过期不出毒犯藏。孔闭肤干势可惶。刻限必求麻疹现。麻黄散子是仙方。
过期不出势淹延。毒闭身中难出现。急用透肌休怠玩。岂堪脏腑受熬煎。
发热六七日以后。明是麻症。却淹延不出。此腠理浓密。毛孔尽闭。皮肤干燥坚浓。毒瓦斯拂郁
于内。或又为风寒袭之。曾有吐利。乃伏而过期不出也。急用托里发散之剂。以麻黄散去升麻。加
胡荽子以发之。或用独圣散加胡荽子、牛蒡子、连翘。春冬寒月。再加蜜酒炒麻黄以发之。又有治
麻欲出不出者。以消毒散加麻黄、穿山甲以治之。似乎大猛。不若以消毒散去僵蚕、蟾酥。加胡荽、
葱白、葛根、蝉蜕。春冬寒月。更加蜜酒炒麻黄以发之。或外用胡荽酒。以苎麻蘸戛为当。若当出不出而无他症者。以
葛根疏邪汤（见三十三条）主之。如不出。急取向东狗粪。烧灰存性。水调服之。即现。若当出而参差不齐者。以黑芝
麻用冷水擂服。若当出而过期不出。反见烦躁闷乱。腹胀气喘。手足冷者。不治。倘一向未更衣者。此毒盛于里。伏而
不出。用河间凉膈散（见二十六条）去甘草。加牛蒡子主之。或从权施治。以七物升麻丸解之发之。解之不出者。死症
也。
麻黄散秘本方
麻黄（去根节。滤去黑汁尽。酒蜜拌砂。） 人中黄（瓦盛火 ） 牛蒡子（炒） 蝉蜕 （去头足） 升麻（酒炒）
水煎服。
朱曰 麻黄治耻实之药。古法去节与先煎去沫。蜜酒拌炒。皆后人之私心自用。不足为法。
独圣散又名柽叶散
西河柳（一名观音柳。一名垂丝柳。又名柽柳。小干弱枝叶细细如丝。花穗长三四寸。水红色。如蓼花之状。花遇
雨即开。）为末。以茅根煎汤、下三、四钱。白水下亦可。
消毒散
牛蒡子 地龙（即蚯蚓。晒干。研末。各二钱。） 僵蚕 贝母（去心） 防风 荆芥（各一钱）
蟾酥（二钱） 为末。淡竹叶煎汤下一钱。
七物升麻丸 凡觉四肢大热。大便艰难。或二、三日不更衣。服之取微利。不利再服。（更衣即大
便也。）
升麻 犀角 黄芩 朴硝 大黄（各二两） 淡豆豉（微炒，二升） 栀仁（二两） 为末。蜜丸。黍米大。
白汤下五、六分。
麻疹过期仍未透发，说明毒邪已侵犯脏腑。若毛孔闭塞、皮肤干燥，病情危急令人担忧。此时必须限期促使麻疹透出，麻黄散是有效的方剂。
若麻疹过期未出且病程拖延，毒邪闭阻体内难以透发。此时急需使用透肌达表的药物，不可懈怠玩忽，否则脏腑将受煎熬。
发热六七日以后，显然是麻疹病症，却拖延未能透出。这是因为腠理致密，毛孔全部闭塞，皮肤干燥坚硬，毒气郁结于内；或者又受到风寒侵袭；或者此前曾有呕吐腹泻，导致毒邪潜伏而过期不出。此时急需使用托里发散的方剂，用麻黄散去升麻，加胡荽子以发散透疹。或者使用独圣散加胡荽子、牛蒡子、连翘。在春冬寒冷月份，再加蜜酒炒制的麻黄以发散透疹。又有治疗麻疹欲出而未出的情况，用消毒散加麻黄、穿山甲来治疗，这似乎药力太猛，不如用消毒散去僵蚕、蟾酥，加胡荽、葱白、葛根、蝉蜕。在春冬寒冷月份，更加蜜酒炒制的麻黄以发散透疹。或者外用胡荽酒，用苎麻蘸取擦拭身体为宜。如果应当透出而未透出且无其他症状的，用葛根疏邪汤（见第三十三条）主治。如仍不透出，急取向东生长的狗粪，烧成灰保留药性，用水调服，即可透出。如果应当透出但出得不整齐的，用黑芝麻用冷水研磨后服用。如果应当透出而过期不出，反而出现烦躁闷乱、腹胀气喘、手足冰冷的，属于不治之症。倘若一直未解大便的，这是毒邪盛于体内，伏藏而不出，用河间凉膈散（见第二十六条）去甘草，加牛蒡子主治。或者权宜施治，用七物升麻丸来解表发散。解表发散后仍不透出的，是死症。
麻黄散秘方：
麻黄（去掉根和节，滤尽黑色汁液，用酒和蜜拌砂炒制。） 人中黄（瓦器盛装火煅） 牛蒡子（炒制） 蝉蜕（去掉头和足） 升麻（酒炒）
水煎服。
朱氏说：麻黄是治疗实证的药物。古法要求去节和先煎去沫，蜜酒拌炒都是后人的私心自用，不值得效法。
独圣散又名柽叶散
西河柳（一名观音柳，一名垂丝柳，又名柽柳，枝干弱小枝叶细细如丝，花穗长三四寸，水红色，像蓼花的形状，花遇雨即开。）研为末。用茅根煎汤，送下三、四钱。用白水送服也可以。
消毒散
牛蒡子 地龙（即蚯蚓，晒干，研为末，各二钱。） 僵蚕 贝母（去掉心） 防风 荆芥（各一钱）
蟾酥（二钱） 研为末。用淡竹叶煎汤送下一钱。
七物升麻丸 凡是感觉四肢大热，大便艰难，或者两三天不排便的，服用此药取轻微腹泻。若不腹泻再服用。（更衣即大便也。）
升麻 犀角 黄芩 朴硝 大黄（各二两） 淡豆豉（微炒，二升） 栀仁（二两） 研为末。蜜丸，大小如黍米。用白开水送下五、六分。
If the measles rash fails to erupt after the expected time, it indicates that the toxic pathogen has invaded the Zang-Fu organs. If the pores are closed and the skin is dry, the situation is alarming. It is imperative to ensure the eruption of the measles within a specified timeframe; Mahuang San (Ephedra Powder) is an efficacious formula.
If the measles fails to erupt after the expected time and the condition lingers, the toxic pathogen is blocked internally, making eruption difficult. One must urgently employ strategies to vent the pathogen through the muscle layer without delay or negligence; otherwise, the Zang-Fu organs will suffer from internal torment.
