微汗常出热不留。初出未收总沐庥。升发之味须禁用。用之大泄反为仇。
自汗之症属阳虚。麻后见之更可危。勿令见风成痉病。治阴抑阳症自除。
发热浑身汗最宜。元府开豁麻出时。卫中表邪从此散。汗多亡阳又忌之。
壮热无汗大非吉。不因风寒因火郁。自始至末总无汗。纵麻已收症百出。
麻有自汗、微汗、大汗、无汗等症。而均有宜有忌。麻初出至未收之时。皆宜微汗。有微汗则
皮肤通畅。腠理开豁。而麻易透。发热之际。有自汗者。则有发散之义。乃为常候。（朱曰 微汗、
自汗。皆为美候。）盖麻遇自汗。则毒从汗解。元府开而麻毒透。卫中之表邪。则从之而散矣。不
可遽止。亦不可复用升发之剂。若自汗而更升发。恐汗大泄。致有亡阳之患。夫自汗之症。原属阳
虚。初时无妨。若麻后自汗。多成痉病。切勿见风。法当治阴抑阳。使腹内虚热清退。而汗自止。以
四物汤（见二十五条）仍去白芍、川芎。加元参、牡蛎粉主之。如麻后自汗。兼不食吐蛔者。真是
虚症。最为难治。（朱曰 自汗不食吐蛔。又为难治之虚证。）亦宜以四物汤（见二十五条）加牡
蛎、藿香、KT 石斛。用旧蒲扇或旧蒲席烧灰研细末。入药中调服。若误投药饵。传变多端。难收功
矣。切勿拘治麻初起常法。而用辛温解散之剂。如果系脾热。可用泻黄散去甘草。因症加减而治。
则又可循麻初之常法矣。若自汗而烦渴气壅脉数者。则以静远主人化斑汤加栝蒌霜主之。至于
大汗过多之症。则有二因。一因衣被盖浓。而致大汗过多者。一因用升发之剂过甚。而发汗过多
者。二者皆不宜也。（朱曰 大汗本非正治。只可偶用。）盖恐大汗过多。致有亡阳之变。轻则症难
脱体。重则多有不救。倘遇麻有隐暗不透之坏症。从权施治。而用升发之剂。取其大汗。使毒从汗
解。此特语其变。而非正治也。然亦多凶。经曰。汗多亡阳。急须止之。以秘本黄连汤或当归六
黄汤。外用温粉扑法治之。（有以人参白虎汤合古方黄连解毒汤治之者。似乎未当。方仍列后备
用。）若妇人麻后汗多。心慌神昏者。亦有因而致。不可不察。有因麻症初起。适遇经行。麻乃火
候。心火旺盛。荣血多亏。今又月期适至。血又下泄。亏耗大过。至麻收之后。气血两虚。未有不成
汗多怔忡神昏等候。（朱曰 麻后气血两虚。又有汗多怔忡等证。）急宜以玉屏散加牡蛎粉与服。
以止其汗。免至亡阳。旋用人参养荣汤。去桂心、五味子。多加牡蛎粉、龙骨。数大剂与服。须宜急
治。迟则不救。若麻症初起。壮热而无汗者。多因外感风寒太重。以致皮肤干燥。毛窍不开。麻疹
壅滞。而汗亦难出。多成内攻之症。（朱曰 麻证无汗。多成内攻之症。寒凉降火清肺。佐以升发。
是救急治法。）或肚腹胀痛。或发喘促。夏秋之间。宜微升散。以葛根解肌汤（见第五条）去赤芍、
甘草。加木通、枳壳治之。春冬寒月。重为发散。如加味三拗汤去桔梗、甘草。或葛根疏邪汤（见三
十三条）加炒麻黄治之。但不可过剂。使浑身常得微汗为妙。有微汗则腠理润泽。而麻易出。又
有一等。因热极火郁而无汗。亦致皮肤干燥而不活泽。麻亦难出。此症外必见唇舌破裂。二便结
涩。昏沉壮热。或身痛肚腹胀疼。多发喘促。 痰鸣。不拘何时。无分迟早。急用寒凉降火清肺
之剂。佐以升发之药。以白虎解毒汤（见二十六条）加地骨皮、贝母、元参、牛蒡子、前胡、干葛治
之。迟则恐成坏症。大抵麻症常以微汗为顺。自始至末。必以得汗为妙。经曰。微汗常出热。热越
而不留。此之谓也。若始终无汗。麻难收敛。后必有余症。宜用寒凉升发解毒为当。
泻黄散
防风（四钱） 栀仁（炒黑一钱） 藿香叶（七分） 石膏（五钱） 甘草（二
钱） 为末。白汤下。或用蜜同酒拌炒。仍用白汤下。
加味三拗汤
麻黄（不去节三钱） 杏仁（不去皮尖油二十粒） 生甘草 荆芥穗 桔梗 水煎服。
静远主人化斑汤
石膏 知母 元参 麦冬 牛蒡子 连翘 黄芩 地骨皮 淡竹叶 水煎服。
