巢氏云∶疟疾者、由夏伤于暑，客于皮肤，至秋因劳动血气，腠理虚而邪气乘之，动前暑热、正邪相击，阴阳交争，
阳盛则热，阴盛则寒，阴阳更盛更虚，故发寒热，阴阳相离，则寒热俱歇，若邪动气至，交争复发。小儿未能触冒于暑，
而亦病疟者，乃乳母持抱解脱，不避风寒者也。夫风邪所伤，客于皮肤，而痰饮积于脏腑，致令血气不和，阴阳交争，
若真气胜则邪气退，邪气未尽，故发疟也；邪气虽退，阴血尚虚，邪干于真气，脏腑热气未散，故余热往来也；其病
正发，寒热交争之时，热气乘脏则燥而渴，留饮停滞成癖，结于胁下，故瘥后胁下结硬也；若引饮不止，小便涩者，则
变
成癖也；寒热往来，而热乘五脏，气积不泄，故烦满，寒热相搏，而击于脏气，故腹痛也。寒多热少无汗者，桂枝麻黄
各半汤；有汗多者、柴胡桂枝汤；汗多渴者，白虎加桂汤；小便赤热多而渴者，小柴胡汤；疟未散者，鬼哭散止之；寒
少热多者，可服清脾汤；养胃汤，治脾胃冷弱者，四兽饮亦可服。其截疟丸子、切不可用砒霜者，但可服有常山者，有
阿魏者，真能散痞癖也。热多汗出而渴腹疼者、大柴胡汤加葛根可也。其疟后加之冷证痞癖结块者，木香丸主之；烦闷
者，五苓散；有热甚者，白虎汤，或加桂，或加人参。时行壮热者，柴胡石膏汤亦可服；头疼甚者、葱白加甘草亦可服；
知母麻黄汤，亦治疟之奇剂也。
桂枝麻黄各半汤 见第五十三问。
白虎加桂汤 见第五十八问白虎汤。
小柴胡汤 见第二十九问。
柴胡桂枝汤
柴胡（八钱） 黄芩（二钱） 半夏（二钱半） 芍药 甘草 桂枝（各三钱）
上锉散，每服三钱，姜三片，枣一枚，煎食前服。
鬼哭散 治止疟疾。
常山 大腹皮 白茯苓 鳖甲（酸炙） 甘草（炙、各等分）
上除鳖甲甘草炙外，三件不得见火，用桃柳枝七寸同煎，临发。略吐涎不妨，只用常山、白茯苓、甘草亦效。
清脾汤 治瘴疟脉来弦数，但热不寒，或热多寒少，膈满不食，口苦舌干，烦渴饮水，小便赤黄，大便欠利。
青皮 浓朴（姜制，炒） 白术 草果（去） 柴胡 茯苓 半夏（汤泡七次） 黄芩 甘草（炙、各等分）
上锉散，每服三钱，水一盏，生姜二片，煎六分，去滓温服，不拘时。
四兽饮 治五脏气虚、喜怒不节，劳逸兼并，致阴阳相胜，结聚痰饮，与卫气相搏，发为疟疾。兼治瘴疟，
最有神效，常服温中快膈。
半夏 茯苓 人参 白术 草果 橘红（各等分） 甘草（减半）
上锉散，每服三钱，乌梅、姜、枣各一，水一盏煎服。
胡黄连散 治小儿疟。
人参 胡黄连 草果 槟榔 甘草 柴胡（各等分）
上锉散，水一盏，煎三分服。
养胃汤 治外感风寒，内伤生冷，温中快膈，能辟山岚瘴气，寒疟，脾胃虚寒。
浓朴 苍术（制） 半夏（泡、各一两） 藿香 草果仁 茯苓 人参（各半两） 甘草（炙） 橘红（各二钱半）
上锉散，每服三钱，水一盏，姜七片，乌梅一个，煎六分，去滓热服。兼治冷冻饮料伤脾，发为疟疾。或中脘虚寒，呕
逆恶心。寒疟加桂。
又方
陈皮（去白、三钱半） 甘草（炙） 浓朴（制） 半夏（各三钱、泡） 人参 草果（各二钱） 白茯苓（四钱）
藿香（七钱、洗） 青皮（去瓤） 莪术 三棱（煨） 大腹皮（各一钱半） 苍术 乌梅（各五钱）
上锉散，每服三钱，姜枣煎服。
经效疟丹 治疟母结癖，寒热无已。
真阿魏 雄黄（各二钱半） 朱砂（一钱半）
上沸汤泡阿魏研散，雄朱和之，稀面糊丸梧桐子大，每服一丸，人参汤候冷，空心服。瘴疟桃枝煎冷服。临发磨一
丸，敷鼻头口畔。
大柴胡汤加干葛 见第二十九问大柴胡汤。
木香丸 见第四十六问。
五苓散 见第五十二问。
白虎汤 见第五十八问。
柴胡石膏汤 见第五十二问。
葱白汤 见第五十一问。
知母麻黄汤 治伤寒瘥后，或十数日，或半月二十日，终不惺惺，常昏沉，似失精神，语言错缪，又无寒热，
医或作鬼祟，或作风痰，多般治之不瘥。或朝夕潮热颊赤，或有寒热似疟。都般发汗不尽，余毒在心胞络间所致。
知母 麻黄（去节） 甘草（炙） 芍药 黄芩（各半两） 桂枝（去皮、半两、盛暑可减半）
上锉散，每服三钱，水一盏，煎七分，去滓温服，令微汗。若心烦不眠，欲饮水，当稍稍与之，令胃气和即愈。未
汗须再服，大小加减。
Chao Yuanfang stated: Malaria (Nüe Ji) is caused by summer-heat pathogen injuring the body in summer, lodging in the skin. By autumn, due to physical exertion causing fluctuations in Qi and Blood, the Cou Li (skin texture and pores) become deficient, allowing the pathogen to invade. The residual summer-heat within interacts with the external pathogen, leading to a struggle between Yin and Yang. When Yang is predominant, heat manifests; when Yin is predominant, cold manifests. Due to the alternating excess and deficiency of Yin and Yang, chills and fever occur. When Yin and Yang temporarily separate, the chills and fever cease; if the pathogen stirs again, the struggle re-emerges.
