论曰久疟者，疟久不瘥，发汗吐下过甚，真气虚，邪气深，沉以内薄，卫气不应，故积
岁月而难治也。虽有虚痞，不可攻治，当先其发时，用汤液以发汗，盖浸渍熏蒸，邪气方出
，出则微汗小便利者，表里俱和，久疟自瘥矣。
治诸疟久不瘥，发动无节，日渐虚困羸瘦。乌梅丸方
乌梅肉（微炒一两半） 鳖甲（酒浸去裙 炙令黄色一两） 天灵盖（涂酥炙令黄色一
两） 虎头骨（酒浸炙令黄色一两） 常山（细锉一两） 柴胡（去苗一两） 肉苁蓉（去
皴皮酒浸炙干一两） 蜀漆叶（三分） 知母（锉焙干三分） 甘草（炙三分） 升麻（三
分） 大黄（锉半两） 豉（炒令黄半两） 桃仁（二十九枚汤浸去皮尖双仁生别研）
上一十四味。除桃仁外，捣罗为细末，与桃仁相和，炼蜜丸如梧桐子大，每日空腹未发
前，以枳壳桑根白皮汤，下二十丸，渐加至三十丸，如瘥后，觉冷损惫，即加生干地黄防风
黄桂各一两，豉心减半，日一服。
治疟久不瘥。鳖甲丸方
鳖甲（醋浸炙令黄色去裙 一两） 虎头骨（酒浸炙令黄色三分） 乌梅肉（炒令干三
分） 麦门冬（去心焙一两） 豉（微炒一两） 石膏（碎切三分） 常山（细锉一两） 白
薇（半两） 葳蕤（半两） 升麻（三分） 人参（一两一分） 知母（锉焙干三分） 地
骨皮（半两）
上一十三味。捣罗为末，炼蜜丸如梧桐子大，未发前米饮服二十丸，明日早晨，又服三
十丸，如人行十里，即食一碗白粥，至临发时，又服三十丸即瘥，不吐不利，瘥后三日内，
将息如常法。
治久疟不瘥，发不以时，或朝或夜，肌瘦食少。地骨皮汤方
地骨皮 升麻 犀角镑 玄参各三分 常山一两细锉
上五味。粗捣筛，每服三钱匕，以水一盏，煎至七分去滓，空腹未发前温服，欲吐须忍，
俟不能禁即吐，如此吐下即瘥。
治久疟四肢虚汗不止。黄 散方
黄 （去苗细锉一两） 牡蛎（烧研如粉一两） 麻黄根（一两） 知母（锉焙干一两）
人参（一两）
上五味。捣罗为细末，研令极细，每服三钱匕，用河水煎小麦汤，未发前调下，未瘥再
服。
治疟久不瘥，发歇无时，渐至黄黑，枯瘁成劳。松萝饮方
松萝（三分） 甘草生（半两） 常山（细锉半两） 鳖甲（去裙 醋浸炙令黄色三分）
竹叶（切半两）
上五味。粗捣筛，每服五钱匕，以水一盏半，煎至一盏，去滓空心未发前温服，以吐为
瘥。
治久疟日多，增寒壮热不止，渴饮水。车前草汤方
车前草（半两） 常山（细锉半两） 升麻（半两） 白粳米（半合） 豉炒（半两） 甘
草生（半两）
上六味。粗捣筛，每用三钱匕，以水一盏半浸药，置于星月下，横一小刀子于药上，五
更煎取七分，去滓分温二服，空腹未发前一服，相次再服，良久得吐，吐定得食浆水粥。
治久疟不瘥，将成骨蒸劳，寒热无时。柴胡饮方
柴胡（去苗半两） 常山（三分） 甘草（生半两） 附子（炮裂去皮脐半两） 干姜
（炮裂一分）
上五味。锉如麻豆，每用五钱匕，用酒一盏半，煎至一盏，去滓分二服，空心未发前
一服，食后再服。
治疟经年不瘥。栀子汤方
栀子仁（一两） 常山（细锉三分） 车前叶（炙干半两） 粳米（半合）
上四味。粗捣筛，每服五钱匕，水一盏半，煎至一盏，去滓温服，未发前一服，临发一
服，以吐利为瘥，利若不止，以冷饭止之。
治久疟。黄连酒方
黄连（去须一两锉） 常山（细锉一两）
上二味。以酒一升半浸之经宿，发前煎取一盏，分二服，临发更一服，有热当吐，有冷
当下。
治疟久难瘥。鲮鲤甲酒方
鲮鲤甲（酒浸炙令黄色半两） 常山（三分） 鳖甲（去裙 醋浸炙黄半两） 乌贼 鱼
骨（去甲三分） 乌梅肉（微炒一分） 桃仁（二十四枚汤浸去双仁皮尖） 竹叶（一握） 豉
（一合） 葱白（七茎切）
上九味。锉如麻豆大，用生绢袋盛。以酒三升浸经一宿，每日空腹，温服半盏，良久
取吐，如不吐，至巳午时，再服三两服，如不瘥，隔日更根据前服之。
治疟久不瘥。鳖甲酒方
鳖甲（去裙 醋浸炙令黄色一分） 升麻（一分） 附子（炮裂去皮脐一分） 常山（三
分） 乌贼鱼骨（去甲一分）
上五味。锉如麻豆大，用生绢袋盛，以酒三升渍之，渐令近火，一宿药成，初服半盏，
比至发时，可数服，快吐即瘥。
治疟久不瘥。常山汤方
常山（一两） 乌梅肉（一两） 甘草（三分并生用）
上三味。粗捣筛，每服二钱匕，水一盏，入生姜三片，煎至六分去滓，不计时温服。
治疟百方不瘥，宜服久疟丸方
砒霜（一分研） 乳香（半两研） 半夏（汤洗七遍焙干秤一两）
上三味。重午日合，同捣罗为末，正午时，粽子尖和丸，如皂子大，发时以醋汤下一丸
，更不再服，如非重午日合药，须两服瘥。
治久疟不瘥，恶寒壮热，百节疼痛，面色黄瘦。神功丸方
阿魏（研） 丹砂（研） 雄黄（研各一两） 腊月狐肝（焙研二两） 麝香（研一钱）
上五味同研为细末，重午日日未出时，同粽子丸如梧桐子大，病者以绯线系一丸于男左
女右中指上，未瘥桃仁汤下一丸，合药时北面，勿令鸡犬妇女见。
治一切疟疾，经年不瘥。常山饮方
常山 鳖甲（去裙 醋炙各一两） 知母（焙） 白头翁 甘草（炙锉） 柴胡（去苗
各三分） 青蒿（一握） 桃枝 柳枝（各一握） 桂（去粗皮半两）
上一十味。粗捣筛，每服四钱匕，酒一盏半，入葱白薤白各三寸切，浸一宿，煎取八分
