天津吴××，年三十二岁，于仲秋病疟久不愈。
病因 厂中作工，歇人不歇机器，轮流恒有夜勤。暑热之时，彻夜不眠，辛苦有火，多食凉物，入秋遂发疟疾。
证候 其疟初发时，寒热皆剧，服西药金鸡纳霜治愈。旬日疟复发如前，又服金鸡纳霜治愈。
七八日疟又发，寒轻热重，服金鸡纳霜不愈，服中药治疟汤剂亦不愈，迁延旬余，始求为
延医。自言疟作时发热固重，即不发疟之日身亦觉热，其脉左右皆弦而无力，数逾五至，知
其阴分阳分俱虚，而阴分之虚尤甚也。此当培养其气血而以治疟之药辅之。
处方 玄参（一两） 知母（六钱） 天冬（六钱） 潞参（三钱）
何首乌（三钱） 炙鳖甲（三钱） 常山（钱半酒炒） 柴胡（钱半） 茵
陈（钱半） 生姜（三钱） 大枣（三个掰开）
此方于发疟之前一夕煎服，翌晨煎渣再服，又于发疟之前四点钟，送服西药盐酸规尼涅（即金鸡纳霜，
以盐酸制者）半瓦。
效果 将药如法服之，一剂疟即不发。而有时身犹觉热，脉象犹数，知其阴分犹虚也。俾用
玄参、生怀山药各一两，生姜三片，大枣三枚，同煎服，以服至身不发热时停服。
天津张××，年十九岁，学生，于孟秋病疟，愈而屡次反复。
病因 其人性笃于学，当溽暑放假之时，仍自补习功课，劳心过度，又复受热过度，兼又多食
瓜果以解其热，入秋遂发疟疾。
证候 自孟秋中旬病疟，服西药金鸡纳霜治愈，后旬日反复，又服金鸡纳霜治愈，后又反复，
服金鸡纳霜无效。以中药治愈，隔旬余病又反复。服中西药皆无效，因来社求治于愚。
其脉洪滑而实，右部尤甚，自觉心中杜塞满闷，常觉有热上攻，其病疟时则寒热平均，皆不甚剧，其大便四日未行。
诊断 此胃间积有热痰，又兼脾作胀也。方书谓久疟在肋下结有硬块名疟母，其块不消疟即不
愈。而西人实验所结之块确系脾脏胀大，此证之自觉满闷，即脾脏胀大也。又方书谓无痰
不作疟，是以治疟之方多用半夏、常山以理其痰，此证之自觉满闷且杜塞，又时有热上攻，
实为热痰充塞于胃脘也。治之者宜消其脾之胀大，清其胃之热痰，兼以治疟之品辅之。
且更可因其大便不通，驱逐脾之病下行自大便泻出，其病疟之根柢可除矣。
处方 川大黄（四钱） 生鸡内金（三钱黄色的捣） 清半夏（三钱） 常山（钱半酒炒）
柴胡（钱半） 茵陈（钱半） 甘草（钱半） 净芒硝（钱半）
药共八味，将前七味煎汤一盅，冲芒硝服之。
其疟每日一发，在下午七点钟。宜于午前早将药服下，至午后两三点钟时，再服金鸡纳霜半瓦。
效果 前午十点钟将药服下，至午后一点时下大便两次，其心中已不觉闷热杜塞，迟至
两点将西药服下，其日疟遂不发，俾再用生怀山药一两，熟莱菔子二钱，生鸡内金钱半煎汤，日
服一剂，连服数日以善其后。
Wu XX from Tianjin, aged 32, suffered from malaria in mid-autumn that persisted for a long time without healing.
Etiology: He worked in a factory where the "machines never stop even if people rest," involving regular night shifts. During the hot summer weather, he stayed awake all night; the hardship and fatigue generated internal heat, and he consumed many cooling foods. Upon entering autumn, he developed malaria.
Symptoms: Initially, his chills and fever were severe. He was cured by taking the Western medicine Cinchonae Cortex (Quinine). Ten days later, the malaria relapsed with similar symptoms, and he was cured again by taking Cinchonae Cortex. Seven or eight days later, it relapsed once more, but this time the chills were mild while the fever was heavy. Taking Cinchonae Cortex was ineffective, and taking Chinese herbal decoctions for malaria also failed to cure him. After lingering for more than ten days, he sought my medical attention. He stated that when the malaria attacked, the fever was indeed severe, but even on days when the malaria did not attack, his body felt hot. His pulses on both left and right sides were wiry (Xian) and forceless, beating more than five times per breath cycle. I knew that both his Yin and Yang aspects were deficient, with the deficiency of Yin being particularly severe. This condition requires nourishing Qi and Blood, assisted by herbs that treat malaria.
