寒热头疼兼背强。遍身痛楚苦难当。更有头项俱肿者。都缘毒火未清降。
麻症本类伤寒。倘或不避风寒。未经清解。邪火内迫。毒攻于里。症生多端。或有伤寒并作。
头疼背强。或头面颈项浮肿。或脉强火盛。大热作渴。或麻收之后。发热而遍身疼痛。种种症候。
在所不免。急宜清火解毒。如寒热并作。头疼背强者。当用表散。以宣毒发表汤（见第五条）去升
麻、桔梗、甘草。略加白芷治之。（有加羌活者。大非所宜。）头面颈项肿者。以宣毒发表汤。（见
第五条）去升麻、白桔梗、甘草。加葶苈主之。脉强火炽。热盛作渴者。则以白虎解毒汤（见二十
六条）主之。如麻出稠密。遍身疼痛烦躁者。以凉血饮子（见四十五条）去赤芍。加连翘、牛蒡子主
之。如麻收后。遍身疼痛者。以古方黄连解毒汤。（见三十五条）加葛根、前胡、白芷、防风治之。
（有加升麻羌活者。亦非所宜。）
朱曰 时医不敢用表散。盖慎之也。惟麻证则必须表散。如项肿遍身痛。以及腹肿腹痛
证。皆毒邪闭塞。证虽凶猛。用清热解毒。佐以表散。无不奏效如神。
腹痛原因毒内攻。首尾治法不相同。清解通利消饮食。更分虚实莫朦胧。
腹痛之症不一。总由火毒内郁。而不能出。或为风寒壅滞遏抑。或因饮食停滞不化。而皆能
致痛。若见于初热正出之间。风寒壅遏。毒反内攻。而腹痛者。急与疏表。麻出透而痛自止。以宣
毒发表汤（见第五条）去升麻、桔梗、甘草、淡竹叶。或葛根解肌汤（见第五条）去赤芍、甘草。加枳
壳。或葛根疏邪汤（见三十三条）治之。若饮食过伤。腹满胀痛者。以枳实导滞化毒汤去山楂、
浓朴、槟榔、甘草治之。（有用平胃散。加神曲、山楂、麦芽、枳壳、木通治之者。治腹痛满固当。而
治麻腹痛亦非所宜。方仍附收。）大便秘者。加丑牛、或大黄以利之。小便赤涩不通者。加猪苓、泽
泻以导之。若于正收及收未尽之时而腹痛者。乃外邪未尽。而复入里所致。宜兼清中外。法当疏
托。佐以清解。使毒复出。而痛自止。以清热透肌汤（见二十五条）加枳壳。木通、黄芩治之。如
麻全敛之后而腹痛者。治宜清凉解毒。佐以风药。兼分利余热。使毒内消、而痛自愈。以化毒清表
汤（见十六条）去知母、花粉、桔梗、甘草。加枳壳治之。又须验其有无他症。分别属虚属实而治。
若邪热内结而腹痛者。以通利大便为主。以河间凉膈散（见二十六条）去甘草治之。如麻后脾气
不调而致腹痛面目四肢浮肿者。以分利小便为主。以导赤散（见二十六条）治之。腹疼而小便不
通者。以导赤散（见二十六条）加芍药治之。若麻症毒重。腹痛烦躁潮热者。以连翘败毒散。去赤
芍、甘草治之。倘腹痛不止。加黄连、麦冬治之。若麻症首尾肚痛者。此皆由毒火内蕴而然。宜先
发散。以防风败毒散（见第五条）去桔梗、甘草治之。后以山楂肉煎汤与服。至若元气大虚。阴阳
不能升降。小水不利。遍身浮肿。喘促兼见者。则难治矣。
枳实导滞化毒汤
枳实 青皮 麦芽 木通 连翘 赤苓 牛蒡子 山楂肉 槟榔 浓朴 甘草 灯心引。水煎服。
连翘败毒散
连翘 防风 牛蒡子 荆芥 木通 赤芍 甘草 水煎服。
平胃散 治胃中宿食不化。藜藿之人宜之。
浓朴（去皮姜汁炒） 苍术（米泔水浸去皮麻油拌炒黄色各四钱） 陈皮（去白） 炙甘草（各
二钱） 姜引。水煎服。
寒热交替、头痛并伴有项背强直，全身疼痛难忍。如果头颈都出现肿胀，这都是因为毒火未能清除下降所致。
麻疹病症本类似于伤寒。倘若不慎避开了风寒，或者未经过清解治疗，邪火内迫，毒素攻入体内，症状就会变得多种多样。有时可能同时患有伤寒。
