Library

Etiology: This disease arises in the Lingnan region, carrying the miasma (Zhangqi) of the mountains. Its manifestations include alternating chills and fever, with paroxysms occurring at regular intervals. This is caused by the inhalation of toxic vapors from the streams and mountain ranges. This condition is more severe than malaria caused by summerheat injury. (From Volume 11)

Duanju Formula for Mountain Malaria (Lingli Jia Decoction): In southern mountain ridges and stream sources, toxicity from miasma induces this disease, causing chills and fever without fixed timing, emaciation with sallow complexion, swelling and fullness, and numbness and weakness in the four limbs. All are caused by mountain toxins; this formula governs these symptoms.
Herbs: Lingli Jia (Testudinis Carapax et Plastrum from *Pelodiscus sinensis*, ten slices, prepared by frying; *Qianjin Fang* uses fourteen slices), Oumou Yugu (Sepiae Endoconcha, shell removed), Biejia (Chelonis Carapax et Plastrum, prepared by frying, each one tael), Changshan (Dichroae Radix, three taels), Fuzi (Aconiti Lateralis Radix Praeparata, one piece, processed).
Usage: The above five herbs are cut, soaked in three sheng of wine overnight. Take a small amount slightly before the onset of malaria, do not discontinue the medication, and apply it to the body externally. During this period, prohibit unrelated persons from eating or drinking near the patient. After the paroxysm has passed, people may enter to provide food. Avoid amaranth, raw green onion, raw vegetables, and pork. (*Qianjin Fang*, *Wenzhen Beiji Jing*, *Xinlu* record the same; From Volume 6)

Qianjin Formula for Wine-Soaked Mountain Malaria with Alternating Chills and Fever, Paroxysms Present and Absent:
Herbs: Changshan (Dichroae Radix, three taels), Biejia (Chelonis Carapax et Plastrum, prepared by frying), Shengma (Cimicifugae Rhizoma), Fuzi (Aconiti Lateralis Radix Praeparata), Oumou Yugu (Sepiae Endoconchum, shell removed, each two taels).
Usage: The above five herbs are cut together, placed in a silk bag, and soaked in six sheng of wine. Heat gently near a fire while turning occasionally. Prepare overnight. Take one ge per dose. Multiple doses may be taken before the paroxysm, which may induce vomiting. Avoid pork, raw green onion, raw vegetables, and amaranth. (*Zhouhou Beiji Fang* treats chronic persistent malaria; From Volume 10)

Treatise on Emergency Preparedness: Miasma (Zhang) and Malaria (Nue) are named differently but share the same essence. Some present with chills first then fever, others with fever first then chills. Lingnan generally calls it "Zhang," while Jiangbei calls it "Nue." This is merely a difference in dialect, not a different disease. However, due to southern warm toxicity, this illness is particularly severe. Tracing its origin, there are roughly four causes: 1. Toxic vapors from mountain streams; 2. Wind-warmth and phlegm-fluid retention; 3. Ghostly pestilence (Gui Li); 4. Heat-toxin paroxysms. Among these, heat-toxin is the heaviest. Therefore, medication must be selected based on careful examination of the etiology. After suffering from malaria-miasma, one must specifically guard against the development of dysentery, as death can follow swiftly. This is because the body is initially deficient after miasma infection, and deficiency does not tolerate dysentery. Furthermore, miasma is best treated with cold-natured remedies, while dysentery requires warm-natured remedies to cease. Using warm remedies to stop dysentery exacerbates miasma, while using cold remedies to stop miasma exacerbates dysentery. Generally, this is the case, so caution is essential. It is not only about medicinal treatment but also about proper nursing to ensure comfort. If one could use a single type of medicine to treat both conditions simultaneously—cold enough to stop dysentery and warm enough to stop malaria—it would be most ingenious. If this is not possible, one must first stop the dysentery, then treat the miasma, because the miasma is slow-acting while the dysentery is urgent. Generally, one must prepare for toxin involvement and not treat dysentery exclusively. Additionally, anti-miasma medicines should be taken before the paroxysm, specifically on an empty stomach at dawn. After taking the medicine, do not wash hands, face, or rinse the mouth; do not allow outsiders in; do not eat; do not exert yourself. Only after the paroxysm time has long passed should one consume a small amount of millet gruel. With such treatment and care, cure is assured. During fever, strictly avoid drinking large amounts of cold water or taking excessive cold medicines. If cold stagnation forms in the epigastrium, it becomes difficult to treat. After contracting malaria, abdominal masses (Zheng Pi) may form; some cases involve sudden qi rebellion leading to death that cannot be saved. For those with heat and thirst, drink warm soybean decoction to induce sufficient vomiting, which is beneficial. Boil soybeans, crush them, mix with rhino horn juice, and take. Also, intermittently drink fresh kudzu root juice. For severe high fever, administer Zi Xue (Purple Snow) the size of two dates, mixed with water. Burning pig manure and human feces to make Huang Long Tang is also effective; each can be taken in amounts of two to three sheng. Crushing a large rat and administering its juice also greatly stops heat-toxin; this is effective for miasma-heat diseases. (The rat, including skin, scalp, and viscera, should be crushed entirely. If the juice yield is low, add a little water to wring it out; it is easy to administer and yields immediate results.)

