粪溏之症不须除。麻得斯候毒得舒。始终粪如黄褐色。虽有变症保无虞。
粪出有沫名水泄。初热正出见为吉。久泻气陷恐成痢。溺赤燥遏脾胃热。
麻症粪溏。理势必然。此肺胃之火所作而致。不必施治。何则。火势极则大便闭结。麻本火
候。倘再便闭。则火毒内作极矣。麻出必险。是以粪溏为正候。初出与出时见此症。其麻纵险可
救。正收与收后。而粪溏色如黄褐者。虽有变症。可保无虞。若水泻之症。粪色必黄而有沫。小
便赤。口干唇燥。皆由脾胃有热所致。然麻症泄泻。热邪得以开泄。是为顺候。初热未出之间。水
泻者以三苓散（见三十七条）加葛根、连翘、木通、滑石主之。正出之时水泻者。亦以三苓散（见
三十七条）加连翘、麦冬。潮热甚者更加黄连、黄芩主之。（古人有用人参白虎汤去知母加麦冬治
之者、实为不妥、方仍收列。）夫麻泄泻。毒火因泻而解。虽曰美候。然不可令其久泻。倘或久泻
不止。则正气必衰。脾气下陷。凡在未发热之前水泻。至正出之际而不止。其为日已久。则麻毒
难以发越。后则留毒。为害不小。宜以加味三苓散主之。倘执泥毒邪得泻而解之说。纵其久泻。而
不为之早治。恐至麻收靥之后。变成痢症。或下紫红血等症。治疗维艰。正收及收后而水泻者。
毒邪虽得泻而尽。然止宜泻三五次。不可过多。若自首至尾。水泻不止者。宜用清凉利水之药。
而佐以升提。古有用三苓散（见三十七条）。加香白芷、大麦冬治之者。须当审理察宜。随机加减
而施。正收及收后、水泻过甚者。须以理脾胃为主。宜以枳实理中汤。随意消息、加减而治。若不
急治。多成肿胀、便血、痢疾等候。至若麻后泻痢不止、口干目闭、四肢不温、与呕吐不食、洞泄
不知者。皆为不治之症。
加味三苓散 治痘麻泻甚。小便红黄。
猪苓 木通 赤苓 车前子（炒各七分） 泽泻（八分） 黄芩（酒炒） 牛蒡子（各五
分） 黄连（酒炒二分） 灯心五十寸引。水煎。食前服。
人参白虎汤 治热病。舌干大渴。发热背寒。
人参（一钱） 炙甘草（一钱） 生石膏（一钱、一书用五钱） 知母（三钱） 糯米（半合
）水煎。分作三次。温服。一日饮尽。
枳实理中汤 治胃挟食及结胸。本虚不能受攻者。
干姜（炒黑五分至一钱） 人参（一钱至三钱） 白术（炒焦一钱至二钱） 枳实 茯苓（
各一钱） 炙甘草（五分至一钱） 水煎服。
大便稀溏的症状不需要特别处理。麻疹出现这种情况，说明体内的毒邪得以舒缓。如果从始至终大便都呈黄褐色，即使出现其他变证，也无需担忧。
大便排出时带有泡沫称为水泻。在发热初期、疹点刚发出时见到此症为吉兆。若长期腹泻导致气机下陷，恐怕会演变为痢疾。小便短赤、口唇干燥，是由于脾胃有热所致。
麻疹并发大便稀溏，从医理和形势上看是必然的。这是由肺胃之火引起的，不必进行治疗。为什么呢？火势极盛时大便会闭结不通。麻疹本属火候，如果再出现便秘，那么火毒在内就会极度亢盛。麻疹发作必然伴随风险，因此大便稀溏属于正常顺候。在初起阶段或出疹期间见此症，即使病情严重也可救治。在收靥期及收靥后，若大便稀溏且颜色如黄褐色，即使有变证，也可保证无虞。如果是水泻症状，大便颜色必黄且有泡沫，小便赤红，口干唇燥，这都是由脾胃有热导致的。然而，麻疹期间的泄泻，使得热邪得以宣泄，这属于顺候。在发热初期、疹点未出之间发生水泻者，以三苓散（见第三十七条）加葛根、连翘、木通、滑石为主方治疗。在正出疹期间发生水泻者，也用三苓散加连翘、麦冬。若潮热严重者，再加黄连、黄芩为主方。（古人有用参白虎汤去掉知母加麦冬治疗的，实际上并不妥当，该方仍收录于此供参考。）对于麻疹泄泻，毒火因腹泻而解除，虽然说是美候（好现象），但不能让患者长期腹泻。倘若久泻不止，正气必然衰弱，脾气下陷。凡是在未发热之前就有水泻，到了正出疹之际仍不止的，因为时间已久，麻毒难以发散透达，之后会导致留毒，危害不小。宜用加味三苓散治疗。倘若拘泥于“毒邪得泻而解”的说法，放任其久泻而不早治，恐怕等到麻疹收靥之后，会变成痢疾，或者出现下紫红色血等症状，治疗将非常困难。在正收靥期及收靥后出现水泻者，毒邪虽随泻而出尽，但也只适宜泻三五次，不可过多。若是从头到尾水泻不止者，宜用清凉利水的药物，并佐以升提药性。古有人用三苓散加香白芷、大麦冬治疗的，必须审察病机，随机加减施治。在正收靥期及收靥后，若水泻过甚者，必须以调理脾胃为主，宜用枳实理中汤，根据情况斟酌加减治疗。若不紧急治疗，多会演变成肿胀、便血、痢疾等症。至于麻疹后泻痢不止、口干目闭、四肢不温，以及呕吐不能进食、洞泄不知人事的，都属于不治之症。
