（附论）
夫妊娠病疟者。由夏伤于暑。客于皮肤。至秋因劳动血气。腠理虚。而风邪乘之。动前
暑热。正邪相击。阴阳交争。阳盛则热。阴盛则寒。阴阳相杂。寒热俱歇。若邪动气至。交
争则复发。故疟休作有时。其发寒时节渐晏者。此由风邪客于风府。循膂而下。卫气至一日
一夜。常大会于风府。故发日晏。其发日早者。卫气之行风府。日下一节。二十一日至尾 。
二十二日入脊内。上注于伏冲之脉。其行九日。出于缺盆之内。其气既上。故发更早。其间
日发者。由风邪内搏。五脏横连募原。其道远。其气深。其行迟。不能日作。故间日蓄积乃
发也。妊娠而发者。则寒热之气相迫伤于胎。故多损动也。
又云。凡怀孕妇人病疟。可煎白虎汤、小柴胡、柴胡饮子等药。如大便结硬。可用大柴
胡汤下。微利过。不可大吐泻。恐伤其孕也。经曰夏伤于暑。秋必 疟。
方
松罗散 治妊娠患疟。发时憎寒壮热。口干多吃冷水。腹内 刺。疼痛不止。
松罗（半两） 鳖甲（半两） 恒山（半两） 乌梅肉（七枚） 朱砂 汉防己（各一
两） 泽泻（半两） 麦门冬（一两） 知母 连翘（各半两） 黄丹 石苇 虎杖（各一
分） 生干姜（一两）
清脾汤 治妊娠作疟。热多者。
青皮 浓朴 白术 草果（各二钱） 柴胡 茯苓 半夏 黄芩 甘草 人参（各等分）
常山（一半） 上锉散。每服四钱。生姜五片。地骨皮少许。煎。不时温服。或加麦门冬去
心二十粒。如未即效。宜服胜金丸。
阿胶散
阿胶（一两半） 赤芍药 当归 柴胡 黄芩 白茯苓 白术（各一两） 麦门冬（一
两半） 甘草（半两） 上捣筛为散。每服四钱。水一盏。入葱白二茎。煎至六分去滓。不
计时候。温服。
人参散 治妊娠疟疾。头疼。憎寒壮热。面黄。不思饮食。
人参 知母 麦门冬 柴胡 桑寄生 白茯苓 浓朴（各一两） 甘草（半两） 上捣
筛为散。每服四钱。水一盏。煎至六分去滓。不计时候。温服。
驱邪散 妊娠疟疾者何故。盖营卫虚弱。脾胃不足。或感风寒。或伤生冷。转成疟
疾。急服驱邪散。莫待吐逆。见物不思。卒难医疗。
高良姜 白术 草果仁 橘红 藿香叶 缩砂仁 白茯苓（各一两） 甘草（炙半两） 上
咀。每服四钱。水一盏半。生姜五片。枣一枚。煎至八分去滓。不拘时候。
七宝散 治男子妇人一切疟疾。或先寒后热。或先热后寒。或寒多热少。或热多寒
少。一日一发。或一日两三发。或连日。或间日发。或三四日一发。不问鬼疟。不伏水
土。山岚瘴气似疟者。一治妇人妊娠六七日而患疟疾。皆可服之。
常山 浓朴 青皮 陈皮 甘草 槟榔 草果（去皮各等分） 上 咀。每服半两。于
未
发隔夜用水一碗。酒一盏。煎至一大盏。滤出。露一宿。却将滓。再用酒水更根据前煎一次去
滓。别以碗盛贮。亦露一宿。来日当发之早。荡温面东先服头药少歇再服药滓。大有神效。
尝治一妇妊娠六七个月而染疟疾。先寒后热。六脉浮紧。众医用药。柴胡、桂枝无效。因言
此疾。非常山不愈也。众医不肯。因循数日。病难无计。黾勉治之。遂用七宝散一服愈。黄
帝问曰。妇人重身。毒之奈何。岐伯曰。有故无殒。帝曰愿闻其故何谓也。岐伯曰。大积大
聚其可犯也。衰其大半而止。岂不以审药之性味。明治疗之方。处以中病与疾适好。于半而
止之。勿过。则何疑余于攻治哉。
当归散 治妊娠患疟憎寒体颤。
当归 白芍药 茯苓 枳壳 白术（各一两） 鳖甲（一两） 甘草（锉一两） 上捣
筛为
散。每服四钱。水一盏。煎至六分去滓。不计时。温服。
知母散 治妊娠疟疾。憎寒壮热。口干烦闷。
知母 白茯苓 麦门冬 柴胡（各一两） 乌梅（三分） 大青 甘草（各半两） 上
捣筛为
散。每服四钱。水一盏。煎至六分去滓。不计时候。温服。
治妊娠患疟疾汤。
恒山（二两） 甘草（一两） 黄芩（三两） 乌梅（十四枚） 石膏（八两） 上
咀。以酒水
各一升半。合渍药一宿。煮三四次。去滓。初服六合。次服四合。后服二合。凡三服。一方
有麦门冬去心一两。无石膏。名恒山散。忌海藻、菘菜、生葱。
黄芩散 治妊娠妇患疟疾。寒热头痛。心烦。
黄芩 麦门冬（各一两） 石膏（二两） 甘草（半两） 乌梅（十四个） 上 咀。
每服四
钱。水一盏。煎至六分去滓。温服。一方不计时。
乌梅散 治妊娠疟疾。寒热体痛头疼。烦渴。
乌梅 黄连 桑寄生 人参 甘草（各一两） 上捣筛为散。每服四钱。以酒一盏。煎
至六分去滓。不计时候。温服。
治妊娠患疟疾汤。
恒山 竹叶（各三两） 石膏（八两） 粳米（一百粒） 上 咀。以水六升煮取二升
半。去
滓。分三服。第一服。取末发前一食顷服之。第二服。临欲发服之。余一服。用以涂头额及
胸前五心。药滓置头边。当一日勿近水。及进饮食。过发后。乃进粥食。忌生葱、菜。
鳖甲散 治妊娠疟疾。寒热腹痛。
鳖甲（一两） 干姜（半两） 当归（一两） 桃仁（三分） 上捣细罗为散。每于发
时。用前水调下一钱。
黄连散 治妊娠疟疾。寒热腹痛。
黄连（一两去须） 当归（一两锉微炒） 上捣筛为散。每服三钱。以水一盏。煎至六
分去滓。不计时候。温服。
驱邪散 治妊娠伤寒。变成疟疾。温脾者何。答曰营卫虚弱。脾脏受湿。发伤寒既
