论曰瘅疟之状，内经所谓但热不寒，阴气先绝，阳气独发，少气烦冤，手足热而欲呕是
也。得之邪热留于身中，厥逆上冲，中气实而不外泄，因用力腠理开，风寒舍于皮肤之内，
分肉之间而发。发则阳气盛，不及于阴，故但热不寒，气内藏于心，外舍于分肉之间，令人
销铄肌肉，名之曰瘅疟，以单阳无阴故也。
治瘅疟发作有时，但热不寒，头痛不安，通身俱黑，大肠秘结，小便黄赤。茵陈蒿汤方
茵陈蒿 山栀子（去皮） 柴胡（去苗） 黄芩（去黑心） 桔梗（炒） 牡丹皮 贝
母（去心） 荆芥穗（去梗） 升麻 杏仁（汤浸去皮尖双仁炒） 半夏（汤洗七遍去滑切
焙） 羌活（去芦头） 独活（去芦头） 麻黄（去根节煎去沫焙各半两） 细辛（去苗叶
一分）
上一十五味。粗捣筛，每服三钱匕，水一盏，生姜二片，煎一沸急泻出，临发热头痛时
，去滓热服，仍须食后，但此疟止发热并初发时先壮热者，可服。
治瘅疟上焦热，身重目黄。茵陈枳壳汤方
茵陈蒿（取叶） 枳壳（去瓤麸炒各一两） 桔梗（锉炒三分） 大黄（锉微炒） 甘
草（炙令黄各半两）
上五味。粗捣筛，每服三钱匕，水一盏，煎至六分，去滓温服，不计时候。
治瘅疟阴气孤绝，阳气独发，脉微其候少气烦满，手足热欲呕，但热而不寒，邪气内藏
于心，外舍于分肉之间，令人销铄肌肉。白虎加桂汤方
石膏（碎一两六钱） 知母（六钱） 甘草（炙二钱） 粳米（半合）
上四味除粳米外， 咀拌匀，以水一升，煮药五钱匕，以米烂为度，去滓加桂末三钱匕
，煎取四合，作一服，复令汗，先寒发热汗出者愈。
治瘅疟但热不寒，呕逆不下食。香豉饮方
豉（半合） 葱白（七茎切） 常山（三分） 升麻（一两） 鳖甲（醋炙令黄去裙 ）
知母（焙） 生地黄（各
上八味。锉如麻豆，每以十钱匕，以水三盏，于星月下浸一夜，横刀一口，安在药上，
早晨煎取一盏半，去滓空腹分为二服，重者不过两剂瘥。
治瘅疟积热痰盛，寒少热多，但热不寒，烦躁引饮。大青饮方
大青（一两茎叶紫者是不紫即是远志不可用也如无真者以青黛代之） 大黄（醋炒） 赤
芍药
上六味。粗捣筛，每服五钱匕，用水一盏半，煎至八分，去滓温服，气盛热多，宜服得
利，或热稍退即止，人素有冷疾，年四十以上者，虽有热证，不宜多服。
治瘅疟发热不止。常山散方
常山（锉一两） 升麻（三分） 鳖甲（去裙 锉生用） 山栀子（去皮各半两）
上四味。捣罗为散，每服三钱匕，未发前，用温水调下，取吐即瘥。
治瘅疟。豉心饮方
豉心（一合） 雄鼠粪（末炒二两匕） 童子小便（三升五合） 甘草（炙半两） 鳖
甲（醋炙去裙 ） 柴胡（去苗各一两一分） 山栀子（去皮三分） 乌梅（七枚去核） 桃
心（一握） 柳心（一握） 生地黄汁（二合） 生姜（一分）
上一十二味。除鼠粪地黄汁小便外，余并细锉，入小便中浸一宿，明日煎取八合，去滓
下鼠粪并地黄汁，分为三服，空心一服，食后再服。
治瘅疟热甚不瘥。栀子汤方
栀子仁（一两） 常山（锉三分） 车前叶（炙干半两） 粳米（四十九粒）
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，以吐利为度，利若不止，以冷饭止之。
治瘅疟。石膏汤方
石膏（碎二两） 白秫米（五十粒） 常山（锉三分）
上三味。粗捣筛，每服五钱匕，以水一盏半，入淡竹叶七片细锉，煎至一盏去滓，空腹
温饮一服，欲发时一服，正发时一服，三服讫，净室中卧，勿与人语，过发时后，即得洗手
面及饮食，七日内禁房室及酒面，久疟不过再剂，一方加乌梅肉二七枚。
治瘅疟。麻黄丸方
麻黄（去根节一两） 常山（锉） 知母（锉焙干） 甘草（炙） 大黄（生锉各半两）
上五味。捣罗为细末，炼蜜和丸，如梧桐子大，每服五丸，温水下。未发前服，日二服，
不瘥稍增之。
治瘅疟壮热不止，渴欲饮水。车前草汤方
车前草 常山（锉） 升麻 豉炒 甘草（生各半两） 白粳米（半合）
上六味。粗捣筛，每五钱匕，以水二盏浸药，于星月下露一宿，横一小刀于药上，入五
更煎取一盏，去滓分温二服，空腹及未发前，各一服，良久即吐，吐定，食少浆粥。
治瘅疟但热不寒，烦渴不止。常山饮方
常山（锉炒半两） 甘草（锉炒一分） 乌梅（七枚椎碎去核焙） 青蒿（焙一分）
上四味。粗捣筛，即以小便一盏，水一盏，酒一盏，煎至一盏去滓，当发日空心服。
Discussion states: The presentation of Dan Malaria (Cao Malaria, characterized by intense heat) is as described in the *Neijing* (Classic of Internal Medicine): fever without chills. This occurs because Yin Qi (Yin energy/fluids) is exhausted first, while Yang Qi (Yang energy/heat) flares up alone. Symptoms include shortness of breath, mental restlessness and oppression, heat in the hands and feet, and a desire to vomit. This condition arises from pathogenic heat lingering within the body, with rebellious Qi rushing upward. The Middle Jiao Qi is full but cannot vent outward. Due to physical exertion