Children who contract malaria without directly being exposed to summer-heat do so because their wet nurses, while holding or caring for them, allow them to shed clothing without avoiding wind and cold pathogens. Wind pathogen damages the body, lodging in the skin, while phlegm-fluids accumulate in the Zang-Fu organs, causing disharmony of Qi and Blood and a struggle between Yin and Yang. If the True Qi is strong, the pathogen retreats; however, if the pathogen is not fully cleared, malaria occurs. Even if the pathogen has retreated, if Yin-Blood remains deficient, the pathogen interferes with the True Qi, and the heat in the Zang-Fu has not dissipated, resulting in lingering heat and alternating symptoms. During the active phase of the disease, when chills and fever struggle, heat invading the Zang organs causes dryness and thirst. If retained fluids stagnate and form masses (Pi), knotting under the hypochondrium, hardness under the hypochondrium may persist after recovery. If excessive drinking continues and urination is difficult, it transforms into Pi masses. Alternating chills and fever, where heat invades the Five Zang organs, leads to Qi accumulation without discharge, causing irritability and fullness. The struggle between cold and heat striking the Zang Qi results in abdominal pain.
For cases with more chills than fever and no sweating, Guizhi Mahuang Ge Ban Tang (Cinnamon Twig and Ephedra Half-Dose Decoction) is used. For cases with profuse sweating, Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction) is used. For cases with profuse sweating and thirst, Baihu Jia Guizhi Tang (White Tiger plus Cinnamon Twig Decoction) is used. For cases with red, hot, frequent urination and thirst, Xiaochaihu Tang (Minor Bupleurum Decoction) is used. For malaria that has not dispersed, Gui Ku San (Ghost Cry Powder) is used to stop it. For cases with less chills and more fever, Qingpi Tang (Clear Spleen Decoction) can be taken. Yangwei Tang (Stomach Nourishing Decoction) treats cold weakness of the Spleen and Stomach; Six Beast Drink (Sishou Yin) can also be taken. Regarding malaria-intercepting pills, Bi Shuang (Realgar/Arsenic compounds) must absolutely not be used; only those containing Changshan (Dichroa Root) or Awei (Asafetida) should be taken, as they truly dissipate masses and Pi. For cases with more heat, sweating, thirst, and abdominal pain, Dachaihu Tang (Major Bupleurum Decoction) added with Gegen (Kudzu Root) is suitable. For post-malaria cold syndromes with mass formation, Muxiang Wan (Aucklandia Pill) is the primary treatment. For irritability, Wuling San (Five-Ingredient Powder with Poria) is used. For severe heat, Baihu Tang (White Tiger Decoction) is used, either with added Guizhi (Cinnamon Twig) or Renshen (Ginseng). For epidemic high fever, Chaihu Shigao Tang (Bupleurum and Gypsum Decoction) can be taken. For severe headache, Congbai (Scallion White) added with Gancao (Licorice) can be taken. Zhimu Mahuang Tang (Anemarrhena and Ephedra Decoction) is also a miraculous formula for treating malaria.
Guizhi Mahuang Ge Ban Tang: See Question 53.
Baihu Jia Guizhi Tang: See Baihu Tang in Question 58.
Xiaochaihu Tang: See Question 29.
Chaihu Guizhi Tang
Ingredients: Chai Hu (8 qian), Huang Qin (2 qian), Ban Xia (2.5 qian), Shao Yao, Gan Cao, Gui Zhi (each 3 qian).
Preparation and Administration: Crush into a powder. Take 3 qian per dose, with 3 slices of fresh ginger and one jujube. Decoct and take before meals.
Gui Ku San: Treats and stops malaria.
Ingredients: Chang Shan, Da Fu Pi, Bai Fu Ling, Bie Jia (vinegar-fried), Gan Cao (fired, each in equal parts).
Preparation and Administration: Excluding the vinegar-fried Bie Jia and fired Gan Cao, the other three ingredients must not be exposed to fire. Decoct together with seven-cun long peach or willow branches. Take before the onset of malaria. Mild expectoration of saliva is acceptable. Using only Chang Shan, Bai Fu Ling, and Gan Cao is also effective.
