疟疾有风、暑、食、痰、老疟、疟母。六法，风暑当发汗，夏月多在风凉处歇，遂
闭其汗而不
正
二日连发住一日者，气血俱病。疟病感虚者，须以人
参、白术一二帖托住其气，不使下陷，后使他药。
内伤挟外邪同发，内必主痰，外以汗解散，二陈汤加柴胡、黄芩、常山、草果煎服。久疟
不得
老疟病，此系风暑于阴分，用血药引出阳分则散。
入方宜
川芎 抚芎 红花 当归 炒柏 白术 苍术 甘草 白芷
上锉。水煎，露一宿，次早服。
治疟一日间一日发者，补药带表，药后以截疟丹截之。若在阴分者，用药掣起阳分，方
可截，即前药之属。
充案∶疟在阴分须彻起阳分者，即《格致论》中云∶脏传出至腑，乱而失期也。又当因
其汗之多寡，而为补养升发之术。下陷，谓阳气下陷入阴血中，无汗要有汗，多用川芎、苍术、干
葛、升麻、柴胡之属。此丹溪治疟之微旨，学人所当知也。
截疟常山饮
穿山甲（炮） 草果 知母 槟榔 乌梅 甘草（炙） 常山
上 咀。水酒一大碗，煎半碗，露一宿，临
发日早服，得吐为顺。一云加半夏、
柴胡，去穿山甲。如吐，加浓朴，又或加青皮、陈皮。
又方
柴胡 草果 常山 知母 贝母 槟榔
上用酒水同煎，露一宿，临发前二时服。
又治疟母，此药消导。
青皮 桃仁 红花 神曲 麦芽 鳖甲（醋煮为君） 三棱 莪术 海粉 香附（并用醋
上为末，丸如梧子大。每服五七十丸，白汤下。
又治疟，寒热头痛如破，渴饮冰水，外多汗出。
人参 白术 黄 黄芩 黄连 山栀 川芎 苍术 半夏 天花粉
上 咀。水二钟，姜三片，煎服。
又治疟病发渴。
生地黄 麦门冬 天花粉 牛膝 知母 葛根 炒柏 生甘草
上 咀。水煎。
截疟青蒿丸
青蒿（半斤） 冬瓜叶 官桂 马鞭草
上焙干为末，水丸胡椒大。每一两分四服，于当发之前一时服尽。又云∶青蒿一两，冬
青落二两，马鞭草二两，桂二两。未知孰是，姑两存之，以俟知者。
截疟
槟榔 陈皮 白术 常山（三钱） 茯苓 乌梅 浓朴（各一钱半）
上 咀。作二服，水酒各一钟，煎至一钟，
当发前，一日一服，临发日早一服，服后少睡片时。
又疟疾后
白术 半夏（一两） 黄连（半两） 白芍（三钱） 陈皮（半两）
上为末，粥丸梧子大。每服六十丸，姜汤下。
〔附录〕世用砒霜等毒，不可轻用。俗谓脾寒，此因名而迷其实也。苟因饮食所伤而得，
亦未必全是寒，况其他乎？在其阳分者易治，阴分者难治。疟母必用毒药消之，行气消坚为
主。东垣谓寒疟属太阳，热疟属阳明，风疟属少阳；在三阴经则不分，总曰温疟，此言是
。但三阴经说不明，作于子午卯酉日者，少阴疟也；寅申巳亥日者，厥阴疟也；辰戌丑未日
者，太阴疟也。
疟脉多弦，但热则弦而带数，寒则弦而带迟，亦有病久而脉极虚微而无力，似乎不弦，
然而必于虚微之中见弦，但不搏手耳。细察可见也。
疟又名 疾者，其证不一。《素问》又有五脏疟、六腑疟，
详矣。初得病势正炽，一二发间，未宜遽截，不问寒热多少，且用清脾饮，或草果饮，或
二陈汤加草果
半钱，或平胃加草果半钱、柴胡半钱，又或养胃汤加川芎、草果各半钱。热少者进取微汗
。寒多者宜快脾汤；服后寒仍多者，养胃汤加附子、桂枝各半钱，独
寒尤宜，不效则七枣汤。热多者宜驱疟饮，或参苏饮，每服加草果半钱；大热不除，宜小
柴胡汤。渴甚者，则以五苓散入辰砂少许；独热无寒，亦与小柴胡汤；热虽剧不甚渴者，本
方加桂四分，或以柴胡桂姜汤，候可截则截之。久疟母不愈者，宜四兽饮，间服山甲汤。
附方
清脾饮
青皮 浓朴 白术 草果 柴胡 茯苓 黄芩 半夏 甘草（炙，等分）
上锉。水二盏，生姜三片，枣一枚，煎。忌生冷油腻。
七枣汤
附子（一个，炮，又以盐水浸，再炮。如此七次，去皮脐。又方∶川乌代附子，以水调陈
壁土为糊，浸七次）
上锉。分作二服，水二钟，姜七片，枣七枚，煎七分
