经曰∶ 疟皆生于风，其蓄作有时者何也？歧伯之对，极为详明。后之论者，乃为疟病皆起于
少阳。缘少阳为半表半里之经，进而与阴争则寒，退而与阳争则热，此解相沿已数百年。初阅之似
亦近理，细思之颇为不然。盖疟有一日一作者，有间日一作者，有三日一作者，轻重悬殊，岂得谓
之皆在少阳乎！且进而与阴争，退而与阳争，谁进之而谁退之，岂病之自为进退乎！当其寒也，鼓
颔战栗，固属病进。及其热也，谵语神昏，岂得谓之病退乎！细绎经文，乃恍然大悟。经曰∶此皆
得之夏伤于暑热，因得秋气，汗出遇风，及得之以浴，水气舍于皮肤之间，邪气与卫气并居。此明
明说暑热之气先入于内，后受风寒，包裹热邪，是热邪在里，寒邪在外也。及其与卫气同发，先发
在外之寒邪，故先寒。次发在内之热邪，故后热。至得汗之后，风热渐解，故寒热俱平。则有寒有
热，乃邪之循序而发，而非进与阴争、退与阳争，断断然矣。其一日一作者何也？邪在卫也。经曰
卫气者，昼日行于阳，夜行于阴，内外相搏，是以日作。此言卫气行于人身，一日一周，
邪气与卫气同行，故疟亦一日一作也。其间日一作者何也？邪在营也。经曰∶邪藏于皮肤之内，肠
胃之外此营气之所舍也。邪气在于营分，则虽卫气独发，而邪气在内，不与之并行，更历一周，而
邪气始与卫气相遇，故疟亦间日一作也。其三日一作者何也？邪在腑也。经曰∶邪气与卫气客于六腑
，有时相失，不能相得，故休数日乃作也。可知人之一身，由卫而营，由营而腑，自表及里，自有
一定次第。邪气在腑，已入第三层，故疟亦三日一作也。治之之法，当先投辛温，解其外裹之寒；
更进辛凉，清其内蕴之热；俾得邪从汗出，而病可霍然。至于在营在腑，按经投剂，方有端绪。雄
于前贤，无能为役，何敢自矜独得，妄议古人；然释经辨症，不得不细细推敲，谁谓医为小道，《
内经》易读乎！
初发寒邪，宜辛温解散，辟寒散主之。
辟寒散（自制）
川芎（八分） 防风（一钱） 白芷（五分） 广皮（一钱） 半夏（一钱五分）
羌活（一钱） 秦艽（一钱） 枳壳（一钱） 苏梗（一钱） 姜（三大片）
次发热邪，宜辛凉解散，清暑散主之。
清暑散（自制）
薄荷叶（二钱） 青蒿梗（一钱五分） 石斛（三钱） 贝母（二钱） 葛根（二钱）
连翘（一钱五分） 豆豉（三钱） 杏仁（三钱） 淡竹叶（二十张）
寒热俱重，体盛脉实者，交加散主之。虚人禁用。
交加散（自制）
附子（七分） 石膏（五分） 羌活（一钱） 防风（一钱） 广皮（一钱）
连翘（一钱五分） 葛根（二钱） 豆豉（三钱） 薄荷（一钱） 藿香（一钱） 姜皮
（八分） 荷叶（一角）
疟邪在营，间日一作者，和营双解散主之。
和营双解散（自制）
当归（二钱） 柴胡（一钱） 葛根（二钱） 广皮（一钱） 半夏（一钱五分） 贝
母（二钱） 茯苓（二钱） 防风（一钱） 薄荷（一钱） 苏梗（一钱） 姜
皮（八分） 河井水煎服。
大疟在腑，三日一作者，返正汤主之。
返正汤（自制）
当归（二钱） 茯苓（二钱） 白术（一钱） 炮姜（五分） 葛根（二钱）
广皮（一钱） 半夏（一钱五分） 贝母（二钱） 砂仁（一钱） 青皮（一钱）
大疟日久，正气虚而邪未解者，斑龙托里汤主之。
斑龙托里汤（自制）
陈鹿胶（一钱五分角霜炒） 制首乌（二钱） 当归（二钱） 茯苓（二钱） 白术（一
钱） 广皮（一钱） 半夏（一钱五分） 贝母（二钱） 砂仁（一钱） 党参（四钱）
苏梗（一钱五分） 大枣（二枚） 姜（三片）
冬令受寒，伏藏于肾，春夏举发，寒变为热，先热后寒，名曰温疟，清正散主之。
清正散（自制）
青蒿梗（一钱五分） 薄荷（一钱） 广皮（一钱） 贝母（二钱） 葛根（二钱）
山栀（一钱五分） 连翘（一钱五分） 豆豉（三钱） 杏仁（三钱） 茅根（五钱）
肺素有热，阳气盛而不衰，故但热而不寒，令人消烁脱肉，名曰瘅疟，玉露散主之。
玉露散（自制）
玉竹（四钱） 花粉（二钱） 沙参（四钱） 麦冬（二钱） 石斛（三钱）
贝母（二钱） 杏仁（三钱） 茯苓（二钱） 山药（三钱） 梨（三大片）
The *Classic of Internal Medicine* states: "All malaria arises from wind. Why does its accumulation and occurrence have a fixed time?" Qi Bo's answer is extremely detailed and clear. Later commentators, however, argued that all malaria originates in the Shaoyang (Lesser Yang) channel. Since the Shaoyang channel is half-exterior and half-interior, when the pathogen advances and contends with Yin, chills occur; when it retreats and contends with Yang, fever occurs. This explanation has been followed for hundreds of years. At first glance, it seems reasonable, but upon careful reflection, it is quite incorrect. Malaria manifests as occurring once daily, every other day, or once every three days, with significant differences in severity. How can it be said to all reside in the Shaoyang channel? Moreover, regarding advancing to contend with Yin and retreating to contend with Yang, who causes it to advance and who causes it to retreat? Is it the pathogen moving on its own? When chills occur, teeth chattering and trembling are indeed signs of disease progression. But when fever occurs, accompanied by delirium and coma, how can this be considered disease regression? Carefully analyzing the classic text leads to sudden enlightenment. The text says: "These are all caused by summer injury from heat, combined with autumn air. Sweat exposed to wind, or bathing in water, causes water qi to lodge between the skin. The