麻证须当避风寒。不避风寒肤燥干。腠理闭密毒难出。后生危证有千般。
风寒本自外来。麻证终始最宜速避。如或不谨。失于避忌。一受风寒。则令肌肤干燥。腠理闭
密。遂至麻毒不得发越。而难出矣。初潮之时。若能避忌。麻则易出。毒则易解。自无后患。正出之
际。不知避忌。麻为风寒所触。出必复收。致毒积于内而不得解。变证生焉。已收之后。切宜避
忌。若不避忌。留毒难尽。变证无穷。轻者证延日久。咳嗽与痰疾终身不愈。重者必变危证而难救
也。是以麻收之后。必待二七之后。热退身凉。无痰不咳。饮食如常。精神复旧。方可不避。慎之
慎之。
麻属火候多烦渴。病者时喜食凉物。初热未出也须禁。纵之恣食毛孔密。
麻用寒凉本所宜。也须审时而察机。大寒遽用麻难出。伏毒内攻咎在医。
麻本火候。自发热至出透之日。未免有口渴烦躁。故多喜食冷物。盖麻证属火。食冷虽曰无
妨。然生冷等物。麻证始终当忌。何则。夫麻最要透表。只宜温暖饮食。以候其透表。若于初潮未
出之际。而食生冷。冰伏火邪。则毛孔闭密。而毒火难出矣。即透表之后。亦忌食生冷。但柿饼、秋
白梨、连藕、荸荠可以略用。桃、李、梅子、柑橘、石榴、菱角等物。又在所必忌。然非但患麻者。生
冷等物忌食。即医家治麻。寒凉之药。亦不可骤用。夫麻初发热之时。而最忌寒凉之品者。盖恐
冰伏麻毒。使毒瓦斯郁遏而不得出。而成内攻之患也。古人谓天气暄热。宜用辛凉之味。如黄连解
毒汤之类。不知天时之暄热热气。岂寒凉之药所能解也。今若骤用寒凉。恐不足以解外热。而适
足以阻内热。使之不得出也。曾见有一岁孩子出麻。发热未见点时。而发惊搐。医家认作急惊。用
寒凉之药攻治。致麻毒隐隐在皮肤之内。不得出表。后一医以滋阴为主。用四物等剂。亦不获效。
烦闷声哑。数日而死。此可以知骤用寒冷、冰伏麻毒之为害也。今因天时暄热。而执泥岁气之说。
骤用寒凉。岂理也哉。故治麻者。凡于麻初出之时。虽有身热、烦渴等证。宜以宣毒发表汤（见第
五条）去甘草、桔梗、升麻。少加酒炒黄芩三、五分以清之。切不可遽投黄连、黄柏、栀仁等味。恐
冰麻毒而内伏。致麻不得外出。后虽设法宣表。而麻终不得出矣。可不畏哉。
朱曰 前条避风寒与本条忌生冷。皆病家所最易患者。中途变证。往往因此。故此二
条。医生对于病家。务必再三叮咛。
麻疹病程中必须避免风寒侵袭。如果不避风寒，皮肤会变得干燥粗糙。腠理（汗孔及皮下组织间隙）闭塞致密，麻毒难以透发出来。由此引发的危重证候有千种之多。
风寒之邪本自外感而来。麻疹从开始到结束，最适宜迅速避开风寒。如果不够谨慎，疏忽了避忌，一旦受到风寒侵袭，就会导致肌肤干燥、腠理闭塞致密，致使麻毒无法发散透达，因而难以出疹。在麻疹初起发热阶段，如果能够注意避忌，麻疹就容易发出，毒邪就容易解除，自然没有后患。在麻疹正欲透发之际，如果不知道避忌，麻疹被风寒所触动，疹点一出即回缩，导致毒邪积聚于体内而无法解除，从而产生变证。在麻疹收没之后，务必严格避忌。如果不避忌，残留的毒邪难以排尽，变证无穷无尽。轻者病程拖延日久，咳嗽和痰疾终身不愈；重者必然转变为危重证候而难以救治。因此，麻疹收没之后，必须等到十四天以后，热退身凉，无痰不咳，饮食正常，精神恢复常态，才可以不再刻意避忌。千万慎重，千万慎重。
麻疹属火，病势如火，患者常感烦渴。病人时常喜欢吃凉的食物。但在初热未出疹时也必须禁止食用。如果放纵恣意食用生冷食物，会导致毛孔闭塞致密。
治疗麻疹使用寒凉药物本是适宜的。但也必须审察时机并观察病机。如果在初期骤然使用大寒之药，会导致麻疹难以透出。毒邪内攻的过错在于医生。
麻疹本性属火。从发热到完全透发之日，难免出现口渴、烦躁等症状，所以患者大多喜欢吃冷物。大概因为麻疹证候属火，吃冷物虽然看似无妨，然而生冷等食物，在麻疹病程始终都应当禁忌。为什么呢？因为麻疹最重要的是透发于表，只宜用温暖饮食，以等待其透发。如果在初潮发热尚未出疹之际，就食用生冷食物，如同冰伏火邪，导致毛孔闭塞致密，毒火就难以透出了。即使透发之后，也忌讳食用生冷食物。只有柿饼、秋白梨、莲藕、荸荠可以稍微食用。桃、李、梅子、柑橘、石榴、菱角等食物，则是绝对禁忌的。然而不仅患麻疹的人要禁忌生冷等食物，就是医生治疗麻疹，寒凉性质的药物，也不可骤然使用。在麻疹初发热的时候，最忌讳寒凉性质的药物，大概是担心冰伏麻毒，使毒气郁结遏止而不能透出，从而造成毒邪内攻的祸患。古人说天气炎热，适宜使用辛凉口味的药物，如黄连解毒汤之类的方剂。却不知道天气的炎热之气，岂是寒凉药物所能化解的？现在如果骤然使用寒凉药物，恐怕不足以解除体表的热邪，反而恰好阻碍了体内的热邪，使其不能透出。曾见过一个一岁的孩子出麻疹，发热但未见疹点时，发生惊厥抽搐。医生误认为是急惊风，使用寒凉药物攻治，导致麻毒隐隐潜伏在皮肤之内，不能透出体表。后来另一位医生以滋阴为主，使用四物汤等方剂，也没有获得疗效。患儿最终因烦闷声哑，数日后死亡。这可以知道骤然使用寒冷药物、冰伏麻毒的危害了。如今因为天气炎热，就拘泥于岁气的说法，骤然使用寒凉药物，这难道合乎道理吗？所以治疗麻疹的人，凡是麻疹初出之时，虽然有身热、烦渴等症状，适宜使用宣毒发表汤（见第五条），去掉甘草、桔梗、升麻，少加酒炒黄芩三至五分来清解热邪。切不可立即投用黄连、黄柏、栀子仁等药物，恐怕冰伏麻毒而使其内伏，导致麻疹不能向外透发。后来即使设法宣散透表，但麻疹终究无法透出了。能不畏惧吗？