After six or seven days of fever, it is clearly a case of measles, yet the eruption is delayed. This occurs because the couli (pores and interstices) are dense, all pores are closed, and the skin is dry and hard, causing the toxic qi to stagnate internally. Alternatively, the patient may have been attacked by wind-cold pathogens, or previously suffered from vomiting and diarrhea, leading to the latent retention of the pathogen and delayed eruption. In such cases, one should urgently use formulas that support the interior and induce dispersion. Use Mahuang San (Ephedra Powder), removing Shengma (Cimicifugae Rhizoma), and add Hushizi (Coriandri Fructus) to induce dispersion. Alternatively, use Dusheng San (Single Holy Powder) with added Hushizi (Coriandri Fructus), Niubangzi (Arctii Fructus), and Lianqiao (Forsythiae Fructus). During the cold months of spring and winter, additionally add Mahuang (Ephedrae Herba) stir-fried with honey and wine to induce dispersion. For treating measles that desire to erupt but fail to do so, Xiaodu San (Detoxification Powder) with added Mahuang (Ephedrae Herba) and Chuanshanjia (Pangolin Scales) can be used. However, this approach seems too potent. A better alternative is to use Xiaodu San (Detoxification Powder), removing Jiangcan (Bombyx Batryticatus) and Chansu (Toad Venom), and adding Hushu (Coriandrum Sativum), Congbai (Allii Fistulosi Bulbus), Gegen (Puerariae Lobatae Radix), and Chantui (Cicadae Periostracum). During the cold months of spring and winter, additionally add Mahuang (Ephedrae Herba) stir-fried with honey and wine to induce dispersion. Externally, one may apply Huixu Jiu (Coriander Wine) by dipping Zhuma (Ramie Fiber) and rubbing it on the body. If the rash should erupt but does not, and there are no other symptoms, Ge Gen Shu Xie Tang (Kudzu Root Decoction for Dispersing Pathogens) (see Article 33) should be administered. If it still does not erupt, urgently obtain dog feces from a dog facing east, burn it to ash while preserving its properties, mix with water, and administer orally; the rash will then appear. If the rash should erupt but appears unevenly, consume black sesame seeds ground in cold water. If the rash should erupt but fails to do so after the expected time, accompanied by restlessness, confusion, abdominal distension, panting, and cold hands and feet, the condition is incurable. If the patient has not had a bowel movement for some time, this indicates excessive toxicity in the interior with latent retention. Hejian Liang Ge San (Liangge Powder from Liu Wansu) (see Article 26), with Gancao (Glycyrrhizae Radix et Rhizoma) removed and Niubangzi (Arctii Fructus) added, should be used. Alternatively, as a provisional treatment, Qi Wu Shengma Wan (Seven-Ingredient Cimicifuge Pills) can be used to resolve and disperse. If resolution and dispersion fail to produce eruption, it is a fatal sign.
