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Xue Lizhai treated a woman whose disease, triggered by anger, had no fixed time of onset and persisted for a long time without healing. She suffered from chest and abdominal discomfort, poor appetite, acid regurgitation, and expectoration of phlegm. He used Liu Jun Zi Tang (Six Gentlemen Decoction) with added Chai Hu (Bupleuri Radix) and Shan Zhi (Gardeniae Fructus). After more than twenty doses, she recovered quickly. However, when she experienced afternoon fever and reduced food intake, he used Si Jun Zi Tang (Four Gentlemen Decoction) with added Chai Hu and Sheng Ma (Cimicifugae Rhizoma) as the main formula, assisted by Xiao Yao San (Free and Easy Wanderer Powder), and she was cured.

Feng Chuzhan treated Zhang Zifang, who was nearly sixty years old. He had no symptoms such as fever or headache, but his food intake decreased day by day. His stool was very thin and difficult to pass, and his urine was very red and difficult to flow. Every three days, at night, he would experience severe qi rebellion and congestion, feeling as if he were dying, unable to sleep all night. His appearance was emaciated, and his spirit gradually declined. His six pulses were surging and rapid, except for the right Guan and Chi positions, which were slightly slow and weak. This indicated extreme deficiency of Yin essence, with isolated Yang lacking a root. The worsening every three days was due to the Spleen's association with trust and periodicity in its pathology. For diseases that are difficult to name, they all stem from the deficiency of the original Qi. By treating from the root, there is nowhere for the pathogen to hide. (This is an unshared secret of the ages.) Therefore, he prescribed Shu Di Huang (Rehmanniae Radix Preparata) 1 liang 6 qian, Mai Dong (Ophiopogonis Radix) 3 qian, Chao Bai Zhu (Stir-fried Atractylodis Macrocephalae Rhizoma) 6 qian, Niu Xi (Achyranthis Bidentatae Radix) 3 qian, Wu Wei Zi (Schisandrae Chinensis Fructus) and Fu Zi (Aconiti Lateralis Radix Preparata) each 1 qian, taken with Ren Shen Tang (Ginseng Decoction). After several doses, at each onset, he experienced chills and fever resembling tertian malaria, indicating that the pathogen was reaching the exterior. Continuing with the same prescription for more than ten doses, all symptoms completely resolved. (Symptoms of upward rushing all originate from the Jueyin Liver channel. Red and difficult urination indicates excessive Liver Fire. Thin and difficult stool indicates Wood overacting on Earth, consuming Stomach fluids. The three-day interval corresponds to the number associated with Wood. With large doses of moistening herbs, fluids are replenished, and the Liver Wood becomes soft. The recurrence of chills and fever indicates the Jueyin pathogen exiting via the Shaoyang channel. Although Feng's discussion is refined, it seems not to hit the exact pathogenesis, and the use of Bai Zhu, Wu Wei Zi, and Fu Zi in the formula is also questionable. This is my opinion, I do not know if it is correct.)

Xue Lizhai treated the mother of Ma Zhijing from Dongting, who, after malaria, was extremely emaciated, suffering from fever and aversion to cold, spontaneous and nocturnal sweating, chest and diaphragm fullness. She drank only about one cup of rice water daily. Taking Ginseng and Atractylodes herbs increased her bloating, and she had been bedridden for half a year. Xue considered this deficiency-cold of Yang Qi and prescribed a large dose of Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with added Fu Zi 1 qian. After two doses, various symptoms gradually receded, food intake slowly increased, and she recovered after another two doses.

A woman suffering from chronic malaria with chills and fever took Qing Pi Yin (Clear the Spleen Drink) and similar formulas, resulting in chest and diaphragm fullness and reduced appetite. She was cured using Bu Zhong Yi Qi Tang with added Fu Ling (Poria), Ban Xia (Pinelliae Rhizoma), and Pao Jiang (Prepared Ginger) each 1 qian.

