孕妇麻症若相当。潮热蒸蒸胎易伤。子去母应无害事。症轻子母两无殃。
大热蒸蒸血海干。毒火内攻胎不安。急宜清热养营血。治不根据法生祸端。
古云。胎遇热则坠。麻为火候。内必有热。最易坠胎。孕妇出麻。此症极险。当于初热未出之
时。须察其热之轻重。正出之际。须验其麻色之红淡。法宜疏解。佐以清凉滋血安胎之药。不可
犯动胎气。初热时。宜用参苏饮去人参、半夏、木香、陈皮。加条实子芩、大腹皮以发之。或以四
物汤（见二十五条）加子芩、荆芥、苏叶、蕲艾主之。或以四物汤（见二十五条）加白术钱半、子芩、
蕲艾、枳壳、砂仁各二钱主之。或以安胎散、罩胎散主之。始终以安胎清热为主。则胎不动而麻易
出。此理诚当。愚按、孕妇出麻初热之时。而用四物汤加白术、艾叶、砂仁。与夫安胎散、罩胎散、
方中之人参、白术、川芎、砂仁、香附、白芍等味。恐燥悍之药。触动毒火。而热转甚。酸收之味。敛
固毒火。毒只内攻。麻难得出。症必增危。非但坠胎。且难保妊妇无虞。即如参苏饮。虽曰除去人
参、半夏、木香、陈皮。而要知桔梗、甘草亦不宜遽用。莫若以宣毒发表汤（见第五条）去升麻、桔
梗、甘草、枳壳、木通。加当归、条实子芩、生地黄、元参、酒炒黄连主之。使麻毒透出。内热自退。
而胎自安矣。麻出之后。则宜以四物汤（见二十五条）加条子芩、黄连、牛蒡子之类主之。至于麻
收之后。亦宜以四物（见二十五条）为主。如安胎散、罩胎散、四物加白术、砂仁、蕲艾、及安胎饮
等方。俱可加减选用。倘无溏泻。而大便闭涩结滞者。则人参、白术。又当慎用。大抵凡一切实脾
行气温燥之药。既碍麻症。复伤子气。咸宜禁用为是。
朱曰 妊娠出麻。在不知者必诧为希奇。其实男子在三十以内。亦间出麻。盖麻为先天
遗毒。于本人气血。原相融洽。故能留藏许久。而始发出。所云燥悍之药。触动
毒火。酸敛之味。敛固毒火。真是至理名言。当奉为金科玉律。
参苏饮
人参（三分） 苏叶 桔梗 葛根 前胡（各四分） 木香（一分五厘） 陈皮 茯苓（各五
分） 枳壳（三分） 半夏 甘草（各二分） 生姜引。水煎服。
安胎散
人参 白术 茯苓 甘草 川芎 当归身 陈皮 白芍药 大腹茸 连壳砂仁 苏叶
香附米 条实子芩 早米引。水煎服。初发热。加升麻、葛根、连翘。麻太多。加酒炒黄连、
牛蒡子、山楂肉。口渴。加麦冬、知母、天花粉。若系痘症。痘不起发。加牛蒡子。倍用白
芍。
罩胎散
白术 当归 白芷 白芍 茯苓 柴胡 川芎 阿胶 陈皮 砂仁 甘草 糯米引。水
煎服。一书、加干柿蒂七个。苎麻根七寸。甜瓜蒂一个。将药入银器内。放水二钟。以薄荷
叶盖定。煎至七分。去渣。仍将薄荷叶盖之。温服。（按苎麻根、苏叶。妊娠出麻初潮。用宣毒
发表汤内宜加入。）
安胎饮 孕妇出麻宜用。
条实子芩（沉水者加二钱） 白术 当归身 白芍药 人参（各一钱） 川芎 陈皮 苏叶
大腹皮（黑豆水浸、洗净、各八分） 连壳砂仁（姜汁炒） 甘草（各五分） 糯米一撮引。
孕妇感染麻疹若病情程度适中，虽见潮热蒸腾之象，胎儿容易受损；但若母体正气尚存，胎儿脱落后母亲无大碍；若症状轻微，则母子均无危险。
若高热蒸腾导致血海（指冲脉，主蓄积血液）枯竭，毒火内攻致使胎元不安，此时急需清热并滋养营血。若治疗不遵循正确法则，便会酿成祸端。
古人说：“胎遇热则坠。”麻疹属于火性燥热之邪，体内必然有热，最易导致堕胎。孕妇出麻疹，此症极为凶险。应当在初热阶段、疹点尚未发出之时，仔细察辨发热的轻重程度；在疹点正发出之际，必须查验疹色的红淡情况。治法宜用疏风解表之法，辅以清凉、滋血、安胎的药物。不可使用扰动胎气的药物。
在初热阶段，宜选用参苏饮，去掉人参、半夏、木香、陈皮，加入条实子芩、大腹皮以透发疹毒。或者选用四物汤（参见第二十五条），加入子芩、荆芥、苏叶、蕲艾为主方。或者选用四物汤（参见第二十五条），加入白术一钱半、子芩、蕲艾、枳壳、砂仁各二钱为主方。或者选用安胎散、罩胎散为主方。始终应以安胎、清热为主要原则，这样胎气不动而麻疹容易透出。这个理论确实恰当。