Moxibustion Method After Taking Medicine for Miasma-Malaria:
Moxa-burn 30–40 cones at Dazhui (GV14). Cure is assured. If chills precede fever, place charcoal fire under the bed beforehand to warm the back. Also, moxa-burn Biejia powder (one cun-bi measure), mixed with warm wine and taken. By the time of the paroxysm, three doses should be consumed. Covering with blankets beyond the paroxysm time ensures cure. This is Master Tao's method. Alternatively, warming the back with fire just before chills begin also leads to immediate recovery; even if a paroxysm occurs, it will be mild. Efficacy is verified.

Changshan Pill for Treating Miasma-Malaria:
Herbs: Changshan (Dichroae Radix), Huanglian (Coptidis Rhizoma), Chi (Fermented Soybean Product/Douchi, each three taels), Fuzi (Aconiti Lateralis Radix Praeparata, two taels, processed).
Usage: The above four herbs are pounded and sifted into powder, mixed with honey to form pills the size of mulberry seeds. Take four pills on an empty stomach before the paroxysm. Take three more pills when the paroxysm is imminent, washed down with water. Do not eat from morning until evening; fast for three days. Avoid pork, fish, fatty/greasy foods, and raw/cold items like green onions and vegetables. (Transmitted in Guangzhou family, proven effective; this formula also cures accompanying dysentery.)

Mahuang Powder:
Herbs: Mahuang (Ephedrae Herba, nodes removed), Changshan (Dichroae Radix), Xingren (Prunus Armeniacus Semen, tips and skins removed, fried), Renshen (Ginseng Radix), Ganqi (Drynariae Rhizoma/Fabricated Drynaria? Note: Text says Ganqi usually Licorice but context implies Ganqi as Drynaria or typo for Ganjiang/Gancao? Standard text often lists Gancao here, but text says Ganqi (Fried). Given "Ganqi" usually means Licorice in modern TCM but historically could vary, however "Ganqi" typically refers to Licorice Root. Wait, standard Mahuang Tang has Gancao. Let's stick to text: Ganqi (Licorice Root, prepared)), Biejia (Chelonis Carapax et Plastrum, each two taels, prepared by frying).
Usage: The above seven herbs are made into powder. Take one cun-bi measure with three ge of warm wine on an empty stomach at dawn. Twice daily. Continue for seven days. For seven days after taking, avoid all other foods. This is one of Xu Renze's five formulas. Yuan Bibu stated it is highly effective in Lingnan. Taking one dose annually also tonifies deficiency and emaciation. Avoid amaranth, raw green onion, raw vegetables, seaweed, and Chinese cabbage.

Dahuang Decoction for Miasma-Heat Excess with Vomiting and Dysentery:
Herbs: Dahuang (Rhei Radix et Rhizoma), Changshan (Dichroae Radix), Shengma (Cimicifugae Rhizoma), Gancao (Licorice Root, prepared, each three taels).
Usage: The above four herbs are cut, boiled in seven sheng of water to reduce to two and a half sheng. Divide into three doses. Take all doses before the paroxysm to induce vomiting and purging. Transmitted by the Jiang family. Avoid seaweed, Chinese cabbage, raw green onion, and raw vegetables.