秘本黄连汤
黄连 黄柏 黄芩 麦冬 生地黄 当归 生黄 水煎。加入烧蒲扇灰调服。
当归六黄汤 治自汗、盗汗。
当归 生地黄 熟地黄 黄 （蜜炒各一钱） 黄芩 黄连 黄柏（各五分） 水煎服。
温粉扑法
黄连 牡蛎粉 贝母（各五钱） 粳米粉（一升） 为末。扑身上。
玉屏风散
黄 （炙炒一两） 大当归（六钱） 陈糯米（一合炒黄色） 水煎服。
玉屏散 治自汗不收。气虚表弱。
黄 （蜜炒） 防风（各一两） 白术（土炒五钱） 生姜、红枣引。水煎服。
人参养营汤 治脾经气虚。营血不足。惊悸健忘。寝汗发热。食少无味。身倦肌瘦。
人参 白术（土炒） 黄 （蜜炒） 炙甘草 陈皮 全当归 桂心（各一钱） 熟地黄 五味子（蜜炒）
白茯苓（各七分） 白芍药（酒炒八分） 远志肉（去骨甘草水煮五分） 生姜、红枣引。水煎服。
人参白虎汤（见六十四条）
黄连解毒汤（见三十五条）
微汗持续出现，热邪便不会滞留。麻疹初出至未收没之前，总得依靠这种汗法来庇护机体。升散发越的药物必须禁用，若误用导致大汗淋漓，反而会成为致病之仇敌。
自汗这一症状属于阳气虚弱。在麻疹之后出现自汗，情况更加危险。切勿让患者受风，以免引发痉病（抽搐痉挛）。治疗上应滋阴以制约阳亢，症状自然消除。
发热时全身微微出汗最为适宜，此时玄府（汗孔）开豁，是麻疹透发的时机。卫分中的表邪从此得以消散。但若汗出过多导致亡阳（阳气暴脱），则又是禁忌。
高热且无汗是大凶之兆。这并非因为风寒，而是由于火邪郁结。从开始到结束始终无汗，即使麻疹已经收没，也会变证百出。
麻疹有自汗、微汗、大汗、无汗等症状，但每种情况都有适宜和禁忌之处。从麻疹初出到未收没的期间，都适宜保持微汗。有微汗则皮肤通畅，腠理开豁，麻疹容易透出。在发热之际，若有自汗现象，则具有发散邪气的作用，这是正常征象。（朱氏说：微汗、自汗，都是良好的征象。）大概麻疹遇到自汗，毒邪便随汗而解，玄府开通而麻毒透发，卫分中的表邪也随之消散。不可立即止汗，也不可再次使用升散发越的药物。如果自汗而又再用升散药，恐怕会导致大汗淋漓，造成亡阳的祸患。自汗这一症状，原本属于阳气虚弱，初期无妨；若在麻疹后出现自汗，多会形成痉病，千万不可见风。治法应当滋阴抑阳，使腹内虚热清退，汗自然停止。可用四物汤（见第二十五条），去掉白芍、川芎，加入玄参、牡蛎粉为主方。如果麻疹后自汗，兼有不进食、吐蛔虫的情况，这真是虚证，最为难治。（朱氏说：自汗不食且吐蛔，又是难以治疗的虚证。）也宜用四物汤（见第二十五条）加牡蛎、藿香、石斛。用旧的蒲扇或旧蒲席烧成灰研成细末，调入药中服用。如果误投药物，病情传变多端，很难取得疗效。切勿拘泥于麻疹初起的常规治法，而使用辛温解散的药物。如果确实是脾热，可用泻黄散去甘草，根据症状加减治疗，这样又可以遵循麻疹初起的常规治法了。如果自汗且伴有烦躁口渴、气壅脉数，则以静远主人的化斑汤加栝蒌霜为主方。至于大汗过多的症状，有两个原因：一是因衣被盖得太厚，导致大汗过多；二是因使用升散发汗的药物过猛，导致发汗过多。这两种情况都不适宜。（朱氏说：大汗本来不是正治之法，只可偶尔使用。）大概是担心大汗过多，导致亡阳的变化。轻则症状难以脱离险境，重则多有无法挽救的。倘若遇到麻疹隐暗不透的坏证，权宜施治，使用升散发汗的药物，取其大汗，使毒邪随汗而解，这只是说明变通之法，并非正治。然而这也多属凶险。经书说：汗多则亡阳，急需止汗。可用秘本黄连汤或当归六黄汤，外用温粉扑法治疗。（有人用人参白虎汤合古方黄连解毒汤治疗，似乎不太恰当，方剂仍列在后面备用。）如果妇女麻疹后汗多，心慌神昏的，也有因此导致的，不可不仔细考察。