朱氏玉堂曰∶凡疹初未见标之时，先必身热，头疼咳嗽，或作吐作泻，或鼻塞，鼻流清
涕，喷鼾，眼胞肿，腮赤，烦躁不宁，细看两耳根下，颈项连耳之间，以及背脊之下至腰间，
必有三五红点，此乃疹之报标。若无红点之证佐，当以别证论，此屡试屡验者也。如果有红
点与前证相同，宜用宣毒发表汤加芫荽作引，以托之出外，不必拘泥。吐泻疹出，而吐泻自
止。盖热蒸胃则吐，热冲大肠则泻，此乃疹之常候，不必忧其吐泻之不止也。昔人云疹出六
腑，或因有此证而云然也。凡出疹见标之后，形似麻粒，大粒而尖，稀疏磊落，再后成片红
色滋润者顺，若神清气爽者更顺。若初出一时涌出不分颗粒，深紫色者险，黑色者逆，不可
视为泛常，不可用药失序，不可过用攻表，不可骤用寒凉，调治之法避风忌荤，兼忌秽恶，
惟在用药宣发其毒，以尽出之于外。虽红肿之甚，状如漆疮，亦不足虑，以其出之于外，即可
免夫内攻，此证若调治得法，用药合宜，百不失一，若调治失宜，则杀人易如反掌，可不慎哉。
初发热时必当发表，见标之后发表而兼清凉，通身上下，通红总成一片，手足之末上
下相同，无有空处此为出透，可用清凉解毒之剂，不必兼用发表之药，一解即愈。
又有一种疹，初出眼胞肿，白夹赤色，声哑唇肿掀翻，鼻干，鼻扇气喘，口燥烦渴，腰疼
腹胀，人事昏沉，口鼻出血，烦乱狂叫，二便出血，此系毒瓦斯郁遏于内名曰闭证，最为难治，
用宣毒发表汤内加酒炒黄芩七分，麻黄五分，若能托疹标出外，渐次出现或可望生，若不出
现则无救矣。但凡疹证鼻出血者毒重，口出血者毒尤重，二便出血者毒更重，且危矣。初起
手足心如火热者毒重，初起脚冷如冰者毒更重。
若初见疹标尚未出透，失于清解，误用芩热之剂以致毒蕴于胃，口鼻出气腥臭，必生牙
疳，宜用化毒清表汤加石膏二钱；若已出透速收速散，身热不退，余毒流注大肠里急后重，
红白相兼已成痢证，宜用清热导滞汤。
若其人素禀虚弱，当出疹之际过于发散，出透之后过用寒凉，解毒以致虚弱之极，骨瘦
神疲，面无红色，且不能多食，食多即吐，急用香砂六君子汤去半夏加麦冬以补之。种种坏证不可不慎。
上海强氏按云∶若非脾胃虚弱，少食吐食，而但本原虚损，朝凉暮热，咳嗽痰多，将成
骨立者，俗名痧劳，恐补脾碍肺，香砂惟恐不宜。
疹之出也，出三日而始尽。每日出二次，子时出者巳时散，午时出者亥时散，经三日而
出，六次出透，稠密无缝，方为吉兆，昔人有云痘喜稀疏，疹宜稠密，虽如漆疮，通红一片，亦不足为虑。
若甫弥月及至半岁一岁之间，时值天气炎热，或出奶疹痧疹风瘾等疹，不在正疹之
列，亦不由于胎毒而致，可以母须用药，（德按∶可用葱白三寸泡汤服之）其疹自散，此类
内因变蒸，外感风热而出，乃皮肤小恙，常见出一次，又出一次及有连出不已者，无关利
害，倘要用药微用疏风清热之剂，一服即愈。凡出疹发热三日见标者为顺，迟至五六日不
见标者为逆，神气清爽者为顺，昏沉者为逆。病家知禁忌者逆可以变顺，不知禁忌者顺亦
变逆，当于出疹之家明言之，防于未然，一体告戒。
朱玉堂说：凡是麻疹在初期尚未显现出典型症状时，患者必然先出现身体发热、头痛、咳嗽，或者伴有呕吐、腹泻，或者鼻塞、流清鼻涕、呼吸有鼾声、眼睑肿胀、腮部发红、烦躁不安。仔细查看耳根下方、颈部连接耳朵之间，以及背部脊柱下方直到腰部，必定会出现三五颗红点，这就是麻疹发出的征兆（报标）。如果没有红点伴随这些症状，应当按其他病症论治，这是经过多次验证确验有效的。如果确实有红点且与前述症状相同，适宜使用宣毒发表汤加入芫荽作为药引，以托举疹毒向外透发，不必拘泥于固定程式。如果是因吐泻导致疹子发出，那么吐泻自然会停止。因为热邪熏蒸胃腑则引起呕吐，热邪冲击大肠则引起腹泻，这是麻疹的常见征候，不必担忧吐泻不止。古人说疹毒出于六腑，或许是因为有此证候才这样说。
凡是麻疹发出并见到征兆之后，形态像麻粒一样，颗粒较大且尖端突出，稀疏分布、错落有致；随后成片呈现红色且滋润的，属于顺证；如果患者神志清晰、气色清爽的，更是顺证。如果初出时一时涌出而不分颗粒，颜色深紫的为险证，黑色的为逆证，不可视为平常情况，不可用药失去次序，不可过度使用发散表邪的药物，不可突然使用寒凉药物。调理治疗的方法要避风、忌食荤腥，同时忌讳污秽恶臭之气，关键在于用药宣发透达疹毒，使其完全透出体外。即使红肿非常严重，状如漆疮，也不必忧虑，因为疹毒已经透出体外，就可以避免内攻脏腑。此病如果调理治疗得当，用药合适，百次治疗不失一次；如果调理治疗失宜，则杀人易如反掌，怎能不谨慎呢？
