疹出之时，自利不止，或泻稀水频数者，最为恶侯，但看其疹。若遍身稠密红紫
者，不妨，盖非泻则郁遏不解，惟宜清利，疹一发透，自然泻止。若疹已收而泻仍不止
者，疹必未尽，宜用清托，并分利之，切不可用诃子、肉蔻涩滞之药，致变腹胀喘急不治之症矣。
夫疹子出没常以六时为准，假如子后出者而午时即收，午后出者而子时即收，盖午
后为阴，子后为阳，乃阴生阳成，阳长阴收之数也。旋出旋收者为轻。若一出三四日而
不收者，乃阳毒太盛，宜大青汤解之。然疮疹非热不出，既出而诸病悉解身凉者，此为
正候。若既出而热甚不减者，此毒壅遏未除，亦宜大青汤，以解其表，便涩者，则用
黄连解毒之类，以解其里。更有烦闷不宁而吐利者，同此意而变通之如有逡巡不出者。
乃风寒外束，皮肤闭密也，宜荆防败毒散之，疹尽出而烦躁吐利自愈矣。然疹子之
出，须使其毒尽解。若不尽解，则毒蓄于中，壮热日久，枯瘁成疳，或成惊阐泄痢，
或咳血喘促，或作疳 而死。
痧疹者，肺胃二经之火热而为病也。注儿居多，大人亦时有之，殆时气瘟疫之类
欤，治法当以清凉发散为主，药用辛寒、甘寒、苦寒以开发之，惟忌酸收，最宜辛散，
辛散如荆芥、西河柳、干葛、石膏、鼠粘、麻黄；清凉如玄参、竹叶、天花粉，青黛、
薄荷；甘寒如麦冬、生甘草、蔗浆；苦寒如黄芩、黄连、贝母、连翘。随证轻重，制大
小，中病则已，毋大过焉。
痧疹初发咳嗽，宜清热透毒，不得止嗽疹后咳嗽，但用贝母、苦梗、甘草、薄荷、
天花粉、玄参、麦冬，以清余热，消痰壅则自愈，慎勿用收敛之剂。多喘者，邪热壅于
肺也。慎勿用定喘药，惟应大剂竹叶石膏汤，加西河柳两许，玄参、薄荷各二钱。心
热势盛者，即用白虎汤，加西河柳，忌用升麻，服之必喘。疹多泄泻，慎勿止泻，惟用
黄连、干葛、升麻、甘草，则泻自止，疹家不忌泻，泻则阳明之邪热得解，是亦表里分
消之义也。疹后泄泻及便脓血，皆由热邪内陷也。大忌止涩，惟直升散，仍用或麻、甘
草、干葛、黄连、白芍药、白扁豆，便脓血则加滑石末，得必自愈也。若果上热下寒，
上实下虚之症，当作虚论，以从治之法治之，不可以寒凉正治也。如冬天寒甚，疹毒
郁于内而不得透出者，不得误投寒凉，如石膏、竹叶、西河柳之类，宜用荆、防、蝉
蜕、羌活、葱白、芫荽之类，再加蜜酒炒麻黄一剂即止，亦勿过用。
疹后牙疳最危，外用牡黄牛粪尖， 存性，研极细，加真片脑一分，研匀，吹之，
内用连翘、干葛、荆芥穗、升麻、玄参、黄连、甘草、生地黄水煎，加生奉角汁二三十
匙调服，缓则不可救药。若脾气虚寒，不能按纳下焦阴火而为牙疳口疮者，又宜理中之
类，火自退舍，总宜凭脉用药，勿以麻疹热毒为定认，盖诸病有初、周、末，异之迥殊
也。
疹退之后，微微咳嗽者，此作余毒未尽也，用清肺饮，加消毒饮主之。若咳甚气
喘，连声不住，名为顿嗽，甚则饮食汤水俱出，或咳出血者，此热毒乘肺也，宜多服麦
冬清肺饮，加连翘主之，若见胸高如圭肩耸而喘，血退场门鼻，摆首摇头，面色，或白或
青，或红而枯黯者，不可治矣。然亦有肺气虚而发喘，连声不已，无咳嗽血出呛食之症
者，宜清肺饮，倍加人参，不可的确于肺热之一端，纯用清肺解毒也。
疹子与痘似轻，然调治失宜，其祸反不旋踵，盖痘由胎毒而发，情势多少轻重吉
凶，自可预断。疹由感受时气而发，轻者可重，重者可轻，皆在于调治有方，故药饵饮
食禁忌。此痘家尤宜中节，痧后生疮，荣分余热未尽也，宜金银花、荆芥穗、连翘、玄
参、甘草、生地、鳖虱参、麻黄、连木通，浓煎饮之。痧疹不宜根据证施治，惟宜治本。
本者，手太阴并阳明二经之邪热也。解其邪热，则诸证自退矣。