有的因麻疹初起，适逢月经来潮，麻疹属火性，心火旺盛，营血本就亏损，如今又值经期，血液下泄，亏耗过大，直到麻疹收没之后，气血两虚，没有不出现汗多、怔忡（心悸）、神昏等状况的。（朱氏说：麻疹后气血两虚，又有汗多怔忡等证。）急宜用玉屏散加牡蛎粉服用，以止其汗，避免亡阳。随后用人参养荣汤，去掉桂心、五味子，多加牡蛎粉、龙骨，大量多次服用。必须紧急治疗，迟则无法挽救。如果麻疹初起，壮热而无汗的，多因外感风寒太重，导致皮肤干燥，毛窍不开，麻疹壅滞，汗也难以出来，多形成内攻的病症。（朱氏说：麻疹证无汗，多形成内攻的病症。寒凉降火清肺，佐以升发，是救急的治法。）或者肚腹胀痛，或者气喘急促。夏秋之间，宜轻微升散，用葛根解肌汤（见第五条）去掉赤芍、甘草，加木通、枳壳治疗。春冬寒冷月份，加重发散力度，如加味三拗汤去掉桔梗、甘草，或葛根疏邪汤（见第三十三条）加炒麻黄治疗。但不可过量，使浑身常得微汗为妙。有微汗则腠理润泽，麻疹容易发出。又有一类情况，因热极火郁而无汗，也导致皮肤干燥而不润泽，麻疹也难以发出。此症外部必然见到唇舌破裂，二便结涩，昏沉高热，或者身痛肚腹胀疼，多发气喘急促、痰鸣。无论何时，不分迟早，急用寒凉降火清肺的药物，佐以升发的药物，用白虎解毒汤（见第二十六条）加地骨皮、贝母、玄参、牛蒡子、前胡、干葛治疗。迟则恐怕形成坏证。大抵麻疹证通常以微汗为顺证，从头到尾，必须以得汗为妙。经书说：微汗常出，热邪散发而不滞留，说的就是这个道理。如果始终无汗，麻疹难以收敛，后来必定有余留的症状，宜用寒凉升发解毒的方法为当。
泻黄散
防风（四钱） 栀仁（炒黑一钱） 藿香叶（七分） 石膏（五钱） 甘草（二钱） 研为末。白开水送服。或用蜜同酒拌炒，仍用白开水送服。
加味三拗汤
麻黄（不去节三钱） 杏仁（不去皮尖油二十粒） 生甘草 荆芥穗 桔梗 水煎服。
静远主人化斑汤
石膏 知母 玄参 麦冬 牛蒡子 连翘 黄芩 地骨皮 淡竹叶 水煎服。
秘本黄连汤
黄连 黄柏 黄芩 麦冬 生地黄 当归 生黄芪 水煎。加入烧过的蒲扇灰调服。
当归六黄汤 治疗自汗、盗汗。
当归 生地黄 熟地黄 黄芩（蜜炒各一钱） 黄柏（各五分） 黄连 黄芩（各五分） 水煎服。
*注：原文此处“黄”字疑似缺字，结合方义及常见配伍，通常指黄芪，但依原文仅译“黄”。*
温粉扑法
黄连 牡蛎粉 贝母（各五钱） 粳米粉（一升） 研为末。扑在身上。
玉屏风散
黄芪（炙炒一两） 大当归（六钱） 陈糯米（一合炒黄色） 水煎服。
玉屏散 治疗自汗不收，气虚表弱。
黄芪（蜜炒） 防风（各一两） 白术（土炒五钱） 生姜、红枣为引。水煎服。
人参养荣汤 治疗脾经气虚，营血不足，惊悸健忘，寝汗发热，食少无味，身倦肌瘦。
人参 白术（土炒） 黄芪（蜜炒） 炙甘草 陈皮 全当归 桂心（各一钱） 熟地黄 五味子（蜜炒） 白茯苓（各七分） 白芍药（酒炒八分） 远志肉（去骨甘草水煮五分） 生姜、红枣为引。水煎服。
人参白虎汤（见第六十四条）
黄连解毒汤（见第三十五条）
Continuous mild sweating prevents heat from lingering. From the initial eruption to the resolution of measles, this type of sweating is essential for protecting the body. Aromatic and ascending herbs must be strictly prohibited; if misused causing profuse sweating, they become enemies rather than remedies.
