹叶 水煎，调服人中黄。
清宁散 主治泻心肝。（即泻青丸，以蜜合丸，淡竹叶煎汤送下，治法相同。）
大黄（酒蒸一两） 羌活 栀仁（炒黑） 川芎 龙胆草 防风 当归（酒洗各五钱） 研为末，蜜水调下。
问：麻疹后出现吐泻，不食发热，多有难救者，为什么？
答：麻疹收没后出现吐泻不食，是脾胃二经的证候。脾虚则泻，胃虚则吐。治法应当以理脾安胃为主，不可立即用人参、白术，只适宜用六仙散治疗。如果热不退，则以四物汤（见二十五条）调和六仙散治疗。倘若用人参、白术，则会助长虚气导致喘促而死。
朱氏评注：此条阐明了麻疹后吐泻不食发热的治法。
六仙散 治疗麻疹后、吐泻、不食、发热。
蚂蚁花（灰二钱） 薏苡仁（二钱） 藕节（一两） 莲肉（二钱） KT 石斛 陈早米（炒各五钱） 研为末。米汤送下三钱。
问：麻疹后鼻干黑燥，昏沉不睡，又有喘急咳嗽，多有用白虎汤而死者，为什么？
答：麻疹后鼻干黑燥，是火邪刑克肺金；作喘急，是胃气虚也。初出时见此证候，是肺胃火邪盛，用白虎汤（见二十六条）清肺经之金而泻胃火，确实适宜。麻疹证日久胃虚，收没后见此证，用白虎汤，则更伤胃气，不死为何？只适宜以消毒清肺饮，去掉桔梗、甘草，加入栝蒌仁、葶苈主治，可保无虞。倘若服用消毒清肺饮而无反应，可用复元散除去罂粟壳、桔梗，加入栝蒌仁、葶苈，一二服则安。或者使用补肺阿胶散，更为奇妙。
朱氏评注：此条阐明了麻疹证鼻干黑燥喘急咳嗽等证，在收没后不宜用白虎汤，另出治法。
消毒清肺饮 治疗麻疹后喘嗽，鼻如烟煤。
防风 荆芥 牛蒡子 连翘 桑皮 知母 贝母 陈皮 赤茯苓 百合 桔梗 甘草 水煎服。
复元散 治疗麻疹后喘急，鼻孔干黑如煤。
贝母 百合 阿胶（炒） 枇杷叶（蜜炙去毛） 桔梗 罂粟壳（炒各一钱） 研为末。用桑白皮煎汤送下一钱。
补肺阿胶散（治法加减详见五十一条）
阿胶（蛤粉炒） 马兜铃 牛蒡子（炒香） 糯米 炙甘草（各一两） 杏仁（去皮尖七粒） 水煎服。
问：麻疹后牙疳，多致不治者为什么？
答：麻疹后牙疳，属于失血证，是热留足阳明胃经，余毒上攻所致。而有五种不治的证候，须要看证明白。自外延入内的不治；无脓血的不治；通龈白色的不治；牙齿脱落的不治；口臭的不治。除此五证，内服犀角消毒饮，或加味清胃散，外用药物方剂搽涂。毒消自愈。
朱氏评注：此条阐明了麻疹后牙疳，有不治及可治的法度。
犀角消毒饮
牛蒡子（炒研一钱五分） 荆芥 黄芩 防风 犀角 甘草（各一钱） 水煎，日服两次。
加味清胃散 治疗口舌生疮，牙龈腐烂。
生地黄 升麻 连翘 丹皮 当归 黄连 犀角 生甘草 水煎服。
搽牙药方 治疗麻疹后走马牙疳。
人中白（ ） 鸡肫皮（各一钱） 乳香（熨） 没药（熨） 儿茶 朱砂（各五分） 血竭五倍子（各三分） 赤石脂（ ） 海螵蛸 明矾（ 各七分） 麝香 冰片（各二分） 研为末。用粟壳煎汤洗净患处，搽之。要速效，须加牛黄（二分） 珍珠末（二分） 和匀搽之。
又搽牙药方
红褐子（烧灰） 人中白（ ） 白梅（烧灰五分） 麝香（二分） 冰片（一分） 五谷虫（炒一钱） 研为末。先以韭菜煎汤洗患处，搽之。
问：麻疹证又有发红斑，而麻疹反不红的，为什么？
答：麻疹出于胃，斑亦发于胃。斑是火大盛，而麻疹纵然不红，也无大害。只适宜以清热消毒治疗，使用犀角消毒饮（见九问）可以。或者单用犀角一味磨汁与服也可以。若发紫斑，则为胃烂，不治。
朱氏评注：此条阐明了麻疹证发红斑，而麻疹反不红的原因与治法。
问：麻疹初起，四肢浮肿，如何治疗？
答：四肢浮肿，是湿热流于四肢。以五皮饮加葶苈治疗。如果无效，用木通散与之，一二服即愈。
朱氏评注：此条阐明了麻疹初起四肢浮肿的治法。
Q: When measles first appear, how can one determine that the pathology originates from the Lung and Stomach meridians?
