San Qi 9g. Decocted in water and taken orally, one dose per day.

(8) Evil invading the blood compartment: Symptoms include persistent high fever, irritability, dense rashes that merge into patches, dark purple in color, and in severe cases, nosebleeds, bruising of the skin, red tongue with yellow coating, and a rapid pulse. Treatment should focus on clearing the blood and cooling the heat, detoxifying and resolving the rash; use Hua Ban Tang with modifications: Rhinoceros Horn 3g (mixed and taken orally), Rehmannia Root 12g, Gardenia Fruit 10g, Xuan Shen 15g, White Peony Root 30g, Paeonia Lactiflora 10g, Purple Grass 12g, Ban Lan Gen 30g, San Qi 9g. Decocted in water and taken orally, one dose per day.

(9) Post-masquerade diarrhea: Symptoms include measles having subsided but still lingering fever, abdominal pain with urgency and heaviness, stools mixed with red and white, poor appetite and fatigue, red tongue with yellow coating, and a slippery, rapid pulse. Treatment should focus on clearing heat, eliminating dampness, detoxifying, and stopping diarrhea; use Bai Tou Weng Tang with modifications: Bai Tou Weng 15g, Coptis Chinensis 10g, Jin Yin Hua 12g, Qin Pi 10g, Red Peony 10g, Citrus Peel 12g, Phellodendron Amurense 9g, Poria 10g, Gan Cao 6g. Decocted in water and taken orally, one dose per day.

(10) Post-masquerade fever: Symptoms include measles having subsided but persistent fever, hot flashes that do not subside, feeling of heat in the five internal organs, emaciation, excessive thirst, red tongue with little coating, and a fine, rapid pulse. Treatment should focus on nourishing yin and clearing heat; use Qing Hao Bie Jia Tang with modifications: Artemisia 15g, Turtle Shell 15g, Cortex Phellodendri 15g, Paeonia Lactiflora 10g, Morus Alba Root 15g, Xuan Shen

Part Two: Infectious Diseases

12g, Yu Zhu 10g, Mai Men Dong 10g. Decocted in water and taken orally, one dose per day.

2. For patients with various types of conditions, if there is a tendency toward yin deficiency and cold constitution, add Ma Huang, Gui Zhi, and Purple Scent; for those with poorly breaking through the rash, add Coriander and Cherry Blossom; for rashes that form large patches and have a dark purple hue, add Saffron and Salvia Miltiorrhiza; for sore throat and hoarseness, add Liu Shen Wan, Jade Butterfly, and Ba Da Hai; for vomiting, add Yu Shu Dan; for poor appetite, add Chicken Intestine and Wheat Germs; for excessive cough and phlegm, add Pinellia and Fresh Bamboo Juice; for excessive phlegm and wheezing, add White Mustard Seed and Radish Seed; for severe heat causing convulsions, add Antelope Horn and Uncaria; for excessive sweating, add Dragon Bone, Oyster Shell, and Floating Wheat; for diarrhea, add Kudzu Root, Scutellaria Root, and Coptis Chinensis; for constipation, add Rheum; for night blindness after measles, add Qiju Di Huang Wan; for itching after measles, add He Shou Wu, White Trehalose, Cicada Slough, and White Violet.

(4) Traditional Chinese Medicine Resources on Diagnosis and Treatment of This Disease

The basic principle of measles treatment is “to allow the rash to break through, clear heat, and nourish yin.” Over the past decade or so, some scholars have adopted new treatment methods, all of which have yielded good results.

Old Chinese medicine practitioner Sun Jinchen believed that measles is a type of yang toxicity, and its treatment principles are no different from those used for warm-heat diseases—however, during the early and middle stages of measles, it is essential to promote rash breakthrough. He emphasized that during the pre-rash stage, the evil resides in the defensive qi; when the rash appears, if heat and toxins are congested, clearing heat and releasing the toxin still requires promoting rash breakthrough. While using rash-promoting herbs, Sun often added blood-circulation-enhancing and meridian-clearing herbs. When measles toxins enter the yin, it is appropriate to clear the yin and unblock the meridians. Commonly used blood-circulation-enhancing and meridian-clearing herbs include Salvia Miltiorrhiza, Red Peony, Peach Kernel, Saffron, Ligusticum Chuanxiong, Loofah Vine, and Earthworm. These blood-circulation-enhancing and meridian-clearing herbs act as blood-activating and wind-dispersing agents during the pre-rash stage, as they help release toxins and promote rash breakthrough during the rash stage; and as they encourage qi and blood circulation during the recovery stage. Therefore, meridian-clearing herbs can be used throughout the entire course of measles. (Jiangsu Traditional Chinese Medicine, 1978.2)