，去滓温服，空心服，欲发时再服。
治疟久不瘥。乌梅苁蓉丸方
乌梅肉（焙） 肉苁蓉（酒浸切焙） 附子（炮裂去脐皮各二两） 常山（三两） 桃
仁（去皮尖双仁炒四两） 豉（三合） 知母（焙） 虎头骨（炙各一两半） 麝香（研一
分） 桂（去粗皮一两）
上一十味。捣罗为末，炼蜜和丸，如梧桐子大，每服三十丸，空心米饮下。
Discussion states: Ji Nu (Chronic Malaria) refers to malaria that persists and does not heal. If previous treatments involving sweating, vomiting, or purging were excessive, leading to a deficiency of Zhen Qi (True Qi), the pathogenic factor becomes deep-seated, sinking internally to invade, while Wei Qi (Defensive Qi) fails to respond appropriately. Consequently, it is difficult to cure even after years. Although symptoms such as Xu Pi (deficiency-type fullness) may appear, aggressive treatment should be avoided. Instead, decoctions should be administered prior to the onset of an attack to induce sweating. Through the soaking and steaming effects of the medication, the pathogenic factor can be expelled. Once expelled, if slight sweating and free urination occur, it indicates that both the exterior and interior are harmonized, and chronic malaria will naturally resolve.
Formula for treating various cases of persistent malaria with irregular attacks, progressive weakness, fatigue, and emaciation: Wumei Wan (Mume Pill)
Wumei Rou (Semen Pruni Mume, half-fried, 1.5 liang), Biejia (Carapax et Plastrum Testudinis, soaked in wine, skirt removed, roasted until yellow, 1 liang), Tianlinggai (Os Cranium Humanum, coated with butter, roasted until yellow, 1 liang), Hutou Gu (Os Tigridis Capitis, soaked in wine, roasted until yellow, 1 liang), Changshan (Radix Dichroae, finely cut, 1 liang), Chaihu (Radix Bupleuri, radix removed, 1 liang), Roubingrong (Caulis Morindae Officinalis, bark removed, soaked in wine, roasted dry, 1 liang), Shuqieye (Folium Euphorbiae Humifusae, 3 fen), Zhimu (Rhizoma Anemarrhenae, cut, roasted dry, 3 fen), Gancao (Radix Glycyrrhizae, roasted, 3 fen), Shengma (Rhizoma Cimicifugae, 3 fen), Dahuang (Radix et Rhizoma Rhei, cut, 0.5 liang), Chi (Folium Sojae Praeparatum, fried until yellow, 0.5 liang), Taoren (Semen Persicae, 29 kernels, soaked in water, skin and tips removed, double-kernel ones separated and ground raw).
