麻疹浮小而有头粒，随出即收，不结脓 ，北人谓之糠疮，南人谓之麸疮，吴人谓之痧，越人谓之喑，古所谓麻，
闻人氏所谓肤疹是也。与前所谓脾为疹者不同。小儿有出一二次者，出轻而日数少者名奶疹子，出稍重而日数
稍多者名正疹子，又，出于痘前者名奶疹子，出于痘后者名正疹子。初出亦与痘疮相似，但痘发于脏，
麻发于腑，脏属阴，其病本深，故难出难收，而药于温平为宜。腑属阳，其病本浅，
故易出易收，而药于清凉为宜。万氏云∶痘大而 肿者，少阳三焦火也，阳道常饶，故大而肿。疹小而碎者，
少阴心火也，阴道常乏，故小而密。三焦水谷之道路，脾胃主纳水谷，治痘专以脾胃为主。心肺属阳，而位乎上，
心火旺则肺受之，治疹专以肺为主。观其咳嗽者，火炎则肺叶焦举也。鼻流清涕者，鼻为肺之窍，以火烁
金而液自流也。目中泪出，肺热则移于肝，肝之窍在目也。或手掐眉目唇鼻及面者，肺热证也。按∶既是
心火刑肺金，即是贼邪，其证当重，何反轻于痘，余每治麻疹，但据见证以泻白散加减，大剂投之，即至危困
之证无不愈者，其他时师用苦寒降火，辛温发表，而阽于危亡者不可胜数，安在其为心火刑肺也。春温、夏
暑、秋清、冬寒，此四时之正气也，冬应寒而反温，阳气暴泄，火令早行，人感之者，至于来春必发疮疥，未出
痘疹者，必感而出，虽曰胎毒，未有不由天行者，故一时传染，大小相似，但见疹痘之出，即宜先服三豆汤、
代天宣化丸（二方俱见前预防）以预解之。麻疹初出，全类伤风发热，咳嗽鼻塞，面肿涕唾稠粘，全是肺经之证，
有末传泄利者，有一起即兼泄利者，肺与大肠相表里，表里俱病也，惟不可触冒风
寒，及于正蒸热时啖食，能变轻为重，不可不慎。麻疹形证亦同，有如发风疹疙瘩，拥起如云头，色赤成 ，
随见随没者。有如粟米头糠，三番俱见而不没，至三日后方收渐没者。然皆谓之麻疹，其于欲出未出之际，
当用发表之药发之，则易出易愈也。麻疹，有发热至十余日始见者，大抵主在发散肺经之热毒者、始事也，
调理补养病后之元气者、终事也，其间或兼风，或兼痰，或伤食，并随宜加对证之药，其有变证，即随病用对
证之药，要不乱投汤剂，则儿无事矣。疹喜清凉，痘喜温暖，此法人皆知之，然疹子初出，亦须和暖则易出，
所以发苗之初，只要发出得尽，则毒便解，非若痘必苗而秀，秀而实，而后毒解也，痘子成实之时，若大温
热，则反溃烂不收，是痘之后，亦喜清凉也，故治痘疹者，无过热，无过寒，温凉适宜，阴阳自和，是为得之。
【初热】痘疹发热之初，多似伤寒，惟麻疹则咳嗽喷嚏，鼻流清涕，眼胞肿，其泪汪汪，面浮腮赤，或
呕恶，或泄利，或手掐眉目鼻面，此为异耳。轻者以泻白散合三味消毒散主之，重者以金沸草散主之，兼泄
利者，合升麻葛根汤，以白芷代葛根。此余创立治法，用之无不效者，即十分危证，守而勿失，终于必济，
每见诸书
所定方，类皆苦寒辛凉发表之剂，不尽对证对经，恐有诛罚无过之失，用者详之。大抵疹欲出已出之际，虽寒
勿用桂枝。虽虚勿用参术。虽呕而有痰勿用半夏、南星。大忌认作伤寒，妄汗妄下，汗之则增其热，为鼻衄，
为咳血，为口疮咽痛，为目赤痛，为烦躁，为大小便不通。下之则虚其里，为滑泄，为滞下，多至不救，慎之慎
之。〔万〕如手足稍微冷，恶寒而无汗，面色青惨而不舒，左额有青纹者，伤寒之热也。手足稍微温，发热有
汗，面赤而光者，伤风之热也，并宜惺惺散（痘初热）发散之。目胞肿而右颊有青筋，发热而头额腹肚最甚，或
兼呕吐腹疼者，伤食之热也，备急丸（痘初热）下之。面色青红，额正中有纹，手掌心有汗，时作惊惕，手络
脉微动而发热者，此惊热也，泻青丸（肝）、牛黄清心丸（痘烦躁）主之。身热而倍能食，唇红颊赤，大小便
秘，胁下汗者，此风热也，宣风散主之（痘发热）。以上诸热，久而不去，内外感发，则所蕴疮疹之毒，亦能乘
间而出矣。疹子只怕不能得出，若出尽，则便毒解，故治疹子者，发热之时，当察时令寒暄，以药发之，如时
太寒，以桂枝葛根汤发之。太热，以升麻葛根汤（俱痘初热）合人参白虎汤发之（痘渴）。不寒不热，以荆防败
毒散发之（痘夹疹）。如兼疫疠之气，以人参败毒散发之（痘初热）。如尽一剂不出，再作本汤发之，外用胡荽
酒（见形）以苎麻蘸酒遍身忧之，务令亟出。如三四作更不出，加腹中胀痛，气上喘促，昏闷谵妄者，必死证也。
泻白消毒散
桑白皮 地骨皮（二味、自采鲜者，各三钱） 牛蒡子（炒研） 荆芥穗（各一钱半） 桔梗 甘草（各一
钱） 浮萍（晒干，二钱）
上为粗末。每服三五钱，水一盏，煎六分，滤清服。
加味金沸草散
旋复花（去梗） 麻黄（去节，水煮去沫，晒干） 前胡（去芦。各七钱） 荆芥穗（一两） 甘草
（炙） 半夏（汤泡七次，姜汁拌炒） 赤芍药（各五钱） 鼠粘子（炒） 浮萍（各七钱）
上为末。每服三钱，生姜二片，薄荷叶三五片，煎。
防风解毒汤（如温暖之时，以此辛凉之药发之）
防风 薄荷 荆芥 石膏 知母 桔梗 甘草 牛蒡子 连翘 木通 枳壳 淡竹叶
黄连解毒汤（如暄热之时，以此辛寒之药、发之）
防风 黄芩 黄连 荆芥穗 知母 石膏 黄柏（酒炒） 栀子仁 大青 玄参 甘草 桔梗 木通
桂枝解毒汤（如大寒之时，以此辛温热之药、发之）
桂枝 麻黄（酒炒） 赤芍药 防风 荆芥 羌活 甘草 桔梗 人参 川芎 牛蒡子 生姜
升麻解毒汤（如时暖时寒，以此辛平之药、发之）
升麻 干葛 荆芥穗 人参 柴胡 前胡 牛蒡子 桔梗 防风 羌活 赤芍药 淡竹叶 连翘 甘草
上方，虽曰因时制宜，亦不可拘泥，如冬月亦有不宜麻桂而宜石膏者，正当以脉证为主耳，若株守而不
知通变，必有失，不如用首二方之为妥当也。
发热六七日以后，明是疹子，却不见出，此皮肤坚浓，腠理闭密，又或为风寒袭之，曾有吐利，乃伏也，
急用托里发表之剂，麻黄汤调柽叶散发之，外用胡荽酒（见形）蘸麻刮之。如一向未更衣者，毒甚于里，伏而
不出也，以七物升麻丸解之，发之解之再不出者，死证也。
麻黄汤
麻黄（去根节，制过） 升麻 牛蒡子（炒） 蝉壳（洗净，去足翅） 甘草（各一钱）
烦渴，加石膏末四钱。
上锉细。加腊茶叶一钱，水一盏，煎七分，去滓服。
柽叶散
柽，亦名西河柳，亦名垂丝柳，青茂时采叶晒干，为末，每服一二钱，茅根煎汤调下。
疹子初发热时，未见出现，咳嗽百十声不止，上气喘急，面浮目胞肿，宜甘桔汤、消毒散、泻白散
三方合用，内桑白皮，采鲜者多用，热盛烦渴，加石膏末、知母、黄芩、天花粉。
疹子发热，或自汗出，或鼻衄者，不须止之，亦发散之义，汗则毒从汗散，衄则毒从衄解，但不可太过，
如汗太多，人参白虎汤（痘渴）合黄连解毒汤（痘烦躁），或黄连汤主之。衄太多，玄参地黄汤（失血）
茅花汤主之。
黄连汤
黄连 麦门冬 当归 黄柏 黄芩 生地黄 黄
水煎，去滓，调败蒲扇灰服之。
茅花汤
茅花 真郁金 生地黄 栀子仁 黄芩
