头翁汤加味，苦寒清热，和中涤肠。
白头翁（一钱五分） 北秦皮（一钱五分） 全当归（三钱） 银花炭（四钱） 酒炒黄芩（三钱） 川黄柏
（一钱五分） 炒青陈皮（各一钱五分） 炒黑荆芥（一钱五分） 炒赤芍（二钱） 地榆炭（一钱） 春砂壳（五分）
荠菜花炭（三钱） 枳实导滞丸（四钱）
马左 夏伤于暑，以营为舍，秋冒风凉，与卫并居。凉者阴邪也，阴欲入而阳拒之，阴并于阳，则阳虚而阴
盛，阴盛则寒；暑者阳邪也，阳欲出而阴格之，阳并于
阴，则阴虚而阳盛，阳盛则热。是以先寒栗鼓颔，而后壮热头痛，根据时而作，汗出而解，日日如是，已有两旬之
久。胸闷不思饮食，舌苔腻布，脉象弦滑，弦为少阳之脉，滑为痰湿之征。邪伏少阳，痰湿阻于募原，无疑义
矣。今拟清脾饮加减，和解枢机，蠲化痰湿。
软柴胡（一钱） 仙半夏（二钱） 酒黄芩（一钱） 制小朴（八分） 煨草果（八分） 细青皮（一钱）
生甘草（四分） 六神曲（三钱） 鲜佩兰（二钱） 生姜（一片）
钱左 寒热日作，已有匝月，胸脘不舒，纳少神疲，脉象弦滑无力，舌苔薄白。此正虚邪伏募原，少阳枢机
为病。今拟小柴胡汤加味，扶正达邪，和胃化痰。
潞党参（一钱五分） 软柴胡（一钱） 姜半夏（二钱） 生甘草（四分） 广皮（一钱） 炒枳壳（一钱）
煨草果（八分） 川象贝（各二钱） 炒谷麦芽（各三钱） 佩兰（一钱五分） 生姜（二片） 红枣（四枚）
陆左 间日疟先战寒而后壮热，热盛之时，烦躁胸闷谵语，自午后至夜半，得汗而解，已发七八次，纳少神
疲，脉弦滑而数，苔薄腻而黄。伏邪痰湿互阻阳明为病，营卫循序失司。拟桂枝白虎汤加味，疏解肌邪，而清阳明。
川桂枝（八分） 陈皮（一钱） 熟石膏（打，四钱） 生甘草
（一钱） 炒谷芽（四钱） 仙半夏（三钱） 川象贝（各二钱） 煨草果（八分） 肥知母（一钱五分） 佩兰
（一钱五分） 生姜（二片） 红枣（四枚） 甘露消毒丹（荷叶包煎，四钱）
二诊 服桂枝白虎汤三剂，间日寒热已减大半，发时谵语亦止，惟胸闷纳少，神疲乏力，脉弦滑不静，苔薄
腻，夜不安寐。伏邪痰湿未楚，胃不和则卧不安也。前法既效，率由旧章。
川桂枝（六分） 仙半夏（三钱） 熟石膏（打，二钱） 生甘草（四分） 陈皮（一钱） 茯神（朱砂拌，三钱）
川象贝（各二钱） 北秫米（包，三钱） 炙远志（一钱） 佩兰（一钱五分） 生姜（二片） 红枣（四枚）
姜童 间日疟已延月余，加之大腹时满，纳少便溏，舌苔薄腻，脉象沉弦。乃久疟伤脾，脾阳不运，浊湿
凝聚募原，三焦输化无权，书所谓诸湿肿满，皆属于脾，又曰浊气在上，则生 胀是也。表病传里，势非轻浅。
亟与温运太阴，以化湿浊，和解枢机，而达经邪。
熟附片（一钱） 淡干姜（五分） 生白术（一钱五分） 连皮苓（四钱） 泽泻（一钱五分） 软柴胡
（八分） 仙半夏（二钱） 生甘草（四分） 制川朴（一钱） 腹皮（二钱） 六神曲（三钱） 炒麦芽 苡仁
（各三钱）
复诊 温运太阴，和解枢机，连服三剂，腹胀满渐
见轻减，寒热又作，是陷入太阴之邪，仍欲还出阳经之佳象。胸闷纳少，腑行不实，小溲短少，脉转弦滑，痰湿
留恋中焦，脾胃运化失职。前法颇合，再进一筹。
