麻疹见形三日之后。当渐次没落。不疾不徐。始为无病。若一二日疹即收没。此为太速。因
调摄不谨。或为风寒所袭。或为邪秽所触。以致毒反内攻。轻则烦渴谵狂。重则神昏闷乱。
急宜内服荆防解毒汤。外用胡荽酒熏其
衣被。使疹透出。方保无虞。当散不散者。内有虚热留滞于肌表也。其证潮
热。烦渴。口燥。咽干切不可纯用寒凉之剂。以柴
胡四物汤治之。使血分和畅。余热悉除。疹即没矣。
荆防解毒汤 治麻毒内攻。
薄荷 连翘 荆芥 防风 黄芩 黄连 粘子 大青叶 犀角 人中黄
引用灯心芦根水煎服。
柴胡四物汤 治虚热留滞当没不没。
白芍 当归 川芎 生地 人参 柴胡 淡竹叶 地骨皮 知母 黄芩 麦冬
引加生姜红枣。
廉按荆防解毒汤。治麻毒内攻。此诚万金良方。余用之屡试屡效。从此可悟其未言者矣。如
冬月风寒甚而内隐者。可再加麻黄。杏仁。或竟用三拗汤。加粘子。蝉蜕。荆防等药。或因
伤食而内伏者。可于荆防解毒汤内。加枳壳。卜子。神曲等药。或遍身青紫热肿。腹胀喘
促
溺涩脐凸者。此毒滞血凝。半匿肌表。急投凉膈散。加麻黄。石膏。葶苈子。大黄。庶或可
救。若内夹痰热。火毒亢极伏匿烦躁。或腹胀喘急不省人事者。白虎汤加元参。淡竹叶。此
二说本于医通。余意后说。夹痰者。宜加杏仁。胆星。腹胀者。宜加枳壳。大黄、并不可离
荆芥。前胡。斟酌用之可也。云当散不散。内有虚热留滞于肌表。不可纯用寒凉之剂。此亦
经常之大法。言不可纯用寒凉。则有宜寒凉者矣。张玉潞曰。西北水土刚劲。禀质亦浓。
麻
必五七日乃收。东南风气柔弱。麻出不过二三日即化。迩来地运变迁。未有不绵延数日者。当
非难没之比。此说是也。又麻疹难没。多属于热。亦有表里未净而迁延五七日不没者。风则表
之。食则消之。下之。痰则化之。火则凉之。毒则解之。又宜兼用鲜生地。丹皮等药。凉血
养血以顾其本耳。又张玉潞曰。麻见点三四日后。点燥色白。隐隐于肌肉而难没者。此必卫
气素弱。不能 发。或衣被单薄。身贪凉快。阻其发越之机以致绵延多日。法当辛散透达。
不可遽用寒凉。蔽塞开泄之路也。
三拗汤 治风寒外袭。麻毒内攻。
麻黄 石膏 杏仁
凉膈散（见前）
麻疹出疹形态显现三天之后，应当逐渐消退隐没。消退过程不疾不徐（不快不慢），这才属于无病状态。如果一两天内疹子就迅速收没，这属于太速（消退过快）。这是因为调护摄生不慎，或者被风寒邪气侵袭，或者被秽浊邪气触动，导致毒邪反而向内攻陷。轻症表现为烦躁口渴、胡言乱语甚至狂躁；重症则出现神志昏迷、心胸烦闷扰乱。此时急需内服荆防解毒汤，外用胡荽酒熏蒸其衣物被褥，使疹毒透出体外，这样才能保证平安无事。当消退时未能消退的，是因为体内有虚热留滞于肌表。其症状表现为潮热、烦躁口渴、口燥咽干。切不可单纯使用寒凉性质的药剂，应用柴胡四物汤治疗，使血分调和畅达，余热全部清除，疹子自然就会消退。
荆防解毒汤：治疗麻毒内攻。
药材包括：薄荷、连翘、荆芥、防风、黄芩、黄连、粘子（牛蒡子）、大青叶、犀角、人中黄。
煎服法：引用灯心草、芦根水煎服。
柴胡四物汤：治疗虚热留滞，该消退时却未消退。
药材包括：白芍、当归、川芎、生地、人参、柴胡、淡竹叶、地骨皮、知母、黄芩、麦冬。
煎服法：加入生姜、红枣为引。
廉按（廉泉按语）：荆防解毒汤治疗麻毒内攻，这确实是价值万金的良方。我使用它屡次尝试都屡试屡效。从此可以领悟其中未明说的道理。例如冬季风寒严重而毒邪内隐者，可以再加麻黄、杏仁，或者干脆使用三拗汤，加粘子、蝉蜕、荆防等药物。或者因为伤食而导致毒邪内伏者，可以在荆防解毒汤内，加枳壳、卜子（莱菔子）、神曲等药物。如果遍身呈现青紫色、热肿、腹胀喘促、小便涩滞、脐部凸出者，这是毒邪停滞、血液凝瘀，半隐匿于肌表，急需投予凉膈散，加麻黄、石膏、葶苈子、大黄，或许还可以挽救。如果内夹痰热，火毒亢盛至极而伏匿，出现烦躁不安，或者腹胀喘急、不省人事者，用白虎汤加元参、淡竹叶。这两种说法本源于《医通》。我的意见是，后一种说法中，夹痰者，宜加杏仁、胆星；腹胀者，宜加枳壳、大黄，并且不可离开荆芥、前胡，斟酌使用即可。文中说“当散不散”，内有虚热留滞于肌表，不可单纯使用寒凉药剂，这也是常规的大法。说不可单纯使用寒凉，那就意味着有适宜使用寒凉的情况了。张玉潞说：西北水土性质刚劲，人的禀赋体质也浓厚，麻疹必须经过五到七天才会收没；东南风气柔弱，麻疹发出不过两三天就会化解。近来地运变迁，没有不绵延数日的，这不属于难以消退的情况。这个说法是正确的。另外，麻疹难以消退，多属于热证，也有表里之邪未净而迁延五七天不消退的。风邪则用解表法，食积则用消导法，实证则用下法，痰湿则用化痰法，火邪则用清凉法，毒邪则用解毒法。又适宜兼用鲜生地、丹皮等药物，以凉血养血来顾护根本。又张玉潞说：麻疹见点三四日后，疹点干燥色白，隐隐在肌肉中而难以消退的，这一定是卫气素来虚弱，不能透发，或者衣被单薄，身体贪图凉快，阻碍了其发越的机制，以致绵延多日。治法应当用辛散透达的方法，不可急于使用寒凉药剂，以免蔽塞开泄的路径。