Zhu Danxi treated the niece-in-law of Yi Yi. After malaria had initially subsided, it relapsed due to rebellious Qi, accompanied by lower back pain and turbid leukorrhea. He had already given a tonic formula containing Ren Shen, Bai Zhu, Bing Lang (Arecae Semen), and Ban Xia to treat the malaria. He also instructed her to take Mu Li (Ostreae Concha) 1 qian, Mu Tong (Akebiae Caulis) 5 fen, Chao Bai Hu (Stir-fried Phellodendri Cortex) 3 fen (to treat turbidity), combined with Bi Xie (Dioscoreae Hypoglaucae Rhizoma), Du Zhong (Eucommiae Cortex), and Gou Qi Gen (Lycii Radix Cortex) (to treat lower back pain), ground into coarse powder and taken together.

Ma Yuanyi treated Song Chuchen, aged forty, who suffered from malaria with shivering during chills and restlessness during fever. His pulse at both Guan and Chi positions was empty and large, feeling hollow upon pressure. (If this pulse appears during fever, one cannot immediately diagnose it as a case for Ginseng and Aconite.) The medicines he had taken were only mild diaphoretic and purgative agents. Ma said: This condition arises from internal deficiency leading to external contraction; the injury is in the Shaoyin Kidney meridian, which is vastly different from malaria caused by wind, summerheat, phlegm, or heat. The treatment method should be to vigorously boost Yang Qi to combat the deficient pathogen. At that time, another doctor strongly opposed this view, but his words were ignored. Thinking that a mistake here would be irreparable, Ma told the relatives: The condition is critical. Tonight, secretly decoct Ren Shen 1 liang and Fu Zi 3 qian, and administer it immediately to potentially reverse the crisis. Following this advice, the patient slept deeply, and chills and fever stopped instantly. After two more doses, he was stable. One month later, vomiting and insomnia returned, with empty and large pulses. Upon inquiry, it was found that a thief had entered, causing fear. Fear injures the Spleen, causing Fire to rebel upwards. Moreover, after a severe illness, when Yuan Qi is just recovering, deficient Yang easily floats upward. Thus, Zhen Wu Tang (True Warrior Decoction) was administered, and he recovered after one dose.

Shen Qingcheng, maternal uncle, contracted malaria suddenly while returning from Jinling, becoming very exhausted after three attacks. His pulses were floating, wiry, slippery, and excess. This was due to wind-summerheat and phlegm-stagnation, with excess in both interior and exterior, affecting both Yin and Yang. Since the pulse and symptoms indicated excess, aggressive dispersing was permissible. He used Chai Hu 3 qian to dispel Shaoyang pathogen; Huang Qin (Scutellariae Radix) 2 qian to clear Shaoyang heat; Ge Gen (Puerariae Lobatae Radix) 2 qian and Bai Zhi (Angelicae Dahuricae Radix) 1 qian to release Yangming exterior; Zhi Mu (Anemarrhenae Rhizoma) 2 qian and Shi Gao (Gypsum Fibrosum) 5 qian to clear Yangming interior; Su Ye (Perillae Folium) 3 qian and Sheng Jiang (Zingiberis Rhizoma Recens) 5 qian to disperse Taiyang cold; Bai Dou Kou (Cardamomi Fructus Rotundus) Hou Po (Magnoliae Officinalis Cortex) Ju Hong (Citri Reticulatae Pericarpium) Ban Xia and Bing Lang each 2 qian to relieve Taiyin stagnation. After two doses, chills and fever greatly decreased, and he recovered in three days.

Huang's aunt suffered from tertian malaria originating in the Yin aspect. She used He Shou Wu (Polygoni Multiflori Radix) 1 liang, Niu Xi 1 liang, Dang Gui (Angelicae Sinensis Radix) 5 qian, Bie Jia (Testudinis Carapax et Plastrum) vinegar-roasted 1 liang, Ju Hong 3 qian. Decocted in three bowls of water to yield one bowl, taken on an empty stomach, she recovered immediately. For extreme deficiency, add Ren Shen 1 liang. (Guang Bei Ji.)

Yu Zhongfu suffered from tertian malaria. Initially, he took Ren Shen 1 liang and Sheng Jiang Pi (Zingiberis Pericarpium) 5 qian, decocted in water, taken on an empty stomach. He refused to take it. Zhong Chun insisted on this prescription, increasing Ren Shen to 3 liang and Sheng Jiang Pi to 1 liang 5 qian. After two doses, he recovered.