causing the Cou Li (pores/skin texture) to open, Wind-Cold pathogens lodge between the skin and the muscle layers (Fen Rou), triggering the disease. Upon onset, Yang Qi becomes excessive and fails to interact with Yin, resulting in fever without chills. The pathogenic Qi stores internally in the Heart and externally in the Fen Rou, causing emaciation of muscles. It is named Dan Malaria because it involves single Yang without Yin.
Treatment for Dan Malaria with regular paroxysms, fever without chills, headache and restlessness, blackening of the whole body, constipation, and yellow-red urine. Yinchen Hao Tang (Artemisiae Scopariae Decoction):
Artemisiae Scopariae Herba (Yinchen), Gardeniae Fructus (Shanzhizi, peeled), Bupleuri Radix (Chaihu, stems removed), Scutellariae Radix (Huangqin, black heart removed), Platycodonis Radix (Jiegeng, stir-fried), Moutan Cortex (Mudanpi), Fritillariae Bulbus (Beimu, heart removed), Schizonepetae Spica (Jingjiesui, stems removed), Cimicifugae Rhizoma (Shengma), Armeniacae Semen Amarum (Xingren, soaked in hot water, peeled, tips and twin kernels removed, stir-fried), Pinelliae Rhizoma Preparatum (Banxia, washed seven times in hot water to remove slipperiness, sliced and dried), Notopterygii Rhizoma et Radix (Qianghuo, rhizome head removed), Angelicae Pubescentis Radix (Duhuo, rhizome head removed), Ephedrae Herba (Mahuang, roots and joints removed, boiled to remove foam, dried, each 0.5 liang), Asari Radix et Rhizoma (Xixin, leaves and stems removed, 1 qian).
The above fifteen ingredients are coarsely crushed and sifted. Each dose consists of 3 qian bi, decocted with one sheng of water and two slices of Zingiberis Rhizoma Recens (Shengjiang). Boil once, then immediately strain. Take hot when fever and headache occur, preferably after meals. This formula is suitable only for malaria presenting solely with fever or initial severe fever.
Treatment for Dan Malaria with upper Jiao heat, heavy body, and jaundice. Yinchen Zhike Tang (Artemisiae Scopariae and Aurantii Fructus Decoction):
Artemisiae Scopariae Herba (Yinchen, leaves taken), Aurantii Fructus (Zhike, pulp removed, bran-stir-fried, each 1 liang), Platycodonis Radix (Jiegeng, cut and stir-fried, 3 qian), Rhei Radix et Rhizoma (Dahuang, cut and slightly stir-fried), Glycyrrhizae Radix et Rhizoma (Gancao, honey-roasted until yellow, 0.5 liang).