水煎，调百草霜服。
疹子发热吐利，乃火邪内迫，纯是热证，不可作寒论。上焦多吐，宜黄芩汤（痘泄利）加茅根、芦根、枇杷
叶。下焦多利，宜黄芩汤送下香连丸（大科泄泻）。中焦吐利俱多，宜黄芩汤多加芦根、茅根煎调六一散
（痘初热）。自利甚，则里急后重而为滞下，宜加味黄芩汤调六一散。大抵疹家吐利滞下，宜于疹家求之，
不可作吐利滞下而治。
加味黄芩汤
黄连 黄芩（各一钱半） 白芍药（三钱） 甘草（七分） 滑石末（三钱）
水煎服。若滑石不煎、调服，止于一钱。血痢，加地榆二钱。
铜璧山人黄芩汤
黄芩 黄连 赤芍药 生地黄 木通 枳壳 甘草 当归梢 人参
水煎，去滓，调天水散服之。初加酒大黄微利之。
疹出之时咽喉肿痛者，乃毒火上熏而然，勿作喉痹治法，妄用针刺，喉痹、内作痈肿，故宜决去恶血。
痘疹只是咽干作痛，宜甘桔汤加玄参、牛蒡、连翘，或射干鼠粘子汤细细咽之，钱氏甘露饮子（俱咽喉）亦
可。外用十全散、玉锁匙点之。
十全散
黄连 黄芩 黄柏（各一钱） 苦参 孩儿茶 雄黄（各五分） 硼砂 玄明粉（各三分） 乳香
（一分） 片脑（少许，临时入）
共为极细末。每用五厘吹之。
疹子渴喜饮水，纯是火邪，肺焦胃干，心火内亢故也。初发热渴者，前发散药中多加石膏、天花粉，或葛
根麦门冬散。疹子出见渴者，人参白虎汤（痘渴）加天花粉、麦门冬，渴甚者，白虎汤合黄连解毒汤主之。
葛根麦门冬散
干葛 麦门冬（各一钱） 石膏 升麻 赤芍药 甘草 茯苓 人参（各五分）
上锉细。加淡竹叶七片，水一盏，煎七分，去滓温服。
白虎合解毒汤
石膏（研粗末，四钱） 知母 天花粉 黄芩 黄连 山栀仁（各一钱） 生地黄 麦门冬（各二钱
）入淡竹叶十片，水二钟，煎一钟，更磨入犀角汁，索汤水则与之。觉胃热渴，甚宜以此方多与之，胃清乃止，
庶免牙疳之害，直至疳成，而后清胃凉血解毒，往往噬肤无及，慈亲仁人，宜早为之所，毋事姑息。
【见形】痘疮，贵三四次出，谓出匀。麻疹，贵一齐涌出，谓出尽。麻疹只要得出，便轻减，以火照之，
遍身如涂朱之状，此将出之状，出形细密，与痘疮密者相似，但疹子随出随没，非若痘子之以渐长大也。出形
鲜红与伤寒发 相似，但疹子粒粒成疮，非若 之皮红成片，如蚊蚤之迹也。
疹痘之色不可同论，大抵痘子怕太红，皮嫩易破，必生瘙痒。疹子喜通红，疹发于心，红者火之正色也。
若色淡白者，心血不足，养血化 汤主之。色太红殷，或微紫者，血热也，或出太甚者，并宜大青汤主之。黑
者，死证也。
养血化 汤
当归身 生地黄 红花 蝉蜕 人参（各等分）
上锉细。水一盏，生姜一片，煎六分，去滓温服，无时。
大青汤
大青 玄参 生地黄 石膏 知母 木通 甘草 地骨皮 荆芥穗（各等分）
上锉细。水一盏，淡竹叶十二片，煎七分，去滓温服。
疹子出没，常以六时为准，假如子后出者，午时即收，午后出者，子时即收，乃阳生阴成，阴生阳成，造
化自然之数也。凡此旋出旋收者轻。若一出连绵，三四日不收者，乃阳毒太甚，宜大青汤解之，逡巡不出者，
乃风外束，皮肤闭密也，宜荆防败毒散主之（夹疹）。
疮疹非热不出，疹子欲出，则遍身发热，或烦躁，或头眩，或身拘急，及既出，则身便凉，诸病悉解，此
一层疹子随收矣。如疹子既出，热甚不减，此毒壅遏，宜大青汤解其表。便涩者，以黄连解毒汤（痘烦躁）合
白虎汤（发热）解其里。大便不通者，四顺清凉饮主之（发热）。
加味地骨皮散 治疹出，发热不退，饮食不进。
地骨皮（鲜者，三钱） 桑白皮（鲜者，二钱） 麦门冬（二钱） 银柴胡 赤芍药 干葛（各一钱
）甘草 生犀屑（各五分）
水煎，调大小无比散五七分（方见痘初热）。亦治喘急不止。
凡疹子，只要出得尽，则毒邪解散，正气和平。如拂拂发热，烦闷不宁，如蛇在灰，如蚓在尘之状，或呕
吐，或注泄，此毒邪壅遏，尚未出尽。烦热者，黄连解毒汤（烦躁）。呕泄者，柴胡橘皮汤。并外用胡荽酒
（见形）以苎麻蘸酒遍身戛之。待疹子出尽，则烦热自去，呕泄自止矣。俱可用大小无比散兼服。
柴胡橘皮汤
柴胡 橘皮 黄芩 半夏 人参 白茯苓（各等分）
上锉细。加竹茹一团，生姜三片，水一盏，煎七分，去滓温服，不拘时。
疹子欲出未出之时，宜早发散，以解其毒，则无余灾。若不预解使之尽出，以致毒蓄于中，或为壮热，日久
枯瘁，或成惊痫，或为泻痢，或咳血喘促，或作疳 而死，此虽一时戾气之染，未有不由于人事之未尽者。
【收后】疹子收后，身有微热者，此虚热也，不须施治，待气血和畅，自然退去。
若热太甚，或日久不减，以柴胡麦门冬散。甚则以黄连解毒汤（烦躁）合人参白虎汤（痘渴），与前方相间
服之。如发枯毛竖，肉消骨立，渐渐羸瘦者，柴胡四物汤主之。
疹子初起，多泻不妨，惟愈后最忌重热，此不可不调治者。盖疹子发热，多至十一二日，少亦不下五七日，
热久元气虚矣，加之疹出饮食不进，而复重热，阴阳耗竭，不死何待。故再热者必大补气血可也。余见忽
以为常，而死者屡矣。
柴胡麦门冬散
柴胡（五分） 龙胆草（三分） 麦门冬（八分） 甘草（二分） 人参 玄参（各半钱）
上锉细。水煎服。
柴胡四物汤
麻疹的特征是皮疹浮起、细小且有颗粒感，发出后很快消退，不会化脓。北方人称之为“糠疮”，南方人称之为“麸疮”，吴地人称之为“痧”，越地人称之为“喑”，古代所说的“麻”，以及闻人氏所说的“肤疹”指的就是这种病。这与前文提到的由脾脏引起的疹子不同。
小儿出疹有出一两次者，出疹轻微且持续时间短的叫“奶疹子”，出疹稍重且持续时间稍长的叫“正疹子”。另外，在痘疮之前出的叫“奶疹子”，在痘疮之后出的叫“正疹子”。初起时也与痘疮相似，但痘疮发于五脏，麻疹发于六腑。五脏属阴，病根深重，所以难出难收，用药宜温和平缓；六腑属阳，病根浅表，所以易出易收，用药宜清凉。万全说：痘疮大而肿胀的，是少阳三焦之火所致，阳道常有余，所以大而肿。疹子小而细碎的，是少阴心火所致，阴道常不足，所以小而密。三焦是水谷运行的通道，脾胃主管受纳水谷，治疗痘疮专以调理脾胃为主。心肺属阳，位居上焦，心火旺盛则波及肺脏，治疗麻疹专以调理肺脏为主。观察那些咳嗽的患儿，是因为火炎上灼导致肺叶焦枯竖起。流清鼻涕的，因为鼻为肺之窍，火热灼伤肺金（肺），津液自流而出。眼中流泪的，是肺热移归于肝，肝之窍在目。用手抓挠眉目唇鼻及面部的，也是肺热的证候。按：既然是心火克制肺金，即是贼邪（相克太过），病情应当严重，为何反而比痘疮轻？我每次治疗麻疹，只是根据见证使用泻白散加减，大剂量投服，即使是极度危重的证候没有不痊愈的。其他时医使用苦寒降火、辛温发表的方法，导致陷入危亡境地的不可胜数，这哪里算是针对心火刑肺呢？
