轻证因小儿气血和平，素无他病，虽感时气而正能制邪，发热和缓，微微汗出，神气清爽，二便调匀，见点
则容易透澈，散
没则不疾不徐，此系轻证为易治。
重证因小儿素有风寒，食滞、表里交杂，一触邪阳火旺之气，内外合发，而正不能制邪，必大热无汗，烦躁
口渴，神气不清，便闭尿涩，见点不易透澈，收散或太紧束，此系重证为难治。
麻疹之证，其初发热，与伤寒相似，但疹则面颇红，咳嗽喷嚏，鼻流清涕，目中泪出，呵欠喜睡，或吐或
泻，或手掐眉目鼻面之为异耳，不可误作伤寒施治，而妄用汗下也。
妄汗则增其热，而证一变，或鼻衄，或咳嗽，或口疮咽痛，或两目赤痛，或烦躁，或大小便不通。
妄下则虚其里，而证又一变，或滑泄，或滞下。
经曰∶必先岁气，勿伐天和，言不可妄汗妄下也，故治麻疹者，于未出之先，宜用表发，不宜过用寒凉，恐
冰伏毒热，虽出也不能尽透，其毒反内攻于心，若已出透，又当用清利之品，以祛内之余热，况麻疹属阳，留热
则伤阴，阴分伤则血耗，最后以养血为正宗，至临时权变之方，则又当随证为转移，非楮墨之所能尽述也。
麻疹初潮，未现标时，必身热憎寒头疼，咳嗽，或吐，或干呕，或泻，或腹痛，或鼻塞，或鼻流清涕，喷嚏
呵欠，眼胞浮肿，目泪汪汪，腮赤，烦躁不宁，古法主宣毒发表汤（如升麻、葛根、前胡、桔梗、枳壳、荆芥、
防风，薄荷、木通、连翘、牛蒡子、淡竹叶、生甘草，引用芫荽）。
〔真按〕疹亦胎毒所发，其色红而碎密，行于皮肤之间者，属手少阴心经君火也，心肺相连，肺位乎上，
心经火旺，则肺受
之，故肺受毒最重。
咳嗽者，肺因心火炎上，而肺叶焦举也。
鼻流清涕者，鼻为肺之窍，以火烁金，而液自流也。
目中泪出者，肺热则移于肝，肝之窍在目也。
呵欠者，肝属木，木能生风之故也。
吐与干呕者，心火流入于胃也。
眼胞浮肿，腹痛而泄泻者，肺热流于大肠，肺与大肠相表里也。
腮赤烦躁，心火旺也。
喷嚏，肺经火邪也。
或手掐眉目唇鼻及面者，肺热之候也。
细看两耳根下颈项连耳之间，以及背脊之下，至于腰间，必有三五红点，此即麻疹之报标，方用薄荷叶八分，
粉葛花五分，荆芥穗五分，连翘壳钱半，牛蒡子一钱，细木通一钱，盐枳壳六分，淡竹叶钱半，引用灯芯七茎。
附加减法∶
无咳加留白陈皮一钱，以甚其咳，有咳切不宜加；往来潮热者，除淡竹叶不用，加苏叶五分，葱白一寸，以
疏表之，潮热太甚者，加赤茯苓八分，生地钱半，淡黄芩一钱；无汗，加葱白三寸以发之；喘促，加栝蒌仁钱半，
甜葶苈三分，炒莱菔子三分；呕吐，加竹茹钱半，柿霜一钱；呃逆，加鲜枇杷叶一片，鲜竹茹一钱；鼻衄，加鲜
茅根三钱；咽喉痛，加射干一钱，牛蒡子照原方倍用之；唇干齿燥，舌苔枯黄口渴等候，加麦冬钱半，天花粉八分，
生条芩八分，黑栀仁五分；热甚、大便坚实者，加火麻仁二钱，炒枳实八分；大便溏者，除枳壳不用；大便溏泄
而有微汗者，除薄荷竹叶二味不用；洞泄者，加猪苓钱半，泽泻钱半；小便赤者，除薄荷叶加赤茯苓钱半，车前
子六分；小便不通者，加细生地三钱，木通八分，淡竹叶照原方倍用。
轻证是因为小儿气血平和，平时没有其他疾病，虽然感染了时行邪气但正气能制约邪气，发热和缓，微微出汗，神志清爽，大小便正常，出疹点容易透发透彻，消退时不急不慢，这属于轻证，容易治疗。
重证是因为小儿素来有风寒、食积停滞，表里病邪夹杂，一旦接触到邪阳火旺之气，内外合并发作，而正气不能制约邪气，必然出现大热无汗，烦躁口渴，神志不清，大便闭塞小便涩滞，出疹点不易透发透彻，收没或太紧束，这属于重证，难以治疗。
麻疹的病症，在初期发热时，与伤寒相似，但麻疹患者面部明显发红，伴有咳嗽喷嚏，流清鼻涕，眼中流泪，打哈欠喜欢睡觉，或者呕吐或者腹泻，或者用手抓挠眉毛眼睛鼻子面部等表现作为区别，不可误当作伤寒来治疗，从而妄用发汗或攻下的方法。