愈。转成疟疾。急服。莫待吐逆。见物不思。卒难医疗。
用良姜一两半。以猪胆汁浸一宿。用东壁炒焦。去土。洗切焙之。以北枣一枚。先焙令
干。碾同前药为末二钱。水一盏煎至五分。候疟发时。便服为妙。一方为丸。紫苏汤下二十
丸。
(Attached Discussion)
When a pregnant woman contracts malaria, it is due to summer-heat pathogen injuring the body in summer. The pathogen lodges in the skin. By autumn, physical labor depletes Qi and Blood, causing the Cou Li (skin texture and pores) to become deficient. Wind pathogen takes advantage of this deficiency to invade, stirring up the latent summer-heat. Righteous Qi and evil pathogen clash, leading to a struggle between Yin and Yang. When Yang is excessive, there is fever; when Yin is excessive, there is chills. As Yin and Yang mix alternately, both cold and heat symptoms appear. If the pathogen activates and righteous Qi arrives, they clash again, causing recurrence. Thus, malaria has specific times for onset and remission. If the onset time gradually delays, it is because wind pathogen lodges in the Fengfu point (GV16) and moves down along the spine. Wei Qi (defensive Qi circulating outside the vessels) completes a cycle in the body once every 24 hours, often converging at Fengfu, hence the delayed onset. If the onset time advances, it is because as Wei Qi travels through Fengfu, it descends one vertebral segment daily. After 21 days, it reaches the coccyx; on the 22nd day, it enters the spine interior, ascending into the Fu Chong Mai (deep collateral vessel). It circulates for nine days before emerging from the Quepen area (supraclavicular fossa). Since the pathogen's position has moved upward, the onset occurs earlier. For every-other-day attacks, it is because wind pathogen struggles internally, connecting horizontally with the Zang organs and reaching the Mu Yuan (membranous origin between organs and viscera). The disease site is distant, the pathogen is deep, and its movement is slow, preventing daily attacks. Therefore, it accumulates until sufficient force triggers an attack. During pregnancy, the clashing cold and heat qi damage the Fetus, often causing fetal restlessness or miscarriage.