春温、夏暑、秋清、冬寒，这是四季的正气。冬天应该寒冷却反常温暖，阳气暴泄，火令提前施行，人感受了这种邪气，到了来年春天必定发生疮疥，尚未出痘疹的，必定会感染而出。虽然说是胎毒，但没有不是由于天行疫气传染的，所以一时之间互相传染，大小症状相似。只要见到疹痘发出，就应当先服用三豆汤、代天宣化丸（这两个方剂都在前面的预防章节中）来预先化解它。
麻疹初起，完全类似伤风发热，伴有咳嗽鼻塞，面部浮肿腮部发红，痰涕稠粘，全是肺经的证候。有的后来传变为泄利，有的同时兼有泄利。肺与大肠相表里，表里两经都患病。唯独不能触犯风寒，以及在正气蒸腾发热时进食，否则能将轻症转为重症，不可不谨慎。
麻疹的形态证候也相同，有的像发出风疹疙瘩，隆起如云头，颜色赤红成片，随见随没的。有的像粟米头或糠皮，三次发作都可见到而不消退，直到三天后才逐渐收敛消退的。然而都称为麻疹。在其欲出未出之际，应当使用发表的药物发散它，这样容易发出也容易痊愈。
麻疹，有发热十多天才见到的，大致主要在于发散肺经的热毒作为始事，调理补养病后的元气作为终事。其间如果兼夹风邪，或兼夹痰饮，或伤食，并随意加入对症的药物。如果有变证，就随病使用对症的药物，只要不乱投汤药，孩子就没有事了。
疹子喜欢清凉，痘子喜欢温暖，这种方法大家都知晓。然而疹子初出时，也需要温和暖适才能容易发出，所以在发苗之初，只要发出得彻底，毒邪就能解除，不像痘疮必须经历苗、秀、实的过程，然后毒邪才解除。痘子成实时，如果过于温热，反而溃烂不收口，所以痘疮后期也喜欢清凉。因此治疗痘疹的人，不要过热，不要过寒，温凉适宜，阴阳自然调和，这就对了。
【初热】痘疹发热初期，大多类似伤寒，只有麻疹表现为咳嗽喷嚏，流清鼻涕，眼睑肿胀，眼泪汪汪，面部浮肿腮部发红，或者呕吐恶心，或者泄利，或者手抓挠眉目鼻面，这是不同的地方。轻症的用泻白散合三味消毒散主治，重症的用金沸草散主治，兼有泄利的，合用升麻葛根汤，用白芷代替葛根。这是我创立的治疗方法，使用无不奏效的，即使是十分危重的证候，坚守此法不失，最终必然救治成功。常见各种书籍所定的方剂，大多是苦寒辛凉发表的药剂，不尽符合对证对经的原则，恐怕有诛罚无过的失误，使用者要详细斟酌。大致而言，疹子欲出已出之际，即使有寒象也不要用桂枝。即使体虚也不用人参、白术。即使呕吐但有痰也不要用半夏、南星。最忌讳误认为伤寒，妄用发汗和攻下。发汗则会增加其热，导致鼻衄、咳血、口疮咽痛、目赤痛、烦躁、大小便不通。攻下则会使其里气虚弱，导致滑泄、滞下，多至无法挽救，务必谨慎。〔万全〕如果手脚稍微冷，恶寒而无汗，面色青惨而不舒展，左额有青纹的，是伤寒的热证。手脚稍微温，发热有汗，面赤而光亮的，是伤风的热证，都适宜用惺惺散（痘初热）发散。眼睑肿胀且右颊有青筋，发热且头额腹肚最甚，或者兼有呕吐腹痛的，是伤食的热证，用备急丸（痘初热）攻下。面色青红，额头正中有纹，手掌心有汗，时常惊惕，手络脉微动而发热的，这是惊热，用泻青丸（肝）、牛黄清心丸（痘烦躁）主治。身体发热且特别能进食，嘴唇红脸颊赤，大小便秘结，胁下有汗的，这是风热，用宣风散主治（痘发热）。以上各种热证，如果长久不去，内外感发，那么所蕴藏的疮疹之毒，也能趁机而出。
疹子只怕不能发出，如果发出尽，毒邪就解除了，所以治疗疹子，在发热之时，应当察时令寒暖，用药发散。如果时令太寒，用桂枝葛根汤发散。太热，用升麻葛根汤（俱痘初热）合人参白虎汤发散（痘渴）。不寒不热，用荆防败毒散发散（痘夹疹）。如果兼有疫疠之气，用人参败毒散发散（痘初热）。如果服完一剂仍不出，再煎本汤发散，外用胡荽酒（见形）用苎麻蘸酒遍身擦拭，务必令其急出。如果三四次更替仍不出，加上腹部胀痛，气上喘促，昏闷谵妄的，是必死之证。
泻白消毒散
桑白皮 地骨皮（这两味，自采鲜品，各三钱） 牛蒡子（炒研） 荆芥穗（各一钱半） 桔梗 甘草（各一钱） 浮萍（晒干，二钱）
以上为粗末。每服三五钱，水一盏，煎至六分，滤清服用。
加味金沸草散
旋复花（去梗） 麻黄（去节，水煮去沫，晒干） 前胡（去芦。各七钱） 荆芥穗（一两） 甘草（炙） 半夏（汤泡七次，姜汁拌炒） 赤芍药（各五钱） 鼠粘子（炒） 浮萍（各七钱）
以上为末。每服三钱，生姜二片，薄荷叶三五片，煎服。
防风解毒汤（如在温暖之时，以此辛凉之药发散）
防风 薄荷 荆芥 石膏 知母 桔梗 甘草 牛蒡子 连翘 木通 枳壳 淡竹叶
黄连解毒汤（如在暄热之时，以此辛寒之药发散）
防风 黄芩 黄连 荆芥穗 知母 石膏 黄柏（酒炒） 栀子仁 大青 玄参 甘草 桔梗 木通
桂枝解毒汤（如在大寒之时，以此辛温热之药发散）
桂枝 麻黄（酒炒） 赤芍药 防风 荆芥 羌活 甘草 桔梗 人参 川芎 牛蒡子 生姜
升麻解毒汤（如时暖时寒，以此辛平之药发散）
升麻 干葛 荆芥穗 人参 柴胡 前胡 牛蒡子 桔梗 防风 羌活 赤芍药 淡竹叶 连翘 甘草
上方，虽然说因时制宜，也不可拘泥，如冬季也有不宜用麻黄桂枝而宜用石膏的，正当以脉证为主罢了，如果固执不知变通，必有失误，不如使用首两个方剂更为妥当。
发热六七日以后，明是疹子，却不见发出，这是因为皮肤坚厚，腠理闭密，又或被风寒侵袭，曾有吐利，这是伏邪，急用托里发表的药剂，用麻黄汤调柽叶散发散，外用胡荽酒（见形）蘸麻刮之。如果一向未排便的，毒邪盛于里，伏而不出，用七物升麻丸解之，发之解之仍不出者，是死证。
麻黄汤
麻黄（去根节，制过） 升麻 牛蒡子（炒） 蝉壳（洗净，去足翅） 甘草（各一钱）
烦渴，加石膏末四钱。
以上锉细。加腊茶叶一钱，水一盏，煎七分，去滓服用。
柽叶散
柽，亦名西河柳，亦名垂丝柳，青茂时采叶晒干，为末，每服一二钱，茅根煎汤调下。
疹子初发热时，未见出现，咳嗽百十声不止，上气喘急，面部浮肿眼睑肿胀，宜甘桔汤、消毒散、泻白散三方合用，内桑白皮，采鲜者多用，热盛烦渴，加石膏末、知母、黄芩、天花粉。
疹子发热，或自汗出，或鼻衄的，不需要止住，这也是发散的意思，汗则毒从汗散，衄则毒从衄解，但不可太过。如汗太多，用人参白虎汤（痘渴）合黄连解毒汤（痘烦躁），或用黄连汤主治。衄太多，用玄参地黄汤（失血）茅花汤主治。
黄连汤
黄连 麦门冬 当归 黄柏 黄芩 生地黄 黄柏
水煎，去滓，调败蒲扇灰服用。
茅花汤
茅花 真郁金 生地黄 栀子仁 黄芩
水煎，调百草霜服用。
疹子发热吐利，是火邪内迫，纯是热证，不可作寒证论治。上焦多吐，宜黄芩汤（痘泄利）加茅根、芦根、枇杷叶。下焦多利，宜黄芩汤送下香连丸（大科泄泻）。中焦吐利俱多，宜黄芩汤多加芦根、茅根煎调六一散（痘初热）。自利甚，则里急后重而为滞下，宜加味黄芩汤调六一散。大致疹家吐利滞下，宜于疹家求之，不可作吐利滞下而治。
加味黄芩汤
黄连 黄芩（各一钱半） 白芍药（三钱） 甘草（七分） 滑石末（三钱）
