麻之出不离肺胃两家，前集已言之详矣。喘闭者肺证也，烦渴者胃证也。冬月喘闭知治
者多麻黄杏仁为救急之药，治之速，麻出喘定而解者有之。夏令出麻，麻黄与时不合，庸工
不识，一见喘闭执而用之，故随药而死。麻多火证，火甚克金，夏令金亏，天人皆病，麻黄万
不能受。冬月之喘闭有面青唇暗者，有四支冷者，故可用麻黄。夏月肺气已亏，表气已开，断
无寒证，亦有四支冷者，是阳气亏不能四达，只可荆防甘桔从轻用药，亏甚者加人参，火甚
喘者升麻石膏汤救之，喘渐定者可治。
胃热烦渴者必多汗，纯是里热，即荆防葛根不可轻使，升麻石膏汤是对证之药，合之甘
桔则肺胃二家之热解矣。
喘闭证在一二朝见，汗渴证在五六朝见，肺不容邪其变也速，胃能容受其变也迟。
麻痘是先天之病，热从内生，必伤阴液，毒解之后，热久不退，总以养阴为主。胃气不
败，缓缓收功，肌瘦不食者，不可为矣。
肺主皮毛，麻虽出于六腑，必从皮毛而解，故不离乎肺。解之不透，久咳潮热，累成麻
疳者有之，此疳字非疳积之疳，潮热肌瘦有似乎疳，宜润肺，辛燥药用不得。
胃为受毒之壑，遣热甚多，莫急于牙疳。牙疳是失清之证，须大剂清里。便闭者下之，
使热毒内泄，与痘后同治。予前集有勒马饮，甚者加大黄，急清之稍迟，不但齿落腮穿，有
唇鼻蚀烂者，涂药不过帮扶而已。
麻证表一透无变证，表未透而生变。在严寒盛暑之月，不过一个时辰便走，未透表之麻证须要早回。
（附）足阳明胃脉，循鼻外，上入齿中，挟口环唇，循颊车，上耳前，主上牙根；手阳明大
肠脉，上颈贯颊，入下齿中，侠口交人中，主下牙根。牙疳阳明经病，煎剂宜经药为响导，予制勒马饮。
生地黄（五钱） 石膏（三钱） 绵茵陈 鲜竹叶 江枳壳 人中黄（各六分） 黄连 犀角（各五
分） 升麻（三分） 金汁（五匙）
此方重用清胃之药，加升麻竹叶茵陈引入阳明之经，人中黄金汁大解胃中热毒。清而
不能达经，与不能解毒，均非法之善也。
凡见牙疳，一日龈黑，二日齿动，三日齿落，其来最速，故谓之走马。
牙疳在门牙者唇肿。在坐牙者腮肿。洗去臭秽，吹以敷药，肿消而牙不落者易愈。若
牙落而肿不消者不可治也。
又有误服辛燥药而成者，治法稍松。但与清解之剂，如竹叶石膏汤加甘草 黑豆山栀木通之类。
牙疳单见无兼证者可治。若身发大热，饮食不思者不可治也。
麻疹的透发离不开肺和胃两经，前集已经详细论述过了。出现气喘闭塞的是肺经受邪的表现，出现烦躁口渴的是胃经受邪的表现。冬季出现气喘闭塞，懂得治疗的医生多使用麻黄、杏仁作为救急的药物，治疗迅速，麻疹透出后气喘平息而病愈的情况是有的。夏季透发麻疹，使用麻黄与时令不合，庸医不认识这一点，一见气喘闭塞就坚持使用麻黄，所以患者随药而死。麻疹多伴有火证，火势旺盛克制肺金，夏季肺气本就亏虚，天人相应皆受其害，此时万万不能承受麻黄的辛温发散。冬季的气喘闭塞有面色青紫、嘴唇暗滞的，有四肢冰冷的，所以可以使用麻黄。夏季肺气已经亏虚，表气已经开泄，断然没有寒证，虽然也有四肢冰冷的情况，但这是阳气亏虚不能通达四肢所致，只能使用荆芥、防风、甘草、桔梗等轻清的药物，亏虚严重的加用人参，火势旺盛导致气喘的使用升麻石膏汤来急救，气喘逐渐平定后可以治愈。
胃热导致的烦躁口渴必然伴随多汗，这完全是里热证，即使是荆芥、防风、葛根也不可以轻易使用，升麻石膏汤是对证的药物，配合甘草、桔梗则肺胃两经的热邪即可解除。
气喘闭塞的症状在发病一二天出现，汗出口渴的症状在发病五六天出现，肺脏不容纳邪气，其变化迅速；胃脏能容纳邪气，其变化缓慢。
麻疹和痘疹是先天性的疾病，热邪从内生发，必然损伤阴液，毒邪解除之后，如果热邪久久不退，总以滋养阴液为主。只要胃气不败坏，就能缓缓收功，如果肌肉消瘦、不能进食，那就无法治愈了。
肺主皮毛，麻疹虽然出于六腑，但必须从皮毛透解，所以离不开肺经。如果透发不彻底，导致久咳、潮热，累积形成麻疳（因麻疹引起的疳积类病症）的情况是有的，这里的“疳”字不是指普通的疳积之疳，潮热肌瘦看起来像疳积，适宜润肺，辛燥的药物绝对不能用。
胃是容纳毒邪的壅塞之处，遣散热邪很多，最紧急的是牙疳（牙龈腐烂坏死）。牙疳是失于清解的证候，必须用大剂量的药物清泻里热。大便闭结的用攻下法，使热毒从内部排泄，与痘疹后的治疗方法相同。我前集中有勒马饮方，病情严重的加大黄，急需清解，如果稍微迟缓，不但牙齿脱落、腮部穿孔，还有嘴唇鼻子蚀烂的情况，涂抹外药不过只是辅助扶持而已。
麻疹证候一旦透发就没有变证，透发不透就会产生变证。在严寒或盛暑的月份，病情变化不过一个时辰就会发生走注（迅速转移），未透发的麻疹证候需要尽早回护透发。
（附注）足阳明胃脉，循行于鼻外侧，向上进入齿中，挟口环绕嘴唇，循行于颊车穴，向上至耳前，主管上牙根；手阳明大肠脉，上行颈部贯穿面颊，进入下齿中，挟口交叉于人中部，主管下牙根。牙疳属于阳明经的病证，煎剂宜用引经药作为向导，我制作勒马饮方。
生地黄（五钱） 石膏（三钱） 绵茵陈 鲜竹叶 江枳壳 人中黄（各六分） 黄连 犀角（各五分） 升麻（三分） 金汁（五匙）
此方重用清胃的药物，加入升麻、竹叶、茵陈引入阳明经，人中黄和金汁大力解除胃中的热毒。如果清热而不能到达经络，与不能解毒一样，都不是好的治法。
凡是见到牙疳，第一天牙龈发黑，第二天牙齿松动，第三天牙齿脱落，其来势最速，所以称为走马牙疳。
牙疳发生在门牙处的，嘴唇会肿胀。发生在侧牙（坐牙）处的，腮部会肿胀。洗去臭秽之物，吹敷药物，肿胀消退且牙齿不脱落的容易治愈。如果牙齿脱落而肿胀不消的，不可治愈。
又有误服辛燥药物而形成的，治疗方法稍宽松。只给予清解的药剂，如竹叶石膏汤加甘草、黑豆、山栀、木通之类的药物。
牙疳单独出现而没有兼夹其他证候的可以治愈。如果身体发高热，不思饮食的，不可治愈。