头痛项背强直，或者头面颈部浮肿，或者脉象强劲、火势旺盛、高热且口渴，或者在麻疹消退之后，发热且全身疼痛，种种症候在所难免。此时应当紧急清热泻火、解毒。如果寒热交替发作，头痛项背强直，应当使用表散法，以宣毒发表汤（见第五条）为基础，去掉升麻、桔梗、甘草，略微加入白芷来治疗。（如果有加入羌活的，非常不适宜。）头面颈部肿胀的，用宣毒发表汤（见第五条），去掉升麻、白桔梗、甘草，加入葶苈子为主治药物。脉象强劲、火势炽盛、热盛口渴的，则以白虎解毒汤（见二十六条）为主治药物。如果麻疹出得稠密，全身疼痛且烦躁的，用凉血饮子（见四十五条），去掉赤芍，加入连翘、牛蒡子为主治药物。如果麻疹消退后，全身疼痛的，用古方黄连解毒汤（见三十五条），加入葛根、前胡、白芷、防风来治疗。（如果有加入升麻、羌活的，也不适宜。）
朱氏说：当时的医生不敢使用表散法，这是出于谨慎。但只有麻疹证必须使用表散法。如项部肿胀、全身疼痛，以及腹部肿胀、腹痛等证，都是毒邪闭塞所致。虽然证候凶猛，但使用清热解毒，佐以表散法，没有不奏效如神的。
腹痛的原因是毒气内攻。初起和末期的治疗方法不相同。需要清解、通利、消食导滞，更要分清虚实，不要模糊不清。
腹痛的症状不一，总归是由于火毒内郁，不能透发出来。或者是被风寒壅滞遏抑，或者是因饮食停滞不化，都能导致疼痛。如果在初热正出疹之间，因风寒壅遏，毒气反而内攻而导致腹痛的，紧急给予疏表法，麻疹透出而疼痛自然停止。可以用宣毒发表汤（见第五条），去掉升麻、桔梗、甘草、淡竹叶；或者用葛根解肌汤（见第五条），去掉赤芍、甘草，加入枳壳；或者用葛根疏邪汤（见三十三条）来治疗。如果是饮食过度损伤，导致腹满胀痛的，用枳实导滞化毒汤，去掉山楂、厚朴、槟榔、甘草来治疗。（有用平胃散，加入神曲、山楂、麦芽、枳壳、木通来治疗的，治疗一般的腹痛胀满固然恰当，但治疗麻疹引起的腹痛却不适宜，该方仍附录在此。）大便秘结的，加入牵牛子，或者大黄来通便。小便红赤涩痛不通的，加入猪苓、泽泻来利尿导湿。如果在麻疹正当收敛或收敛未尽之时出现腹痛，这是外邪未尽，又复入里所致。应当兼清内外，治法应当疏托，佐以清解，使毒气再次透出，疼痛自然停止。用清热透肌汤（见二十五条），加入枳壳、木通、黄芩来治疗。如果麻疹完全收敛之后出现腹痛，治疗宜清凉解毒，佐以风药，兼分利余热，使毒气在内消散，疼痛自愈。用化毒清表汤（见十六条），去掉知母、天花粉、桔梗、甘草，加入枳壳来治疗。还必须查验是否有其他症状，分别属于虚证还是实证进行治疗。如果是邪热内结而导致腹痛的，以通利大便为主，用河间凉膈散（见二十六条），去掉甘草来治疗。如果是麻疹后脾气不调而导致腹痛、面目四肢浮肿的，以分利小便为主，用导赤散（见二十六条）来治疗。腹痛且小便不通的，用导赤散（见二十六条），加入芍药来治疗。如果麻疹毒重，腹痛、烦躁、潮热的，用连翘败毒散，去掉赤芍、甘草来治疗。如果腹痛不止，加入黄连、麦冬来治疗。如果麻疹从头到尾都肚子痛，这都是由毒火内蕴造成的。应当先发散，用防风败毒散（见第五条），去掉桔梗、甘草来治疗。随后用山楂肉煎汤给患者服用。至于元气大虚，阴阳不能升降，小便不利，全身浮肿，气喘急促并见的，那就难以治疗了。
枳实导滞化毒汤
组成：枳实、青皮、麦芽、木通、连翘、赤茯苓、牛蒡子、山楂肉、槟榔、厚朴、甘草。用法：灯心草为引，水煎服。
连翘败毒散
组成：连翘、防风、牛蒡子、荆芥、木通、赤芍、甘草。用法：水煎服。
平胃散 治疗胃中宿食不化，适合吃粗粮的人服用。
组成：厚朴（去皮，姜汁炒）、苍术（米泔水浸，去皮，麻油拌炒至黄色，各四钱）、陈皮（去白）、炙甘草（各二钱）。用法：生姜为引，水煎服。
Alternating chills and fever, headache accompanied by stiffness of the neck and back, and unbearable pain throughout the body. If swelling occurs in both the head and neck, it is all due to the failure of toxic fire to clear and descend.
