先寒后热身无汗，此为寒疟不须评，先热后寒身有汗，此为风疟须详明，
寒宜麻黄羌活剂，风惟桂枝羌活从。
[注]
此疟疾初起，发散之法也，
先寒后热者，因先伤于寒后伤于风，寒多热少身无汗者，谓之寒疟，
以麻黄羌活汤主之，
先热后寒者，因先伤于风，后伤于寒，热多寒少，身有汗者，谓之风疟，
以桂枝羌活汤主之。
(麻黄羌活汤) 麻黄 羌活 防风 甘草生 引用生姜水煎服。
(方歌)
麻黄羌活汤医疟，身体无汗寒热璔，麻黄羌活防风草，引姜煎服体安宁。
(桂枝羌活汤) 羌活 防风 桂枝 甘草生 引用生姜水煎服。
(方歌)
桂枝羌活汤，治疟岂寻常，羌活生甘草，防风桂枝良。
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疟疾门
食疟寒热腹胀膨，面黄恶食闷不通，轻者须用柴平剂，便□加味大柴攻。
[注]
食疟者，因食而病疟者也，由小儿饮食无节，复受风暑之气，
以致寒热交作，胸腹胀满，痞闷不通，面黄恶食也，
但食有轻重，须当别之，
轻者宜柴平汤主 ，重者宜大柴胡汤加槟榔草果主之，
治者果能因证调理，则积滞清，而疟惭退矣。
(柴平汤) 陈皮 半夏姜制 苍术米泔水浸炒 厚朴姜炒 黄芩
柴胡 甘草 人参 引用姜枣水煎服。
(方歌)
柴平汤治伤食疟，陈半苍术同厚朴，黄芩柴胡草人参，姜枣作引为良药。
(大柴胡汤) 方见伤寒。
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疟疾门
Chills precede fever with no sweating on the body; this is Cold Malaria (Han Nue), which needs no further discussion. Fever precedes chills with sweating on the body; this is Wind Malaria (Feng Nue), which must be distinguished in detail.
For Cold Malaria, the Mahuang Qianghuo Formula (Ephedra and Notopterygium Decoction) is appropriate; for Wind Malaria, only the Guizhi Qianghuo Formula (Cinnamon Twig and Notopterygium Decoction) should be followed.
[Note]
This refers to the dispersing method used at the initial stage of malaria.
When chills precede fever, it is due to first being injured by cold and then by wind. When cold is predominant over heat and there is no sweating, it is called Cold Malaria (Han Nue).
It is treated primarily with Mahuang Qianghuo Tang (Ephedra and Notopterygium Decoction).
When fever precedes chills, it is due to first being injured by wind and then by cold. When heat is predominant over cold and there is sweating, it is called Wind Malaria (Feng Nue).
It is treated primarily with Guizhi Qianghuo Tang (Cinnamon Twig and Notopterygium Decoction).
(Mahuang Qianghuo Tang / Ephedra and Notopterygium Decoction) Ingredients: Ephedrae Herba (Mahuang, 麻黄), Notopterygii Rhizoma et Radix (Qianghuo, 羌活), Saposhnikoviae Radix (Fangfeng, 防风), Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) raw. Usage: Add fresh ginger as a guide, decoct in water and take orally.
(Verse)
Mahuang Qianghuo Tang treats malaria, where the body has no sweat and chills and fever alternate.
Ephedra, Notopterygium, Saposhnikovia, and Licorice,
Decocted with ginger to bring peace to the body.
(Guizhi Qianghuo Tang / Cinnamon Twig and Notopterygium Decoction) Ingredients: Notopterygii Rhizoma et Radix (Qianghuo, 羌活), Saposhnikoviae Radix (Fangfeng, 防风), Cinnamomi Ramulus (Guizhi, 桂枝), Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) raw. Usage: Add fresh ginger as a guide, decoct in water and take orally.
(Verse)
Guizhi Qianghuo Tang, treating malaria is not an ordinary matter.
Notopterygium and raw Licorice, Saposhnikovia and Cinnamon Twig are excellent.
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Section on Malaria Diseases
Food-induced malaria presents with alternating chills and fever, abdominal distension and bloating, sallow complexion, aversion to food, and chest/epigastric stuffiness and obstruction. For mild cases, Chai Ping Tang (Bupleurum and Pinellia Decoction) is required; for severe cases, modified Da Chai Hu Tang (Major Bupleurum Decoction) is used to purge the accumulation.
[Note]
Food-induced malaria (Shi Nue) is malaria caused by dietary indiscretion. It arises because children have irregular eating habits and are subsequently exposed to wind and summer-heat pathogens,
leading to alternating chills and fever, fullness and distension in the chest and abdomen, stifling sensation and obstruction, sallow complexion, and aversion to food.
However, the severity of food accumulation varies and must be differentiated.
For mild cases, Chai Ping Tang (Bupleurum and Pinellia Decoction) is appropriate; for severe cases, Da Chai Hu Tang (Major Bupleurum Decoction) added with Arecae Semen (Binglang, 槟榔) and Tsaoko Fructus (Caoguo, 草果) is appropriate.
If the practitioner can regulate treatment according to the syndrome, the accumulation will be cleared, and the malaria will gradually recede.
(Chai Ping Tang / Bupleurum and Pinellia Decoction) Ingredients: Citri Reticulatae Pericarpium (Chenpi, 陈皮), Pinelliae Rhizoma (Banxia) prepared with ginger, Atractylodis Rhizoma (Cangzhu, 苍术) soaked in rice wash water and stir-fried, Magnoliae Officinalis Cortex (Houpo, 厚朴) stir-fried with ginger, Scutellariae Radix (Huangqin, 黄芩), Bupleuri Radix (Chaihu, 柴胡), Glycyrrhizae Radix et Rhizoma (Gancao, 甘草), Panacis Ginseng Radix (Renshen, 人参). Usage: Add fresh ginger and Ziziphi Jujubae Fructus (Dazao, 大枣) as guides, decoct in water and take orally.
(Verse)
Chai Ping Tang treats food-injury malaria, Chenpi, Banxia, Cangzhu together with Houpo,
Scutellaria, Bupleurum, Licorice, and Ginseng,
Using ginger and jujube as guides makes it a good medicine.
(Da Chai Hu Tang / Major Bupleurum Decoction) See the section on Cold Damage (Shanghan).
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Section on Malaria Diseases