The eruption of measles (Measles) does not depart from the Lung and Stomach meridians, which has been discussed in detail in the previous collection. Wheezing and obstruction are manifestations of the Lung meridian; irritability and thirst are manifestations of the Stomach meridian. In winter, for those with wheezing and obstruction who understand treatment, doctors often use Ephedrae Herba (Mahuang, 麻黄) and Armeniacae Semen Amarum (Xingren, 杏仁) as emergency rescue medicines. The treatment is rapid, and there are cases where the measles erupt, the wheezing subsides, and the disease resolves. In summer, when measles erupt, using Ephedrae Herba (Mahuang, 麻黄) is contrary to the season. Quack doctors fail to recognize this; upon seeing wheezing and obstruction, they insist on using it, leading to death shortly after administration. Measles are mostly accompanied by Fire syndromes. When Fire is excessive, it overacts on Metal (Lung). In summer, Lung Qi is already deficient, and both heaven (nature) and humanity are affected; thus, Ephedrae Herba (Mahuang, 麻黄) absolutely cannot be tolerated. Winter wheezing and obstruction may present with a cyan face and dark lips, or cold limbs, so Ephedrae Herba (Mahuang, 麻黄) can be used. In summer, Lung Qi is already deficient, and the exterior Qi is already open; there is definitely no Cold syndrome. Although there may be cold limbs, this is due to deficient Yang Qi failing to reach the extremities. One should only use light medications such as Schizonepetae Spica (Jingjie, 荆芥), Saposhnikoviae Radix (Fangfeng, 防风), Glycyrrhizae Radix et Rhizoma (Gancao, 甘草), and Platycodonis Radix (Jiegeng, 桔梗). If deficiency is severe, add Ginseng Radix (Renshen, 人参). For severe Fire causing wheezing, use Shengma Shigao Tang (Cimicifugae and Gypsum Decoction) for rescue. If the wheezing gradually stabilizes, the patient can be cured.
Stomach Heat causing irritability and thirst must be accompanied by profuse sweating; this is purely Interior Heat. Even Schizonepetae Spica (Jingjie, 荆芥), Saposhnikoviae Radix (Fangfeng, 防风), and Puerariae Radix (Ge Gen, 葛根) should not be lightly administered. Shengma Shigao Tang (Cimicifugae and Gypsum Decoction) is the appropriate formula. Combined with Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) and Platycodonis Radix (Jiegeng, 桔梗), the Heat in both the Lung and Stomach meridians will be resolved.
