三诊：其痛并不满腹皆然，则病不在腹膜；痛处若重按，亦无所苦，是病灶在肠之实质。其范围：肠溃疡、慢性肠炎居多。全当归15克，杭白芍9克，熟锦纹9克，桃仁泥24克，薤白头9克，川楝子9克，两头尖9克，皂荚子9克(打)，香橼皮9克，山楂肉9克。四诊：吸气则作咳，是大可玩味。大致腹之胀满，上迫胸膛。黑白丑各4．5克，郁李仁15克(打)，大戟4．5克，海南片6克，杭白芍9克，晚蚕沙12克(包)，葶苈子9克，麦芽9克，糖炒山楂12克，大枣5枚。
五诊：其主症，一则心下痞闷，一则少腹胀满如石，按之有痛处。叠用通便、破气，痞闷略失，胀满大减，而痛亦稍止。吾人据此经验，病者如便不爽利，以致腹壁紧张，按之硬者，十之六七是慢性阿米巴痢，而破气药多寓有杀虫之意。海南片12克，黑白丑各6克，十枣丸3克(分2次吞)，续随子6克，皂荚子9克，台乌药9克，小青皮6克，川楝子9克，山楂肉18克。六诊：叠用猛攻，少腹胀硬者十去其七，其痛亦除。验便有阿米巴痢疾原虫，然则下者亦驱虫之一法。自觉消化力迟钝，再拟消补兼施之法。炮附子4．5克，生白术9克，淮山药9克，十枣丸3．6克(分2次吞)，云苓9克，潞党参9克，炮姜炭4．5克，鸡内金9克，谷麦芽各9克。
[按]先生根据患者的痢疾病史，以及便不爽利、腹胀按之剧痛、腹壁紧张等症状和体征，认为十之六七是慢性阿米巴痢。随后验大便，果然找到阿米巴原虫，可见先生辨证辨病，细致人微。案中提出的"破气药多寓有杀虫之意"，"下者亦驱虫之一法"的见解，经过临床实践，确实可信。
26．马男。病白痢两月于兹，日行七八次，甚则10余次，其质粘，腹不痛而不能自约，有时溲亦欲后。炮附块6克，罂粟壳9克，炮姜炭6克，熟锦纹9克，海南片9克，乌梅4．5克，石榴皮9克，全当归9克，薤白头9克，川楝子9克，脏连丸9克(分2次吞)。
二诊：药三服，滞下次数减其半，其质亦不如往日之纯如白冻，但溏而黑，尚未得正常之便，依然不能自约。炮附块9克，白槿花9克，海南片9克，罂粟壳15克，石榴皮12克，川楝子9克，脏连丸9克(分2次吞)，升麻4．5克，生艾叶9克，车前子15克(包)，木瓜9克。三诊：滞下2个月之久，肠功能未有不伤者，故临圊不能自约而完谷不化。古人于此，多用温脾、附子理中加连。加连者，苦以坚之也。炮附块12克，焦白术15克，炮姜炭9克，潞党参9克，川雅连1．8克(研末分2次吞)，粉甘草3克。另：乌梅丸早晚各服6克。'
四诊：二便不能自约，如不痛者，皆是虚证。其下迄今两月有半，仍有白冻，慢性痢之朕兆也。炮附块6克，诃子肉9克，升麻4．5克，炮姜炭4．5克，土炒党参9克，乌梅6克，生艾叶6克，石榴皮9克，威喜丸12克。五诊：经治，痢之日十余行者，今已三、四行，虽白冻未除，亦稍能见粪。凡痢见粪则愈，而慢性原虫痢则否，古籍有休息之说，溲则便不能自约。炮附块9克，生艾叶9克，罂粟壳12克，诃子肉3克，乌梅肉9克，苦桔梗4．5克，苦参片9克，石榴皮6克，陈红茶9克。另：早服补中益气丸9克，晚服千金驻车丸9克。
[按]本案初诊是由于痢泻日久、大便不能自约。在治疗过程中，虽大便化验未找到原虫，然而先生仍坚持应用具有驱虫作用的海南片、乌梅及乌梅九等药。最后因"溲则便不能自约"，除用清肠温涩、止痢药外，另服补中益气丸以扶正，千金驻车丸以驱虫，是攻补兼施，标本兼顾，患者经服补中益气丸与乌梅丸3个月后，泄痢痊愈。
27．钱男。滞下3个月之久，其腹痛逐渐消失，魄门胀急不舒，食物难消，而精神困顿。附块15克，熟锦纹24克，苦桔梗12克，乌梅15克，槟榔12克，禹余粮24克，罂粟壳15克，薤白头15克，石榴皮24克，川连9克，诃子肉15克，苦参片15克，川楝子15克，黑丑15克。共研细末，蜜泛为丸，如桐子大，每服20粒。
二诊：服丸剂，胀几减除其半。上见呕哕，下则腹胀，气体也。薤白头9克，蓬莪术9克，晚蚕沙9克(包)，尖槟榔6克，炮姜炭4．5克，莱菔子9克，神曲9克，山楂炭12克。另：韭菜根炒猪肝食。[按]病痢3个多月，先生以温涩、苦下并用，且制为丸剂，以缓图其效。果然二诊时，病势除去一半。呕哕、腹胀久病者，总属于脾胃不足，运降失职，故以理气、消导为治。韭菜根炒猪肝，是强壮性营养剂，久痢体虚者适用，但每次量不宜多，以免造成消化不良。
28．王男。越数日，排便如脓状而腹痛，迄今已年余，往日发作无表症，今寒热交作，此卒疾也。青防风9克，荆芥6克，羌独活各4．5克，柴胡9克，生枳实9克，桔梗6克，当归9克，白芍9克，大川芎6克，乌梅丸9克，炒枯赤砂糖9克(分2次冲)。另：苦参子用桂圆肉包吞，每次7～10粒，日2次。
二诊：腹痛剧，外邪罢，下亦频，而其脓如故。油当归9克，炮附块9克，薤白头12克，苦参9克，川楝子9克，延胡索12克，桔梗9克，熟锦纹9克，杏仁泥18克，青防风9克，甘草3克。三诊：下如纯脓，将圊，腹部绞痛不可耐，1周时十数行。炮附片9克，当归12克，海南片9克，白头翁9克，黄柏6克，白芍9克，炮姜炭6克，延胡索9克，薤白头12克，杏仁泥24克，陈红茶6克，石榴皮9克，炒枯赤砂糖9克(分2次冲)。
四诊：脓除，而腹之绞痛、临圊努责者亦罢。夫休息痢，原作辍无常，此不能决其根株。薤白头15克，槟榔12克，生枳实9克，苦参片9克，制黑丑6克，石榴皮9克，白芍9克，苦桔梗6克，炮姜炭4．5克，炒枯赤砂糖9克(分2次冲)。[按]此为慢性痢疾并发外感，经过4次诊治，病情基本稳定。此慢性痢疾颇难根治，所以先生提出"此不能决其根株"。
29．胡男。1周时，便仅四五行，此大佳事。少腹作胀，此因未服炭类，气体无由排泄。炮附块9克，乌梅4．5克，罂粟壳15克，诃子肉9克，川楝子9克，苦参片9克，败酱草15克，槟榔9克，生地榆12克，当归12克，威喜丸12克(吞)。
二诊：便之次数又增加，但临圊不如往日之艰难，绞痛，排泄物纯是白粘液。炮附块9克，生艾叶4．5克，炙乌梅4．5克，诃子肉9克，石榴皮9克，罂粟壳15克，延胡索9克，苦参片9克，陈红茶9克，威喜丸12克，当归9克，炒枯赤砂糖12克(分2次冲)。三诊：进温涩药，排便反爽，可见痢症用攻法，不可一成不变。罂粟壳15克，全当归9克，延胡索9克，禹余粮24克，炙乌梅4．5克，诃子肉6克，生艾叶6克，石榴皮9克，脏连丸6克(分2次服)。
四诊：病痢1个月之久，而今已能见粪，病势渐入坦途。全当归9克，海南片9克，炙乌梅4．5克，生地榆9克，熟锦纹9克，川楝子9克，罂粟壳12克，戊己丸6克(吞)，柿饼霜12克(分2次人)。五诊：改方：熟锦纹6克，加白槿花15克，杭白芍6克。六诊：后重腹痛，十去其八，已能见黄粪，但赤粘液不除。炙乌梅4．5克，白槿花18克，黄柏9克，秦皮9克，滑石15克(包)，生地榆12克，槐花9克，石榴皮9克，百草霜12克(包)。
七诊：病势虽成尾声，而终未根治，以现代观点，亦原虫未尽也。海南片9克，乌梅4．5克，白槿花15克，北秦皮9克，制黑丑6克，川楝子9克，薤白头12克，生地榆12克，艾叶4．5克，石榴皮9克。[按]本案是阿米巴痢疾，经过七诊，病势虽已平定，但先生对杀虫、攻下之剂，仍不肯放弃，可见此病极难根治。
