夹疹之痢最难当，毒热凝结移大肠，腹痛下痢赤白色，悉用清热导滞良。
【注】麻疹作痢，谓之夹疹痢。因毒热未解，移于大肠所致也。有腹痛欲解，或赤或
白，与赤白相兼者，悉用清热导滞汤主之，不可轻投涩剂。
清热导滞汤
山楂 浓朴（姜炒） 生甘草 枳壳（麸炒） 槟榔 当归 白芍（酒炒） 条芩（酒炒）
连翘（去心） 牛蒡子（炒、研） 青皮（炙） 黄连（吴茱萸炒）
引用生姜，水煎服。
【方歌】痢用清热导滞汤，山楂朴草壳槟榔，归芍条芩翘牛蒡，青皮黄连引生姜。
小儿发疹腹中疼，毒郁肠胃食滞凝，曲腰啼叫眉频蹙，加味平胃散堪行。
【注】麻疹腹痛者，由食滞凝结，毒瓦斯不得宣发于外，故不时油腰啼叫，两眉频蹙。须
以加味平胃散治之，滞消毒解，而痛自除矣。
加味平胃散
防风 升麻 枳壳（麸炒） 葛根 苍术（炒） 陈皮 浓朴（姜炒） 南山楂 麦芽（炒）
生甘草
引用生姜、灯心，水煎服。
【方歌】加味平胃散如神，防风升麻枳葛根，苍陈浓朴楂芽草，生姜灯心水煎匀。
疹家衄血莫仓惶，毒从衄解妙非常，衄甚吹鼻发灰散，内服犀角地黄汤。
【注】肺开窍于鼻，毒热上冲，肺气载血妄行，则衄作矣。然衄中有发散之义，以毒
从衄解，不须止之。但不可太过，过则血脱而阴亡也。如衄甚者，宜外用发灰散吹入鼻
中，内服犀角地黄汤，其血可止。
发灰散 犀角地黄汤（方俱见痘门衄血便血）
夹带麻疹的痢疾最为难治，这是毒热邪气凝结并转移至大肠所致。出现腹痛、下痢赤白脓血的症状，都应当使用清热导滞汤来治疗，效果良好。
【注】麻疹并发痢疾，称为“夹疹痢”。这是因为毒热之邪未能解除，移入大肠所导致的。患者有腹痛想要排便，排出物或为红色、或为白色、或红白相兼的情况，均应以清热导滞汤为主方治疗，不可轻易使用收敛止涩的药物。
清热导滞汤
山楂、浓朴（姜炒）、生甘草、枳壳（麸炒）、槟榔、当归、白芍（酒炒）、条芩（酒炒）、连翘（去心）、牛蒡子（炒、研）、青皮（炙）、黄连（吴茱萸炒）
引用生姜，加水煎煮后服用。
【方歌】治疗痢疾用清热导滞汤，方中含山楂、厚朴、甘草、枳壳、槟榔，以及当归、白芍、黄芩、连翘、牛蒡子，还有青皮、黄连，最后以生姜为引。
小儿出疹时腹部疼痛，是因为毒邪郁结在肠胃，加上食积停滞凝聚。患儿弯腰啼哭，双眉频繁皱起，此时使用加味平胃散进行治疗是合适的。
【注】麻疹期间出现腹痛，是由于食积停滞凝聚，导致毒气不能向外宣发，所以患儿不时弯腰啼哭，双眉紧锁。必须用加味平胃散来治疗，待积滞消除、毒邪解散，疼痛自然就会去除。
加味平胃散
防风、升麻、枳壳（麸炒）、葛根、苍术（炒）、陈皮、浓朴（姜炒）、南山楂、麦芽（炒）、生甘草
引用生姜、灯心草，加水煎煮后服用。
【方歌】加味平胃散疗效如神，方中有防风、升麻、枳壳、葛根，苍术、陈皮、厚朴、山楂、麦芽、甘草，再用生姜和灯心草一起水煎均匀。
患疹病的人出现鼻出血不要惊慌，毒邪通过鼻出血得以发散，这非常巧妙。如果鼻出血严重，可用吹鼻发灰散吹入鼻腔，同时内服犀角地黄汤。
【注】肺开窍于鼻，毒热上冲，肺气推动血液妄行，就会导致鼻出血。然而，鼻出血中包含发散的意义，因为毒邪可以通过鼻出血而解除，不需要强行止血。但是出血量不可过大，否则会导致血脱和阴液亡失。如果鼻出血严重，适宜外用发灰散吹入鼻中，内服犀角地黄汤，这样血就可以止住。
发灰散、犀角地黄汤（这两个方剂的具体组成见痘科门下的衄血便血章节）
Dysentery accompanied by measles is the most difficult to manage; this results from toxic heat condensing and shifting to the large intestine. With symptoms of abdominal pain and dysentery presenting red and white purulent matter, all cases should be treated with Qingre Daoshi Decoction (Clear Heat and Guide Out Stagnation Decoction) for good effect.
