鲜红光艳有重轻。粒头离肉肤润平。若是低塌不高耸。清肺泻火保安宁。
麻色淡红正所宜。本来肺胃毒少稀。若是粒头不离肉。低塌色焦又贵医。
麻色鲜红。内多有热。鲜红者必光活而有艳色是也。若是粒头离肉。皮肤活润。症还轻平。倘
粒头低塌不高者。其症多重。急宜清肺泻火。如黄芩、知母、麦冬、天花粉、牛蒡子、石膏清金之
药。黄连、栀仁、连翘、元参、大青、黄柏泻火之品。在所必用。以黄芩泻肺汤去桔梗、大黄、甘草。
加麦冬、牛蒡子、元参主之。至若麻色淡红。麻所正宜。盖肺胃之毒原轻。麻色故淡。再得粒头
高耸而离肉。此上吉之候。若粒头低塌而色焦枯燥。又因风寒外折。药宜疏散之剂。以葛根解肌
汤（见第五条）去赤芍药、甘草治之。又有一等。初出粒头不高。色带赤淡红。大便闭结。唇口燥
赤者。此火邪内郁。大热症也。急宜用大寒凉之剂。佐以疏托之药。以白虎解毒汤（见二十六条）
去竹叶。加元参、荆芥治之。若不早治。过数日后。色变紫黑而难治矣。
朱曰 鲜红淡白。在成粒高耸与低塌不高上分吉凶。审证何等的确。
黄芩泻肺汤 治肺热里实症。
黄芩 栀仁 枳壳 薄荷叶 连翘 杏仁 大黄 桔梗 甘草 水煎。食后服。
麻出成片被风押。忽然一变为白色。若是粒红只肤白。毒从血化症候吉。
麻之粒头高耸。色红淡润。而肌肤白者。此肺胃之火原轻。乃上吉之症。不须服药。又有毒从
血化而见此候者。亦有因热毒从汗解而见此候者。俱不必用药而愈。若初出之时。麻色如肌肤
一样白。不分肉地。惟粒头高耸。 时即收者。邪热本轻也。然有表气本虚而色白者。调护温暖。
无冒风寒。越二三日而自变红活也。古云。白疹温暖而后灭者。此之谓也。又有一等。正出之时。
为风寒所遏。致麻色如肤白者。其人必见毛窍竦栗。此等症候。必用疏散之剂。解毒散风。方得红
活。以葛根疏邪汤（见三十三条）或葛根解肌汤（见第五条）去赤芍、甘草。加苏叶、薄荷、枳壳、赤
茯苓主之。倘若失治。致毒难尽。变症多端。又有一种。麻出成片。一被风寒所折。即变为白色。身
不发热。而毒反内攻。烦躁腹痛。痰喘气急者。危候也。如毒攻于胃。则呕吐清水。毒攻于脾。则
腹胀不食。毒攻于肺。则鼻塞喘促。毒攻于心。则唇舌焦裂。不省人事。摇头掣手。毒攻于肝、肾。
则变黑色。而不救矣。
朱曰 白色。除粒头高耸。邪热本轻而外。非风寒所遏。即毒反内攻。医家遇此。切勿大意。
鲜红色泽的轻重程度不同。麻疹颗粒头部与皮肤分离，皮肤滋润平坦。如果疹粒低陷不隆起，应当清肺泻火以保平安。
麻疹颜色淡红正是适宜的表现。这是因为肺胃中的毒邪较少且稀薄。如果疹粒头部紧贴皮肤不分离，颜色焦枯，就需要请医生诊治。
麻疹颜色鲜红，体内多有热邪。所谓鲜红，是指光泽活跃且有艳丽的色泽。如果疹粒头部与皮肤分离，皮肤鲜活滋润，病情还算轻浅平和。倘若疹粒低陷不隆起，病情大多较重，急需清肺泻火。如使用黄芩、知母、麦冬、天花粉、牛蒡子、石膏等清金（清肃肺气）的药物；黄连、栀子仁、连翘、玄参、大青叶、黄柏等泻火的药物，都是必须使用的。可以用黄芩泻肺汤去掉桔梗、大黄、甘草，加入麦冬、牛蒡子、玄参来主治。至于麻疹颜色淡红，是麻疹最适宜的颜色。因为肺胃的毒邪原本轻微，所以麻色发淡。再加上疹粒高耸且与皮肤分离，这是上等的吉兆。如果疹粒低陷且颜色焦枯干燥，又是因为风寒外束所致，用药宜用疏散的方剂。用葛根解肌汤（见第五条）去掉赤芍药、甘草来治疗。另外有一类情况，初出时疹粒不高，颜色带赤淡红，大便闭结，嘴唇口角燥赤，这是火邪内郁，属于大热症。急需使用大寒凉的方剂，配合疏托的药。用白虎解毒汤（见二十六条）去掉竹叶，加入玄参、荆芥来治疗。如果不尽早治疗，过了几天后，颜色变为紫黑就难以治愈了。