A: The Lung governs the skin and body hair (Pí máo), while the Stomach is responsible for receiving and digesting the five grains. If the skin is firm and dense, and the Cou Li (pores and interstitial spaces) are closed, it is difficult for the measles rash to emerge. If the pores are open, allowing the pathogenic toxins to exit from the interior, the measles rash will easily manifest. If Stomach Fire is stagnant, it leads to an inability to eat; once the Fire pathogen dissipates, normal appetite returns. This is how we know. Therefore, the treatment principle in the early stage of measles focuses primarily on dispersing and releasing the exterior, and clearing Stomach Fire. The appropriate formula is Ji Jian Shen Su Yin (Modified Ginseng and Perilla Decoction), removing Jie Geng (Platycodon Root) and Gan Cao (Licorice Root), and adding Lian Qiao (Forsythia Fruit), Niu Bang Zi (Arctium Seed), Jing Jie (Schizonepeta Herb), Fang Feng (Saposhnikovia Root), and Shi Gao (Gypsum Fibrosum).
Another question: If Ji Jian Shen Su Yin fails to disperse the measles, how should it be treated?
Answer: Use Ma Huang San (Ephedra Powder) to disperse and vent the rash, or use San Xian San (Three Immortals Powder), and the rash will emerge.
Ji Jian Shen Su Yin (Modified Ginseng and Perilla Decoction)
Zi Su Ye (Perilla Leaf), Qian Hu (Peucedanum Root), Fen Ge (Kudzu Root), Fu Ling (Poria), Zhi Ke (Bitter Orange Fruit), Jie Geng (Platycodon Root), Gan Cao (Licorice Root), Sheng Jiang (Fresh Ginger), Cong Bai (Scallion White) as a guide. Decoct in water and take orally.
Ma Huang San (Ephedra Powder)
Ma Huang (Ephedrae Herba, stir-fried black with honey and wine), Zhi Ke (Bitter Orange Fruit), Chi Fu Ling (Red Poria), Mu Tong (Akebia Stem), Su Ye (Perilla Leaf), Qian Hu (Peucedanum Root), Ge Gen (Kudzu Root), Lian Qiao (Forsythia Fruit), Niu Bang Zi (Arctium Seed), Chan Tui (Cicada Slough), Hong Hua (Carthamus Flower).
Cong Bai (Scallion White) as a guide. Decoct in water and take hot.
San Xian San (Three Immortals Powder)
Hong Hua (Carthamus Flower), Niu Bang Zi (Arctium Seed, stir-fried), Chuan Shan Jia (Pangolin Scale, stir-fried until pearl-like).
Decoct in water and take hot.
Q: Measles patterns contraindicate the use of Ren Shen (Ginseng), Ban Xia (Pinellia Tuber), and Sheng Ma (Cimicifuga Rhizome), whereas smallpox patterns use Sheng Ma instead of Xi Jiao (Rhinoceros Horn) to tonify Qi. How to distinguish?
