疹之初出未出时，俱宜微汗。汗则肌肤通畅，腠理开豁，而毒自透。一见微汗，不
宜过用升发之药，致使汗多亡阳，轻者变重，
重者难救。隐暗不透之症，因之并发，不可不慎。又有无汗者何？缘重感风寒，使皮肤
干燥，毛窍不开，而疹不出，多成内攻之患，使腹胀气喘，秋夏宜微加升发，春冬重以疏
散，但使浑身有微汗为妙。又有痰鸣，无分迟早，急用寒凉降火清润之药，佐以升发，否
则变为败症。故自始至终，得汗为主，若无汗，后必多余毒，宜解毒为要。
秋夏微加升发汤
升麻 葛根 苏叶 羌活 赤芍 甘草
春冬重以疏散汤 即升发汤。加
麻黄 桂枝
寒凉降火汤
生地 黄芩 黄连 山栀 石膏 花粉 杏仁 苏子 生甘草
佐以升发汤
薄荷 山楂 大力 桔梗 杏仁 苏子 升麻
（微热 壮热 乍热 潮热 复热）
小儿口唇红如丹，是欲发渴，皆内热所致。然宜辨其虚实，二便闭是实，用清热和
凉之药。二便清利，唇口淡而渴是虚，必其先食寒凉，致中气干燥也，急补中气。若腹
胀不食，是为败症，至于麻症有远近，不比于痘，或三四日，或五六日，或八九日或半
月，又乍寒乍热，至壮热经日不退是也。若始热遂见外疹，又宜详察。有微热者，热轻
而不壮也，此初起之时则犹可，将出之时则不可，恐其不能透表，急用疏托之药。如没
当未尽没时，毒轻而清，不必服药。若夫壮热者，热甚而经日不退也，初见太热，至出
时而不稍退，其症必重，若先热至出重是为顺症，如已出尽而有此壮热，宜服疏托和解
之药，至没后而热不退，更宜用和解之药，以免后患。又有乍热者，或热数日，过数日又
热，或乍热，或午热，未出之时见之，总毒不透，急宜疏托。没后及未没见之，毒有未
尽，宜凉解分利。亦有因病后中气虚弱者，临症者须酌治。若夫潮热者，一日一至，如潮
之汛而不失也。初出必无此症，至出后没后者有之。此因气血而作，治宜益阴而退阳可
也。且有复热者，谓热退而复发也，皆因余毒未解，宜疏解为上，妄用燥剂，必致不治。
在麻疹初出或尚未发出时，都适宜采用微汗法。发汗能使肌肤通畅，腠理（皮肤纹理及毛孔）开泄，毒邪自然透发。一旦见到微汗，就不宜过度使用升提发散的药物，致使出汗过多而亡失阳气，轻的病情加重，重的难以救治。隐暗不透的症状，因此并发，不可不谨慎。又有无汗的情况是什么原因呢？是因为再次感受风寒，使皮肤干燥，毛窍闭塞，导致疹子发不出来，多形成毒邪内攻的祸患，出现腹胀气喘等症状。秋夏季节适宜轻微增加升发药物，春冬季节则需重剂以疏散，只要使浑身有微汗为妙。又有痰鸣音，不分发病迟早，急用寒凉降火、清润的药物，佐以升发药物，否则变为败症。所以自始至终，以得汗为主，若无汗，后来必然有余毒残留，应以解毒为要务。
寒凉降火汤
生地黄 黄芩 黄连 山栀 石膏 天花粉 杏仁 苏子 生甘草
（微热 壮热 乍热 潮热 复热）
小儿口唇红如丹砂，是想要发生口渴，都是内热所致。然而应当辨别其虚实，二便闭塞是实证，用清热和凉的药物。二便清利，口唇淡白而渴是虚证，必定是先食用了寒凉食物，导致中气干燥，急需补益中气。若腹胀不食，这是败症。至于麻疹有发作时间的远近，不同于痘疮，有的三四天，有的五到六天，有的八九天甚至半个月，又有忽冷忽热，直到壮热持续几天不退的情况。如果开始发热随即见到外发疹子，又应当详细察辨。有微热的，热度轻而不剧烈，这在初起之时还可以，将要发出之时则不可以，恐怕不能透达体表，急用疏托的药物。如当未完全发出或未完全消退时，毒邪轻而清浅，不必服药。至于壮热，热度甚高且持续几天不退，初见太热，到发出时也不稍退，症状必然严重，如果先发热至发出时转为重证是为顺症，如果已经出尽而有此壮热，宜服用疏托和解的药物，到消退后热仍不退，更宜用和解的药物，以免后患。又有乍热，有的发热几天，过几天又发热，或突然发热，或午后发热，在未发出之时见到，总因毒邪不透，急宜疏托。在消退后及未完全消退时见到，毒邪有未尽，宜用凉解分利的方法。也有因病后中气虚弱者，临症医生须酌情治疗。至于潮热，一天一次，如潮水涨落般规律不失。初出时必无此症，到发出后及消退后有此症。这是因为气血运行所致，治疗宜益阴而退阳即可。且有复热，指热退后又复发，都是因为余毒未解，宜用疏解为上策，妄用燥剂，必定导致无法医治。
When the rash is just beginning to appear or has not yet appeared, a mild diaphoresis (inducing sweating) is appropriate. Sweating facilitates the patency of the skin and muscles, opens the couli (pores and interstices), allowing the pathogenic toxin to naturally emerge. Once mild sweating is observed, one should avoid overusing ascending and dispersing herbs to prevent excessive sweating that leads to the loss of Yang Qi; mild cases may worsen, while severe ones may become incurable. Symptoms of hidden and non-emergent rashes may arise from this negligence, so caution is essential. What causes the absence of sweating? It is due to a secondary contraction of Wind-Cold, causing dryness of the skin and closure of hair follicles, preventing the eruption of the rash, which often leads to internal invasion of toxins, resulting in abdominal distension and wheezing. In autumn and summer, mild ascending and dispersing herbs are suitable; in spring and winter, heavier doses for dispersion are required, aiming for mild sweating throughout the body. Regarding rattling phlegm, regardless of timing, urgent use of cold-natured herbs to descend fire and clear heat with moistening properties, assisted by ascending herbs, is necessary; otherwise, it transforms into a critical condition. Therefore, throughout the course, achieving sweating is primary. If sweating does not occur, residual toxins will likely remain later, making detoxification essential.
Autumn/Summer Mild Ascending Decoction
