麻疹发自脾肺。故多咳嗽。若咳嗽太甚者。当分初没治之。初起咳嗽。此为风邪所郁。以升
麻葛根汤加前胡桔梗苏叶杏仁治之。已出咳嗽。乃肺为火灼。以清金宁嗽汤主之。
廉按云治之。不必加减也。云主之。当随症加减也。
升麻葛根汤（见前）
清金宁嗽汤
橘红 前胡 甘草 杏仁 桑皮 川连 蒌仁 桔梗 浙贝
疹毒热盛。上攻咽喉。轻则肿痛。甚则汤水难下。最为可虑。表邪郁遏。疹毒不能发舒于外
。致咽喉作痛者。元参升麻汤主之。里热壅盛。或疹已发于外。而咽喉作痛。以凉膈消毒
饮主之。
元参升麻汤 治表郁喉痛
荆芥 防风 升麻 粘子 元参 甘草
凉膈消毒饮
荆芥 防风 连翘 薄荷 黄芩 栀子(生) 甘草 粘子 芒硝 大黄(生)
加灯心
失音者。乃热毒闭塞肺窍而然也。疹初失音者。元参升麻汤主之。疹已发而失音者。加减凉
膈散主之。疹没后声哑者。儿茶散主之。
元参升麻汤 见喉痛
加减凉膈散
薄荷 栀子(生) 元参 连翘 甘草 桔梗 麦冬 粘子 黄芩
儿茶散
硼砂(二钱) 孩儿茶(五钱)
共为细末。凉水一盏。调药一匙服之。
廉按喉痛。可于元参升麻汤内。再加射干。山豆根。其余随症加减。疹后失音而至不能出声
者。名哑 。多不治。宜用甘。桔。元参。粘子。蝉蜕。射干。黄芩。花粉。杏仁。卜子。
沙参。麦冬。川贝。竹肉。山豆根之类。或以竹沥八匙。姜汁二匙冲服。再用丹参茯神。石
菖蒲。麦冬。花粉。桔梗。陈皮。甘草。诃子肉之类。痰盛。加川连蒌仁。羚羊或牛黄散吹
入终不开声者。不救。若但声音低微不清。与此不同。养阴润肺自愈。又有其声哑嗄。默睡
不食上唇有疮。则虫蚀其肺。下唇有疮。则虫蚀其肛。上下不定。名为狐惑。此由内热生虫
。水谷久虚。虫无所食。故内食脏腑及肛。而外见唇口也。此候最恶。治宜黄连化 丸主之
。便结桃仁承气汤加减服之。先用苦参煎汤洗之。后用末药敷治。京山郭某有子患此疹向系金
竺天医治。病既大危。令其生邀余看视。其声哑嗄，呛饮。上下唇内。及舌上。舌根。喉间
。俱有疮。其脉软微。余决为不治。果死。
牛黄散
牛黄 青黛 黄柏 硼砂 雄黄 冰片
共为末。先用薄荷汤。漱咽后次入神效。
黄连化 丸 治狐惑疮。
黄连(二钱) 芦荟(一钱二分) 干蝉(一钱二分) 芜荑(一钱五分) 川楝子肉(一钱)
加槟榔。雄黄。青黛。黄芩。胡连
共为末。用乌梅洗净去核。捣膏和丸米汤下。或杏仁汤下。
清热黄连犀角汤 治狐惑。
犀角(二钱磨冲) 黄连(一钱) 木香(三分研冲) 乌梅(四个)
桃仁汤 治狐惑 唇口生疮。声哑不出。
桃仁 槐子 蕲艾(各三钱)
枣十个。水二钟。煎至一钟。分二次服。
狐惑疮末药
川连 黄柏 青黛 槟榔(各一钱) 雄黄 杏仁 使君子肉(各一钱五分)
石膏(五钱) 芜荑 松花(各七分) 枯矾(五分)
共研细末。先用香油调成块次用凉水调薄涂疮上数次自愈。亦可加兰香叶烧存性研末。共调
。此方再加胡连。芦荟化虫丸。可治鼻疳。
麻疹的病机源于脾肺两脏。因此，患者常伴有咳嗽症状。如果咳嗽过于剧烈，应当根据疹子发出的不同阶段进行辨证治疗。在麻疹初起、尚未透发时的咳嗽，这是由于风邪郁闭所致，宜用升麻葛根汤加入前胡、桔梗、苏叶、杏仁来治疗。在麻疹已经透发后的咳嗽，则是由于肺脏被火热之邪灼伤，宜以清金宁嗽汤为主方治疗。廉按语指出：对于“治之”的方剂，不必随意加减药物；而对于“主之”的方剂，则应当根据具体症状进行加减。
升麻葛根汤（见前文）
清金宁嗽汤
橘红、前胡、甘草、杏仁、桑白皮、川黄连、瓜蒌仁、桔梗、浙贝母
疹毒热势亢盛，向上攻冲咽喉，轻者表现为咽喉肿痛，重者甚至导致汤水难以下咽，这种情况最为令人担忧。若因表邪郁遏，导致疹毒不能向外透发，从而引起咽喉疼痛的，以元参升麻汤为主方治疗。若里热壅盛，或者疹子虽然已经发于体表，但依然出现咽喉疼痛的，以凉膈消毒饮为主方治疗。
元参升麻汤 用于治疗表邪郁闭引起的喉痛
荆芥、防风、升麻、牛蒡子、玄参、甘草
凉膈消毒饮
荆芥、防风、连翘、薄荷、黄芩、生栀子、甘草、牛蒡子、芒硝、生大黄
加灯心草
失音（声音嘶哑或说不出话），是由于热毒闭塞肺窍所致。在麻疹初起时出现失音的，以元参升麻汤为主方治疗。在麻疹已经透发后出现失音的，以加减凉膈散为主方治疗。在麻疹消退后出现声音嘶哑的，以儿茶散为主方治疗。
元参升麻汤 见喉痛部分
加减凉膈散
薄荷、生栀子、玄参、连翘、甘草、桔梗、麦冬、牛蒡子、黄芩
儿茶散
硼砂（二钱）、孩儿茶（五钱）