A: Measles erupts due to accumulated heat-toxin in the Lung and Stomach. It should not be internally excess, nor should it be treated with warming tonification; it prefers cooling agents. Measles emerges from the Six Fu Organs, thus initially moving Yang Qi. Yin Blood is often deficient; "Yang" refers to Qi, hence the filling stage may be insufficient. Sheng Ma can ascend and move Yang Qi upward, which is why it is strictly contraindicated in measles. Smallpox emerges from the Five Zang Organs, requiring internal solidity, and benefits most from warming tonification to assist pus formation. The use of Sheng Ma replacing Xi Jiao occurs in Sheng Xi Di Huang Tang (Raw Rhino-Horn and Rehmannia Decoction) [see Article 82], where Sheng Ma is used to guide Sheng Di Huang (Rehmannia Root) into the Foot-Yangming Stomach Meridian.
Commentary by Zhu: Measles emerges from the Six Fu Organs and prefers cooling; smallpox emerges from the Five Zang Organs and prefers warming tonification. This section elucidates the rationale for using Sheng Ma instead of Xi Jiao.
Q: When measles first appear accompanied by cough, how should it be treated?
A: For cough accompanying early-stage measles, use Jia Jian Xie Bai San (Modified Draining White Powder), removing Ren Shen (Ginseng), Gan Cao (Licorice Root), and Nuo Mi (Glutinous Rice), combined with San Wei Xiao Du San (Three-Ingredient Detoxifying Powder), removing Gan Cao (Licorice Root). Alternatively, use Bai Hu Tang (White Tiger Decoction), removing Gan Cao (Licorice Root) and Jing Mi (Rice Grain), combined with San Wei Xiao Du San (Three-Ingredient Detoxifying Powder), removing Gan Cao (Licorice Root). Or treat with San Ao Tang (Three Uninhibited Decoction). If ineffective, use Jia Wei Wu Xian San (Modified Five Immortals Powder), removing Jie Geng (Platycodon Root) and Ya Cha (Bud Tea), adding Niu Bang Zi (Arctium Seed) and Mai Dong (Ophiopogon Tuber) as the main treatment.
Commentary by Zhu: This section elucidates the treatment method for cough at the initial eruption of measles.
Jia Jian Xie Bai San (Modified Draining White Powder) Treats pneumonia with wheezing and cough.
Sang Bai Pi (Mulberry Root Bark, honey-fried), Di Gu Pi (Lycium Root Bark), Chao Gan Cao (Stir-fried Licorice Root), Ren Shen (Ginseng), Bai Fu Ling (White Poria), Fei Zhi Mu (Anemarrhena Rhizome), Ku Huang Qin (Scutellaria Root), Jing Mi (Rice Grain, a pinch) as a guide.
San Wei Xiao Du San (Three-Ingredient Detoxifying Powder)
Niu Bang Zi (Arctium Seed, stir-fried, 2 liang), Jing Jie (Schizonepeta Herb, 2 qian 5 fen). Take 3 qian per dose, decoct in water and take orally. (Note: The original edition omitted Gan Cao/Licorice Root).
Bai Hu Tang (White Tiger Decoction) Clears Lung Metal and drains Stomach Fire.
Shi Gao (Gypsum Fibrosum), Zhi Mu (Anemarrhena Rhizome), Zhi Gan Cao (Honey-fried Licorice Root), Jing Mi (Rice Grain, a pinch) as a guide.
San Ao Tang (Three Uninhibited Decoction) Treats cough caused by Wind-Cold injuring the Lung, where mistaken use of lung-astringents causes Qi stagnation, resulting in cough and wheezing.
Ma Huang (Ephedrae Herba, without nodes, 3 qian), Xing Ren (Apricot Seed, with skin and tip, 20 grains), Sheng Gan Cao (Raw Licorice Root, 1 qian). Decoct in water and take orally.
Jia Wei Wu Xian San (Modified Five Immortals Powder) Treats persistent cough.
Zhi Mu (Anemarrhena Rhizome), Bei Mu (Fritillaria Bulb, each 2 qian), Kuan Dong Hua (Coltsfoot Flower, 4 qian), Sang Bai Pi (Mulberry Root Bark, 7 qian), Jie Geng (Platycodon Root, 7 qian), Ya Cha (Bud Tea, 5 qian). Grind into powder. Take 1 qian per dose, washed down with Apricot Seed decoction.
Q: In measles patterns with fever, after five or six days, the rash desires to emerge but does not, or convulsive symptoms appear, accompanied by alternating vomiting and diarrhea, how should it be treated?