30．朱男。休息痢，现代所谓慢性痢疾，有缠绵多年而不愈者。临固有腹痛感，以汤剂荡之，以丸剂缓之。海南片、杭白芍、熟绵纹、乌梅丸(分吞)各9克，薤白头12克，生枳实9克，苦桔梗4．5克，陈红茶9克。另服育肠圆加石榴皮。[按]育肠圆为洪氏集验方，治远近一切赤白痢，能实肠胃、进饮食。其方组成为：当归30克，肉蔻仁15克，诃子肉15克，黄连0．3克，乌梅0．3克，罂粟壳15克，共研细末，炼蜜制圆，圆大如绿豆许，每服15丸，温陈米饮送，食前服。
31．贾女。腹隐痛，间日一更衣，或日行数次。将圊，腹更痛，圊后则痛止，其便爽利。平素稍进冷食，则脘腹皆痛。盖往者属寒，今者属气。薤白头12克，橘青皮各6克，晚蚕沙9克(包)，制香附9克，延胡索9克，焦枳实9克，神曲9克，肉豆蔻9克，焦麦芽12克，艾叶6克，炮附片9克。二诊：临圊少腹坠痛不可耐，圊后痛大定，但亦隐隐然不舒，一日便下四五行而溏，是肠病也。熟绵纹9克，海南片9克，制香附6克，生枳实9克，薤白头12克，五灵脂9克，炮姜炭6克，制黑丑6克。
三诊：攻之，腹痛大减，便亦调整。经过期不至，腰痛。熟锦纹、当归、杭白芍、五灵脂(包)各9克，炮姜炭4．5克，桃仁9克，炒蒲黄9克(包)，海南片9克，薤白头12克，炒丹皮9克，延胡索9克，大川芎6克。[按]本例腹痛便溏，先生以其往者属寒，今则属气，而予温通法，至三诊见效。足见临床治病，对既往症，务须参酌，三诊用药，大部分是针对月经不调。
1．赵男。两次高热，皆有退清时；当热之将作，凛寒而头剧痛。时间虽不规则，颇类是疟。其苔腻，先以柴平汤消息之。柴胡5克，黄芩9克，党参9克，厚朴3克，姜半夏9克，生苍术5克，陈皮5克，清炙草5克，生姜2片，大枣7枚。[按]此证先寒后热，继之热退身凉，且已反复两次，故谓"颇类是疟"。方以小柴胡汤和解达邪；苔腻，为里有湿痰，复用平胃散燥湿化痰。
2．李女。壮热8日不休，既非回归热，亦非伤寒。据其面容惨淡，实是温疟之类。桂枝6克，知母12克，常山6克，石膏24克，草果6克，生甘草3克，粳米l杯，雄黄0．6克（研吞）。【按】温疟之证，汗出不畅，骨节酸痛，少气烦冤，口渴引冷，苔黄脉洪。桂枝白虎汤为其正方，复加常山、草果、雄黄以劫痰抗疟。
3．唐女。近人研究马鞭草为截疟圣剂。此说未见古人记载，或是经验所得之单方。马鞭草12克，陈胆星5克，煨草果6克，姜半夏9克，甜茶5克，陈青皮各5克，薤白头9克（洗），炒积实9克，粉草2．4克，佛手6克。【按】此先生乐用民间单方之一例。马鞭草截疟确属有效，单味可用至30～60克在疟疾发作前3小时煎服。此方以马鞭草为主，参人宣中化痰截疟之品。
4．邱男。间日疟最为可疑：寒不战栗，热不得汗，但头痛如劈而已。凡疟不作汗者自较有汗为严重。柴胡、党参、全当归各9克，煨草果6克，淡黄芩6克，姜半夏9克，马鞭草12克，粉甘草3克，生姜3片，大枣5枚。【按】正气不足，无力与邪抗争，故寒不战粟，热不得汗。方用小柴胡汤加当归以扶正达邪，草果、马鞭草以截疟。
5．唐女。此间日疟，苔白腻满布。前人称"无疾不作疟"，实对此等证而言，非任何疟疾皆得用本方也。姜半夏9克，煨草果5克，陈胆星5克，薤白头9克，青陈皮各5克，威灵仙9克，炒枳实9克，佛手5克，马鞭草12克，甜茶5克。【按】其苔白腻满布，乃内有湿痰，故用半夏、胆星、陈皮、佛手、薤白头等以化痰湿。草果、甜茶、威灵仙与马鞭草同用则相辅相成，截疟之力更雄。
6．江女。其热间日而作，并不战栗，此疟之不正规者。苔腻有痰。春柴胡6克，淡黄芩9克，煨草果9克，川桂枝3克，执白芍9克，粉甘草3克，象贝母9克，马鞭草15克，春砂仁2．4克，姜半夏9克，生姜2片，大枣5枚。【按】疟疾战栗，是正邪交争的表现，今间日发热，而不战粟，乃卫阳不足。方用桂枝汤助小柴胡汤以和解达邪；砂仁、象贝，以化痰湿；草果、马鞭草以截疟。
7．沈男。旬日前在乡间曾病间日疟，用斑螫膏药外治而愈。长途劳顿，风寒外乘，热又作，但不凛寒战栗。深虑病根未清，转酿他症。杭白芍9克，柴胡5克，黄芩9克，草果2．4克，焦枳实9克，川厚朴3克（后下），青蒿9克，甘草3克，知母9克，全瓜萎12克，槟榔9克。【按】疟疾初愈，病根未除，故感寒、劳倦均易复发。此热多寒少，治以清脾饮加减，偏重清热。槟榔、草果都经现代药理研究证实有截疟作用，瓜萎、枳实、槟榔同用，能除痰通腑，帮助退热。
Third visit: The pain is not present throughout the entire abdomen, indicating that the pathology is not in the peritoneum; pressing heavily on the painful area causes no significant distress, suggesting the lesion is located in the solid tissue of the intestines. The likely scope includes intestinal ulcers or chronic enteritis. Prescription: Quan Dang Gui (Total Angelicae Sinensis Radix) 15g, Hang Bai Shao (Paeoniae Radix Alba) 9g, Shu Jin Wen (Prepared Rhei Radix et Rhizoma) 9g, Tao Ren Ni (Persicam Semen Paste) 24g, Xie Bai Tou (Allii Macrostemonis Bulbus) 9g, Chuan Lian Zi (Toosendan Fructus) 9g, Liang Tou Jian (Gastrodiae Rhizoma) 9g, Zao Jia Zi (Gleditsiae Spina) 9g (crushed), Xiang Yuan Pi (Citri Reticulatae Pericarpium Flavum) 9g, Shan Zha Rou (Crataegi Fructus) 9g.
