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Zhang Zhongjing's Biejia Jian Wan (Oyster Shell Pill for Reducing Masses) treats malaria that has not resolved, where qi and blood stagnate to form a mass, known as "Nuomother" (Malaria Mother). (Formula see *Jingui Yaolue*).

Yan Yonghe's Biejia Yin Zi (Oyster Shell Decoction) treats long-standing malaria that does not heal, with masses forming in the abdomen, also called "Nuomother".
Ingredients: Bie Jia (Oyster Shell, prepared with vinegar), Bai Zhu (Atractylodis Rhizoma), Huang Qin (Scutellariae Radix), Cao Guo (Tsaoko Fructus), Bing Lang (Arecae Semen), Xiong Gui (Ligustici Chuanxiong Rhizoma), Ju Hong (Citri Reticulatae Pericarpium), Bai Shao (Paeoniae Radix Alba), Gan Cao (Glycyrrhizae Radix et Rhizoma, prepared), Hou Po (Magnoliae Officinalis Cortex) (all equal parts).
Preparation and Administration: Coarsely crush the above herbs, add seven slices of fresh ginger, one jujube, and a few smoked plums, decoct in water, and take.

Commentary: Malaria often forms癖 (masses) under the left hypochondrium, called "Nuomother", which is an accumulation of the Liver. Malaria belongs to Shaoyang disease (pathology of the Foot-Shaoyang Gallbladder channel); Shaoyang corresponds to the East element, thus returning to the Liver. Moreover, long-standing malaria affects the Blood level, which is also governed by the Liver. Therefore, one should use Bie Jia as the sovereign herb, assisted by minister and courier herbs, adjusting according to the deficiency or excess of the syndrome, without rigidly adhering to this specific formula.

Hong Wan Zi (Red Pill) from *San Yin Fang* specifically treats Shi Nue (Food Stagnation Malaria).
Ingredients: Peng Zhi (Curcumae Rhizoma), San Leng (Sparganii Rhizoma) (each two liang, boiled in vinegar for one shi), Hu Jiao (Piperis Longi Fructus) (one liang), Qing Pi (Citri Reticulatae Pericarpium Viride) (three liang, stir-fried), A Wei (Ferulae Resina) (one fen, dissolved in vinegar).
Preparation and Administration: Grind into fine powder. Separately grind Cang Zhu (Atractylodis Rhizoma) powder. Use A Wei vinegar and rice paste as binders to make pills the size of paulownia seeds. Coat with fried Tu Zhu (Earth Cinnabar). Take 50-100 pills per dose.

Commentary: This formula originates from the Jueyin chapter examples involving Nan Xing (Arisaematis Rhizoma Praeparatum) and Ban Xia (Pinelliae Rhizoma), belonging to warm herbs that eliminate accumulations and unblock stagnant qi. Since Food Stagnation Malaria arises from dietary injury, it should be treated according to the specific cause of injury.

Zhang Hezi's Chang Shan San (Dichroa Powder) induces vomiting to treat malaria.
Ingredients: Chang Shan (Dichroae Radix) (two liang, boiled in water then dried).
Preparation and Administration: Decoct in water, take on an empty stomach.
Also, Li Lu San (Pear and Asarum Powder) and Xiong Huang San (Realgar Powder) from *Jiyao* (see Vomiting Formulas section).

Commentary: Malaria is caused by external pathogens and involves the Upper Jiao; phlegm-saliva often accumulates in the chest and diaphragm. Thus, emesis is used for efficacy. However, herbs like Chang Shan and Pi Shuang (Arsenic) induce vomiting and expel phlegm; although they may bring temporary relief, they damage the Spleen and Stomach. It is better to use non-toxic herbs to achieve efficacy.

Wen Pi San (Warm the Spleen Powder) from *Weisheng Baojian* treats malaria with alternating chills and fever, prolonged intervals, and failure to resolve after a long time.
Ingredients: Zi He Che (Placenta Humana), Lv Dou (Phaseoli Vulgaris Semen) (each one liang), Gan Cao (Glycyrrhizae Radix et Rhizoma) (half liang), Sheng Pi (Raw Arsenic) (one and a half liang, separately ground finely; Zhang Hezi suggests using half qian).
Preparation and Administration: Grind the non-arsenic ingredients into powder, mix uniformly with the arsenic. Take half qian per dose, mixed with a small amount of fresh well-water. Must be taken late at night on the eve of the malaria attack. Avoid meat, alcohol, fruits, raw/cold foods, and fish/meat products for three days. Pregnant women must not take this. Even if taken sincerely by others, it will not cause vomiting. Although this formula contains toxic arsenic, the cooling properties of Placenta, Licorice, and Mung Bean, along with fresh water, can mitigate its toxicity.