Spontaneous sweating (Zi Han) belongs to Yang deficiency. Its appearance after measles is particularly critical. One must prevent exposure to wind to avoid convulsions (Jing Bing). The treatment should focus on nourishing Yin to restrain hyperactive Yang, thereby resolving the symptoms.
Mild whole-body sweating during fever is most appropriate, as it indicates open Yuan Fu (sweat pores), facilitating the eruption of measles. Pathogenic factors in the Wei (Defensive) level are thus dispersed. However, excessive sweating leading to collapse of Yang (Wang Yang) is contraindicated.
High fever with no sweating is a dire omen. This is not due to Wind-Cold but to Fire constraint. Persistent absence of sweating from onset to resolution, even after the rash subsides, leads to numerous complications.
Measles may present with spontaneous sweating, mild sweating, profuse sweating, or anhidrosis, each having specific indications and contraindications. Throughout the period from initial eruption to resolution, mild sweating is preferred. Mild sweating ensures smooth skin and open Cou Li (interstices), allowing the measles to emerge easily. During fever, spontaneous sweating has a dispersing effect and is considered a normal sign. (Zhu stated: Both mild and spontaneous sweating are auspicious signs.) Generally, when measles encounter spontaneous sweating, toxins are resolved through sweat, Yuan Fu opens, and measles toxins erupt, while pathogenic factors in the Wei level disperse. One must not abruptly stop sweating nor re-administer ascending/dispersing agents. If ascending agents are used despite existing spontaneous sweating, it may cause profuse sweating and lead to collapse of Yang. Spontaneous sweating originally stems from Yang deficiency; it is harmless initially, but if it occurs after measles, it often leads to convulsions. Wind exposure must be avoided. The method should be to nourish Yin and suppress Yang, clearing internal deficient heat so that sweating stops naturally. Use Si Wu Tang (see Article 25), removing Bai Shao and Chuan Xiong, adding Xuan Shen and Mu Li Fen. If post-measles spontaneous sweating is accompanied by anorexia and vomiting of roundworms, it is a severe deficiency syndrome, very difficult to treat. (Zhu stated: Spontaneous sweating with anorexia and vomiting of worms is another difficult deficiency syndrome.) One may also use Si Wu Tang (see Article 25) added with Mu Li, Huo Xiang, and Shi Hu. Burn old palm fans or mats to ash, grind into fine powder, and mix with the medicine. Mismedication can lead to complex transformations and poor outcomes. Do not rigidly apply standard early-measles treatments using acrid-warm dispersing agents. If Spleen Heat is confirmed, use Xie Huang San removing Gan Cao, adjusting according to symptoms, which aligns with standard early-measles protocols. For spontaneous sweating with irritability, thirst, Qi stagnation, and rapid pulse, use Jing Yuan Zhu Ren's Hua Ban Tang added with Gua Lou Shuang.
Profuse sweating has two causes: excessive bedding causing overheating, or overuse of ascending/dispersing agents. Neither is desirable. (Zhu stated: Profuse sweating is not a standard treatment and should only be used occasionally.) The concern is that profuse sweating may cause collapse of Yang. Mild cases may fail to recover; severe cases may be fatal. In cases of obscured measles failing to erupt, one might temporarily use ascending agents to induce profuse sweating to resolve toxins via sweat. This is a variable method, not standard treatment, and carries high risk. As the Classics state: "Excessive sweating leads to collapse of Yang; stop it immediately." Use Mi Ben Huang Lian Tang or Dang Gui Liu Huang Tang, externally applying Wen Fen Pu Fa. (Some use Ren Shen Bai Hu Tang combined with Huang Lian Jie Du Tang, which seems inappropriate; these formulas are listed below for reference.) In women, post-measles profuse sweating with palpitations and mental confusion may result from menstruation coinciding with measles. Measles involves Fire; Heart Fire is strong, and Ying Blood is already depleted. Menstruation further depletes blood. After measles resolution, both Qi and Blood are deficient, leading to profuse sweating, palpitations, and confusion. (Zhu stated: Post-measles Qi and Blood deficiency includes profuse sweating and palpitations.) Urgently administer Yu Ping San added with Mu Li Fen to stop sweating and prevent Yang collapse. Subsequently, use Ren Shen Yang Rong Tang, removing Gui Xin and Wu Wei Zi, adding large amounts of Mu Li Fen and Long Gu, administered in large doses. Immediate treatment is crucial; delay is fatal.