Fourth visit: Coughing induced by inhalation is a point worthy of careful consideration. Generally, abdominal distension presses upward against the chest. Prescription: Hei Bai Chou (Pharbitidis Semen Nigrum et Album) 4.5g each, Yu Li Ren (Pruni Semen) 15g (crushed), Da Ji (Euphorbiae Pekinensis Radix) 4.5g, Hai Nan Pian (Gambir Extract/Gansui preparation) 6g, Hang Bai Shao (Paeoniae Radix Alba) 9g, Wan Can Sha (Bombyx Batryticatus) 12g (wrapped), Ting Li Zi (Lepidii Semen) 9g, Mai Ya (Hordei Fructus Germinatus) 9g, Tang Chao Shan Zha (Sugar-fried Crataegi Fructus) 12g, Da Zao (Jujubae Fructus) 5 pieces.
Fifth visit: The main symptoms are twofold: one is epigastric fullness and oppression, and the other is lower abdominal distension hard as stone, with tenderness upon pressure. After successive use of purgatives and Qi-breaking herbs, the epigastric oppression has slightly subsided, the distension has greatly reduced, and the pain has also slightly stopped. Based on our clinical experience, if a patient has difficult defecation leading to tense abdominal walls that are hard upon pressure, six or seven out of ten cases are chronic amoebic dysentery, and Qi-breaking herbs often contain the intent of killing parasites. Prescription: Hai Nan Pian (Gambir Extract/Gansui preparation) 12g, Hei Bai Chou (Pharbitidis Semen Nigrum et Album) 6g each, Shi Zao Wan (Ten Date Pill) 3g (taken in two doses), Xu Sui Zi (Euphorbiae Lathyridis Semen) 6g, Zao Jia Zi (Gleditsiae Spina) 9g, Tai Wu Yao (Linderae Radix) 9g, Xiao Qing Pi (Young Citri Reticulatae Pericarpium) 6g, Chuan Lian Zi (Toosendan Fructus) 9g, Shan Zha Rou (Crataegi Fructus) 18g.
Sixth visit: After successive use of strong purgatives, seven-tenths of the lower abdominal hardness and distension have resolved, and the pain has also disappeared. Stool examination revealed Entamoeba histolytica trophozoites, indicating that purgation is also a method for deworming. The patient feels sluggish digestion, so we prescribe a method combining digestion-promoting and tonifying strategies. Prescription: Pao Fu Zi (Prepared Aconiti Lateralis Radix) 4.5g, Sheng Bai Zhu (Atractylodis Macrocephalae Rhizoma) 9g, Huai Shan Yao (Dioscoreae Rhizoma) 9g, Shi Zao Wan (Ten Date Pill) 3.6g (taken in two doses), Yun Ling (Poria) 9g, Lu Dang Shen (Codonopsis Radix) 9g, Pao Jiang Tan (Charred Zingiberis Rhizoma) 4.5g, Ji Nei Jin (Galli Gigerii Endothelium Corneum) 9g, Gu Ya and Mai Ya (Hordei Fructus Germinatus and Setariae Fructus Germinatus) 9g each.
[Commentary] Based on the patient's history of dysentery and symptoms/signs such as difficult defecation, abdominal distension with severe tenderness upon pressure, and tense abdominal wall, the physician concluded that six or seven out of ten cases were chronic amoebic dysentery. Subsequent stool examination indeed found amoebic trophozoites, demonstrating the physician's meticulous integration of syndrome differentiation and disease identification. The views proposed in the case—that "Qi-breaking herbs often contain the intent of killing parasites" and "purgation is also a method for deworming"—have been verified by clinical practice as credible.