水煎服。若滑石不煎、调服，止于一钱。血痢，加地榆二钱。
铜璧山人黄芩汤
黄芩 黄连 赤芍药 生地黄 木通 枳壳 甘草 当归梢 人参
水煎，去滓，调天水散服用。初加酒大黄微利之。
疹出之时咽喉肿痛者，是毒火上熏所致，不要作喉痹治法，妄用针刺，喉痹内部作痈肿，所以宜决去恶血。
痘疹只是咽干作痛，宜甘桔汤加玄参、牛蒡、连翘，或射干鼠粘子汤细细咽之，钱氏甘露饮子（俱咽喉）也可。外用十全散、玉锁匙点之。
十全散
黄连 黄芩 黄柏（各一钱） 苦参 孩儿茶 雄黄（各五分） 硼砂 玄明粉（各三分） 乳香（一分） 片脑（少许，临时入）
共为极细末。每用五厘吹之。
疹子渴喜饮水，纯是火邪，肺焦胃干，心火内亢所致。初发热渴者，在前发散药中多加石膏、天花粉，或葛根麦门冬散。疹子出见渴者，人参白虎汤（痘渴）加天花粉、麦门冬，渴甚者，白虎汤合黄连解毒汤主治。
葛根麦门冬散
干葛 麦门冬（各一钱） 石膏 升麻 赤芍药 甘草 茯苓 人参（各五分）
以上锉细。加淡竹叶七片，水一盏，煎七分，去滓温服。
白虎合解毒汤
石膏（研粗末，四钱） 知母 天花粉 黄芩 黄连 山栀仁（各一钱） 生地黄 麦门冬（各二钱）入淡竹叶十片，水二钟，煎一钟，更磨入犀角汁，索汤水则与之。觉胃热渴，甚宜以此方多与之，胃清乃止，庶免牙疳之害，直至疳成，而后清胃凉血解毒，往往噬肤无及，慈亲仁人，宜早为之所，毋事姑息。
【见形】痘疮，贵三四次出，谓出匀。麻疹，贵一齐涌出，谓出尽。麻疹只要得出，便轻减，以火照之，遍身如涂朱之状，此将出之状，出形细密，与痘疮密者相似，但疹子随出随没，非若痘子之以渐长大也。出形鲜红与伤寒发斑相似，但疹子粒粒成疮，非若斑之皮红成片，如蚊蚤之迹也。
疹痘之色不可同论，大致痘子怕太红，皮嫩易破，必生瘙痒。疹子喜通红，疹发于心，红者火之正色也。若色淡白者，心血不足，养血化斑汤主治。色太红殷，或微紫者，血热也，或出太甚者，并宜大青汤主治。黑者，死证也。
养血化斑汤
当归身 生地黄 红花 蝉蜕 人参（各等分）
以上锉细。水一盏，生姜一片，煎六分，去滓温服，无时。
大青汤
大青 玄参 生地黄 石膏 知母 木通 甘草 地骨皮 荆芥穗（各等分）
以上锉细。水一盏，淡竹叶十二片，煎七分，去滓温服。
疹子出没，常以六时为准，假如子后出者，午时即收，午后出者，子时即收，乃阳生阴成，阴生阳成，造化自然之数也。凡此旋出旋收者轻。若一出连绵，三四日不收者，乃阳毒太甚，宜大青汤解之，逡巡不出者，乃风外束，皮肤闭密也，宜荆防败毒散主治（夹疹）。
疮疹非热不出，疹子欲出，则遍身发热，或烦躁，或头眩，或身拘急，及既出，则身便凉，诸病悉解，此一层疹子随收矣。如疹子既出，热甚不减，此毒壅遏，宜大青汤解其表。便涩者，以黄连解毒汤（痘烦躁）合白虎汤（发热）解其里。大便不通者，四顺清凉饮主治（发热）。
加味地骨皮散 治疹出，发热不退，饮食不进。
地骨皮（鲜者，三钱） 桑白皮（鲜者，二钱） 麦门冬（二钱） 银柴胡 赤芍药 干葛（各一钱）甘草 生犀屑（各五分）
水煎，调大小无比散五七分（方见痘初热）。亦治喘急不止。
凡疹子，只要出得尽，则毒邪解散，正气和平。如拂拂发热，烦闷不宁，如蛇在灰，如蚓在尘之状，或呕吐，或注泄，此毒邪壅遏，尚未出尽。烦热者，黄连解毒汤（烦躁）。呕泄者，柴胡橘皮汤。并外用胡荽酒（见形）以苎麻蘸酒遍身戛之。待疹子出尽，则烦热自去，呕泄自止矣。俱可用大小无比散兼服。
柴胡橘皮汤
柴胡 橘皮 黄芩 半夏 人参 白茯苓（各等分）
以上锉细。加竹茹一团，生姜三片，水一盏，煎七分，去滓温服，不拘时。
疹子欲出未出之时，宜早发散，以解其毒，则无余灾。若不预解使之尽出，以致毒蓄于中，或为壮热，日久枯瘁，或成惊痫，或为泻痢，或咳血喘促，或作疳积而死，此虽一时戾气之染，未有不由于人事之未尽者。
【收后】疹子收后，身有微热者，此虚热也，不须施治，待气血和畅，自然退去。
若热太甚，或日久不减，用柴胡麦门冬散。甚则以黄连解毒汤（烦躁）合人参白虎汤（痘渴），与前方相间服之。如发枯毛竖，肉消骨立，渐渐羸瘦者，柴胡四物汤主治。
疹子初起，多泻不妨，惟愈后最忌重热，此不可不调治者。盖疹子发热，多至十一二日，少亦不下五七日，热久元气虚矣，加之疹出饮食不进，而复重热，阴阳耗竭，不死何待。故再热者必大补气血可也。余见忽以为常，而死者屡矣。
Measles is characterized by rashes that are floating, small, and granular. They appear and disappear quickly without forming pus. People in the North call it "Kuang Chuang" (Bran Sore), people in the South call it "Fu Chuang" (Bran Sore), people in Wu call it "Sha", and people in Yue call it "Yin". The "Ma" mentioned in ancient texts, and the "Fu Zhen" (Skin Rash) described by Wenren Shi, refer to this condition. It differs from the rash associated with the Spleen mentioned earlier.
Children may have one or two outbreaks. Those with mild eruptions and short duration are called "Nai Zhen Zi" (Milk Measles). Those with slightly more severe eruptions and longer duration are called "Zheng Zhen Zi" (True Measles). Additionally, those appearing before variola (smallpox) are called "Nai Zhen Zi", and those appearing after variola are called "Zheng Zhen Zi". Initially, they resemble variola, but variola originates from the Zang organs (Viscera), while measles originates