大全云∶妊娠病疟（疟病虐人，症候大都相似，但妊妇患此，恐伤其胎，故立），乃夏伤
于暑，客于皮肤，至秋而发，阳盛则热，阴盛则寒，阴阳相胜，寒热俱作。其发晏者，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；其发早者，卫气之行风府，
日下一节，二十一日，下至尾 ，二十二日，入脊内，上注于伏冲之脉，其行九日出缺盆，其
气既上，故发更早；其间日发者，风邪内搏五脏，横连募原，其道远，其气深，其行迟，不能
日作也。妊娠而发，多伤于肺。
薛氏曰∶前证因脾胃虚弱，饮食停滞，或外邪所感，或郁怒伤脾，或暑邪所伏，实系饮
食停滞，用六君子加桔梗、苍术、藿香；外邪多而饮食少，用藿香正气散；外邪少而饮食多，
用人参养胃汤；劳伤元气，用补中益气汤。若郁怒所伤，用小柴胡汤兼归脾汤；若木侮土，
久而不愈，用六君子为主，佐以安胎药，仍参三阴三阳经而治之。
七宝散 治男妇一切疟疾，或先寒后热，或先热后寒，或寒多热少，或热多寒少，或一
日一发，或一日两三发，或连日发，或间日发，或三四日一发，不问块疟食疟，不伏水土，山
岚瘴气，似疟者并皆治之。
常山 浓朴（姜制） 青皮 陈皮（一不去白，一云去白） 甘草（炒） 槟榔 草果（去壳，各等分）
上 咀，每服半两，于未发隔夜，用水酒各一盏煎至一大盏，去滓，露一宿，再用水酒
煎滓，亦露一宿，来日当发之早，烫温，面东先服头药，少顷再服药滓，大有神效。
准绳云∶尝治一妊妇六七个月患疟，先寒后热，六脉浮紧，医用柴胡、桂枝无效。予曰∶
此非常山不愈。众医难之。越数日疾甚，乃从予治，以七宝散一服瘥。黄帝问曰∶妇人重
身，毒之奈何？歧伯曰∶有故无殒。帝曰∶何谓也？歧伯曰∶大积大聚，其可犯也，衰其大半而
止。诚审药物之性，明治疗之方，何疑攻治哉。
人参养胃汤 治妊娠疟疾，寒多热少，或但寒不热，头痛恶心，身痛面色青白，脉弦迟
者，驱邪散治证亦同。
半夏 浓朴（制） 橘红（各八分） 苍术（一钱） 藿香叶 草果 茯苓 人参（各五分） 甘草（炙，
三分）
上加生姜七片，乌梅一个，水煎服。
清脾饮 治妊娠疟疾，寒少热多，或但热不寒，口苦舌干，大便秘涩，不进饮食，脉弦数者。
青皮 浓朴（姜制） 白术（炒） 草果 茯苓 半夏 黄芩 柴胡 甘草（炙，各五分）
上加生姜，水煎服。
驱邪散 治妊娠停食，感冷发为疟疾。
高良姜（炒） 白术 草果仁 橘红 藿香叶 缩砂仁 白茯苓（各一钱半） 甘草（炙，五分）
上 咀，作一服，加生姜五片，枣一枚，水煎服。
柴胡散 治妊娠疟疾。（此大柴胡汤法也，惟外邪未解，而内热实甚者，宜之。然须酌用）
柴胡（二钱） 生大黄（二钱） 生黄芩（一钱五分） 甘草（一钱）
上作一服，水煎，临发日，五更温服，取利为度。
又方（此方伤暑而内有痰热、多烦渴者宜之）
常山 石膏（各一两） 黄芩 甘草（炙，各半两） 乌梅（七个）
上细切，以水酒各一碗浸一宿，平旦，煎至一碗，去滓，分二服，临发时服。
上二方，犯常山、大黄吐下之剂，若六脉浮紧有力，中有顽痰积热者用之，所谓有故无
殒也。其他疗治方法，已备杂证疟门。若热甚恐致动胎者（若果内热之极，必须用药以清
之），亦如伤寒热病治方，以白药子、伏龙肝等，涂脐上下可也。
The *Yi Zong Bi Du* states: Pregnancy malaria (malaria torments the patient, and symptoms are generally similar, but when pregnant women suffer from this, there is fear of damaging the fetus, hence this syndrome is established separately). It arises from summerheat injury in summer, with pathogenic factors lodging in the skin, manifesting in autumn. When Yang is excessive, heat occurs; when Yin is excessive, cold occurs. As Yin and Yang contend with each other, both cold and heat appear simultaneously. In cases where onset is late, it is due to wind pathogens lodging in the Fengfu (GV16) acupoint, traveling down along the spine. The Wei Qi (Defensive Qi) circulates for a day and night, often converging at Fengfu, thus delaying the onset. In cases where onset is early, the Wei Qi travels through Fengfu, descending one vertebral segment daily. After twenty-one days, it reaches the coccyx; on the twenty-second day, it enters the interior of the spine and ascends into the Fu Chong vessel. Its qi travels nine days to reach the Quepen area. Since the qi has ascended, the onset is earlier. In cases of every-other-day onset, wind pathogens internally constrain the five Zang organs and horizontally connect to the Mu Yuan (Moyuan/Roots of the Abdomen). The disease pathway is distant, the pathogenic qi is deep, and its movement is slow, preventing daily occurrence. Malaria occurring during pregnancy often injures the Lung.