三拗汤：治疗风寒外袭，麻毒内攻。
药材包括：麻黄、石膏、杏仁。
凉膈散（见前文）
After the measles rash has manifested for three days, it should gradually recede. A moderate pace of recession (neither too fast nor too slow) indicates a state of health. If the rash recedes within one or two days, this is considered "too rapid" (excessive speed). This occurs due to improper care and nursing, or invasion by wind-cold pathogens, or contact with turbid pathogens, causing the toxin to attack inwardly. Mild cases present with irritability, thirst, delirium, and mania; severe cases present with coma, mental confusion, and restlessness. At this point, it is urgent to internally administer Jingfang Jiedu Tang (Jingfang Detoxification Decoction) and externally fumigate clothing and bedding with Huqiu Jiu (Coriander Wine) to allow the rash to emerge outward, thereby ensuring safety. When the rash should recede but fails to do so, it is because deficiency-heat remains stagnant in the muscle layer. The symptoms include tidal fever, irritability, thirst, dry mouth, and dry throat. One must absolutely avoid using purely cold-natured formulas; instead, treat with Chaihu Siwu Tang (Bupleurum Four Substances Decoction) to harmonize and smooth the blood level, eliminating residual heat completely, after which the rash will naturally disappear.
Jingfang Jiedu Tang: Treats internal attack of measles toxin.
Herbs include: Bohe (Menthae Haplocalycis Herba), Lianqiao (Forsythiae Fructus), Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Niu Bang Zi (Arctii Fructus), Da Qing Ye (Isatidis Folium), Xi Jiao (Rhinocerotis Cornu), Ren Zhong Huang (Hominis Excrementum Purificatum).
Preparation: Decoct with Deng Xin Cao (Junci Medullae) and Lu Gen (Phragmitis Rhizoma) water as guides.
Chaihu Siwu Tang: Treats deficiency-heat stagnation where the rash should recede but does not.