Yi Jian Jin (One Cut Gold) treats malaria and is considered a sacred medicine.
Ingredients: Xin Shi (Arsenolite), Liu Huang (Sulfur), equal parts.
Preparation and Administration: Pound into powder in a mortar. Wrap a pinch of the powder in red silk cloth, roll into a pill the size of a bean, secure tightly with fine thread, and cut. Take one pill per dose. Use only when stars are auspicious. Swallow with fresh well-water on an empty stomach. Do not let others know. Alternatively, take the night before.

Chun Sha Dan (Cinnabar Lip Pill) treats malaria.
Ingredients: Zhu Sha (Cinnabar) (one liang five qian; reserve five qian for coating), Xin Shi (Arsenolite), Xiong Huang (Realgar) (each five qian, separately ground finely).
Preparation and Administration: Grind into powder, add six qian of white flour, mix well. Make pills the size of mung beans using water drops. Coat with Cinnabar. Swallow with "rootless water" (rainwater/snowmelt) when stars are auspicious.

Pi Xie Dan (Evil-Repelling Pill) from *Xuanming Fang* treats Lan Zhang (Mountain Miasma), Gui Nue (Ghost Malaria), and Shi Nue (Food Stagnation Malaria).
Ingredients: Lv Dou (Phaseoli Vulgaris Semen), Hei Da Dou (Black Soybean) (each 49 grains), Xin Pi (Arsenic) (half qian, separately ground), Zhu Sha (Cinnabar) (2 grains), Huang Dan (Lead Oxide) (one qian, for coating).
Preparation and Administration: Grind into powder, mix in a mortar, make pills using water drops, divide into 30 pills. Take one pill per dose. Take seven heartwood pieces from peach trees growing towards the southeast, grind them to extract juice. Swallow facing the east at dawn on the day of the attack, just before sunrise. Vinegar soup is also acceptable.

Hong San Zi (Red Scattered Particles) from *San Yin Fang*.
Ingredients: Huang Dan (Lead Oxide) (stir-fried until color changes).
Preparation and Administration: Mix with Jian Cha (Jian Tea), 2.7 qian per dose. Mix with white tea water or warm wine. Another prescription uses garlic (any amount) pounded with Huang Dan to make pills the size of corn kernels. Take one pill early in the morning, facing east, with fresh water.

Commentary: Malaria-dans often use Pi Shuang (Arsenic), a highly toxic substance. Materia Medica states it treats various malarias and wind-phlegm in the chest/diaphragm, serving as an emetic because its nature is extremely dry and strongly dries phlegm. Huang Dan (Lead Oxide) in Materia Medica treats convulsions, epilepsy, clears heat, and descends qi; it is also a drug to overcome phlegm and remove accumulations. Generally, while malaria-dans have the merit of drying phlegm, they severely damage Stomach Qi. Those with weak Spleen/Stomach must exercise extreme caution.

Respectfully noted: For treating malaria, formulas for exterior wind-heat/dampness are detailed in *Jiyao*. Treatment of malaria should follow Danxi's discussions. Chen Wuyue discussed Shi Nue (Damp Malaria) with Zhu Fu Tang (Aconite and Atractylodes Decoction), which is not detailed here. Also, *Jiyao* discusses involvement of the Three Yin channels; although there is one formula for malaria entering the blood, the methods and prescriptions are not sufficiently detailed. Yan Shi stated that malaria arises from phlegm. *San Yin Fang* lists Yi Nue (Epidemic Malaria), Shi Nue, Zhang Nue (Miasma Malaria), and emotions-induced malarias, but most listed formulas are not suitable, and there are many omissions. I speculate the author's intent was that formulas for Spleen Dampness and Dry Heat could treat various malarias generally, hence the lack of detailed description. This explains the omissions. Learners who understand the names and principles, and reflect upon them, can apply treatment. Why wait for exhaustive details?