Fan Dingguang used “Qing Jie Huo Hua Tang” to treat measles and pneumonia. Regardless of the severity of the condition, whenever the child could swallow, he would use Qing Jie Huo Hua Tang (including Scutellaria Root, Forsythia Fruit, Ban Lan Gen, Large Green Leaf, Burdock Seed, Chuanxiong, Saffron, Red Peony, Salvia Miltiorrhiza, Peach Kernel, Niu Xi, Yujin, and Ligusticum Chuanxiong) as the main formula. By combining traditional Chinese and Western medicine, 41 pediatric patients were treated without antibiotics in most cases; among them, 39 recovered, and 2 showed improvement. The average body temperature dropped to normal within 3–4 days; lung signs disappeared on average within 4 days. Based on diagnosis, the cases were categorized as follows: ① Heat-Toxin Type: Use the original formula of Qing Jie Huo Hua Tang supplemented with Ginseng and Shengma, and apply a decoction of Coriander and Tamarisk for steam therapy. ② Deficiency-Cold Type: Treatment should focus on strengthening the body’s righteous qi, opening the lungs, and restoring yang to rescue the vital energy; remove the heat-clearing herbs from the original formula and instead use Canfu Tang and Ma Xing Shi Gan Tang. (Ningxia Medical and Health, 1979.2)

Xu Zibai believed that when treating measles, one should follow the principle of “if the rash breaks through too late, it is better to promote its release; if it breaks through too early, it is better to detoxify appropriately,” thereby balancing the yin and yang of the patient’s body and preventing excess while seeking balance. For mild cases, use a modified Xuan Du Fa Xue Tang to promote rash breakthrough. For cases where the rash breaks through too late, add Ma Huang, Mud Fish String, and Tamarisk. Once the rash has broken through, use Yin Qiao San with modifications to clear heat and detoxify, while also promoting rash breakthrough. If heat toxins are severe and the patient experiences high fever and confusion, use San Huang Jie Du Tang with modifications. When the patient’s physical strength has not yet recovered, it is common to use yin-nourishing and heat-clearing herbs to regulate the body; detoxification herbs are designed for this purpose, with commonly used formulas like Dao Chi San with modifications. (Sichuan Medical, 1980.1)

Old Chinese medicine practitioner Qu Shaozhang summarized that the medications used in measles treatment fall into three categories: “three benefits” and “three drawbacks”: benefit from clearing (clearing in the early stage, clearing heat and detoxifying in the middle stage, nourishing in the later stage); promote rash breakthrough (focus heavily on the words “loosening and breaking through,” even if the rash has already broken through, still use light, clear, and dispersing herbs to avoid blocking the qi mechanism); cool the blood (clear the yin and cool the blood during the rash stage, and nourish and replenish fluids after the rash). Avoid warming herbs (herbs like Qianghuo, Fangfeng, Ma Huang, Gui Zhi, and Ligusticum Chuanxiong should be avoided); avoid bitter and cold herbs (herbs like Scutellaria Root, Coptis Chinensis, Phellodendron Amurense, Gardenia Fruit, and Gentiana are prone to damaging the spleen and causing toxic imbalances, so they should not be used indiscriminately); avoid greasy herbs (during the later stages, it is not advisable to use overly greasy products like Collagen, Goji Berries, or Rehmannia Root). (Guangzhou Clinical Data Compilation, 1980.3)