妄用发汗会增加其热势，导致病情变化，可能出现鼻出血，或咳嗽，或口疮咽痛，或双眼红肿疼痛，或烦躁，或大小便不通。
妄用攻下会损伤体内正气，导致病情再次变化，可能出现滑泄不止，或痢疾。
医经说：必须首先考虑当年的气候特点，不要破坏人体的自然和谐，说的就是不可妄用发汗和攻下之法。因此治疗麻疹的人，在疹子未发出之前，适宜使用解表透发的方法，不宜过度使用寒凉药物，恐怕会使毒热被冰伏在内，即使疹子发出也不能完全透发，毒热反而内攻于心；如果疹子已经透发，又应当使用清热利湿的药物，以清除体内的余热。况且麻疹属阳证，留有余热则会损伤阴液，阴分受损则血液耗伤，最后以养血为根本治法。至于临时的权变方剂，则应当随证候变化而转移，不是笔墨所能详尽叙述的。
麻疹初潮阶段，尚未显现典型标志时，必然身体发热怕冷，头痛，咳嗽，或者呕吐，或者干呕，或者腹泻，或者腹痛，或者鼻塞，或者流清鼻涕，打喷嚏打哈欠，眼睑浮肿，眼中泪水汪汪，腮部发红，烦躁不安，古法主张使用宣毒发表汤（包含升麻、葛根、前胡、桔梗、枳壳、荆芥、防风、薄荷、木通、连翘、牛蒡子、淡竹叶、生甘草，引用芫荽）。
〔真按〕疹也是胎毒所发，颜色红且细密，行于皮肤之间，属于手少阴心经君火。心肺相连，肺位于上焦，心经火旺，则肺受其影响，所以肺受到的毒邪最重。
或者用手抓挠眉毛、眼睛、嘴唇、鼻子及面部，是肺热的征候。
仔细查看两耳根下颈项连耳之间，以及背脊之下，直到腰间，必然有三五个红点，这就是麻疹的报标（先兆），此时方用薄荷叶八分，粉葛花五分，荆芥穗五分，连翘壳一钱半，牛蒡子一钱，细木通一钱，盐枳壳六分，淡竹叶一钱半，引用灯芯七茎。
加减法：
没有咳嗽加留白陈皮一钱，以加重其咳（注：此处原文逻辑似有误，通常无咳不加辛散，或有特定语境，依原文直译）；有咳嗽切忌不宜加；往来潮热者，去掉淡竹叶不用，加苏叶五分，葱白一寸，以疏解表邪，潮热太甚者，加赤茯苓八分，生地一钱半，淡黄芩一钱；无汗，加葱白三寸以发汗；喘促，加栝蒌仁一钱半，甜葶苈三分，炒莱菔子三分；呕吐，加竹茹一钱半，柿霜一钱；呃逆，加鲜枇杷叶一片，鲜竹茹一钱；鼻出血，加鲜茅根三钱；咽喉痛，加射干一钱，牛蒡子照原方加倍使用；嘴唇干燥牙齿燥渴，舌苔枯黄口渴等症状，加麦冬一钱半，天花粉八分，生条芩八分，黑栀仁五分；热势甚、大便坚实者，加火麻仁二钱，炒枳实八分；大便溏者，去掉枳壳不用；大便溏泄而有微汗者，去掉薄荷、竹叶两味不用；洞泄（严重腹泻）者，加猪苓一钱半，泽泻一钱半；小便赤者，去掉薄荷叶加赤茯苓一钱半，车前子六分；小便不通者，加细生地三钱，木通八分，淡竹叶照原方加倍使用。
Mild cases occur because the child's Qi and Blood are harmonious, with no prior illnesses. Although exposed to seasonal pathogens, the healthy Qi can control the pathogenic factors. The fever is mild, with slight sweating, clear spirit, and regular bowel and bladder movements. When the rash appears, it penetrates easily and thoroughly; when it fades, it does so neither too fast nor too slow. This constitutes a mild case, which is easy to treat.