在疹子发出期间，如果出现腹泻不止，或者频繁排出稀水样便的情况，这是最为凶险的征候。此时只需观察疹子的形态：如果全身疹子稠密且颜色红紫，则无大碍，这是因为如果不通过腹泻，体内的郁结之气就无法解除；治疗上只宜采用清热利湿的方法，待疹子完全透发出来，腹泻自然会停止。如果疹子已经消退但腹泻仍不停止，说明疹毒尚未排尽，适宜使用清托法（清解余毒并扶助正气），并配合分利小便的方法，切不可使用诃子、肉豆蔻等具有收敛固涩作用的药物，以免导致腹胀、气喘急促等无法救治的病症。
疹子的出没通常以十二时辰为规律。例如，子时之后发出的疹子，到午时就会消退；午后发出的疹子，到子时就会消退。这是因为午后属阴，子时之后属阳，符合“阴生阳成，阳长阴收”的自然数理。疹子刚出现就迅速消退的属于轻症。如果疹子发出后三四天都不消退，这是阳热毒邪太盛，适宜用大青汤来解表清热。然而，疮疹并非有热就不能发出，既然疹子发出了，各种病症都解除了，身体也凉下来了，这才是正常的征候。如果疹子发出后发热依然严重不减，这是毒邪壅滞未除，也适宜用大青汤来解表；如果伴有小便短赤涩痛，则应用黄连解毒汤之类的方剂来清里热。更有甚者，出现烦躁闷乱、不安宁以及呕吐腹泻的症状，其道理与此相同，只是需要灵活变通。如果有疹子迟迟发不出的情况，这是由于风寒外束，皮肤毛孔闭塞所致，适宜用荆防败毒散治疗，待疹子全部发出，烦躁、呕吐、腹泻等症状自然痊愈。然而，疹子的发出，必须使其毒邪完全解除。如果未能完全解除，毒邪蓄积在体内，会导致长期高热，身体枯瘦憔悴而成疳积，或者引发惊风、泄泻痢疾，或者咳血、气喘急促，甚至因患疳积而死。
痧疹（麻疹）是由于肺经和胃经的火热之邪致病。多见于儿童，成人偶尔也有患病，这大概是时行瘟疫一类的疾病吧。治疗方法应当以清凉发散为主，用药多用辛寒、甘寒、苦寒性质的药物来开发腠理，唯独忌讳酸味收敛的药物，最适宜用辛散的药物。辛散药如荆芥、西河柳、干葛（葛根）、石膏、鼠粘子（牛蒡子）、麻黄；清凉药如玄参、竹叶、天花粉、青黛、薄荷；甘寒药如麦冬、生甘草、蔗浆；苦寒药如黄芩、黄连、贝母、连翘。根据病情的轻重，决定方剂的大小剂量，中病即止，不要过度用药。
痧疹初发时出现咳嗽，适宜清热透毒，不能强行止咳。疹后咳嗽，只用贝母、桔梗、甘草、薄荷、天花粉、玄参、麦冬，以清除余热，消除痰浊壅滞，症状自然痊愈，务必慎用收敛类药物。喘息较多的，是邪热壅塞于肺所致。切勿使用定喘药，只应使用大剂量的竹叶石膏汤，加入约一两西河柳，玄参、薄荷各二钱。心火炽盛的，立即使用白虎汤，加入西河柳，忌用升麻，服用升麻必然导致气喘。疹子多伴有泄泻，切勿止泻，只用黄连、干葛、升麻、甘草，腹泻自然停止。患疹者并不忌讳腹泻，因为腹泻能使阳明经的邪热得到解除，这也符合表里分消的道理。疹后泄泻及大便带脓血，都是由热邪内陷所致。严禁使用止涩药，只宜升散，仍可用麻黄、甘草、干葛、黄连、白芍药、白扁豆，若大便脓血则加滑石末，服药后必能自愈。如果确实是上热下寒、上实下虚的证候，应按虚证论治，采用从治法（反治法）治疗，不可单纯用寒凉药正治。如冬天寒冷严重，疹毒郁结在体内而不能透发出来的，不得误投寒凉药，如石膏、竹叶、西河柳之类，适宜用荆芥、防风、蝉蜕、羌活、葱白、芫荽之类，再加蜜酒炒制的麻黄，一剂即可见效，也不要过量使用。
疹后出现牙疳是最危险的，外用黄牛粪尖（保留药性），研成极细粉末，加入真冰片一分，研匀，吹入患处；内服连翘、干葛、荆芥穗、升麻、玄参、黄连、甘草、生地黄水煎，加入鲜牛角汁二三十匙调服，若拖延则不可救药。如果是脾气虚寒，不能摄纳下焦阴火而导致的牙疳口疮，又适宜用理中汤之类的方剂，火气自然消退。总之，应当凭脉象用药，不要认定麻疹一定是热毒，因为各种疾病在初期、中期、末期，差异非常大。