Niuxi Gan Cao Tang (Niuxi 20g, Gan Cao 10g) was used to treat measles complicated with laryngitis. This formula was prepared by adding 150ml of water, decocting until 60ml remained, and administering 4–6ml every 20–40 minutes. A total of 119 cases were treated, with 117 cases cured, accounting for 98.3%; among the 10 severe cases of laryngitis, 8 were successfully treated. The duration of hoarseness disappeared ranged from 2 to 13 days; the duration of coughing disappeared ranged from 1 to 10 days, with an average of 2.8 days; the time for respiratory distress to improve ranged from 4 to 18 hours, with an average of 5.8 hours. (Intermediate Medical Journal, 1987.9)

Some cases also employed single herbal formulas or acupuncture to treat measles. Coriander was used for 15 days; boil water and pour it into a basin, first steaming the area, then washing the feet to aid the rash to break through. Five scallions were crushed into a paste and applied to the navel for cases where the rash did not break through. (Wu Xueqiao et al., eds.: Practical Pediatrics, 1st Edition, Shaanxi Science Press, 1985: Measles Section). Acupuncture was used: in the pre-rash stage, points such as Hegu and Fulu were selected; during the rash stage, points like Chize and Neitong were added; for sore throat, draw blood from Shaoshang; for diarrhea in the thighs, apply Zusanli; for high fever, add Dazhui; for convulsions, add Renzhong and Shenmen; in the post-rash stage, if no complications arose, acupuncture was generally not necessary. (First Affiliated Hospital of Jiangsu New Medical College, ed.: Clinical Handbook of Common Diseases – Measles Section)

Since March 2005, Wang Jianming and his colleagues treated more than 500 cases of measles. Among these, 86 cases with more severe conditions were treated simultaneously with Western medicine such as α-interferon and gamma-globulin injections, while also employing methods to promote wind-dispelling, benefit the lungs, clear heat, detoxify, and promote rash breakthrough. The basic formula was: Scutellaria Root 3–12g, Niu Lao Zi, Mulberry Leaves, and Chrysanthemum Flowers each 3–15g; Platycodon Root and Fritillaria Bulb 3–12g; Roasted Loquat Leaves 3–15g; Light Bamboo Leaves 3–6g; Rehmannia Root 5–20g. During the early stage of measles, when the rash broke through, add Shengma and Kudzu to promote rash breakthrough; for nasal congestion and runny nose, and sore throat, use Xin Huang, Cucurbita Pepo, Xuan Shen, and She Gan to help clear the throat and open the airways; when the rash turned dark purple, indicating heat accumulation, add Red Peony, Paeonia Lactiflora, and Purple Grass to clear heat, cool the blood, and activate blood circulation; for cough and wheezing, add roasted Ma Huang, Sheng Shi Gao, Apricot Kernel, and Ruo Bai to clear heat and calm the airways.