The above five ingredients are coarsely crushed and sifted. Each dose consists of 3 qian bi, decocted with one sheng of water until reduced to 0.6 sheng. Strain and take warm at any time.
Treatment for Dan Malaria with isolated exhaustion of Yin Qi and solo flare-up of Yang Qi, faint pulse, symptoms of shortness of breath, fullness and irritability, heat in hands and feet, desire to vomit, fever without chills, pathogenic Qi storing in the Heart and lodging in the Fen Rou, causing muscle emaciation. Baihu Jia Gui Tang (White Tiger Plus Cinnamon Twig Decoction):
Gypsum Fibrosum (Shigao, crushed, 1 liang 6 qian), Anemarrhenae Rhizoma (Zhimu, 6 qian), Glycyrrhizae Radix et Rhizoma (Gancao, honey-roasted, 2 qian), Oryza Sativa (Jingmi, 0.5 he).
The above four ingredients, except Jingmi, are cut and mixed well. Decoct with one sheng of water using 5 qian bi of herbs, cooking until the rice is soft. Strain, add 3 qian bi of Cinnamomi Ramulus powder (Guimò), and decoct to obtain 4 he. Take as a single dose to induce sweating. Recovery occurs if there is initial chills followed by fever and sweating.
Treatment for Dan Malaria with fever without chills, vomiting, and inability to eat. Xiangchi Yin (Fermented Soybean Drink):
Sojae Seminis Preparatum (Chi, half he), Allii Fistulosi Bulbus (Congbai, seven stalks, cut), Dichroae Radix (Changshan, 3 qian), Cimicifugae Rhizoma (Shengma, 1 liang), Testudinis Carapax et Plastrum (Biejia, vinegar-roasted until yellow, skirt removed), Anemarrhenae Rhizoma (Zhimu, dried), Rehmanniae Radix Fresha (Shengdihuang, amounts unspecified in text).
The above eight ingredients are cut like hemp seeds. Use 10 qian bi per dose, soak overnight under starlight in three sheng of water. Place a knife horizontally over the medicine. In the morning, decoct to obtain 1.5 sheng. Strain and divide into two doses on an empty stomach. Severe cases may resolve within two doses.
Treatment for Dan Malaria with accumulated heat and profuse phlegm, less chills and more fever, fever without chills, irritability, and thirst. Daqing Yin (Isatis Decoction):
Isatidis Folium et Caulis (Daqing, 1 liang; true material has purple stems and leaves; non-purple is Polygalae Radix Yuanzhi and should not be used; substitute with Indigo Naturalis Qingdai if authentic is unavailable), Rhei Radix et Rhizoma (Dahuang, vinegar-stir-fried), Paeoniae Radix Rubra (Chishaoyao).
The above six ingredients (note: text lists fewer than six explicitly, following source structure) are coarsely crushed and sifted. Each dose is 5 qian bi, decocted with 1.5 sheng of water until reduced to 0.8 sheng. Strain and take warm. If Qi is abundant and heat is high, purgation is desired; stop if heat subsides slightly. Patients with chronic cold conditions over forty years old should not take this frequently even if heat signs are present.
Treatment for persistent fever in Dan Malaria. Changshan San (Dichroa Powder):
Dichroae Radix (Changshan, cut, 1 liang), Cimicifugae Rhizoma (Shengma, 3 qian), Testudinis Carapax et Plastrum (Biejia, skirt removed, cut, raw), Gardeniae Fructus (Shanzhizi, peeled, each 0.5 liang).
The above four ingredients are pounded into a fine powder. Each dose is 3 qian bi, taken before onset with warm water. Vomiting leads to recovery.
Treatment for Dan Malaria. Shixin Yin (Fermented Bean Heart Drink):
Sojae Seminis Preparatum Hearts (Shixin, 1 he), Excrement Muscae Domesticae Masculinum (Xiongshufen, fried powder, 2 liang bi), Urine Pueri Virilis (Tongzi Xiaobian, 3 sheng 5 he), Glycyrrhizae Radix et Rhizoma (Gancao, honey-roasted, 0.5 liang), Testudinis Carapax et Plastrum (Biejia, vinegar-roasted, skirt removed), Bupleuri Radix (Chaihu, stems removed, each 1 liang 1 qian), Gardeniae Fructus (Shanzhizi, peeled, 3 qian), Mume Fructus (Wumei, seven fruits, pitted), Prunus Persica Core (Taoxin, one handful), Salix Alba Core (Liuxin, one handful), Juice of Rehmanniae Radix Fresha (Shengdihuangzhi, 2 he), Zingiberis Rhizoma Recens (Shengjiang, 1 qian).