26. Male Ma. Suffering from white dysentery for two months, defecating seven to eight times daily, sometimes more than ten times. The consistency is sticky, there is no abdominal pain but an inability to control defecation voluntarily, and sometimes the urge to defecate occurs during urination. Prescription: Pao Fu Kuai (Prepared Aconiti Lateralis Radix Preparata) 6g, Ying Su Ke (Papaveris Pericarpium) 9g, Pao Jiang Tan (Charred Zingiberis Rhizoma) 6g, Shu Jin Wen (Prepared Rhei Radix et Rhizoma) 9g, Hai Nan Pian (Gambir Extract/Gansui preparation) 9g, Wu Mei (Mume Fructus) 4.5g, Shi Liu Pi (Granati Cortex) 9g, Quan Dang Gui (Total Angelicae Sinensis Radix) 9g, Xie Bai Tou (Allii Macrostemonis Bulbus) 9g, Chuan Lian Zi (Toosendan Fructus) 9g, Zang Lian Wan (Viscera-Connecting Pill) 9g (taken in two doses).
Second visit: After three doses, the frequency of diarrhea decreased by half, and the consistency was no longer purely like white jelly as before, but rather loose and black. Normal stool has not yet returned, and voluntary control remains absent. Prescription: Pao Fu Kuai (Prepared Aconiti Lateralis Radix Preparata) 9g, Bai Jin Hua (Hibisci Mutabilis Flos) 9g, Hai Nan Pian (Gambir Extract/Gansui preparation) 9g, Ying Su Ke (Papaveris Pericarpium) 15g, Shi Liu Pi (Granati Cortex) 12g, Chuan Lian Zi (Toosendan Fructus) 9g, Zang Lian Wan (Viscera-Connecting Pill) 9g (taken in two doses), Sheng Ma (Cimicifugae Rhizoma) 4.5g, Sheng Ai Ye (Artemisiae Argyi Folium) 9g, Che Qian Zi (Plantaginis Semen) 15g (wrapped), Mu Gua (Chaenomelis Fructus) 9g.
Third visit: Diarrhea has persisted for two months, inevitably injuring intestinal function, hence the inability to control defecation and undigested food in stool. Ancients typically used Warming Spleen formulas or Fuzi Lizhong Tang added with Huang Lian. Huang Lian is added for its bitter property to consolidate and astringe. Prescription: Pao Fu Kuai (Prepared Aconiti Lateralis Radix Preparata) 12g, Jiao Bai Zhu (Scorched Atractylodis Macrocephalae Rhizoma) 15g, Pao Jiang Tan (Charred Zingiberis Rhizoma) 9g, Lu Dang Shen (Codonopsis Radix) 9g, Chuan Ya Lian (Coptidis Rhizoma) 1.8g (powdered, taken in two doses), Fen Gan Cao (Licorice Root) 3g. Additionally: Wu Mei Wan (Mume Pill) taken morning and evening, 6g each time.
Fourth visit: Inability to control both urination and defecation, without pain, indicates deficiency syndromes. Having had diarrhea for two and a half months with persistent white mucus, this is a sign of chronic dysentery. Prescription: Pao Fu Kuai (Prepared Aconiti Lateralis Radix Preparata) 6g, He Zi Rou (Terminalia Chebulae Fructus) 9g, Sheng Ma (Cimicifugae Rhizoma) 4.5g, Pao Jiang Tan (Charred Zingiberis Rhizoma) 4.5g, Tu Chao Dang Shen (Earth-fried Codonopsis Radix) 9g, Wu Mei (Mume Fructus) 6g, Sheng Ai Ye (Artemisiae Argyi Folium) 6g, Shi Liu Pi (Granati Cortex) 9g, Wei Xi Wan (Wei Xi Pill) 12g.
Fifth visit: After treatment, the frequency of over ten stools per day has reduced to three or four. Although white mucus persists, feces are now visible. Seeing feces generally indicates recovery from dysentery, but not so for chronic protozoal dysentery. Ancient texts mention "resting dysentery," where defecation cannot be controlled during urination. Prescription: Pao Fu Kuai (Prepared Aconiti Lateralis Radix Preparata) 9g, Sheng Ai Ye (Artemisiae Argyi Folium) 9g, Ying Su Ke (Papaveris Pericarpium) 12g, He Zi Rou (Terminalia Chebulae Fructus) 3g, Wu Mei Rou (Mume Fructus Flesh) 9g, Ku Jie Geng (Scrophulariae Radix) 4.5g, Ku Shen Pian (Sophorae Flavescentis Radix) 9g, Shi Liu Pi (Granati Cortex) 6g, Chen Hong Cha (Aged Black Tea) 9g. Additionally: Bu Zhong Yi Qi Wan (Tonify the Middle and Augment the Qi Pill) 9g in the morning, Qian Jin Zhu Che Wan (Thousand Gold Parking Cart Pill) 9g in the evening.
[Commentary] The initial diagnosis was due to prolonged dysentery and diarrhea causing loss of bowel control. Although stool examinations failed to find protozoa during treatment, the physician persisted in using drugs with deworming properties such as Hai Nan Pian (Gambir Extract/Gansui preparation), Wu Mei (Mume Fructus), and Wu Mei Wan (Mume Pill). Finally, due to "inability to control defecation during urination," besides using clearing-intestine, warming-astringent, and anti-diarrheal drugs, Bu Zhong Yi Qi Wan (Tonify the Middle and Augment the Qi Pill) was taken to support healthy Qi, and Qian Jin Zhu Che Wan (Thousand Gold Parking Cart Pill) to expel parasites. This represents a combination of attacking and tonifying, addressing both root and branch. After taking Bu Zhong Yi Qi Wan (Tonify the Middle and Augment the Qi Pill) and Wu Mei Wan (Mume Pill) for three months, the diarrhea and dysentery were cured.
