数日不食有何妨。麻色淡润保无殃。吐虫自汗相兼见。果系脾热用泻黄。
胃火蒸蒸食频频。通利小水便安宁。吃食太早生奇症。咬指嘶唇好怕人。
麻于初热未出之际。多有不食者。乃胃经火邪炽甚。故饱而不索食也。但得麻色淡红润泽。
虽数日不进饮食。亦无妨害。不必强与之食。盖热毒未解。内蕴实热。自必不食。若见初热未出及
正出之时。以白虎解毒汤(见二十六条)去天花粉、黄连、山栀仁、麦冬。加荆芥、葛根、牛蒡子、连
翘主之。使麻透尽。内热清散。自能食也。出尽而不食者。宜清解胃火。以石斛清胃散(见五十九
条)去赤芍、甘草。量加健运之味治之。麻收之后。如仍不食者。以四物汤(见二十五条)加神曲、
山楂、麦芽。或更加砂仁。以三剂与服。则自能食。但方内有熟地黄。胃虚弱者。宜少用之。如元
气蒌颓者。急须培补。防有虚羸之患。若麻收后。胃虚而不纳五谷者。当以理脾养胃为主。宜以
六仙散(见七问内)治之。若麻后身热不除。烦躁不食者。此属膈热。以河间凉膈散(见二十六条)
去芒硝、大黄。加丑牛以治之。如麻后身大热、口渴不食、唇裂、眼肿、大便秘、小便不知出者。以
河间凉膈散(见二十六条)通利三四次即愈。若麻后脸青、唇紫赤。身热不食。乃毒火太甚。或
泻或渴。或咳嗽。俱宜以古方黄连解毒汤(见三十五条)倍用栀仁。加薄荷叶、地骨皮。以二剂与
服即愈。若麻收后。而不思饮食。鼻干无涕者。以清肺消毒汤除桔梗、甘草。加桑白皮、贝母主之。
若因先服凉药过多。有伤脾胃。身热虚烦不食者。以四君子汤(见七十二条)去白术。加薏苡仁、
连翘、牛蒡子、解毒之味治之。但方中之人参。必要察人之虚实而施。须其脸不红、口不渴、唇
不赤。方可用之。否则不宜。若麻不食而兼吐虫。则为胃败不治之症。若麻后不食而吐虫。又兼自
汗者。真是虚症。最为难治。用药不当。变症多端。不可根据麻初常法。当用辛温解散之剂。如果系
脾热。则以泻黄散酌量加减而治之。凡出麻之后。胃气未平。饮食不可骤进。宜以清粥缓缓调和。
使胃气舒畅。渐进饮食。自无后患。麻后若吃食太早。咬指甲。撕口唇。KT 眼毛。看手、咬人等症。
宜以解毒化滞汤去甘草、桔梗。加青皮治之。又有麻收之后。贪食不厌者。乃胃火太盛所致。宜
以大连翘饮(见十八条)去赤芍、甘草、柴胡。加地骨皮、黄连、石膏、知母、生地黄治之。
六仙散
蚂蚁花(烧灰) 莲肉 薏苡仁(各二钱) 藕节(一两) KT 石斛 陈早米(炒各五钱) 为
末。米汤送下三钱。
清肺消毒汤
防风 枳壳(各五分) 连翘 前胡 黄芩 桔梗(各一钱) 荆芥 甘草(各四分) 水煎。
作十余次服。
泻黄散
防风(四钱) 栀仁(炒黑一钱) 藿香叶(七分) 石膏(五钱) 甘草(二钱) 为末。白汤
送下。或用蜜酒拌。略炒。仍以白汤送下。
解毒化滞汤
防风 荆芥 枳壳(炒) 神曲(炒) 麦冬(去心炒各五分) 连翘 黄芩(酒炒) 前胡
(各七分) 茯苓(七分) 楂肉 甘草(各三分) 桔梗(一钱) 水煎。作十余次服。
数日不进食有什么妨碍呢?如果麻疹颜色淡红润泽,就能保证没有灾殃。如果出现吐虫和自汗同时并见的情况,如果是确属脾热,就使用泻黄散治疗。
胃火蒸腾,食欲频繁发作。通利小便,大便就会安宁。进食太早会产生奇怪的病症,如咬手指、撕嘴唇,让人非常害怕。
在麻疹初热尚未透发的时候,大多有不想吃东西的情况。这是因为胃经火邪炽盛,所以吃饱了也不索求食物。只要看到麻疹颜色淡红润泽,即使几天不进饮食,也没有妨害,不必强行给他喂食。因为热毒未解,体内蕴藏实热,自然一定不想吃东西。如果在初热未出及正出之时,用白虎解毒汤(见第二十六条),去掉天花粉、黄连、山栀仁、麦冬,加入荆芥、葛根、牛蒡子、连翘来主治。使麻疹透发尽,内热清散,自然能进食。麻疹出尽后仍不进食的,应当清解胃火,用石斛清胃散(见第五十九条),去掉赤芍、甘草,酌情加入健运脾胃的药物来治疗。
