麻出高耸润泽点。清解重施肺无险。自表至里渐次收。肤无疮痕名为敛。
麻出一日即便收。非冒风寒即挟热。误食酸物亦能致。三者源来有分别。
旋出旋收病势轻。连绵不尽势堪惊。化斑解毒令消灭。莫使余邪集病身。
麻疹出收合阴阳。出以温和收以凉。连出不收阳气盛。迟迟间出是阴强。
麻疹出收。常以六时为准。如子后出。午时即收。午后出。子时即收。乃阳生阴长。阴生阳成。
造化自然之数也。凡此旋出旋收者。乃为易收。其症则轻。然麻之易收。必须先时麻出高耸。粒尖
淡红色润。以其毒轻。而肌表易清。肺无加咳。故易收也。又有一等。火毒虽重。而重施清解。以致
肺胃火邪悉退而易收者有之。然必于三日之间。从肌表而渐收于里。或三日之间。一时收尽。肤
上并无疮痕形影者。方为易收。治者当详审之。若麻出一日而收者。乃见风大早。为风寒所冲。
麻毒内攻。未清爽者。非为易收。急宜施治。若不早治。必致胃烂而死。宜以葛根疏邪汤(见三十
三条)主之。虽不复出。亦无后患。即三日后麻已收敛明白。如有被风寒所袭者。亦宜以此方主
之。至于早收。则与易收不同。早收者。麻出未经三日。或一二日、或半日而收尽。周身肌肤暖
处。绝无红影。乃为早收。终变危候。若虽未经三日而早收。肌肤上暖处。尚未全收。其毒未尽而
攻于内。急宜清毒、解肌、透表以救之。宜用解毒快斑汤。去楂肉、生甘草、川芎、桔梗、紫草茸。加
石膏、知母、元参治之。发之不起。当审其所因。而与内解。何则。早收之候有三因。一因正出未
透之际。而胃风寒。麻因风寒所遏。邪反内攻。以致早收。宜以葛根疏邪汤(见三十三条)加葱白
与之热服。或以消毒饮(见二十二条)去甘草加葱白、葛根与之热服。服后便透者吉。不透。再用
消毒饮(见二十二条)去甘草、加酒蜜炒麻黄。有更加穿山甲者。当酌量而加以治之。不急治。必
发喘胀而死。亦有遍身青紫热肿。喘胀气急。此毒滞血凝。半匿肌表。急用河间凉膈散(见第二十
六条)去大黄、芒硝、甘草。加元参、紫草茸、丑牛、蜜炒麻黄、石膏以发越之。若腹胀喘促、溺清脐
突者。以河间凉膈散(见二十六条)去大黄、芒硝。加丑牛、葶苈、芥子治之。庶或可救一二。一因
内挟热痰。火毒抗剧而伏匿。烦躁或腹胀喘急。不省人事者。以白虎解毒汤(见二十六条)除天
花粉、淡竹叶。加元参、牛蒡子、连翘、栝蒌霜治之。一因误食酸醋收敛之物。以致肺脏不通。毛
窍闭密而伏匿。壮热喘咳烦闷者。以猪胆汁煮甘草煎汤。续续与服。或以苦瓠同生甘草煎浓汤
灌之以探吐。吐中便有发越之义。然仍宜疏托。当以消毒饮(见二十二条)去甘草与服。如误食
猪肉。喘胀气急者。亦以消毒饮(见二十二条)去甘草。加枳壳、丑牛、楂肉以下夺之。有用枳壳汤
去浓朴、甘草。加神曲、麦芽治之者。确无济于事。若误食桃李生冷、喘咳声喑者。以消毒饮(见二
十二条)加木通、枳壳、石膏、马兜铃。去生甘草主之。果得热退身安。气息渐调者。方可无虞。又
有因大病或久病之后而出麻。其人中气虚耗。致毒不能发越而收早者。或有因初潮始热之时。
泄泻久经不止。或未发热之先。曾经洞泄者。亦致中气虚损。麻才出尽而随即收者。此数者。虽
用疏托之药。而毒终难发尽。惟当健运中气。略兼解表清热之剂。如香砂六君汤去半夏。少用白
术、木香、砂仁等分。加麦冬、连翘、牛蒡子、酒炒黄连、酒炒黄芩、荆芥、防风、葛根之类。可以
施用。(愚意当以沙参易人参。薏苡仁易白术。木香砂仁可除。更可加贝母。)但与微整门户。仍即
用消毒之剂。如消毒饮(见二十二条)又宜继用。慎勿迟延。恐致肺胃败烂而不救。若麻已出而
复收。(有用当归红花饮加葱白、牛蒡子、连翘、葛根、治之者。大为不妥。姑录是方证谬。)或出不
尽。心慌啼哭不止。十分危急。死在须臾。或下痢腹痛。(有用黄芩、白芍二味治之者。不妥。)须当
以解毒快斑汤去桔梗、甘草、楂肉、紫草茸、川芎加枳壳、赤茯苓。随症加减治之。大抵麻在三四
日之后。觉渐次收敛。方为顺候。然必待肌表清凉。麻方能收。若麻出致三四日、五七日不收者。
肌肤必然壮热。此为难收之症。宜用解肌凉血之剂。佐以利水之药。以凉血饮子(见四十五条)除
去赤芍。加木通、赤茯苓、枳壳、葛根主之。若一出连绵至四五日不收者。乃阳毒大甚。须用化斑
解毒汤。去升麻、大黄。加黄连、黄芩、生地黄、地骨皮以解之。便闭而有腹疼者。并用大黄以利
之。或以秘本大青汤(见第四十条)去升麻、桔梗。加黄连、地骨皮、黄芩、生地黄以解之。便闭腹
疼者。加丑牛以利之。解其毒使之发于外。庶里无余邪。免生后患。若解之而仍逡巡不出者。乃
风寒外束。皮肤秘密也。宜以葛根疏邪汤(见三十三条)加薄荷、地骨皮治之。若麻点带白燥色。
隐隐于肌表之间。似收非收。而实不收者。此必因风寒所绊。而不能透表。非难收也。宜急用疏托
之剂。佐以寒凉之药。以葛根解肌汤(见第五条内)去赤芍药、甘草。加防风、黄芩治之。若肌肤
之上无点粒。惟见如片。肤平不高。此为易收而未收尽也。宜用解肌之药。亦以葛根解肌汤(见
