病源夫温疟与寒疟安舍，温疟得之冬，中于风寒，寒气藏于骨髓之中，至春则阳气大发
，邪气不能出，因遇大暑，脑髓铄，肌肉消释，腠理发泄，因有所用力，邪气与汗偕出，此
邪气先藏于肾，其气先从内出之于外，如是则阴虚而阳盛，盛则病矣，阳衰则气复反入，入
则阳虚，阳虚则寒矣，故先热而后寒，名曰温疟，疟先寒而后热者，此由夏伤于大暑，汗大
出，腠理开发，因遇夏气凄沧之小寒，寒迫之，藏于腠理皮肤之中，秋伤于风，则病成矣，
夫寒者阴气也，风者阳气也，先伤于寒而后伤于风，故先寒而后热，病以时作，名曰寒疟，
先伤于风而后伤于寒，故先热而后寒，亦以时作，名曰温疟，夫病疟六七日但见热者，温疟
也。（出第十一卷中）
甲乙经黄帝曰夫疟皆生于风夏伤于暑，秋为 疟。黄帝问疟先寒而后热，何也。岐伯对
曰∶夫寒者阴气也，风者阳气也，先伤于寒而后伤于风，故先寒而后热也，名曰寒疟。
又问曰∶先热而后寒者，何也？对曰∶先伤于风而后伤于寒，故先热而后寒也，名曰温
疟。
其但热而不寒者，阴气先（千金作孤）绝，阳气独发，即少气烦冤，手足热而欲呕，名
曰
瘅疟。
又曰温疟者得之冬，中于风寒，寒气藏于骨髓之中，至春即阳气大发，邪气不能出，因
遇大暑，脑髓铄肌肉消释。（腠理）理发泄因有所用力邪气与汗偕出，此邪气先藏于肾，其
气
先从内出之于外，如是者阴虚而阳盛，盛则病矣，阳衰则气复反入，入则阳虚，阳虚则复寒
矣，故先热而后寒，名曰温疟。
又曰，瘅疟者，肺素有热，气盛于身，厥气逆上，中气实而不外泄，因有所用力，腠理
开，风寒舍于皮肤之内，分肉之间而发，发则阳气盛，阳气盛而不衰，则病矣，其气不及于
阴，故但热不寒，热气内藏于心，外舍分肉之间，令人销铄脱肉，故名曰瘅疟。（出庚卷第
七千金同）
广济疗温疟渐渐羸瘦欲成骨蒸常山汤方。
常山（三两） 车前叶（一握） 甘草（二两炙） 猕猴骨（三两炙） 乌梅肉（二两）
天灵盖
（一两烧作灰末） 驴粪汁（三合）
上七味切，以水六升，煮五味，取三升，去滓，下粪汁天灵盖末分三服，微吐不利。
忌生葱生菜海藻菘菜面粘食等。
又疗温疟，常山丸方。
常山 乌梅肉（熬） 豉 天灵盖（烧各六分） 知母 朱砂 蜀漆 大黄（各四分）
上八味捣筛，蜜和丸如梧子，空肚以温酒下二十丸，至三十丸，日三服，并未发前服，
不吐利。忌生葱生菜生血等物。（并出第十卷中）
千金论曰，瘅疟者，阴气孤绝，阳气独发，其候也，少气烦满，手足热，欲呕，热而不
寒，气藏在心。
又曰，有温疟者，其脉如平人，无寒时热，其候骨节疼烦，时呕，朝发暮解，暮发朝解
，皆白虎加桂心汤主之方。
知母（六两） 甘草（二两炙） 石膏（碎一斤） 粳米（六合）
上四味切，以水一斗二升煮，取米烂，去滓，加桂心三两，煎取三升，分温三服，覆令
汗，先寒发热汗出者愈。忌海藻菘菜生葱。伤寒论云，用秕粳米，不熟稻米是也。（出第十
卷中）
备急竹叶常山汤疗温疟，壮热微寒温疟之候也，壮热后如觉微寒，或瘅疟依时手足冷，
少时便壮热，亦有手足烦热干呕者， 疟先大寒后大热者，并主之神效，尤宜乳下小儿亦瘥
方。
常山（三两切） 淡竹叶（一握） 小麦（一升）
上三味，以水五升渍一宿，明旦煮取二升，温分三服。忌生菜生葱。（支短剧文仲并同
出第三卷中）
延年疗温疟壮热不能食知母鳖甲汤方。
知母 鳖甲（炙） 地骨皮（各三两） 常山（二两） 竹叶（切一升） 石膏（四两
碎）
上六味切，以水七升，煮取二升五合，去滓，分三服。忌蒜猪肉苋菜生葱生菜。（出第
十七卷中）
[Pathogenesis] Where do warm malaria and cold malaria originate? Warm malaria arises from contracting wind-cold in winter, where cold qi hides within the bone marrow. By spring, when yang qi expands vigorously, the pathogenic qi cannot exit. If one then encounters intense summer heat, the brain marrow melts, muscles atrophy, and the cou li (skin pores) open. If physical exertion occurs at this time, the pathogenic qi exits along with sweat. This pathogenic qi originally hid in the Kidney; its qi moves from the interior to the exterior first. Consequently, yin deficiency and yang excess occur; excess leads to disease. If yang qi declines, the qi reverses and enters the interior; entering leads to yang deficiency, and yang deficiency results in cold. Thus, fever precedes chills, named "Warm Malaria" (Wen Nue).