Xue Ji stated: The aforementioned conditions result from Spleen and Stomach deficiency, food stagnation, external pathogenic invasion, emotional depression injuring the Spleen, or latent summerheat. Essentially, they belong to food stagnation. Use Liu Jun Zi Tang (Six Gentlemen Decoction) with Jie Geng (Platycodon Root), Cang Zhu (Atractylodis Rhizoma), and Huo Xiang (Patchouli Herb). If external pathogens are heavy and food stagnation is light, use Huo Xiang Zheng Qi San (Patchouli Powder to Rectify the Qi). If external pathogens are light and food stagnation is heavy, use Ren Shen Yang Wei Tang (Ginseng Decoction to Nourish the Stomach). If labor and fatigue damage Yuan Qi (Original Qi), use Bu Zhong Yi Qi Tang (Decoction to Supplement the Middle and Augment the Qi). If injured by emotional depression, use Xiao Chai Hu Tang (Minor Bupleurum Decoction) combined with Gui Pi Tang (Restore the Spleen Decoction). If Liver Wood insults Spleen Earth and the condition persists for a long time, use Liu Jun Zi Tang as the main formula, assisted by fetal-calming herbs, and treat according to the Three Yin and Three Yang meridians.
Qi Bao San (Seven Treasures Powder): Treats all types of malaria in men and women, whether starting with chills then fever, fever then chills, more chills than fever, more fever than chills, once daily, two or three times daily, consecutive days, every other day, or every three to four days. It treats all forms regardless of mass malaria (Kuai Nue) or food malaria (Shi Nue), maladaptation to local environment, mountain miasma, or malaria-like conditions.
Ingredients: Chang Shan (Dichroa Root), Nong Po (Magnolia Bark processed with ginger), Qing Pi (Green Tangerine Peel), Chen Pi (Tangerine Peel - some say keep the white pith, others say remove it), Gan Cao (Licorice Root roasted), Bing Lang (Areca Seed), Cao Guo (Black Cardamom fruit removed from shell), all in equal proportions.
Usage: Coarsely crush the herbs. Take 0.5 liang per dose. The night before onset, decoct with one cup of water and one cup of wine until reduced to one large cup. Strain the dregs and expose to dew overnight. Decoct the dregs again with water and wine, also exposing to dew overnight. On the morning of onset, face east and take the first decoction first, followed shortly by the second decoction (dregs). This yields great efficacy.
*Zhun Sheng* records: I once treated a pregnant woman of six or seven months suffering from malaria, presenting with chills preceding fever, and floating-tight pulses in all six positions. Physicians used Chai Hu (Bupleurum Root) and Gui Zhi (Cinnamon Twig) without effect. I said: "This will not heal without Chang Shan." The other physicians found this difficult to accept. A few days later, the illness worsened, so they followed my treatment. One dose of Qi Bao San cured her. The *Huang Di Nei Jing* asks: "How should toxic substances be used for a pregnant woman?" Qi Bo answers: "If there is an existing pathology, there will be no miscarriage." The Emperor asks: "What does this mean?" Qi Bo answers: "For large accumulations and masses, attacking agents may be used, but stop when the pathology has diminished by more than half." As long as one carefully examines the nature of drugs and clarifies treatment methods, why doubt attacking therapies?
