答曰。疟者。寒热之疾。皆繇风寒入中也。夫风为阳邪。阳化气而为热。寒为阴邪。阴化气
而为寒。阴阳上下交争。虚实邪正更作。或阴并于阳。则阴实而阳虚。若阳并于阴。则阳
实而阴虚。或先伤于寒而后伤于风。其为候也。则先寒而后热。或先伤于风而后伤于寒。其
为证也。则先热而后寒。休作有时。与伤寒颇异者。故名为疟也。经曰。夏伤于暑。秋必病
疟者。此因暑气之所伤也。若妊娠寒热者。皆繇血气虚损。风邪乘之。致阴阳关隔。寒热
互见也。经云。阳微
恶寒。阴弱发热。若此之类。皆繇虚之所致。此不因暑气之作也。若热极不已。则伤胎。
大安散。治脾寒如疟。发热无时。
草豆蔻(七个和皮细切) 浓朴(半两) 乌梅(十个去核仁) 甘草 人参(各一分) 大枣(十
枚) 肥姜(一分连皮) 陈皮(七个全者洗净切) 良姜(一分)
下共锉拌匀。分作五裹。先以盐水蘸纸湿。裹煨香熟。第一服一裹。水一碗。煎一碗。温服
。第二服用二裹。并煎滓。以水二碗。煎一碗。温服。第三服用三裹。并煎滓。以水三碗。
煎一碗。作两服。并空心食前温服。妊娠患疟热者可服。
常山 竹叶(各半两) 人参 石膏(各一两研) 糯米(一百粒)
上为 咀。每服三钱。水盏半。煎八分。去滓通口服。不拘时。
地黄丸。治寒热类疟。久之为劳。
生地(二两) 柴胡(洗) 秦艽 黄芩(各半两) 赤芍
上为细末。蜜丸桐子大。每服三十丸。乌梅汤下。不拘时。
清肌汤。治头目昏重不悦。颊赤口燥咽干。发热盗汗。饮食减少。
甘草(炙半两) 草果仁(五钱) 当归(微炒) 白术(一两) 白茯苓 芍药 柴胡(各一两)
川芎(半两)
上 咀。每服三钱。水一盏半。煨姜一块切碎。薄荷少许。煎七分。去滓热服。不拘时。
Answer: Malaria (Nüe, 疟疾) is a disease characterized by alternating chills and fever, caused by the invasion of Wind-Cold pathogens into the interior. Wind is a Yang pathogen; when Yang transforms Qi, it generates Heat. Cold is a Yin pathogen; when Yin transforms Qi, it generates Cold. When Yin and Yang Qi contend with each other above and below, deficiency and excess, as well as pathogenic factors and healthy Qi, alternate in their activity. Sometimes Yin merges into Yang, resulting in an excess of Yin and deficiency of Yang; sometimes Yang merges into Yin, resulting in an excess of Yang and deficiency of Yin. If one is first injured by Cold and subsequently by Wind, the manifestation is chills preceding fever. If one is first injured by Wind and subsequently by Cold, the manifestation is fever preceding chills. This disease occurs at regular intervals and differs significantly from Shanghan (Cold Damage, 伤寒), hence it is named Malaria. The Classics state: "If Summer-Heat is injured in summer, Malaria will inevitably occur in autumn." This refers to injury caused by Summer-Heat Qi. However, chills and fever during pregnancy are all due to deficiency and damage of Blood and Qi, allowing Wind pathogens to take advantage of this weakness, leading to obstruction between Yin and Yang, resulting in alternating chills and fever. The Classics say: "When Yang is weak, there is aversion to cold; when Yin is weak, there is fever." Such cases are all caused by deficiency, not by Summer-Heat. If the Heat becomes extreme and persists without cessation, it will injure the Fetus.
Da'an San (Great Peace Powder): Treats Spleen Cold resembling malaria, with fever occurring at irregular times.
Ingredients: Caodoukou (Cardamomi Fructus Rotundus, 草豆蔻) - seven pods, finely sliced with skin; Houpo (Magnoliae Officinalis Cortex, 厚朴) - half liang; Wumei (Mume Fructus, 乌梅) - ten, pits removed; Gancao (Glycyrrhizae Radix et Rhizoma, 甘草); Renshen (Panacis Ginseng Radix, 人参) - each one fen; Dazao (Ziziphi Jujubae Fructus, 大枣) - ten pieces; Feijiang (Zingiberis Rhizoma Recens, 生姜) - one fen, with skin; Chenpi (Citri Reticulatae Pericarpium, 陈皮) - seven whole ones, washed and sliced; Liangjiang (Alpiniae Officinarum Rhizoma, 高良姜) - one fen.
All ingredients are coarsely crushed and mixed evenly, divided into five bundles. First, moisten paper with salt water, wrap the bundles, and roast until fragrant and cooked. For the first dose, use one bundle, add one bowl of water, decoct to one bowl, and take warm. For the second dose, use two bundles including the dregs, add two bowls of water, decoct to one bowl, and take warm. For the third dose, use three bundles including the dregs, add three bowls of water, decoct to one bowl, divide into two doses, and take warm on an empty stomach or before meals. Pregnant women suffering from malaria with fever may take this formula.
Changshan (Dichroae Radix, 常山) and Zhuye (Bambusae Folium, 竹叶) - each half liang; Renshen (Panacis Ginseng Radix, 人参); Shigao (Gypsum Fibrosum, 石膏) - each one liang, ground; Nuomi (Oryza Sativa Glutinosa, 糯米) - one hundred grains.
The above are processed into coarse powder. Each dose is three qian. Add one and a half bowls of water, decoct to eight-tenths strength, filter out the dregs, and drink orally. Time is not restricted.
Dihuang Wan (Rehmannia Pill): Treats chills and fever resembling malaria; if prolonged, it leads to consumption disorders (Lao, 劳).
Ingredients: Shengdi (Rehmanniae Radix, 生地黄); Chaihu (Bupleuri Radix, 柴胡) - washed; Qinjiao (Gentianae Macrophyllae Radix, 秦艽); Huangqin (Scutellariae Radix, 黄芩) - each half liang; Chishao (Paeoniae Radix Rubra, 赤芍).
The above are made into fine powder and formed into pills the size of paulownia seeds using honey. Each dose is thirty pills, taken with Wu Mei Tang (Mume Decoction, 乌梅汤). Time is not restricted.
Qingji Tang (Clear Muscle Decoction): Treats heaviness and discomfort in the head and eyes, red cheeks, dry mouth and throat, fever, night sweats, and decreased appetite.
Ingredients: Gancao (Glycyrrhizae Radix et Rhizoma, 甘草) - stir-fried with honey, half liang; Caoguoren (Tsaoko Fructus, 草果仁) - five qian; Danggui (Angelicae Sinensis Radix, 当归) - slightly stir-fried; Baizhu (Atractylodis Macrocephalae Rhizoma, 白术) - one liang; Baifuling (Poria, 茯苓); Shaoyao (Paeoniae Radix, 芍药); Chaihu (Bupleuri Radix, 柴胡) - each one liang; Chuanxiong (Ligustici Chuanxiong Rhizoma, 川芎) - half liang.
The above are processed into coarse powder. Each dose is three qian. Add one and a half bowls of water, one piece of roasted ginger chopped finely, and a small amount of Bohe (Menthae Haplocalycis Herba, 薄荷). Decoct to seven-tenths strength, filter out the dregs, and take hot. Time is not restricted.