When Miao Zhongchun was seventeen, he suffered from malaria. He tried all kinds of decoctions, pills, drinks, and exorcisms, but none helped. After searching medical texts, he realized malaria is caused by Summerheat. The Classics state: "Injury by Summerheat in summer leads to malaria in autumn." Thus, he treated it as Summerheat-related, and recovered within ten days. Later, he frequently adjusted his approach based on his understanding, focusing on nourishing Stomach Qi after dispersing pathogens. For abundant phlegm, he resolved phlegm; for Qi deficiency, he tonified Qi; for Blood deficiency, he nourished Blood. He differentiated by Zang-Fu and meridians, applying guiding herbs accordingly. Even cases lasting years were suddenly cured. (Ibid.)

Chancellor Shen Shaoqing, upon retiring, suffered bitterly from malaria. Zhong Chun visited and found him extremely exhausted. He said: "One more attack will kill him." The Chancellor asked: "What formula can stop it immediately?" Zhong Chun replied: "You speak too lightly." He prescribed three formulas, made into five doses, to be consumed within one day and night. By the next morning, the malaria stopped. The first two doses cleared Summerheat using a large dose of Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) with added Gui Zhi (Cinnamomi Ramulus), because of thirst and profuse sweating. The middle two doses strengthened the Spleen and removed stagnation using Ju Hong, Bai Dou Kou, Bai Zhu, Fu Ling, Gu Ya (Setariae Fructus Germinatus) W Mei (Mume Fructus) Bian Dou (Phaseoli Semen) Shan Zha (Crataegi Fructus) and Mai Ya (Hordei Fructus Germinatus). The final dose consisted of Ren Shen 1 liang and Sheng Jiang Pi 1 liang, decocted in water and exposed overnight, taken warm at dawn. After finishing the dose, efficacy was achieved. (Ibid.)

Gu Boqin suffered from malaria. A disciple of Zhong Chun prescribed Bai Hu Tang (White Tiger Decoction) with added Ren Shen 1 liang. A quack doctor said: "How can one use Ginseng in such large quantities?" and changed it to Qing Pi Yin. After more than twenty doses, the malaria did not stop, and the body became weak. When Zhong Chun arrived, he laughed and said: "The deficiency is severe; Ginseng is indispensable. My disciple was not wrong." He administered a large dose of Ren Shen and Huang Qi (Astragali Radix). One dose led to recovery. The prescription was: Ren Shen 1 liang, Huang Qi honey-roasted 1 liang, Zhi Mu honey-roasted 5 qian, Chen Pi (Citri Reticulatae Pericarpium) 2 qian, Ge Gen 2 qian, Gan Cao (Glycyrrhizae Radix et Rhizoma) 8 fen, Shi Gao 5 qian. (Ibid.)

The relative of Zhuang Lianzhi suffered from malaria with less chills and intense fever, little sweating, headache, and loss of appetite. I diagnosed him; the pulse was surging, rapid, and excess. I used Mai Dong 5 qian, Zhi Mu 3 qian 5 fen, Shi Gao 1 liang 5 qian, Zhu Ye (Bambusae Folium) 60 pieces, Jing Mi (Oryzae Semen) a pinch, Ju Hong 2 qian, Niu Xi 1 liang, Ge Gen, Fu Ling, and Bian Dou each 3 qian. After three doses, there was no response. Suddenly, one day, after two episodes of chills and fever, he fell into coma and exhaustion, unconscious, in critical condition. Lianzhi said: "Perhaps it is deficiency malaria. The previous formula with Shi Gao, Zhi Mu, and Zhu Ye seems too cooling and incorrect." Miao also suspected it, removing Shi Gao etc., and adding Ren Shen 2 qian, which altered the situation. Recalling the previous pulse, he confirmed it was indeed deficiency. He urgently sent someone to check, instructing them to prepare the Ginseng decoction but not to administer it lightly, waiting for pulse diagnosis to decide. The next morning, upon checking, the pulse was still surging and rapid as before. He urgently stopped the Ginseng and continued with the previous formula but increased Shi Gao to 2 liang and added He Shou Wu 5 qian, ordering two doses. The malaria then stopped. (Xiong An: Yuan Zicai said: In September of Bingzi year, I suffered from malaria. After drinking Dr. Lv's medicine in the morning, by noon, I suffered from incessant vomiting, dizziness, and vertigo. My mother held me up, and I felt blood and Qi surging from my chest, my life hanging by a thread. Fortunately, my friend Zhao Licun from Nanfeng visited. Diagnosing my pulse, he said: 'Wrong. This is Yangming Summerheat malaria.' Mistakenly using Sheng Ma and Qiang Huo (Notopterygii Rhizoma et Radix) to lift, the blood flowed backward. Only Bai Hu Tang can treat this. As soon as one spoonful was given, it felt like pressing down the Yang Stomach with a thousand-jun weight, the blood and Qi vanished, and I fell asleep before finishing half a bowl, waking with slight sweating. Zhao asked if I wanted to eat watermelon. I said yes. He ordered me to eat as much as possible. After eating a slice, it felt like pouring cream over my head. I could eat porridge that evening and recovered the next day.)