The above twelve ingredients. Except for mouse feces and fresh rehmannia juice/urine, finely cut the rest and soak in urine overnight. Next day, decoct to obtain 8 he. Strain, add mouse feces and rehmannia juice. Divide into three doses: one on an empty stomach, one after meals.
Treatment for severe, unresolving heat in Dan Malaria. Zhizi Tang (Gardenia Decoction):
Gardeniae Semen (Zhiziren, 1 liang), Dichroae Radix (Changshan, cut, 3 qian), Plantaginis Herba (Cheqianye, roasted dry, 0.5 liang), Oryza Sativa (Jingmi, 49 grains).
The above four ingredients are coarsely crushed and sifted. Each dose is 5 qian bi, decocted with 1.5 sheng of water until reduced to 1 sheng. Strain and take warm. One dose before onset, one dose at onset. Stop when vomiting or diarrhea occurs. If diarrhea persists, stop it with cold cooked rice.
Treatment for Dan Malaria. Shigao Tang (Gypsum Decoction):
Gypsum Fibrosum (Shigao, crushed, 2 liang), Panicum miliaceum (Baishumi, 50 grains), Dichroae Radix (Changshan, cut, 3 qian).
The above three ingredients are coarsely crushed and sifted. Each dose is 5 qian bi, decocted with 1.5 sheng of water and seven cut pieces of Bambusae Folium (Danzhuye) until reduced to 1 sheng. Strain and take warm on an empty stomach. One dose when onset is imminent, one dose during onset. After three doses, rest in a clean room without speaking. Resume washing and eating only after the paroxysm passes. Avoid sexual intercourse, alcohol, and wheat products for seven days. Chronic malaria usually resolves within two doses. Another variation adds fourteen Mume Fructus meats.
Treatment for Dan Malaria. Mahuang Wan (Ephedra Pill):
Ephedrae Herba (Mahuang, roots and joints removed, 1 liang), Dichroae Radix (Changshan, cut), Anemarrhenae Rhizoma (Zhimu, cut and dried), Glycyrrhizae Radix et Rhizoma (Gancao, honey-roasted), Rhei Radix et Rhizoma (Dahuang, raw cut, each 0.5 liang).
The above five ingredients are pounded into a fine powder, mixed with refined honey to form pills the size of Sophora japonica seeds. Take five pills with warm water. Administer before onset, twice daily. Increase dosage slightly if ineffective.
Treatment for unremitting high fever and thirst in Dan Malaria. Cheqiancao Tang (Plantago Herb Decoction):
Plantaginis Herba (Cheqiancao), Dichroae Radix (Changshan, cut), Cimicifugae Rhizoma (Shengma), Sojae Seminis Preparatum (Chi, fried), Glycyrrhizae Radix et Rhizoma (Gancao, raw, each 0.5 liang), Oryza Sativa (Baijingmi, 0.5 he).
The above six ingredients are coarsely crushed and sifted. Use 5 qian bi per dose, soak in two sheng of water, expose overnight under stars with a small knife placed across the vessel. Decoct at the fifth watch (early morning) to obtain one sheng. Strain and divide into two warm doses: one on an empty stomach, one before onset. Vomiting will occur shortly after. Once vomiting settles, consume small amounts of gruel.
Treatment for Dan Malaria with fever without chills and incessant irritability/thirst. Changshan Yin (Dichroa Drink):
Dichroae Radix (Changshan, cut and fried, 0.5 liang), Glycyrrhizae Radix et Rhizoma (Gancao, cut and fried, 1 qian), Mume Fructus (Wumei, seven fruits, crushed, pitted, dried), Artemisiae Annuae Herba (Qinghao, dried, 1 qian).
The above four ingredients are coarsely crushed and sifted. Decoct with one sheng of urine, one sheng of water, and one sheng of wine until reduced to one sheng. Strain and take on an empty stomach on the day of onset.