Wumei Drink for Miasma-Heat with Dysentery and Severe Thirst:
Herbs: Wumei (Mume Fructus, twenty pieces, select good ones and break open).
Usage: The above single herb is boiled in one da sheng of water to reduce to one da zhan. Remove the plums, add one spoonful of honey, and sip slowly. Recent prescriptions verify efficacy. (All from Volume 2)

Yannian Shuqi Pill: Governs outbreaks of Lingnan miasma, alternating hot and cold, accumulation of fatigue resembling malaria.
*Qianjin Yifang* states it also governs malaria persisting for years without cure:
Herbs: Shuqi (Perillae Folium/Prepared Perilla Leaf?), Zhi Mu (Anemarrhenae Rhizoma), Shengma (Cimicifugae Rhizoma), Baiwei (Clehmanniae Radix), Digupi (Lycii Cortex), Maidong (Ophiopogonis Radix, each five fen), Wumei Rou (Mume Fructus Flesh), Biejia (Chelonis Carapax et Plastrum, prepared by frying), Weirui (Polygonati Odorati Rhizoma, each four fen), Shigao (Gypsum Fibrosum, eight fen), Gancao (Licorice Root, prepared, three fen), Changshan (Dichroae Radix, six fen), Douchi (Fermented Soybean Product, one he, fried).
Usage: The above thirteen herbs are pounded and sifted into powder, mixed with honey to form pills the size of mulberry seeds. Take ten pills with water, twice daily, increasing to twenty pills. This formula ensures cure. Adding one liang of Guangming Sha (Refined Cinnabar) makes it miraculous. Avoid seaweed, Chinese cabbage, Amaranthus, raw green onion, and raw vegetables. (*Qianjin Fang* also treats labor-malaria; *Cui Shi*, *Qianjin Yi*, *Ji Yan* records are identical; From Volume 17)

Emergency Rescue Decoction for Malaria, Miasma, and Pestilence: For cases lasting over 100 days or a year where various drugs fail, this formula is universally beneficial. Shuqi Decoction:
Herbs: Baiwei (Clehmanniae Radix), Shuqi (Perillae Folium), Zhi Mu (Anemarrhenae Rhizoma), Gancao (Licorice Root, prepared), Kushen (Sophorae Flavescentis Radix), Shengma (Cimicifugae Rhizoma), Longdan (Gentianae Radix, each two taels), Changshan (Dichroae Radix), Dahuang (Rhei Radix et Rhizoma, soaked separately and added later, each four taels), Biejia (Chelonis Carapax et Plastrum, prepared), Shigao (Gypsum Fibrosum, crushed), Fuling (Poria), Huangqin (Scutellariae Radix, each three taels), Xiangshi (Fermented Soybean Product, two he, wrapped), Dusu (Allium Sativum Bulb, seven cloves, cut), Danzhuye (Lophatheri Herba, cut, one sheng).
Usage: The above sixteen herbs are cut, soaked in one dou of water, combined with two sheng of spring wine, and boiled to yield three sheng. Strain and divide into three doses. Take one dose before the paroxysm begins, and another dose as the paroxysm approaches. Both should be taken warm. On the day of the paroxysm, do not see people; lie in a quiet room. Place the herbal dregs near the patient's head. Apply the liquid to the hands and face. Leave only after the time has passed. Avoid fatty, fishy, slippery, cold/raw, seaweed, Amaranthus, strong vinegar, Chinese cabbage, raw green onion, and raw vegetables.

Zhusha Pill:
Herbs: Zhusha (Cinnabar, bright quality), Niuxi (Achyranthis Bidentatae Radix), Changshan (Dichroae Radix, equal parts).
Usage: The above three herbs are pounded and sifted into powder, mixed with honey to form pills the size of mulberry seeds. On the day of the malaria paroxysm, take seven pills at dawn with water. When feeling the paroxysm approaching, take another seven pills. If not cured on the first day, take another dose. It will then heal. Avoid raw green onion, raw vegetables, raw blood products, greasy foods, and beef.

Imperial Bestowal Changshan Decoction Extremely Effective for Zhangsun Xiang:
Herbs: Changshan (Dichroae Radix, eight fen), JuPi (Citri Reticulatae Pericarpium, six fen), Muli (Concha Ostreae, four fen, roasted), Guixin (Cinnamomi Ramulus, two fen).
Usage: The above four herbs are pounded and sifted into powder. On the day of the paroxysm, take one cun-bi measure with wine at dawn, one more just before the paroxysm, and one more after the paroxysm. Do not wash hands or face for two days. Avoid miscellaneous foods for seven days; only medicinal wine is allowed, everything else is prohibited. Whether vomiting occurs or not, cure is achieved. Avoid raw green onion and raw vegetables.

Another Formula:
Take one sheng of urine from a five- or six-year-old child, add two large spoonfuls of white honey, stir well, remove white foam, and drink immediately. Profuse vomiting of green bile-phlegm should occur, followed by eating. If vomiting does not occur, frequent urination is also acceptable. Besides the green bile-phlegm vomited by the previous two formulas, once white foam is vomited, food can be eaten. Otherwise, the miasma will never be eliminated.