熟附片（一钱） 炮干姜（六分） 生白术（二钱） 赤猪苓（各三钱） 泽泻（一钱五分） 软柴胡（一钱）
仙半夏（二钱） 粉葛根（一钱） 生甘草（五分） 小朴（八分） 大腹皮（二钱） 六神曲（三钱）
干荷叶（一角）
杨右 三日疟已延半载，发时寒战壮热，历十小时始衰，纳谷渐少，面色萎黄，脉象沉弦无力，苔薄腻。
此正气已虚，邪伏三阴，营卫循序失司，缠绵之症。姑拟扶正达邪，用阳和阴。
炒潞党（一钱五分） 柴胡（八分） 生甘草（六分） 仙半夏（二钱） 川桂枝（六分） 熟附片（一钱）
炙鳖甲（四钱） 青蒿梗（一钱五分） 鹿角霜（三钱） 茯苓（三钱） 陈皮（一钱） 焦谷芽（四钱）
生姜（二片） 红枣（四枚）
二诊 前方服六剂，寒热即止，接服六君子汤，加草果、姜、枣。
俞左 伏邪久蕴，消耗阴液，临晚身热，至夜半而减，已延数月，咳呛咯痰不爽，纳少形肉消瘦，苔薄黄，
脉弦滑而数。少阴之阴已伤，阳明之邪不解。书云∶但热不寒，名曰瘅疟，久不愈，即为痨疟也。
潞党参（一钱五分） 生甘草（六分） 青蒿梗（一钱五分） 炙鳖甲（三钱） 川贝母（三钱） 熟石膏
（打，三钱） 仙半夏（一钱五分） 银柴胡（一钱） 冬瓜子（三钱） 朱茯神（三钱） 嫩白薇（一钱五分）
大荸荠（五枚） 焦谷芽（四钱）
屠右 但寒不热，名曰牡疟，间日而作，已有月余，汗多淋漓，纳谷减少，脉沉细而弦，舌中剥边薄白而腻。
是阳虚失于外护，不能托邪外出，痰湿困于中宫，脾胃运化失职，高年患此，勿轻视之。亟拟助阳达邪，和中化湿。
潞党参（三钱） 熟附块（二钱） 川桂枝（一钱） 软柴胡（一钱） 陈广皮（一钱） 姜半夏（三钱）
云茯苓（三钱） 鹿角霜（三钱） 煨草果（八分） 清炙草（五分） 生姜（二片） 红枣（四枚）
二诊 寒减，胸闷气逆，去参，加旋复花（包，一钱五分） 炙白苏子（二钱）。
三诊 牡疟寒热已减，汗多淋漓，纳少胸闷，脉沉细而弦，舌中剥边薄腻。阳虚气弱，不能托邪外出，痰
湿逗留募原，皮毛开而经隧闭也。仍宜助阳达邪，和中化湿。
潞党参（三钱） 熟附片（二钱） 川桂枝（一钱） 白芍（一钱五分） 清炙草（五分） 软柴胡（八分）
仙半夏（三钱） 煨草果（一钱） 常山（一钱） 鹿角霜（三钱） 生姜（二片） 红枣（四
枚）
杨左 伏邪痰湿，逗留募原，营卫失其常度，邪与营争则热，与卫争则寒，寒热日作，胸闷泛恶，舌苔薄
腻，脉象弦滑。此邪在少阳，湿在阳明，少阳为半表半里之经，寒热往来，职是故也。今宜和解宣化，淡渗湿
热，俾得邪从外达，湿从下趋，则营卫调和，寒热自解矣。
前柴胡（各一钱五分） 茯苓皮（四钱） 块滑石（三钱） 仙半夏（二钱） 象贝母（三钱） 通草（八分）
酒炒黄芩（一钱五分） 白蔻壳（八分） 鲜藿香（一钱五分） 生姜（二片）
Baitouweng Decoction with modifications, possessing the functions of bitter-cold clearing heat, harmonizing the middle jiao, and purging intestinal damp-heat.