麻疹收没之后,如果仍然不进食,用四物汤(见第二十五条)加神曲、山楂、麦芽。或者再加砂仁,给患者服用三剂,则自然能进食。但方中有熟地黄,对于胃虚弱的人,应当少用。如果元气萎靡颓败,急需培补,防止出现虚羸的祸患。如果麻疹收没后,胃虚而不能纳受五谷,应当以调理脾胃为主,宜用六仙散(见第七问内)治疗。
如果麻疹后身热不退,烦躁不进食,这属于膈热,用河间凉膈散(见第二十六条),去掉芒硝、大黄,加入牵牛子来治疗。如果麻疹后身体大热、口渴不进食、嘴唇裂开、眼睛肿胀、大便秘结、小便不通,用河间凉膈散(见第二十六条)通利二便三四次即可痊愈。
如果麻疹后脸色青、嘴唇紫赤,身热不进食,这是毒火太甚,或者腹泻或者口渴,或者咳嗽,都适宜用古方黄连解毒汤(见第三十五条),加倍使用山栀仁,加入薄荷叶、地骨皮,给患者服用两剂即可痊愈。
如果麻疹收没后,不思饮食,鼻子干燥无鼻涕,用清肺消毒汤去掉桔梗、甘草,加入桑白皮、贝母来主治。
如果因为先前服用凉药过多,损伤了脾胃,导致身热虚烦不进食,用四君子汤(见第七十二条)去掉白术,加入薏苡仁、连翘、牛蒡子、解毒类药物来治疗。但是方中的人参,必须观察人的虚实情况而施用。必须等到病人脸色不红、口不渴、嘴唇不赤,才可以用人参。否则不宜使用。
如果麻疹期间不进食并且兼有吐虫,这是胃气败坏的不治之症。如果麻疹后不进食又兼有吐虫,再加上自汗,这真是虚证,最为难治。用药不当,变症多端,不能根据麻疹初期常法,当用辛温解散的药剂。如果确实是脾热,就用泻黄散酌情加减来治疗。
凡是出麻疹之后,胃气未平,饮食不可骤然进补,宜用清粥缓缓调和,使胃气舒畅,逐渐增加饮食,自然没有后患。
麻疹后如果吃食太早,出现咬指甲、撕口唇、揉眼睛、看手、咬人等症状,宜用解毒化滞汤去掉甘草、桔梗,加入青皮来治疗。又有麻疹收没之后,贪食不厌的,这是胃火太盛所致,宜用大连翘饮(见第十八条),去掉赤芍、甘草、柴胡,加入地骨皮、黄连、石膏、知母、生地黄来治疗。
六仙散:蚂蚁花(烧成灰)、莲肉、薏苡仁(各二钱)、藕节(一两)、石斛、陈早米(炒,各五钱)。研为细末。用米汤送服三钱。
清肺消毒汤:防风、枳壳(各五分)、连翘、前胡、黄芩、桔梗(各一钱)、荆芥、甘草(各四分)。水煎。分十多次服用。
泻黄散:防风(四钱)、山栀仁(炒黑一钱)、藿香叶(七分)、石膏(五钱)、甘草(二钱)。研为细末。用白开水送服。或者用蜜酒拌,略炒,仍以白开水送服。
解毒化滞汤:防风、荆芥、枳壳(炒)、神曲(炒)、麦冬(去心炒,各五分)、连翘、黄芩(酒炒)、前胡(各七分)、茯苓(七分)、山楂肉、甘草(各三分)、桔梗(一钱)。水煎。分十多次服用。
What harm is there in not eating for several days? If the measles rash is pale and moist/lustrous, one can be assured that no disaster will occur. If vomiting of worms and spontaneous sweating appear simultaneously, and it is indeed Spleen Heat (Spleen organ heat), use Xie Huang San (Yellow-Draining Powder).
