麻症泄泻本常候。当分属热与属寒。泻下清稀白沫者。莫作热候一般看。
麻症泄泻。本属常候。属热者多。属寒者少。然亦有泻下清稀白沫者。其症喜温。腹疼喜按。
此属寒泻。宜以胃苓汤。去苍术。少用白术、肉桂。加煨姜治之。不可一例而治也。
胃苓汤 治饮食停积。浮肿泄泻。脉症俱实者。
苍术（米泔水浸、去皮、以芝麻油拌炒黄色、四两） 川浓朴（去皮姜汁炒） 广陈皮（去
白） 肉桂（一钱） 炙甘草（各三两） 生白术 白茯苓 坚猪苓（各二钱） 泽泻（三钱） 水煎服。
平胃本平胃气之敦阜。若因脾土之虚。不能消运。又须稍借参苓。如养胃汤之类。然复有土
衰不能分利。而成肿胀。且气壅不胜参术。难合理中者。宜合五苓。以健运水土之正气。与假
苏藿以散客邪。两不易之定例也。
泻下腹疼与胀满。嗳气秽息如败卵。饮食不节腹中停。宽肠化食自安妥。
泻而窘急。腹痛胀满。或有嗳气如败卵者。此乃饮食不节。停滞腹中。宜用枳壳汤（见四十九
条）去炙甘草。加山楂肉、麦芽、木通治之。
咳衄吐泻麻之宜。热毒由斯消减时。治法解毒同一例。用方首尾不共施。
麻疹初出。必要咳嗽。使腠理疏通。鼻衄则热毒得以随衄而解。泄泻则上下热毒得出。呕吐
均属美候。亦脾胃二经热毒所致。且麻出自肺胃。其理只以解热毒为主。六一散、至宝丹、或四物
汤（见二十五条）。加黄连、黄芩。仍凭择用。若麻出之后。而见咳嗽、鼻衄、吐泻等候。则又不宜
用上三方。俱宜以三味消毒饮（见三十三条）主之。
六一散 治表里三焦之热。解肌清燥。
滑石（六两） 甘草（一两） 为末。灯心汤、或姜汤下。
前方滑石四两。甘草一两。名曰天水散。治痘干燥而痛。用蜜水调涂。并白汤调服。
至宝丹（又名祛风至宝丹）
防风 荆芥 连翘 麻黄 薄荷叶 川芎 当归 白芍（炒） 栀仁（炒黑） 大黄（酒蒸） 芒硝（各
五钱） 枯黄芩 石膏 桔梗（各二钱） 甘草（二两） 滑石（三两） 人参 熟地 川黄柏 黄连 羌
活独活 天麻 细辛 全蝎 白术（五钱） 为末。蜜丸。弹子大。不拘茶酒。任下一丸。
前方即防风通圣散。此则加人参补气。熟地益血。黄柏、黄连除热。羌活、独活、天麻、细辛、
全蝎祛风。自利。去硝、黄。自汗。去麻黄、加桂枝。涎嗽。加姜制半夏。
麻疹并发泄泻本是常见症状。应当辨别其属于热证还是寒证。如果泻下物为清稀的白色泡沫，不要将其当作热证来对待。
麻疹并发泄泻，本属常见症状。其中属于热证的较多，属于寒证的较少。然而也有出现泻下清稀白沫的情况，这类患者喜欢温暖，腹痛时喜欢按压腹部。
这属于寒性泄泻。适宜使用胃苓汤，去掉苍术，少量使用白术和肉桂，加入煨姜进行治疗。不可一概而论地统一治疗。
胃苓汤：用于治疗饮食停滞积聚、浮肿泄泻，且脉象与症状均表现为实证的患者。
药材组成：苍术（用米泔水浸泡，去皮，用芝麻油拌炒至黄色，四两）、川厚朴（去皮，用姜汁炒制）、广陈皮（去白色内层）、肉桂（一钱）、炙甘草（各三两）、生白术、白茯苓、坚猪苓（各二钱）、泽泻（三钱）。加水煎煮后服用。
平胃散原本是为了平复胃气的敦厚壅滞。如果是由于脾土虚弱，不能运化消化，又需要稍微借助人参、茯苓等补益药物，如养胃汤之类的方剂。然而又有因土气衰败不能分利水湿，而形成肿胀，且气机壅塞无法耐受参、术等补药，难以单独使用理中汤的情况。此时适宜合用五苓散，以健运水土的正气，并配合苏叶、藿香以发散客邪。这是两条不易改变的定例。
泻下伴有腹痛与胀满，嗳气有腐败鸡蛋般的臭味，这是由于饮食不节制导致食物停滞腹中。使用宽肠化食的方法自然能安妥。
腹泻急迫窘迫，腹痛胀满，或者有嗳气像腐败鸡蛋味道的，这是饮食不节制，食物停滞在腹中造成的。适宜使用枳壳汤（见第四十九条），去掉炙甘草，加入山楂肉、麦芽、木通进行治疗。
咳嗽、鼻衄、呕吐、泄泻是麻疹过程中的适宜表现。热毒由此得以消减。治疗方法都是解毒，原则一致，但具体用药在病程首尾阶段并不通用。
麻疹初出时，必然会出现咳嗽，这是为了使腠理疏通；鼻衄则使热毒能够随着出血而解除；泄泻使上下的热毒得以排出；呕吐也都属于良好的征候，也是脾胃二经热毒所致。且麻疹病源出自肺胃，其道理只在于以解热毒为主。可选用六一散、至宝丹，或者四物汤（见第二十五条），加入黄连、黄芩，仍然根据具体情况选择使用。如果麻疹发出之后，再出现咳嗽、鼻衄、吐泻等症状，则又不宜使用上述三个方子。都适宜以三味消毒饮（见第三十三条）为主治方剂。
药材组成：滑石（六两）、甘草（一两）。研成粉末，用灯心草汤或姜汤送服。
前方中滑石四两、甘草一两，名为天水散。用于治疗痘疮干燥疼痛，用蜜水调匀涂抹，并用白开水调服。
药材组成：防风、荆芥、连翘、麻黄、薄荷叶、川芎、当归、白芍（炒）、栀仁（炒黑）、大黄（酒蒸）、芒硝（各五钱）、枯黄芩、石膏、桔梗（各二钱）、甘草（二两）、滑石（三两）、人参、熟地黄、川黄柏、黄连、羌活、独活、天麻、细辛、全蝎、白术（五钱）。研成粉末，用蜂蜜制成丸药，大小如弹子，不拘泥于茶或酒，任意服用一丸。
前方即是防风通圣散。此方在此基础上加入人参补气，熟地黄益血，黄柏、黄连清热，羌活、独活、天麻、细辛、全蝎祛风。若自利（腹泻），去掉芒硝、大黄；若自汗，去掉麻黄，加入桂枝；若有痰嗽，加入姜制半夏。
Diarrhea accompanying measles is a common manifestation. It should be differentiated into heat syndrome or cold syndrome. If the stool consists of clear, thin white foam, it should not be treated as a heat syndrome.
