吕沧洲治经历哈散侍人病喘不得卧，众作肺气受风邪治之。吕诊之气口盛于人迎一
倍，厥阴弦动而疾，两尺俱短而离经。因告之曰∶病盖得之毒药动血，以致胎死不下，奔
迫而上冲，非风寒作喘也。乃用催生汤加芎、归煮二三升服之，夜半果下一死胎，喘即止。
哈散密嘱曰∶病外家诚有怀，以室人见嫉，故药去之，众所不知也。众惭而去。
平安散 治妊娠上气喘急，大便不通，呕吐不食，腹胁胀痛。
川芎 木香（各一钱半） 陈皮 熟地黄（洗）
干姜（炮） 生姜 浓朴（去粗皮，制。炒） 甘草（各一钱）
上作一服，水二盅，入烧盐一捻，煎至一盅，不拘时服。
桔梗汤 马兜铃散（并见前咳嗽条。）
〔大〕妊娠病疟，乃夏伤于暑，客于皮肤，至秋而发，阳盛则热，阴盛则寒，阴阳
相离，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，故发日晏与早者，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。其气既止，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，多伤于胎。
〔薛〕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。审系
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。（杂病中风。）外
邪少而饮食多，用人参养胃汤。（杂疟。）劳伤元气，用补中益气汤。（杂劳倦。）若郁怒所伤，用
小柴胡汤（伤寒少阳病。）兼归脾汤。（健忘。）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。一妇人因怒患疟，举发无期，久而不已，胸腹不利，饮食少思，
吞酸吐痰。用六君子加柴胡、山栀，二十余剂，寻愈。但晡热少食，又用四君子加柴胡、
升麻为主，佐以逍遥散而痊。一妊妇疟久不已，嗳气下气，胸腹膨胀，食少欲呕，便
血少寐。此属肝脾郁怒，用归脾汤加柴胡、山栀渐愈；又用六君子汤加柴胡、山栀、升麻
而愈。一妊妇患疟已愈，但寒热少食，头痛晡热内热，此脾虚血弱也。用补中益气汤
加蔓荆子，头痛顿止；又用六君子汤加芎、归，饮食顿进；再用逍遥散加参、术而寒热愈。
驱邪散 治妊娠停食感冷，发为疟疾。
白术 草果仁 高良姜（炒） 缩砂仁 藿香叶 橘红 白茯苓（去皮，各一钱半）
甘草（炙，五分）
上作一服，水二盅，生姜五片，红枣一枚，煎一盅，不拘时服。
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，不问鬼疟、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（并不去白） 甘草 槟榔 草果（去皮，各等分）
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，再用酒
水煎滓次，去滓亦露一宿，来日当发之早，烫温面东先服头药，少顷再服药滓，大有神效。
予尝治一妊妇，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∶妇人重身，
毒之奈何？岐伯曰∶有故无殒。帝曰∶何谓也，岐伯曰∶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。
柴胡散 治妊娠疟疾。
柴胡（二钱） 生大黄（二钱） 生黄芩（一钱半） 甘草（一钱）
上 咀作一服，水煎，临发日五更温服，必取利为愈。如胎上逼心，可服枳壳散。忌
油面辛热等物。
又方
用大黄（二两） 柴胡（一两半） 黄芩（一两） 芍药（一两）
为细末，清水糊为丸，如梧桐子大。每服百丸，临发日五更冷汤吞下，隔两时再服
五十丸，以利为度。
若妊娠疟疾，发热口干，渴饮无度者，亦用。
生地黄（一两半） 黄芩 麦门冬（去心） 人参 知母（各一两） 石膏（二两） 甘草（半两）
干葛
（一两）
上 咀，每服五钱，入乌梅（半个） 煎服。
又方
用常山（一两） 石膏（一两） 甘草（炙） 黄芩（各半两） 乌梅（七个）
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，兹不赘。若热甚恐致动胎者，亦如伤寒热病治法，
以白药子、伏龙肝等，涂脐上下可也。
Lu Cangzhou treated a servant of Jingli Hasan who suffered from asthma (asthma) and could not lie down. The physicians generally treated it as lung Qi affected by wind pathogen (wind pathogen). Lu diagnosed that the Qi Kou pulse was one times larger than the Ying Ren pulse, the Jue Yin pulse was wiry, moving, and rapid, and both Chi pulses were short and deviated from the normal meridian qi (Li Jing Mai). He then informed them: "This illness is likely caused by toxic drugs inducing bleeding, resulting in a dead fetus retained in the uterus. The fetal Qi rushes upward, compressing the lungs, rather than being asthma caused by wind-cold." He then used Cui Sheng Tang (Delivery Decoction) added with Chuanxiong Rhizome (Chuanxiong) and Angelicae Sinensis Radix (Danggui), boiled two to three sheng, and administered it. At midnight, a dead fetus was indeed expelled, and the asthma stopped immediately. Hasan privately instructed: "The patient's wife was indeed pregnant. Because the principal wife was jealous, she used drugs to terminate the pregnancy. This was unknown to others." The other physicians left in shame.