Stomach Fire steaming upward causes frequent hunger. Unblocking and promoting urination leads to normal bowel movements. Eating too early generates strange symptoms, such as biting fingers and tearing lips, which are terrifying.
During the initial fever stage before the measles erupt, patients often lose their appetite. This is because Fire Pathogens in the Stomach Meridian are flourishing, so they feel full but do not seek food. As long as the measles rash appears pale red and lustrous, even if no food or drink is taken for several days, there is no harm; one need not force them to eat. Since the Heat-Toxin has not resolved and solid Heat accumulates internally, loss of appetite is natural. During the initial fever before eruption or during active eruption, treat with Baihu Jiedu Tang (White Tiger Decoction for Resolving Toxins) [see Article 26], removing Tian Hua Fen (Trichosanthes Root), Huang Lian (Coptis Rhizome), Shan Zhi Ren (Gardenia Seed), and Mai Dong (Ophiopogon Tuber), and adding Jing Jie (Schizonepeta Spike), Ge Gen (Pueraria Root), Niu Bang Zi (Arctium Fruit), and Lian Qiao (Forsythia Fruit) as the principal prescription. This allows the measles to fully erupt and internal Heat to clear and dissipate, restoring the ability to eat. If the patient does not eat after the measles have fully erupted, clear and resolve Stomach Fire using Shi Hu Qing Wei San (Dendrobium Powder for Clearing the Stomach) [see Article 59], removing Chi Shao (Red Peony Root) and Gan Cao (Licorice Root), and appropriately adding herbs that strengthen and regulate digestion.
After the measles have receded, if the patient still does not eat, use Si Wu Tang (Four Substances Decoction) [see Article 25] added with Shen Qu (Medicated Leaven), Shan Zha (Hawthorn Fruit), and Mai Ya (Barley Sprout). One may additionally add Sha Ren (Amomum Fruit). Administer three doses, and the ability to eat will naturally return. However, since Shu Di Huang (Prepared Rehmannia Root) is in the formula, it should be used sparingly for those with weak Stomachs. If Yuan Qi (Primal Qi/Vital Energy) is depleted and decadent, urgent tonification is required to prevent complications of emaciation and weakness. If, after the measles recede, Stomach deficiency fails to accept the five grains, the treatment should focus on regulating the Spleen and nourishing the Stomach; Liu Xian San (Six Immortals Powder) [see Question 7] is appropriate.
If body heat persists after the measles, accompanied by irritability and anorexia, this belongs to Diaphragm Heat. Treat with Hejian Liang Ge San (Liangge Powder from Liu Wansu) [see Article 26], removing Mang Xiao (Mirabilite) and Da Huang (Rhubarb Root), and adding Chou Niu (Morning Glory Seed) to treat it. If after the measles there is high fever, thirst, anorexia, cracked lips, swollen eyes, constipation, and urinary retention, treat with Hejian Liang Ge San [see Article 26]; unblocking the bowels and promoting urination three or four times will lead to recovery.
If after the measles the face is cyanotic and lips are purple-red, with body heat and anorexia, this indicates excessive Toxic Fire. Whether accompanied by diarrhea, thirst, or cough, all cases should be treated with the ancient formula Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxins) [see Article 35], doubling the dosage of Zhi Ren (Gardenia Seed), and adding Bo He Ye (Mint Leaf) and Di Gu Pi (Lycium Bark). Two doses will lead to recovery.
If after the measles recede there is no desire for food and the nose is dry without mucus, treat with Qing Fei Xiaodu Tang (Clear Lung Detoxifying Decoction), removing Jie Geng (Platycodon Root) and Gan Cao (Licorice Root), and adding Sang Bai Pi (Mulberry Root Bark) and Bei Mu (Fritillaria Bulb) as the principal prescription.
If excessive prior intake of cooling medicines has damaged the Spleen and Stomach, resulting in lingering low-grade fever, empty irritability, and anorexia, treat with Si Jun Zi Tang (Four Gentlemen Decoction) [see Article 72], removing Bai Zhu (Atractylodes Macrocephala Rhizome), and adding Yi Yi Ren (Coix Seed), Lian Qiao (Forsythia Fruit), Niu Bang Zi (Arctium Fruit), and other detoxifying herbs. However, the Ren Shen (Ginseng Root) in the formula must be administered based on an assessment of the patient’s deficiency or excess. It may only be used when the face is not red, the mouth is not thirsty, and the lips are not crimson. Otherwise, it is unsuitable.
