翰臣 症起七日，先寒后热，寒则震战，热则烦渴，恶心胸闷，汗出溱溱，而气味甚秽。脉象弦滑，苔白质
腻。病起之际，适值失精，若论邪势直入阴经，则喻氏治黄长人房劳后伤寒论极详细。此盖由时感之
邪，与湿混合，阻遏于少阳阳明，名曰湿疟。所恐少阳之邪，并入阳明，而转但热不寒，或热而不退，便多
变局，以少阳主半表半里，无出无入，而阳明胃络，上通于心也。若有寒有热，当无大患耳。用小柴胡以
和解表里，合达原饮以达募原之邪。即请商政。
净柴胡（五分） 草果仁（五分炒） 花槟榔（八分） 赤茯苓（三钱） 橘红（一钱） 黄芩（酒炒一钱五分）
制半夏（一钱五分） 枳壳（一钱炒） 制川朴（一钱） 竹茹（一钱五分姜汁炒）
周（江阴） 久咳屡次见红，痰阻营卫，阴阳不能交通，寒热三日而至，其营卫郁勃之气，欲借阳经泄越，
间有衬交，气血由此凝滞，偏左有形。脉象弦滑而带微数。阴气有渐伤之虑。欲和阴阳，当通营卫之痹。
拟白虎加桂法，参宣通搜络之品。
川桂枝（四分） 肥知母（一钱五分） 生甘草（三分） 云茯苓（三钱） 枳实（一钱） 杏仁泥（三钱）
广郁金（一钱五分） 石膏（煨研五钱） 粉当归（一钱五分） 鳖甲煎丸（九粒开水先送下）
某 大疟而转寒热叠来，汗多而气酸带秽。右脉濡软，左部细弦。此由痰湿不运，熏蒸阳明，营卫阴阳，
亦为之阻。宜和中化痰，兼通营卫。
制半夏（二钱） 枳实（二钱） 川桂枝（五分） 炒冬术（二钱） 石膏（煨研四钱） 橘红（一钱）
泽泻（一钱五分） 白茯苓（四钱） 竹二青（姜汁炒一钱）
正蒙 暑湿先伏膜原，兹从少阳外达，热壮烦恶，热退汗畅。舌苔中黄边赤。恐成瘅疟。拟方即请正之。
肥知母（二钱） 茯苓皮（四钱） 黑山栀（二钱） 广郁金（一钱） 大豆卷（三钱） 白蔻仁（五分）
益元散（四钱） 淡黄芩（酒炒一钱五分） 香青蒿（一钱五分） 荷梗（六钱）
二诊 畅汗热达，痰热未净，夜寐不安。苔根黄腻，脉弦滑转甚。拟加味温胆法。候正。
半夏（青盐水炒二钱） 川石斛（先煎三钱） 广皮（一钱） 川毛连（姜汁炒四分） 益元散（包四钱） 丹
皮炭（一钱五分） 栝蒌皮（三钱） 朱茯神（各三钱） 小枳实（一钱） 黑山栀（一钱五分） 竹二青（盐水炒一
钱半） 荷梗（五钱）
贾（左） 寒热间作，脉糊不爽，此湿疟也。和以化之。
制半夏（一钱五分） 上广皮（一钱） 柴胡（五分） 枳实（一钱） 淡黄芩（一钱五分） 大腹皮（二钱）
川朴（一钱） 草果（四分）
二诊 寒热仍来，汗不获畅。邪势为湿所遏，不得外越。再和以化之。
柴胡 炒杏仁 制半夏 淡黄芩 草果仁 广皮 郁金 赤猪苓 枳实 竹茹
萧（左） 寒热间作，汗不获畅。暑湿阻于表里之间。先为和化。
白蔻仁 大豆卷 柴胡 淡黄芩 川朴 青陈皮 赤白苓 大腹皮 炒枳实
沈（左） 久疟屡止屡发，刻虽止住，而食入不舒，左胁下按之板滞，胃钝少纳。脉濡，苔白质腻。脾胃气弱，
余邪结聚肝络。拟和中运脾疏络。
于潜术（二钱炒） 陈皮（一钱） 川朴（一钱） 制半夏（一钱五分） 沉香曲（一钱五分） 焦楂炭（三钱）
茯苓（一钱） 炒竹茹（一钱） 鳖甲煎丸（一钱五分开水先服）
二诊 脉濡滑，苔白质腻。胃钝少纳，形体恶寒，饮食入胃，命火蒸变，则胃如大烹之鼎，旋入旋化。今湿
有余阳不足，胃气呆钝，亦所不免。拟化湿和中，温助阳气。脾胃能得转旋，则络邪亦归默化也。
奎党参（三钱） 炒于术（一钱） 茯苓（三钱） 煨益智仁（六分） 藿香（三钱） 炒沉香曲（一钱五分）
制半夏（一钱五分） 生熟谷芽（各一钱） 玫瑰花（二朵）
王（左） 少阳间疟。而少阳胆为肝之外府，疟虽止住，肝木纵横，腹痛甚剧，拟疏泄木郁。
杭白芍（一钱五分川桂枝四分同炒） 柴胡（醋炒五分） 香附（醋炒二钱） 茯苓（三钱） 焦楂炭（三钱）
青皮（醋炒一钱） 缩砂仁（五分） 煨姜（二片）
二诊 腹痛大减。肝邪横扰，络滞不宣。效方进退。
杭白芍（一钱五分川桂枝五分同炒） 柴胡（醋炒五分） 金铃子（一钱五分炒） 香附（醋炒二钱） 延
胡索（一钱五分） 青皮（醋炒八分） 茯苓（三钱） 楂炭（三钱） 鳖甲煎丸（二钱先服）
某 寒热稍减，寒势甚微，而热则五心烦躁，喜得凉饮。脉细数，左部微弦。营卫阴阳不和，皆由阴虚而
木火内炽。再和阴而参酸苦涌泄。
制首乌（四钱） 淡黄芩（七分） 香青蒿（一钱五分） 当归炭（一钱五分） 炒木瓜（一钱） 炙鳖甲（四钱）
炒白芍（二钱） 生熟甘草（各二分） 大南枣（二枚）