The relative of Zhuang Lianzhi, who had previously suffered from malaria, one year later suddenly suffered from splitting headache, mental confusion, sore throat, aphonia, tongue ulceration, cough with phlegm, chest distension, nausea, and anorexia. This lasted four days, then suddenly developed chills and fever resembling malaria, with less chills and more fever, resolving only after frequent sweating post-fever. He usually suffered from heart-mouth pain and weakness in the lower origin, resembling podagra. Lianzhi suspected Cold Damage. Miao said: "This is a Summerheat syndrome, essentially the malaria from last year but aggravated." The treatment should first address the branch. He prescribed Shi Gao 2 liang, Mai Dong and Niu Xi each 5 qian, Zhi Mu, Bei Mu (Fritillariae Thunbergii Bulbus), Hua Fen (Trichosanthis Radix) each 3 qian, Ju Hong 2 qian 5 fen, Bie Jia 4 qian, Zhu Ye 150 pieces, decocted in river water. After three to four doses, the mind cleared, and headache, sore throat, aphonia, tongue ulceration, distension, and chills/fever all healed. However, nausea and anorexia persisted, as did heart-mouth pain and lower weakness. Thus, Shi Gao, Zhi Mu, Zhu Ye, Bie Jia, Bei Mu, and Hua Fen were removed, and Yan Hu Suo (Corydalis Rhizoma), Mu Gua (Chaenomelis Fructus), Zhu Ru (Bambusae Caulis in Taenia) each 2 qian, Wu Ling Zhi (Trogopterori Faeces) 7 fen, Sheng Pu Huang (Typhae Pollen) 1 qian 5 fen, Yi Yi Ren (Coicis Semen) 8 qian, Shi Hu (Dendrobii Caulis), Bian Dou, and Bai Shao (Paeoniae Radix Alba) each 3 qian, Pi Pa Ye (Loquats Leaf) 3 pieces, Zhi Gan Cao 4 fen were added. After dozens of doses, he recovered. (Xiong An: Summerheat malaria pathogen in the Qi level must be primarily treated with Bai Hu Tang, modified according to symptoms. Miao alone knew this method and did not rigidly stick to Xiao Chai Hu Tang. However, herbs like Niu Xi and Bie Jia are not suitable for sudden use at the beginning. If the pathogen enters the Ying level, it is harmless. This summer, Mrs. Shi Zhijing suffered from this. Because her Yin level was inherently deficient, the pathogen entered the Ying level. I added Xi Jiao (Rhinocerotis Cornu - now substituted with Shui Niu Jiao Buffalo Horn) Xuan Shen (Scrophulariae Radix) Yin Hua (Lonicerae Japonicae Flos) Shi Hu, and Zhu Ye to Bai Hu Tang, administering a large dose, and she recovered. Those who heard this were amazed. Actually, treating the disease as seen, what is strange about it? Early autumn, Mrs. Wang Ziyu, a widow, suffered from Summerheat malaria. Mistakenly taking Chai Hu, Jiang, and Yu (Corni Fructus), she became comatose with fever and impending collapse, with empty Chi pulses, in critical condition. Her grandfather, Grand Secretary Zhu Zhuangnian, asked me to see her. I also treated her with modified Xi Jiao Di Huang Tang (Rhino Horn and Rehmannia Decoction) twice, and she recovered.)