共研为细末，取凉水一盏，调和药末一匙服用。
廉按语：治疗喉痛，可以在元参升麻汤内再加射干、山豆根，其余药物随症加减。麻疹后失音发展到完全不能出声的，称为“哑”，大多难以治愈。适宜使用甘草、桔梗、玄参、牛蒡子、蝉蜕、射干、黄芩、天花粉、杏仁、莱菔子、沙参、麦冬、川贝母、竹茹、山豆根等药物；或者用竹沥八匙、姜汁二匙冲服；再用丹参、茯神、石菖蒲、麦冬、天花粉、桔梗、陈皮、甘草、诃子肉等药物调理。若痰湿盛者，加川黄连、瓜蒌仁；羚羊角或牛黄散吹入鼻腔或咽喉，如果最终仍不开声，则无法救治。如果只是声音低微不清，与此情况不同，通过养阴润肺即可自愈。又有声音嘶哑、沉默嗜睡、不思饮食，且上唇有疮疡的，这是虫蚀其肺的表现；下唇有疮疡的，是虫蚀肛门的表现；上下部位不固定，这种病症名为“狐惑”。这是由于内热生虫，水谷精微久虚，虫子没有食物可吃，所以向内侵蚀脏腑及肛门，而外部表现在唇口。此证候最为凶险，治疗宜用黄连化虫丸为主方。大便干结者，加减服用桃仁承气汤。先用苦参煎汤清洗患处，后用散剂敷治。京山人郭某有一个儿子患此病，先前由金竺天医生治疗，病情已非常危急，于是请我诊治。该患儿声音嘶哑呛咳，上下唇内侧以及舌面、舌根、喉间都有疮疡，脉象软而微弱，我判断为不治之症，果然死亡。
牛黄散
牛黄、青黛、黄柏、硼砂、雄黄、冰片
共研为细末，先用薄荷汤漱口咽部后，再用药粉吹入，效果极佳。
黄连化虫丸 用于治疗狐惑疮
黄连（二钱）、芦荟（一钱二分）、干蝉蜕（一钱二分）、芜荑（一钱五分）、川楝子肉（一钱）
加槟榔、雄黄、青黛、黄芩、胡黄连
共研为细末，用乌梅洗净去核，捣成膏状，与药末混合制成丸药，用米汤送服，或用杏仁汤送服。
清热黄连犀角汤 用于治疗狐惑
犀角（二钱磨汁冲服）、黄连（一钱）、木香（三分研末冲服）、乌梅（四个）
桃仁汤 用于治疗狐惑，症见唇口生疮、声音嘶哑不出
桃仁、槐子、蕲艾（各三钱）
大枣十个，水两钟，煎至一钟，分两次服用。
狐惑疮外敷散剂
川黄连、黄柏、青黛、槟榔（各一钱）、雄黄、杏仁、使君子肉（各一钱五分）
石膏（五钱）、芜荑、松花（各七分）、枯矾（五分）
共研细末，先用香油调成块状，次用凉水调薄涂于疮面上，数次后可自愈。也可加入兰香叶烧存性研末，共同调和。此方再加胡黄连、芦荟制成的化虫丸，可以治疗鼻疳。
Measles originates from the Spleen and Lung. Therefore, cough is a common symptom. If the cough is excessively severe, treatment should be differentiated based on the stage of eruption. For cough occurring at the initial stage before eruption, caused by wind-pathogen stagnation, Shengma Gegen Tang (Cinnamon Twig and Rhizoma Cimicifugae Decoction) added with Qianhu (Peucedani Radix), Jiegeng (Platycodonis Radix), Ziye (Perillae Folium), and Xingren (Armeniacae Semen Amarum) should be used. For cough occurring after eruption, caused by lung heat scorching, Qingjin Ningsou Tang (Clear Metal and Calm Cough Decoction) is the principal formula. Commentator Lian notes: for formulas indicated with "treat with" (zhi zhi), no modifications are necessary; for those indicated with "mainly use" (zhu zhi), modifications should be made according to symptoms.