If early measles present with high fever and anhidrosis, it is often due to severe external Wind-Cold causing dry skin and closed pores, obstructing measles eruption and leading to internal attack. (Zhu stated: Anhidrosis in measles often leads to internal attack. Cooling, descending fire, clearing Lung, assisted by ascending herbs is an emergency treatment.) Symptoms may include abdominal distension/pain or wheezing. In summer/autumn, use mild ascending/dispersing methods: Ge Gen Jie Ji Tang (see Article 5) removing Chi Shao and Gan Cao, adding Mu Tong and Zhi Ke. In winter/spring cold months, increase dispersing strength: Jia Wei San Ao Tang removing Jie Geng and Gan Cao, or Ge Gen Shu Xie Tang (see Article 33) added with Chao Ma Huang. Do not overdose; aim for continuous mild sweating to keep Cou Li moist and facilitate eruption. Another cause of anhidrosis is extreme heat and Fire constraint, causing dry, unyielding skin and difficult eruption. External signs include cracked lips/tongue, constipation/dysuria, lethargy, high fever, body pain, abdominal distension, wheezing, and phlegm rattle. Regardless of timing, urgently use cooling/descending fire/clearing Lung herbs assisted by ascending agents: Bai Hu Jie Du Tang (see Article 26) added with Di Gu Pi, Bei Mu, Xuan Shen, Niu Bang Zi, Qian Hu, and Gan Ge. Delay risks complicated syndromes. Generally, mild sweating is favorable in measles; obtaining sweat throughout is ideal. The Classics state: "Continuous mild sweating allows heat to dissipate without lingering." If there is no sweat throughout, measles cannot resolve properly, leaving residual symptoms. Cooling, ascending, and detoxifying methods are appropriate.
Xie Huang San
Fang Feng (4 qian), Zhi Ren (stir-fried black, 1 qian), Huo Xiang Ye (0.7 fen), Shi Gao (5 qian), Gan Cao (2 qian). Grind to powder. Take with warm water. Or stir-fry with honey and wine, then take with warm water.
Jia Wei San Ao Tang
Ma Huang (without root ends, 3 qian), Xing Ren (with skin and tip, oil removed, 20 grains), Sheng Gan Cao, Jing Jie Sui, Jie Geng. Decoct in water.
Jing Yuan Zhu Ren Hua Ban Tang
Shi Gao, Zhi Mu, Xuan Shen, Mai Dong, Niu Bang Zi, Lian Qiao, Huang Qin, Di Gu Pi, Dan Zhu Ye. Decoct in water.
Mi Ben Huang Lian Tang
Huang Lian, Huang Bo, Huang Qin, Mai Dong, Sheng Di Huang, Dang Gui, Sheng Huang. Decoct. Mix in ash from burned palm fan.
Dang Gui Liu Huang Tang Treats spontaneous sweating and night sweats.
Dang Gui, Sheng Di Huang, Shu Di Huang, Huang [Qi] (honey-fried, 1 qian each), Huang Qin, Huang Lian, Huang Bo (0.5 fen each). Decoct in water.
Wen Fen Pu Fa
Huang Lian, Mu Li Fen, Bei Mu (5 qian each), Jing Mi Fen (1 sheng). Grind to powder. Apply to the body.
Yu Ping Feng San
Huang [Qi] (roasted, 1 liang), Da Dang Gui (6 qian), Chen Nu Mi (1 he, stir-fried yellow). Decoct in water.
Yu Ping San Treats unremitting spontaneous sweating, Qi deficiency, and weak exterior.
Huang [Qi] (honey-fried), Fang Feng (1 liang each), Bai Zhu (earth-fried, 5 qian). Use Sheng Jiang and Hong Zao as guides. Decoct in water.
Ren Shen Yang Rong Tang Treats Spleen Qi deficiency, Ying-Blood insufficiency, palpitations, amnesia, night sweats, fever, anorexia, aversion to taste, fatigue, emaciation.
Ren Shen, Bai Zhu (earth-fried), Huang [Qi] (honey-fried), Zhi Gan Cao, Chen Pi, Quan Dang Gui, Gui Xin (1 qian each), Shu Di Huang, Wu Wei Zi (honey-fried), Bai Fu Ling (0.7 fen each), Bai Shao Yao (wine-fried, 0.8 fen), Yuan Zhi Rou (de-boned, boiled in Gan Cao water, 0.5 fen). Use Sheng Jiang and Hong Zao as guides. Decoct in water.
Ren Shen Bai Hu Tang (see Article 64)
Huang Lian Jie Du Tang (see Article 35)