Ping An San (Peaceful Safety Powder) treats asthma and rapid breathing during pregnancy, accompanied by constipation, vomiting, inability to eat, and abdominal and hypochondriac distension and pain.
Chuanxiong Rhizome (Chuanxiong), Aromatic Tuber (Muxiang) (each 1.5 qian), Tangerine Peel (Chenpi), Prepared Rehmannia Root (Shudihuang) (washed), Fried Ginger (Ganjiang), Fresh Ginger (Shengjiang), Prepared Magnolia Bark (Noupo) (coarse bark removed, processed, stir-fried), Licorice Root (Gancao) (each 1 qian).
Take as one dose, add two zhong of water and a pinch of burnt salt, decoct until one zhong remains, take at any time.
Jiegeng Tang (Platycodon Decoction) and Madouling San (Aristolochia Powder) (both see previous section on cough).
[Da] Malaria during pregnancy occurs due to summer-heat injury in summer, with pathogens lodging in the skin, manifesting in autumn. When Yang is excessive, there is heat; when Yin is excessive, there is cold. When Yin and Yang separate, both cold and heat appear simultaneously. If the onset is late, it is because wind pathogen lodges in Fengfu (GV16), traveling down along the spine. Wei Qi (Defensive Qi) gathers at Fengfu once every day and night. Thus, the variation in onset time depends on the daily descent of Wei Qi at Fengfu by one vertebral segment. After twenty-one days, it reaches the coccyx; on the twenty-second day, it enters the spine, ascends into the Fuchong Mai (Confluent Vessel), travels for nine days, and emerges at Quepen (LI12). Once this Qi stops, the onset becomes earlier. For every-other-day attacks, the wind pathogen internally combats the five Zang organs and horizontally connects to the Mu Yuan (Sea of Origin). The path is distant, the Qi is deep, and its movement is slow, preventing daily attacks. Pregnancy malaria often injures the fetus.
[Xue] The aforementioned symptoms are due to Spleen and Stomach deficiency, food stagnation, external pathogen invasion, liver Qi stagnation injuring the Spleen, or latent summer-heat. If due to food stagnation, use Liu Jun Zi Tang (Six Gentlemen Decoction) added with Platycodon Root (Jiegeng), Atractylodes Macrocephala Rhizome (Cangzhu), and Agastache Herba (Huoxiang). If external pathogens are predominant and food stagnation is minor, use Huoxiang Zhengqi San (Agastache Powder to Rectify the Qi). If external pathogens are minor and food stagnation is significant, use Renshen Yangwei Tang (Ginseng Decoction to Nourish the Stomach). If Qi is damaged by overexertion, use Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi). If injured by anger/liver Qi stagnation, use Xiaochaihu Tang (Minor Bupleurum Decoction) combined with Guipi Tang (Restore the Spleen Decoction). If Liver Wood insults Spleen Earth and persists, use Liu Jun Zi Tang as the base, assisted by fetal-calming herbs. Treatment should still reference the Three Yin and Three Yang meridians. One woman developed malaria due to anger, with irregular onset, persisting for a long time, causing chest/abdominal discomfort, poor appetite, acid regurgitation, and phlegm expectoration. She was treated with Liu Jun Zi Tang added with Bupleurum Root (Chaihu) and Gardenia Fruit (Shanzhi) for over twenty doses, gradually recovering. However, with afternoon fever and poor appetite, she was treated with Sizhunzi Tang (Four Gentlemen Decoction) added with Chaihu and Cimicifugae Rhizoma (Shengma) as the main formula, assisted by Xiaoyao San (Free and Easy Wanderer Powder), leading to recovery. A pregnant woman had persistent malaria, belching, flatulence, abdominal distension, poor appetite, nausea, blood in stool, and insomnia. This belonged to Liver-Spleen Qi stagnation due to anger. She was treated with Guipi Tang added with Chaihu and Shanzhi, gradually improving; subsequently treated with Liu Jun Zi Tang added with Chaihu, Shanzhi, and Shengma, leading to full recovery. Another pregnant woman recovered from malaria but had chills/fever, poor appetite, headache, afternoon fever, and internal heat. This indicated Spleen deficiency and Blood weakness. She was treated with Buzhong Yiqi Tang added with Vitex Fruit (Manjingzi), and the headache ceased instantly; then treated with Liu Jun Zi Tang added with Chuanxiong and Danggui, and appetite improved instantly; finally treated with Xiaoyao San added with Ginseng (Renshen) and Atractylodes Macrocephala Rhizome (Baizhu), resolving the chills and fever.