，当发日早温服。
驱疟饮
前胡 柴胡（各四两） 桂心 桔梗 浓朴 半夏（各三两） 黄 干姜（炮） 甘草（炙，各二
上锉。水二盏，生姜三片，枣四个，煎。
山甲汤
穿山甲 木鳖子（等分）
上为末。每服二钱，空心温酒调下。
人参 白术 茯苓 甘草（减半）陈皮 草果 半夏 枣子 乌梅 生姜（等分）
上锉。同姜枣，以盐少许淹，食顷，浓皮纸裹，
以水润湿，慢火煨令香熟，焙干，每服半两，水湿，未发前并进数服。
有汗要无汗，正气为主。小柴胡加桂，或白虎加桂。无汗要有汗，散邪为主，带补。桂
枝加黄 、知母、石膏汤，或人参柴胡饮子。热多寒少、目痛多汗、脉大，以大柴胡汤，微利为
度。余邪未尽，以白芷石膏三物汤，以尽其邪。
六和汤
人参 知母 草果 贝母 乌梅 白芷 槟榔 柴胡（各一钱，用酒拌） 常山（二钱）
上锉。水煎，姜三片，枣一个。
秘方清脾丸 治疟，三日一发，或十日一发。
姜黄（三钱） 白术（一两半）人参 槟榔 草果 莪术（醋炒） 浓朴（各半两） 黄芩 半夏
青皮（各一两） 甘草（三钱）
上为末，饭丸如梧子大。每六十丸食远，白汤下，日二服。
红丸子 消食疟。
胡椒（一两） 阿魏（一钱，醋化） 莪术 三棱（醋煮一伏时，各二两） 青皮（炒，三两）
上为末，另用陈仓米末，同阿魏醋煮，糊丸梧子大，炒土朱为衣。每服七十丸，
二陈汤 见中风类。
草果饮子
草果 川芎 紫苏叶 白芷 良姜 炙甘草 青皮（去白炒） 陈皮（去白）
上等分，为粗末。每服三钱，水一盏，煎至七分，去渣温服；留渣，两服
并一服，当发日进三服，不以时。
人参养胃汤
平胃散加人参 茯苓 半夏 草果 藿香 生姜 乌梅
参苏饮
陈皮（去白） 枳壳（麸炒） 桔梗 甘草（炙） 木香（各半两） 半夏 干葛 苏叶 前胡
人参 茯苓（各七钱半，一方不用木香）
上锉。每服五钱，水盏半，生姜七片，枣一
五芩散 见中暑类。
柴胡桂姜汤
柴胡（八两） 桂枝 黄芩（各三两） 栝蒌根（四两） 牡蛎（二两） 甘草（炙，二两） 干姜（二两）
上锉。水煎，日三服，烦汗出，愈。
小柴胡汤
柴胡（八两） 黄芩 人参 甘草（炙，各三两） 半夏（三两）
上锉。每五钱，水盏半，生姜五片，枣一枚
，煎服，不拘时。
白虎加桂枝汤 治温疟。
知母（六两） 甘草（炙，二两） 石膏（四两，碎） 桂枝（一两） 粳米（六合）
上锉。水煎，日三，汗出愈。
小柴胡加桂汤
本方去人参，加桂（一两）
桂枝加黄 知母石膏汤
本方加黄 知母 石膏（各四钱半）
大柴胡汤
柴胡（八两） 黄芩 赤芍（各三两） 大黄（二两） 半夏（二两半）枳实（半两，麸炒）
上锉。每五钱，水盏半，生姜五片，枣一枚
白芷石膏三物汤
白芷（一两） 知母（一两七钱） 石膏（四两）
上为粗末。每半两，水一盏半，煎一盏，温服。
Malaria is classified into six types: Wind Malaria, Summerheat Malaria, Food Stagnation Malaria, Phlegm Malaria, Chronic Malaria (Lao Nue), and Malarial Mass (Nue Mu). Regarding the six treatment methods, those caused by wind and summerheat should be treated with diaphoresis (sweating method); in summer, if resting in cool places causes pore closure and impedes sweating, appropriate measures must be taken.