朱氏说：鲜红或淡白，通过观察疹粒是否高耸或低陷不隆起来区分吉凶，审察证候非常确切。
黄芩泻肺汤 治疗肺热里实证。
黄芩、栀子仁、枳壳、薄荷叶、连翘、杏仁、大黄、桔梗、甘草，水煎服，饭后服用。
麻疹成片发出后被风邪压制，突然变成白色。如果是疹粒红而皮肤白，说明毒邪从血分化解，病情吉利。
麻疹的疹粒高耸，颜色红而淡润，肌肤白皙，这是肺胃之火原本轻微，属于上等的吉症，不需要服药。又有毒邪从血分化解而出现这种征象的，也有因热毒随汗液排出而出现这种征象的，都不必用药即可痊愈。如果在初发出时，麻疹颜色像肌肤一样白，分不清肉地（疹底），只有疹粒高耸，随即收没，这是邪热本来轻微。然而有表气本虚导致颜色白的，要注意调护保暖，不要冒犯风寒，过两三天后自然会变为红活。古语说：“白疹在温暖环境下随后消退”，说的就是这种情况。又有一类情况，正当发出之时，被风寒所遏制，导致麻疹颜色像肤色一样白，此人必定出现毛孔竖立战栗的症状。这类证候，必须使用疏散的方剂，解毒散风，才能使皮疹红活。用葛根疏邪汤（见三十三条）或葛根解肌汤（见第五条）去掉赤芍、甘草，加入苏叶、薄荷、枳壳、赤茯苓来主治。如果失治，导致毒邪不能尽除，变症繁多。又有一种情况，麻疹成片发出，一旦被风寒折抑，立即变为白色，身体不发热，但毒邪反而内攻，出现烦躁腹痛、痰喘气急的症状，这是危重征候。如果毒邪攻入胃，则呕吐清水；毒邪攻入脾，则腹胀不食；毒邪攻入肺，则鼻塞喘促；毒邪攻入心，则唇舌焦裂，神志不清，摇头甩手；毒邪攻入肝、肾，则变为黑色，无法救治。
朱氏说：白色，除了疹粒高耸、邪热本轻的情况之外，如果不是被风寒所遏制，就是毒邪反向内攻。医家遇到这种情况，千万不要大意。
The intensity of the bright red color varies. The heads of the macules are separated from the skin, and the skin is moist and flat. If the macules are depressed and not elevated, one should clear the Lung and purge fire to ensure peace.
A pale red color for the macules is precisely what is desirable. This is because the toxic heat in the Lung and Stomach is scanty and mild. If the heads of the macules do not separate from the skin, and the color is scorched, a physician should be consulted.
