麻疹未出,升发为先。防风、荆芥散腠理之留邪;升麻、干葛开营卫之蕴热。麻黄发斑毒之出现,淹
延热盛,发不出而无汗者,不拘冬夏可用桂枝,令血气之横流。四肢不出者,便宜加入
薄荷、竹叶,解肤热之汪洋。苏叶、葱头疏肌表之拂郁。既知君臣还有佐使,青皮拔毒止痛,陈皮理气
化痰。咳嗽咽痛,肺燥贵乎滋润,桔梗、大力最宜。呕吐不食,痰气滞于胸隔,散涎毒
出,前胡、复花为良。色不红润,川芎、红花行血而开滞。色若
紫黑,急宜火烧人粪路朝东,必然黑色而转红。大便秘结,用大
黄、枳壳。小便不利须用木通。出不快者,宜大力、蝉衣,能透肌解表,此乃未出与见点之前,用之一法也。
若既出足之后,解毒清火为良。里热毒重,药宜降之,柴胡、黄芩入肺加苏子以定喘;玄参、石膏治邪火之浮
游;生栀、连翘开恶毒之郁结。栝蒌润肺止渴,滑肠化痰而解毒,合用麦冬解烦渴而清肺金;生知母
降火生津;黄柏解毒蒸用;犀角解心胃之热;羚羊泄肝肺之炎;牛膝去下部之邪;力子解阳明之毒;柴胡去厥
阴之邪;黄连泻心火;大黄号名将军;生甘和中得国老之称;蒸山楂通气血而去腹中之宿垢;止咳嗽,解涎
痰,石膏、贝母争先;利咽喉者桔梗、大力、射干、豆根、玄参最宜;荆芥去皮肤之热;薄荷、钩藤解
惊悸之宗。痰药尤要,苏子、杏仁、天麻、竹沥、消痰而下气,陈皮、枳壳,利气以开痰;钩藤、桑皮、定喘;
花粉、干葛止渴。若风热痰壅,胆星九制;痰毒便闭,栝蒌仁莫去壳油,消肿定喘解毒最妙,化痰定嗽,顺气为良。
麻疹尚未发出时,治疗以升发透疹为优先原则。防风、荆芥能疏散腠理中滞留的病邪;升麻、干葛(葛根)能开通营卫之间蕴积的热邪。麻黄能促进斑毒的透发;若病程拖延、热势炽盛,导致疹点无法透出且无汗者,不论冬夏均可使用桂枝,以使气血通畅运行。若四肢部位疹出不畅,适宜加入薄荷、竹叶,以解除肌肤表面的热邪。苏叶、葱头能疏解肌表的郁结。既然明确了君臣佐使的配伍原则,青皮可拔除毒邪并止痛,陈皮能调理气机并化痰。出现咳嗽、咽痛症状,因肺燥所致,关键在于滋润,桔梗、牛蒡子最为适宜。出现呕吐、食欲不振,是因痰气阻滞于胸膈,此时应促使涎毒外透,前胡、复花(款冬花)是良好的选择。疹色不红润,需用川芎、红花来活血行血并疏通瘀滞。若疹色呈紫黑色,急需使用火烧的人粪路朝东方向的地土(即陈久人粪尿或特定地骨皮类引申,此处依原文直译:火烧人粪路朝东),必然能使黑色转为红色。大便秘结,使用大黄、枳壳。小便不利,须用木通。疹出不快者,宜用牛蒡子、蝉蜕,它们能透达肌表解表,这是麻疹未出及见点之前的治疗方法之一。
如果疹子已经出齐之后,以解毒清火为良策。若里热毒重,药物宜用降泄之法,柴胡、黄芩入肺经,加苏子以平喘;玄参、石膏治疗邪火的浮游上炎;生栀子、连翘开通恶毒的郁结。栝蒌润肺止渴,滑肠化痰并解毒,配合麦冬可解烦渴并清肺金;生知母降火生津;黄柏解毒后蒸制使用;犀角解除心胃之热;羚羊角清泄肝肺之火;牛膝祛除下部的邪气;力子(莱菔子)解除阳明经的毒邪;柴胡祛除厥阴经的邪气;黄连泻心火;大黄号称将军;生甘草和中,得国老之称;蒸山楂能通气血并去除腹中的宿垢;止咳嗽、解涎痰,石膏、贝母争先发挥作用;利咽喉者,桔梗、牛蒡子、射干、豆根、玄参最为适宜;荆芥去除皮肤之热;薄荷、钩藤解除惊悸的根本原因。化痰的药物尤为重要,苏子、杏仁、天麻、竹沥能消痰下气,陈皮、枳壳能利气开痰;钩藤、桑白皮定喘;花粉、干葛止渴。若风热痰壅,使用九制胆南星;若痰毒伴随便闭,栝蒌仁不要去掉壳和油,消肿定喘解毒效果最好,化痰定嗽,顺气为良。
When measles have not yet erupted, the priority is to promote their emergence. Fangfeng (Saposhnikovia Root) and Jingjie (Schizonepeta Herb) disperse pathogenic factors retained in the couli (interstices); Shengma (Cimicifugae Rhizoma) and Gange (Puerariae Radix) open up the heat stagnation in the Ying (Nutritive) and Wei (Defensive) levels. Mahuang (Ephedrae Herba) promotes the eruption of macules and toxic rashes; if the course is prolonged with intense heat, preventing eruption and accompanied by anhidrosis (absence of sweating), Guizhi (Cinnamomi Ramulus) can be used regardless of season to ensure smooth flow of Qi and Blood. If eruptions do not appear on the four limbs, Bohe (Menthae Haplocalycis Herba) and Zhuye (Bambusae Folium) should be added to resolve the excessive heat on the skin surface. Suye (Perillae Folium) and Congtou (Allii Fistulosi Bulbus) relieve surface constraint. Understanding the roles of Jun (Monarch), Chen (Minister), Zuo (Assistant), and Shi (Envoy) herbs, Qingpi (Aurantii Fructus Immaturus) extracts toxins and relieves pain, while Chenpi (Aurantii Pericarpium) regulates Qi and transforms phlegm. For cough and sore throat due to Lung dryness, moistening is essential; Jiegeng (Platycodonis Radix) and Dali (Arctii Fructus) are most suitable. For vomiting and loss of appetite caused by phlegm-Qi stagnation in the chest and diaphragm, promoting the release of salivary toxins makes Qianhu (Peucedani Radix) and Fuhua (Adenophorae Radix or Sonchi Flos, contextually likely Adenophorae or similar resolving herb) good choices. If the rash color is not rosy, Chuanxiong (Ligustici Chuanxiong Rhizoma) and Honghua (Carthami Flos) should be used to invigorate blood and resolve stasis. If the rash color is purple-black, it is urgent to use "fire-burned human feces from a road facing east" (a specific folk remedy reference for transforming black to red). For constipation, Dahuang (Rhei Radix et Rhizoma) and Zhike (Aurantii Fructus) are used. For difficult urination, Mutong (Akebiae Caulis) is required. For slow eruption, Dali (Arctii Fructus) and Chanyi (Cicadae Periostracum) are appropriate as they penetrate the muscle layer and release the exterior; this is one method for the pre-eruption and initial spotting stages.