Malaria occurring every other day indicates disease affecting both Qi and Blood. For patients with malaria complicated by deficiency, Ginseng Radix et Rhizoma (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu) should be administered for one to two doses first to support the Qi and prevent its sinking, followed by other medications.
When internal injury coexists with external pathogenic factors, there is inevitably internal phlegm obstruction; the exterior should be resolved via diaphoresis. Er Chen Tang (Two-Cured Decoction) added with Bupleuri Radix (Chaihu), Scutellariae Radix (Huangqin), Dichroiae Radix (Changshan), and Tsaoko Fructus (Caoguo) may be decocted and taken.
For chronic malaria that has not healed:
Chronic Malaria (Lao Nue) results from wind and summerheat pathogens lurking in the Yin aspect. Blood-invigorating and blood-nourishing herbs should be used to draw the pathogen out to the Yang aspect so it can dissipate.
Prescription: Ligusticum Chuanxiong Rhizome (Chuanxiong/Fuxiong), Carthami Flos (Honghua), Angelicae Sinensis Radix (Danggui), Stir-fried Phellodendri Cortex (Chao Bai), Atractylodis Macrocephalae Rhizoma (Baizhu), Atractylodis Rhizoma (Cangzhu), Glycyrrhizae Radix et Rhizoma (Gancao), and Angelicae Dahuricae Radix (Baizhi).
Crush the ingredients. Decoct in water, leave exposed overnight, and take early the next morning.
To treat malaria occurring every other day, use tonifying herbs combined with exterior-resolving herbs, then use Jie Nue Dan (Malaria-Intercepting Pill) to intercept the attack. If the pathogen is in the Yin aspect, it must be lifted to the Yang aspect using medication before interception can occur; this refers to the aforementioned formulas.
Case Record (Chong An): The principle of thoroughly lifting malaria from the Yin aspect to the Yang aspect is stated in "Ge Zhi Lun": Disease transmitting from Zang organs to Fu organs causes chaos and loss of rhythmic timing. Furthermore, treatment should adjust based on the degree of sweating, employing nourishing or ascending methods. "Sinking" refers to Yang Qi sinking into Yin Blood. To induce sweating where there is none, herbs such as Chuanxiong, Cangzhu, Puerariae Radix (Gegen), Cimicifugae Rhizoma (Shengma), and Chaihu are frequently used. This represents the subtle essence of Zhu Danxi’s treatment of malaria, which students of medicine should understand.
Jie Nue Changshan Yin (Malaria-Intercepting Dichroa Decoction)
Manis Squama (Chuanshanjia, prepared), Caoguo, Anemarrhenae Rhizoma (Zhimu), Arecae Semen (Binglang), Mume Fructus (Wumei), Glycyrrhizae Radix et Rhizoma (Zhi Gancao), Dichroiae Radix (Changshan).
Crush the ingredients. Decoct in a large bowl of water and wine until half remains, leave exposed overnight, and take early on the day of onset. Vomiting is considered a favorable reaction. Another version adds Pinelliae Rhizoma (Banxia) and Chaihu, removing Chuanshanjia. If vomiting occurs, add Magnoliae Officinalis Cortex (Houpo), or additionally Qingpi and Chenpi.