Herbs include: Bai Shao (Paeoniae Radix Alba), Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Sheng Di Huang (Rehmanniae Radix), Ren Shen (Ginseng Radix), Chai Hu (Bupleuri Radix), Dan Zhu Ye (Lophatheri Herba), Di Gu Pi (Lycii Cortex), Zhi Mu (Anemarrhenae Rhizoma), Huang Qin (Scutellariae Radix), Mai Dong (Ophiopogonis Tuber).
Preparation: Add Sheng Jiang (Zingiberis Rhizoma Recens) and Hong Zao (Jujubae Fructus) as guides.
Commentary by Lianquan: Jingfang Jiedu Tang treats internal attack of measles toxin; this is indeed a precious prescription worth ten thousand gold. I have used it repeatedly with consistent success. From this, one can infer the unspoken principles. For instance, in winter when wind-cold is severe and the toxin is hidden internally, one may add Ma Huang (Ephedrae Herba) and Xing Ren (Armeniacae Semen Amarum), or even use San'ao Tang (Three Uninhibited Decoction), adding Niu Bang Zi, Chan Tui (Cicadae Periostracum), and Jingjie. If the condition is caused by food stagnation leading to internal retention of toxin, one may add Zhi Qiao (Aurantii Fructus), Bo Zi (Raphani Fructus), and Shen Qu (Massa Medicata Fermentata) to Jingfang Jiedu Tang. If the entire body presents with cyanosis, hot swelling, abdominal distension, panting, dysuria, and umbilical protrusion, this indicates toxin stagnation and blood coagulation, half-hidden in the muscle layer. Urgently administer Liangge San (Cooling the Chest Powder) with added Ma Huang, Shi Gao (Gypsum Fibrosum), Ting Li Zi (Descurainiae Semen), and Da Huang (Rhei Radix et Rhizoma); there may be hope for rescue. If there is internal phlegm-heat, with fire-toxin extremely hyperactive and hidden, causing restlessness, or abdominal distension, panting, and unconsciousness, use Baihu Tang (White Tiger Decoction) with added Xuan Shen (Scrophulariae Radix) and Dan Zhu Ye. These two explanations originate from *Yi Tong*. My opinion is that for the latter explanation, if phlegm is involved, add Xing Ren and Dan Xing (Arisaematis Cum Bile); if abdominal distension is present, add Zhi Qiao and Da Huang. However, one must not dispense with Jingjie and Qian Hu (Peucedani Radix); use them with discretion. The text states "when it should disperse but does not," implying deficiency-heat stagnating in the muscle layer, and advises against purely cold-natured agents. This is also a general principle. Saying "do not use purely cold agents" implies there are situations where cold agents are appropriate. Zhang Yulu said: In the northwest, the soil and water are rigid, and people's constitutions are dense; measles takes five to seven days to recede. In the southeast, the wind and qi are soft, and measles resolve within two or three days. Recently, due to changes in geographical fortune, measles last for several days and do not fall into the category of difficult-to-recede cases. This view is correct. Furthermore, difficult-to-recede measles mostly belong to heat syndromes, but there are also cases where exterior and interior pathogens are not cleared, lingering for five to seven days. For wind, use exterior-releasing methods; for food stagnation, use digestion-promoting methods; for excess, use purgative methods; for phlegm, use phlegm-resolving methods; for fire, use cooling methods; for toxin, use detoxifying methods. It is also advisable to concurrently use fresh Sheng Di Huang and Dan Pi (Moutan Cortex) to cool blood and nourish blood to protect the root. Zhang Yulu also said: After measles spots appear for three or four days, if the spots are dry, white, faintly visible in the muscles, and difficult to recede, this is due to deficient Wei Qi (Defensive Qi) unable to express, or due to thin clothing/bedding and seeking coolness, which obstructs the mechanism of expression, causing prolongation. The treatment method should be acrid-dispersing and penetrating; one must not hastily use cold agents to block the pathways of opening and venting.
San'ao Tang: Treats external invasion of wind-cold and internal attack of measles toxin.
Herbs include: Ma Huang (Ephedrae Herba), Shi Gao (Gypsum Fibrosum), Xing Ren (Armeniacae Semen Amarum).
Liangge San (See previous section)