Once the rash has fully erupted, detoxification and clearing fire are the best approaches. For severe internal heat and toxicity, descending herbs are indicated: Chaihu (Bupleuri Radix) and Huangqin (Scutellariae Radix) enter the Lung meridian, combined with Suzi (Perillae Fructus) to calm wheezing; Xuanshen (Scrophulariae Radix) and Shigao (Gypsum Fibrosum) treat floating pathogenic fire; Shengzhizi (Gardeniae Fructus) and Lianqiao (Forsythiae Fructus) open toxic stagnation. Gualou (Trichosanthis Fructus) moistens the Lung, stops thirst, lubricates the intestines, transforms phlegm, and detoxifies; when combined with Maidong (Ophiopogonis Radix), it resolves irritability and thirst and clears Lung Metal. Sheng Zhimu (Anemarrhenae Rhizoma) descends fire and generates fluids; Huangbai (Phellodendri Cortex) is detoxified via steaming; Xijiao (Rhinocerotis Cornu) clears Heat in the Heart and Stomach; Lingyangjiao (Saigae Tataricae Cornu) drains Fire from the Liver and Lung; Niuxi (Achyranthis Bidentatae Radix) eliminates pathogens in the lower body; Lizhi (likely referring to Laifuzi/Raphini Semen or similar) resolves Yangming toxicity; Chaihu eliminates Jueyin pathogens; Huanglian (Coptidis Rhizoma) drains Heart Fire; Dahuang is known as the General; Sheng Gancao (Glycyrrhizae Radix et Rhizoma) harmonizes the middle and is called the State Elder; Zheng Shanzha (Crataegi Fructus) unites Qi and Blood and removes old food retention in the abdomen; for stopping cough and resolving salivary phlegm, Shigao (Gypsum Fibrosum) and Beimu (Fritillariae Cirrhosae Bulbus) take precedence; for benefiting the throat, Jiegeng (Platycodonis Radix), Dali (Arctii Fructus), Shegan (Belamcandae Rhizoma), Dougen (likely Glycyrrhizae Radix or similar root), and Xuanshen (Scrophulariae Radix) are most suitable; Jingjie (Schizonepetae Spica) removes skin heat; Bohe (Menthae Haplocalycis Herba) and Gouteng (Uncariae Ramulus cum Uncis) address the root of palpitations and fright. Phlegm-resolving herbs are particularly important: Suzi (Perillae Fructus), Xingren (Armeniacae Semen Amarum), Tianma (Gastrodiae Rhizoma), and Zhuli (Bambusa Textilis Cauterium Succus) transform phlegm and direct Qi downward; Chenpi (Aurantii Pericarpium) and Zhike (Aurantii Fructus) benefit Qi to open phlegm; Gouteng (Uncariae Ramulus cum Uncis) and Sangbai (Mori Cortex) calm wheezing; Huafen (Trichosanthis Radix) and Gange (Puerariae Radix) stop thirst. For Wind-Heat with phlegm obstruction, Jiuzhi Dansheng (Calculus Bovis prepared nine times) is used; for phlegm-toxicity with constipation, Gualou Ren (Trichosanthis Semen) should retain its shell and oil for optimal swelling reduction, wheezing control, detoxification, phlegm transformation, cough cessation, and Qi regulation.