The measles syndrome is originally similar to Shanghan (Cold Damage). If one fails to avoid wind-cold, or if it has not been cleared and resolved, evil fire presses inward, and toxins attack the interior, resulting in a variety of symptoms. Sometimes, Shanghan may occur concurrently.
Headache with stiffness of the neck and back, or swelling of the face, head, and neck; or a strong pulse with excessive fire, high fever, and thirst; or fever and body pain after the measles have receded—all these manifestations are inevitable. At this point, it is urgent to clear heat, purge fire, and detoxify. If chills and fever occur together with headache and neck/back stiffness, a releasing method should be used. Use Xuandu Fabiao Decoction (see Article 5), removing Shengma (Cimicifugae Rhizoma), Jiegeng (Platycodonis Radix), and Gancao (Glycyrrhizae Radix et Rhizoma), and slightly adding Baizhi (Angelicae Dahuricae Radix) for treatment. (Adding Qianghuo (Notopterygii Rhizoma et Radix) is highly inappropriate.) For swelling of the face, head, and neck, use Xuandu Fabiao Decoction (see Article 5), removing Shengma, Baiejiegeng (Platycodonis Radix), and Gancao, and adding Tingli (Descurainiae Semen seu Lepidii Semen) as the main treatment. For a strong pulse, blazing fire, intense heat, and thirst, use Baihu Jiedu Decoction (see Article 26) as the main treatment. If the measles appear dense, accompanied by body pain and irritability, use Liangxue Yinzi (see Article 45), removing Chishao (Paeoniae Radix Rubra), and adding Lianqiao (Forsythiae Fructus) and Niubangzi (Arctii Fructus) as the main treatment. If body pain persists after the measles have receded, use the ancient formula Huanglian Jiedu Decoction (see Article 35), adding Gegen (Puerariae Lobatae Radix), Qianhu (Peucedani Radix), Baizhi, and Fangfeng (Saposhnikoviae Radix) for treatment. (Adding Shengma and Qianghuo is also inappropriate.)
Zhu stated: Contemporary physicians dare not use releasing methods, out of caution. However, for measles syndromes, releasing methods are essential. In cases such as neck swelling with body pain, or abdominal swelling and pain, the cause is blockage by toxic pathogens. Although the syndrome appears fierce, using heat-clearing and detoxifying methods combined with releasing methods yields miraculous results without exception.
Abdominal pain is caused by internal attack of toxins. The treatment methods at the beginning and end of the disease differ. One must clear, resolve, unblock, promote urination, and digest food stagnation, while distinguishing between deficiency and excess to avoid ambiguity.