27. Male Qian. Diarrhea persisted for three months. Abdominal pain gradually disappeared, but the anus felt swollen and urgent, food was difficult to digest, and spirit was listless. Prescription: Fu Kuai (Aconiti Lateralis Radix Preparata) 15g, Shu Jin Wen (Prepared Rhei Radix et Rhizoma) 24g, Ku Jie Geng (Scrophulariae Radix) 12g, Wu Mei (Mume Fructus) 15g, Bing Lang (Arecae Semen) 12g, Yu Yu Liang (Levis Corpus Calculum) 24g, Ying Su Ke (Papaveris Pericarpium) 15g, Xie Bai Tou (Allii Macrostemonis Bulbus) 15g, Shi Liu Pi (Granati Cortex) 24g, Chuan Lian (Coptidis Rhizoma) 9g, He Zi Rou (Terminalia Chebulae Fructus) 15g, Ku Shen Pian (Sophorae Flavescentis Radix) 15g, Chuan Lian Zi (Toosendan Fructus) 15g, Hei Chou (Pharbitidis Semen Nigrum) 15g. Pulverized into fine powder, honey-pelleted into pills the size of tung seeds, 20 pills per dose.
Second visit: After taking the pill, distension reduced by nearly half. Upper body shows vomiting and hiccups, lower body shows abdominal distension due to gas. Prescription: Xie Bai Tou (Allii Macrostemonis Bulbus) 9g, Peng E Zhu (Curcumae Rhizoma) 9g, Wan Can Sha (Bombyx Batryticatus) 9g (wrapped), Jian Bing Lang (Sharp Arecae Semen) 6g, Pao Jiang Tan (Charred Zingiberis Rhizoma) 4.5g, Lai Fu Zi (Raphani Semen) 9g, Shen Qu (Massa Medicata Fermentata) 9g, Shan Zha Tan (Charred Crataegi Fructus) 12g. Additionally: Stir-fried pork liver with leek roots. [Commentary] For dysentery lasting over three months, the physician used warming-astringent and bitter-purgative methods together, formulated as pills for slow effect. Indeed, by the second visit, the disease severity was halved. Vomiting, hiccups, and abdominal distension in chronic patients generally belong to spleen-stomach deficiency and failure of transportation and descent functions, so treatment focuses on regulating Qi and promoting digestion. Stir-fried pork liver with leek roots is a strengthening nutritional agent suitable for chronic dysentery with body weakness, but the quantity per serving should not be excessive to avoid indigestion.
28. Male Wang. Several days later, stool became pus-like with abdominal pain, persisting for over a year. Previous episodes had no exterior symptoms, but today there are alternating chills and fever, indicating an acute onset. Prescription: Qing Fang Feng (Saposhnikoviae Radix) 9g, Jing Jie (Schizonepetae Spica) 6g, Qiang Huo (Notopterygii Rhizoma et Radix) and Du Huo (Angelicae Pubescentis Radix) 4.5g each, Chai Hu (Bupleuri Radix) 9g, Sheng Zhi Shi (Immature Aurantii Fructus) 9g, Jie Geng (Platycodonis Radix) 6g, Dang Gui (Angelicae Sinensis Radix) 9g, Bai Shao (Paeoniae Radix Alba) 9g, Da Chuan Xiong (Ligusticum Chuanxiong Rhizoma) 6g, Wu Mei Wan (Mume Pill) 9g, Chao Ku Chi Sha Tang (Stir-fried Charred Brown Sugar) 9g (dissolved in two doses). Additionally: Ku Shen Zi (Sophorae Flavescentis Seed) wrapped in longan flesh, 7–10 grains per dose, twice daily.
Second visit: Severe abdominal pain, exterior pathogens resolved, frequent defecation, but pus remains. You Dang Gui (Oil-treated Angelicae Sinensis Radix) 9g, Pao Fu Kuai (Prepared Aconiti Lateralis Radix Preparata) 9g, Xie Bai Tou (Allii Macrostemonis Bulbus) 12g, Ku Shen (Sophorae Flavescentis Radix) 9g, Chuan Lian Zi (Toosendan Fructus) 9g, Yan Hu Suo (Corydalis Rhizoma) 12g, Jie Geng (Platycodonis Radix) 9g, Shu Jin Wen (Prepared Rhei Radix et Rhizoma) 9g, Xing Ren Ni (Prunus Armeniaca Semen Paste) 18g, Qing Fang Feng (Saposhnikoviae Radix) 9g, Gan Cao (Licorice Root) 3g.
Third visit: Stool is pure pus. Before defecation, unbearable abdominal colic occurs, with more than ten movements per week. Prescription: Pao Fu Pian (Prepared Aconiti Lateralis Radix Slice) 9g, Dang Gui (Angelicae Sinensis Radix) 12g, Hai Nan Pian (Gambir Extract/Gansui preparation) 9g, Bai Tou Weng (Pulsatillae Radix) 9g, Huang Bo (Phellodendri Cortex) 6g, Bai Shao (Paeoniae Radix Alba) 9g, Pao Jiang Tan (Charred Zingiberis Rhizoma) 6g, Yan Hu Suo (Corydalis Rhizoma) 9g, Xie Bai Tou (Allii Macrostemonis Bulbus) 12g, Xing Ren Ni (Prunus Armeniaca Semen Paste) 24g, Chen Hong Cha (Aged Black Tea) 6g, Shi Liu Pi (Granati Cortex) 9g, Chao Ku Chi Sha Tang (Stir-fried Charred Brown Sugar) 9g (dissolved in two doses).
Fourth visit: Pus eliminated, and abdominal colic and straining during defecation have ceased. Resting dysentery originally presents with irregular attacks; here, the root cause cannot be determined. Prescription: Xie Bai Tou (Allii Macrostemonis Bulbus) 15g, Bing Lang (Arecae Semen) 12g, Sheng Zhi Shi (Immature Aurantii Fructus) 9g, Ku Shen Pian (Sophorae Flavescentis Radix) 9g, Zhi Hei Chou (Processed Pharbitidis Semen Nigrum) 6g, Shi Liu Pi (Granati Cortex) 9g, Bai Shao (Paeoniae Radix Alba) 9g, Ku Jie Geng (Scrophulariae Radix) 6g, Pao Jiang Tan (Charred Zingiberis Rhizoma) 4.5g, Chao Ku Chi Sha Tang (Stir-fried Charred Brown Sugar) 9g (dissolved in two doses). [Commentary] This is chronic dysentery complicated by an exterior infection. After four visits, the condition stabilized. Chronic dysentery is difficult to cure completely, hence the physician stated "the root cause cannot be determined."