但我认为：孕妇出麻疹在初热阶段，使用四物汤加白术、艾叶、砂仁，以及安胎散、罩胎散等方剂中的人参、白术、川芎、砂仁、香附、白芍等药味，恐怕这些燥烈悍猛的药材会触动毒火，使热势更甚；酸收敛固的药味会使毒火内敛固结，导致毒火只能向内攻伐，麻疹难以透出，病情必定加重危险。这不仅会导致堕胎，而且难以保证孕妇平安。
就拿参苏饮来说，虽然去掉了人参、半夏、木香、陈皮，但要知道桔梗、甘草也不宜立即使用。不如选用宣毒发表汤（参见第五条），去掉升麻、桔梗、甘草、枳壳、木通，加入当归、条实子芩、生地黄、玄参、酒炒黄连为主方。使麻疹毒邪透出，内热自然消退，胎元自然安定。
麻疹发出之后，则宜以四物汤（参见第二十五条）加入条子芩、黄连、牛蒡子等为主方。至于麻疹收没之后，也宜以四物汤（参见第二十五条）为主方。如安胎散、罩胎散、四物汤加白术、砂仁、蕲艾，以及安胎饮等方剂，都可以加减选用。倘若没有腹泻，而大便闭涩结滞者，那么人参、白术又应当慎用。大抵凡是一切实脾、行气、温燥的药物，既妨碍麻疹病症，又会损伤胎儿之气，都应当禁止使用为宜。
朱氏说：妊娠期间出麻疹，在不知情的人看来必定觉得稀奇。其实男子在三十岁以内，也偶尔出麻疹。大概麻疹是先天遗留的毒邪，在本人气血中原本相融洽，所以能潜伏许久才发出。所谓“燥烈之药触动毒火，酸敛之味敛固毒火”，这真是至理名言，应当奉为金科玉律。
参苏饮
人参（三分） 苏叶 桔梗 葛根 前胡（各四分） 木香（一分五厘） 陈皮 茯苓（各五分） 枳壳（三分） 半夏 甘草（各二分） 生姜为引，水煎服。
安胎散
人参 白术 茯苓 甘草 川芎 当归身 陈皮 白芍药 大腹茸 连壳砂仁 苏叶 香附米 条实子芩 早米为引，水煎服。初发热时，加升麻、葛根、连翘；麻疹太多时，加酒炒黄连、牛蒡子、山楂肉；口渴时，加麦冬、知母、天花粉；若是痘症且痘不起发，加牛蒡子，倍用白芍。
罩胎散
白术 当归 白芷 白芍 茯苓 柴胡 川芎 阿胶 陈皮 砂仁 甘草 糯米为引，水煎服。另一版本：加干柿蒂七个，苎麻根七寸，甜瓜蒂一个。将药放入银器内，放水两钟，用薄荷叶盖住，煎至七分，去渣，仍将薄荷叶盖在上面，温服。（按语：苎麻根、苏叶，在妊娠出麻疹初起潮热时，应在宣毒发表汤中加入。）
安胎饮 孕妇出麻疹宜用。
条实子芩（沉水者加二钱） 白术 当归身 白芍药 人参（各一钱） 川芎 陈皮 苏叶 大腹皮（黑豆水浸、洗净，各八分） 连壳砂仁（姜汁炒） 甘草（各五分） 糯米一撮为引。
If the measles in a pregnant woman are moderate in severity, although tidal fever and steaming heat may occur causing potential harm to the fetus; if the mother's righteous qi remains sufficient, there will be no major issue even if the fetus is lost; if the symptoms are mild, both mother and child will remain unharmed.
If high fever and steaming heat deplete the Blood Sea (Chong Mai, which stores blood), and toxic fire attacks internally causing fetal instability, it is urgent to clear heat and nourish Ying-Blood. If treatment does not follow correct principles, disaster will ensue.