Ren Shen Yang Wei Tang (Ginseng Decoction to Nourish the Stomach): Treats pregnancy malaria with more chills than fever, or only chills without fever, headache, nausea, body pain, blue-white complexion, and string-taut-slow pulse. The indications for Qu Xie San (Evil-Expelling Powder) are the same.
Ingredients: Ban Xia (Pinellia Tuber), Nong Po (Magnolia Bark processed), Ju Hong (Red Tangerine Peel) (each 8 fen), Cang Zhu (Atractylodis Rhizoma) (1 qian), Huo Xiang Ye (Patchouli Leaf), Cao Guo (Black Cardamom), Fu Ling (Poria), Ren Shen (Ginseng Root) (each 5 fen), Gan Cao (Licorice Root honey-fried) (3 fen).
Usage: Add seven slices of Sheng Jiang (Fresh Ginger) and one Wu Mei (Chinese Plum), decoct with water and take orally.
Qing Pi Yin (Clear the Gallbladder Decoction): Treats pregnancy malaria with less chills and more fever, or only fever without chills, bitter taste in mouth, dry tongue, constipation, loss of appetite, and string-taut-rapid pulse.
Ingredients: Qing Pi (Green Tangerine Peel), Nong Po (Magnolia Bark processed with ginger), Bai Zhu (Atractylodis Macrocephalae Rhizoma stir-fried), Cao Guo (Black Cardamom), Fu Ling (Poria), Ban Xia (Pinellia Tuber), Huang Qin (Scutellaria Root), Chai Hu (Bupleurum Root), Gan Cao (Licorice Root honey-fried) (each 5 fen).
Usage: Add fresh ginger, decoct with water and take orally.
Qu Xie San (Evil-Expelling Powder): Treats pregnancy food stagnation complicated by cold contraction leading to malaria.
Ingredients: Gao Liang Jiang (Galangal Rhizome roasted), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Cao Guo Ren (Black Cardamom seed), Ju Hong (Red Tangerine Peel), Huo Xiang Ye (Patchouli Leaf), Suo Sha Ren (Amomum Fruit), Bai Fu Ling (Poria) (each 1.5 qian), Gan Cao (Licorice Root honey-fried) (5 fen).
Usage: Coarsely crush, prepare as one dose. Add five slices of fresh ginger and one date, decoct with water and take orally.
Chai Hu San (Bupleurum Powder): Treats pregnancy malaria. (This follows the method of Da Chai Hu Tang (Major Bupleurum Decoction), suitable only when exterior pathogens have not resolved and internal heat is severe and excess. However, dosage must be carefully considered.)
Ingredients: Chai Hu (Bupleurum Root) (2 qian), Sheng Da Huang (Rhubarb Root raw) (2 qian), Sheng Huang Qin (Scutellaria Root raw) (1.5 qian), Gan Cao (Licorice Root) (1 qian).
Usage: Prepare as one dose, decoct with water. Take warm at Wugeng (3-5 AM) on the day of onset. Stop when bowel movements become loose.
Another Prescription (Suitable for summerheat injury with internal phlegm-heat and severe irritability/thirst)
Ingredients: Chang Shan (Dichroa Root), Shi Gao (Gypsum Fibrosum) (each 1 liang), Huang Qin (Scutellaria Root), Gan Cao (Licorice Root honey-fried) (each 0.5 liang), Wu Mei (Chinese Plum) (7 pieces).
Usage: Finely chop. Soak in one bowl of water and one bowl of wine overnight. Decoct at dawn until reduced to one bowl. Strain and divide into two doses. Take at the time of malaria onset.
The above two prescriptions contain emetic and purgative agents like Chang Shan and Da Huang. They should be used if the six pulses are floating, tight, and forceful, indicating stubborn phlegm and accumulated heat. This exemplifies "if there is pathology, there is no miscarriage." Other treatment methods are detailed in the miscellaneous diseases section on malaria. If heat is severe and risks disturbing the fetus (if internal heat is extreme, medication is necessary to clear it), follow the treatment principles for febrile diseases in Shang Han (Cold Damage). White Yao Zi (Stemonae Radix) and Fu Long Gan (Furnace Soil) can be applied around the navel.