Cimicifugae Rhizoma (Shengma), Puerariae Radix (Gegen), Perillae Folium (Suye), Notopterygii Rhizoma et Radix (Qianghuo), Paeviae Radix Rubra (Chishao), Glycyrrhizae Radix et Rhizoma (Gancao)
Spring/Winter Heavy Dispersing Decoction: Same as Ascending Decoction, plus
Ephedrae Herba (Mahuang), Cinnamomi Ramulus (Guizhi)
Cold-Natured Fire-Descending Decoction
Rehmanniae Radix Preparata (Shengdi), Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), Gardeniae Fructus (Shanzhi), Gypsum Fibrosum (Shigao), Trichosanthis Radix (Huafen), Armeniacae Semen Amarum (Xingren), Perillae Fructus (Suzi), Glycyrrhizae Radix et Rhizoma (Sheng Gancao)
Assisted Ascending Decoction
Menthae Haplocalycis Herba (Bohe), Crataegi Fructus (Shanzha), Arctii Fructus (Niubangzi), Platycodonis Radix (Jiegeng), Armeniacae Semen Amarum (Xingren), Perillae Fructus (Suzi), Cimicifugae Rhizoma (Shengma)
(Mild Fever, High Fever, Intermittent Fever, Tidal Fever, Recurrent Fever)
Red lips like cinnabar in children indicate an impending thirst caused by internal heat. However, deficiency and excess must be distinguished. Constipation and urinary retention indicate excess; treat with heat-clearing and cooling herbs. Clear urination and defecation with pale lips and thirst indicate deficiency, likely due to prior consumption of cold foods drying the Middle Qi; urgently tonify the Middle Qi. Abdominal distension with anorexia indicates a critical condition. Unlike smallpox, the onset of measles varies, occurring on days 3–4, 5–6, 8–9, or even half a month later, accompanied by alternating chills and fever, progressing to persistent high fever. If fever begins and rashes appear immediately, careful observation is needed. Mild fever implies light heat without intensity; this is acceptable at the very beginning but problematic when the rash is about to erupt, as it may fail to reach the exterior; urgently use dispersing and supporting herbs. If the toxin is light and clear before full emergence or resolution, medication may not be necessary. High fever implies intense heat persisting for days; if initial heat remains high upon eruption, the condition is severe. Initial fever leading to heavy eruption is a favorable progression; if high fever persists after full eruption, use dispersing and harmonizing herbs; if fever persists after resolution, use harmonizing herbs to prevent complications. Intermittent fever involves periods of fever followed by intervals, or sudden fever, or afternoon fever; seen before eruption, it indicates trapped toxin requiring urgent dispersing support; seen after or during resolution, it indicates incomplete toxin clearance, requiring cooling, clearing, and separating methods. Cases with post-illness Middle Qi deficiency require individualized treatment. Tidal fever occurs once daily, regular as the tide; it does not occur at the initial stage but appears after eruption or during resolution, caused by Qi and Blood dynamics; treatment should nourish Yin and subdue Yang. Recurrent fever refers to fever returning after subsiding, due to unresolved residual toxins; dispersing and resolving is superior. Improper use of drying agents will inevitably lead to untreatable conditions.