Severe cases arise because the child previously suffered from wind-cold or food stagnation, resulting in mixed exterior and interior pathologies. Upon exposure to intense Yang-fire pathogenic energy, internal and external factors combine to erupt, while the healthy Qi fails to control the pathogens. Symptoms must include high fever without sweating, irritability, thirst, unclear spirit, constipation, and dysuria. The rash points are difficult to penetrate thoroughly, and their fading may be either too tight/constricted or irregular. This constitutes a severe case, which is difficult to treat.
The symptoms of measles, during the initial fever stage, resemble those of cold damage (Shanghan). However, in measles, the face is notably red, accompanied by coughing, sneezing, runny nose with clear mucus, tearing eyes, yawning, drowsiness, vomiting or diarrhea, or scratching at the eyebrows, eyes, nose, and face. These differences distinguish it from cold damage. It must not be mistaken for cold damage and treated with reckless diaphoresis (sweating) or purgation.
Reckless diaphoresis will increase heat, altering the syndrome: symptoms may include epistaxis, cough, mouth ulcers, sore throat, red and painful eyes, irritability, or obstruction of urination and defecation.
Reckless purgation will empty the interior, further altering the syndrome: symptoms may include slippery diarrhea or dysentery.
The Classics state: "First consider the annual climate qi, do not violate the harmony of Heaven (natural vitality)." This means one must not recklessly use diaphoresis or purgation. Therefore, in treating measles, before the eruption, one should employ methods to release the exterior and promote eruption, avoiding excessive use of cold-cooling herbs. Otherwise, the toxic heat may be frozen inside like ice; even if the rash emerges, it may not fully penetrate, and the toxin may attack the Heart internally. If the rash has already fully erupted, one should then use clearing and draining agents to remove residual internal heat. Moreover, since measles belongs to Yang, retained heat damages Yin; damage to the Yin aspect leads to blood consumption. Thus, nourishing blood is the fundamental treatment principle at the end stage. As for temporary adaptive formulas, they must shift according to the specific syndrome, which cannot be exhaustively described in writing.
During the initial onset of measles, before typical signs appear, there is invariably body heat with aversion to cold, headache, cough, vomiting, dry heaving, diarrhea, abdominal pain, nasal congestion, runny nose with clear mucus, sneezing, yawning, swollen eyelids, watery eyes, flushed cheeks, and irritability. Ancient methods advocate using Xuan Du Fa Biao Tang (Disperse Toxicity and Release Exterior Decoction), containing Shengma (Cimicifugae Rhizoma), Gegen (Puerariae Lobatae Radix), Qianhu (Peucedani Radix), Jiegeng (Platycodonis Radix), Zhike (Aurantii Fructus), Jingjie (Schizonepetae Spica), Fangfeng (Saposhnikoviae Radix), Bohe (Menthae Haplocalycis Herba), Mutong (Akebiae Caulis), Lianqiao (Forsythiae Fructus), Niubangzi (Arctii Fructus), Danzhuye (Lophatheri Herba), and Sheng Gancao (Glycyrrhizae Radix et Rhizoma Preparata), with Yuansui (Coriandri Fructus) as an引 (guide).
[Commentary by Zhen] Rashes also erupt from fetal toxins. Their color is red and dense, moving within the skin, belonging to the Jun Fire of the Hand-Shaoyin Heart Meridian. The Heart and Lung are connected; the Lung resides in the upper jiao. When Heart Fire flares up, the Lung is affected, so the Lung bears the heaviest toxic burden.