Diarrhea accompanying measles is inherently a common occurrence. Cases attributed to heat are more frequent, while those attributed to cold are less common. However, there are instances where the stool is clear, thin, and contains white foam. In such cases, the patient prefers warmth, and abdominal pain is relieved by pressure.
This belongs to cold-type diarrhea. It is appropriate to treat with Weiling Tang (Gastrointestinal Regulation Decoction), removing Cangzhu (Atractylodis Rhizoma), using small doses of Baizhu (Atractylodis Macrocephalae Rhizoma) and Rougui (Cinnamomi Cortex), and adding Wei Jiang (Prepared Ginger). Treatment must not be uniform across all cases.
Weiling Tang (Gastrointestinal Regulation Decoction): Used for treating food stagnation accumulation, edema, and diarrhea, when both pulse and symptoms indicate excess patterns.
Ingredients: Cangzhu (Atractylodis Rhizoma) (soaked in rice washing water, peeled, stir-fried with sesame oil until yellow, 4 liang); Chuan Houpo (Magnoliae Officinalis Cortex) (peeled, stir-fried with ginger juice); Guang Chenpi (Citri Reticulatae Pericarpium) (remove white pith); Rougui (Cinnamomi Cortex) (1 qian); Zhi Gancao (Glycyrrhizae Radix et Rhizoma Preparata) (each 3 liang); Sheng Baizhu (Atractylodis Macrocephalae Rhizoma); Bai Fuling (Poria); Jian Zhuling (Polyporus) (each 2 qian); Zexie (Alismatis Rhizoma) (3 qian). Decoct in water and take orally.
Pingwei San (Stomach-Pacifying Powder) originally aims to pacify the excessive abundance of stomach qi. If the condition arises from spleen earth deficiency, leading to an inability to digest and transport, it is necessary to slightly assist with Ren Shen (Ginseng Radix) and Fu Ling (Poria), such as in Yangwei Tang (Stomach-Nourishing Decoction). However, in cases where earth qi is too weak to separate clear from turbid fluids, resulting in swelling, and where qi stagnation cannot tolerate tonics like Ren Shen and Baizhu, making Lizhong Tang (Middle-Warming Decoction) unsuitable, it is appropriate to combine with Wuling San (Five-Ingredient Powder with Poria) to strengthen the righteous qi of earth and water, and use Su Ye (Perillae Folium) and Huo Xiang (Agastaches Herba) to disperse pathogenic factors. These are two unchangeable standard principles.