第五条)去赤芍、甘草。随症加减治之。如见有内热之症。亦宜清内热。倘内热不除。多致不能尽
收。如生地骨皮汤(见三十条)去甘草。古方黄连解毒汤。(见三十五条)加味导赤散。俱可选用。
加减而施。
张璐先生曰。西北水土刚劲。禀质亦浓。麻必五七日乃收。东南风气柔弱。麻出不过二三日
即收。迩来地运变迁。无分西北东南。体质均弱。未有不绵延日久方收者。当非难收之比。若三
四日后。麻疹点燥色白。隐隐于肌肤之间而难收者。此必卫气素弱。不能掀发。或因衣被单薄。致
冒风寒。阻其发越之机。以致延绵多日。法当用辛散透表之剂。如荆芥、葛根、前胡、牛蒡子、西
河柳、麻黄之类。以发散之。淡竹叶、元参、薄荷、蝉蜕之类以透肌。切不可遽用寒凉。闭其开泄
之路。此训可以为万世治麻大法。
朱曰 予治麻必经六七日始收。从未有三日即收者。今读张石顽先生此训。乃恍然。
解毒快斑汤 麻疹现形一二日宜用。
连翘 牛蒡子 防风 荆芥穗 当归尾 桔梗(各七分) 生地黄 楂肉(各八分) 蝉
蜕(去头足七只) 黄芩 紫草茸(各六分) 干葛(一钱) 西河柳(五分) 川芎(五分) 生甘草(去皮三
分) 水煎。以犀角磨汁对服
枳壳汤
浓朴(去皮姜汁炒) 陈皮(姜汤泡去白各三钱) 枳壳(麸炒四钱) 炙甘
草(三钱) 水煎服。
香砂六君汤 治气虚痰滞、食滞、气滞等症。
人参 白术 白茯苓 炙甘草 陈皮 半夏 木香 砂仁 红枣、姜引。
当归红花饮 治麻已出而复收。(系备用方)
当归(酒炒) 红花 葛根 连翘 牛蒡子 甘草 水煎服 一书有升麻。一书有生白芍、
桔梗。
化斑解毒汤
元参 知母 石膏 牛蒡子 连翘 大黄(酒蒸) 人中黄(火 另研) 淡竹叶 升麻 水煎。调人
中黄服。
加味导赤散
薄荷叶(四分) 生地黄(酒洗) 木通 元参 车前子(炒研末) 淡竹叶(各七分) 连翘(六分
)黄连(二分) 灯心、石膏引。
麻疹出疹高耸且润泽,点状清晰。此时若再次重用清解之法,肺脏便无危险。疹毒从体表向体内逐渐消退,皮肤上不留疮痕,这称为“敛”(收没)。
如果麻疹发出后一天就立即收没,这不是因为冒受风寒,就是兼夹热邪。误食酸味食物也能导致这种情况。这三种情况的病因来源是有区别的。
疹子刚出来不久就迅速收没的,病情较轻;连绵不断、迟迟不收的,病势令人惊恐。应当使用化斑解毒汤来消除病邪,不要让残余的病邪聚集在患者身上。
麻疹的发出与收没符合阴阳规律:发出时要温和,收没时要清凉。连续发出而不收没,说明阳气过盛;迟迟间断地发出,说明阴气偏强。
麻疹的发出与收没,通常以十二时辰为准则。例如子时之后发出,午时就会收没;午后发出,子时就会收没。这是阳生阴长、阴生阳成的自然造化之数。凡是这种旋出旋收的情况,属于“易收”,症状较轻。然而,麻疹之所以容易收没,必须先满足以下条件:麻点高耸,颗粒尖端呈淡红色且润泽。这是因为毒邪轻浅,肌表容易清解,肺部没有加重咳嗽,所以容易收没。另外还有一种情况,虽然火毒较重,但通过反复施用清解之法,致使肺胃的火邪全部退去而容易收没的,也有这种情况。但这必须是在三天之内,从肌表逐渐向体内收没,或者在三天之内一次性完全收没,皮肤上没有任何疮痕影子的,才算是易收。治疗者应当详细审察。
如果麻疹发出后一天就收没的,这是见风太早,被风寒冲撞所致。麻毒内攻,未能清爽,这不属于易收。急需进行治疗。如果不早点治疗,必然导致胃烂而死。应当用葛根疏邪汤(见第三十三条)为主方治疗。即使不再复出,也没有后患。即使是三天后麻已收敛清楚,如果有被风寒侵袭的情况,也适宜用这个方子主治。至于“早收”,则与“易收”不同。所谓早收,是指麻疹发出未满三天,或一两天,或半天就完全收没。全身肌肤温暖的地方,完全没有红色的影子,这才叫早收。最终会转变为危重证候。如果虽然未满三天就早收,但肌肤温暖处尚未完全收没,其毒邪未尽而向内攻伐,急需清热解毒、解肌透表来救治。适宜用解毒快斑汤,去掉山楂肉、生甘草、川芎、桔梗、紫草茸,加入石膏、知母、玄参来治疗。
如果疹发不起来,应当审查其原因,并与以内解的方法配合。为什么呢?早收的证候有三种原因。第一种原因是正当疹子发出但未透达之际,感受了风寒,麻因风寒遏制,邪气反而内攻,以致早收。适宜用葛根疏邪汤(见第三十三条)加葱白,给患者热服。或者用消毒饮(见第二十二条)去掉甘草,加葱白、葛根,给患者热服。服药后疹子透出的是吉兆。如果不透出,再用消毒饮(见第二十二条)去掉甘草,加酒蜜炒制的麻黄。有的还加穿山甲,应当酌情加入以治疗。如果不急治,必然导致发喘胀而死。也有一种情况是遍身青紫、热肿、喘胀气急,这是毒邪停滞、血液凝滞,一半隐匿在肌表。急需用河间凉膈散(见第二十六条)去掉大黄、芒硝、甘草,加入玄参、紫草茸、牵牛子、蜜炒麻黄、石膏以发散透越。如果出现腹胀喘促、小便清长、肚脐突起的情况,用河间凉膈散(见第二十六条)去掉大黄、芒硝,加入牵牛子、葶苈子、芥子来治疗,或许能救活一二。第二种原因是体内兼夹热痰,火毒剧烈而伏匿,出现烦躁或腹胀喘急、不省人事的情况。