疹退之后，若有轻微咳嗽，这是余毒未尽的表现，用清肺饮，配合消毒饮主治。如果咳嗽剧烈、气喘，连续不断，名为顿嗽，严重时饮食汤水俱出，或者咳出血来，这是热毒乘袭肺脏，适宜多服麦冬清肺饮，加入连翘主治。如果见到胸部高耸如丘、耸肩喘息，血液从肛门和鼻孔流出，摆头摇首，面色或白或青，或红而枯黯的，是不可治愈的死证。然而也有因肺气虚而导致气喘，连续不断，但没有咳嗽、咳血、呛食等症状的，适宜用清肺饮，加倍加入人参，不可固执地认为仅是肺热一端，而纯用清肺解毒药。
疹子与痘疮看似较轻，但如果调理治疗不当，其祸患反而来得很快。痘疮由胎毒引发，病情的大致轻重吉凶，可以预先判断。疹子由感受时气引发，轻的可能变重，重的可能变轻，关键在于调理治疗是否有方，因此药物、饮食禁忌都要讲究适度。痘家尤其要注意用药的中节。痧后生疮，是营分中余热未尽，适宜用金银花、荆芥穗、连翘、玄参、甘草、生地、鳖虱参（注：此处疑为异名或笔误，依原文提取）、麻黄、连木通，浓煎饮用。治疗痧疹不宜仅仅根据表面症状施治，只宜治本。所谓本，就是手太阴肺经和手阳明大肠经的邪热。解除了这些邪热，各种症状自然消退。
During the eruption of rashes (Measles), if diarrhea persists without stopping, or if frequent watery stools are passed, this is the most ominous sign. At this time, one should only observe the rash: if the rash is dense all over the body and red-purple in color, there is no cause for alarm, because if not for the diarrhea, the stagnant qi would not be resolved; treatment should focus on clearing heat and promoting diuresis. Once the rash fully erupts, the diarrhea will naturally cease. If the rash has subsided but the diarrhea continues, it indicates that the rash toxin has not been completely expelled. It is appropriate to use a method of clearing and supporting (clearing residual toxins while supporting healthy qi) along with methods to separate and promote urination. One must absolutely avoid using astringent drugs such as Chebula Fructus (Hezi) and Myristica Seed (Roukou), lest they lead to abdominal distension, panting, and urgency, which are untreatable conditions.