Shengma Gegen Tang (See previous section)
Qingjin Ningsou Tang (Clear Metal and Calm Cough Decoction)
Juhong (Citri Reticulatae Pericarpium Rubrum), Qianhu (Peucedani Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Xingren (Armeniacae Semen Amarum), Sangpi (Mori Cortex), Chuanlian (Coptidis Rhizoma), Louren (Trichosanthis Fructus Semen), Jiegeng (Platycodonis Radix), Zhebei (Fritillariae Thunbergii Bulbus).
When measles toxin-heat is excessive and attacks upward to the throat, mild cases present with swelling and pain, while severe cases may result in difficulty swallowing liquids, which is most concerning. For throat pain caused by exterior pathogen stagnation preventing the measles toxin from venting outward, Yuanshen Shengma Tang (Scrophulariae Radix and Cimicifugae Rhizoma Decoction) is the principal formula. For throat pain due to interior heat congestion, or when the rash has erupted externally but throat pain persists, Liangge Xiaodu Yin (Cool the Diaphragm and Detoxify Decoction) is the principal formula.
Yuanshen Shengma Tang (Scrophulariae Radix and Cimicifugae Rhizoma Decoction) Treats exterior stagnation throat pain
Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Shengma (Cimicifugae Rhizoma), Niuzi (Armeniacae Semen Apium), Yuanshen (Scrophulariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma).
Liangge Xiaodu Yin (Cool the Diaphragm and Detoxify Decoction)
Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Lianqiao (Forsythiae Fructus), Bohe (Menthae Haplocalycis Herba), Huangqin (Scutellariae Radix), Zhizi (Gardeniae Fructus - raw), Gancao (Glycyrrhizae Radix et Rhizoma), Niuzi (Armeniacae Semen Apium), Mangxiao (Natrii Sulfas), Dahuang (Rhei Radix et Rhizoma - raw).
Add Dengxincao (Junci Medulla).
Loss of voice (aphonia/dysphonia) results from heat-toxin blocking the lung orifices. For loss of voice at the initial stage of measles, Yuanshen Shengma Tang is the principal formula. For loss of voice after eruption, Jiajian Liangge San (Modified Cool the Diaphragm Powder) is the principal formula. For hoarseness after measles resolution, Ercha San (Child's Tea Powder) is the principal formula.
Yuanshen Shengma Tang See Throat Pain section
Jiajian Liangge San (Modified Cool the Diaphragm Powder)
Bohe (Menthae Haplocalycis Herba), Zhizi (Gardeniae Fructus - raw), Yuanshen (Scrophulariae Radix), Lianqiao (Forsythiae Fructus), Gancao (Glycyrrhizae Radix et Rhizoma), Jiegeng (Platycodonis Radix), Maidong (Ophiopogonis Radix), Niuzi (Armeniacae Semen Apium), Huangqin (Scutellariae Radix).
Ercha San (Child's Tea Powder)
Pengsha (Borisovi Borax), Ercha (Kadua Lacca - five qian).
Grind into fine powder. Mix one spoonful of medicine with one cup of cool water and administer.