Diarrhea accompanied by abdominal pain and distension, belching with a foul odor resembling rotten eggs, indicates food stagnation in the abdomen due to irregular diet. Using methods to widen the intestines and transform food will naturally bring relief.
Urgent and distressing diarrhea, abdominal pain and distension, or belching smelling like rotten eggs, are caused by irregular diet leading to food stagnation in the abdomen. It is appropriate to use Zhike Tang (Citri Reticulatae Decoction) (see Article 49), removing Zhi Gancao (Prepared Licorice Root), and adding Shan Zha Rou (Crataegi Fructus flesh), Mai Ya (Hordei Fructus Germinatus), and Mu Tong (Akebiae Caulis) for treatment.
Cough, epistaxis, vomiting, and diarrhea are favorable manifestations during measles. Heat toxins are thereby reduced. The treatment principle is detoxification, which remains consistent, but the specific formulas used at the beginning and end of the disease course differ.
When measles first emerge, coughing is inevitable, serving to open the interstices (couli); epistaxis allows heat toxins to resolve through bleeding; diarrhea allows upper and lower heat toxins to exit; vomiting is also considered a favorable sign, caused by heat toxins in the Stomach and Spleen meridians. Since measles originate from the Lung and Stomach, the core principle is resolving heat toxins. One may choose from Liuyi San (Six-to-One Powder), Zhibao Dan (Precious Treasure Pill), or Siwu Tang (Four Substances Decoction) (see Article 25), adding Huanglian (Coptidis Rhizoma) and Huangqin (Scutellariae Radix), selecting based on specific circumstances. However, if cough, epistaxis, vomiting, and diarrhea appear after the measles have erupted, the aforementioned three formulas should not be used. Instead, Sanwei Xiaodu Yin (Three-Ingredient Detoxifying Decoction) (see Article 33) should be the primary prescription.
Liuyi San (Six-to-One Powder): Treats heat in the exterior, interior, and Triple Burner; resolves the muscle layer and clears dryness.
Ingredients: Huashi (Talcum) (6 liang); Gancao (Licorice Root) (1 liang). Grind into powder. Take with Dengxin Tang (Juncus Decoction) or Jiang Tang (Ginger Decoction).
The previous formula with 4 liang of Huashi and 1 liang of Gancao is named Tianshui San (Heavenly Water Powder). It treats dry and painful pox. Apply mixed with honey water externally, or take internally mixed with plain boiled water.
Zhibao Dan (Precious Treasure Pill) (also known as Qufeng Zhibao Dan / Wind-Expelling Precious Treasure Pill)
Ingredients: Fangfeng (Saposhnikoviae Radix), Jingjie (Schizonepetae Spica), Lianqiao (Forsythiae Fructus), Mahuang (Ephedrae Herba), Bohe Ye (Menthae Haplocalycis Folium), Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba) (stir-fried), Zhiren (Gardeniae Semen) (charred), Dahuang (Rhei Radix et Rhizoma) (steamed with wine), Mangxiao (Natrii Sulfas) (each 5 qian); Ku Huangqin (Scutellariae Radix), Shigao (Gypsum Fibrosum), Jiegeng (Platycodonis Radix) (each 2 qian); Gancao (Licorice Root) (2 liang); Huashi (Talcum) (3 liang); Renshen (Ginseng Radix), Shudi (Rehmanniae Radix Preparata), Chuan Huangbai (Phellodendri Chinensis Cortex), Huanglian (Coptidis Rhizoma), Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Tianma (Gastrodiae Rhizoma), Xixin (Asari Radix et Rhizoma), Quanxie (Scorpio), Baizhu (Atractylodis Macrocephalae Rhizoma) (5 qian). Grind into powder, make pills with honey, size of a bullet. Take one pill regardless of tea or wine.
The previous formula is Fangfeng Tongsheng San (Wind-Barrier and Unblocking Vitality Powder). This formula adds Renshen (Ginseng Radix) to tonify qi, Shudi (Rehmanniae Radix Preparata) to nourish blood, Huangbai (Phellodendri Chinensis Cortex) and Huanglian (Coptidis Rhizoma) to remove heat, Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Tianma (Gastrodiae Rhizoma), Xixin (Asari Radix et Rhizoma), and Quanxie (Scorpio) to dispel wind. For spontaneous diarrhea, remove Mangxiao (Natrii Sulfas) and Dahuang (Rhei Radix et Rhizoma); for spontaneous sweating, remove Mahuang (Ephedrae Herba) and add Guizhi (Cinnamomi Ramulus); for phlegm-cough, add Banxia (Pinelliae Rhizoma) prepared with ginger.