朱氏说：前一条讲避风寒和本条讲忌生冷，都是病患家属最容易犯的错误。中途出现的变证，往往因此引起。所以这两条，医生对于病患家属，务必再三叮咛告诫。
During the course of measles, one must avoid exposure to wind and cold. Failure to do so results in dry and rough skin. The couli (pores and interstitial spaces) become closed and dense, making it difficult for the measles toxin to erupt. Consequently, thousands of critical syndromes may arise.
Wind and cold pathogens originate from external invasion. Throughout the entire course of measles, from onset to resolution, it is most appropriate to promptly avoid wind and cold. If one is not careful and neglects these precautions, once exposed to wind and cold, it will cause the skin and muscles to become dry and the couli to close tightly. This prevents the measles toxin from dispersing and erupting, making it difficult for the rash to appear. During the initial fever stage, if precautions are taken, the measles will erupt easily, and the toxin will resolve, leaving no aftereffects. However, during the critical phase of eruption, if precautions are neglected, the measles may be triggered by wind and cold, causing the rash to retract after appearing. This leads to the accumulation of toxins internally without resolution, resulting in complicated syndromes. After the measles have subsided, strict avoidance is essential. Neglecting this leaves residual toxins that are difficult to eliminate, leading to endless complications. Mild cases may result in prolonged illness with lifelong cough and phlegm disorders; severe cases inevitably progress to critical conditions that are difficult to save. Therefore, after the measles have subsided, one must wait until fourteen days later, when the fever has receded, the body is cool, there is no phlegm or cough, appetite is normal, and spirit has recovered, before relaxation of precautions is permissible. Exercise utmost caution.