Wheezing and obstruction symptoms appear on the first or second day; sweating and thirst symptoms appear on the fifth or sixth day. The Lung cannot tolerate pathogenic factors, so its changes are rapid; the Stomach can accommodate them, so its changes are slow.
Measles and Smallpox are congenital diseases. Heat arises from within, inevitably damaging Yin fluids. After the toxin is resolved, if Heat persists for a long time, the primary approach is to nourish Yin. As long as Stomach Qi does not collapse, recovery can be achieved gradually. If the muscles are emaciated and the patient refuses food, it is incurable.
The Lung governs the skin and hair. Although measles emerge from the Six Fu Organs, they must resolve through the skin and hair, hence they are inseparable from the Lung. If resolution is incomplete, chronic cough and tidal fever may result, accumulating into Mei Gan (Measles-related Phthisis/Gan Syndrome). Here, "Gan" does not refer to ordinary Gan accumulation (Phthisis due to malnutrition); rather, the tidal fever and emaciation resemble Gan syndrome. It is suitable to moisten the Lung; acrid-drying herbs must not be used.
The Stomach is the reservoir where toxins accumulate, discharging much heat. The most urgent complication is Ya Gang (Gangrene of the Gums). Ya Gang (Gangrene of the Gums) is a condition resulting from failure to clear Heat. It requires large doses of herbs to clear Interior Heat. If there is constipation, use purgation to allow Heat and toxins to drain internally, treating it similarly to post-smallpox conditions. In my previous collection, I presented Le Ma Yin (Horse-Restraining Drink). For severe cases, add Rhei Radix et Rhizoma (Dahuang, 大黄). Urgent clearing is required; if delayed, not only will teeth fall out and cheeks perforate, but lips and noses may also erode and rot. Topical applications merely provide auxiliary support.
If the exterior of Measles is fully released, there are no complicated transformations; if not fully released, complications arise. In months of severe cold or intense heat, the condition can shift in just one shichen (two hours). Unreleased Measles must be addressed early to restore proper release.
(Attachment) The Foot-Yangming Stomach Meridian runs along the outside of the nose, enters the teeth, surrounds the mouth and lips, runs along the Jiache point, and ascends to the front of the ear, governing the upper gum roots. The Hand-Yangming Large Intestine Meridian ascends the neck, passes through the cheek, enters the lower teeth, crosses the mouth at the Renzhong point, and governs the lower gum roots. Ya Gang (Gangrene of the Gums) is a disease of the Yangming meridians. Decoctions should use channel-guiding herbs as leaders. I formulated Le Ma Yin (Horse-Restraining Drink):
Rehmanniae Radix Preparata (Sheng Dihuang, 5 qian), Gypsum Fibrosum (Shigao, 3 qian), Eupatorii Herba (Mian Yinch en, fresh Zhuye, Imperatae Rhizoma - note: text says Mian Yinch en, usually Artemisiae Scopariae Herba or similar, here interpreted as茵陈), Fresh Bambusae Folium (Xian Zhuye), Aurantii Fructus (Jiang Zhiqiao), Hominis Excrementia Depurata (Ren Zhonghuang) (each 6 fen), Coptidis Rhizoma (Huanglian), Cornu Bubali (Xijiao) (each 5 fen), Cimicifugae Rhizoma (Shengma, 3 fen), Jin Zhi (5 spoons).
This formula heavily uses herbs that clear the Stomach, adding Cimicifugae Rhizoma (Shengma, 3 fen), Bambusae Folium, and Eupatorii Herba to guide the action into the Yangming meridian. Hominis Excrementia Depurata (Ren Zhonghuang, 6 fen) and Jin Zhi powerfully resolve Heat and toxins in the Stomach. If clearing Heat fails to reach the meridians, or fails to resolve toxins, neither is an effective method.
Whenever Ya Gang (Gangrene of the Gums) appears, the gums turn black on the first day, teeth become loose on the second day, and teeth fall out on the third day. Its progression is extremely rapid, hence it is called "Running Horse" Ya Gang.
If Ya Gang (Gangrene of the Gums) occurs in the incisors, the lips swell. If it occurs in the molars (Zuo Ya), the cheeks swell. Wash away foul matter, apply powder topically. If swelling subsides and teeth do not fall out, it is easy to cure. If teeth fall out and swelling persists, it is incurable.
There are also cases caused by mistakenly taking acrid-drying herbs; the treatment method is slightly more lenient. Only administer clearing and resolving formulas, such as Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) added with Glycyrrhizae Radix et Rhizoma (Gancao, 甘草), Sojae Semen Preparatum (Heidou), Gardeniae Fructus (Shanzhi), and Akebiae Caulis (Mutong).
Ya Gang (Gangrene of the Gums) appearing alone without accompanying syndromes can be cured. If the body has high fever and the patient has no appetite, it is incurable.