用白虎解毒汤(见第二十六条)除去天花粉、淡竹叶,加入玄参、牛蒡子、连翘、瓜蒌霜来治疗。第三种原因是误食酸醋等收敛之物,致使肺脏不通,毛窍闭密而毒邪伏匿,出现壮热、喘咳、烦闷的情况。用猪胆汁煮甘草煎汤,慢慢给患者服用。或者用苦瓠同生甘草煎浓汤灌服以探吐。吐法中便含有发越毒邪的意思。然而仍然适宜疏托,应当用消毒饮(见第二十二条)去掉甘草给患者服用。如果误食猪肉,出现喘胀气急的情况,也用消毒饮(见第二十二条)去掉甘草,加入枳壳、牵牛子、山楂肉以下夺积滞。有用枳壳汤去掉厚朴、甘草,加入神曲、麦芽治疗的,确实没有什么帮助。如果误食桃李生冷食物,出现喘咳声音嘶哑的情况,用消毒饮(见第二十二条)加木通、枳壳、石膏、马兜铃,去掉生甘草主治。果然热退身安,气息逐渐调和的,才可以没有忧虑。
还有因为大病或久病之后而出麻疹的人,其中气虚耗,导致毒邪不能发越而早收的。或者有因为初潮开始发热之时,泄泻长久不止,或未发热之前,曾经发生洞泄(严重腹泻)的,也导致中气虚损,麻疹才出尽随即收没的。这几类情况,虽然使用疏托的药物,但毒邪终究难以发尽。只应当健运中气,略微兼用解表清热的药剂。如香砂六君汤去掉半夏,少用白术、木香、砂仁各等分,加入麦冬、连翘、牛蒡子、酒炒黄连、酒炒黄芩、荆芥、防风、葛根之类,可以施用。(我的意见是用沙参代替人参,薏苡仁代替白术,木香砂仁可以去除,更可加入贝母。)只是稍微整理门户,仍然立即使用解毒的药剂,如消毒饮(见第二十二条)又适宜继续使用。千万不要迟延,恐怕导致肺胃败烂而无法救治。
如果麻疹已经发出而又收回去的(有用当归红花饮加葱白、牛蒡子、连翘、葛根治疗的,非常不妥,姑且记录此方证以显示谬误),或者出不完全,心慌啼哭不止,十分危急,死在顷刻之间。或者下痢腹痛(有用黄芩、白芍两味药治疗的,不妥)。应当用解毒快斑汤去掉桔梗、甘草、山楂肉、紫草茸、川芎,加入枳壳、赤茯苓,随症加减治疗。大抵麻疹在三四日之后,觉得逐渐收敛,这才是顺证。然而必须等到肌表清凉,麻疹才能收没。如果麻疹发出到三四日、五七日还不收没的,肌肤必然壮热,这是难收的证候。适宜用解肌凉血的药剂,佐以利水的药物,以凉血饮子(见第四十五条)除去赤芍,加入木通、赤茯苓、枳壳、葛根主治。如果一出连绵至四五日不收的,这是阳毒极甚,须用化斑解毒汤,去掉升麻、大黄,加入黄连、黄芩、生地黄、地骨皮来解之。大便闭塞而有腹疼的,并用大黄来利导。或者用秘本大青汤(见第四十条)去掉升麻、桔梗,加入黄连、地骨皮、黄芩、生地黄来解之。大便闭塞腹疼的,加入牵牛子来利导。解除毒邪使其发于体外,这样体内就没有余邪,避免产生后患。如果解之而仍然迟疑不出,这是风寒外束,皮肤秘密所致。适宜用葛根疏邪汤(见第三十三条)加薄荷、地骨皮治疗。如果麻点带有白色燥色,隐隐于肌表之间,似收非收,而实际不收的,这必定是因为风寒所绊,而不能透表,这并不是难收。适宜急用疏托的药剂,佐以寒凉的药,以葛根解肌汤(见第五条内)去掉赤芍药、甘草,加入防风、黄芩治疗。如果肌肤之上没有点粒,只见如片状,肤平不高,这是易收而未收尽。适宜用解肌的药,也以葛根解肌汤(见第五条)去掉赤芍、甘草,随症加减治疗。如果见到有内热的症状,也宜清内热。倘若内热不除,多导致不能完全收没。如生地骨皮汤(见三十条)去掉甘草,古方黄连解毒汤(见三十五条),加味导赤散,都可选用,加减而施。
张璐先生说:西北水土刚劲,禀赋体质也浓厚,麻疹必须五七日才收没。东南风气柔弱,麻疹发出不过二三日就收没。近来地运变迁,无论西北东南,体质均弱,没有不是绵延日久才收没的。这就不属于难收的类别了。如果三四日后,麻疹点燥色白,隐隐于肌肤之间而难收的,这必定是卫气素来虚弱,不能掀发,或者因为衣被单薄,导致冒受风寒,阻遏其发越的机制,以致延绵多日。治法应当用辛散透表的药剂,如荆芥、葛根、前胡、牛蒡子、西河柳、麻黄之类,以发散它;淡竹叶、玄参、薄荷、蝉蜕之类以透肌。切不可急于用寒凉药,闭其开泄之路。这一训诫可以作为万世治疗麻疹的大法。
朱氏说:我治疗麻疹必经六七日才收没,从未有三日即收没的。现在读张石顽先生的这一训诫,才恍然大悟。
解毒快斑汤:麻疹现形一二日宜用。
连翘、牛蒡子、防风、荆芥穗、当归尾、桔梗(各七分);生地黄、楂肉(各八分);蝉蜕(去头足七只);黄芩、紫草茸(各六分);干葛(一钱);西河柳(五分);川芎(五分);生甘草(去皮三分)。水煎,以犀角磨汁对服。
枳壳汤:
厚朴(去皮姜汁炒)、陈皮(姜汤泡去白各三钱)、枳壳(麸炒四钱)、炙甘草(三钱)。水煎服。
香砂六君汤:治气虚痰滞、食滞、气滞等症。
人参、白术、白茯苓、炙甘草、陈皮、半夏、木香、砂仁、红枣、姜引。
当归红花饮:治麻已出而复收。(系备用方)
当归(酒炒)、红花、葛根、连翘、牛蒡子、甘草。水煎服。一书有升麻,一书有生白芍、桔梗。
化斑解毒汤:
玄参、知母、石膏、牛蒡子、连翘、大黄(酒蒸)、人中黄(火另研)、淡竹叶、升麻。水煎,调人中黄服。
加味导赤散:
薄荷叶(四分)、生地黄(酒洗)、木通、玄参、车前子(炒研末)、淡竹叶(各七分)、连翘(六分)、黄连(二分)。灯心、石膏引。
The measles rash emerges tall and moist, with distinct spots. At this time, if clearing and resolving methods are applied heavily again, the Lung will be free from danger. The pathogenic factor gradually recedes from the exterior to the interior; when no scar marks remain on the skin, it is called "Lian" (resolution/absorption).
If the measles rash resolves immediately after one day of emergence, it is either due to exposure to wind-cold or concurrent heat pathogens. Ingestion of sour foods can also cause this condition. The etiological sources of these three situations are distinguishable.
When the rash emerges and quickly resolves, the disease condition is mild; when it lingers continuously and fails to resolve, the pathological trend is alarming. One should employ Huaban Jiedu Tang (Spot-Transforming Detoxification Decoction) to eliminate the pathogen, preventing residual evil from accumulating in the body.
The emergence and resolution of measles conform to Yin-Yang laws: emergence requires gentleness, while resolution requires coolness. Continuous emergence without resolution indicates excessive Yang Qi; intermittent and delayed emergence indicates strong Yin.
The emergence and resolution of measles are typically measured by the twelve two-hour periods (Shichen). For instance, if emerging after Zi hour, it resolves at Wu hour; if emerging in the afternoon, it resolves at Zi hour. This is the natural number of creation where Yang generates and Yin grows, Yin generates and Yang completes. Cases of such rapid emergence and resolution belong to "Yi Shou" (Easy Resolution), with mild symptoms. However, for measles to be easily resolved, certain prerequisites must be met first: the rash spots must stand high, with granular tips that are pale red and moist. This is because the toxin is light and superficial, making the muscle layer easy to clear, and the Lungs do not suffer aggravated coughing, thus facilitating