from the Fu organs (Bowels). The Zang organs belong to Yin, so the disease root is deep, making it difficult to erupt and resolve; thus, medication should be warm and neutral. The Fu organs belong to Yang, so the disease root is superficial, making it easy to erupt and resolve; thus, medication should be cool and clearing. Wan Quan stated: Variola that is large and swollen is due to Fire of the Shaoyang Sanjiao (Triple Burner). The Yang path is often abundant, hence large and swollen. Measles that are small and fragmented are due to Heart Fire of the Shaoyin. The Yin path is often deficient, hence small and dense. The Sanjiao is the pathway for water and grain; the Spleen and Stomach govern the reception of water and grain, so treating variola focuses primarily on the Spleen and Stomach. The Heart and Lungs belong to Yang and reside in the Upper Jiao. When Heart Fire is excessive, it affects the Lung. Therefore, treating measles focuses primarily on the Lung. Observing those who cough indicates that Fire blazing causes the Lung lobes to become dry and elevated. Clear nasal discharge occurs because the nose is the opening of the Lung; Fire scorching Metal (Lung) causes fluids to flow freely. Tears from the eyes indicate Lung Heat transferring to the Liver, as the Liver opens into the eyes. Scratching the eyebrows, eyes, lips, nose, and face also indicates Lung Heat. Note: Since this is Heart Fire punishing Lung Metal, it is a "Thief Evil" (excessive counter-restriction), and the symptoms should be severe. Why are they lighter than variola? In my treatment of measles, I simply use Xie Bai San (Drain White Decoction) with modifications based on the manifestations, administering large doses. Even critically severe cases recover without exception. Other contemporary physicians using bitter-cold fire-draining or acrid-warm exterior-releasing methods have caused countless deaths. How can this be considered treating Heart Fire punishing Lung Metal?
Spring warmth, Summer heat, Autumn clarity, Winter cold—these are the correct Qi of the four seasons. If Winter should be cold but is instead warm, Yang Qi leaks violently, and the Fire mandate acts early. Those who contract this will inevitably develop sores and boils in the following Spring. Those not yet having variola or measles will inevitably contract and erupt them. Although termed "Fetal Toxin," none arise without transmission via Heavenly Pestilence (Epidemic Qi). Thus, infection spreads simultaneously, with similar symptoms in all ages. Upon seeing the eruption of measles or variola, one should first administer San Dou Tang (Three Bean Decoction) and Dai Tian Xuan Hua Wan (Heavenly Agent Transforming Pill) [both seen in the Prevention section] to preemptively resolve it.