加味三苓散：治疗痘疮麻疹泄泻严重，小便红黄。
猪苓、木通、赤茯苓、车前子（炒，各七分）、泽泻（八分）、黄芩（酒炒）、牛蒡子（各五分）、黄连（酒炒二分），灯心草五十寸为引，水煎服，饭前服用。
人参白虎汤：治疗热病，舌干大渴，发热伴背部恶寒。
人参（一钱）、炙甘草（一钱）、生石膏（一钱，另一书用五钱）、知母（三钱）、糯米（半合），水煎，分三次温服，一日饮完。
枳实理中汤：治疗胃中有食积及结胸证，体质虚弱不能耐受攻伐者。
干姜（炒黑五分至一钱）、人参（一钱至三钱）、白术（炒焦一钱至二钱）、枳实、茯苓（各一钱）、炙甘草（五分至一钱），水煎服。
The symptom of loose stools does not require specific treatment. When measles presents with this condition, it indicates that the pathogenic toxins are being relieved. If the stools remain yellowish-brown throughout the course, even if other complicated symptoms arise, there is no cause for alarm.
Stools discharged with foam are termed "water diarrhea" (Shuixie). Seeing this symptom during the initial fever stage when the rash is just beginning to emerge is an auspicious sign. However, prolonged diarrhea leading to sinking of Qi may evolve into dysentery. Red urine and dry mouth/lips are caused by heat in the Spleen and Stomach.
Loose stools accompanying measles are inevitable according to medical principles. This is caused by Fire-Heat in the Lung and Stomach, and no treatment is necessary. Why? When Fire-Heat is extreme, bowel movements become constipated. Measles itself belongs to a Fire-Heat pattern; if constipation occurs additionally, internal Fire-Toxin will become excessively intense. Since measles onset carries inherent risks, loose stools constitute a normal, favorable presentation. Observing this symptom during the initial or eruptive stages means that even severe cases can be saved. During the resolution phase and after resolution, if stools are loose and yellowish-brown, safety can be guaranteed despite potential complications.