easy resolution. Another scenario exists where, although the Fire-Toxin is heavy, repeated application of clearing and resolving methods causes the Fire-Evil in the Lungs and Stomach to retreat completely, leading to easy resolution. However, this must occur within three days, gradually receding from the muscle layer to the interior, or completely resolving within three days, leaving no trace or shadow of sores on the skin. Only then is it considered Easy Resolution. The practitioner must examine carefully.
If the measles resolves after only one day of emergence, it is due to premature exposure to wind, struck by wind-cold. The measles toxin attacks inwardly and has not cleared smoothly; this is not Easy Resolution. Urgent treatment is required. If not treated early, it will inevitably lead to rotting of the Stomach and death. Ge Gen Shu Xie Tang (Kudzu Root Decoction for Dispersing Evil) (see Article 33) should be used as the primary formula. Even if it does not re-emerge, there will be no sequelae. Even if the measles has clearly resolved after three days, if there is an attack by wind-cold, this formula is still appropriate. "Zao Shou" (Early Resolution) differs from "Yi Shou". Zao Shou refers to the measles resolving completely before three days have passed, or within one to two days, or even half a day. In cases of Zao Shou, the warm areas of the body's skin show absolutely no red shadows. This ultimately transforms into a critical condition. If, although resolving early before three days, the warm areas of the skin have not fully resolved, and the toxin is incomplete but attacking inwardly, urgent detoxification, muscle-releasing, and surface-penetrating measures are needed to save the patient. Jiedu Kuaiban Tang (Detoxifying Rapid Spot-Transforming Decoction) should be used, removing Hawthorn Flesh (Zha Rou), Raw Licorice (Sheng Gan Cao), Chuanxiong (Chuanxiong Rhizome), Platycodon (Jie Geng), and Arnebia (Zicao Rong), and adding Gypsum (Shi Gao), Anemarrhena (Zhi Mu), and Scrophularia (Yuan Shen).