The initial stage of measles closely resembles Wind-Cold injury with fever, cough, nasal congestion, facial swelling, red cheeks, thick sticky sputum and mucus—all signs of the Lung Meridian. Some later transmit to diarrhea, while others present with diarrhea simultaneously. The Lung and Large Intestine are interior-exterior pairs, so both the exterior and interior meridians are diseased. One must strictly avoid exposure to Wind-Cold and eating during the peak of internal heat steaming, as doing so can transform a mild case into a severe one. Caution is essential.
The morphology and symptoms of measles vary. Some resemble wind-rash wheals, rising like cloud heads, red in color, appearing and disappearing instantly. Others resemble millet heads or bran, visible through three stages without fading, only gradually resolving after three days. All are termed measles. During the interval when the rash desires to erupt but has not yet done so, exterior-releasing medications should be used to promote eruption, facilitating easier emergence and recovery.
In some cases of measles, fever persists for over ten days before appearance. Generally, the primary task at the beginning is to disperse Lung Heat-Toxin, and the final task is to regulate and tonify post-illness Yuan Qi. If complicated by Wind, Phlegm, or Food Stagnation, appropriate symptomatic herbs should be added. If complications arise, treat according to the specific pathology. As long as decoctions are not administered indiscriminately, the child will remain safe.
Measles prefers coolness, while variola prefers warmth—a principle known to all. However, initially, measles requires warmth to facilitate eruption. Once the "seedlings" (rash) emerge completely, the toxin resolves. This differs from variola, which must progress through budding, flowering, and fruiting stages before the toxin resolves. When variola matures, excessive heat causes ulceration and failure to heal; thus, late-stage variola also benefits from coolness. Therefore, in treating both, avoid excessive heat and excessive cold. Warmth and coolness should be balanced so that Yin and Yang harmonize naturally. This constitutes proper treatment.
[Initial Fever] The initial fever of variola and measles often resembles Taiyang Cold Damage (Shanghan). However, measles is distinguished by coughing, sneezing, clear nasal discharge, swollen eyelids, watery eyes, facial edema, red cheeks, vomiting, diarrhea, or scratching the face and eyes. Mild cases are treated with Xie Bai San combined with San Wei Xiao Du San. Severe cases are treated with Jin Fei Cao San. Cases accompanied by diarrhea use Sheng Ma Ge Gen Tang, substituting Baizhi for Gegen. This is my established method, which proves effective even in critical conditions. Many classical formulas rely on bitter-cold or acrid-cool exterior-releasing agents, which may not align precisely with the meridian or syndrome, risking unjust punishment of healthy Qi. Users should deliberate carefully. Generally, during the eruptive phase of measles, do not use Guizhi (Cinnamon Twig) even if cold signs are present. Do not use Renshen (Ginseng) or Baizhu (Atractylodes Macrocephala Rhizome) even if deficiency exists. Do not use Banxia (Pinellia Tuber) or Nanting (Arisaema Rhizome) if vomiting is accompanied by phlegm. It is strictly forbidden to misdiagnose as Shanghan and misuse sweating or purging methods. Sweating increases heat, leading to epistaxis, hemoptysis, mouth ulcers, sore throat, red painful eyes, restlessness, and urinary/fecal retention. Purging empties the interior, leading to incontinence or dysentery, often resulting in death. Be extremely cautious.
[Wan Quan:] If hands and feet are slightly cold, with aversion to cold, no sweat, sullen blueish complexion, and blue veins on the left forehead, this is Heat from Shanghan. If hands and feet are slightly warm, with fever, sweat, and bright red face, this is Heat from Wind Injury. Both should be dispersed using Xing Xing San [for Initial Fever of Variola]. If eyelids are swollen, blue veins appear on the right cheek, fever is most intense on the head, forehead, abdomen, and belly, possibly with vomiting and abdominal pain, this is Heat from Food Stagnation. Treat with Bei Ji Wan [for Initial Fever of Variola] to purge. If the complexion is green-red, with a line on the center of the forehead, sweat on palms, frequent startle, slight tremors in hand collaterals, and fever, this is Heat from Fright. Treat with Xie Qing Wan (Liver) and Niu Huang Qing Xin Wan [for Variola Restlessness]. If body heat is accompanied by increased appetite, red lips and cheeks, constipation, and sweat under the ribs, this is Wind-Heat. Treat with Xuan Feng San [for Variola Fever]. If any of these heats persist, internal and external pathogens interact, allowing the accumulated toxin of sores and rashes to erupt opportunistically.
The main concern with measles is ensuring complete eruption. Once fully erupted, the toxin resolves. Therefore, during the febrile stage, observe the seasonal climate and use herbs to induce eruption. If too cold, use Guizhi Genge Tang. If too hot, use Shengma Gegen Tang [both for Initial Fever of Variola] combined with Renshen Baitu Tang [for Variola Thirst]. If neither cold nor hot, use Jingfang Baidu San [for Variola Complicated by Measles]. If epidemic Qi is present, use Renshen Baidu San [for Initial Fever of Variola]. If one dose fails to produce eruption, repeat the decoction. Externally, apply Hu Su Jiu (Coriander Wine) [for Appearance Phase] using Ramie cloth to wipe the body, urging rapid eruption. If after three or four attempts the rash does not appear, accompanied by abdominal distension/pain, wheezing, coma, and delirium, it is a fatal sign.
Xie Bai Xiao Du San
Sangbaipi (Mulberry Root Bark), Digupi (Groundcherry Root Bark) [Freshly harvested, 3 qian each], Niubangzi (Arctii Fructus, stir-fried and ground), Jingjie Sui (Schizonepeta Spike, 1.5 qian each), Jiegeng (Platycodon Root), Gancao (Licorice Root, 1 qian each), Fuping (Floating Duckweed, dried, 2 qian).
Grind into coarse powder. Take 3-5 qian per dose, boil in one cup of water until reduced to 0.6 cup, filter, and drink.
Jia Wei Jin Fei Cao San
Xuanfuhua (Inula Flower, remove stem), Mahuang (Ephedra Stem, remove joints, boil to remove foam, dry), Qianhu (Peucedani Radix, remove rhizome, 7 qian each), Jingjie Sui (1 liang), Gancao (Honey-fried), Banxia (Pinellia Tuber, soaked in boiling water seven times, stir-fried with ginger juice), Chishao (Red Peony Root, 5 qian each), Shuniuzi (Arctii Fructus, stir-fried), Fuping (7 qian each).
Grind into powder. Take 3 qian per dose with 2 slices of fresh ginger and 3-5 mint leaves, decoct and drink.
Fangfeng Jiedu Tang [Use this acrid-cool formula for warm weather]
Fangfeng (Saposhnikoviae Radix), Bohe (Menthae Haplocalycis Herba), Jingjie (Schizonepetae Herba), Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), Jiegeng (Platycodonis Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Niubangzi (Arctii Fructus), Lianqiao (Forsythiae Fructus), Mutong (Akebiae Caulis), Zhike (Aurantii Fructus), Danzhuye (Lophatheri Herba).