A: Fever with the desire for the rash to emerge but failure to do so indicates that excessive Fire toxin is attacking each other internally, causing the Stomach to suffer from Fire toxin, leading to vomiting and diarrhea. Urgent separation and draining (diuresis) is required, combined with clearing Stomach and draining Fire. Use Jia Wei Dao Chi San (Modified Guiding Outward Red Powder) as the main treatment. If convulsions are present, add Chen Sha (Cinnabar) and Hua Shi (Talcum) powder, mix and take orally; this is foolproof. Alternatively, use Ma Huang San (Ephedra Powder), removing Sheng Ma (Cimicifuga Rhizome), combined with Ji Sheng San (Life-Sustaining Powder) and other formulas.
Commentary by Zhu: This section elucidates the treatment for impending convulsions and alternating vomiting/diarrhea.
Jia Wei Dao Chi San (Modified Guiding Outward Red Powder) Treats Heart and Stomach conditions, promotes urination, stops convulsive diarrhea.
Bo He Ye (Mint Leaf, 4 qian), Sheng Di Huang (Rehmannia Root, wine-washed), Mu Tong (Akebia Stem), Yuan Shen (Scrophularia Root), Che Qian Zi (Plantago Seed), Lian Qiao (Forsythia Fruit), Dan Zhu Ye (Lophatherum Leaf, each 7 qian), Huang Lian (Coptis Rhizome, 3 qian).
Deng Xin Cao (Juncus Medulla) and Shi Gao (Gypsum Fibrosum) as guides.
Ma Huang San (Ephedra Powder)
Ma Huang (Ephedrae Herba, roots and joints removed, boiled to remove green juice, then stir-fried with wine and honey until coal-black), Sheng Ma (Cimicifuga Rhizome, wine-fried), Ren Zhong Huang (Human Waste Carbon, fired in earthenware), Niu Bang Zi (Arctium Seed, stir-fried), Chan Tui (Cicada Slough, head and feet removed).
Decoct in water and take orally.
Ji Sheng San (Life-Sustaining Powder) Treats measles desiring to emerge but failing, complicated by miscellaneous syndromes; effective upon entry.
Zi Cao Rong (Arnebia Root), Mei Rui (Plum Blossom), Feng Wei Cao (Pteris Multifida), Yu Jin (Curcuma Tuber, each 1 qian), Niu Huang (Calculus Bovis, 1 fen), Chuan Shan Jia (Pangolin Scale, 5 fen), Chan Tui (Cicada Slough, head and feet removed, 1 qian). Grind into powder. Take 1 qian, washed down with Ophiopogon Tuber decoction.
Q: Measles appears for one day and then recedes, accompanied by abdominal distension and wheezing urgency. What is the cause?
A: Appearing and then receding is caused by contact with Wind-Cold. Abdominal distension indicates Measles toxin attacking inward. Wheezing urgency indicates Measles toxin attacking the Stomach. Early treatment is urgent; if delayed, transmission to the Three Meridians makes it difficult to treat. One should use Ge Gen Shu Xie Tang (Kudzu Exterior-Dispersing Decoction), adding Gua Lou Ren (Trichosanthes Seed), Shi Gao (Gypsum Fibrosum), and Zhi Shi (Immature Bitter Orange). Alternatively, use Hui Sheng Qing Du San (Reviving Toxin-Clearing Powder) to resolve the Measles toxin internally, preventing future complications.
Commentary by Zhu: This section elucidates the treatment for measles appearing and receding, with abdominal distension and wheezing.
Ge Gen Shu Xie Tang (Kudzu Exterior-Dispersing Decoction)
Ge Gen (Kudzu Root), Fang Feng (Saposhnikovia Root), Jing Jie (Schizonepeta Herb), Su Ye (Perilla Leaf), Niu Bang Zi (Arctium Seed), Lian Qiao (Forsythia Fruit), Di Gu Pi (Lycium Root Bark), Qian Hu (Peucedanum Root), Chi Fu Ling (Red Poria), Zhi Ke (Bitter Orange Fruit), Mu Tong (Akebia Stem). Decoct in water and take orally.
Hui Sheng Xiao Du San (Reviving Toxin-Clearing Powder) Treats measles appearing and receding, with abdominal distension and wheezing.