在刚开始发热时，必须使用发散表邪的方法；见到征兆之后，发散的同时兼用清凉药物。如果通体上下通红连成一片，手足末端上下相同，没有空隙，这叫做出透，可以使用清凉解毒的药剂，不必兼用发散表邪的药物，一经解表即痊愈。
又有一种麻疹，初起时眼睑肿胀，白色中夹杂赤色，声音嘶哑、嘴唇肿胀翻起，鼻孔干燥、鼻翼扇动、气喘，口燥烦渴，腰痛腹胀，人事昏沉，口鼻出血，烦躁混乱、狂叫，大小便出血，这是毒瓦斯郁结遏阻在体内，名叫闭证，最为难治。使用宣毒发表汤内加酒炒黄芩七分、麻黄五分，如果能托举疹毒向外透出，逐渐显现出来，或许还有希望存活；如果不出现，就没有救药了。大凡患麻疹证候中，鼻出血的说明毒重，口出血的说明毒更重，大小便出血的说明毒更重，而且病情危急。初起时手足心如火烧般热的，说明毒重；初起时脚冷如冰的，说明毒更重。
如果初见疹子征兆但尚未出透，疏忽了清热解表的措施，误用苦寒温热的药剂，导致毒邪蕴结在胃腑，口鼻呼出的气息腥臭，必然生牙疳，适宜使用化毒清表汤加石膏二钱；如果疹子已经出透却迅速收敛消散，身体发热不退，余毒流注到大肠，出现里急后重，大便红白相兼，已成痢疾证候，适宜使用清热导滞汤。
如果其人平素体质虚弱，在出疹之际过于使用发散药物，疹子出透之后又过度使用寒凉解毒药物，导致虚弱到了极点，骨瘦如柴、精神疲惫，面色无红润，且不能多吃食物，吃多就呕吐，急需使用香砂六君子汤去掉半夏加入麦冬来补益。种种坏证不可不谨慎。
上海强氏按语说：如果不是脾胃虚弱、少食或呕吐，而是仅仅本原虚损，早晨凉爽傍晚发热，咳嗽痰多，将要形成骨立消瘦的，俗名痧劳，恐怕补脾会妨碍肺气，香砂丸恐怕不宜使用。
麻疹的发出，发出三天才能发尽。每天发出两次，子时发出的巳时消散，午时发出的亥时消散，经过三天发出，六次出透，稠密无缝隙，才是吉兆，古人有话说痘疮喜欢稀疏，麻疹适宜稠密，虽然像漆疮一样通红一片，也不足为虑。
如果是刚满一个月到半岁、一岁之间的婴儿，正值天气炎热，或者出奶疹、痧疹、风瘾等疹子，不在正疹之列，也不是由于胎毒所致，可以不需要用药，（德按：可以用葱白三寸泡汤服用）疹子自然消散，这类属于内因变蒸、外感风热而发出，乃是皮肤小病，常见出一次，又出一次及有连续不断发出的，无关利害，如果要用药，轻微使用疏风清热的药剂，一服即愈。凡是出疹发热三天见到征兆的属于顺证，延迟到五六天不见征兆的属于逆证，神气清爽的属于顺证，昏沉的属于逆证。病家知道禁忌的，逆证可以变为顺证，不知道禁忌的，顺证也会变成逆证，应当向出疹的家庭明确说明，预防于未然，一体告诫。
Zhu Yutang stated: When measles (Mazhen) have not yet manifested their typical signs, the patient must first experience fever (Shenre), headache (Toutong), and cough (Kesou), possibly accompanied by vomiting (Tou) or diarrhea (Xie), nasal congestion (Bisai), runny clear nose (Biliu Qingti), snoring breathing (Penhan), swollen eyelids (Yanbao Zhong), red cheeks (Sai Chi), and restlessness (Fanzao Buning). Carefully inspecting below the ear roots, between the neck and ears, and from the lower back to the waist, one will inevitably find three to five red spots. This is the "reporting sign" (Biao) of measles. If these symptoms occur without red spots, it should be treated as a different condition; this has been repeatedly verified. If