Prescription: Xuan Shen (Radix Scrophulariae), 1 liang; Zhi Mu (Rhizoma Anemarrhenae), 6 qian; Tian Dong (Radix Asparagi), 6 qian; Lu Shen (Radix Codonopsis), 3 qian; He Shou Wu (Radix Polygoni Multiflori Preparata), 3 qian; Zhi Bie Jia (Carapax et Plastrum Testudinis Preparatum), 3 qian; Chang Shan (Radix Dichroae), 1.5 qian, stir-fried with wine; Chai Hu (Radix Bupleuri), 1.5 qian; Yin Chen (Herba Artemisiae Scopariae), 1.5 qian; Sheng Jiang (Rhizoma Zingiberis Recens), 3 qian; Da Zao (Fructus Jujubae), 3 pieces, split open.
This prescription was decocted and taken the evening before the expected onset of malaria. The dregs were decocted again and taken the next morning. Additionally, half a grain of the Western medicine Quinine Hydrochloride (i.e., Cinchonae Cortex prepared with hydrochloric acid) was administered four hours before the expected onset of malaria.
Effect: Following this method of administration, one dose prevented the malaria from attacking. However, at times his body still felt hot, and the pulse remained rapid, indicating that the Yin aspect was still deficient. Therefore, he was instructed to use Xuan Shen and Sheng Huai Shan Yao (Rhizoma Dioscoreae) each 1 liang, along with 3 slices of Sheng Jiang and 3 pieces of Da Zao, decocted together and taken until the body no longer felt hot.
Zhang XX from Tianjin, aged 19, a student, contracted malaria in early autumn, which healed but relapsed repeatedly.
Etiology: He was dedicated to his studies. During the holidays in the humid heat, he continued to tutor himself, overworking his mind. Coupled with excessive exposure to heat and consuming many melons and fruits to cool down, he developed malaria upon entering autumn.
Symptoms: From mid-early autumn, he had malaria. He was cured by taking the Western medicine Cinchonae Cortex. After ten days, it relapsed, and he was cured again by taking Cinchonae Cortex. It relapsed again, and this time Cinchonae Cortex was ineffective. A Chinese herbal formula cured him, but after more than ten days, the illness relapsed again. Both Chinese and Western medicines became ineffective, so he came to my clinic seeking treatment. His pulse was surging (Hong), slippery (Hua), and excess (Shi), especially prominent on the right side. He felt stuffiness and fullness in his heart region, often sensing heat rushing upward. When suffering from malaria, the chills and fever were balanced and not very severe. His bowels had not moved for four days.
Diagnosis: There is accumulated phlegm-heat in the stomach, accompanied by splenic distension. Medical texts state that chronic malaria may form hard masses under the ribs called "Malaria Mother" (Nuomu); if these masses do not dissipate, the malaria will not heal. Western experiments confirm that such formed masses are indeed enlarged spleens. The patient's subjective feeling of fullness corresponds to splenic enlargement. Furthermore, texts state "no phlegm, no malaria," hence formulas for treating malaria often use Ban Xia (Rhizoma Pinelliae) and Chang Shan (Radix Dichroae) to resolve phlegm. In this case, the subjective feelings of fullness, blockage, and upward-rushing heat indicate that phlegm-heat is obstructing the epigastrium. Treatment should focus on reducing splenic enlargement, clearing gastric phlegm-heat, and assisting with anti-malarial agents. Moreover, leveraging the constipation, we can guide the pathogenic factors of the spleen downward to be expelled via the bowels, thereby eliminating the root cause of the malaria.
Prescription: Chuan Da Huang (Radix et Rhizoma Rhei), 4 qian; Sheng Ji Nei Jin (Endothelium Corneum Gigeriae Galli), 3 qian (yellow ones, crushed); Qing Ban Xia (Rhizoma Pinelliae Preparatum), 3 qian; Chang Shan (Radix Dichroae), 1.5 qian, stir-fried with wine; Chai Hu (Radix Bupleuri), 1.5 qian; Yin Chen (Herba Artemisiae Scopariae), 1.5 qian; Gan Cao (Radix Glycyrrhizae), 1.5 qian; Jing Mang Xiao (Natrii Sulfas), 1.5 qian.
The eight ingredients: Decoct the first seven ingredients to obtain one cup of liquid, then dissolve the Mang Xiao in it for administration.
His malaria occurred once daily at 7 PM. It is advisable to take the medicine early in the morning before noon. At 2 or 3 PM, administer half a grain of Cinchonae Cortex.
Effect: The medicine was taken at 10 AM. By 1 PM, he had two bowel movements, and the stuffy, hot sensation in his chest disappeared. At 2 PM, he took the Western medicine, and the malaria for that day did not occur. Subsequently, he was instructed to take a decoction of Sheng Huai Shan Yao (Rhizoma Dioscoreae) 1 liang, Shu Lai Fu Zi (Semen Raphani Preparatum) 2 qian, and Sheng Ji Nei Jin (Endothelium Corneum Gigeriae Galli) 1.5 qian, taken as one dose daily for several days to consolidate the recovery.