Niu Bang Zi (Arctium Seed), Chan Su (Toad Venom, 2 qian), Di Long (Earthworm, dried, cleaned, 2 qian), Jiang Can (Bombyx Batryticatus), Bei Mu (Fritillaria Bulb), Fang Feng (Saposhnikovia Root), Jing Jie (Schizonepeta Herb, each 1 qian). Grind into powder. Take 1 qian of powder, washed down with Lophatherum Leaf decoction.
Q: In measles patterns, after administering dispersing and detoxifying agents, the measles do not emerge but macules (ban) appear. How should this be treated?
A: Administering dispersing and detoxifying agents in measles patterns results in no measles emergence but appearance of macules. This is due to excessive Ministerial Fire in the Heart Meridian and internal attack by toxin. One should use purgative/draining agents, termed "drawing firewood from under the cauldron." Once internal heat is resolved, the measles will easily emerge; even if they do not, it will not cause harm. Use Hua Ban Jie Du Tang (Macule-Dissolving Detoxifying Decoction), removing Sheng Ma (Cimicifuga Rhizome). Alternatively, Qing Ning San (Clearing Peace Powder) with modifications can also be used.
Commentary by Zhu: This section elucidates the treatment for measles transforming into macule syndrome.
Hua Ban Jie Du Tang (Macule-Dissolving Detoxifying Decoction)
Yuan Shen (Scrophularia Root), Zhi Mu (Anemarrhena Rhizome), Shi Gao (Gypsum Fibrosum), Niu Bang Zi (Arctium Seed), Lian Qiao (Forsythia Fruit), Sheng Ma (Cimicifuga Rhizome), Ren Zhong Huang (Human Waste Carbon, fired and ground separately), Da Huang (Rhubarb Root, steamed in wine), Dan Zhu Ye (Lophatherum Leaf). Decoct in water, mix with Ren Zhong Huang and take orally.
Qing Ning San (Clearing Peace Powder) Primarily drains Heart and Liver. (This is Xie Qing Wan, formed into pills with honey, taken with Lophatherum Leaf decoction; treatment is identical.)
Da Huang (Rhubarb Root, steamed in wine, 1 liang), Qiang Huo (Notopterygium Rhizome), Zhi Ren (Gardenia Seed, stir-fried black), Chuan Xiong (Ligusticum Rhizome), Long Dan Cao (Gentiana Root), Fang Feng (Saposhnikovia Root), Dang Gui (Angelica Sinensis Root, wine-washed, each 5 qian). Grind into powder, mix with honey and water, and take orally.
Q: After measles, vomiting, diarrhea, anorexia, and fever occur; many cases are incurable. Why?
A: Vomiting, diarrhea, and anorexia after measles resolution are syndromes of the Spleen and Stomach meridians. Spleen deficiency leads to diarrhea; Stomach deficiency leads to vomiting. The treatment principle should focus on regulating the Spleen and calming the Stomach. One must not immediately use Ren Shen (Ginseng) and Bai Zhu (Atractylodes Rhizome). Only Liu Xian San (Six Immortals Powder) is suitable. If fever persists, combine Si Wu Tang (Four Substances Decoction) [see Article 25] with Liu Xian San. If Ren Shen (Ginseng) and Bai Zhu (Atractylodes Rhizome) are used, they will exacerbate deficiency Qi, leading to wheezing and death.
Commentary by Zhu: This section elucidates the treatment for post-measles vomiting, diarrhea, anorexia, and fever.
Liu Xian San (Six Immortals Powder) Treats post-measles vomiting, diarrhea, anorexia, and fever.
Ma Yi Hua (Ant Flower, ash 2 qian), Yi Yi Ren (Coix Seed, 2 qian), Ou Jie (Lotus Rhizome Node, 1 liang), Lian Rou (Lotus Seed, 2 qian), KT Shi Hu (Dendrobium Stem), Chen Zao Mi (Old Early Rice, stir-fried, each 5 qian). Grind into powder. Take 3 qian, washed down with Rice Decoction.
Q: After measles, the nose becomes dry, black, and scaly, with lethargy and insomnia, accompanied by wheezing and cough. Many die after using Bai Hu Tang (White Tiger Decoction). Why?