周（左） 疟症必有黄涎聚于胸中，故曰无痰不成疟也。脉弦主痰饮，故曰疟脉自弦。疟疾湿痰未清，以
西药止截，遂致腹满肤肿面浮，为疟胀重症，未可轻视。
川朴（一钱） 广皮（一钱） 木猪苓（二钱） 五加皮（三钱） 生姜衣（三分） 白术（一钱）
腹皮（一钱五分） 泽泻（一钱五分） 薏仁（四钱） 炙内金（研末调服一钱五分） 范志曲（二钱）
陈（左） 大便通行，热仍起伏，汗出即解。脉象溷数，苔腻心黄。有形之积，虽已下达，而湿热氤氲，极难泄
化。从泄化之中，参入辛温寒以通营卫。
制半夏（一钱五分） 生薏仁（四钱） 赤白苓（四钱） 知母（二钱） 通草（一钱） 草果仁（五分）
上广皮（一钱） 川桂枝（三分） 石膏（煨打三钱）
二诊 昨晚寒热分明，阳明之邪，并归少阳，极为正色。阳明胃脉，上通于心，而少阳胆经，无出无入，虽
有邪居，不能蔓延脏腑，从此不虑病变矣。
制半夏（一钱五分） 淡黄芩（酒炒一钱五分） 建泽泻（一钱五分） 细柴胡（五分） 橘皮（一钱）
通草（一钱） 蔻仁（五分） 生薏仁（四钱） 茯苓（三钱）
三诊 疟未复来，苔未净化。拟和中利湿。
制半夏（一钱五分） 白茯苓（一钱） 陈皮（一钱） 猪苓（二钱） 佛手（七分） 白术（二钱）
川朴（七分） 泽泻（一钱五分） 生熟薏仁（各二钱）
张（左） 寒热五日一来。脉形左大。邪在表里之间。宜为和化。
制半夏 淡黄芩 川朴 草果仁（炒研） 花槟榔 白术 茯苓 柴胡 广皮 老生姜
张（左） 喻氏谓疟必有黄涎聚于胸中，疟而截止，涎安能尽。大泻数次，痰湿当由此而发泄矣。再和中为主。
沉香曲 上广皮 藿香 川朴 赤白苓 泽泻 炒薏仁 煨木香 制半夏
某 由寒热而至瘅疟，少阳之邪，并归阳明。从三焦宣化。
广郁金 大腹皮 蔻仁 通草 赤猪苓 淡黄芩 桔梗 杏仁 制半夏 鲜佛手
（原注）少阳之病寒战，故用柴胡，此转但热，则在阳明，阳土蕴热，宣三焦之气可奏功。
某 疟母结聚，寒热不期而来。营卫阴阳痹阻。再为宣通。
川朴（一钱） 归须（一钱五分） 桂枝（五分） 冬术（二钱炒） 青蒿（鳖血拌炒三钱） 广皮（一钱）
乌药（一钱五分） 槟榔（一钱五分） 焦麦芽（四钱） 焦楂炭（三钱） 延胡索（一钱五分）
二诊 邪结于营络之中，聚形坚硬满而不化。未可过于攻克，以防其散漫等变。
当归尾 蓬术 焦麦芽 西潞党 南楂炭 川桂枝 延胡 炒于术 制川朴
杨（左） 大疟虽止，漫热不退，中脘不舒。痰湿内聚，营卫开合失常。阳气宣畅。其热自退。
川桂枝（四分） 干姜（四分） 制首乌（三钱） 炙鳖甲（先煎五钱） 制香附（二钱） 熟附片（五分）
当归（酒炒二钱） 炒沉香曲（二钱） 制半夏（一钱五分） 茯苓（三钱）
某 温疟不止。宜两和阴阳。
川桂枝 肥知母 橘红 广郁金 冬术 茯苓 泽泻 煨石膏 炒枳实 制半夏
Han Chen: The illness began seven days ago, with chills preceding fever. During chills, there is severe trembling; during fever, there is irritability and thirst, nausea, chest fullness, profuse sweating with a foul odor. The pulse is wiry and slippery, the tongue coating is white, and the tongue body is greasy. At the onset of the illness, seminal emission occurred. If discussing pathogenic factors directly entering the Yin meridians, Yu Jia Yan's (Yu Caiyan) discussion on treating cold damage after sexual exhaustion in his treatment of Huang Changren is extremely detailed. This case is due to seasonal pathogenic factors mixing with dampness, obstructing the Shaoyang and Yangming meridians, named