Baitouweng (1.5 qian) Beiqinpi (1.5 qian) Quandonggui (3 qian) Yinhua Tan (4 qian) Jiuchaohuangqin (3 qian) Chuanhuangbo (1.5 qian) Chaoqingchenpi (each 1.5 qian) Chaoheijingjie (1.5 qian) Chaochishao (2 qian) Diyu Tan (1 qian) Chunshaqiao (0.5 qian) Qicaihua Tan (3 qian) Zhishi Daozhi Wan (4 qian)
Patient Ma Zuo: In summer, he was injured by summer-heat, which took the Ying level as its dwelling place; in autumn, he was exposed to wind and coolness, and the pathogen resided together with the Wei level. Coolness is a Yin pathogen; when Yin desires to enter but Yang rejects it, Yin merges with Yang, leading to Yang deficiency and Yin excess, resulting in cold sensations. Summer-heat is a Yang pathogen; when Yang desires to exit but Yin blocks it, Yang merges with Yin, leading to Yin deficiency and Yang excess, resulting in heat sensations. Therefore, there are initial chills with teeth chattering, followed by high fever and headache. The episodes occur at fixed times, resolving with sweating, day after day, for twenty days. There is chest tightness, loss of appetite, greasy coating covering the tongue, and a wiry-slippery pulse. A wiry pulse indicates Shaoyang disease (pathogen between the exterior and interior), and a slippery pulse indicates phlegm-dampness. It is undoubtedly that the pathogen is latent in the Shaoyang meridian, and phlegm-dampness obstructs the Mu Yuan (membrane source). Now, Qingpi Yin (Clear the Spleen Decoction) with modifications is prescribed to harmonize the pivot mechanism and dispel phlegm-dampness.
Ruan Chaihu (1 qian) Xian Banxia (2 qian) Jiu Huangqin (1 qian) Zhi Xiaopo (0.8 fen) Wei Caoguo (0.8 fen) Xi Qingpi (1 qian) Sheng Gancao (0.4 fen) Liushenqu (3 qian) Xian Peilan (2 qian) Shengjiang (1 slice)
Patient Qian Zuo: Alternating chills and fever occur daily for over a month. There is discomfort in the chest and epigastrium, poor intake, mental fatigue, a wiry-slippery-but-weak pulse, and a thin-white coating. This indicates righteous Qi deficiency with pathogen latent in the Mu Yuan, and dysfunction of the Shaoyang pivot mechanism. Now, Xiaochaihu Tang (Minor Chest Bi Decoction) with modifications is prescribed to support the righteous Qi, expel the pathogen, harmonize the Stomach, and resolve phlegm.
Ludangshen (1.5 qian) Ruan Chaihu (1 qian) Jiang Banxia (2 qian) Sheng Gancao (0.4 fen) Guangpi (1 qian) Chao Zhike (1 qian) Wei Caoguo (0.8 fen) Chuanxiangbei (each 2 qian) Chao Guyamaiya (each 3 qian) Peilan (1.5 qian) Shengjiang (2 slices) Hongzao (4 pieces)
Patient Lu Zuo: Every-other-day malaria presents with initial chills followed by high fever. During high fever, there is irritability, chest tightness, and delirium. Symptoms resolve with sweating from afternoon until midnight. It has occurred seven or eight times. Intake is poor, spirit is fatigued, pulse is wiry-slippery-rapid, and coating is thin-greasy-yellow. Latent pathogen and phlegm-dampness mutually obstruct the Yangming meridian, causing disorder in the sequential circulation of Ying and Wei. Guizhi Baitu Tang (Cinnamon Twig and White Tiger Decoction) with modifications is prescribed to release muscle-layer pathogens and clear Yangming heat.