A: Post-measles dry, black, and scaly nose indicates Fire toxin punishing Lung Metal. Wheezing urgency indicates Stomach Qi deficiency. At the initial eruption, seeing these signs means Lung and Stomach Fire toxin are abundant; using Bai Hu Tang (White Tiger Decoction) [see Article 26] to clear Lung Metal and drain Stomach Fire is appropriate. However, in prolonged measles patterns with Stomach deficiency, seeing these signs after resolution and using Bai Hu Tang further damages Stomach Qi, leading inevitably to death. One should only use Xiao Du Qing Fei Yin (Detoxifying Lung-Clearing Infusion), removing Jie Geng (Platycodon Root) and Gan Cao (Licorice Root), adding Gua Lou Ren (Trichosanthes Seed) and Ting Li (Lepidium Seed). This ensures safety. If there is no response to Xiao Du Qing Fei Yin (Detoxifying Lung-Clearing Infusion), use Fu Yuan San (Restoring Primordial Powder), removing Ying Su Ke (Poppy Capsule) and Jie Geng (Platycodon Root), adding Gua Lou Ren (Trichosanthes Seed) and Ting Li (Lepidium Seed). One or two doses will bring peace. Alternatively, Bu Fei E Jiao San (Tonifying Lung and Donkey-Hide Gelatin Powder) is even better.
Commentary by Zhu: This section elucidates post-measles dry/black nose, wheezing, and cough, noting that Bai Hu Tang (White Tiger Decoction) is contraindicated after resolution, and provides alternative treatments.
Xiao Du Qing Fei Yin (Detoxifying Lung-Clearing Infusion) Treats post-measles wheezing and cough, nose resembling soot.
Fang Feng (Saposhnikovia Root), Jing Jie (Schizonepeta Herb), Niu Bang Zi (Arctium Seed), Lian Qiao (Forsythia Fruit), Sang Pi (Mulberry Bark), Zhi Mu (Anemarrhena Rhizome), Bei Mu (Fritillaria Bulb), Chen Pi (Citrus Peel), Chi Fu Ling (Red Poria), Bai He (Lily Bulb), Jie Geng (Platycodon Root), Gan Cao (Licorice Root). Decoct in water and take orally.
Fu Yuan San (Restoring Primordial Powder) Treats post-measles wheezing urgency, dry black nostrils like coal.
Bei Mu (Fritillaria Bulb), Bai He (Lily Bulb), E Jiao (Donkey-Hide Gelatin, stir-fried), Pi Pa Ye (Loquat Leaf, honey-fried and de-hairy), Jie Geng (Platycodon Root), Ying Su Ke (Poppy Capsule, stir-fried, each 1 qian). Grind into powder. Take 1 qian, washed down with Mulberry Root Bark decoction.
Bu Fei E Jiao San (Tonifying Lung and Donkey-Hide Gelatin Powder) (For detailed modification methods, see Article 51)
E Jiao (Donkey-Hide Gelatin, fried with clam powder), Ma Dou Ling (Aristolochia Stem), Niu Bang Zi (Arctium Seed, stir-fried until fragrant), Nuo Mi (Glutinous Rice), Zhi Gan Cao (Honey-fried Licorice Root, each 1 liang), Xing Ren (Apricot Seed, peeled and de-tipped, 7 grains). Decoct in water and take orally.
Q: After measles, gum disease (Ya Gan) occurs, often proving incurable. Why?
A: Post-measles gum disease is a blood-loss syndrome, caused by residual heat remaining in the Foot-Yangming Stomach Meridian and residual toxin attacking upward. There are five incurable signs to observe carefully. If spreading from outside inward, it is incurable. If no pus or blood, it is incurable. If gums are uniformly white, it is incurable. If teeth fall out, it is incurable. If bad breath, it is incurable. Excluding these five signs, internally administer Xi Jiao Xiao Du Yin (Rhino-Horn Detoxifying Infusion) or Jia Wei Qing Wei San (Modified Clearing Stomach Powder), and apply external medicinal paste. Once toxin clears, self-healing occurs.
Commentary by Zhu: This section elucidates post-measles gum disease, distinguishing between incurable and treatable cases.