pathogenic qi resides together with Wei Qi." This clearly states that summer-heat qi enters the interior first, followed by exposure to wind-cold which wraps around the heat pathogen. Thus, the heat pathogen is inside, and the cold pathogen is outside. When they move together with Wei Qi, the exterior cold pathogen activates first, causing initial chills. Then the interior heat pathogen activates, causing subsequent fever. After sweating, the wind-heat gradually resolves, so both chills and fever subside. Therefore, having chills and fever means the pathogen is releasing in sequence, not advancing to contend with Yin and retreating to contend with Yang. This is certain.
Why does it occur once daily? Because the pathogen is in the Wei (Defensive) level. The text says: "Wei Qi travels in the Yang during the day and in the Yin at night. Interior and exterior contend, hence it occurs daily." This refers to Wei Qi circulating through the body, completing one cycle per day. The pathogen moves with Wei Qi, so malaria also occurs once daily.
Why does it occur every other day? Because the pathogen is in the Ying (Nutritive) level. The text says: "The pathogen hides within the skin, outside the intestines and stomach, where Ying Qi resides." When the pathogen is in the Ying level, even if Wei Qi activates alone, the pathogen remains inside and does not move concurrently with it. It must wait for another full cycle before the pathogen meets Wei Qi again, so malaria occurs every other day.
Why does it occur once every three days? Because the pathogen is in the Fu (Hollow) organs. The text says: "The pathogen and Wei Qi lodge in the Six Fu organs. Sometimes they miss each other and cannot interact, so there is a rest period of several days before recurrence." Thus, the human body proceeds from Wei to Ying, from Ying to Fu, from exterior to interior, following a fixed order. The pathogen in the Fu organs has entered the third layer, so malaria occurs once every three days.
The treatment method should first administer acrid-warm herbs to resolve the exterior wrapping cold; then advance to acrid-cool herbs to clear the interior accumulated heat. This allows the pathogen to exit via sweat, and the disease will be cured abruptly. For pathogens in the Ying and Fu levels, prescribing formulas according to the channels provides direction. I am unable to match the contributions of former sages, so how dare I boast of unique insights or rashly critique ancients? However, explaining the classics and differentiating symptoms requires meticulous scrutiny. Who says medicine is a trivial art and the *Inner Canon* easy to read!
For initial cold pathogen attack, use acrid-warm dispersing methods. The main formula is Bi Han San (Cold-Avoiding Powder).
Bi Han San (Self-made)
Chuanxiong Rhizome (8 fen), Saposhnikovia Root (1 qian), Angelica Dahurica Root (5 fen), Tangerine Peel (1 qian), Pinellia Tuber (1.5 qian), Notopterygium Rhizome (1 qian), Gentiana Macrophylla Root (1 qian), Aurantium Fruit (1 qian), Perilla Stem (1 qian), Ginger (3 large slices).
