治 瘴。神清目开。大小便如常。惟全不能出声身热。
麦冬（去心） 人参 白术 陈皮 川芎 半夏 当归 肉桂 乌梅 大附子 甘草 茯苓（去皮）
上加姜三片。水煎温调。黑神散服。
瘴若神昏直视。不知人事。痰响者属痰。神昏不知人事。不痰响能饮食。惟不能出声。此邪
热涌沸其血。上塞心肺之窍。故不能言也。是方用六君子。缓火邪以补脾救元气。门冬解心肺之热。
乌梅生津以收外泄阳气。归芎以行散上窍之血。血得热则行。故用桂附之热以行之。且能引上焦之
阳下入阴分。再调黑神散。以驱逐其血。血散则心肺之窍开。而声音出矣。
治 瘴。
黑豆（二合半炒去皮） 当归（二两） 蒲黄（二两） 干姜（二两） 熟地（二两）
肉桂（二两去粗皮） 白芍（酒炒五钱） 甘草（五钱）
上为末每服二钱。调麦门冬汤下。瘴病之热专
熬心肺。热甚则涌沸其血。出于上窍。则为吐衄。不能上退场门鼻。惟塞于心肺之窍。则为 瘴。
是方蒲黄能逐败血。芍归能去旧血。生新血。姜能使血行。甘草以和气益血。乃阴类。熟地黑豆。乃
北方之物。合诸药以导血归源也。
治 瘴目上视。口噤痰涎闭塞。昏不知人。遗尿遗屎。及治中风痰甚等证。
生半夏（七两） 南星（二两） 生白附子（二两） 生川乌（五钱）
上为细末。以生绢袋。盛于井花水内。摆出未
出者。再以手揉。令出渣。再研再入。绢袋摆尽为度。于瓷盆中。日晒夜露。每日一换新水。搅
澄清。春五夏三。秋七冬十日。去水晒干。研细以糯米粉煎粥。清为丸。绿豆大。每服二十丸。
生姜汤下。
瘴口噤。目上视。痰涎闭塞。昏不知人。遗尿遗屎。因脾胃感冷。中气不能运痰。以致痰气
上迷心窍。故神昏不能言也。痰生于湿。半夏南星能燥湿。痰滞于寒。
白附之温。川乌之辛热。能祛寒。送以姜汤。最能治痰滞之瘴也。
Treats *Zhang* malaria (malaria-like syndrome characterized by heat and toxicity). The patient is conscious with eyes open, bowel and bladder functions are normal, but completely unable to speak and has a fever.
Ophiopogonis Radix (remove the heart) Ginseng Radix Atractylodis Macrocephalae Rhizoma Citri Reticulatae Pericarpium Chuanxiong Rhizoma Pinelliae Rhizoma Prepared Angelicae Sinensis Radix Cinnamomi Cortex Fructus Mume Radix Aconiti Lateralis Preparata Glycyrrhizae Radix et Rhizoma Poria Sclerotium (remove the bark)
Add three slices of fresh ginger to the above ingredients, decoct in water, and take warm. Administer with Heishen San (Black Divine Powder).
If *Zhang* malaria causes coma, fixed gaze, loss of consciousness, and phlegm rattle in the throat, it belongs to Phlegm syndrome. If there is coma, loss of consciousness, no phlegm rattle, ability to eat, but inability to speak, this is due to pathogenic heat boiling and forcing blood to rush upwards, blocking the orifices of the Heart and Lung, thus causing aphonia. This formula uses Liu Junzi Tang (Six Gentlemen Decoction) principles to soothe fire-heat and tonify the Spleen to rescue Yuan Qi; Ophiopogonis Radix clears Heat from the Heart and Lung; Fructus Mume generates fluids to consolidate Yang Qi leaking externally; Angelicae Sinensis Radix and Chuanxiong Rhizoma move and disperse stagnant Blood in the upper orifices. Blood moves when warmed, hence Cinnamomi Cortex and Aconiti Lateralis Preparata are used for their warmth to promote circulation. Furthermore, they guide Yang Qi from the Upper Jiao down into the Yin divisions. Then, adjust with Heishen San (Black Divine Powder) to expel stagnant Blood. Once the Blood disperses, the orifices of the Heart and Lung open, and speech returns.
Treats *Zhang* malaria.
Soja Seed Preparatum (2.5 he, stir-fried and skin removed) Angelicae Sinensis Radix (2 liang) Polygoni Orientalis Sporangium (2 liang) Zingiberis Rhizoma Preparatum (2 liang) Rehmanniae Radix Preparata (2 liang)
Cinnamomi Cortex (2 liang, remove rough bark) Paeoniae Radix Alba (5 qian, stir-fried with wine) Glycyrrhizae Radix et Rhizoma (5 qian)
Grind the above into powder. Take 2 qian per dose, administered with Maidong Tang (Ophiopogon Decoction). The heat of *Zhang* disease specifically boils the Heart and Lung. When heat is severe, it forces blood to surge and erupt from the upper orifices, resulting in hematemesis or epistaxis. If the blood cannot retreat upwards to the anus or nose but instead blocks the orifices of the Heart and Lung, it results in aphonia (*Zhang*). In this formula, Polygoni Orientalis Sporangium expels stale Blood; Paeoniae Radix Alba and Angelicae Sinensis Radix remove old Blood and generate new Blood; Zingiberis Rhizoma Preparatum promotes Blood circulation; Glycyrrhizae Radix et Rhizoma harmonizes Qi and benefits Blood, possessing a Yin nature. Rehmanniae Radix Preparata and Soja Seed Preparatum are products of the North. Combined with other herbs, they guide Blood back to its source.
Treats *Zhang* malaria presenting with upward deviation of the eyes, lockjaw, obstruction by phlegm-saliva, coma with loss of consciousness, and incontinence of urine and feces. Also treats conditions such as stroke with excessive phlegm.
Pinelliae Rhizoma (7 liang) Arisaematis Rhizoma (2 liang) Typhonii Rhizoma (2 liang) Aconiti Kusnezoffii Radix (5 qian)
Grind the above into fine powder. Place in a raw silk bag and immerse in well water, agitating to extract the active components. For those not yet extracted, knead by hand to release the residue. Grind again and re-enter the bag. Continue until all components are extracted through the silk bag. Place in a porcelain basin, expose to sun during the day and dew at night. Change the water daily, stirring to clarify. Spring: 5 days; Summer: 3 days; Autumn: 7 days; Winter: 10 days. Remove water, dry, grind finely, and use glutinous rice porridge as a binder to form pills, size of mung beans. Take 20 pills per dose, administered with Ginger Decoction.
*Zhang* malaria causing lockjaw, upward deviation of the eyes, obstruction by phlegm-saliva, coma with loss of consciousness, and incontinence occurs because the Spleen and Stomach have contracted cold, and Middle Qi fails to transform phlegm, causing phlegm-Qi to ascend and confuse the Heart orifices, leading to coma and aphonia. Phlegm arises from Dampness; Pinelliae Rhizoma and Arisaematis Rhizoma can dry Dampness. Phlegm stagnates due to Cold; Typhonii Rhizoma's warmth and Aconiti Kusnezoffii Radix's acrid-hot nature can dispel Cold. Administering with Ginger Decoction best treats *Zhang* aphonia caused by phlegm stagnation.