Symptoms of abdominal pain vary, but generally stem from internal depression of fire-toxins that cannot vent outward, or from obstruction and suppression by wind-cold, or from food stagnation and indigestion, all of which can cause pain. If abdominal pain occurs during the initial fever and eruption phase due to wind-cold obstruction causing toxins to retreat inward, emergency release of the exterior is required. Once the measles erupt thoroughly, the pain will cease spontaneously. This can be treated with Xuandu Fabiao Decoction (see Article 5), removing Shengma, Jiegeng, Gancao, and Danzhuye (Lophatheri Herba); or Gegen Jiexi Decoction (see Article 5), removing Chishao and Gancao, and adding Zhike (Aurantii Fructus Immaturus); or Gegen Shuxie Decoction (see Article 33). If abdominal fullness and distending pain result from dietary overindulgence, use Zhishi Daoli Huadu Decoction, removing Shanzha (Crataegi Fructus), Houpo (Magnoliae Officinalis Cortex), Binglang (Arecae Semen), and Gancao. (Some use Pingwei San, adding Shenqu (Megaspermi Fermentatus), Shanzha, Maiya (Hordei Fructus Germinatus), Zhike, and Mutong (Akebiae Caulis), which is suitable for general abdominal fullness but inappropriate for measles-related abdominal pain; the formula is still appended here.) For constipation, add Qiuniu (Pharbitidis Semen) or Dahuang (Rhei Radix et Rhizoma) to promote bowel movement. For red, scanty, or obstructed urination, add Zhuling (Polyporus) and Zexie (Alismatis Rhizoma) to guide out dampness. If abdominal pain occurs during the proper contraction phase or when contraction is incomplete, it indicates that external pathogens remain and have re-entered the interior. Treatment should simultaneously clear the interior and exterior, employing a dispersing and supporting method assisted by heat-clearing and detoxification to force the toxins out again, thereby stopping the pain. Use Qingre Touji Decoction (see Article 25), adding Zhike, Mutong, and Huangqin (Scutellariae Radix) for treatment. If abdominal pain occurs after the measles have completely receded, treatment should focus on cooling, clearing, and detoxifying, assisted by wind-dispelling herbs, and promoting diuresis to clear residual heat, allowing toxins to dissipate internally and pain to heal spontaneously. Use Huadu Qingbiao Decoction (see Article 16), removing Zhimu (Anemarrhenae Rhizoma), Huafen (Trichosanthis Radix), Jiegeng, and Gancao, and adding Zhike for treatment. One must also examine for other symptoms to distinguish between deficiency and excess patterns. If abdominal pain is caused by internal binding of evil heat, the primary approach is to unblock and promote bowel movements, using Hejian Liangge San (see Article 26), removing Gancao. If abdominal pain and edema of the face, eyes, and limbs result from spleen-qi dysfunction after measles, the primary approach is to promote diuresis, using Daochi San (see Article 26) for treatment. For abdominal pain accompanied by obstructed urination, use Daochi San (see Article 26), adding Shaoyao (Paeoniae Radix Alba) for treatment. If measles toxicity is severe, presenting with abdominal pain, irritability, and tidal fever, use Lianqiao Baidu San, removing Chishao and Gancao for treatment. If abdominal pain persists, add Huanglian (Coptidis Rhizoma) and Maidong (Ophiopogonis Radix). If abdominal pain persists from the beginning to the end of the measles course, it is due to internal accumulation of toxic fire. Initial treatment should involve dispersion using Fangfeng Baidu San (see Article 5), removing Jiegeng and Gancao. Subsequently, administer decoction made from Shanzha Rou (Crataegi Fructus) for drinking. As for cases of significant yuan-qi deficiency, where yin and yang fail to ascend and descend, accompanied by difficult urination, generalized edema, and panting, the condition is difficult to treat.
Zhishi Daoli Huadu Decoction
Ingredients: Zhishi (Aurantii Fructus Immaturus), Qingpi (Citri Reticulatae Pericarpium Viride), Maiya (Hordei Fructus Germinatus), Mutong (Akebiae Caulis), Lianqiao (Forsythiae Fructus), Chiling (Polyporus), Niubangzi (Arctii Fructus), Shanzha Rou (Crataegi Fructus), Binglang (Arecae Semen), Houpo (Magnoliae Officinalis Cortex), Gancao (Glycyrrhizae Radix et Rhizoma). Usage: Use Dengxincao (Junci Medullia) as a guiding herb, decoct in water, and take orally.
Lianqiao Baidu San
Ingredients: Lianqiao (Forsythiae Fructus), Fangfeng (Saposhnikoviae Radix), Niubangzi (Arctii Fructus), Jingjie (Schizonepetae Spica), Mutong (Akebiae Caulis), Chishao (Paeoniae Radix Rubra), Gancao (Glycyrrhizae Radix et Rhizoma). Usage: Decoct in water and take orally.
Pingwei San
Indication: Treats retained food stagnation in the stomach; suitable for individuals consuming coarse grains.
Ingredients: Houpo (Magnoliae Officinalis Cortex) (peeled, stir-fried with ginger juice), Cangzhu (Atractylodis Rhizoma) (soaked in rice wash water, peeled, stir-fried with sesame oil until yellow, each 4 qian), Chenpi (Citri Reticulatae Pericarpium) (remove white pith), Zhi Gancao (Glycyrrhizae Radix et Rhizoma) (each 2 qian). Usage: Use Shengjiang (Zingiberis Rhizoma Recens) as a guiding herb, decoct in water, and take orally.