The niece of Gao Cunzhi suffered from fetal malaria after marriage, which persisted for a long time. Zhong Chun said: "The disease is in the Yin level. Use Ren Shen 5 qian and Niu Xi 1 liang, simultaneously strengthening the Spleen and clearing Summerheat. One dose stopped it." (Ibid.)

The wife of Zhang Hengyang's son suffered from aphonia and intensified chills and fever after malaria, sending urgent message to Zhong Chun. Zhong Chun said: "This must be due to the reckless administration of Ban Xia during the malaria by someone without clear vision." He prescribed a large dose of Mai Dong, Fu Ling, Zhi Gan Cao, Bie Jia, Zhi Mu, and Bei Mu. After several doses, she recovered. (Ibid.)

Lai Tianpei treated Pan Kanghou, who suffered from malaria in late autumn with chills, fever, headache, body ache, vomiting, no sweating, heavy waist, sore legs, occurring every other day. His pulse was deep and wiry. Lai said: "This is Cold pathogen trapped in the Mu Yuan (Diaphragmatic Origin), unable to resolve externally." He used Chai Ge Jie Ji Tang (Bupleurum and Kudzu Decoction to Release the Muscles), Qiang Huo (Notopterygii Rhizoma et Radix) and Xiong (Ligustici Chuanxiong Rhizoma) for headache, Huo Xiang (Agastaches Patchouliae Herba) Guang Huo Xiang, and Ban Xia for vomiting, Zhi Ke (Aurantii Fructus) and Jie Geng (Platycodonis Radix) to benefit Lung Qi, Bai Dou Kou to warm the Stomach, Gui Zhi to reach the Mu Yuan and lead the pathogen out preventing re-entry, Fu Ling to promote diuresis, and Jiang and Zao (Jujubae Fructus) to harmonize Ying and Wei. After one dose, all symptoms were relieved.

Shen Mingsheng treated Ding Youming, who got angry after eating and was subsequently exposed to wind pathogen, resulting in chills, fever, and continuous fatigue. Everyone thought it was food stagnation and cold damage. Shen said: "Chills come at times, fever resolves with sweat, pulse is wiry and rapid. Although he never had malaria before, this marks the beginning of malaria." It turned out to be true. He gave modified Qing Pi Yin, and chills/fever gradually lightened. However, his penis and testicles shrunk daily, resembling impotence, causing great worry. Shen said: "Do not worry. This is not a critical Jueyin Cold Damage syndrome, nor is it Yang deficiency. It is extreme Yangming Heat failing to moisten the Zong Jin (Genitals), known as 'all flaccidity syndromes arise from Lung Heat'. If you treat it as deficiency and tonify, it will be a mistake." So he used formulas with Ling and Zhi. Over time, the genital shrinking remained, but the malaria stopped. Only constipation persisted for many days, but without bloating or pain. This was because profuse sweating during malaria dried the fluids and emptied the intestines. Wait for diet to improve, then use Ren Shen and Bai Zhu to tonify, and when Qi and Blood are sufficient, stool will pass naturally. Do not rush. Another doctor diagnosed that the pathogen was still excess and questioned the use of tonics, suggesting purgation. He was given Cheng Qi Tang (Order the Qi Decoction). After half a day, stool did not pass, and genital shrinking worsened. Shen was consulted again and continued with regulation and tonification. After several days, more than 2 liang of Ren Shen was administered, expelling much accumulated waste, and he fully recovered. Thus, this case had three benefits: At the beginning, one could identify malaria at the start of pathogen invasion. In the middle, one learned that flaccidity does not solely result from sexual deficiency (Wang Jiezai explained this in detail). At the end, one learned that constipation can be relieved by taking Ren Shen and Bai Zhu, and should not be aggressively purged. If purged inappropriately, even Mang Xiao (Natrii Sulfas) and Da Huang (Rhei Radix et Rhizoma) cannot cleanse, merely depleting the True Yuan. The Classics have clear instructions, but the world only knows to reduce hardness, failing to understand the method of treating obstruction with tonification.

