Unfavorable measles pattern

Any manifestation of unfavorable turns in the development of measles that result from right vacuity and evil repletion in measles, e.g., signs such as inhibited eruption of papules, immediate disappearance of papules after eruption, or a dull purple coloration of the macules, signs such as vigorous heat [effusion], acute cough, rapid breathing with phlegm rale, flared nostrils and raised chest, green-blue or purple lips, and surging racing pulse. Such signs as a whole indicate heat toxin attacking the lung. Blackish purplish macules forming patches, and a dry crimson tongue with prickles indicate toxin penetrating provisioning-blood. Clouded spirit and tetanic reversal with convulsions indicate evil toxin falling inward to the pericardium. A somber-white complexion with dull pale macules lacking a red flush with clouding spleen, limb reversal, white glossy tongue fur, and a faint sunken pulse indicate vacuity of original qì preventing the outthrust of evil. Also falling within the scope of unfavorable measles patterns are: a) the early disappearance of macules; b) the sudden disappearance of macules as they are erupting; c) failure of macules to disappear within the usual period with continuing vigorous heat [effusion]; d) the appearance of vigorous heat [effusion], cough, and diarrhea after the papules have disappeared.

Medicinal therapy: A general formula is Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction (麻杏甘石汤 má xìng gān shí tāng) plus fritillaria (Fritillariae Bulbus, 贝母 bèi mǔ), trichosanthes seed (Trichosanthis Semen, 栝楼子 guā lóu zǐ), bamboo sap (Bambusae Succus, 竹沥 zhú lì), scutellaria (Scutellariae Radix, 黄芩 huáng qín), and lycium root bark (Lycii Cortex, 地骨皮 dì gǔ pí). For evil penetrating provisioning-blood, use Rhinoceros Horn and Rehmannia Decoction (犀角地黄汤 xī jiǎo dì huáng tāng) plus arnebia/lithospermum (Arnebiae/Lithospermi Radix, 紫草 zǐ cǎo) and isatis leaf (Isatidis Folium, 大青叶 dà qīng yè). For evil entering the pericardium, use Peaceful Palace Bovine Bezoar Pill (安宫牛黄丸 ān gōng niú huáng wán) or Purple Snow (紫雪 zǐ xuě). For original qì vacuity, use Center-Supplementing Qì-Boosting Decoction (补中益气汤 bǔ zhōng yì qì tāng).