If the symptom is water diarrhea, the stool color must be yellow with foam, accompanied by red urine, dry mouth, and dry lips, all resulting from Heat in the Spleen and Stomach. However, diarrhea during measles allows Heat-Evil to vent, which is considered a favorable progression. For water diarrhea occurring before the rash fully emerges (during the initial fever), Sanling San (Three-Ling Decoction) added with Gegen (Puerariae Radix), Lianqiao (Forsythiae Fructus), Mutong (Akebiae Caulis), and Huashi (Talcum) should be used as the main formula. For water diarrhea during the full eruption phase, Sanling San added with Lianqiao and Maidong (Ophiopogonis Radix) is also appropriate. In cases with severe tidal fever, Huanglian (Coptidis Rhizoma) and Huangqin (Scutellariae Radix) should be added. (Ancient practitioners sometimes used Renshen Baihu Tang minus Zhimu plus Maidong, but this is actually inappropriate; the formula is retained here for reference.) Regarding measles-related diarrhea, the toxic fire is resolved through evacuation. Although this is a favorable sign, prolonged diarrhea must be prevented. If diarrhea persists for a long time, Righteous Qi will inevitably decline, and Spleen Qi will sink. If water diarrhea existed before fever onset and continues during the eruption phase, the duration has been too long, making it difficult for Measles-Toxin to vent outward, leading to residual toxin and significant harm. Jiawei Sanling San (Modified Three-Ling Decoction) should be used. If one rigidly adheres to the theory that "toxins are resolved via diarrhea" and allows prolonged diarrhea without early intervention, it may lead to dysentery or passage of purple-red blood after the rash resolves, making treatment extremely difficult. For water diarrhea during the resolution phase and after, although toxins are evacuated, diarrhea should ideally occur only three to five times and not excessively. If water diarrhea persists from start to finish, cooling and diuretic herbs should be used, assisted by herbs that lift Qi. Ancient texts mention using Sanling San added with Xiangbaizhi (Bai Zhi) and Da Maidong (Ophiopogon) for treatment; however, clinical judgment and flexible modification are required. For excessive water diarrhea during the resolution phase and after, regulating the Spleen and Stomach is primary; Zhishi Lizhong Tang (Immature Bitter Orange and Ginseng Decoction) should be used with appropriate modifications. Failure to treat urgently often results in edema, hematochezia, or dysentery. Furthermore, post-measles persistent dysentery/diarrhea, dry mouth with closed eyes, cold limbs, vomiting with inability to eat, and profuse watery diarrhea with loss of consciousness are all untreatable conditions.
Jiawei Sanling San (Modified Three-Ling Decoction): Treats severe diarrhea in smallpox/measles with red-yellow urine.
Zhu Ling (Polypori Sclerotium), Mutong (Akebiae Caulis), Chi Ling (Poria cum Rubro), Che Qian Zi (Plantaginis Semen - stir-fried, 0.7 fen each), Ze Xie (Alismatis Rhizoma, 0.8 fen), Huang Qin (Scutellariae Radix - wine-fried), Niu Bang Zi (Arctii Fructus, 0.5 fen each), Huang Lian (Coptidis Rhizoma - wine-fried, 0.2 fen), Deng Xin Cao (Junci Medulla, 50 cun as guide). Decoct in water, take before meals.
Renshen Baihu Tang (Ginseng and White Tiger Decoction): Treats febrile disease with dry tongue, extreme thirst, fever with chills on the back.
Renshen (Ginseng Radix et Rhizoma, 1 qian), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma, 1 qian), Sheng Shi Gao (Gypsum Fibrosum, 1 qian; another text uses 5 qian), Zhi Mu (Anemarrhenae Rhizoma, 3 qian), Nuomi (Glutinous Oryzae Semen, 0.5 he). Decoct in water, divide into three doses, take warm, consume within one day.
Zhishi Lizhong Tang (Immature Bitter Orange and Ginseng Decoction): Treats Stomach with food retention and Jie Xiong (Chest Binding syndrome), in patients with underlying deficiency unable to tolerate purgation.
Gan Jiang (Zingiberis Rhizoma - charred black, 0.5-1 qian), Renshen (Ginseng Radix et Rhizoma, 1-3 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma - stir-fried until scorched, 1-2 qian), Zhishi (Aurantii Fructus Immaturus), Fu Ling (Poria, 1 qian each), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma, 0.5-1 qian). Decoct in water and take.