For subsequent heat pathogen attack, use acrid-cool dispersing methods. The main formula is Qing Shu San (Summer-Heat-Clearing Powder).
Qing Shu San (Self-made)
Mint Leaf (2 qian), Artemisia Annua Stem (1.5 qian), Dendrobium Stem (3 qian), Fritillaria Bulb (2 qian), Kudzu Root (2 qian), Forsythia Fruit (1.5 qian), Fermented Soybean (3 qian), Apricot Seed (3 qian), Bamboo Leaf (20 leaves).
When chills and fever are both severe, and the constitution is robust with a forceful pulse, use Jiao Jia San (Interlaced Powder). Contraindicated for deficient persons.
Jiao Jia San (Self-made)
Aconite Lateral Root (7 fen), Gypsum Fibrosum (5 fen), Notopterygium Rhizome (1 qian), Saposhnikovia Root (1 qian), Tangerine Peel (1 qian), Forsythia Fruit (1.5 qian), Kudzu Root (2 qian), Fermented Soybean (3 qian), Mint (1 qian), Patchouli Leaf (1 qian), Ginger Skin (8 fen), Lotus Leaf (1 corner).
For malaria pathogen in the Ying level, occurring every other day, use He Ying Shuang Jie San (Harmonizing Ying and Double-Resolving Powder).
He Ying Shuang Jie San (Self-made)
Angelica Sinensis Root (2 qian), Bupleurum Root (1 qian), Kudzu Root (2 qian), Tangerine Peel (1 qian), Pinellia Tuber (1.5 qian), Fritillaria Bulb (2 qian), Poria (2 qian), Saposhnikovia Root (1 qian), Mint (1 qian), Perilla Stem (1 qian), Ginger Skin (8 fen). Decoct with river well water.
For major malaria pathogen in the Fu organs, occurring every three days, use Fan Zheng Tang (Return-to-Righteousness Decoction).
Fan Zheng Tang (Self-made)
Angelica Sinensis Root (2 qian), Poria (2 qian), Atractylodes Macrocephala Rhizome (1 qian), Processed Ginger (5 fen), Kudzu Root (2 qian), Tangerine Peel (1 qian), Pinellia Tuber (1.5 qian), Fritillaria Bulb (2 qian), Amomum Fruit (1 qian), Green Tangerine Peel (1 qian).
For prolonged major malaria, where righteous Qi is deficient and pathogen remains unresolved, use Ban Long Tuo Li Tang (Spotted Dragon Supporting-Interior Decoction).
Ban Long Tuo Li Tang (Self-made)
Deer Antler Glue (processed with antler horn frost) (1.5 qian), Prepared Polygonum Multiflorum Root (2 qian), Angelica Sinensis Root (2 qian), Poria (2 qian), Atractylodes Macrocephala Rhizome (1 qian), Tangerine Peel (1 qian), Pinellia Tuber (1.5 qian), Fritillaria Bulb (2 qian), Amomum Fruit (1 qian), Codonopsis Root (4 qian), Perilla Stem (1.5 qian), Chinese Jujube (2 pieces), Ginger (3 slices).
If cold is contracted in winter, lying dormant in the Kidney, and erupts in spring/summer, transforming from cold to heat, presenting with fever preceding chills, it is named Wen Malaria (Warm Malaria). The main formula is Qing Zheng San (Clearing-Rectifying Powder).
Qing Zheng San (Self-made)
Artemisia Annua Stem (1.5 qian), Mint (1 qian), Tangerine Peel (1 qian), Fritillaria Bulb (2 qian), Kudzu Root (2 qian), Gardenia Fruit (1.5 qian), Forsythia Fruit (1.5 qian), Fermented Soybean (3 qian), Apricot Seed (3 qian), Imperata Rhizome (5 qian).
If the Lung harbors latent heat, and Yang Qi is abundant and unceasing, resulting in fever without chills, causing emaciation and flesh wasting, it is named Dan Malaria (Crimson Malaria). The main formula is Yu Lu San (Jade Dew Powder).
Yu Lu San (Self-made)
Polygonatum Odoratum Rhizome (4 qian), Trichosanthes Root (2 qian), Glehnia Root (4 qian), Ophiopogon Tuber (2 qian), Dendrobium Stem (3 qian), Fritillaria Bulb (2 qian), Apricot Seed (3 qian), Poria (2 qian), Chinese Yam (3 qian), Pear (3 large slices).