Coughing occurs because Lung Fire flares upward due to Heart Fire, causing the lung tissue to become scorched and elevated.
Runny nose with clear mucus occurs because the nose is the opening of the Lung; fire scorching Metal (Lung) causes fluids to flow freely.
Tearing occurs because Lung heat transfers to the Liver, and the Liver opens into the eyes.
Yawning occurs because the Liver belongs to Wood, and Wood generates Wind.
Vomiting and dry heaving occur because Heart Fire flows into the Stomach.
Swollen eyelids, abdominal pain, and diarrhea occur because Lung heat flows into the Large Intestine, as the Lung and Large Intestine are exterior-interior paired organs.
Flushed cheeks and irritability indicate vigorous Heart Fire.
Sneezing indicates Fire-pathogens in the Lung Meridian.
Scratching at the eyebrows, eyes, lips, nose, and face indicates Lung heat.
Carefully examine the area between the roots of both ears, the neck connecting to the ears, the lower back, and the waist. There will inevitably be three to five red spots; these are the herald signs (bao biao) of measles. The formula used is: Bohe Ye (Menthae Haplocalycis Folium) 8 fen, Fengehua (Puerariae Flos) 5 fen, Jingjie Sui (Schizonepetae Spica) 5 fen, Lianqiao Qiao (Forsythiae Fructus) 1.5 qian, Niubangzi (Arctii Fructus) 1 qian, Xi Mutong (Akebiae Caulis) 1 qian, Yan Zhike (Aurantii Fructus cum Sale) 6 fen, Danzhuye (Lophatheri Herba) 1.5 qian, with Dengxin (Junci Medulla) 7 strands as a guide.
Modifications:
If there is no cough, add Liubai Chenpi (Citri Reticulatae Pericarpium prepared with white residue) 1 qian to intensify the cough (Note: Textual logic implies preventing premature suppression or specific context); if there is a cough, do not add this. For alternating tidal fever, remove Danzhuye, add Ziye (Perillae Folium) 5 fen and Congbai (Allii Fistulosi Bulbus) 1 cun to release the exterior; if tidal fever is severe, add Chifuling (Polypori Cum Poria Rubra) 8 fen, Shengdi (Rehmanniae Radix Preparata) 1.5 qian, and Huangqin (Scutellariae Radix) 1 qian. For absence of sweat, add Congbai 3 cun to induce sweating. For panting/wheezing, add Gualouren (Trichosanthis Semen) 1.5 qian, Tiantingli (Descurainiae Semen seu Lepidii Semen) 3 fen, and Laofuzi (Radish Seed) 3 fen. For vomiting, add Zhuru (Bambusae Caulis in Taenia) 1.5 qian and Shishuang (Diospyros Frost) 1 qian. For hiccups, add Xin Pipaye (Eriobotryae Folium) 1 leaf and Xin Zhuru (Bambusae Caulis in Taenia) 1 qian. For epistaxis, add Mao Gen (Imperatae Rhizoma) 3 qian. For sore throat, add Shegan (Belamcandae Rhizoma) 1 qian, and double the dose of Niubangzi from the original formula. For dry lips, dry teeth, withered yellow tongue coating, and thirst, add Maidong (Ophiopogonis Radix) 1.5 qian, Tianhuafen (Trichosanthis Radix) 8 fen, Sheng Tiaoqin (Scutellariae Radix) 8 fen, and Hei Zhiren (Gardeniae Fructus Preparata) 5 fen. For intense heat and hard stool, add Huomaren (Cannabis Semen) 2 qian and Chao Zhishi (Aurantii Fructus Preparatus) 8 fen. For loose stool, remove Zhike. For loose stool with slight sweating, remove Bohe and Zhu Ye. For profuse watery diarrhea, add Zhuling (Polyporus) 1.5 qian and Zexie (Alismatis Rhizoma) 1.5 qian. For red urine, remove Bohe Ye, add Chifuling 1.5 qian, and Cheqianzi (Plantaginis Semen) 6 fen. For urinary obstruction, add Xi Shengdi (Rehmanniae Radix Preparata) 3 qian, Mutong 8 fen, and double the dose of Danzhuye from the original formula.