太痘秀实症已平。倏尔麻疹又来侵。此时胎毒曾经解。惟宜用药养肺金。
出痘已经收靥落痂。痘症已平。此时胎毒已经清解。适值天行麻疹发现。旋即出麻。惟宜清
金养肺为主。以参贝散主之。愚按痘后即出麻。虽曰胎毒曾经清解。然痘当起灌之时。岂有不施
补剂催浆灌脓之理。其间定有余热留毒。今痘后相继出麻。未必绝无毒火。全因天行而发者。虽
宜清金养肺。而方中之桔梗、甘草。仍须停用。即沙参亦当以玄参易之。更宜加枯黄芩。泻肺以清
肌表。连翘、牛蒡子以解心肺之留毒。赤苓、枳壳。利二便而泄心与大肠之火。则肺金清而毒尽
解。尤为妥当。
参贝散
沙参 贝母 桔梗（各一钱） 西河柳（二钱） 甘草（五分） 水煎服。
麻见闭症眼肿赤。声哑鼻干发喘渴。腰腹胀痛人昏沉。唇掀烦躁二便血。
麻初出时。眼胞肿。白夹赤色。声哑。唇肿掀翻。鼻干、鼻扇、气喘。烦躁口渴。腰痛腹胀。人事
昏沉。口鼻出血。烦乱狂叫。二便出血。此乃毒火郁遏于内。名曰闭症。最为难治。宜用宣毒发表
汤（见第五条）去升麻、甘草、桔梗。加酒炒黄芩七分。酒蜜炒麻黄五分。或更加元参、山豆根治
之。若能托出麻标外现。渐次发出者。可以望生。如仍闭而不出。则无望矣。
朱曰 麻见闭证。最为危险。当此病家惊心动魄之时。全赖医者有胆有识。方不误事。
痘症已经结痂脱落，病情平稳。突然麻疹再次侵袭。此时胎毒虽然已经解除，但只适宜用药养护肺金（肺脏）。
出痘已经收靥落痂，痘症已平。此时胎毒已经清解，恰逢时行麻疹出现，随即发出麻疹。治疗应以清金养肺为主，使用参贝散主治。我认为：痘后紧接着出麻，虽然说胎毒已经清解，然而在痘疹起发、灌浆的时候，岂有不使用补剂来催浆灌脓的道理？其间必定有余热留毒。现在痘后相继出麻，未必完全没有毒火，完全是因为时行邪气而引发的。虽然适宜清金养肺，但方中的桔梗、甘草，仍然必须停用。即使是沙参，也应当用玄参替代。更适宜加入枯黄芩，以泻肺热从而清除肌表之邪；加入连翘、牛蒡子以解除心肺中残留的毒邪；加入赤茯苓、枳壳，以通利二便并泄除心与大肠的火邪。这样肺金得以清净，毒邪尽数解除，尤为妥当。
参贝散
沙参、贝母、桔梗（各一钱），西河柳（二钱），甘草（五分），水煎服。
麻疹见闭症：眼肿红赤，声音嘶哑，鼻干气喘口渴，腰腹胀痛，人神昏沉，嘴唇掀翻烦躁，大小便出血。
麻疹初出时，眼睑肿胀，白睛夹杂赤色，声音嘶哑，嘴唇肿胀掀翻，鼻干、鼻翼扇动、气喘，烦躁口渴，腰痛腹胀，人事昏沉，口鼻出血，烦乱狂叫，大小便出血。这是毒火郁遏在体内，称为闭症，最为难治。适宜使用宣毒发表汤（见第五条），去掉升麻、甘草、桔梗，加入酒炒黄芩七分，酒蜜炒麻黄五分。或者再加玄参、山豆根来治疗它。如果能够托出麻疹至体表显现，逐渐发出的，还可以希望生存。如果仍然闭塞不出，那就无望了。
The variola (smallpox) has completed its course, with pustules crusted and fallen off, and the condition is stable. Suddenly, measles reappears to invade. At this time, although the fetal toxin (congenital toxicity) has been resolved, it is only appropriate to use medication to nourish the Lung Metal (the Lung organ in Five-Phase theory).
After smallpox has crusted and scabbed off, the disease is quiescent. At this juncture, the fetal toxin has been cleared and resolved. Coinciding with an epidemic outbreak of measles appearing, the measles erupts immediately. Treatment should primarily focus on clearing Metal and nourishing the Lung, using Shenbei San (Ginseng and Fritillaria Powder) as the main formula. I observe: Measles appearing after smallpox, although it is said that the fetal toxin has been cleared, during the stage when smallpox was rising and filling with pus, was there not a necessity to use tonifying agents to promote pus formation? Therefore, residual heat and lingering toxins must remain within. The subsequent eruption of measles after smallpox does not necessarily mean there is no toxic fire; it is entirely triggered by epidemic pathogenic factors. Although clearing Metal and nourishing the Lung is suitable, Jiegeng (Platycodon Root) and Gancao (Licorice Root) in the formula must still be discontinued. Even Shashen (Adenophora Root) should be replaced with Xuanshen (Scrophularia Root). It is further advisable to add Kuhuangqin (Dried Scutellaria Root) to drain Lung heat and clear the muscle layer; add Lianqiao (Forsythia Fruit) and Niubangzi (Arctium Seed) to resolve lingering toxins in the Heart and Lung; add Chiling (Red Poria) and Zhike (Immature Bitter Orange) to promote urination and defecation, thereby draining Fire from the Heart and Large Intestine. In this way, Lung Metal becomes clear, and toxins are completely resolved, which is particularly appropriate.
Shenbei San
Shashen (Adenophorae Radix), Beimu (Fritillariae Bulbus), Jiegeng (Platycodonis Radix) (each 1 qian), Xihe Liu (Tamarisci Ramulus) (2 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (0.5 qian). Decoct in water and take orally.
Measles presenting with Bi Syndrome (closure syndrome): swollen and red eyes, hoarse voice, dry nose, panting, thirst, lower back and abdominal pain, mental confusion, everted lips, restlessness, bleeding from both bowels.
When measles first appear, the eyelids are swollen, with white sclera mixed with redness; the voice is hoarse; lips are swollen and everted; the nose is dry, alae nasi flare, and there is panting; restlessness and thirst occur; lower back pain and abdominal distension manifest; consciousness is clouded; bleeding occurs from the mouth and nose; there is chaotic agitation and screaming; bleeding occurs from both urine and feces. This is due to toxic fire being constrained within, named Bi Syndrome (Closure Syndrome). It is the most difficult to treat. It is appropriate to use Xuan Du Fa Biao Tang (Toxin-Releasing and Exterior-Dispersing Decoction) (see Item 5), removing Shengma (Cimicifugae Rhizoma), Gancao (Licorizae Radix), and Jiegeng (Platycodonis Radix), adding Jiuchao Huangqin (Scutellariae Radix stir-fried with wine) 0.7 fen, and Jiumi Chao Mahuang (Ephedrae Herba stir-fried with wine and honey) 0.5 fen. Alternatively, add Xuanshen (Scrophulariae Radix) and Shandougen (Sophorae Tonkinensis Radix) to treat it. If the measles can be pushed out to the exterior and gradually emerge, survival may be hoped for. If they remain closed and do not erupt, there is no hope.
Zhu stated: When measles present with Bi Syndrome (Closure Syndrome), it is extremely dangerous. During this terrifying time for the patient's family, it relies entirely on the physician having courage and insight, so as not to mishandle the case.