If anorexia during the measles is accompanied by vomiting worms, this is a sign of Stomach Qi failure and is incurable. If anorexia after the measles is accompanied by vomiting worms and spontaneous sweating, this is truly a Deficiency Syndrome, which is extremely difficult to treat. Improper medication can lead to numerous complications. One must not follow the standard methods used at the beginning of the measles. Instead, acrid-warm dispersing agents should be used. If it is confirmed as Spleen Heat, treat with Xie Huang San (Yellow-Draining Powder) with appropriate modifications.
Generally, after the eruption of measles, Stomach Qi is not yet stable; diet should not be advanced abruptly. It is advisable to use clear rice gruel to gently harmonize the system, allowing Stomach Qi to flow smoothly, and then gradually advance the diet to avoid future complications.
If food is eaten too early after the measles, symptoms such as biting fingernails, tearing lip skin, rubbing eyes, staring at hands, and biting people may occur. These should be treated with Jiedu Huazhi Tang (Detoxifying and Stasis-Resolving Decoction), removing Gan Cao (Licorice Root) and Jie Geng (Platycodon Root), and adding Qing Pi (Citrus Peel).
Another scenario is insatiable greed for food after the measles recede, caused by excessive Stomach Fire. This should be treated with Da Lian Qiao Yin (Large Forsythia Decoction) [see Article 18], removing Chi Shao (Red Peony Root), Gan Cao (Licorice Root), and Chai Hu (Bupleurum Root), and adding Di Gu Pi (Lycium Bark), Huang Lian (Coptis Rhizome), Shi Gao (Gypsum Fibrosum), Zhi Mu (Anemarrhena Rhizome), and Sheng Di Huang (Rehmannia Root).
**Liu Xian San (Six Immortals Powder)**
* Ma Yi Hua (Ant Flower) – burnt to ash
* Lian Rou (Lotus Seed Flesh)
* Yi Yi Ren (Coix Seed)
* Ou Jie (Lotus Node) – 1 liang
* Shi Hu (Dendrobium Stem)
* Chen Zao Mi (Aged Early Rice) – stir-fried
*(Dosages: Ant Flower, Lotus Seed Flesh, Coix Seed each 2 qian; Lotus Node 1 liang; Dendrobium Stem, Aged Early Rice each 5 qian.)*
Grind into powder. Take 3 qian with rice water.
**Qing Fei Xiaodu Tang (Clear Lung Detoxifying Decoction)**
* Fang Feng (Saposhnikovia Root)
* Zhi Ke (Bitter Orange Fruit) – each 5 fen
* Lian Qiao (Forsythia Fruit)
* Qian Hu (Peucedanum Root)
* Huang Qin (Scutellaria Root)
* Jie Geng (Platycodon Root) – each 1 qian
* Jing Jie (Schizonepeta Spike)
* Gan Cao (Licorice Root) – each 4 fen
Decoct in water. Divide into more than ten doses for administration.
**Xie Huang San (Yellow-Draining Powder)**
* Fang Feng (Saposhnikovia Root) – 4 qian
* Zhi Ren (Gardenia Seed) – stir-fried until black, 1 qian
* Huo Xiang Ye (Patchouli Leaf) – 7 fen
* Shi Gao (Gypsum Fibrosum) – 5 qian
* Gan Cao (Licorice Root) – 2 qian
Grind into powder. Take with plain boiled water. Alternatively, mix with honey and wine, stir-fry slightly, and take with plain boiled water.
**Jiedu Huazhi Tang (Detoxifying and Stasis-Resolving Decoction)**
* Fang Feng (Saposhnikovia Root)
* Jing Jie (Schizonepeta Spike)
* Zhi Ke (Bitter Orange Fruit) – stir-fried
* Shen Qu (Medicated Leaven) – stir-fried
* Mai Dong (Ophiopogon Tuber) – heart removed, stir-fried, each 5 fen
* Lian Qiao (Forsythia Fruit)
* Huang Qin (Scutellaria Root) – wine-fried
* Qian Hu (Peucedanum Root) – each 7 fen
* Fu Ling (Poria) – 7 fen
* Zha Rou (Hawthorn Flesh)
* Gan Cao (Licorice Root) – each 3 fen
* Jie Geng (Platycodon Root) – 1 qian
Decoct in water. Divide into more than ten doses for administration.