Practical Internal Medicine Combining Traditional and Western Medicine For nausea and vomiting, add Zhuyu, Chenpi, and Su Jing; for diarrhea, use Poria, Coix Seed, and Talc to strengthen the spleen and eliminate dampness; for weak vital energy, poor rash breakthrough, and pale rash colors, add Dangshen and Danggui to support the vital energy and promote rash breakthrough; during the recovery phase, when the rash has broken through, but heat toxins have damaged fluids, switch to Sha Shen, Mai Dong, Yu Zhu, Mulberry Leaves, Bamboo Leaves, Rehmannia Root, Roasted Loquat Leaves, Chrysanthemum Flowers, and other herbs to nourish yin and generate fluids, clearing residual toxins. Take one dose per day, decocted in water and divided into two doses. After 3–10 days of treatment, 79 cases were clinically cured, and 7 cases showed improvement. (Chinese Journal of Integrated Medicine, 2006.6) Yang Jianmin treated 52 measles patients with obvious liver function abnormalities and elevated myocardial enzyme levels. In addition to standard Western medical treatments, he also used traditional Chinese medicine to promote surface penetration, clear heat, and detoxify, using the following herbs: Kudzu Root and Scutellaria Root each 15g, Coptis Chinensis 9g, Gan Cao 6g, Chai Hu, Ligusticum Chuanxiong, Cicada Slough, Mustard Seed, and Mint each 12g, along with 60g of Water Buffalo Horn powder. For cases where the rash was purplish-red and densely clustered, add Purple Grass 9g, Paeonia Lactiflora 12g; as the rash gradually faded and the fever decreased, and residual heat persisted, add Sha Shen, Mai Dong, and Artemisia 12g; for corneal opacity and dry eyes, add Cassia Seed 15g, and 12g each of Herb of Grass and Chrysanthemum Flowers. Take one dose per day, decocted in water. Results: After 2–4 days of treatment, 52 patients had normal body temperatures, and the measles subsided completely 5–10 days after the fever broke; liver function and myocardial enzyme levels returned to normal within 15–20 days. All patients were clinically cured and discharged. (Shanxi Traditional Chinese Medicine, 2007.8) Zhang Feng and his colleagues treated 32 cases of measles complicated with pneumonia, using 0.3–0.5ml/kg·d of Tan Re Qing Injection in combination with 5% glucose solution via intravenous drip, once daily. The average time for body temperature stabilization, the time for lung rales to disappear, and the average length of hospital stay were all shorter than those in the conventional treatment group (p<0.01). (Medical Theory and Practice, 2006.5) Zhang Guoxi also achieved ideal therapeutic effects when treating measles complicated with pneumonia using White Flower Snake Tongue Herb. (Traditional Chinese Medicine Magazine, 2007.8) Wang Xian and his colleagues treated 35 patients with measles complicated with pneumonia, using Ma Xing Shi Gan Tang with modifications as part of their routine Western medical treatment. The formula consisted of: Roasted Ma Huang 6g, Apricot Kernel 9g, Sheng Shi Gao 30g, Gan Cao 6g, Yu Xing Cao 6g, Lian Qiao 6g, Jin Yin Hua 12g. Take one dose per day, decocted in water twice and mixed together, administered in 2–5 doses orally, for a total of 7 days per course. During the prodromal stage, add Jing Jie, Mint, and Cicada Slough to promote surface penetration with a cool, refreshing effect; during the rash stage, add Burdock Seed, Scutellaria Root, and Gardenia Fruit to clear heat and detoxify; during the recovery stage, add Sha Shen, Mai Dong, and Begonia to nourish yin and clear the lungs. The treatment group saw 32 cases with marked improvement, 3 cases with effective treatment, and a total effective rate (marked improvement plus effective treatment) of 100.0%; the hospital stay ranged from 3 to 8 days, with an average of 6.3 days, including 2–5 days for rash removal, averaging 2.6 days. In the Western medical treatment group, 20 cases showed marked improvement, 15 cases were effective, and the total effective rate was 100.0%; the hospital stay ranged from 5 to 13 days, with an average of 8.2 days, including 3–8 days for rash removal, averaging 4.3 days. Neither group had any ineffective cases. The treatment group demonstrated significantly superior efficacy and faster rash removal compared to the control group, with a statistically significant difference (p<0.05). (Clinical and Experimental Medicine Journal, 2008.9) IV. Western Medical Treatment (1) General Care Patients should be isolated for treatment, ensuring good air circulation in the room and paying attention to keeping the oral cavity, nasal cavity, and skin clean. Protect the eyes and avoid strong light exposure; if eye discharge is excessive, rinse with a 3% boric acid solution. For cracked lips, apply plant oil. Provide adequate fluids and calories, and consider giving vitamin B₁, C, and other nutrients. (2) Western Medical Treatment In the early stages, use Viralol or Ban Lan Gen injection. For high fever, use physical cooling methods or administer small doses of antipyretics. For patients who are irritable, give phenobarbital orally or inject diazepam intramuscularly. For severe cough, prescribe cough syrups or cough tablets. For secondary infections, select antibiotics as appropriate. (3) Complication Treatment For patients with complications such as pneumonia, laryngitis, encephalitis, or heart failure, please refer to the relevant sections for specific treatment guidelines. Qiao Fuchu believed that for measles with poor rash breakthrough or what Traditional Chinese Medicine refers to as “white rash,” the cause lies in microcirculatory disorders, and he found remarkable therapeutic effects with 654-2, with a high efficacy and prevention of complications. (Li Yu Ying, Wu Kai Chang, Qiao Fuchu, Wu Bin)