初热之时证未明。医家诊视生疑心。此时且勿峻发表。略施清解得安宁。
初热不见麻路。不可发表。略宜清解。用利咽散主之。如见麻路。当以葛根解肌汤（见第五
条）。去赤芍、甘草。加防风、枳壳、葱白主之。更加苏叶亦可。或以苏葛汤去赤芍、柴胡、甘草。加
枳壳、葱白主之。如麻不出。则用苏葛汤去柴胡、赤芍、甘草。加蜜酒炒麻黄以发之。或以宣毒
发表汤（见第五条）去升麻、淡竹叶、桔梗、甘草。加苏叶、葱白。或加蜜酒炒麻黄。开提腠理。或
用浓衣绵絮盖之。得汗自头至脚。渐减衣被。使皮肤通畅。腠理开豁。而麻易出。纵不出。不可
再汗。恐致亡阳之变。只宜频以葱白汤与服。使毛窍中微汗润泽。其麻自出。庶无热闭发搐之患。
既出之后。可用防风败毒散（见第五条）。去淡竹叶、石膏、知母、桔梗、甘草主之。不可无表。防其
内伏。既出而潮热甚。或兼口渴者。则石膏、知母、竹叶并宜用之。且更可加地骨皮、生地黄、麦
冬之类。以清其热。而凉其血。以生其津也。更可加枯黄芩以清肺。生黄连以泻心。而诸候不生矣。
朱曰 不发表。麻何从出。勿峻发表。恐发之太过。或变生他证耳。
利咽散 治咽喉肿痛。
牛蒡子（炒） 元参 防风 水煎服。
苏葛汤（联杏心法方） 治麻初热未明证候。
苏叶 粉葛 木通 元参 黄连（微炒用） 连翘 防风 黄芩 柴胡 赤芍 甘草 无汗
加蜜酒炒麻黄。发热太甚者。加牛蒡子。（炒五分）发热太甚不止。加鲜骨皮、生地黄。如热不太
甚者。黄连、黄芩俱去之。加枳壳、荆芥穗。葱三根引。水煎热服。
在麻疹初热阶段，证候尚未明确时，医生诊察容易产生疑虑。此时暂且不要使用峻烈的发表药物，只需稍加清解之法，即可使病情安宁。
若初热阶段未见麻疹透发之迹象（麻路），不可使用发表法，宜稍用清解法，以“利咽散”为主方。如果已经见到麻疹透发之迹象，应当使用“葛根解肌汤”（见第五条），去掉其中的赤芍、甘草，加入防风、枳壳、葱白来主治。也可以加入苏叶。或者使用“苏葛汤”，去掉赤芍、柴胡、甘草，加入枳壳、葱白来主治。如果麻疹仍然不能透出，则使用“苏葛汤”，去掉柴胡、赤芍、甘草，加入经蜜酒炒制的麻黄以发散透疹。或者使用“宣毒发表汤”（见第五条），去掉升麻、淡竹叶、桔梗、甘草，加入苏叶、葱白；或者加入经蜜酒炒制的麻黄，以开提腠理。或者用厚衣服和绵絮覆盖患者，使其出汗，汗液从头部至脚部逐渐渗出，然后逐渐减少衣被，使皮肤通畅，腠理开豁，从而促使麻疹容易透出。即使麻疹仍未透出，也不可再次强行发汗，恐怕导致亡阳的变证。只宜频繁服用葱白汤，使毛孔中微微出汗并保持润泽，这样麻疹自然就会透出，从而避免热邪闭塞导致抽搐的祸患。
麻疹透出之后，可以使用“防风败毒散”（见第五条），去掉淡竹叶、石膏、知母、桔梗、甘草来主治。不可让表邪无出路，以防其内伏。如果麻疹透出后潮热严重，或者兼有口渴症状的，那么石膏、知母、竹叶都适宜使用。并且还可以加入地骨皮、生地黄、麦冬之类的药物，以清除热邪，凉血生津。还可以加入枯黄芩以清肺热，生黄连以泻心火，那么各种病症就不会再发生了。
朱氏说：如果不使用发表法，麻疹从哪里透出呢？所谓“不要使用峻烈的发表法”，是担心发汗太过，或者衍生出其他证候罢了。
苏葛汤（出自《联杏心法》方）：治疗麻疹初热阶段证候未明的情况。
苏叶、粉葛、木通、元参、黄连（微炒后使用）、连翘、防风、黄芩、柴胡、赤芍、甘草。若无汗，加入蜜酒炒制的麻黄。发热特别严重的，加入牛蒡子（炒制五分）。发热严重不止的，加入鲜地骨皮、生地黄。如果热势不是特别严重的，去掉黄连、黄芩，加入枳壳、荆芥穗，以三根葱为引，水煎后热服。
During the initial fever stage of measles, when the syndrome is not yet clear, physicians may feel doubtful upon examination. At this time, do not use harsh diaphoretic (sweat-inducing) methods; instead, apply mild clearing and resolving techniques to bring peace to the condition.