Chuan Guizhi (0.8 fen) Chenpi (1 qian) Shu Shigao (crushed, 4 qian) Sheng Gancao (1 qian) Chao Guya (4 qian) Xian Banxia (3 qian) Chuanxiangbei (each 2 qian) Wei Caoguo (0.8 fen) Fei Zhimu (1.5 qian) Peilan (1.5 qian) Shengjiang (2 slices) Hongzao (4 pieces) Ganlu Xiaodu Dan (wrapped in lotus leaf, decocted, 4 qian)
Second visit: After taking three doses of Guizhi Baitu Tang, every-other-day chills and fever have reduced significantly, and delirium during attacks has ceased. However, there remains chest tightness, poor intake, mental fatigue, restless wiry-slippery pulse, thin-greasy coating, and insomnia at night. Latent pathogen and phlegm-dampness are not yet cleared. "When the Stomach is disharmonious, sleep is uneasy." Since the previous method was effective, continue with the same approach.
Chuan Guizhi (0.6 fen) Xian Banxia (3 qian) Shu Shigao (crushed, 2 qian) Sheng Gancao (0.4 fen) Chenpi (1 qian) Fushen (mixed with Cinnabar, 3 qian) Chuanxiangbei (each 2 qian) Beishumi (wrapped, 3 qian) Zhi Yuanzhi (1 qian) Peilan (1.5 qian) Shengjiang (2 slices) Hongzao (4 pieces)
Patient Jiang Tong: Every-other-day malaria has persisted for over a month, accompanied by frequent abdominal distension, poor intake, loose stools, thin-greasy coating, and deep-wiry pulse. This is long-term malaria injuring the Spleen, with Spleen Yang failing to transform, turbid dampness condensing in the Mu Yuan, and the Sanjiao losing its transport and transformation authority. As stated in texts: "All dampness, swelling, and fullness belong to the Spleen," and "Turbid Qi remaining above causes distension." Exterior disease transmitting to the Interior is not mild. Urgently warm and transport the Taiyin, to transform damp-turbidity, harmonize the pivot mechanism, and expel meridional pathogens.
Shu Fupian (1 qian) Dan Ganjiang (0.5 fen) Sheng Baizhu (1.5 qian) Lianpiling (4 qian) Zexie (1.5 qian) Ruan Chaihu (0.8 fen) Xian Banxia (2 qian) Sheng Gancao (0.4 fen) Zhi Chuanpo (1 qian) Fupi (2 qian) Liushenqu (3 qian) Chao Maiya Yiiren (each 3 qian)
Follow-up visit: Warming and transporting Taiyin, harmonizing the pivot mechanism, taken for three consecutive doses. Abdominal distension has gradually lightened, but chills and fever have recurred. This is a favorable sign where pathogens trapped in Taiyin seek to return to the Yang meridians. Chest tightness, poor intake, loose stools, scanty urine, and wiry-slippery pulse indicate phlegm-dampness lingering in the Middle Jiao and failure of Spleen-Stomach transport. The previous method is quite suitable; advance further.
Shu Fupian (1 qian) Pao Ganjiang (0.6 fen) Sheng Baizhu (2 qian) Chi Zhu Ling (each 3 qian) Zexie (1.5 qian) Ruan Chaihu (1 qian) Xian Banxia (2 qian) Fen Gegen (1 qian) Sheng Gancao (0.5 fen) Xiaopo (0.8 fen) Dafupi (2 qian) Liushenqu (3 qian) Gan Heye (one corner)
Patient Yang You: Three-day malaria has persisted for half a year. Attacks involve chills and high fever lasting ten hours before subsiding. Intake gradually decreases, complexion is sallow, pulse is deep-wiry-weak, and coating is thin-greasy. Righteous Qi is already deficient, pathogens are latent in the Three Yin meridians, and Ying-Wei circulation is disordered, making this a lingering condition. Tentatively prescribe supporting righteous Qi and expelling pathogens, using Yang to harmonize Yin.
Chao Ludang (1.5 qian) Chaihu (0.8 fen) Sheng Gancao (0.6 fen) Xian Banxia (2 qian) Chuan Guizhi (0.6 fen) Shu Fupian (1 qian) Zhi Biejia (4 qian) Qinghao Geng (1.5 qian) Lujiaoshuang (3 qian) Fuling (3 qian) Chenpi (1 qian) Jiao Guya (4 qian) Shengjiang (2 slices) Hongzao (4 pieces)
Second visit: After six doses of the previous prescription, chills and fever stopped. Subsequently take Liujunzi Tang (Six Gentlemen Decoction) with Caoguo, Shengjiang, and Hongzao added.
