仲景云。太阳病发热而渴。不恶寒者。为温病。若发汗已。身灼热者。名风温。风温为病。脉阴阳俱浮。自汗出。
身重多眠。睡、鼻息必鼾。语言难出。若被下者。小便不利。直视。失溲。若被火者。微发黄色。
剧、则如惊痫。时 。又云。阳脉浮滑。阴脉濡弱。更遇于风。变成风温。大抵温气大行。更
感风邪。则有是证。今当春夏。病此者多。医作伤寒漏风治之。非也。不可火。不可下。不可大
发汗。而仲景无药方。古法或谓当取手少阴火。足厥阴木。随经所在而取之。如麻黄薏苡仁汤、
葳蕤汤之辈。予以谓败毒。独活。续命。减麻黄去附子。益佳。
仲景云。若脉阴阳俱盛。重感于寒者。变成温疟。故朱肱初虞世以小柴胡白虎之类加桂以治
之。此则仲景所谓温疟。疟之一证也。今庸医见前人有此治法。不问是何疟证。但见发寒发热。
一概治之。疏矣。大抵疟证多端。有暑疟、有食疟、瘅疟、脾寒。而千金又有五脏所受不同。六
腑之中止有胃疟一证。种类最多。安得一概而论。瘅疟者但热不寒。当用白虎。食疟者中有伏积。
当下而去之。至于中暑、脾寒。此二证。若水火相反。素问曰。夏伤于暑。秋为 疟。又曰。夏
暑。汗不出者。秋成风疟。盖暑伏于中。得秋气乃发。故先热后寒。热多寒少。头昏痛。虚则发
战。汗出。一时乃止。盖心恶暑。心不受邪。而包络受之。包络众涎所聚。暑伏于涎。心、岂若
脾寒。浓朴草果所能祛也。岂若温疟。柴胡黄芩所能除也。非砒沙脑麝之属不能入。故暑疟脾寒。
患者多。而医不识病。妄投以药。邪未退。真气先受病。所以连绵不瘥也。予曾精意深究疟病一
科。须是辨脉察证。穷究得病之渊源。故十治十中。无有失者。众人以疟为难治。予独以为易。
要在辨其种类。识其先后。素问疟论。甚有妙处。当思而得之。
Zhang Zhongjing stated: When Taiyang disease (a syndrome caused by pathogenic invasion of the Taiyang channel) presents with fever and thirst, without aversion to cold, it is termed Warm Disease. If after inducing sweating, the body remains scorching hot, it is named Wind-Warmth. In Wind-Warmth illness, the pulse is floating at all three positions (cun, guan, chi); there is spontaneous sweating; the body feels heavy; there is excessive drowsiness; snoring is inevitable during sleep; and speech is difficult. If mistakenly treated with purgation, it leads to difficulty in urination, fixed staring of the eyes, and involuntary loss of urine and feces. If mistakenly treated with fire therapy (such as moxibustion or heat application), mild cases result in a slight yellowish complexion, while severe cases resemble convulsions seen in epilepsy. It is also stated: If the yang pulse (cun position) is floating and slippery, and the yin pulse (chi position) is soggy and weak, and wind pathogen is additionally contracted, it transforms into Wind-Warmth. Generally, when warm qi prevails and wind pathogen is contracted, these symptoms appear. Currently, during spring and summer, many suffer from this. Physicians mistakenly treat it as Cold Damage with leaking wind, which is incorrect. Fire therapy, purgation, and strong diaphoresis are contraindicated. Zhang Zhongjing did not provide a prescription. Ancient methods suggest selecting acupoints from the Hand-Shaoyin Heart meridian and Foot-Jueyin Liver meridian, treating according to the meridian's pathway. Examples include Mahuang Yiyiren Ren Decoction (Ephedra and Coix Seed Decoction) and Weihui Tang. I believe that Baidu San (Poison-Resolving Powder), Duhuo Tang, and Xuming Tang, with Mahuang removed and Fuzi omitted, yield better results.
Zhang Zhongjing stated: If the pulse is vigorous at all three positions and cold pathogen is contracted again, it transforms into Warm Malaria. Therefore, Zhu Gong and Chu Yushi treated it using modifications of Xiao Chai Hu Tang (Minor Bupleurum Decoction) or Bai Hu Tang (White Tiger Decoction) with added Guizhi (Cinnamon Twig). This refers to the Warm Malaria mentioned by Zhang Zhongjing, which is a type of Malaria. Modern mediocre physicians, seeing such treatments in ancient texts, fail to distinguish the specific type of malaria. They indiscriminately apply this treatment whenever chills and fever are present, which is overly simplistic. Generally, malaria manifests in various forms, including Summerheat-Malaria, Food-Stagnation Malaria, Dan-Malaria (Intense Heat Malaria), and Spleen-Cold. The *Qianjin Fang* further categorizes them by the five zang organs affected, noting that among the six fu organs, only Stomach-Malaria exists. The varieties are numerous; how can they be generalized? Dan-Malaria is characterized by fever without chills and should be treated with Bai Hu Tang. Food-Stagnation Malaria involves latent accumulation and requires purgation to remove the stagnation. Regarding Summerheat and Spleen-Cold, these two conditions are contrary like water and fire. The *Su Wen* states: Summerheat contracted in summer develops into malaria in autumn. It also says: Summerheat where sweat does not escape leads to Wind-Malaria in autumn. This is because summerheat lies latent within, manifesting upon the arrival of autumn qi. Thus, fever precedes chills, with more heat than cold, accompanied by dizziness and headache. When deficiency occurs, trembling and sweating ensue, resolving after a period. The Heart dislikes summerheat; the Heart itself does not accept pathogenic invasion, but the Pericardium (Pericardium Meridian) does. The Pericardium is the gathering place for phlegm-fluids; summerheat lies latent in the phlegm. How could the Heart be treated like Spleen-Cold, which can be dispelled by Houpo (Magnolia Bark) and Caoguo (Black Cardamom)? How could it be cleared like Warm Malaria, which responds to Chaihu (Bupleurum Root) and Huangqin (Scutellaria Root)? Only substances like arsenic, camphor, and musk can penetrate the pathology. Consequently, patients with Summerheat-Malaria and Spleen-Cold are common, yet physicians fail to recognize the disease and administer drugs blindly. The pathogen remains, while the healthy qi is damaged first, leading to chronic, lingering illness. I have meticulously studied the discipline of malaria. One must differentiate the pulse and observe the symptoms, thoroughly investigating the origin of the disease. Thus, my ten treatments were ten successes, with no errors. While others consider malaria difficult to treat, I find it easy, provided one distinguishes its types and recognizes the sequence of events. The *Su Wen: Chapter on Malaria* contains profound insights that deserve deep contemplation.