Qian Guobin treated Zhang Dao, Commander of the Right Camp in Datong, who had suffered from malaria for seven years, barely breathing. His six pulses were wiry and long, yet still contained Stomach Qi. This was Tan Xue (Phlegm-Blood) knotting in the right abdomen of the Foot Taiyin Spleen meridian, named Nu Mu (Malaria Mother). Since long-term illness causes blood coagulation in collaterals, without attacking phlegm and blood, the disease will not heal. The Neijing states: "For malaria occurring at intervals, the pathogen has penetrated deeply and attached to Yin. Yang Qi erupts alone, Yin pathogen stays inside. Yin and Yang struggle but cannot exit, hence the interval occurrence." First, he used Si Wu Tang (Four Substances Decoction) with Tao Ren (Persicae Semen) Hong Hua (Carthami Flos) Niu Xi, Ren Shen, Cang Bai Zhu (Atractylodis Rhizoma) for more than ten doses. Once collaterals were active, the malaria shifted to the Yang level. Then, he used Ba Zhen Tang (Eight Treasures Decoction) with added Huang Qi 1 qian and He Shou Wu 1 liang for ten doses to tonify Zheng Qi, making the malaria milder and earlier. Then, he used Chang Shan (Dichroae Radix) 3 qian (wine-fried seven times), Chen Pi 1 qian 5 fen, Gan Cao 1 qian 5 fen, Cong Bai (Allii Fistulosi Bulbus) 3 segments, Sheng Jiang 5 slices, decocted and exposed overnight, taken hot on an empty stomach. The malaria stopped. Then, he pierced an egg, stirred the white and yolk with a hairpin, inserted one Strychnos seed (Fan Mu Die) and 4 li of real Musk, sealed the top with paper, steamed it in rice, removed the shell and Strychnos seed, and ate the egg with hot wine on an empty stomach daily. After more than a month, the Nu Mu completely dissipated. For any long-standing malaria, not knowing this method means non-recovery.