Huanglian Jiedu Tang [Use this acrid-cold formula for hot weather]
Fangfeng (Saposhnikoviae Radix), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Jingjie Sui (Schizonepetae Spica), Zhimu (Anemarrhenae Rhizoma), Shigao (Gypsum Fibrosum), Huangbai (Phellodendri Cortex, wine-fried), Zhizi Ren (Gardeniae Semen), Daqing (Indigo Naturalis), Xuanshen (Scrophulariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Jiegeng (Platycodonis Radix), Mutong (Akebiae Caulis).
Guizhi Jiedu Tang [Use this acrid-warm-hot formula for severe cold]
Guizhi (Cinnamomi Ramulus), Mahuang (Ephedrae Herba, wine-fried), Chishao (Paeoniae Radix Rubra), Fangfeng (Saposhnikoviae Radix), Jingjie (Schizonepetae Herba), Qianghuo (Notopterygii Rhizoma et Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Jiegeng (Platycodonis Radix), Renshen (Ginseng Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Niubangzi (Arctii Fructus), Shengjiang (Zingiberis Rhizoma Recens).
Shengma Jiedu Tang [Use this acrid-neutral formula for fluctuating temperature]
Shengma (Cimicifugae Rhizoma), Gan Ge (Puerariae Lobatae Radix), Jingjie Sui (Schizonepetae Spica), Renshen (Ginseng Radix), Chaihu (Bupleuri Radix), Qianhu (Peucedani Radix), Niubangzi (Arctii Fructus), Jiegeng (Platycodonis Radix), Fangfeng (Saposhnikoviae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Chishao (Paeoniae Radix Rubra), Danzhuye (Lophatheri Herba), Lianqiao (Forsythiae Fructus), Gancao (Glycyrrhizae Radix et Rhizoma).
Although these formulas adapt to seasonal changes, rigid adherence is inadvisable. For instance, in winter, Shigao may be preferred over Mahuang and Guizhi. Treatment must prioritize pulse and symptoms. Stubborn adherence without flexibility leads to error; the first two formulas are generally safer.
If fever persists for six to seven days and measles are evident but not erupting, it may be due to thick skin and closed pores, or invasion by Wind-Cold, or prior vomiting/diarrhea causing latent toxin. Urgently use interior-supporting and exterior-releasing agents. Use Mahuang Tang to administer Chengye San externally. Apply Hu Su Jiu [Appearance Phase] with hemp scraping. If constipation persists, toxin is trapped internally; use Qi Wu Shengma Wan to resolve and release. If still unresponsive, it is fatal.
Mahuang Tang
Mahuang (Ephedrae Herba, roots/joints removed, processed), Shengma (Cimicifugae Rhizoma), Niubangzi (Arctii Fructus, stir-fried), Chanqiao (Cicadae Periostracum, cleaned, legs/wings removed), Gancao (Glycyrrhizae Radix et Rhizoma, 1 qian each).
For irritability/thirst, add 4 qian Shigao powder.
Cut finely. Add 1 qian wax tea leaves, boil in one cup of water to 0.7 cup, strain, and drink.
Chengye San
Cheng (Tamarisci Ramulus), also known as Xihe Liu or Chuisi Liu. Harvest leaves when lush, dry, and grind. Take 1-2 qian per dose, mixed with Mugwort Root decoction.
When measles initially feverish without eruption, accompanied by incessant coughing, asthma, facial edema, and swollen eyelids, combine Ganjie Tang, Xiaodu San, and Xie Bai San. Use more fresh Sangbaipi. For severe heat/thirst, add Shigao, Zhimu, Huangqin, and Tianhuafen.
If measles fever presents with spontaneous sweating or epistaxis, do not stop them; this aids dispersion. Sweat releases toxin via pores; epistaxis releases toxin via nose. However, avoid excess. For excessive sweating, use Renshen Baitu Tang [Variola Thirst] combined with Huanglian Jiedu Tang [Variola Restlessness], or Huanglian Tang. For excessive epistaxis, use Xuanshen Dihuang Tang [Hemorrhage] or Maohua Tang.
Huanglian Tang
Huanglian (Coptidis Rhizoma), Maidong (Ophiopogonis Tuber), Danggui (Angelicae Sinensis Radix), Huangbai (Phellodendri Cortex), Huangqin (Scutellariae Radix), Shengdihuang (Rehmanniae Radix).
Decoct, strain, and mix with powdered charred reed fan ash.
Maohua Tang
Maohua (Miscanthi Flower), Zhen Yujin (Curcumae Radix), Shengdihuang (Rehmanniae Radix), Zhizi Ren (Gardeniae Semen), Huangqin (Scutellariae Radix).
Decoct, strain, and mix with Baicao Shuang (Soot from burning hundred herbs).
Measles fever with vomiting and diarrhea results from Fire Evil forcing inward; it is purely a Heat syndrome, not Cold. Upper Jiao vomiting: Huangqin Tang [Variola Diarrhea] plus Mugwort Root, Reed Root, Loquat Leaf. Lower Jiao diarrhea: Huangqin Tang with Xianglian Wan [General Diarrhea]. Middle Jiao both: Huangqin Tang with extra Reed/Mugwort roots, decocted with Liuyi San [Variola Initial Fever]. Severe self-diarrhea with tenesmus becomes dysentery; use Jia Wei Huangqin Tang with Liuyi San. Generally, treat vomiting/diarrhea/dysentery in measles patients by addressing the measles itself, not just the gastrointestinal symptoms.
Jia Wei Huangqin Tang
Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix, 1.5 qian each), Baishao (Paeoniae Radix Alba, 3 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 0.7 qian), Huashi (Talcum, 3 qian).
Decoct. If Huashi is not decocted but mixed, limit to 1 qian. For bloody dysentery, add Diyü (Sanguisorbae Radix, 2 qian).
Tongbi Shanren Huangqin Tang
Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Chishao (Paeoniae Radix Rubra), Shengdihuang (Rehmanniae Radix), Mutong (Akebiae Caulis), Zhike (Aurantii Fructus), Gancao (Glycyrrhizae Radix et Rhizoma), Danggui Shao (Angelicae Sinensis Radix tip), Renshen (Ginseng Radix).
Decoct, strain, mix with Tianshui San. Initially add Jiu Dahuang (Rhei Radix et Rhizoma, wine-processed) for mild purgation.
Sore throat/swelling during eruption is due to Toxic Fire ascending. Do not treat as Hou Bi (Throat Bi) or use needle pricking. Treat variola/measles throat dryness/pain with Ganjie Tang plus Xuanshen, Niubangzi, Lianqiao, or Shegan Niubangzi Tang gargled slowly. Qian's Ganlu Yinzi [Throat] is also suitable. Externally, use Shiquan San or Yusuo Chi.
Shiquan San
Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Huangbai (Phellodendri Cortex, 1 qian each), Kushen (Sophorae Flavescentis Radix), Haiercha (Camelliae Seed Tea), Xionghuang (Realgar, 0.5 fen each), Pengsha (Borax), Xuanmingfen (Mirabilite, 0.3 fen each), Rushi (Dragon's Blood Resin, 1 fen), Piannao (Borneolum Syntheticum,少许, add last).
Grind to fine powder. Blow 0.05 fen into throat.