Damp Malaria. The concern is that Shaoyang pathogens merge into Yangming, turning into fever without chills, or persistent fever, leading to many variations, as Shaoyang governs half-exterior and half-interior, having no exit or entry, while the Yangming stomach meridian connects upwards to the heart. If there are both chills and fever, there should be no major complications. Use Xiao Chai Hu Tang (Minor Bupleurum Decoction) to harmonize exterior and interior, combined with Da Yuan Yin (Reach the Primordial Origin Drink) to reach pathogens in the Mu Yuan (Omental Origin). Please advise.
Cleaned Chai Hu (5 fen), Caoguo Ren (5 fen, stir-fried), Hua Binglang (8 fen), Chi Fuling (3 qian), Juhong (1 qian), Huang Qin (1.5 qian, wine-fried), Zhi Banxia (1.5 qian), Zhike (1 qian, stir-fried), Zhi Chuanpu (1 qian), Zhu Ru (1.5 qian, stir-fried with ginger juice).
Zhou (Jiangyin): Chronic cough with recurrent hemoptysis. Phlegm obstructs Ying and Wei (Nutritive and Defensive levels), preventing communication between Yin and Yang. Chills and fever occur every three days. The stagnant Qi of Ying and Wei seeks to vent through the Yang meridians, occasionally intersecting, causing Qi and Blood stagnation, resulting in palpable masses on the left side. The pulse is wiry, slippery, and slightly rapid. There is concern about gradual injury to Yin Qi. To harmonize Yin and Yang, one must unblock the obstruction of Ying and Wei.
Prescribe Baihu Jia Guizhi Fa (White Tiger plus Cinnamon Twig Method), incorporating herbs to promote circulation and search out collaterals.
Chuan Guizhi (4 fen), Fei Zhimu (1.5 qian), Sheng Gancao (3 fen), Yun Fuling (3 qian), Zhishi (1 qian), Xingren Ni (3 qian), Guang Yujin (1.5 qian), Shigao (5 qian, roasted and ground), Fen Danggui (1.5 qian), Biejia Jian Wan (9 pills, taken first with boiling water).