Changshan Decoction:
Herbs: Changshan Miao (Stem of Dichroa, one handful; if no stem, use five taels of root), Dusu (Allium Sativum Bulb, seven cloves), Danzhuye (Lophatheri Herba, two handfuls), Chi (Fermented Soybean Product, one he, wrapped), Biejia (Chelonis Carapax et Plastrum, three taels, prepared by frying).
Usage: The above five herbs are cut, boiled in three sheng of Ku Jiu (Vinegar/Wine) to reduce to one sheng. Take appropriate amount before the paroxysm. After finishing the dose, profuse vomiting should occur, leading to recovery. Avoid Amaranthus, raw green onion, and raw vegetables.

Gu Jin Lu Yan Changshan Decoction for Miasma-Malaria and Zhang Qi:
Herbs: Changshan (Dichroae Radix, three taels, finely cut).
Usage: The above single herb is crushed. For weak patients, use two taels. Seven cloves of garlic, peeled and sliced. Soak in one and a half sheng of wine overnight. Strain in the morning, drink warm completely. Vomiting should occur shortly thereafter to expel the pathogen; this is ideal. Eat after the time has passed. Do not rinse mouth or wash hands/face for one day. For 21 days, avoid raw green onion, raw vegetables, cold/raw foods, meat, noodles, and greasy foods. If early onset, take at midnight, ensuring vomiting occurs. (From Volume 4)

Recent Efficacy Changshan Pill for Malaria-Miasma, brought by Supplementor Meng from Lingnan:
Herbs: Changshan (Dichroae Radix), Chi (Fermented Soybean Product, fried), Taoren (Prunus Persica Seed, tips and skins removed, fried, equal parts).
Usage: Each of the three herbs is pounded into powder. First, pound Chi and Taoren into a paste, then mix in the Changshan powder finely. Form pills with honey the size of mulberry seeds. Take forty pills with wine one meal-time before the paroxysm. Shortly after, take twenty more pills. If not cured, take again. No more than three doses are needed. Those who trust and use it will invariably be cured. Avoid raw green onion and raw vegetables.

Muxiang Xijiao Pill for Prevention of Miasma, Pestilence, and Insect Toxins While Traveling:
Herbs: Qingmuxiang (Aucklandiae Radix/Xanthocerii Radix), Xijiao (Rhino Hornis Cornu, shaved), Lingyangjiao (Saiga Tataricae Cornu, shaved, each six fen), Shengma (Cimicifugae Rhizoma), Xuanshen (Scrophulariae Radix), Zhuling (Polyporus), Binglang (Arecae Semen, each ten fen), Biejia (Chelonis Carapax et Plastrum, prepared), Gancao (Licorice Root, prepared, each eight fen), Chi (Fermented Soybean Product, twenty fen, fried).
Usage: The above ten herbs are pounded and sifted into powder, mixed with honey to form pills the size of mulberry seeds. Take thirty pills with wine, twice daily. If the body feels hot, remove Gancao and Binglang, and add Dahuang (Rhei Radix et Rhizoma, twenty fen). Avoid seaweed and Chinese cabbage.

Huanglian Xijiao Pill for Malaria Accompanied by Dysentery (Red, White, Watery, Undigested, Bloody, or Miasmatic):
Herbs: Huanglian (Coptidis Rhizoma), Xijiao (Rhino Hornis Cornu, shaved), Xiangshi (Fermented Soybean Product, fried, each two taels), Longgu (Fossilia Ossis Maxillaris, four taels), Muli (Concha Ostreae, two fen, roasted).
Usage: The above five herbs are pounded and sifted into powder, mixed with honey to form pills the size of mulberry seeds. Take thirty pills with rice water, three times daily. Stop when cured. Avoid pork, cold water, and greasy foods.

Shuqi Pill for Persistent Miasma-Malaria:
Herbs: Shuqi (Perillae Folium), Qingmuxiang (Aucklandiae Radix/Xanthocerii Radix), Shengma (Cimicifugae Rhizoma), Biejia (Chelonis Carapax et Plastrum, prepared), Muli (Concha Ostreae, roasted), Zhusha (Cinnabar), Zhuling (Polyporus), Xiangshi (Fermented Soybean Product, each four fen), Changshan (Dichroae Radix), Dahuang (Rhei Radix et Rhizoma, each eight fen).
Usage: The above ten herbs are pounded and sifted into powder, mixed with honey to form pills the size of mulberry seeds. Take twelve pills with rice soup, twice daily. Gradually improve until full recovery. Avoid Amaranthus, greasy foods, stale/foul-smelling items, and raw blood products.