Another Formula
Chaihu, Caoguo, Changshan, Zhimu, Fritillariae Cirrhosae Bulbus (Beimu), Binglang.
Decoct together with wine and water, leave exposed overnight, and take two hours before the expected onset.
Another treatment for Malarial Mass (Nue Mu), this formula promotes digestion and dispersion.
Qingpi, Persicamii Semen (Taoren), Honghua, Medicated Leaven (Shenqu), Hordeum Vulgare Sprout (Maiya), Testudinis Carapax et Plastrum (Biejia, boiled in vinegar as the sovereign herb), Sparganii Rhizoma (Sanleng), Curcumae Longae Rhizoma (Ezhu), Calx Marina (Haifen), Cyperi Rhizoma (Xiangfu, all processed with vinegar).
Grind into powder, make pills the size of soybeans. Take 50–70 pills each time, washed down with warm water.
Another treatment for malaria presenting with alternating cold and heat, severe headache as if splitting, thirst desiring ice water, and profuse sweating.
Renshen, Baizhu, Astragali Membranacei Radix (Huangqi), Huangqin, Coptidis Rhizoma (Huanglian), Gardeniae Fructus (Shanzhi), Chuanxiong, Cangzhu, Banxia, Trichosanthis Radix (Tianhuafen).
Crush the ingredients. Decoct in two cups of water with three slices of ginger.
Another treatment for thirst following malaria onset.
Rehmanniae Radix Preparata (Shengdihuang - *Note: Text says Sheng Di Huang, usually implies raw*), Ophiopogonis Radix (Maidong), Tianhuafen, Achyranthis Bidentatae Radix (Niuxi), Zhimu, Gegen, Chao Bai, Raw Gancao.
Crush and decoct in water.
Jie Nue Qinghao Wan (Malaria-Intercepting Artemisia Pill)
Artemisiae Annuae Herba (Qinghao, half jin), Benincasae Exocarpium (Donggua Ye), Cinnamomi Ramulus (Guangui), Verbena Herba (Mabiancao).
Dry by baking, grind into powder, make pills the size of peppercorns using water. Divide one liang into four doses, taking all at once one hour before onset. Another record states: Qinghao one liang, Ilex Rotunda Leaves (Dongqing Luo) two liang, Mabiancao two liang, Guizhi two liang. Uncertainty exists regarding which is correct; both are preserved here for verification by experts.
Malaria-Intercepting Formula
Binglang, Chenpi, Baizhu, Changshan (3 qian), Poria (Fuling), Wumei, Houpo (1.5 qian each).
Crush. Divide into two doses. Decoct in one cup of water and one cup of wine until one cup remains. Take once daily the day before onset, and once early on the day of onset. Sleep briefly after administration.
Post-Malaria Treatment
Baizhu, Banxia (1 liang), Huanglian (0.5 liang), Paeoniae Radix Alba (Baishao, 3 qian), Chenpi (0.5 liang).
Grind into powder, make pills the size of soybeans using congee paste. Take 60 pills each time, washed down with ginger soup.
[Appendix] Arsenic trioxide (Pishuang) and other toxic substances used by the world should not be used lightly. The folk term "Spleen Cold" confuses the name with the reality. Even if caused by dietary injury, it is not necessarily purely cold, let alone other cases. Those in the Yang aspect are easy to treat; those in the Yin aspect are difficult. Malarial Mass must be eliminated using toxic drugs, focusing on moving Qi and dissolving hardness. Li Dongyuan stated that Cold Malaria belongs to the Taiyang channel, Heat Malaria to the Yangming channel, and Wind Malaria to the Shaoyang channel; for the Three Yin channels, they are not distinguished and are collectively called Warm Malaria. This statement is correct. However, the description of the Three Yin channels is unclear. Malaria occurring on Zi, Wu, Mao, You days is Shaoyin Malaria; on Yin, Shen, Si, Hai days is Jueyin Malaria; on Chen, Xu, Chou, Wei days is Taiyin Malaria.
