【注】毒热内盛火上炎,心胃扰乱烦渴添,未出升葛汤加味,已出白虎汤为先,没
落竹叶石膏用,因时医治莫迟延。
【注】凡出麻疹烦渴者,乃毒热壅盛也。盖心为热扰则烦,胃为热郁则渴。当未出时,
宜升麻葛根汤加麦冬、天花粉;已出者,宜白虎汤;没后烦渴者,用竹叶石膏汤。
升麻葛根汤(方见痘门发热证治)
白虎汤
石膏( ) 生知母 生甘草
引用粳米,水煎服。
【方歌】麻疹已发多烦渴,白虎清热自能安,石膏知母生甘草,引加粳米用水煎服。
竹叶石膏汤
人参 麦冬(去心) 石膏( ) 生知母 竹叶 生甘草
水煎服。
【方歌】疹已没落当安静,若加烦渴热未清,竹叶石膏汤参麦,石膏知母竹甘从。
疹发最怕毒火盛,热昏心神谵妄生,未出三黄石膏治,已出黄连解毒灵。
【注】谵妄一证,乃毒火太盛,热昏心神而然也。疹未出而谵妄者,三黄石膏汤主之;
疹已出而谵妄者,黄连解毒汤主之。
三黄石膏汤(方见麻疹见形证治)
黄连解毒汤(方见痘门结痂落痂证治)
疹初无汗作喘急,宣发麻杏石甘宜,毒热内攻金受克,保肺清气化毒医。
【注】喘为恶候,麻疹尤忌之。如初出未透,无汗喘急者,此表实拂郁其毒也,宜用
麻杏石甘汤发之;疹已出,胸满喘急,此毒瓦斯内攻,肺金受克,宜用清气化毒饮清之。若
迟延失治,以致肺叶焦举,则难求矣。
麻杏石甘汤
石膏( ) 麻黄(蜜妙) 杏仁(去皮、尖、炒) 生甘草
用引用生姜水煎服。
【方歌】喘用麻杏石甘汤,石膏火 合麻黄,杏仁去尖须微炒,甘草相配引生姜。
清气化毒饮
前胡 桔梗 栝蒌仁 连翘(去心) 桑皮(炙) 杏仁(炒,去皮、尖) 黄芩
黄连 元参 生甘草 麦冬(去心)
引用芦根,水煎服。
【方歌】毒热内攻肺喘满,清气化毒饮最灵,前桔栝蒌翘桑杏,苓连元参草麦冬。
【注释】毒热在体内炽盛并向上炎蒸,扰乱心与胃,导致烦躁和口渴加重。在皮疹尚未发出时,宜用升麻葛根汤加味治疗;皮疹已经发出时,以白虎汤为首选;皮疹消退后若仍有烦渴,则使用竹叶石膏汤。因时制宜进行治疗,切勿延误时机。
【注释】凡是出麻疹出现烦躁口渴症状的,是因为毒热壅盛所致。心被热邪扰乱则产生烦躁,胃被热邪郁结则产生口渴。当皮疹尚未发出时,适宜用升麻葛根汤加入麦冬、天花粉;皮疹已经发出的,适宜用白虎汤;皮疹消退后仍感烦渴的,使用竹叶石膏汤。
【方歌诀】麻疹已经发出多伴有烦躁口渴,白虎汤清热自然能使病情安定,石膏、知母、生甘草,加上粳米作为引经药用水煎服。
竹叶石膏汤
人参 麦冬(去心) 石膏( ) 生知母 竹叶 生甘草
水煎服。
【方歌诀】疹子已经消退应当安静,如果加上烦躁口渴说明热邪未清,使用竹叶石膏汤配合人参、麦冬,石膏、知母、竹叶、甘草随之使用。
疹子发出最怕毒火旺盛,热邪昏蒙心神导致谵语妄言。在皮疹尚未发出时,用三黄石膏汤治疗;皮疹已经发出时,用黄连解毒汤治疗。
【注释】谵妄这一证候,是由于毒火太盛,热邪昏蒙心神而造成的。疹子未发出而出现谵妄的,主方用三黄石膏汤;疹子已经发出而出现谵妄的,主方用黄连解毒汤。
疹子初起无汗表现为喘急,宣发透疹宜用麻杏石甘汤。毒热内攻克制肺金,保肺清气化解毒需医治。
【注释】喘是恶候,麻疹尤其忌讳它。如刚出疹尚未透发,无汗且喘急的,这是表实郁闭导致毒邪不得外泄,适宜用麻杏石甘汤发散透疹;疹子已经发出,胸满且喘急的,这是毒气内攻,肺金受克,适宜用清气化毒饮清解。如果延误失治,导致肺叶焦枯上举,那就难以救治了。
麻杏石甘汤
石膏( ) 麻黄(蜜炙) 杏仁(去皮、尖、炒) 生甘草
用生姜水煎服。
【方歌诀】喘症使用麻杏石甘汤,石膏合麻黄,杏仁去尖须微炒,甘草相配引生姜。
清气化毒饮
前胡 桔梗 栝蒌仁 连翘(去心) 桑皮(炙) 杏仁(炒,去皮、尖) 黄芩
黄连 元参 生甘草 麦冬(去心)
引用芦根,水煎服。
[Annotation] When toxic heat is abundant internally and flares upward, it disturbs the Heart and Stomach, adding to restlessness and thirst. Before the rash erupts, Shengma Gegen Tang (Cinnamon Twig and Kudzu Root Decoction) with modifications should be used; after eruption, Baihu Tang (White Tiger Decoction) is preferred; after the rash subsides, Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) is used. Treat according to the timing of the disease without delay.