29. Male Hu. Within a week, defecation occurred only four or five times, which is very good. Lower abdominal distension occurred because carbon-type astringents were not taken, preventing gas expulsion. Prescription: Pao Fu Kuai (Prepared Aconiti Lateralis Radix Preparata) 9g, Wu Mei (Mume Fructus) 4.5g, Ying Su Ke (Papaveris Pericarpium) 15g, He Zi Rou (Terminalia Chebulae Fructus) 9g, Chuan Lian Zi (Toosendan Fructus) 9g, Ku Shen Pian (Sophorae Flavescentis Radix) 9g, Bai Jiang Cao (Patriniae Herba) 15g, Bing Lang (Arecae Semen) 9g, Sheng Di Yu (Sanguisorbae Radix) 12g, Dang Gui (Angelicae Sinensis Radix) 12g, Wei Xi Wan (Wei Xi Pill) 12g (swallowed).
Second visit: Defecation frequency increased again, but defecation was less difficult than before, with colic, and excretion was purely white mucus. Prescription: Pao Fu Kuai (Prepared Aconiti Lateralis Radix Preparata) 9g, Sheng Ai Ye (Artemisiae Argyi Folium) 4.5g, Zhi Wu Mei (Honey-fried Mume Fructus) 4.5g, He Zi Rou (Terminalia Chebulae Fructus) 9g, Shi Liu Pi (Granati Cortex) 9g, Ying Su Ke (Papaveris Pericarpium) 15g, Yan Hu Suo (Corydalis Rhizoma) 9g, Ku Shen Pian (Sophorae Flavescentis Radix) 9g, Chen Hong Cha (Aged Black Tea) 9g, Wei Xi Wan (Wei Xi Pill) 12g, Dang Gui (Angelicae Sinensis Radix) 9g, Chao Ku Chi Sha Tang (Stir-fried Charred Brown Sugar) 12g (dissolved in two doses).
Third visit: Taking warming-astringent herbs resulted in smoother defecation, showing that treating dysentery with purgative methods cannot be rigidly applied. Prescription: Ying Su Ke (Papaveris Pericarpium) 15g, Quan Dang Gui (Total Angelicae Sinensis Radix) 9g, Yan Hu Suo (Corydalis Rhizoma) 9g, Yu Yu Liang (Levis Corpus Calculum) 24g, Zhi Wu Mei (Honey-fried Mume Fructus) 4.5g, He Zi Rou (Terminalia Chebulae Fructus) 6g, Sheng Ai Ye (Artemisiae Argyi Folium) 6g, Shi Liu Pi (Granati Cortex) 9g, Zang Lian Wan (Viscera-Connecting Pill) 6g (taken in two doses).
Fourth visit: Dysentery lasted one month, but now feces are visible, indicating the disease is entering a favorable stage. Prescription: Quan Dang Gui (Total Angelicae Sinensis Radix) 9g, Hai Nan Pian (Gambir Extract/Gansui preparation) 9g, Zhi Wu Mei (Honey-fried Mume Fructus) 4.5g, Sheng Di Yu (Sanguisorbae Radix) 9g, Shu Jin Wen (Prepared Rhei Radix et Rhizoma) 9g, Chuan Lian Zi (Toosendan Fructus) 9g, Ying Su Ke (Papaveris Pericarpium) 12g, Wu Ji Wan (Wu Ji Pill) 6g (swallowed), Shi Bing Shuang (Persimmon Frost) 12g (added in two doses).
Fifth visit: Modified prescription: Shu Jin Wen (Prepared Rhei Radix et Rhizoma) 6g, add Bai Jin Hua (Hibisci Mutabilis Flos) 15g, Hang Bai Shao (Paeoniae Radix Alba) 6g.
Sixth visit: Tenesmus and abdominal pain reduced by eight-tenths, yellow feces are visible, but red mucus persists. Prescription: Zhi Wu Mei (Honey-fried Mume Fructus) 4.5g, Bai Jin Hua (Hibisci Mutabilis Flos) 18g, Huang Bo (Phellodendri Cortex) 9g, Qin Pi (Fraxini Cortex) 9g, Hua Shi (Talcum) 15g (wrapped), Sheng Di Yu (Sanguisorbae Radix) 12g, Huai Hua (Sophorae Flos) 9g, Shi Liu Pi (Granati Cortex) 9g, Bai Cao Shuang (Ash of Hundred Herbs) 12g (wrapped).
Seventh visit: Although the disease is nearing its end, it has not been completely cured. From a modern perspective, protozoa may still remain. Prescription: Hai Nan Pian (Gambir Extract/Gansui preparation) 9g, Wu Mei (Mume Fructus) 4.5g, Bai Jin Hua (Hibisci Mutabilis Flos) 15g, Bei Qin Pi (Fraxini Cortex) 9g, Zhi Hei Chou (Processed Pharbitidis Semen Nigrum) 6g, Chuan Lian Zi (Toosendan Fructus) 9g, Xie Bai Tou (Allii Macrostemonis Bulbus) 12g, Sheng Di Yu (Sanguisorbae Radix) 12g, Ai Ye (Artemisiae Argyi Folium) 4.5g, Shi Liu Pi (Granati Cortex) 9g. [Commentary] This case is amoebic dysentery. After seven visits, although the disease is subdued, the physician refuses to abandon insect-killing and purgative agents, showing how difficult this disease is to cure completely.
30. Male Zhu. Resting dysentery, known in modern medicine as chronic dysentery, can linger for years without healing. There is inherent abdominal pain. Decoctions are used to sweep away pathogens, while pills are used for slow resolution. Prescription: Hai Nan Pian (Gambir Extract/Gansui preparation), Hang Bai Shao (Paeoniae Radix Alba), Shu Mian Wen (Prepared Rhei Radix et Rhizoma), Wu Mei Wan (Mume Pill - taken separately) each 9g, Xie Bai Tou (Allii Macrostemonis Bulbus) 12g, Sheng Zhi Shi (Immature Aurantii Fructus) 9g, Ku Jie Geng (Scrophulariae Radix) 4.5g, Chen Hong Cha (Aged Black Tea) 9g. Additionally take Yu Chang Yuan (Intestinal-Nourishing Pill) with added Shi Liu Pi (Granati Cortex). [Commentary] Yu Chang Yuan comes from Hong Shi Ji Yan Fang, treating all types of bloody and white dysentery, strengthening the intestines and stomach, and promoting appetite. Its composition is: Dang Gui (Angelicae Sinensis Radix) 30g, Rou Kou Ren (Myristicae Semen) 15g, He Zi Rou (Terminalia Chebulae Fructus) 15g, Huang Lian (Coptidis Rhizoma) 0.3g, Wu Mei (Mume Fructus) 0.3g, Ying Su Ke (Papaveris Pericarpium) 15g. Pulverized, honey-pelleted into pills the size of mung beans, 15 pills per dose, taken with warm aged rice water before meals.