Measles belongs to fire; the pathological heat causes irritability and thirst. Patients often desire cold foods. However, consumption must be prohibited during the initial fever stage before eruption. Indulging in raw and cold foods causes the pores to close tightly.
While the use of cold-natured herbs is suitable for treating measles, one must carefully assess the timing and pathogenesis. Sudden use of major cold herbs in the early stage hinders the eruption of measles. The fault for internal attack by toxins lies with the physician.
Measles inherently involves fire pathology. From the onset of fever until full eruption, symptoms such as thirst and irritability are inevitable, leading patients to prefer cold foods. Although measles pathology is fire-related, suggesting cold food might seem harmless, raw and cold foods should be contraindicated throughout the entire course of measles. Why? Because the primary goal in measles treatment is to promote eruption through the exterior. Warm dietary intake is appropriate to facilitate this process. If raw and cold foods are consumed during the initial fever stage before eruption, they act like ice subduing fire, closing the pores and preventing the toxic heat from erupting. Even after eruption, raw and cold foods remain contraindicated. Only dried persimmon, autumn white pear, lotus root, and water chestnut may be used sparingly. Peaches, plums, plums (ume), citrus fruits, pomegranates, and water caltrops are strictly forbidden. Moreover, it is not only the patient who must avoid raw and cold foods; physicians must also refrain from suddenly using cold-natured drugs. In the initial febrile stage of measles, cold-natured substances are most contraindicated because they risk freezing the measles toxin, causing qi and toxins to stagnate and fail to erupt, leading to internal attack. Ancients stated that in hot weather, pungent-cool flavors should be used, such as Huanglian Jiedu Tang (Coptis Decoction for Resolving Toxicity). However, they failed to realize that atmospheric heat cannot be resolved merely by cold medicines. Today, sudden use of cold medicines may fail to resolve external heat and instead obstruct internal heat, preventing its release. I once treated a one-year-old child with measles who developed convulsions during fever but before the appearance of spots. The physician misdiagnosed this as acute convulsion syndrome and administered cold-natured drugs to purge heat. This caused the measles toxin to remain hidden within the skin, unable to reach the exterior. A subsequent physician attempted to treat with yin-nourishing formulas, such as Siwu Tang (Four Substance Decoction), without success. The child died several days later due to irritability and hoarseness. This illustrates the harm of suddenly using cold substances to freeze the measles toxin. Today, some rigidly adhere to seasonal theories and suddenly use cold medicines due to hot weather; this is illogical. Therefore, when treating measles at the initial eruption stage, even if symptoms such as fever and irritability/thirst are present, Xian Du Fa Biao Tang (Toxin-Releasing Exterior-Dispersing Decoction) should be used, removing Gancao (Licorice Root), Jiegeng (Platycodon Root), and Shengma (Cimicifuga Rhizome), and adding a small amount (3-5 fen) of wine-fried Huangqin (Scutellaria Root) to clear heat. One must absolutely avoid immediately administering Huanglian (Coptis Rhizome), Huangbai (Phellodendron Bark), or Zhiren (Gardenia Seed), lest they freeze the toxin internally and prevent outward eruption. Later attempts to disperse the exterior would fail, and the measles would never erupt. How can one not fear this?
Zhu stated: The previous section on avoiding wind and cold and this section on avoiding raw and cold foods are errors most easily committed by patients' families. Complicated syndromes arising midway are often caused by these mistakes. Therefore, regarding these two sections, physicians must repeatedly admonish the patients' families.