Commentator Lian notes: To treat throat pain, add Shegan (Belamcandae Rhizoma) and Shandougen (Sophorae Tonkinensis Radix) to Yuanshen Shengma Tang, and modify other herbs according to symptoms. Loss of voice progressing to complete aphonia after measles is called "Ya" (mute), which is mostly incurable. Suitable herbs include Gancao (Glycyrrhizae Radix et Rhizoma), Jiegeng (Platycodonis Radix), Yuanshen (Scrophulariae Radix), Niuzi (Armeniacae Semen Apium), Chantui (Cicadae Periostracum), Shegan (Belamcandae Rhizoma), Huangqin (Scutellariae Radix), Huafen (Trichosanthis Radix), Xingren (Armeniacae Semen Amarum), Bofuzi (Raphani Semen), Shashen (Adenophorae Radix), Maidong (Ophiopogonis Radix), Chuanbei (Fritillariae Cirrhosae Bulbus), Zhuru (Bambusae Caulis in Taenia), and Shandougen (Sophorae Tonkinensis Radix). Alternatively, mix eight spoons of Zhuli (Bambusae Sap) and two spoons of Jiangzhi (Zingiberis Recens Juice) for oral administration. Subsequently, use Danshen (Salviae Miltiorrhizae Radix), Fushen (Poria cum Radix), Shichangpu (Acori Tatarinowii Rhizoma), Maidong (Ophiopogonis Radix), Huafen (Trichosanthis Radix), Jiegeng (Platycodonis Radix), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma), and Hezirou (Terminaliae Chebulae Fructus Mesocarpium). If phlegm is abundant, add Chuanlian (Coptidis Rhizoma) and Louren (Trichosanthis Fructus Semen). Blowing Yangjiao (Rhinocerotis Cornu) or Niuhuang San (Calculus Bovis Powder) into the nose/throat: if the voice does not return, it is incurable. If the voice is merely low and unclear, this is different; nourishing yin and moistening the lungs will lead to self-healing. There is also a condition characterized by hoarseness, silence, lethargy, anorexia, and sores on the upper lip, indicating worms eroding the lungs; sores on the lower lip indicate worms eroding the anus; lesions appearing intermittently above and below are named "Huo Huo" (Fox-Spirit Disease). This arises from internal heat generating worms due to prolonged deficiency of food essence, causing worms to feed internally on organs and the anus, manifesting externally on lips and mouth. This condition is extremely malignant. Treatment should primarily use Huanglian Hua Chong Wan (Coptis Deworming Pill). For constipation, administer Tao Ren Cheng Qi Tang (Peach Kernel and Magnolia Bark Decoction) with modifications. First wash with Kushen decoction, then apply powder topically. A case from Mr. Guo in Jingshan: his son suffered from this disease, previously treated by Dr. Jin Zhutian, becoming critically ill. Upon consultation, the child had hoarseness, choking on drinks, and sores on the inner upper/lower lips, tongue surface, tongue root, and throat. The pulse was soft and faint. I judged it incurable, and indeed, the child died.
Niuhuang San (Calculus Bovis Powder)
Niuhuang (Calculus Bovis), Qingdai (Indici Folium), Huangbai (Phellodendri Cortex), Pengsha (Borisovi Borax), Xionghuang (Realgar), Bingpian (Borneolum Syntheticum).
Grind into powder. Rinse the throat with Bohe tea first, then apply the powder for excellent effect.
Huanglian Hua Chong Wan (Coptis Deworming Pill) Treats Huo Huo sores
Huanglian (Coptidis Rhizoma - two qian), Lvhui (Aloe - one qian two fen), Ganchan (Dry Cicadae Periostracum - one qian two fen), Wuyi (Myrobalani Fructus - one qian five fen), Chuanlianzi Rou (Toosendan Fructus Mesocarpium - one qian).
Add Binglang (Arecae Semen), Xionghuang (Realgar), Qingdai (Indici Folium), Huangqin (Scutellariae Radix), Huluian (Isodontis Rhizoma).
Grind into powder. Wash Wumei (Chebulae Fructus), remove pits, mash into paste, mix with powder to form pills. Administer with rice soup or Almond soup.
Qingre Huanglian Xijiao Tang (Heat-Clearing Coptis and Rhinoceros Horn Decoction) Treats Huo Huo
Xijiao (Rhinocerotis Cornu - two qian, ground and mixed), Huanglian (Coptidis Rhizoma - one qian), Muxiang (Aucklandiae Radix - three fen, ground and mixed), Wumei (Chebulae Fructus - four pieces).
Tao Ren Tang (Peach Kernel Decoction) Treats Huo Huo with sores on lips/mouth and aphonia
Taoren (Persicae Semen), Huaizi (Stemonae Rhizoma), Qiai (Artemisiae Argyi Folium) (three qian each).
Ten Jujubes, two cups of water, decoct to one cup. Divide into two doses.
Huo Huo Sore External Powder
Chuanlian (Coptidis Rhizoma), Huangbai (Phellodendri Cortex), Qingdai (Indici Folium), Binglang (Arecae Semen) (one qian each), Xionghuang (Realgar), Xingren (Armeniacae Semen Amarum), Shijunzi Rou (Quisqualis Fructus Mesocarpium) (one qian five fen each).
Shigao (Gypsum Fibrosum - five qian), Wuyi (Myrobalani Fructus), Songhua (Pinus Pollen) (seven fen each), Kufan (Alumen Exsiccatum) (five fen).
Grind into fine powder. First mix with sesame oil into a lump, then dilute with cool water and apply thinly to sores multiple times until healed. Can also add Lanxiangye (Litseae Folium) calcined to ash and ground, mixed together. Adding Huluian (Isodontis Rhizoma) and Lvhui (Aloe) to make Deworming Pills can treat nasal gangrene.