Qingpi Tang: Treats Zhang Malaria with wiry and rapid pulse, fever without chills, or more fever than chills, chest fullness, anorexia, bitter taste, dry tongue, irritability, thirst, red-yellow urine, and incomplete bowel movements.
Ingredients: Qing Pi, Hou Po (ginger-processed, fried), Bai Zhu, Cao Guo (de-shelled), Chai Hu, Fu Ling, Ban Xia (soaked in boiling water seven times), Huang Qin, Gan Cao (fired, each in equal parts).
Preparation and Administration: Crush into a powder. Take 3 qian per dose, with one cup of water and two slices of fresh ginger. Decoct until reduced to 60%, strain, and take warm at any time.
Sishou Yin: Treats Qi deficiency of the Five Zang organs, unregulated emotions, overwork or lack of exercise, leading to Yin-Yang imbalance, phlegm-fluid accumulation, and struggle with Wei Qi, causing malaria. Also treats Zhang Malaria with great efficacy. Regular use warms the middle and relieves chest oppression.
Ingredients: Ban Xia, Fu Ling, Ren Shen, Bai Zhu, Cao Guo, Ju Hong (each in equal parts), Gan Cao (half amount).
Preparation and Administration: Crush into a powder. Take 3 qian per dose, with one myrobalan, one slice of ginger, and one jujube. Decoct with one cup of water.
Huhuanglian San: Treats pediatric malaria.
Ingredients: Ren Shen, Hu Huang Lian, Cao Guo, Bing Lang, Gan Cao, Chai Hu (each in equal parts).
Preparation and Administration: Crush into a powder. Decoct with one cup of water until reduced to 30% and take.
Yangwei Tang: Treats external wind-cold invasion and internal injury from raw/cold foods. It warms the middle, relieves chest oppression, dispels mountain miasma, and treats cold malaria and Spleen-Stomach deficiency-cold.
Ingredients: Hou Po, Cang Zhu (processed), Ban Xia (soaked, each 1 liang), Huo Xiang, Cao Guo Ren, Fu Ling, Ren Shen (each 0.5 liang), Gan Cao (fired), Ju Hong (each 2.5 qian).
Preparation and Administration: Crush into a powder. Take 3 qian per dose, with one cup of water, seven slices of ginger, and one myrobalan. Decoct until reduced to 60%, strain, and take hot. It also treats malaria caused by spleen injury from frozen drinks, or vomiting/nausea due to Middle Jiao deficiency-cold. Add Gui Zhi for cold malaria.
Another Prescription:
Chen Pi (de-white, 3.5 qian), Gan Cao (fired), Hou Po (processed), Ban Xia (each 3 qian, soaked), Ren Shen, Cao Guo (each 2 qian), Bai Fu Ling (4 qian), Huo Xiang (7 qian, washed), Qing Pi (de-pith), E Zhu, San Leng (roasted), Da Fu Pi (each 1.5 qian), Cang Zhu, Wu Mei (each 5 qian).
Preparation and Administration: Crush into a powder. Take 3 qian per dose, decoct with ginger and jujube.
Jingxiao Madan: Treats Malaria Mother (masses) and Pi, with endless chills and fever.
Ingredients: Zhen A Wei, Xiong Huang (each 2.5 qian), Zhu Sha (1.5 qian).
Preparation and Administration: Soak A Wei in boiling water and grind into powder. Mix with Xiong Huang and Zhu Sha. Form pills using thin flour paste, sized like paulownia seeds. Take one pill per dose with cooled Ginseng decoction on an empty stomach. For Zhang Malaria, take with cooled peach branch decoction. Before onset, grind one pill and apply to the nose tip and around the mouth.
Dachaihu Tang added with Gan Ge: See Dachaihu Tang in Question 29.
Muxiang Wan: See Question 46.
Wuling San: See Question 52.
Baihu Tang: See Question 58.
Chaihu Shigao Tang: See Question 52.
Congbai Tang: See Question 51.
Zhimu Mahuang Tang: Treats conditions after recovery from Shanghan (Cold Damage), whether ten days, half a month, or twenty days later, where the patient remains listless, often drowsy, lacking spirit, speaking erroneously, without chills or fever. Physicians sometimes mistake this for ghost possession or wind-phlegm, and various treatments fail. Or there is tidal fever in the morning and evening with red cheeks, or chills and fever resembling malaria. This is caused by incomplete sweating, leaving residual toxins in the Pericardium Collaterals.
Ingredients: Zhi Mu, Ma Huang (nodes removed), Gan Cao (fired), Shao Yao, Huang Qin (each 0.5 liang), Gui Zhi (bark removed, 0.5 liang; reduce by half in midsummer).
Preparation and Administration: Crush into a powder. Take 3 qian per dose, with one cup of water. Decoct until reduced to 70%, strain, and take warm to induce slight sweating. If there is heart vexation, insomnia, and desire for water, give small amounts gradually until Stomach Qi harmonizes and recovery occurs. If no sweat occurs, administer again, adjusting based on major/minor changes.