It is also stated that for pregnant women suffering from malaria, Baihu Tang (White Tiger Decoction), Xiaochaihu Tang (Minor Bupleurum Decoction), or Chaihu Yinzi (Bupleurum Drink) may be decocted and taken. If stool is dry and hard, Daxiehu Tang (Major Bupleurum Decoction) can be used to purge. However, only mild purgation should be induced; violent emesis or severe purgation must be avoided to prevent harming the pregnancy. The Classics state: "Summer injury by summer-heat leads to malaria in autumn."
Formulas:
Songluo San (Pine Moss Powder): Treats malaria during pregnancy, characterized by aversion to cold with high fever, dry mouth craving cold water, stabbing pain in the abdomen, and unceasing pain.
Ingredients: Songluo (Pine Moss, 0.5 liang), Biejia (Tartaric Shell, 0.5 liang), Changshan (Dichroa Root, 0.5 liang), Wumei Rou (Mume Seed Flesh, 7 pieces), Zhusha (Cinnabar), Hanfangji (Stephania Tetrandra, 1 liang each), Zexie (Alisma, 0.5 liang), Maimendong (Ophiopogon Tuber, 1 liang), Zhimu (Anemarrhena Rhizome), Lianqiao (Forsythia Fruit, 0.5 liang each), Huangdan (Lead Oxide), Shiwei (Pyrrosia Leaf), Huzhang (Polygonum Cuspidatum, 1 fen each), Sheng Ganjiang (Raw Dried Ginger, 1 liang).
Qingpi Tang (Clear Spleen Decoction): Treats malaria during pregnancy where heat symptoms predominate.
Ingredients: Qingpi (Aged Tangerine Peel), Houpo (Magnolia Bark), Baizhu (Atractylodes Macrocephala Rhizome), Caoguo (Black Cardamom Fruit, 2 qian each); Chaihu (Bupleurum Root), Fuling (Poria), Banxia (Pinellia Tuber), Huangqin (Scutellaria Root), Gancao (Licorice Root), Renshen (Ginseng Root, equal parts); Changshan (Dichroa Root, half amount). All are coarsely crushed into a powder. Take 4 qian per dose, add 5 slices of Shengjiang (Fresh Ginger) and a small amount of Digupi (Dogwood Cortex). Decoct and take warm at any time. If ineffective, consider Shengjin Wan (Golden Victory Pill).
Ejiao San (Donkey-Hide Gelatin Powder):
Ingredients: Ejiao (Donkey-Hide Gelatin, 1.5 liang); Chishao Yao (Red Peony Root), Danggui (Angelica Sinensis Root), Chaihu (Bupleurum Root), Huangqin (Scutellaria Root), Bai Fuling (White Poria, Baizhu (Atractylodes Macrocephala Rhizome), 1 liang each); Maimendong (Ophiopogon Tuber, 1.5 liang); Gancao (Licorice Root, 0.5 liang). Crush and sieve into a powder. Take 4 qian per dose with one cup of water, adding two stalks of Congbai (Green Onion White). Decoct until reduced to 60%, strain, and take warm at any time.
Renshen San (Ginseng Powder): Treats malaria during pregnancy with headache, aversion to cold with high fever, sallow complexion, and loss of appetite.
Ingredients: Renshen (Ginseng Root), Zhimu (Anemarrhena Rhizome), Maimendong (Ophiopogon Tuber), Chaihu (Bupleurum Root), Sangjisheng (Taxillus Branch), Bai Fuling (White Poria), Houpo (Magnolia Bark, 1 liang each); Gancao (Licorice Root, 0.5 liang). Crush and sieve into a powder. Take 4 qian per dose with one cup of water. Decoct until reduced to 60%, strain, and take warm at any time.