If malaria presents with chills preceding fever, it is caused by summer injury from intense heat, leading to profuse sweating and open cou li. Subsequently, encountering the slight cold of a chilly summer day forces cold to hide within the cou li and skin. Autumn injury from wind completes the pathology. Cold belongs to Yin Qi, while wind belongs to Yang Qi. Injury from cold first, then wind, results in chills preceding fever, occurring at regular intervals, named "Cold Malaria" (Han Nue). Injury from wind first, then cold, results in fever preceding chills, also occurring at regular intervals, named "Warm Malaria." For those suffering from malaria for six or seven days exhibiting only heat, it is Warm Malaria. (From Volume 11)
The *Jia Yi Jing* states: Huangdi said, "Malaria all originates from Wind; Summer injury from Heat leads to Malaria in Autumn." Huangdi asked, "Why does malaria present with chills preceding fever?" Qibo replied, "Cold is Yin Qi, Wind is Yang Qi. Injury from cold first, then wind, results in chills preceding fever, named 'Cold Malaria.'"
He further asked, "Why does it present with fever preceding chills?" The reply was, "Injury from wind first, then cold, results in fever preceding chills, named 'Warm Malaria.'"
Those who exhibit only heat without chills have their Yin Qi severed first (the *Qian Jin Fang* reads 'isolated'), while Yang Qi acts alone. Symptoms include shortness of breath, vexation and oppression, heat in the hands and feet, and a desire to vomit. This is named "Dan Malaria" (Dan Nue).
It is also stated: Warm malaria arises from winter contraction of wind-cold, with cold qi hiding in the bone marrow. By spring, when yang qi expands, the pathogen cannot exit. Encountering great summer heat causes brain marrow to melt and muscles to atrophy. With open cou li and physical exertion, the pathogen exits with sweat. Originally hiding in the Kidney, the qi moves from interior to exterior, causing yin deficiency and yang excess, leading to disease. When yang declines, qi returns inward, causing yang deficiency and subsequent cold, resulting in fever preceding chills, named "Warm Malaria."
Furthermore, Dan Malaria occurs because the Lungs harbor latent heat, making qi abundant throughout the body. Rebellious Qi ascends, middle jiao Qi is full but fails to vent outward. Upon physical exertion, cou li opens, allowing wind-cold to lodge between the skin and muscle layers. Upon onset, Yang Qi becomes excessive and does not decline, causing disease. Because the heat does not reach the Yin aspect, there is only heat without chills. The hot qi hides internally in the Heart and externally in the muscle layers, causing emaciation and flesh wasting, hence named "Dan Malaria." (From Geng Volume 7, same as *Qian Jin Fang*)
The *Guang Ji* formula for treating Warm Malaria progressing to emaciation and impending Bone Steaming Consumption: Changshan Tang (Dichroa Decoction).
Changshan (*Dichroae Radix*, 3 liang), Cheqian Ye (*Plantaginis Leaf*, 1 handful), Gancao (*Glycyrrhizae Radix et Rhizoma*, 2 liang, honey-fried), Mihou Gu (*Simiae Os*, 3 liang, honey-fried), Wumei Rou (*Mume Fructus Flesh*, 2 liang), Tianlinggai (*Cranii Os*, 1 liang, burned to ash), Lv Fen Zhi (*Asini Feces Juice*, 3 he).