red spots are indeed present along with the aforementioned symptoms, it is appropriate to use Xuandu Fabiao Tang (Toxin-Releasing Exterior-Dispersing Decoction) added with Yuanxu (Coriandrum Fruit) as a guiding drug to help push the rash outward, without being rigidly bound by fixed protocols. If vomiting and diarrhea accompany the eruption of the rash, they will naturally cease. Heat steaming the Stomach causes vomiting, while heat rushing into the Large Intestine causes diarrhea; this is a common manifestation of measles, so there is no need to worry about persistent vomiting or diarrhea. Ancients said that measles toxins originate from the Six Fu Organs, perhaps due to such symptoms.
After the measles erupt and show signs, the lesions resemble millet grains, being large and pointed, sparse and distinct. Later, if they form patches of moist red color, it is a favorable course (Shun); if the spirit is clear and complexion is fresh, it is even more favorable. If initially erupting all at once without distinct grains, appearing deep purple indicates a dangerous condition, and black indicates an adverse condition (Ni). These should not be considered ordinary. Medication order must not be lost, exterior-dispersing methods should not be overused, and cold-cooling drugs should not be applied abruptly. The method of care involves avoiding wind, avoiding meat, and avoiding foul odors. The key lies in using medication to ventilate and disperse the toxin, allowing it to fully emerge externally. Even if swelling and redness are severe, resembling lacquer dermatitis, there is no need to worry, because the toxin has emerged externally, preventing internal attack. If managed correctly with appropriate medication, success is nearly certain; if mismanaged, death can occur easily. How can one not be cautious?