Ancient texts state: "The fetus falls when exposed to heat." Measles belong to the category of dry and hot pathogenic factors, inevitably generating internal heat, which most easily leads to abortion. Measles during pregnancy is an extremely critical condition. During the initial fever stage before the rash appears, one must carefully observe the severity of the fever; during the eruption phase, one must examine whether the color of the measles is bright red or pale. The treatment method should involve dispersing and resolving the exterior, assisted by cooling, blood-nourishing, and fetal-anchoring herbs. One must avoid using herbs that disturb the fetal qi.
During the initial fever stage, Shen Su Yin (Ginseng and Perilla Decoction) should be used, removing Ren Shen (Ginseng), Ban Xia (Pinellia Rhizome), Mu Xiang (Aucklandiae Radix), and Chen Pi (Citrus Peel), and adding Tiao Shi Zi Qin (Scutellariae Radix) and Da Fu Pi (Arecae Pericarpium) to promote eruption. Alternatively, Si Wu Tang (Four Substances Decoction) (see Article 25) can be used with added Zi Qin (Scutellariae Radix), Jing Jie (Schizonepetae Herba), Su Ye (Perillae Folium), and Qi Ai (Artemisiae Argyi Folium). Or, Si Wu Tang (see Article 25) can be used with added Bai Zhu (Atractylodis Macrocephalae Rhizoma, 1.5 qian), Zi Qin, Qi Ai, Zhi Qiao (Aurantii Fructus), and Sha Ren (Amomi Fructus, each 2 qian). Or, An Tai San (Fetal-Anchling Powder) or Zhao Tai San (Fetal-Covering Powder) can be used as the main formula. The principle should always be anchoring the fetus and clearing heat, so that the fetal qi remains stable and the measles erupt easily. This theory is indeed sound.
However, I opine that during the initial fever stage of measles in pregnancy, using Si Wu Tang with Bai Zhu, Ai Ye (Artemisiae Argyi Folium), and Sha Ren, as well as formulas like An Tai San and Zhao Tai San containing herbs such as Ren Shen, Bai Zhu, Chuan Xiong (Ligustici Chuanxiong Rhizoma), Sha Ren, Xiang Fu (Cyperi Rhizoma), and Bai Shao (Paeoniae Radix Alba), these dry and aggressive herbs might stir up toxic fire, exacerbating the heat. Sour and astringent flavors might consolidate the toxic fire internally, preventing it from venting outward, making it difficult for the measles to erupt, thereby worsening the condition dangerously. This could lead not only to abortion but also endanger the pregnant woman's life.
Take Shen Su Yin, for example. Although Ren Shen, Ban Xia, Mu Xiang, and Chen Pi are removed, one must realize that Jie Geng (Platycodonis Radix) and Gan Cao (Glycyrrhizae Radix et Rhizoma) should also not be used hastily. It is better to use Xuan Du Fa Biao Tang (Toxin-Releasing Exterior-Dispersing Decoction) (see Article 5), removing Sheng Ma (Ephedrae Herba - *Note: Text says Shengma but usually refers to Cimicifugae Rhizoma in this context, however literal translation of character is Ephedra, but standard TCM Sheng Ma is Cimicifuga. Given context of measles eruption, likely Cimicifuga, but sticking to text literalism or standard term? Standard term for 升麻 is Cimicifugae Rhizoma. I will use Cimicifugae Rhizoma*), Jie Geng, Gan Cao, Zhi Qiao, and Mu Tong (Akebiae Caulis), and adding Dang Gui (Angelicae Sinensis Radix), Tiao Shi Zi Qin, Sheng Di Huang (Rehmanniae Radix), Yuan Shen (Scrophulariae Radix), and Jiu Chao Huang Lian (Coptidis Rhizoma fried with wine). This allows the measles toxin to vent outward, internal heat will naturally recede, and the fetus will stabilize.
After the measles have erupted, Si Wu Tang (see Article 25) with added Zi Qin, Huang Lian (Coptidis Rhizoma), and Niu Bang Zi (Arctii Fructus) should be used as the main formula. After the measles have resolved, Si Wu Tang (see Article 25) should still be the basis. Formulas such as An Tai San, Zhao Tai San, Si Wu Tang with Bai Zhu, Sha Ren, Qi Ai, and An Tai Yin (Fetal-Anchoring Decoction) can all be selected and modified as needed. If there is no loose stool, but constipation and stagnation, then Ren Shen and Bai Zhu should be used with caution. Generally, all herbs that strengthen the spleen, move qi, and are warm and dry should be strictly prohibited, as they hinder the measles pathology and damage the fetal qi.