Cut the seven ingredients. Boil the first five in 6 sheng of water to obtain 3 sheng. Remove dregs, add the Asini Feces Juice and Cranii Os ash. Divide into three doses. Aim for mild vomiting or purgation. Avoid raw green onions, raw vegetables, seaweed, Chinese cabbage, wheat products, and sticky foods.
Another formula for Warm Malaria: Changshan Wan (Dichroa Pill).
Changshan (*Dichroae Radix*), Wumei Rou (*Mume Fructus Flesh*, roasted), Chishao (*Sojae Preparata*, i.e., fermented soybean), Tianlinggai (*Cranii Os*, burned, each 6 fen), Zhimu (*Anemarrhenae Rhizoma*, 4 fen), Zhusha (*Cinnabaris*, 4 fen), Shuqi (*Perillae Folium*, i.e., Perilla leaf, 4 fen), Dahuang (*Rhei Radix et Rhizoma*, 4 fen).
Pulverize the eight ingredients, mix with honey to form pills the size of wu zi (wu berry). Take 20-30 pills on an empty stomach with warm wine, three times daily. Administer before the onset of symptoms. Aim to avoid vomiting or purgation. Avoid raw green onions, raw vegetables, and raw blood products. (All from Volume 10)
The *Qian Jin Fang* discusses: Dan Malaria involves isolated Yin Qi and independent Yang Qi emission. Symptoms include shortness of breath, fullness and vexation, heat in hands and feet, desire to vomit, heat without chills, and qi stagnating in the Heart.
It also states: For Warm Malaria patients whose pulse resembles that of a healthy person, with no chills—only heat—the symptoms include painful and vexed joints, occasional vomiting, resolution in the morning if onset was in the evening, or resolution in the evening if onset was in the morning. These are treated with Baihu Jia Guixin Tang (White Tiger Decoction plus Cinnamon Twig).
Zhimu (*Anemarrhenae Rhizoma*, 6 liang), Gancao (*Glycyrrhizae Radix et Rhizoma*, 2 liang, honey-fried), Shigao (*Gypsum Fibrosum*, crushed, 1 jin), Jingmi (*Oryza Sativa Var. Glutinosa*, 6 he).
Cut the four ingredients. Boil in 12 dou of water until the rice is soft. Remove dregs, add Guixin (*Cinnamomi Ramulus*, 3 liang), and decoct to obtain 3 sheng. Divide into three warm doses. Cover the patient to induce sweating. Those who experience chills followed by heat and sweating will be cured. Avoid seaweed, Chinese cabbage, and raw green onions. The *Shanghan Lun* specifies using bi jingmi, which refers to immature rice grains. (From Volume 10)
The *Beiji* formula: Zhuye Changshan Tang (Bamboo Leaf and Dichroa Decoction) treats Warm Malaria characterized by high fever and slight chills. If after high fever one feels slight chills, or if Dan Malaria presents with cold hands and feet at specific times followed quickly by high fever, or if there are hot hands/feet and dry retching, or if there is severe chills followed by severe heat, this formula is effective and especially suitable for nursing infants.
Changshan (*Dichroae Radix*, 3 liang, cut), Danye Zhu (*Phyllostachys Pubescens Leaf*, 1 handful), Xiaomai (*Tritici Semen*, 1 sheng).
Soak the three ingredients in 5 sheng of water overnight. Boil the next morning to obtain 2 sheng. Divide into three warm doses. Avoid raw vegetables and raw green onions. (Records by Zhi Dao, Duan Ju, and Wen Zhong are identical; From Volume 3)
The *Yannian* formula for treating Warm Malaria with high fever and inability to eat: Zhimu Biejia Tang (Anemarrhena and Turtle Shell Decoction).
Zhimu (*Anemarrhenae Rhizoma*), Biejia (*Testudinis Carapax et Plastrum*, honey-fried), Digupi (*Lycii Cortex*, each 3 liang), Changshan (*Dichroae Radix*, 2 liang), Zhuye (*Bamboo Leaf*, cut, 1 sheng), Shigao (*Gypsum Fibrosum*, crushed, 4 liang).
Cut the six ingredients. Boil in 7 sheng of water to obtain 2.5 sheng. Remove dregs. Divide into three doses. Avoid garlic, pork, amaranth, raw green onions, and raw vegetables. (From Volume 17)