31. Female Jia. Dull abdominal pain, defecating once every other day or several times a day. Pain increases before defecation and stops after, with smooth stool passage. Usually, consuming cold food causes epigastric and abdominal pain. Previously attributed to cold, currently attributed to Qi stagnation. Prescription: Xie Bai Tou (Allii Macrostemonis Bulbus) 12g, Ju Qing Pi (Citri Reticulatae Pericarpium Viride et Flavum) 6g each, Wan Can Sha (Bombyx Batryticatus) 9g (wrapped), Zhi Xiang Fu (Cyperi Rhizoma) 9g, Yan Hu Suo (Corydalis Rhizoma) 9g, Jiao Zhi Shi (Scorched Immature Aurantii Fructus) 9g, Shen Qu (Massa Medicata Fermentata) 9g, Rou Dou Kou (Myristicae Semen) 9g, Jiao Mai Ya (Scorched Hordei Fructus Germinatus) 12g, Ai Ye (Artemisiae Argyi Folium) 6g, Pao Fu Pian (Prepared Aconiti Lateralis Radix Slice) 9g.
Second visit: Severe lower abdominal pain before defecation, significantly relieved after, but lingering discomfort remains. Defecating four to five times daily with loose stool indicates intestinal disease. Prescription: Shu Mian Wen (Prepared Rhei Radix et Rhizoma) 9g, Hai Nan Pian (Gambir Extract/Gansui preparation) 9g, Zhi Xiang Fu (Cyperi Rhizoma) 6g, Sheng Zhi Shi (Immature Aurantii Fructus) 9g, Xie Bai Tou (Allii Macrostemonis Bulbus) 12g, Wu Ling Zhi (Trogopterori Faeces) 9g, Pao Jiang Tan (Charred Zingiberis Rhizoma) 6g, Zhi Hei Chou (Processed Pharbitidis Semen Nigrum) 6g.
Third visit: After purgation, abdominal pain greatly reduced, stool normalized. Menstruation is delayed, accompanied by lower back pain. Prescription: Shu Jin Wen (Prepared Rhei Radix et Rhizoma), Dang Gui (Angelicae Sinensis Radix), Hang Bai Shao (Paeoniae Radix Alba), Wu Ling Zhi (Trogopterori Faeces - wrapped) each 9g, Pao Jiang Tan (Charred Zingiberis Rhizoma) 4.5g, Tao Ren (Persicam Semen) 9g, Chao Pu Huang (Polygoni Multiflori Caulis - stir-fried) 9g (wrapped), Hai Nan Pian (Gambir Extract/Gansui preparation) 9g, Xie Bai Tou (Allii Macrostemonis Bulbus) 12g, Chao Dan Pi (Moutan Cortex - stir-fried) 9g, Yan Hu Suo (Corydalis Rhizoma) 9g, Da Chuan Xiong (Ligusticum Chuanxiong Rhizoma) 6g. [Commentary] For this case of abdominal pain and loose stool, the physician considered previous cold patterns and current Qi stagnation, applying warming and unblocking methods, effective by the third visit. This shows that in clinical practice, past medical history must be consulted. The third visit prescriptions largely targeted irregular menstruation.
Malaria
1. Male Zhao. Two episodes of high fever, each resolving completely; just before the fever starts, there is severe chills and intense headache. Although the timing is irregular, it resembles malaria. Tongue coating is greasy. Initially treat with Chai Ping Tang (Bupleurum and Pingwei Decoction) with caution. Prescription: Chai Hu (Bupleuri Radix) 5g, Huang Qin (Scutellariae Radix) 9g, Dang Shen (Codonopsis Radix) 9g, Hou Po (Magnoliae Officinalis Cortex) 3g, Jiang Ban Xia (Pinelliae Tuber - ginger processed) 9g, Sheng Cang Zhu (Atractylodis Rhizoma - raw) 5g, Chen Pi (Citri Reticulatae Pericarpium) 5g, Qing Zhi Gan Cao (Licorice Root - clear honey-fried) 5g, Sheng Jiang (Zingiberis Rhizoma Recens) 2 slices, Da Zao (Jujubae Fructus) 7 pieces. [Commentary] This syndrome features chills followed by fever, then cooling down, repeated twice, thus described as "resembling malaria." The formula uses Xiao Chai Hu Tang (Minor Bupleurum Decoction) to harmonize and expel pathogens; the greasy coating indicates damp-phlegm inside, so Ping Wei San (Powder to Maintain Wellness) is added to dry dampness and transform phlegm.
2. Female Li. High fever for 8 days without relief, neither recurrent fever nor shaoyang syndrome. Given her pale complexion, it is likely warm malaria. Prescription: Gui Zhi (Cinnamomi Ramulus) 6g, Zhi Mu (Anemarrhenae Rhizoma) 12g, Chang Shan (Dichroae Radix) 6g, Shi Gao (Gypsum Fibrosum) 24g, Cao Guo (Tsaoko Fructus) 6g, Sheng Gan Cao (Licorice Root) 3g, Jing Mi (Oryza Sativa Grain) 1 cup, Xiong Huang (Realgar) 0.6g (powdered, swallowed). [Commentary] Symptoms of warm malaria include incomplete sweating, sore joints, shortness of breath, irritability, thirst for cold drinks, yellow tongue coating, and surging pulse. Gui Zhi Bai Hu Tang (Cinnamon Twig and White Tiger Decoction) is the standard formula, supplemented with Chang Shan (Dichroae Radix), Cao Guo (Tsaoko Fructus), and Xiong Huang (Realgar) to resolve phlegm and combat malaria.
3. Female Tang. Recent studies suggest Verbena officinalis is a holy remedy for stopping malaria. This view is not recorded in ancient texts, possibly an empirical folk single herb. Prescription: Ma Bian Cao (Verbena Herba) 12g, Chen Dan Xing (Arisaema Cum Bile - aged) 5g, Wei Cao Guo (Roasted Tsaoko Fructus) 6g, Jiang Ban Xia (Pinelliae Tuber - ginger processed) 9g, Tian Cha (Sweet Tea) 5g, Chen Qing Pi (Young Citri Reticulatae Pericarpium - aged) 5g, Xie Bai Tou (Allii Macrostemonis Bulbus) 9g (washed), Chao Zhi Shi (Immature Aurantii Fructus - stir-fried) 9g, Fen Gan Cao (Licorice Root) 2.4g, Fo Shou (Citri Sarcodactylis Fructus) 6g. [Commentary] This is an example of the physician's preference for folk single herbs. Verbena officinalis is indeed effective for malaria; a single dose can be 30–60g, decocted 3 hours before malaria onset. This formula centers on Verbena officinalis, combined with herbs that ventilate the middle, transform phlegm, and stop malaria.