If no signs of measles eruption (Ma Lu) are visible during the initial fever, do not use diaphoretic methods; a mild clearing and resolving approach is appropriate, using Liyan San as the main formula. If signs of measles eruption are already visible, use Gegen Jieji Tang (Pueraria Decoction for Unbinding the Muscles) (see Article 5), removing Chi Shao (Radix Paeoniae Rubra) and Gan Cao (Radix Glycyrrhizae), and adding Fang Feng (Radix Saposhnikoviae), Zhi Ke (Fructus Aurantii), and Cong Bai (Bulbus Allii Cepae). Adding Su Ye (Folium Perillae) is also acceptable. Alternatively, use Sugan Tang, removing Chi Shao, Chai Hu (Radix Bupleuri), and Gan Cao, and adding Zhi Ke and Cong Bai. If the measles still fail to erupt, use Sugan Tang, removing Chai Hu, Chi Shao, and Gan Cao, and adding Ma Huang (Herba Ephedrae) stir-fried with honey and wine to induce dispersion. Or use Xuandu Fabiao Tang (Decoction for Promoting Dispersion and Expelling Pathogens from the Exterior) (see Article 5), removing Sheng Ma (Rhizoma Cimicifugae), Dan Zhu Ye (Caulis Bambusae in Taeniam), Jie Geng (Radix Platycodi), and Gan Cao, and adding Su Ye and Cong Bai; or add Ma Huang stir-fried with honey and wine to open and raise the Cou Li (pores and interstices). Alternatively, cover the patient with thick clothing and cotton wadding to induce sweating, allowing sweat to flow gradually from head to toe, then gradually reduce clothing and bedding to ensure skin patency and open Cou Li, facilitating the eruption of measles. Even if the measles do not erupt, do not induce sweating again, lest it lead to the collapse of Yang (Wang Yang). Instead, frequently administer Cong Bai Tang (Scallion Decoction) to induce slight perspiration and moisten the hair follicles, so that the measles will naturally erupt, thereby avoiding complications such as convulsions due to heat closure.
After the measles have erupted, use Fangfeng Baidu San (Saposhnikovia Powder for Overcoming Toxins) (see Article 5), removing Dan Zhu Ye, Shi Gao (Gypsum Fibrosum), Zhi Mu (Rhizoma Anemarrhenae), Jie Geng, and Gan Cao. Do not leave the exterior pathogen without an outlet, to prevent its internal retention. If tidal fever is severe after eruption, or accompanied by thirst, then Shi Gao, Zhi Mu, and Zhu Ye are all suitable. Furthermore, one may add Di Gu Pi (Cortex Lycii), Sheng Di Huang (Radix Rehmanniae Recens), and Mai Dong (Radix Ophiopogonis) to clear heat, cool the blood, and generate fluids. One may also add Ku Huang Qin (Scutellariae Radix) to clear lung heat, and Sheng Huang Lian (Coptidis Rhizoma) to drain heart fire, so that various symptoms will cease.
Zhu said: If diaphoretic methods are not used, how will the measles erupt? The instruction "do not use harsh diaphoretic methods" is to avoid excessive sweating or the generation of other syndromes.
Liyan San: Treats soreness and swelling of the throat.
Niu Bang Zi (Arctii Fructus, stir-fried), Xuan Shen (Scrophulariae Radix), Fang Feng (Radix Saposhnikoviae), decocted in water and taken orally.
Sugan Tang (Formula from *Lianxing Xinfa*): Treats unclear syndromes during the initial fever stage of measles.
Su Ye (Folium Perillae), Fen Ge (Puerariae Radix), Mu Tong (Akebiae Caulis), Xuan Shen (Scrophulariae Radix), Huang Lian (Coptidis Rhizoma, lightly stir-fried), Lian Qiao (Forsythiae Fructus), Fang Feng (Radix Saposhnikoviae), Huang Qin (Scutellariae Radix), Chai Hu (Radix Bupleuri), Chi Shao (Radix Paeoniae Rubra), Gan Cao (Radix Glycyrrhizae). If there is no sweat, add Ma Huang (Herba Ephedrae) stir-fried with honey and wine. If fever is extremely severe, add Niu Bang Zi (Arctii Fructus, stir-fried, 5 fen). If severe fever persists, add fresh Di Gu Pi (Cortex Lycii) and Sheng Di Huang (Radix Rehmanniae Recens). If fever is not too severe, remove Huang Lian and Huang Qin, add Zhi Ke (Fructus Aurantii) and Jing Jie Sui (Schizonepetae Spica), using three stalks of Cong Bai (Bulbus Allii Cepae) as a guide, decocted in water and taken hot.