The above fourteen ingredients. Except for Taoren, crush and sieve into fine powder, mix with Taoren, and combine with refined honey to form pills the size of Sophora japonica seeds. Take twenty pills on an empty stomach before the attack, using a decoction of Zhike (Fructus Aurantii) and Sangbaipipi (Cortex Morus Radicis) to wash them down. Gradually increase to thirty pills. If cured but feeling cold and exhausted afterwards, add Sheng Gan Dihuang (Radix Rehmanniae Recens), Fangfeng (Radix Saposhnikoviae), Huangqin (Radix Scutellariae), and Guizhi (Ramulus Cinnamomi) each one liang, reduce the heart of Chi by half, and take once daily.
Formula for treating persistent malaria: Biejia Wan (Turtle Shell Pill)
Biejia (Carapax et Plastrum Testudinis, soaked in vinegar, roasted until yellow, skirt removed, 1 liang), Hutou Gu (Os Tigridis Capitis, soaked in wine, roasted until yellow, 3 fen), Wumei Rou (Semen Pruni Mume, fried dry, 3 fen), Maimendong (Radix Ophiopogonis, heart removed, roasted, 1 liang), Chi (Folium Sojae Praeparatum, slightly fried, 1 liang), Shigao (Gypsum Fibrosum, crushed and cut, 3 fen), Changshan (Radix Dichroae, finely cut, 1 liang), Baiwei (Radix Cynanchi Atrati, 0.5 liang), Weirui (Rhizoma Polygonati Odorati, 0.5 liang), Shengma (Rhizoma Cimicifugae, 3 fen), Renshen (Radix Ginseng, 1 liang 1 fen), Zhimu (Rhizoma Anemarrhenae, cut, roasted dry, 3 fen), Digupi (Cortex Lycii Radicis, 0.5 liang).
The above thirteen ingredients. Crush and sieve into powder, combine with refined honey to form pills the size of Sophora japonica seeds. Take twenty pills with rice drink before the attack. On the next morning, take thirty pills. Walk about ten li, then eat one bowl of plain white porridge. At the time of the next attack, take another thirty pills to achieve cure. There should be no vomiting or diarrhea. For three days after cure, rest and recover according to standard methods.
Formula for treating persistent malaria with irregular timing (morning or night), muscle wasting, and poor appetite: Digupi Tang (Lycium Root Bark Decoction)
Digupi (Cortex Lycii Radicis), Shengma (Rhizoma Cimicifugae), Xijiao (Cornu Rhinocerotis, sliced), Xuanshen (Radix Scrophulariae) each 3 fen; Changshan (Radix Dichroae, finely cut, 1 liang).
The above five ingredients. Coarsely crush and sieve. Each dose consists of three qianbi (approx. 4-5 grams), boiled in one zhan (approx. 200ml) of water until reduced to seven parts. Strain and take warm on an empty stomach before the attack. Suppress the urge to vomit; when it cannot be suppressed, allow vomiting. This induction of vomiting and purging leads to cure.
Formula for treating persistent malaria with incessant deficient sweating of the four limbs: Huangqi San (Astragalus Powder)
Huangqi (Radix Astragali, tips removed, finely cut, 1 liang), Muli (Concha Ostreae, calcined and ground to powder, 1 liang), Mahuanggen (Radix Ephedrae, 1 liang), Zhimu (Rhizoma Anemarrhenae, cut, roasted dry, 1 liang), Renshen (Radix Ginseng, 1 liang).
The above five ingredients. Crush, sieve, and grind to an extremely fine powder. Each dose consists of three qianbi, mixed with a decoction of wheat cooked in river water, taken before the attack. If not cured, repeat administration.
Formula for treating persistent malaria with irregular intervals, gradual darkening of complexion, emaciation, and progression to consumption: Songluo Yin (Tree Moss Drink)
Songluo (Usnea, 3 fen), Gancao (Radix Glycyrrhizae, raw, 0.5 liang), Changshan (Radix Dichroae, finely cut, 0.5 liang), Biejia (Carapax et Plastrum Testudinis, skirt removed, soaked in vinegar, roasted until yellow, 3 fen), Zhuye (Folium Bambusae, cut, 0.5 liang).