Xi Jiao Xiao Du Yin (Rhino-Horn Detoxifying Infusion)
Niu Bang Zi (Arctium Seed, stir-fried and ground, 1 qian 5 fen), Jing Jie (Schizonepeta Herb), Huang Qin (Scutellaria Root), Fang Feng (Saposhnikovia Root), Xi Jiao (Rhinoceros Horn), Gan Cao (Licorice Root, each 1 qian). Decoct in water, take twice daily.
Jia Wei Qing Wei San (Modified Clearing Stomach Powder) Treats mouth and tongue ulcers, gum rot.
Sheng Di Huang (Rehmannia Root), Sheng Ma (Cimicifuga Rhizome), Lian Qiao (Forsythia Fruit), Dan Pi (Moutan Bark), Dang Gui (Angelica Sinensis Root), Huang Lian (Coptis Rhizome), Xi Jiao (Rhinoceros Horn), Sheng Gan Cao (Raw Licorice Root). Decoct in water and take orally.
Ya Cha Yao Fang (Tooth-Pasting Prescription) Treats post-measles gangrenous stomatitis (Zou Ma Ya Gan).
Ren Zhong Bai (Human Waste Ash), Ji Dun Pi (Chicken Gizzard Membrane, each 1 qian), Ru Xiang (Frankincense, ironed), Mo Yao (Myrrh, ironed), Er Cha (Children's Tea), Zhu Sha (Cinnabar, each 5 fen), Xue Jie (Dragon's Blood), Wu Bei Zi (Galla Chinensis, each 3 fen), Chi Shi Zhi (Red Halloysite), Hai Piao Xiao (Cuttlefish Bone), Ming Fan (Alum, each 7 fen), She Xiang (Musk), Bing Pian (Borneol, each 2 fen). Grind into powder. Wash the area with Poppy Shell decoction, then apply. For rapid effect, add Niu Huang (Calculus Bovis, 2 fen) and Zhen Zhu Mo (Pearl Powder, 2 fen), mix evenly, and apply.
Another Tooth-Pasting Prescription
Hong He Zi (Red Brown Seed, burnt to ash), Ren Zhong Bai (Human Waste Ash, each 2 fen), Bai Mei (White Plum, burnt to ash, 5 fen), She Xiang (Musk, 2 fen), Bing Pian (Borneol, 1 fen), Wu Gu Chong (Five-Grain Worm, stir-fried, 1 qian). Grind into powder. First wash the affected area with Leek decoction, then apply.
Q: In measles patterns, red macules appear, yet the measles themselves are not red. Why?
A: Measles emerges from the Stomach, and macules also erupt from the Stomach. Macules indicate excessive Fire. Even if the measles are not red, it causes no major harm. One should only treat with clearing heat and detoxifying. Using Xi Jiao Xiao Du Yin (Rhino-Horn Detoxifying Infusion) [see Question 9] is appropriate. Alternatively, grinding a single herb of Xi Jiao (Rhinoceros Horn) and taking the juice is also acceptable. If purple macules appear, it indicates Stomach rot, which is incurable.
Commentary by Zhu: This section elucidates the cause and treatment for measles patterns presenting with red macules while the measles themselves are not red.
Q: At the initial eruption of measles, edema of the four limbs occurs. How should it be treated?
A: Edema of the four limbs is caused by Damp-Heat flowing into the four limbs. Treat with Wu Pi Yin (Five-Bark Infusion) added with Ting Li (Lepidium Seed). If ineffective, use Mu Tong San (Akebia Powder); one or two doses will result in recovery.
Commentary by Zhu: This section elucidates the treatment for edema of the four limbs at the initial eruption of measles.
Wu Pi Yin (Five-Bark Infusion)
Da Fu Pi (Areca Peel), Fu Ling Pi (Poria Bark), Chen Pi (Citrus Peel), Wu Jia Pi (Acanthopanacis Cortex), Jiang Pi (Ginger Peel). Decoct in water and take orally.
Mu Tong San (Akebia Powder)
Di Long (Earthworm, dried and burnt to ash, 1 qian), Tong Cao (Tetrapanax Pith, roasted until scorched), Mu Tong (Akebia Stem, dried, each 5 qian). Grind into powder. Take 1 qian, mixed with Rice Decoction.