[Note] Measles complicated by dysentery is called "Measles-complicated Dysentery" (Jia Zhen Li). It is caused by toxic heat that has not resolved, which shifts into the large intestine. Patients experience abdominal pain and an urge to defecate, discharging material that may be red, white, or a mixture of both. In all such cases, Qingre Daoshi Decoction should be used as the primary formula; astringent agents should not be lightly administered.
Qingre Daoshi Decoction (Clear Heat and Guide Out Stagnation Decoction)
Crataegi Fructus (Shanzha), Magnoliae Officinalis Cortex (Houpo - stir-fried with ginger juice), Glycyrrhizae Radix et Rhizoma Preparata (Gancao), Aurantii Fructus (Zhike - bran-stir-fried), Arecae Semen (Binglang), Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Baishao - wine-stir-fried), Scutellariae Radix (Tiaoqin - wine-stir-fried), Forsythiae Fructus (Lianqiao - heart removed), Arctii Fructus (Niubangzi - stir-fried and ground), Aurantii Fructus Immaturus (Qingpi - roasted), Coptidis Rhizoma (Huanglian - stir-fried with Evodiae Fructus)
Add fresh ginger as a guide ingredient, decoct in water, and take orally.
[Formula Song] For dysentery use Qingre Daoshi Decoction, containing Shanzha, Houpo, Gancao, Zhike, and Binglang; Danggui, Baishao, Tiaoqin, Lianqin, and Niubangzi; Qingpi and Huanglian, guided by fresh ginger.
When children develop rashes and suffer from abdominal pain, it is due to toxic pathogens stagnating in the stomach and intestines combined with food stagnation condensing. The child bends their waist while crying out frequently, with eyebrows often furrowed; Jiawei Pingwei San (Modified Pingwei Powder) is appropriate for treatment.
[Note] Abdominal pain during measles eruption occurs because food stagnation condenses, preventing toxic qi from being vented outward. Consequently, the child frequently bends over and cries, with eyebrows tightly knitted. One must treat with Jiawei Pingwei San; once stagnation is eliminated and toxins are resolved, the pain will naturally cease.
Jiawei Pingwei San (Modified Pingwei Powder)
Saposhnikoviae Radix (Fangfeng), Cimicifugae Rhizoma (Shengma), Aurantii Fructus (Zhike - bran-stir-fried), Puerariae Lobatae Radix (Gegen), Atractylodis Rhizoma (Cangzhu - stir-fried), Citri Reticulatae Pericarpium (Chenpi), Magnoliae Officinalis Cortex (Houpo - stir-fried with ginger juice), Crataegi Fructus (Nanshan zha), Malto (Maiya - stir-fried), Glycyrrhizae Radix et Rhizoma Preparata (Gancao)
Add fresh ginger and Juncus effusus (Dengxin) as guide ingredients, decoct in water, and take orally.
[Formula Song] Jiawei Pingwei San works miraculously, containing Fangfeng, Shengma, Zhike, and Gegen; Cangzhu, Chenpi, Houpo, Shan zha, Maiya, and Gancao; decoct evenly with fresh ginger and Dengxin in water.
Do not panic if patients with rashes experience epistaxis (nosebleed); it is highly effective when toxins are released through the nosebleed. If the bleeding is severe, apply Fahui San (Hair-ash Powder) insufflated into the nose, and internally administer Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction).
[Note] The lungs open into the nose. When toxic heat rushes upward, lung qi forces blood to move recklessly, causing epistaxis. However, epistaxis contains the principle of dispersion, as toxins can be resolved through bleeding, so there is no need to forcibly stop it. Nevertheless, the bleeding must not be excessive; otherwise, blood depletion and yin exhaustion will occur. If epistaxis is severe, it is suitable to externally insufflate Fahui San into the nose and internally administer Xijiao Dihuang Tang, which will stop the bleeding.
Fahui San (Hair-ash Powder) and Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) (See the section on Epistaxis and Hematochezia under the Measles Chapter for formulas.)