The emergence and disappearance of rashes usually follow a twelve-hour cycle. For example, rashes emerging after the Zi hour (11 PM - 1 AM) will subside by the Wu hour (11 AM - 1 PM); those emerging in the afternoon will subside at the Zi hour. This is because the afternoon belongs to Yin, and the period after Zi belongs to Yang, conforming to the natural principle of "Yin generates, Yang completes; Yang grows, Yin retracts." Rashes that emerge and quickly subside are considered mild cases. If rashes emerge and do not subside for three to four days, it indicates excessive Yang heat toxin, and Daqing Tang (Great Blue Decoction) should be used to resolve the exterior. However, sores and rashes require heat to erupt; once the rashes have erupted and all other symptoms have resolved with the body cooling down, this is the normal course. If fever remains severe even after the rashes have erupted, it indicates that the toxin is still congested and unremoved. In this case, Daqing Tang should also be used to resolve the exterior; if accompanied by scanty and painful urination, formulas like Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxins) should be used to clear interior heat. Furthermore, if there is irritability, restlessness, vomiting, and diarrhea, the principle is similar, requiring flexible adaptation. If rashes fail to emerge for a while, it is due to external constraint by wind-cold and closed skin pores; Jingfang Baidu San (Schizonepeta and Saposhnikovia Powder to Rescue from Toxicity) should be used. Once the rashes fully emerge, the irritability, vomiting, and diarrhea will naturally heal. However, the emergence of rashes must ensure that the toxin is completely resolved. If not completely resolved, the toxin accumulates internally, leading to prolonged high fever, emaciation, and development of malnutrition syndromes (Gan), or triggering convulsions, diarrhea, and dysentery, hemoptysis, panting, and even death due to Gan syndrome.
Sha Zhen (Scarlet Fever/Measles-like rash) is caused by fire-heat in the Lung and Stomach meridians. It occurs mostly in children, and occasionally in adults; it is likely a type of seasonal epidemic disease. The treatment method should primarily focus on clearing heat and dispersing externally. Medicines should be pungent-cold, sweet-cold, or bitter-cold to open the pores. Astringent flavors are strictly contraindicated, while pungent dispersants are highly suitable. Pungent dispersants include Schizonepeta Spike (Jingjie), Tamarix Herb (Xihe Liu), Kudzu Root (Gegen), Gypsum Fibrosum (Shigao), Arctium Fruit (Niubangzi), and Ephedra Stem (Mahuang); cooling agents include Scrophularia Root (Xuanshen), Bamboo Leaf (Zhuye), Trichosanthes Root (Tianhuafen), Indigo Naturalis (Qingdai), and Mint (Bohe); sweet-cold agents include Ophiopogon Tuber (Maidong), Raw Licorice Root (Sheng Gancao), and Sugarcane Juice (Zhe Jiang); bitter-cold agents include Scutellaria Root (Huangqin), Coptis Rhizome (Huanglian), Fritillaria Bulb (Beimu), and Forsythia Fruit (Lianqiao). Depending on the severity of the condition, adjust the dosage size. Stop when the disease is cured; do not overdose.
When Sha Zhen initially erupts with cough, it is appropriate to clear heat and vent toxins; cough should not be suppressed. For post-rash cough, use Fritillaria Bulb (Beimu), Platycodon Root (Kujie/Gancao context implies Platycodon here often referred to as Kujie in some texts, though standard is Jiegeng), Licorice Root (Gancao), Mint (Bohe), Trichosanthes Root (Tianhuafen), Scrophularia Root (Xuanshen), and Ophiopogon Tuber (Maidong) to clear residual heat and eliminate phlegm congestion; the condition will heal itself. Strictly avoid astringent preparations. For significant panting, it is due to pathogenic heat congesting the Lung. Do not use anti-panting medicines; instead, use a large dose of Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction), adding approximately one tael of Tamarix Herb (Xihe Liu), and two qian each of Scrophularia Root (Xuanshen) and Mint (Bohe). For intense heart heat, use Baihu Tang (White Tiger Decoction) added with Tamarix Herb (Xihe Liu). Avoid using Angelica Dahurica Root (Shengma), as it will inevitably cause panting. For rashes accompanied by frequent diarrhea, do not stop the diarrhea; use Coptis Rhizome (Huanglian), Kudzu Root (Gegen), Angelica Dahurica Root (Shengma), and Licorice Root (Gancao), and the diarrhea will stop naturally. Patients with rashes do not fear diarrhea, as diarrhea allows the pathogenic heat of the Yangming meridian to be resolved, which aligns with the principle of resolving both interior and exterior. Post-rash diarrhea and bloody/purulent stools are caused by heat pathogens sinking inward. Astringents are strictly forbidden; only ascending and dispersing methods should be used. Formulas may include Ephedra Stem (Mahuang), Licorice Root (Gancao), Kudzu Root (Gegen), Coptis Rhizome (Huanglian), White Peony Root (Baishao), and White Hyacinth Bean (Baibidou). Add Talcum (Huashi) powder for bloody/purulent stools; self-healing is expected. If there is truly upper heat and lower cold, or upper excess and lower deficiency, treat it as a deficiency syndrome using contrary treatment methods (treating false signs with opposite nature drugs), and do not use cold-natured drugs for direct treatment. For instance, in severe winter cold, if rash toxin is constrained internally and cannot emerge, do not mistakenly administer cold drugs like Gypsum Fibrosum (Shigao), Bamboo Leaf (Zhuye), or Tamarix Herb (Xihe Liu). Instead, use Schizonepeta Spike (Jingjie), Saposhnikovia Root (Fangfeng), Cicada Slough (Chantui), Notopterygium Rhizome (Qianghuo), Green Onion White (Congbai), and Coriander Fruit (Yansui), plus one dose of Ephedra Stem (Mahuang) fried with honey wine. This will stop the condition immediately; do not overuse.