Secret Formula for Mahuang San:
Mahuang (Ephedrae Herba) (Remove roots and joints, filter out all dark juice, stir-fry with sand mixed with wine and honey.) Renzhonghuang (Human Waste Yellow) (Fire-calcine in a tile vessel.) Niubangzi (Arctii Fructus) (Stir-fry.) Chantui (Cicadae Periostracum) (Remove head and feet.) Shengma (Cimicifugae Rhizoma) (Stir-fry with wine.)
Decoct in water and take orally.
Zhu stated: Mahuang (Ephedrae Herba) is a drug for treating excess conditions. Ancient methods required removing joints and pre-decocting to remove foam. Stir-frying with honey and wine are later innovations driven by personal preference and are not worthy of emulation.
Dusheng San, also known as Chengye San:
Xihe Liu (Tamarix Chinensis Twig), also called Guanyin Liu, Chuisi Liu, or Cheng Liu. It has small, weak stems and fine, thread-like leaves. The flower spikes are three to four inches long, water-red in color, resembling Polygonum flowers, and open upon contact with rain. Grind into powder. Decoct Mugen (Imperatae Rhizoma) in water, take three to four qian of the powder with the decoction. Taking with plain water is also acceptable.
Xiaodu San:
Niubangzi (Arctii Fructus) Dilong (Earthworm) (Dry and grind into powder, two qian each.) Jiangcan (Bombyx Batryticatus) Beimu (Fritillariae Bulbus) (Remove heart.) Fangfeng (Saposhnikoviae Radix) Jingjie (Schizonepetae Spica) (One qian each.) Chansu (Toad Venom) (Two qian.) Grind into powder. Take one qian with a decoction of Dan Zhuye (Phyllostachys Viridis Folium).
Qi Wu Shengma Wan:
Whenever one feels intense heat in the four limbs, experiences difficulty in defecation, or has not had a bowel movement for two or three days, take this pill to induce mild diarrhea. If diarrhea does not occur, take another dose. (Gengyi refers to having a bowel movement.)
Shengma (Cimicifugae Rhizoma) Xijiao (Rhinocerotis Cornu) Huangqin (Scutellariae Radix) Poxiao (Natrii Sulfas) Dahuang (Rhei Radix et Rhizoma) (Two liang each.) Danshichu (Fermented Soybean) (Lightly stir-fry, two sheng.) Zhiren (Gardeniae Fructus) (Two liang.) Grind into powder. Make pills with honey, size of Setaria italica seeds. Take five to six fen with warm water.