Patient Yu Zuo: Latent pathogen accumulated for a long time, consuming Yin fluids. Evening fever subsides by midnight, persisting for months. Coughing with difficult expectoration, poor intake, emaciation, thin-yellow coating, and wiry-slippery-rapid pulse. Shaoyin Yin is injured, Yangming pathogen unresolved. Texts state: "Fever without chills is called Dan Malaria; if prolonged, it becomes Lao Malaria."
Ludangshen (1.5 qian) Sheng Gancao (0.6 fen) Qinghao Geng (1.5 qian) Zhi Biejia (3 qian) Chuan Beimu (3 qian) Shu Shigao (crushed, 3 qian) Xian Banxia (1.5 qian) Yin Chaihu (1 qian) Dongguazi (3 qian) Zhu Fushen (3 qian) Nen Baiwei (1.5 qian) Da Biqi (5 pieces) Jiao Guya (4 qian)
Patient Tu You: Chills without fever is called Mu Malaria, occurring every other day for over a month. Profuse sweating, decreased intake, deep-thin-wiry pulse, peeled center of tongue with thin-white-greasy edges. Yang deficiency fails to protect externally and cannot push pathogens out. Phlegm-dampness traps the Middle Palace, impairing Spleen-Stomach transport. Elderly patients with this should not be underestimated. Urgently prescribe assisting Yang to expel pathogens, harmonizing the middle and transforming dampness.
Ludangshen (3 qian) Shu Fu Kuai (2 qian) Chuan Guizhi (1 qian) Ruan Chaihu (1 qian) Chen Guangpi (1 qian) Jiang Banxia (3 qian) Yun Fuling (3 qian) Lujiaoshuang (3 qian) Wei Caoguo (0.8 fen) Qing Zhi Cao (0.5 fen) Shengjiang (2 slices) Hongzao (4 pieces)
Second visit: Chills reduced, but chest tightness and rebellious Qi appeared. Remove Dangshen, add Xuanfuhua (wrapped, 1.5 qian) and Zhi Baizisu (2 qian).
Third visit: Mu Malaria chills and fever reduced, but profuse sweating, poor intake, and chest tightness remain. Pulse is deep-thin-wiry, tongue center peeled with thin-greasy edges. Yang deficiency and Qi weakness fail to expel pathogens. Phlegm-dampness lingers in Mu Yuan, pores open while meridians close. Continue assisting Yang to expel pathogens, harmonizing the middle and transforming dampness.
Ludangshen (3 qian) Shu Fupian (2 qian) Chuan Guizhi (1 qian) Baishao (1.5 qian) Qing Zhi Cao (0.5 fen) Ruan Chaihu (0.8 fen) Xian Banxia (3 qian) Wei Caoguo (1 qian) Changshan (1 qian) Lujiaoshuang (3 qian) Shengjiang (2 slices) Hongzao (4 pieces)
Patient Yang Zuo: Latent pathogen and phlegm-dampness linger in Mu Yuan, disrupting Ying-Wei rhythms. Pathogen contending with Ying causes heat; contending with Wei causes chills. Daily alternating chills and fever, chest tightness, nausea, thin-greasy coating, wiry-slippery pulse. Pathogen is in Shaoyang, dampness in Yangming. Shaoyang is the half-exterior half-interior meridian, responsible for alternating chills and fever. Now, harmonize and diffuse, lightly leach damp-heat, so pathogens exit outward and dampness drains downward, harmonizing Ying-Wei and resolving chills and fever.
Qian Chaihu (each 1.5 qian) Fuling Pi (4 qian) Kuai Huashi (3 qian) Xian Banxia (2 qian) Xiang Beimu (3 qian) Tongcao (0.8 fen) Jiuchaohuangqin (1.5 qian) Baokou Qiao (0.8 fen) Xian Huoxiang (1.5 qian) Shengjiang (2 slices)