Certain Patient: Severe malaria turning into alternating chills and fever, with profuse sweat and sour, foul odor. Right pulse is soggy and soft, left part is fine and wiry. This is due to failure of phlegm-dampness transport, steaming Yangming, thereby obstructing Ying, Wei, Yin, and Yang. Suitable for harmonizing the middle and resolving phlegm, simultaneously unblocking Ying and Wei.
Zhi Banxia (2 qian), Zhishi (2 qian), Chuan Guizhi (5 fen), Chao Dongzhu (2 qian), Shigao (4 qian, roasted and ground), Juhong (1 qian), Zexie (1.5 qian), Bai Fuling (4 qian), Zhu Erqing (1 qian, stir-fried with ginger juice).
Zheng Meng: Summer-heat and dampness were initially latent in the Moyuan (Membrane Source), now reaching outward from Shaoyang. High fever, irritability, and aversion; upon fever subsiding, sweat flows freely. Tongue coating is yellow in the center and red at the edges. Fear of developing Dan Malaria (Febrile Malaria). Prescribed formula for review.
Fei Zhimu (2 qian), Fuling Pi (4 qian), Hei Shanzhi (2 qian), Guang Yujin (1 qian), Dadou Juan (3 qian), Baiko Ren (5 fen), Yi Yuan San (4 qian), Dan Huangqin (1.5 qian, wine-fried), Xiang Qinghao (1.5 qian), Hegeng (6 qian).
Second Visit: Profuse sweating relieved heat, but phlegm-heat remains unresolved, causing insomnia at night. Root of tongue coating is yellow and greasy, pulse is wiry and slippery, worsening. Prescribe Jiawei Wendan Fa (Modified Warm Gallbladder Method). Awaiting correction.
Banxia (2 qian, stir-fried with green salt water), Chuan Shihu (3 qian, decocted first), Guangpi (1 qian), Chuan Maolian (0.4 qian, stir-fried with ginger juice), Yi Yuan San (4 qian, wrapped), Danpitan (1.5 qian, charred), Gualou Pi (3 qian), Zhufushen (3 qian each), Xiao Zhishi (1 qian), Hei Shanzhi (1.5 qian), Zhu Erqing (1.5 qian, stir-fried with salt water), Hegeng (5 qian).
Jia (Left): Alternating chills and fever, pulse is indistinct and unsmooth, this is Damp Malaria. Harmonize to resolve it.
Zhi Banxia (1.5 qian), Shang Guangpi (1 qian), Chaihu (5 fen), Zhishi (1 qian), Dan Huangqin (1.5 qian), Dafupi (2 qian), Chuanpu (1 qian), Caoguo (4 fen).
Second Visit: Chills and fever persist, sweat is not smooth. Pathogenic factor is restrained by dampness, unable to vent outward. Again, harmonize to resolve it.
Chaihu, Chao Xingren, Zhi Banxia, Dan Huangqin, Caoguo Ren, Guangpi, Yujin, Chi Zhuling, Zhishi, Zhu Ru.
Xiao (Left): Alternating chills and fever, sweat not smooth. Summer-heat and dampness obstruct between exterior and interior. First, harmonize and resolve.
Baiko Ren, Dadou Juan, Chaihu, Dan Huangqin, Chuanpu, Qingchenpi, Chi Bai Ling, Dafupi, Chao Zhishi.
Shen (Left): Long-term malaria repeatedly stopping and recurring. Although currently stopped, discomfort after eating, hardness upon pressing below the left hypochondrium, dull stomach with poor appetite. Pulse is soggy, coating white, tongue body greasy. Spleen and Stomach Qi is weak, residual pathogens accumulate in Liver collaterals. Plan to harmonize middle, strengthen spleen, and unblock collaterals.
Yu Qian Zhu (2 qian, stir-fried), Chenpi (1 qian), Chuanpu (1 qian), Zhi Banxia (1.5 qian), Chenxiang Qu (1.5 qian), Jiao Zhata (3 qian), Fuling (1 qian), Chao Zhu Ru (1 qian), Biejia Jian Wan (1.5 qian, taken first with boiling water).