If the eruption fails to rise, one must investigate the cause and combine it with internal resolution methods. Why? There are three causes for Early Resolution. The first cause occurs when the rash is emerging but not yet penetrating, and wind-cold is contracted. The measles is constrained by wind-cold, causing the evil to counter-attack inwardly, resulting in early resolution. Ge Gen Shu Xie Tang (see Article 33) with Scallion White (Cong Bai) should be given hot. Alternatively, Xiaodu Yin (Detoxification Drink) (see Article 22) without Licorice, plus Scallion White and Kudzu Root, should be given hot. If the rash penetrates after administration, it is auspicious. If not, Xiaodu Yin (see Article 22) without Licorice, plus Ephedra (Ma Huang) fried with wine and honey, should be used. Some add Pangolin Scales (Chuanshanjia); the dosage should be adjusted accordingly. Failure to treat urgently will lead to wheezing and distension death. Another presentation involves generalized cyanosis, hot swelling, wheezing, and shortness of breath, indicating stagnant toxin and coagulated blood, half-hidden in the muscle layer. Hejian Liangge San (He Jian's Cooling Pagoda Powder) (see Article 26) should be used urgently, removing Rhubarb (Da Huang), Mirabilite (Mang Xiao), and Licorice, adding Scrophularia, Arnebia, Morning Glory Seed (Qiuniu), Ephedra fried with honey, and Gypsum to disperse and vent. If abdominal distension, panting, clear urination, and umbilical protrusion occur, use Hejian Liangge San (see Article 26) removing Rhubarb and Mirabilite, adding Morning Glory Seed, Lepidium Fruit (Tingli), and Mustard Seed (Jiezi) to treat. This may save one or two patients. The second cause is internal accumulation of Phlegm-Heat, where Fire-Toxin is severe and latent, causing restlessness, abdominal distension, panting, and unconsciousness. Baihu Jiedu Tang (White Tiger Detoxification Decoction) (see Article 26) should be used, removing Trichosanthes Root (Tianhuafen) and Bamboo Leaf (Danzhuye), adding Scrophularia, Butterfly Bush Seed (Niubangzi), Forsythia (Lianqiao), and Trichosanthes Peel (Gualou Shuang). The third cause is ingestion of sour/astringent substances like vinegar, causing Lung obstruction, closed pores, and latent toxin, presenting with high fever, panting, cough, and stifling sensation. Decoct Licorice in Pig Bile water and administer slowly. Or decoct bitter bottle gourd (Ku Hu) with Raw Licorice into a thick soup for gastric lavage to induce vomiting. Vomiting contains the meaning of venting the toxin. However, dispersing and supporting is still necessary; use Xiaodu Yin (see Article 22) without Licorice. If pork was ingested mistakenly, causing panting and shortness of breath, use Xiaodu Yin (see Article 22) without Licorice, adding Citrus Aurantium (Zhike), Morning Glory Seed, and Hawthorn Flesh to purge stagnation. Some use Zhike Tang removing Magnolia Bark (Houpo) and Licorice, adding Medicated Leaven (Shenqu) and Malt (Maiya), but this is indeed ineffective. If raw fruits like plums and peaches were ingested, causing panting, cough, and hoarseness, use Xiaodu Yin (see Article 22) adding Akebia (Mutong), Citrus Aurantium, Gypsum, and Aristolochia (Madou Ling), removing Raw Licorice. If heat subsides, the body feels comfortable, and breathing regulates, there is no cause for worry.