The above five ingredients. Coarsely crush and sieve. Each dose consists of five qianbi, boiled in one and a half zhan of water until reduced to one zhan. Strain and take warm on an empty stomach before the attack. Cure is indicated by vomiting.
Formula for treating worsening persistent malaria with relentless severe chills and fever, thirst, and desire for water: Cheqiancao Tang (Plantago Herb Decoction)
Cheqiancao (Herba Plantaginis, 0.5 liang), Changshan (Radix Dichroae, finely cut, 0.5 liang), Shengma (Rhizoma Cimicifugae, 0.5 liang), Baijingmi (Semen Oryzae Glutinosa, 0.5 he), Chi (Folium Sojae Praeparatum, fried, 0.5 liang), Gancao (Radix Glycyrrhizae, raw, 0.5 liang).
The above six ingredients. Coarsely crush and sieve. Use three qianbi per dose. Soak herbs in one and a half zhan of water under the starlight, placing a small knife horizontally across the herbs. Boil at the fifth watch (around 3-5 AM) until reduced to seven parts. Strain and divide into two warm doses. Take one dose on an empty stomach before the attack, followed by the second dose shortly after. Vomiting should occur soon after; once settled, consume fermented grain water porridge.
Formula for treating persistent malaria nearing bone-steaming consumption with irregular chills and fever: Chaihu Yin (Bupleurum Drink)
Chaihu (Radix Bupleuri, tips removed, 0.5 liang), Changshan (Radix Dichroae, 3 fen), Gancao (Radix Glycyrrhizae, raw, 0.5 liang), Fuzi (Radix Aconiti Lateralis Preparata, cracked, skin and navel removed, 0.5 liang), Ganjiang (Rhizoma Zingiberis Seccati, cracked, 1 fen).
The above five ingredients. Cut to the size of hemp seeds. Use five qianbi per dose. Boil in one and a half zhan of wine until reduced to one zhan. Strain and divide into two doses. Take one dose on an empty stomach before the attack, and the second dose after eating.
Formula for treating malaria persisting for years: Zhizi Tang (Gardenia Decoction)
Zhiziren (Semen Gardeniae, 1 liang), Changshan (Radix Dichroae, finely cut, 3 fen), Cheqianyè (Folium Plantaginis, roasted dry, 0.5 liang), Jingsmi (Semen Oryzae Sativa, 0.5 he).
The above four ingredients. Coarsely crush and sieve. Each dose consists of five qianbi, boiled in one and a half zhan of water until reduced to one zhan. Strain and take warm. Take one dose before the attack and one dose at the onset. Cure is indicated by vomiting and purging. If diarrhea persists, stop it with cold cooked rice.
Formula for treating persistent malaria: Huanglian Jiu (Coptis Wine)
Huanglian (Rhizoma Coptidis, roots removed, 1 liang, cut), Changshan (Radix Dichroae, finely cut, 1 liang).
The above two ingredients. Soak in one and a half sheng of wine overnight. Boil to obtain one zhan before the attack. Divide into two doses, with an additional dose at the onset. Heat symptoms indicate vomiting; cold symptoms indicate purging.
Formula for treating stubborn persistent malaria: Linglijia Jiu (Pangolin Scale Wine)
Linglijia (Scuta Manis, soaked in wine, roasted until yellow, 0.5 liang), Changshan (Radix Dichroae, 3 fen), Biejia (Carapax et Plastrum Testudinis, skirt removed, soaked in vinegar, roasted until yellow, 0.5 liang), Wuzeiyugu (Endoconcha Sepiae, shell removed, 3 fen), Wumei Rou (Semen Pruni Mume, slightly fried, 1 fen), Taoren (Semen Persicae, 24 kernels, soaked in water, double-kernels and skins/tips removed), Zhuye (Folium Bambusae, one handful), Chi (Folium Sojae Praeparatum, one he), Congbai (Caulium Allii Fistulosi, seven stalks, cut).
The above nine ingredients. Cut to the size of hemp seeds. Place in a raw silk bag. Soak in three sheng of wine overnight. Take half a zhan warm on an empty stomach daily to induce vomiting. If no vomiting occurs, take again during the Si-Wu hours (9 AM - 1 PM), up to two or three doses. If not cured, repeat every other day according to the previous method.
Formula for treating persistent malaria: Biejia Jiu (Turtle Shell Wine)
Biejia (Carapax et Plastrum Testudinis, skirt removed, soaked in vinegar, roasted until yellow, 1 fen), Shengma (Rhizoma Cimicifugae, 1 fen), Fuzi (Radix Aconiti Lateralis Preparata, cracked, skin and navel removed, 1 fen), Changshan (Radix Dichroae, 3 fen), Wuzeiyugu (Endoconcha Sepiae, shell removed, 1 fen).