4. Male Qiu. Alternating-day malaria is highly suspected: chills without shivering, fever without sweating, only splitting headache. Malaria without sweating is generally more severe than with sweating. Prescription: Chai Hu (Bupleuri Radix), Dang Shen (Codonopsis Radix), Quan Dang Gui (Total Angelicae Sinensis Radix) each 9g, Wei Cao Guo (Roasted Tsaoko Fructus) 6g, Dan Huang Qin (Light Scutellariae Radix) 6g, Jiang Ban Xia (Pinelliae Tuber - ginger processed) 9g, Ma Bian Cao (Verbena Herba) 12g, Fen Gan Cao (Licorice Root) 3g, Sheng Jiang (Zingiberis Rhizoma Recens) 3 slices, Da Zao (Jujubae Fructus) 5 pieces. [Commentary] Insufficient healthy Qi lacks the strength to struggle against pathogens, hence no shivering during chills and no sweating during fever. The formula uses Xiao Chai Hu Tang (Minor Bupleurum Decoction) plus Dang Gui (Angelicae Sinensis Radix) to support healthy Qi and expel pathogens, and Cao Guo (Tsaoko Fructus) and Ma Bian Cao (Verbena Herba) to stop malaria.
5. Female Tang. This alternating-day malaria presents with a tongue coating of white grease covering the entire surface. Ancients said "no dampness, no malaria," referring specifically to such syndromes, not all malaria. Prescription: Jiang Ban Xia (Pinelliae Tuber - ginger processed) 9g, Wei Cao Guo (Roasted Tsaoko Fructus) 5g, Chen Dan Xing (Arisaema Cum Bile - aged) 5g, Xie Bai Tou (Allii Macrostemonis Bulbus) 9g, Qing Chen Pi (Citri Reticulatae Pericarpium Viride et Flavum) 5g each, Wei Ling Xian (Syneilesidis Rhizoma) 9g, Chao Zhi Shi (Immature Aurantii Fructus - stir-fried) 9g, Fo Shou (Citri Sarcodactylis Fructus) 5g, Ma Bian Cao (Verbena Herba) 12g, Tian Cha (Sweet Tea) 5g. [Commentary] The white greasy coating indicates internal damp-phlegm, so Ban Xia (Pinelliae Tuber), Dan Xing (Arisaema Cum Bile), Chen Pi (Citri Reticulatae Pericarpium), Fo Shou (Citri Sarcodactylis Fructus), and Xie Bai Tou (Allii Macrostemonis Bulbus) are used to transform phlegm-dampness. Cao Guo (Tsaoko Fructus), Tian Cha (Sweet Tea), Wei Ling Xian (Syneilesidis Rhizoma), and Ma Bian Cao (Verbena Herba) work synergistically, enhancing the malaria-stopping power.
6. Female Jiang. Fever occurs every other day without shivering, an atypical form of malaria. Tongue coating is greasy with phlegm. Prescription: Chun Chai Hu (Spring Bupleuri Radix) 6g, Dan Huang Qin (Light Scutellariae Radix) 9g, Wei Cao Guo (Roasted Tsaoko Fructus) 9g, Chuan Gui Zhi (Cinnamomi Ramulus) 3g, Zhi Bai Shao (Prepared Paeoniae Radix Alba) 9g, Fen Gan Cao (Licorice Root) 3g, Xiang Bei Mu (Fritillariae Thunbergii Bulbus) 9g, Ma Bian Cao (Verbena Herba) 15g, Chun Sha Ren (Amomi Fructus Rotundus - spring harvest) 2.4g, Jiang Ban Xia (Pinelliae Tuber - ginger processed) 9g, Sheng Jiang (Zingiberis Rhizoma Recens) 2 slices, Da Zao (Jujubae Fructus) 5 pieces. [Commentary] Shivering in malaria represents the struggle between healthy Qi and pathogens. Here, fever every other day without shivering indicates insufficiency of defensive Yang. The formula uses Gui Zhi Tang (Cinnamon Twig Decoction) to assist Xiao Chai Hu Tang (Minor Bupleurum Decoction) in harmonizing and expelling pathogens; Sha Ren (Amomi Fructus Rotundus) and Xiang Bei Mu (Fritillariae Thunbergii Bulbus) transform phlegm-dampness; Cao Guo (Tsaoko Fructus) and Ma Bian Cao (Verbena Herba) stop malaria.
7. Male Shen. Ten days ago, he suffered from alternating-day malaria in the countryside and was cured with external application of Mylabris plaster. Exhaustion from long travel allowed wind-cold to invade externally, causing fever to recur, but without severe chills and shivering. Deep concern exists that the pathogenic root is not cleared, potentially leading to other conditions. Prescription: Hang Bai Shao (Paeoniae Radix Alba) 9g, Chai Hu (Bupleuri Radix) 5g, Huang Qin (Scutellariae Radix) 9g, Cao Guo (Tsaoko Fructus) 2.4g, Jiao Zhi Shi (Scorched Immature Aurantii Fructus) 9g, Chuan Hou Po (Magnoliae Officinalis Cortex) 3g (added later), Qing Hao (Artemisiae Annuae Herba) 9g, Gan Cao (Licorice Root) 3g, Zhi Mu (Anemarrhenae Rhizoma) 9g, Quan Gua Lou (Trichosanthis Fructus) 12g, Bing Lang (Arecae Semen) 9g. [Commentary] After recovering from malaria, if the root pathogen remains, exposure to cold or fatigue easily triggers recurrence. This case features more heat than chills, treated with modified Qing Pi Yin (Clear Spleen Decoction), focusing on clearing heat. Both Bing Lang (Arecae Semen) and Cao Guo (Tsaoko Fructus) are confirmed by modern pharmacological research to have anti-malarial effects. The combination of Gua Lou (Trichosanthis Fructus), Zhi Shi (Immature Aurantii Fructus), and Bing Lang (Arecae Semen) resolves phlegm and unblocks the bowels, aiding fever reduction.