Zhu stated: Measles during pregnancy seem rare to those unfamiliar with them. In fact, men under thirty also occasionally contract measles. Measles are considered congenital latent toxins that originally harmonize with the individual's qi and blood, allowing them to remain dormant for a long time before erupting. The statement that "dry and aggressive herbs stir up toxic fire, while sour and astringent flavors consolidate toxic fire" is truly profound wisdom and should be regarded as an inviolable rule.
Shen Su Yin (Ginseng and Perilla Decoction)
Ren Shen (Panacis Ginseng Radix, 3 fen) Su Ye (Perillae Folium) Jie Geng (Platycodonis Radix) Ge Gen (Puerariae Lobatae Radix) Qian Hu (Peucedani Radix) (each 4 fen) Mu Xiang (Aucklandiae Radix, 1.5 fen) Chen Pi (Citri Reticulatae Pericarpium) Fu Ling (Poria) (each 5 fen) Zhi Qiao (Aurantii Fructus, 3 fen) Ban Xia (Pinelliae Rhizoma) Gan Cao (Glycyrrhizae Radix et Rhizoma) (each 2 fen) Use Sheng Jiang (Zingiberis Rhizoma Recens) as a guide. Decoct in water and take orally.
An Tai San (Fetal-Anchoring Powder)
Ren Shen Panax Ginseng Radix Bai Zhu Atractylodis Macrocephalae Rhizoma Fu Ling Poria Gan Cao Glycyrrhizae Radix et Rhizoma Chuan Xiong Ligustici Chuanxiong Rhizoma Dang Gui Shen Angelicae Sinensis Radix (body part) Chen Pi Citri Reticulatae Pericarpium Bai Shao Paeoniae Radix Alba Da Fu Rong Arecae Pericarpium Sha Ren Amomi Fructus (with shell) Su Ye Perillae Folium Xiang Fu Cyperi Rhizoma Tiao Shi Zi Qin Scutellariae Radix Use Zao Mi (Oryza Sativa Germ) as a guide. Decoct in water and take orally. For initial fever, add Sheng Ma (Cimicifugae Rhizoma), Ge Gen, and Lian Qiao (Forsythiae Fructus). For excessive measles, add Jiu Chao Huang Lian and Niu Bang Zi. For thirst, add Mai Dong (Ophiopogonis Radix), Zhi Mu (Anemarrhenae Rhizoma), and Tian Hua Fen (Trichosanthis Radix). If it is smallpox and the lesions fail to erupt, add Niu Bang Zi and double the amount of Bai Shao.
Zhao Tai San (Fetal-Covering Powder)
Bai Zhu Atractylodis Macrocephalae Rhizoma Dang Gui Angelicae Sinensis Radix Bai Zhi Angelicae Dahuricae Radix Bai Shao Paeoniae Radix Alba Fu Ling Poria Chai Hu Bupleuri Radix Chuan Xiong Ligustici Chuanxiong Rhizoma E Jiao Asini Corii Colla Chen Pi Citri Reticulatae Pericarpium Sha Ren Amomi Fructus Gan Cao Glycyrrhizae Radix et Rhizoma Use Nuomi (Oryza Sativa Japonica Glutinosa Rice) as a guide. Decoct in water and take orally. Another version: Add seven dried persimmon calyces (Qian Shi Di), seven cun of Zhuma Gen (Ramie Root), and one sweet melon stalk tip (Tian Gua Di). Place herbs in a silver vessel, add two zhong of water, cover with Bo He Ye (Menthae Haplocalycis Folium), decoct until three-tenths remain, strain, cover again with Bo He Ye, and take warm. (Note: Zhuma Gen and Su Ye should be added to Xuan Du Fa Biao Tang during the initial tidal fever of measles in pregnancy.)
An Tai Yin (Fetal-Anchoring Decoction) Suitable for measles during pregnancy.
Tiao Shi Zi Qin Scutellariae Radix (add 2 qian if it sinks in water) Bai Zhu Atractylodis Macrocephalae Rhizoma Dang Gui Shen Angelicae Sinensis Radix (body part) Bai Shao Paeoniae Radix Alba Ren Shen Panacis Ginseng Radix (each 1 qian) Chuan Xiong Ligustici Chuanxiong Rhizoma Chen Pi Citri Reticulatae Pericarpium Su Ye Perillae Folium Da Fu Pi Arecae Pericarpium (soaked in black soybean water, washed, each 8 fen) Sha Ren Amomi Fructus (stir-fried with ginger juice) Gan Cao Glycyrrhizae Radix et Rhizoma (each 5 fen) Use a pinch of Nuomi (Oryza Sativa Japonica Glutinosa Rice) as a guide.