The above five ingredients. Cut to the size of hemp seeds. Place in a raw silk bag. Soak in three sheng of wine. Gently heat near fire overnight. Initial dose is half a zhan. Multiple doses can be taken until the onset of the attack. Severe vomiting indicates cure.
Formula for treating persistent malaria: Changshan Tang (Dichroa Decoction)
Changshan (Radix Dichroae, 1 liang), Wumei Rou (Semen Pruni Mume, 1 liang), Gancao (Radix Glycyrrhizae, 3 fen, all used raw).
The above three ingredients. Coarsely crush and sieve. Each dose consists of two qianbi, boiled in one zhan of water with three slices of fresh ginger until reduced to six parts. Strain and take warm at any time.
Formula for treating malaria unresponsive to hundreds of methods: Ji Nu Wan (Chronic Malaria Pill)
Pishuang (Arsenic Trioxidum, 1 fen, ground), Ruxiang (Resina Acaciae Cathartae, 0.5 liang, ground), Banxia (Rhizoma Pinelliae, washed seven times in water, roasted dry, weighed 1 liang).
The above three ingredients. Prepare on the Fifth Day of the Fifth Month (Dragon Boat Festival). Grind together into powder. At noon, mix with the tip of a zongzi (sticky rice dumpling) to form pills the size of soap beans. Take one pill with vinegar water at the onset of the attack; do not take more. If prepared on a non-festival day, two doses are required for cure.
Formula for treating persistent malaria with aversion to cold, high fever, joint pain, and sallow thin complexion: Shengong Wan (Divine Merit Pill)
awei (Resina Ferulae, ground), Dansha (Cinnabaris, ground), Xionghuang (Realgar, ground, each 1 liang), Layue Huga (Liver of Fox from the twelfth lunar month, roasted and ground, 2 liang), Shexiang (Moschus, ground, 1 qian).
The above five ingredients. Grind together into fine powder. On the Fifth Day of the Fifth Month before sunrise, mix with zongzi to form pills the size of Sophora japonica seeds. The patient ties one pill with a red thread to the middle finger of the left hand (for males) or right hand (for females). If not cured, take one pill with Taoren Tang (Peach Kernel Decoction). When preparing the medicine, face north; ensure chickens, dogs, and women do not see the process.
Formula for treating all types of malaria persisting for years: Changshan Yin (Dichroa Drink)
Changshan (Radix Dichroae), Biejia (Carapax et Plastrum Testudinis, skirt removed, vinegar-roasted, each 1 liang), Zhimu (Rhizoma Anemarrhenae, roasted), Baitouweng (Radix Pulsatillae), Gancao (Radix Glycyrrhizae, roasted and cut), Chaihu (Radix Bupleuri, tips removed, each 3 fen), Qinghao (Herba Artemisiae Annuae, one handful), Taozhi (Ramulus Persicae), Liuzhi (Ramulus Salicis, each one handful), Gui (Cortex Cinnamomi, rough bark removed, 0.5 liang).
The above ten ingredients. Coarsely crush and sieve. Each dose consists of four qianbi. Add one and a half zhan of wine, along with three cun of cut Congbai (Caulium Allii Fistulosi) and Xiebai (Caulium Allii Macrostemonis). Soak overnight. Boil to obtain eight parts. Strain and take warm on an empty stomach. Take again just before the attack.
Formula for treating persistent malaria: Wumei Rongrong Wan (Mume and Morinda Pill)
Wumei Rou (Semen Pruni Mume, roasted), Roubingrong (Caulis Morindae Officinalis, soaked in wine, cut, roasted), Fuzi (Radix Aconiti Lateralis Preparata, cracked, skin and navel removed, each 2 liang), Changshan (Radix Dichroae, 3 liang), Taoren (Semen Persicae, skin, tips, and double-kernels removed, fried, 4 liang), Chi (Folium Sojae Praeparatum, 3 he), Zhimu (Rhizoma Anemarrhenae, roasted), Hutou Gu (Os Tigridis Capitis, roasted, each 1.5 liang), Shexiang (Moschus, ground, 1 fen), Gui (Cortex Cinnamomi, rough bark removed, 1 liang).
The above ten ingredients. Crush and sieve into powder. Combine with refined honey to form pills the size of Sophora japonica seeds. Take thirty pills on an empty stomach with rice drink.