At the initial stage of fever, exterior-dispersing methods must be used. After signs appear, dispersing should be combined with cooling. If the entire body becomes uniformly red, including the extremities of hands and feet, with no gaps, this is called "fully erupted." At this stage, cooling and detoxifying agents can be used without additional exterior-dispersing drugs; recovery follows quickly.
There is another type of measles where, upon initial eruption, eyelids are swollen, white mixed with red, voice is hoarse, lips are swollen and everted, nostrils are dry, alae nasi flaring with asthma, mouth dry with irritability and thirst, lower back pain, abdominal distension, mental confusion, bleeding from mouth and nose, agitation with狂叫 (wild shouting), and bleeding from both bowels and urine. This is caused by toxic qi stagnating internally, named "Closed Syndrome" (Bi Zheng), which is the most difficult to treat. Use Xuandu Fabiao Tang added with wine-fried Huangqin (Scutellariae Radix) 7 fen and Mahuang (Ephedrae Herba) 5 fen. If the rash can be pushed out gradually, survival may be hoped for; otherwise, there is no rescue. Generally, nasal bleeding in measles indicates heavy toxin; oral bleeding indicates heavier toxin; bleeding from bowels and urine indicates even heavier toxin and critical danger. Hot palms and soles at onset indicate heavy toxin; ice-cold feet at onset indicate even heavier toxin.
If the rash signs are seen but not fully erupted, and clearing/resolving measures are neglected, mistakenly using bitter-cold or hot agents causing toxin accumulation in the Stomach, leading to foul breath from mouth and nose and likely developing gangrenous gums (Yagan), use Huadu Qingbiao Tang added with Shigao (Gypsum Fibrosum) 2 qian. If the rash has fully erupted but rapidly recedes, with persistent fever, residual toxin flowing into the Large Intestine causing tenesmus (Liji Houzhong) and dysentery-like stool (red and white mixed), use Qingre Daozhi Tang.
For individuals with inherent weakness, if excessive dispersing is used during eruption, followed by excessive cold-cooling detoxification after full eruption, leading to extreme weakness, emaciation, fatigue, pale complexion, inability to eat much, and vomiting after eating, urgently use Xiangsha Liujunzi Tang (Aucklandia and Amomum Six Gentlemen Decoction) removing Banxia (Pinelliae Rhizoma) and adding Maidong (Ophiopogonis Radix) to tonify. Various deteriorated conditions require great caution.
Strong's commentary from Shanghai states: If it is not Spleen-Stomach weakness causing poor appetite or vomiting, but rather fundamental deficiency manifesting as morning coolness and evening fever, copious phlegm cough, progressing to skeletal emaciation (commonly known as Sha Lao), tonifying Spleen might hinder Lung Qi, making Xiangsha pills unsuitable.
Measles typically take three days to fully erupt. Erupting twice daily: those erupting at Zi hour dissipate at Si hour; those at Wu hour dissipate at Hai hour. After three days, six eruptions fully dispersed, dense without gaps, is an auspicious sign. Ancients said chickenpox prefers sparsity, while measles prefers density. Even if resembling lacquer dermatitis with uniform redness, it is not a cause for concern.
For infants aged one month to half a year or one year, during hot weather, if they develop milk rash, sha rash, or wind hives, these are not classified as standard measles nor caused by fetal toxin. Medication is generally unnecessary (De notes: boiling 3 cun of Congbai [Allii Fistulosi Bulbus] in water for consumption can help); the rash will dissipate on its own. These arise from internal physiological changes (Bianzheng) and external wind-heat invasion, constituting minor skin ailments. It is common to see them erupt multiple times consecutively without harm. If medication is desired, mild wind-dispersing and heat-clearing agents suffice for quick recovery. Fever lasting three days with visible signs is favorable; delay to five or six days without signs is adverse. Clear spirit is favorable; lethargy is adverse. Families observing taboos can turn adverse cases favorable; ignoring taboos can turn favorable cases adverse. One must clearly instruct families to prevent issues proactively.