Wei Yuheng said: Shi Huanzhi was my closest friend. Between summer and autumn, he traveled from the capital to Wumen for marriage. In early winter, after attending a feast for a newborn relative, he developed chills, fever, and headache. He self-medicated with Xiong Su Yin (Ligusticum and Perilla Drink) for one dose, which failed. He then took Li Zhong Tang (Regulate the Middle Decoction), which worsened the condition. Presumably due to recent marriage, he suspected it was a Yin syndrome. From then on, all doctors summoned treated him with warming and tonifying herbs, making him increasingly weak. He urgently sent for me in Hangzhou. By the time I arrived, more than ten days had passed. Entering the room, I saw the decocted medicine had not been discarded. His pulse was deep, wiry, and rapid, beating six or seven times per breath. His tongue was stiff, coating black and dry. He said that after taking warming tonics, chills and fever had subsided, but he had no bowel movement and frequent urination, especially at night, almost 50-60 times. There was occasional cold air rushing up in the chest. He could only eat a small bowl of porridge daily, appearing critically weak. I said: "This is latent Qi transforming into malaria. Frequent urination is due to internal heat forcing downward. The urine must be scanty, red, and turbid." Verification proved this correct. Regarding the cold air rushing up, it is due to heat stagnating in the Middle Palace; just as above a flame there must be cold air. The lack of bowel movement is due to internal heat causing dryness and accumulation, which goes without saying. Since the pathogen is deeply latent, its manifestation stops. How can one rashly use warming tonics? Fortunately, his visceral Yin was not exhausted in his prime. Urgently administer cooling resolution. If chills and fever recur, then there will be no danger. Asking about the decocted medicine, it contained Ren Shen, Bai Zhu, Jiang, Fu, Gui, Yu, Suan Zao Ren (Ziziphi Spinosae Semen), Wu Wei Zi, etc. He said he took one dose yesterday, and the condition did not improve. Today, he used Ren Shen 3 qian, Gui and Fu each 1 qian 5 fen. Examining previous prescriptions, they were all Er Chen Tang (Two Aged Herbs Decoction), Si Jun Zi Tang, Gui, Jiang, Yu, etc. I said: "If we continue with Ren Shen, Bai Zhu, Gui, and Fu today, it will be incurable." I combined Xiao Chai Hu Tang (Minor Bupleurum Decoction) and Xiao Xian Xiong Tang (Minor Inhibiting Chest Decoction) with Bai Hu Tang into one dose and gave it to him. His brother-in-law was confused and hesitant, firmly refusing to comply. This was because doctors from Dongting dominated his household, creating difficulties. I said: "Since you do not believe, please let me leave on the original boat. Although we are close friends, I came to treat illness, not to attend a funeral." Hearing this, Huanzhi begged me to stay. I handed over the medicinal supplies and personally supervised the decoction. After taking it, urination frequency decreased. The next day, porridge intake increased. Giving the same formula again, chills and fever erupted, but the black tongue coating gradually receded, and spirit improved. Removing Bai Hu Tang, after two doses, chills and fever decreased, and urination volume increased. Two days later, large amounts of black, dry stool were passed. Changed to Gan Lu Yin (Sweet Dew Drink), modified over several doses, and he stabilized. (Xiong An: This autumn, Tang Zhensheng suffered from malaria in Jiaxing. The doctor knew it was Summerheat and gave clearing/resolving herbs, which turned into diarrhea. Then switched to warming/drying herbs, worsening diarrhea, while fever persisted, leaving the doctor helpless. Ordered him to return to Hangzhou. Relative Zhang Yueqing invited me to examine him. Black coating, red face, chest tenderness/rejection, stool like glue/pitch, no urine, delirium, deafness, insomnia, laughter, pulse knotted and rapid. I gave Huang Lian (Coptidis Rhizoma) Huang Qin Huang Bai (Phellodendri Cortex) Zhi Zi (Gardeniae Fructus) Yin Hua Shi Hu Zhi Mu Lou Ren (Trichosanthis Semen) Xuan Shen, Lu Dou (Phaseoli Semen) and Shen Xi Dan (Divine Calyx Pill). After four doses, chest rejection ceased, slight gruel intake resumed, black stools became less frequent, slight urination appeared. Then removed Shen Xi Dan, added Di Huang (Rehmanniae Radix) and Shi Gao. After three doses, fever subsided, spirit cleared, pulse quieted. Then administered sweet-cool fluid-nourishing herbs. After more than ten doses, he recovered. Also, Zhu Shengfu's son Zhonghe suffered from malaria several years ago, lingering for half a year, causing great suffering. This summer, he suffered from it again, with similar presentation. I was urgently consulted. He said: "Must have suffered year-round." I said: "Summer-dampness pathogen. Without taking Chai, Gui, Jiang, Zao, it can recover in ten days." He didn't believe much, but after administration, he recovered in eight doses, realizing previously he was misled by Xiao Chai Hu Tang.)

Xu Minhua, nearly thirty, suffered from fetal malaria. A famous doctor from He was staying in Hangzhou and examined him. He saw the tongue coating peeled like rotten iron, pale yellow where coated, deep purple like a pig kidney where uncoated. After three or four attacks, he was extremely exhausted, needing a cane to stand, appetite suddenly dropped, drinking only two bowls of thin porridge daily, so medication was withheld. Pulse was deficient, rapid, and wiry. Left Cun was surging and overflowing; Right Chi was weak. I said: "This is inherent deficiency of Hand and Foot Shaoyin, plus Summerheat pathogen entering the Pericardium. The Classics say Summerheat injures the Heart; the tongue is the orifice of the Heart, hence these symptoms." Initially, I gave Huang Lian Xiang Ru Yin (Coptis and Elsholtzia Drink). After one dose, he desired food. Then, I gave Dao Chi San (Directing Fire Away Powder) combined with Yi Yuan San (Benefit Primordial Powder), and the purple tongue faded. Then, Ren Shen Xiao Chai Hu Tang, and chills/fever healed. After recovery, he told me: "Three relatives/friends also developed malaria on the same day, all with tongue coating changes. Two died, surnamed Ye and Zhou." (Xiong An: The treatment methods in this section are lacking for Summer-damp seasonal malaria...)