Thirst and desire for water in measles indicate pure Fire Evil, drying Lung/Stomach and hyperactive Heart Fire. Initial fever/thirst: Add Shigao, Tianhuafen to dispersing formulas, or use Gegen Maidong San. Eruption/thirst: Renshen Baitu Tang [Variola Thirst] plus Tianhuafen, Maidong. Severe thirst: Baitu Tang combined with Huanglian Jiedu Tang.
Gegen Maidong San
Gegen (Puerariae Lobatae Radix), Maidong (Ophiopogonis Tuber, 1 qian each), Shigao (Gypsum Fibrosum), Shengma (Cimicifugae Rhizoma), Chishao (Paeoniae Radix Rubra), Gancao (Glycyrrhizae Radix et Rhizoma), Fuling (Poria), Renshen (Ginseng Radix, 0.5 fen each).
Cut finely. Add 7 Danzhuye leaves, boil in one cup water to 0.7 cup, strain, drink warm.
Baitu He Jiedu Tang
Shigao (Gypsum Fibrosum, coarsely ground, 4 qian), Zhimu (Anemarrhenae Rhizoma), Tianhuafen (Trichosanthis Radix), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Shanzhiren (Gardeniae Semen, 1 qian each), Shengdihuang (Rehmanniae Radix), Maidong (Ophiopogonis Tuber, 2 qian). Add 10 Danzhuye leaves, boil in two cups water to one cup. Grind in Xijiao (Rhinocerotis Cornu) juice. Provide soup/water as desired. For stomach heat/thirst, administer generously until cleared to prevent Ya Gan (Gum Gangrene). Delaying treatment until gangrene forms renders remedies ineffective. Benevolent parents should act early.
[Appearance Phase] Variola ideally erupts in three or four batches (even distribution). Measles ideally erupts all at once (complete eruption). Measles lightens once erupted. Illuminated, the body looks like cinnabar. This pre-eruption state shows dense, fine rash resembling dense variola, but measles fades as it appears, unlike variola which grows gradually. Bright red rash resembles Shanghan Ban (Macules), but measles forms individual pustules, unlike macules which form red patches like insect bites.
Color analysis differs. Variola fears excessive redness (thin skin breaks, causes itching). Measles prefers uniform redness (Heart origin, Red is Fire's true color). Pale/white indicates Heart Blood deficiency; treat with Yangxue Hua Ban Tang. Deep red/purple indicates Blood Heat or excessive eruption; treat with Daqing Tang. Black indicates fatality.
Yangxue Hua Ban Tang
Danggui Shen (Angelicae Sinensis Radix), Shengdihuang (Rehmanniae Radix), Honghua (Carthami Flos), Chantui (Cicadae Periostracum), Renshen (Ginseng Radix, equal parts).
Cut finely. Boil in one cup water with one ginger slice to 0.6 cup, strain, drink warm anytime.
Daqing Tang
Daqing (Indigo Naturalis), Xuanshen (Scrophulariae Radix), Shengdihuang (Rehmanniae Radix), Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), Mutong (Akebiae Caulis), Gancao (Glycyrrhizae Radix et Rhizoma), Digupi (Lycii Cortex), Jingjie Sui (Schizonepetae Spica, equal parts).
Cut finely. Boil in one cup water with 12 Danzhuye leaves to 0.7 cup, strain, drink warm.
Measles timing follows six-hour cycles. Erupting after Zi hour resolves at Wu hour; erupting after Wu hour resolves at Zi hour (Yin/Yang generation). Rapid eruption/resolution is mild. Continuous eruption for 3-4 days without resolution indicates extreme Yang Toxin; treat with Daqing Tang. Hesitant eruption indicates external Wind binding closed skin; treat with Jingfang Baidu San [Complicated Measles].
Sores/rashes require Heat to erupt. Pre-eruption: whole-body fever, restlessness, dizziness, stiffness. Post-eruption: body cools, symptoms resolve, rash recedes. If fever persists post-eruption, toxin is blocked; use Daqing Tang to release exterior. Urinary difficulty: Huanglian Jiedu Tang [Restlessness] + Baitu Tang [Fever] to release interior. Constipation: Sishun Qingliang Yin [Fever].
Jia Wei Digupi San [Treats persistent fever/anorexia post-eruption]
Digupi (Lycii Cortex, fresh, 3 qian), Sangbaipi (Mori Cortex, fresh, 2 qian), Maidong (Ophiopogonis Tuber, 2 qian), Yinchaihu (Cymopodi Radix), Chishao (Paeoniae Radix Rubra), Gan Ge (Puerariae Lobatae Radix, 1 qian each), Gancao (Glycyrrhizae Radix et Rhizoma), Shengxi Xi (Rhinocerotis Cornu, 0.5 fen each).
Decoct, mix with Dawu Bisu San/Xiaowu Bisu San [0.5-0.7 qian] (see Variola Initial Fever). Also treats persistent asthma.
Complete eruption dissolves toxin and harmonizes Zheng Qi. Lingering fever/restlessness ("snake in ash," "earthworm in dust"), vomiting, or diarrhea indicate incomplete toxin release. Restlessness: Huanglian Jiedu Tang [Restlessness]. Vomiting/Diarrhea: Chaihu Jupi Tang. Externally, use Hu Su Jiu [Appearance Phase] with ramie wiping. Once erupted, symptoms cease. Dawu/Bixiao Bisu San may be taken concurrently.
Chaihu Jupi Tang
Chaihu (Bupleuri Radix), Jupi (Citri Reticulatae Pericarpium), Huangqin (Scutellariae Radix), Banxia (Pinelliae Tuber), Renshen (Ginseng Radix), Baifuling (Poria cum Risu, equal parts).
Cut finely. Add Zhu Ru (Bambusae Caulis in Taenia), 3 ginger slices. Boil in one cup water to 0.7 cup, strain, drink warm anytime.
Early dispersion during pre-eruption prevents residual disaster. Failure to release toxin leads to high fever, wasting, convulsions, dysentery, hemoptysis, asthma, or Gan Ji (Infantile Malnutrition) death. Though caused by epidemic Qi, human negligence contributes.
[Post-Resolution] Mild fever after resolution is Deficiency Heat; no treatment needed. It resolves as Qi/Blood harmonize. Excessive/prolonged fever: Chaihu Maidong San. Severe: Huanglian Jiedu Tang [Restlessness] + Renshen Baitu Tang [Variola Thirst], alternating. Dry hair, standing bristles, muscle wasting, emaciation: Chaihu Siwu Tang.
Initial diarrhea is acceptable; post-recovery heavy heat is taboo. Prolonged fever (5-12 days) depletes Yuan Qi. Poor intake plus recurrent heat exhausts Yin/Yang, leading to death. Recurrent heat requires major Qi/Blood tonification. I have witnessed many deaths from ignoring this.
Chaihu Maidong San
Chaihu (Bupleuri Radix, 0.5 fen), Longdancao (Gentianae Radix, 0.3 fen), Maidong (Ophiopogonis Tuber, 0.8 fen), Gancao (Glycyrrhizae Radix et Rhizoma, 0.2 fen), Renshen (Ginseng Radix), Xuanshen (Scrophulariae Radix, 0.5 fen each).
Cut finely. Decoct and drink.
Chaihu Siwu Tang