Quxie San (Expel Evil Powder): What causes malaria during pregnancy? Generally, it is due to deficiency of Ying Qi (nutritive Qi) and Wei Qi (defensive Qi), insufficiency of the Spleen and Stomach, contraction of wind-cold, or injury from raw/cold foods, transforming into malaria. Take Quxie Xi urgently; do not wait until vomiting, aversion to food, and difficulty in treatment occur.
Ingredients: Gaoliangjiang (Galangal Rhizome), Baizhu (Atractylodes Macrocephala Rhizome), Caoguo Ren (Black Cardamom Seed), Juhong (Exocarpium Citri Reticulatae Rubrum), Huoxiang Ye (Patchouli Leaf), Suosharen (Amomum Villosum Fruit), Bai Fuling (White Poria, 1 liang each); Gancao (Licorice Root, honey-fried, 0.5 liang). Chop finely. Take 4 qian per dose with 1.5 cups of water, 5 slices of Shengjiang (Fresh Ginger), and one Jujube. Decoct until reduced to 80%, strain, and take at any time.
Qibao San (Seven Treasures Powder): Treats all types of malaria in men and women, whether starting with chills then heat, heat then chills, more chills than heat, or more heat than chills. It applies to daily attacks, multiple attacks per day, consecutive days, every-other-day attacks, or attacks every three to four days. It treats all ghosts' malaria, acclimatization issues, and mountain miasma resembling malaria. It is also suitable for women contracting malaria in the sixth or seventh month of pregnancy.
Ingredients: Changshan (Dichroa Root), Houpo (Magnolia Bark), Qingpi (Aged Tangerine Peel), Chenpi (Aged Tangerine Peel), Gancao (Licorice Root), Binglang (Areca Seed), Caoguo (Black Cardamom Fruit, peeled, equal parts). Chop finely. Take 0.5 liang per dose. On the night before the expected attack, decoct with one bowl of water and one cup of wine until reduced to one large cup. Strain and leave exposed overnight. Return the dregs, decoct again with the same water and wine, strain, store in another bowl, and leave exposed overnight. On the morning of the attack, face East and drink the first decoction. Rest briefly, then consume the second decoction (dregs). This yields great efficacy.
Case Record: I once treated a woman in her sixth or seventh month of pregnancy who contracted malaria, presenting with chills followed by heat and floating-tight pulses in all six positions. Physicians using Chaihu (Bupleurum) and Guizhi (Cinnamon Twig) failed. I stated that only Changshan (Dichroa) could cure this. They refused, delaying treatment for days until the condition became critical. Reluctantly, I administered Qibao San, which cured her in one dose.
The Yellow Emperor asked: How should toxic drugs be used for pregnant women? Qibo answered: If there is a disease, the disease bears the toxicity, and the fetus is not harmed. The Emperor asked for the rationale. Qibo replied: If there are large accumulations or masses, attacking agents may be used, but stop when the pathogen is reduced by more than half. Does this not imply examining drug properties, clarifying treatment formulas, prescribing to hit the disease precisely, and stopping halfway without excess? Then what doubt remains regarding attacking treatments?
Danggui San (Angelica Powder): Treats malaria during pregnancy with aversion to cold and body tremors.
Ingredients: Danggui (Angelica Sinensis Root), Baishao Yao (White Peony Root), Fuling (Poria), Zhike (Bitter Orange Fruit), Baizhu (Atractylodes Macrocephala Rhizome, 1 liang each); Biejia (Tartaric Shell, 1 liang); Gancao (Licorice Root, chopped, 1 liang). Crush and sieve into a powder. Take 4 qian per dose with one cup of water. Decoct until reduced to 60%, strain, and take warm at any time.
Zhimu San (Anemarrhena Powder): Treats malaria during pregnancy with aversion to cold, high fever, dry mouth, and irritability.
Ingredients: Zhimu (Anemarrhena Rhizome), Bai Fuling (White Poria), Maimendong (Ophiopogon Tuber), Chaihu (Bupleurum Root, 1 liang each); Wumei (Mume Seed, 3 fen); Daqing (Isatis Root), Gancao (Licorice Root, 0.5 liang each). Crush and sieve into a powder. Take 4 qian per dose with one cup of water. Decoct until reduced to 60%, strain, and take warm at any time.