Second Visit: Pulse soggy and slippery, coating white, tongue body greasy. Dull stomach, poor appetite, aversion to cold. Food entering the stomach, Mingmen Fire steams and transforms, making the stomach like a large cooking tripod, transforming food immediately. Now, dampness is excessive and Yang is insufficient, so dull Stomach Qi is inevitable. Plan to resolve dampness, harmonize middle, and warm-assist Yang Qi. If Spleen and Stomach can rotate properly, collateral pathogens will also silently transform.
Kui Dangshen (3 qian), Chao Yu Zhu (1 qian), Fuling (3 qian), Wei Yizhi Ren (6 fen), Huoxiang (3 qian), Chao Chenxiang Qu (1.5 qian), Zhi Banxia (1.5 qian), Sheng Shu Guya (1 qian each), Meiguihua (2 flowers).
Wang (Left): Shaoyang intermittent malaria. Shaoyang Gallbladder is the outer mansion of the Liver. Although malaria has stopped, Liver Wood spreads horizontally, causing severe abdominal pain. Plan to soothe and drain Wood stagnation.
Hang Baishao (1.5 qian, stir-fried with Chuan Guizhi 4 fen), Chaihu (0.5 qian, vinegar-fried), Xiangfu (2 qian, vinegar-fried), Fuling (3 qian), Jiao Zhata (3 qian), Qingpi (1 qian, vinegar-fried), Suosharen (5 fen), Wei Jiang (2 slices).
Second Visit: Abdominal pain greatly reduced. Liver pathogen disturbs horizontally, collaterals are stagnant and unventilated. Adjust effective prescription.
Hang Baishao (1.5 qian, stir-fried with Chuan Guizhi 5 fen), Chaihu (0.5 qian, vinegar-fried), Jinlingzi (1.5 qian, stir-fried), Xiangfu (2 qian, vinegar-fried), Yanhusuo (1.5 qian), Qingpi (0.8 qian, vinegar-fried), Fuling (3 qian), Zhata (3 qian), Biejia Jian Wan (2 qian, taken first).
Certain Patient: Chills and fever slightly reduced, chills are minimal, but fever causes five-palm irritability, preferring cool drinks. Pulse is fine and rapid, left part slightly wiry. Disharmony of Ying, Wei, Yin, and Yang is all due to Yin deficiency and internal blazing of Wood-Fire. Further harmonize Yin and incorporate Sour-Bitter vomiting/draining methods.
Zhi Shouwu (4 qian), Dan Huangqin (0.7 qian), Xiang Qinghao (1.5 qian), Danggui Tan (1.5 qian), Chao Mugua (1 qian), Zhi Biejia (4 qian), Chao Baishao (2 qian), Sheng Shu Gancao (0.2 qian each), Da Nanzao (2 pieces).
Zhou (Left): Malaria must have yellow saliva accumulating in the chest, hence "No phlegm, no malaria." Wiry pulse indicates phlegm-fluid, hence "Malaria pulse is naturally wiry." Malaria damp-phlegm not cleared, using Western medicine to stop/intercept leads to abdominal fullness, skin swelling, and facial edema, a severe condition of Malaria Distension, not to be underestimated.
Chuanpu (1 qian), Guangpi (1 qian), Mu Zhuling (2 qian), Wujiapi (3 qian), Shengjiangyi (0.3 qian), Baizhu (1 qian), Fupi (1.5 qian), Zexie (1.5 qian), Yiren (4 qian), Zhi Neijin (1.5 qian, powder mixed and taken), Fanzhi Qu (2 qian).
Chen (Left): Bowel movement unblocked, heat still fluctuates, resolves with sweating. Pulse is turbid and rapid, coating greasy with yellow center. Solid accumulation has been discharged downward, but damp-heat is misty and difficult to drain-transform. From draining-transforming, incorporate Pungent-Warm-Cold to unblock Ying and Wei.
Zhi Banxia (1.5 qian), Sheng Yiren (4 qian), Chi Bai Ling (4 qian), Zhimu (2 qian), Tongcao (1 qian), Caoguo Ren (5 fen), Shang Guangpi (1 qian), Chuan Guizhi (0.3 qian), Shigao (3 qian, roasted and beaten).