The pulse in malaria is mostly wiry (Xian). With heat, it is wiry and rapid (Shuo); with cold, it is wiry and slow (Chi). In long-standing disease, the pulse may be extremely deficient, minute, and weak, seemingly not wiry, but upon close inspection, a wiry quality will be seen within the deficiency, merely lacking force against the finger. It can be detected by careful examination.
Malaria, also known as Dan Malaria, presents with various symptoms. "Su Wen" further discusses Five Zang Malaria and Six Fu Malaria in detail. When the disease is newly acquired and vigorous, during the first one or two attacks, it is inappropriate to immediately intercept. Regardless of the amount of cold or heat, initially use Qing Pi Yin, or Caoguo Yin, or Er Chen Tang plus Caoguo (half qian), or Ping Wei San plus Caoguo (half qian) and Chaihu (half qian), or Yang Wei Tang plus Chuanxiong and Caoguo (half qian each). If heat predominates, aim for slight sweating. If cold predominates, use Kuai Pi Tang; if cold persists after administration, use Yang Wei Tang plus Fuzi and Guizhi (half qian each), especially suitable for isolated cold; if ineffective, use Seven Date Soup. If heat predominates, use Qu Nue Yin or Renshen Su Yin, adding Caoguo (half qian) per dose; if high heat persists, use Xiao Chai Hu Tang. For severe thirst, use Wu Ling San with a small amount of Cinnabar (Chensha). For isolated heat without cold, also give Xiao Chai Hu Tang. For intense heat but not severe thirst, add Guizhi (4 fen) to the base formula, or use Chaihu Guijiang Tang. Intercept when appropriate. For chronic malaria with unresolved mass, use Si Shou Yin, alternating with Shan Jia Tang.
Attached Formulas
Qing Pi Yin (Clear the Spleen Decoction)
Qingpi, Houpo, Baizhu, Caoguo, Chaihu, Fuling, Huangqin, Banxia, Zhi Gancao (equal parts).
Crush. Decoct in two cups of water with three slices of ginger and one date. Avoid cold, raw, and greasy foods.
Seven Date Soup (Qi Zao Tang)
Fuzi (one piece, prepared, soaked in salt water, re-prepared; repeat seven times, remove skin and umbilicus. Alternative: Use Chuanwu instead of Fuzi, soak seven times in paste made from old wall earth mixed with water).
Crush. Divide into two doses. Decoct in two cups of water, seven slices of ginger, and seven dates until reduced to 7/10 volume. Take warm early on the day of onset.
Qu Nue Yin (Expel Malaria Decoction)
Peucedani Radix (Qianhu), Chaihu (4 liang each), Guixin, Platycodonis Radix (Jiegeng), Houpo, Banxia (3 liang each), Huangqi, Ganjiang (prepared), Zhi Gancao (2 liang each).
Crush. Decoct in two cups of water with three slices of ginger and four dates.
Shan Jia Tang
Chuanshanjia, Momordicae Semen (Mubiezi) (equal parts).
Grind into powder. Take 2 qian each time, mixed with warm wine on an empty stomach.
Si Shou Yin (Four Beasts Decoction)
Renshen, Baizhu, Fuling, Gancao (halved), Chenpi, Caoguo, Banxia, Zaozi, Wumei, Shengjiang (equal parts).
Crush. Marinate with a little salt alongside ginger and dates. Wrap in thick paper, moisten with water, and slow-roast until fragrant and cooked. Dry. Take 0.5 liang each time, decocted in water, taken several times before onset.
If sweating needs to be stopped, focus on supporting Righteous Qi. Xiao Chai Hu Tang plus Guizhi, or Bai Hu Jia Guizhi Tang. If no sweating needs to be induced, focus on dispersing pathogens with tonification. Guizhi Tang plus Huangqi, Zhimu, and Shigao, or Renshen Chaihu Yinzi. For heat more than cold, eye pain, profuse sweating, and large pulse, use Da Chai Hu Tang, aiming for mild purgation. For residual pathogens, use Baizhi Shigao Sanwu Tang to exhaust them.
Liu He Tang
Renshen, Zhimu, Caoguo, Beimu, Wumei, Baizhi, Binglang, Chaihu (1 qian each, soaked in wine), Changshan (2 qian).