Post-rash gum rot (Ya Gan) is most critical. Externally, apply the tip of fresh yellow cow dung (preserved property), ground into an extremely fine powder, mixed with one fen of real borneol (Pian Nao), and insufflated into the mouth. Internally, decoct Forsythia Fruit (Lianqiao), Kudzu Root (Gegen), Schizonepeta Spike (Jingjie Sui), Angelica Dahurica Root (Shengma), Scrophularia Root (Xuanshen), Coptis Rhizome (Huanglian), Licorice Root (Gancao), and Rehmannia Root (Shengdi) in water, mixed with 20-30 spoons of fresh buffalo horn juice. Delay leads to incurability. If the spleen qi is deficient and cold, failing to anchor the yin fire of the lower jiao, causing gum rot and mouth ulcers, formulas like Lizhong Tang (Regulate the Middle Decoction) are appropriate, and the fire will recede. In general, medication should be based on pulse diagnosis. Do not rigidly assume all measles cases are heat-toxin, as diseases differ significantly in their initial, middle, and terminal stages.
After the rash subsides, slight cough indicates residual toxin. Use Qingfei Yin (Clear the Lung Drink) combined with Xiaodu Yin (Detoxify Toxin Drink). If cough is severe with panting, continuous and unceasing, named Dun Sou (Spasmodic Cough), and severe cases involve vomiting food/fluids or hemoptysis, this is heat-toxin attacking the Lung. Administer Maidong Qingfei Yin (Ophiopogon Clear-Lung Drink) with Forsythia Fruit (Lianqiao). If chest elevation like a mound, shoulder shrugging, bleeding from anus/nose, head shaking, and complexion changes (white, blue, or red/dull) occur, it is untreatable. However, panting due to Lung qi deficiency, continuous without cough/hemoptysis/choking, should be treated with Qingfei Yin (Clear the Lung Drink) with doubled Ginseng (Renshen). Do not stubbornly attribute it solely to lung heat and use only clearing-lung detoxifying drugs.
Rashes appear milder than smallpox, but improper management can lead to rapid disaster. Smallpox arises from fetal toxin, allowing prediction of severity and prognosis. Rashes arise from seasonal pathogens; mild cases can become severe, and severe cases mild, depending on proper management. Therefore, dietary and medicinal taboos must be observed moderately. Smallpox patients especially need balanced medication. Sores after scarlet fever indicate residual heat in the Ying (Nutrient) level. Use Honeysuckle Flower (Jinyinhua), Schizonepeta Spike (Jingjie Sui), Forsythia Fruit (Lianqiao), Scrophularia Root (Xuanshen), Licorice Root (Gancao), Rehmannia Root (Shengdi), Bi Shi Shen (a specific herb name from text), Ephedra Stem (Mahuang), and Akebia Caulis (Mutong), decocted strongly for drinking. Treatment of Sha Zhen should not merely address symptoms but treat the root. The root is the pathogenic heat in the Hand-Taiyin Lung and Hand-Yangming Large Intestine meridians. Resolving this heat causes all symptoms to recede.