Second Visit: Last night chills and fever were distinct. Yangming pathogen merged into Shaoyang, which is very typical. Yangming Stomach meridian connects upwards to the heart, while Shaoyang Gallbladder meridian has no exit or entry. Although pathogens reside there, they cannot spread to viscera, thus no need to worry about pathological changes from now on.
Zhi Banxia (1.5 qian), Dan Huangqin (1.5 qian, wine-fried), Jian Zexie (1.5 qian), Xi Chaihu (5 fen), Ju Pi (1 qian), Tongcao (1 qian), Kourén (5 fen), Sheng Yiren (4 qian), Fuling (3 qian).
Third Visit: Malaria has not returned, coating not purified. Plan to harmonize middle and promote dampness drainage.
Zhi Banxia (1.5 qian), Bai Fuling (1 qian), Chenpi (1 qian), Zhuling (2 qian), Foshou (0.7 qian), Baizhu (2 qian), Chuanpu (0.7 qian), Zexie (1.5 qian), Sheng Shu Yiren (2 qian each).
Zhang (Left): Chills and fever come every five days. Pulse shape is larger on the left. Pathogen is between exterior and interior. Should harmonize and resolve.
Zhi Banxia, Dan Huangqin, Chuanpu, Caoguo Ren (stir-fried and ground), Hua Binglang, Baizhu, Fuling, Chaihu, Guangpi, Lao Shengjiang.
Zhang (Left): Yu Shi stated that malaria must have yellow saliva accumulating in the chest. If malaria is stopped, how can saliva be completely exhausted? After several large purgations, phlegm-dampness should be excreted through this. Again, harmonize middle as the main approach.
Chenxiang Qu, Shang Guangpi, Huoxiang, Chuanpu, Chi Bai Ling, Zexie, Chao Yiren, Wei Muxiang, Zhi Banxia.
Certain Patient: Progressing from chills and fever to Dan Malaria, Shaoyang pathogen merges into Yangming. Promote transformation from Triple Burner.
Guang Yujin, Dafupi, Kourén, Tongcao, Chi Zhuling, Dan Huangqin, Jiegeng, Xingren, Zhi Banxia, Xian Foshou.
(Original Note): Shaoyang disease involves chills, hence Chaihu is used. This turns into pure fever, indicating Yangming. Yang Earth accumulates heat, promoting Triple Burner Qi can achieve success.
Certain Patient: Malaria mother (mass) aggregates, chills and fever come unexpectedly. Ying, Wei, Yin, and Yang are obstructed. Again, promote unblocking.
Chuanpu (1 qian), Guixu (1.5 qian), Guizhi (5 fen), Dongzhu (2 qian, stir-fried), Qinghao (3 qian, stir-fried with Biejia blood), Guangpi (1 qian), Wuyao (1.5 qian), Binglang (1.5 qian), Jiao Maiya (4 qian), Jiao Zhata (3 qian), Yanhusuo (1.5 qian).
Second Visit: Pathogen binds within Ying collaterals, forming hard masses that do not transform. Do not attack too severely, to prevent scattering and other variations.
Danggui Wei, Pengzhu, Jiao Maiya, Xi Lu Dang, Nan Zhata, Chuan Guizhi, Yanhu, Chao Yu Zhu, Zhi Chuanpu.
Yang (Left): Severe malaria has stopped, but lingering heat does not recede, epigastric discomfort. Phlegm-dampness gathers internally, Ying and Wei opening/closing functions are abnormal. When Yang Qi is promoted and smooth, heat will retreat spontaneously.
Chuan Guizhi (4 fen), Ganjiang (4 fen), Zhi Shouwu (3 qian), Zhi Biejia (5 qian, decocted first), Zhi Xiangfu (2 qian), Shu Fupian (5 fen), Danggui (2 qian, wine-fried), Chao Chenxiang Qu (2 qian), Zhi Banxia (1.5 qian), Fuling (3 qian).
Certain Patient: Wen Malaria (Warm Malaria) persists. Should harmonize Yin and Yang equally.
Chuan Guizhi, Fei Zhimu, Juhong, Guang Yujin, Dongzhu, Fuling, Zexie, Wei Shigao, Chao Zhishi, Zhi Banxia.