Decoction for Treating Malaria in Pregnancy:
Ingredients: Hengshan (Dichroa Root, 2 liang), Gancao (Licorice Root, 1 liang), Huangqin (Scutellaria Root, 3 liang), Wumei (Mume Seed, 14 pieces), Shigao (Gypsum Fibrosum, 8 liang). Chop finely. Soak overnight in 1.5 sheng of wine and 1.5 sheng of water. Boil three to four times, strain. Initial dose: 6 he; second dose: 4 he; third dose: 2 he. Total three doses. Another version includes Maimendong (Ophiopogon Tuber, 1 liang, heart removed) and excludes Shigao (Gypsum Fibrosum), named Hengshan San (Dichroa Powder). Avoid Haizao (Sargassum), Songcai (Chinese Cabbage), and raw Cong (Onion).
Huangqin San (Scutellaria Powder): Treats malaria in pregnant women with chills, heat, headache, and irritability.
Ingredients: Huangqin (Scutellaria Root), Maimendong (Ophiopogon Tuber, 1 liang each); Shigao (Gypsum Fibrosum, 2 liang); Gancao (Licorice Root, 0.5 liang); Wumei (Mume Seed, 14 pieces). Chop finely. Take 4 qian per dose with one cup of water. Decoct until reduced to 60%, strain, and take warm. Another version allows taking at any time.
Wumei San (Mume Powder): Treats malaria during pregnancy with chills, heat, body pain, headache, irritability, and thirst.
Ingredients: Wumei (Mume Seed), Huanglian (Coptis Rhizome), Sangjisheng (Taxillus Branch), Renshen (Ginseng Root), Gancao (Licorice Root, 1 liang each). Crush and sieve into a powder. Take 4 qian per dose with one cup of wine. Decoct until reduced to 60%, strain, and take warm at any time.
Decoction for Treating Malaria in Pregnancy:
Ingredients: Hengshan (Dichroa Root), Zhuye (Bamboo Leaf, 3 liang each); Shigao (Gypsum Fibrosum, 8 liang); Jingmi (Glutinous Rice, 100 grains). Chop finely. Boil in 6 sheng of water until reduced to 2.5 sheng. Strain. Divide into three doses. First dose: take about one meal's time before the expected attack. Second dose: take just before the attack begins. Remaining dose: apply externally to the head, forehead, chest, and five centers (palms, soles, and heart). Place dregs near the head. Avoid water and food intake for the entire day. After the attack passes, resume congee diet. Avoid raw onion and vegetables.
Biejia San (Tartaric Shell Powder): Treats malaria during pregnancy with chills, heat, and abdominal pain.
Ingredients: Biejia (Tartaric Shell, 1 liang); Ganjiang (Dried Ginger, 0.5 liang); Danggui (Angelica Sinensis Root, 1 liang); Taoren (Peach Kernel, 3 fen). Grind finely and sieve into a powder. At the time of attack, take 1 qian mixed with water.
Huanglian San (Coptis Powder): Treats malaria during pregnancy with chills, heat, and abdominal pain.
Ingredients: Huanglian (Coptis Rhizome, 1 liang, remove roots); Danggui (Angelica Sinensis Root, 1 liang, chop and stir-fry slightly). Crush and sieve into a powder. Take 3 qian per dose with one cup of water. Decoct until reduced to 60%, strain, and take warm at any time.
Quxie San (Expel Evil Powder): Treats malaria resulting from cold damage during pregnancy. Why warm the Spleen? Answer: Deficiency of Ying Qi (nutritive Qi) and Wei Qi (defensive Qi), dampness invading the Spleen. After cold damage resolves, it transforms into malaria. Take urgently; do not wait until vomiting and anorexia occur, making treatment difficult.
Usage: Use 1.5 liang of Gaoliangjiang (Galangal Rhizome), soak overnight in Pig Gallbladder Juice. Stir-fry on the east-facing wall until charred, remove soil, wash, cut, and bake dry. Dry-roast one Northern Jujube until dry. Grind together with the previous medicine into powder. Take 2 qian, decoct in one cup of water until reduced to 50%. Take when malaria attacks. Another version forms pills; take 20 pills with Zisu Tang (Perilla Decoction).