Bright red macules indicate internal heat. "Bright red" refers to a lustrous, vibrant, and active appearance. If the macule heads separate from the skin and the skin is fresh and moist, the condition is relatively mild and peaceful. However, if the macules are depressed and not elevated, the condition is usually severe; it is urgent to clear the Lung and purge fire. Herbs such as Huangqin (Scutellariae Radix), Zhimu (Anemarrhenae Rhizoma), Maidong (Ophiopogonis Radix), Tianhuafen (Trichosanthis Radix), Niubangzi (Arctii Fructus), and Shigao (Gypsum Fibrosum) are used to clear Metal (Lung Qi); herbs such as Huanglian (Coptidis Rhizoma), Zhiren (Gardeniae Fructus), Lianqiao (Forsythiae Fructus), Yuanshen (Scrophulariae Radix), Daqingye (Isatidis Folium), and Huangbai (Phellodendri Cortex) are used to purge fire. These are essential. One may use Huangqin Xiefei Tang (Scutellaria Decoction to Drain the Lung), removing Jiegeng (Platycodonis Radix), Dahuang (Rhei Radix et Rhizoma), and Gancao (Glycyrrhizae Radix), and adding Maidong, Niubangzi, and Yuanshen as the main prescription. As for pale red macules, this is the most appropriate color for measles. Since the toxic heat in the Lung and Stomach is originally light, the macule color is pale. Furthermore, if the macules are elevated and separated from the skin, this is an auspicious sign. If the macules are depressed and the color is scorched and dry, due to external constraint by Wind-Cold, the treatment should employ dispersing formulas. Use Gegen Jiemo Tang (Pueraria Decoction to Release the Muscles) [see Article 5], removing Chishaoyao (Paeoniae Radix Rubra) and Gancao, to treat it. There is another category: initially, the macules are not elevated, the color is reddish-pale, there is constipation, and the lips and mouth are dry and red. This indicates internal stagnation of Fire-Evil, constituting a severe Heat syndrome. It is urgent to use major cold-cooling formulas combined with dispersing and supporting agents. Use Baihu Jiedu Tang (White Tiger Decoction to Resolve Toxicity) [see Article 26], removing Zhuye (Bambusae Folium), and adding Yuanshen and Jingjie, to treat it. If not treated early, after several days, the color will turn purple-black and become difficult to cure.
Zhu stated: Whether the color is bright red or pale white, one distinguishes between good and bad omens based on whether the macules are elevated or depressed. This examination of symptoms is very accurate.
Huangqin Xiefei Tang treats Lung-Heat with interior excess.
Huangqin, Zhiren, Zhike, Boheye, Lianqiao, Xingren, Dahuang, Jiegeng, Gancao. Decoct in water and take after meals.
When macules erupt in patches and are suppressed by Wind, they suddenly turn white. If the macules are red but the skin is white, it indicates that the toxicity is transforming from the Blood level, which is an auspicious sign.
When the heads of the macules are elevated, the color is red, pale, and moist, and the skin is white, this indicates that the Fire in the Lung and Stomach is originally slight, representing an upper-grade auspicious syndrome. Medication is not required. In cases where toxicity transforms from the Blood level presenting this sign, or when toxic heat resolves through sweating, medication is also unnecessary for recovery. If upon initial eruption, the macule color is white like the skin, without distinct bases, but only the heads are elevated and they quickly recede, this indicates that the pathogenic heat was originally slight. However, some have deficient Wei-Qi at the exterior leading to whiteness; these patients require warm care and protection from Wind-Cold, and within two to three days, the color will naturally become red and vibrant. The ancient saying, "White rashes subside after warming," refers to this. Another category occurs during the eruption phase when constrained by Wind-Cold, causing the macule color to resemble the skin tone. Such patients exhibit piloerection and shivering. This syndrome requires dispersing formulas to resolve toxicity and scatter Wind, allowing the rash to become red and vibrant. Use Gegen Shuxie Tang (Pueraria Decoction to Disperse Pathogens) [see Article 33] or Gegen Jiemo Tang [see Article 5], removing Chishaoyao and Gancao, and adding Zisuye (Perillae Folium), Bohe (Menthae Haplocalycis Herba), Zhike (Aurantii Fructus), and Chi Fuling (Poria cum Radix Glycyrrhizae). If treatment is delayed, toxicity may not be fully expelled, leading to various complications. Another scenario involves macules erupting in patches; once constrained by Wind-Cold, they immediately turn white. The body does not feel feverish, but the toxicity attacks inward, causing restlessness, abdominal pain, phlegm-wheezing, and rapid breathing. This is a critical sign. If toxicity attacks the Stomach, there is vomiting of clear fluid; if it attacks the Spleen, there is abdominal distension and anorexia; if it attacks the Lung, there is nasal congestion and panting; if it attacks the Heart, there are cracked lips and tongue, unconsciousness, head shaking, and limb jerking; if it attacks the Liver and Kidney, the color turns black, and recovery is impossible.
Zhu stated: Regarding whiteness, apart from cases where macules are elevated and pathogenic heat is slight, it is either due to constraint by Wind-Cold or counter-attack of toxicity inward. Physicians must not be careless when encountering this.