There are also cases where measles emerge after severe or chronic illness, where Middle Qi is depleted, preventing toxin venting and causing early resolution. Or cases where diarrhea persists long during the initial fever stage, or severe diarrhea occurred before fever onset, damaging Middle Qi, causing measles to resolve immediately after full emergence. In these cases, although dispersing and supporting herbs are used, the toxin is difficult to fully vent. One must strengthen and transport Middle Qi, slightly combining exterior-dispersing and heat-clearing agents. Xiangsha Liujun Tang (Fragrant and Amomum Six Gentlemen Decoction) without Pinellia, using small doses of equal parts Atractylodes Macrocephala (Baizhu), Aucklandia (Muxiang), and Amomum (Sharen), added with Ophiopogon (Maidong), Forsythia, Butterfly Bush Seed, Coptis (Huanglian) fried with wine, Scutellaria (Huangqin) fried with wine, Schizonepeta (Jingjie), Saposhnikovia (Fangfeng), and Kudzu Root can be applied. (My opinion suggests replacing Ginseng with Glehnia (Shashen), Atractylodes with Coix Seed (Yiyiren), removing Aucklandia and Amomum, and adding Fritillaria (Beimu).) Merely adjusting the gateways, one should immediately continue using detoxifying agents like Xiaodu Yin (see Article 22). Do not delay, lest Lung and Stomach decay become incurable.
If measles emerge and then retract (some use Danggui Honghua Yin plus Scallion White, Butterfly Bush Seed, Forsythia, Kudzu Root; this is highly inappropriate, recorded here to show error), or emerge incompletely with palpitations and incessant crying, it is extremely critical, with death imminent. Or if accompanied by dysentery and abdominal pain (some use Scutellaria and Paeonia Lactiflora; this is inappropriate), use Jiedu Kuaiban Tang removing Platycodon, Licorice, Hawthorn Flesh, Arnebia, and Chuanxiong, adding Citrus Aurantium and Red Poria (Chi Fuling), modified according to symptoms. Generally, if measles appear to gradually resolve after the third or fourth day, it is a favorable sign. However, resolution can only occur when the muscle layer becomes cool. If measles fail to resolve after three to four days, or five to seven days, the skin will surely be hot, indicating a Difficult Resolution syndrome. Use muscle-releasing and blood-cooling agents assisted by diuretics. Liangxue Yinzi (Blood-Cooling Infusion) (see Article 45) without Red Peony Root (Chishao), adding Akebia, Red Poria, Citrus Aurantium, and Kudzu Root should be used. If lingering unresolved for four to five days, this indicates extreme Yang-Toxin. Huaban Jiedu Tang should be used, removing Cimicifuga (Shengma) and Rhubarb, adding Scutellaria, Scrophularia, Rehmannia (Shengdihuang), and Groundsel Root (Digupi) to resolve. If constipation with abdominal pain occurs, use Rhubarb to purge. Or use Mimben Daqing Tang (Secret Big Blue Decoction) (see Article 40) removing Cimicifuga and Platycodon, adding Scutellaria, Groundsel Root, Scrophularia, and Rehmannia to resolve. If constipation and abdominal pain persist, add Morning Glory Seed to purge. Resolve the toxin so it vents outward, ensuring no residual evil remains internally, avoiding sequelae. If, after resolution, the rash still hesitates to emerge, it is due to external wind-cold binding and closed skin. Ge Gen Shu Xie Tang (see Article 33) plus Mint (Bohe) and Groundsel Root should be used. If the measles spots have a white, dry color, faintly visible between the muscles, appearing to resolve but actually not, this is likely due to wind-cold hindering penetration, not Difficult Resolution. Urgently use dispersing and supporting agents assisted by cooling herbs. Ge Gen Jieji Tang (Kudzu Root Muscle-Releasing Decoction) (see Article 5) without Red Peony Root and Licorice, adding Saposhnikovia and Scutellaria should be used. If no spots are seen on the skin, only flat patches, it is Easy Resolution that is incomplete. Use muscle-releasing herbs, specifically Ge Gen Jieji Tang (see Article 5) without Red Peony Root and Licorice, modified according to symptoms. If internal heat signs are present, clear the internal heat. If internal heat is not removed, complete resolution is often hindered. Shengdi Gupi Tang (Rehmannia and Groundsel Root Decoction) (see Article 30) without Licorice, the ancient Fang Huang Lian Jiedu Tang (Coptis Detoxification Decoction) (see Article 35), and Jiawei Daochi San (Modified Guiding Outward Red Powder) are all selectable options, applied with modifications.