Crush. Decoct in water with three slices of ginger and one date.
Secret Recipe: Qing Pi Wan (Clear Spleen Pill)
For malaria occurring every three days or every ten days.
Jianghuang (3 qian), Baizhu (1.5 liang), Renshen, Binglang, Caoguo, Ezhu (stir-fried with vinegar), Houpo (0.5 liang each), Huangqin, Banxia, Qingpi (1 liang each), Gancao (3 qian).
Grind into powder, make pills the size of soybeans using rice paste. Take 60 pills after meals, washed down with white water, twice daily.
Hong Wan Zi (Red Pill)
For food-stagnation malaria.
Hu jiao (1 liang), Asari Resina (Awei, dissolved in vinegar), Ezhu, Sanleng (boiled in vinegar for one shichen, 2 liang each), Qingpi (stir-fried, 3 liang).
Grind into powder. Mix with flour from aged grain and Awei boiled in vinegar to make paste for pills the size of soybeans. Coat with roasted cinnabar. Take 70 pills each time, washed down with rice gruel.
Er Chen Tang See Stroke Category.
Caoguo Yinzi (Tsao-ko Decoction)
Caoguo, Chuanxiong, Perillae Folium (Zisuye), Baizhi, Galangal (Liangjiang), Zhi Gancao, Qingpi (scraped and stir-fried), Chenpi (scraped).
Equal parts, coarse powder. Take 3 qian each time, decoct in one cup of water until 7/10 remains. Strain and take warm. Retain dregs; combine two doses into one. On the day of onset, take three doses, regardless of time.
Renshen Yang Wei Tang
Ping Wei San plus Renshen, Fuling, Banxia, Caoguo, Huoxiang, Shengjiang, Wumei.
Renshen Su Yin
Chenpi (scraped), Zhiqiao (bran-fried), Jiegeng, Zhi Gancao, Muxiang (0.5 liang each), Banxia, Gange, Suye, Qianhu, Renshen, Fuling (0.75 liang each, one version excludes Muxiang).
Crush. Take 5 qian each time, decoct in 1.5 cups of water with seven slices of ginger and one date.
Wu Ling San See Summerheat Category.
Chaihu Guijiang Tang
Chaihu (8 liang), Guizhi, Huangqin (3 liang each), Trichosanthis Radix (Gualougen), Muli (2 liang each), Zhi Gancao, Ganjiang (2 liang each).
Crush. Decoct in water, take three times daily. Recovery follows sweating and relief of irritability.
Xiao Chai Hu Tang (Minor Bupleurum Decoction)
Chaihu (8 liang), Huangqin, Renshen, Zhi Gancao (3 liang each), Banxia (3 liang).
Crush. Take 5 qian each time, decoct in 1.5 cups of water with five slices of ginger and one date. Take at any time.
Bai Hu Jia Guizhi Tang (White Tiger Plus Cinnamon Twig Decoction)
For Warm Malaria.
Zhimu (6 liang), Zhi Gancao (2 liang), Shigao (4 liang, crushed), Guizhi (1 liang), Jingmi (6 he).
Crush. Decoct in water, take three times daily. Recovery follows sweating.
Xiao Chai Hu Jia Gui Tang
Base formula minus Renshen, plus Guizhi (1 liang).
Guizhi Jia Huangqi Zhimu Shigao Tang
Base formula plus Huangqi, Zhimu, Shigao (0.45 liang each).
Da Chai Hu Tang (Major Bupleurum Decoction)
Chaihu (8 liang), Huangqin, Chishao (3 liang each), Dahuang (2 liang), Banxia (2.5 liang), Zhishi (0.5 liang, bran-fried).
Crush. Take 5 qian each time, decoct in 1.5 cups of water with five slices of ginger and one date.
Baizhi Shigao Sanwu Tang (Angelica, Gypsum, Three-Ingredient Decoction)
Baizhi (1 liang), Zhimu (1.7 qian), Shigao (4 liang).
Coarse powder. Take 0.5 liang each time, decoct in 1.5 cups of water until one cup remains. Take warm.