[Annotation] Restlessness and thirst in measles are caused by the accumulation and abundance of toxic heat. The Heart being disturbed by heat causes restlessness, and the Stomach being constrained by heat causes thirst. Before the rash erupts, Shengma Gegen Tang (Cinnamon Twig and Kudzu Root Decoction) added with Maidong (Ophiopogonis Radix) and Tianhuafen (Trichosanthis Radix) is appropriate; after eruption, Baihu Tang (White Tiger Decoction) is appropriate; if restlessness and thirst persist after the rash subsides, Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) is used.
Shengma Gegen Tang (See formula in Chapter on Fever in Measles/Pox)
Baihu Tang (White Tiger Decoction)
Shigao (Gypsum Fibrosum) [dose missing]
Sheng Zhimu (Raw Anemarrhenae Rhizoma)
Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma)
Use Jingmi (Oryzae Semen Germum, Rice) as a guide, decoct in water and take orally.
[Formula Song] Measles erupted with much restlessness and thirst, Baihu Tang clears heat and brings peace naturally, Shigao, Zhimu, Sheng Gancao, add Jingmi and decoct in water.
Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction)
Renshen (Ginseng Radix et Rhizoma)
Maidong (Ophiopogonis Radix) (remove heart)
Shigao (Gypsum Fibrosum) [dose missing]
Sheng Zhimu (Raw Anemarrhenae Rhizoma)
Zhuye (Bambusae Folium)
Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma)
Decoct in water and take orally.
[Formula Song] After the rash subsides, calmness is expected; if restlessness and thirst appear, heat is not yet cleared. Use Zhuye Shigao Tang with Renshen and Maidong; Shigao, Zhimu, Zhuye, and Gancao follow.
The greatest fear when the rash erupts is excessive toxic fire, which confuses the Heart Spirit causing delirium and妄言 (delirious speech). Before the rash erupts, Sanhuang Shigao Tang (Three-Yellow and Gypsum Decoction) treats it; after the rash erupts, Huanglian Jiedu Tang (Coptis Decoction for Detoxification) treats it.
[Annotation] Delirium is a syndrome caused by excessive toxic fire confusing the Heart Spirit. If delirium occurs before the rash erupts, Sanhuang Shigao Tang (Three-Yellow and Gypsum Decoction) is the main formula; if delirium occurs after the rash erupts, Huanglian Jiedu Tang (Coptis Decoction for Detoxification) is the main formula.
Sanhuang Shigao Tang (See formula in Chapter on Rash Appearance in Measles)
Huanglian Jiedu Tang (See formula in Chapter on Crusting and Scabbing in Pox/Measles)
Initial rash with no sweat presents as wheezing and urgency; Xuanfa (disperse and vent) using Maxing Shigan Tang (Ephedra, Apricot Kernel, Gypsum, and Licorice Decoction) is suitable. Toxic heat attacks internally, overcoming Metal (Lung); preserve Lung Qi, clear heat, and transform toxin for treatment.
[Annotation] Wheezing is an ominous sign, especially contraindicated in measles. If the rash has just begun and not fully emerged, with no sweat and wheezing urgency, this indicates exterior excess and constraint preventing toxin release; use Maxing Shigan Tang (Ephedra, Apricot Kernel, Gypsum, and Licorice Decoction) to disperse and vent. If the rash has emerged, with chest fullness and wheezing urgency, this indicates internal attack of toxic qi overcoming Lung Metal; use Qingqi Huadu Yin (Clear Qi and Transform Toxin Decoction) to clear. If treatment is delayed, leading to scorched and elevated Lung lobes, recovery will be difficult.
Maxing Shigan Tang (Ephedra, Apricot Kernel, Gypsum, and Licorice Decoction)
Shigao (Gypsum Fibrosum) [dose missing]
Mahuang (Ephedrae Herba) (honey-fried)
Xingren (Armeniacae Semen Amarum) (skin and tip removed, fried)
Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma)
Use Shengjiang (Zingiberis Rhizoma Recens, Fresh Ginger) as a guide, decoct in water and take orally.
[Formula Song] For wheezing, use Maxing Shigan Tang; Shigao combined with Mahuang, Xingren tip removed and slightly fried, Gancao paired with Shengjiang as guide.
Qingqi Huadu Yin (Clear Qi and Transform Toxin Decoction)
Qianhu (Peucedani Radix)
Jiegeng (Platycodonis Radix)
Gualou Ren (Trichosanthis Semen)
Lianqiao (Forsythiae Fructus) (remove heart)
Sangbai Pi (Mori Cortex) (stir-fried)
Xingren (Armeniacae Semen Amarum) (fried, skin and tip removed)
Huangqin (Scutellariae Radix)
Huanglian (Coptidis Rhizoma)
Yuanshen (Scrophulariae Radix)
Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma)
Maidong (Ophiopogonis Radix) (remove heart)
Use Lugen (Phragmitis Rhizoma, Reed Rhizome) as a guide, decoct in water and take orally.
[Formula Song] Toxic heat attacking internally causing lung wheezing and fullness, Qingqi Huadu Yin is most effective; Qian, Jie, Gualou, Lianqiao, Sangbai Pi, Xingren, Huangqin, Huanglian, Yuanshen, Gancao, Maidong.