Mr. Zhang Lu stated: The water and soil in the Northwest are rigid, and people's constitution is dense; measles take five to seven days to resolve. The wind and qi in the Southeast are soft; measles resolve in two to three days. Recently, geographical changes have occurred; regardless of North/South, constitutions are weak, and none resolve without lingering for a long time. These do not fall under Difficult Resolution. If after three to four days, measles spots are dry and white, faintly visible in the skin and difficult to resolve, this is due to inherent weakness of Wei Qi (Defensive Qi) failing to lift, or thin clothing causing wind-cold exposure, blocking the venting mechanism, leading to prolonged duration. The method should use acrid-dispersing and surface-penetrating agents like Schizonepeta, Kudzu Root, Peucedanum (Qianhu), Butterfly Bush Seed, Tamarix (Xihe Liu), and Ephedra to disperse them; Bamboo Leaf, Scrophularia, Mint, and Cicada Slough to penetrate the muscle. Cold and cool herbs must never be used hastily to close the opening and venting pathways. This instruction can serve as the great principle for treating measles for generations.
Zhu said: I treat measles requiring six to seven days to resolve, never three days. Reading Mr. Zhang Shiwen's instruction, I suddenly understand.
Jiedu Kuaiban Tang (Detoxifying Rapid Spot-Transforming Decoction): Suitable for measles showing form for one to two days.
Lianqiao (Forsythia Fructus), Niubangzi (Arctii Fructus), Fangfeng (Saposhnikoviae Radix), Jingjie Sui (Schizonepetae Spica), Danggui Wei (Angelicae Sinensis Radix caudex), Jiegeng (Platycodonis Radix) (each 7 fen); Shengdihuang (Rehmanniae Radix), Zha Rou (Crataegi Fructus) (each 8 fen); Chantui (Cicadae Periostracum, remove head and feet, 7 pieces); Huangqin (Scutellariae Radix), Zicao Rong (Arnebiae Radix) (each 6 fen); Qian Ge (Puerariae Lobatae Radix) (1 qian); Xihe Liu (Tamaricis Cacumen) (5 fen); Chuanxiong (Ligustici Chuanxiong Rhizoma) (5 fen); Sheng Gancao (Glycyrrhizae Radix et Rhizoma, peeled, 3 fen). Decoct in water, mix with Rhinoceros Horn (Xijiao) ground juice for administration.
Zhike Tang (Citrus Aurantium Decoction):
Houpo (Magnoliae Officinalis Cortex, peeled, stir-fried with ginger juice), Chenpi (Citri Reticulatae Pericarpium, soaked in ginger water, pith removed, each 3 qian), Zhike (Aurantii Fructus, bran-fried, 4 qian), Zhi Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, 3 qian). Decoct in water and take.
Xiangsha Liujun Tang (Fragrant and Amomum Six Gentlemen Decoction): Treats Qi deficiency with Phlegm stagnation, Food stagnation, Qi stagnation, etc.
Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Baifuling (Poria), Zhi Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma), Muxiang (Aucklandiae Radix), Sharen (Amomi Fructus), Hongzao (Jujubae Fructus), Ginger as guide.
Danggui Honghua Yin (Angelica and Safflower Infusion): Treats measles that emerge and then retract. (Backup formula)
Danggui (Angelicae Sinensis Radix, wine-fried), Honghua (Carthami Flos), Ge Gen (Puerariae Lobatae Radix), Lianqiao (Forsythiae Fructus), Niubangzi (Arctii Fructus), Gancao (Glycyrrhizae Radix et Rhizoma). Decoct in water and take. One book lists Shengma (Cimicifugae Rhizoma); another lists Sheng Baishao (Paeoniae Radix Alba) and Jiegeng (Platycodonis Radix).
Huaban Jiedu Tang (Spot-Transforming Detoxification Decoction):
Yuan Shen (Scrophulariae Radix), Zhi Mu (Anemarrhenae Rhizoma), Shi Gao (Gypsum Fibrosum), Niubangzi (Arctii Fructus), Lianqiao (Forsythiae Fructus), Dahuang (Rhei Radix et Rhizoma, wine-steamed), Renzhonghuang (Human Manure Ash, fire-treated, separately ground), Danzhuye (Phyllostachydis Folium), Shengma (Cimicifugae Rhizoma). Decoct in water, mix with Renzhonghuang for administration.
Jiawei Daochi San (Modified Guiding Outward Red Powder):
Bohe Ye (Menthae Haplocalycis Herba) (4 fen), Shengdihuang (Rehmanniae Radix, wine-rinsed), Mutong (Akebiae Caulis), Yuan Shen (Scrophulariae Radix), Cheqianzi (Plantaginis Semen, fried and ground), Danzhuye (Phyllostachydis Folium) (each 7 fen), Lianqiao (Forsythiae Fructus) (6 fen), Huanglian (Coptidis Rhizoma) (2 fen). Jixin (Centaurii Herba) and Shi Gao (Gypsum Fibrosum) as guides.