Quxie San (Evil-Expelling Powder) treats pregnancy complicated by food retention and cold invasion, leading to malaria.
Atractylodes Macrocephala Rhizome (Baizhu), Areca Seed (Caoguoren), Greater Galangal Rhizome (Gaoliangjiang) (stir-fried), Amomum Fruit (Suosharen), Agastache Leaf (Huoxiangye), Exocarpium Citri Reticulatae (Juhong), Poria (Baifuling) (peeled, each 1.5 qian), Licorice Root (Gancao) (honey-fried, 0.5 qian).
Take as one dose, add two zhong of water, five slices of fresh ginger, and one red date, decoct until one zhong remains, take at any time.
Qibao San (Seven Treasures Powder) treats all types of malaria in men and women, whether presenting with chills first then fever, fever first then chills, more chills than fever, or more fever than chills; occurring once a day, two to three times a day, consecutive days, every other day, or every three to four days. It treats ghost malaria, food malaria, maladaptation to climate, and mountain miasma resembling malaria.
Dichroa Root (Changshan), Magnolia Bark (Noupo) (processed with ginger), Green Tangerine Peel (Qingpi), Tangerine Peel (Chenpi) (do not remove white pith), Licorice Root (Gancao), Betel Nut (Binglang), Areca Seed (Caoguo) (peeled, equal parts).
Coarsely crush. Take 0.5 liang per dose. On the eve before onset, decoct with one zhong of water and one zhong of wine until one large zhong remains. Strain and leave exposed overnight. Decoct the dregs again with water and wine, strain, and leave exposed overnight. On the morning of onset, face east and drink the first decoction while warm. Shortly after, consume the second decoction (dregs). This has great efficacy.
I once treated a pregnant woman of six to seven months suffering from malaria with chills first then fever. Her six pulses were floating and tight. Physicians used Chaihu and Gui Zhi Tang (Cinnamon Twig Decoction) without effect. I said: "Only Changshan can cure this." The physicians hesitated. Days later, the condition worsened, and they accepted my treatment. One dose of Qibao San cured her. The Yellow Emperor asked: How should toxic substances be used in pregnancy? Qibo answered: If there is an existing pathology, the mother will not be harmed. The Emperor asked: What does this mean? Qibo said: In cases of massive accumulation, attack may be used, but stop when the pathogenic factor is reduced by more than half. If one carefully studies drug properties and clarifies treatment methods, what is there to doubt regarding attack therapies?
Chaihu San (Bupleurum Decoction) treats pregnancy malaria.
Bupleurum Root (Chaihu) (2 qian), Raw Rhubarb (Sheng Dahuang) (2 qian), Raw Scutellaria Root (Sheng Huangqin) (1.5 qian), Licorice Root (Gancao) (1 qian).
Coarsely crush for one dose. Decoct in water. Take warm at wu geng (3-5 AM) on the day of onset. Recovery requires purgation. If the fetus presses against the heart, Zhike San (Citrus Aurantium Powder) can be taken. Avoid oily noodles, spicy, and hot foods.
Another prescription:
Raw Rhubarb (2 liang), Bupleurum Root (1.5 liang), Scutellaria Root (1 liang), Peony Root (1 liang).
Grind into fine powder, make pills with clear water paste, size of Sophora seeds. Take 100 pills on the morning of onset with cold water. Take another 50 pills two hours later. Stop when purged.
This is also used if pregnancy malaria presents with fever, dry mouth, and excessive thirst.
Rehmannia Root (Sheng Dihuang) (1.5 liang), Scutellaria Root (Huangqin), Ophiopogon Tuber (Maidong) (core removed), Ginseng (Renshen), Anemarrhena Rhizome (Zhimu) (each 1 liang), Gypsum (Shigao) (2 liang), Licorice Root (Gancao) (0.5 liang), Kudzu Root (Gegen) (1 liang).
Coarsely crush. Take 5 qian per dose, add half a Chinese Plum (Wumei), decoct and take.
Another prescription:
Dichroa Root (Changshan) (1 liang), Gypsum (Shigao) (1 liang), Licorice Root (Gancao) (honey-fried), Scutellaria Root (Huangqin) (each 0.5 liang), Chinese Plum (Wumei) (7 fruits).
Cut finely. Soak overnight in one bowl of water and one bowl of wine. Decoct at dawn until one bowl remains. Strain and divide into two doses. Take at the time of onset.
The above formulas contain Changshan and Dahuang, which induce vomiting and purging. They are used when the six pulses are floating, tight, and forceful, indicating stubborn phlegm and accumulated heat. This exemplifies "if there is pathology, the mother is not harmed." Other treatments are detailed in the miscellaneous diseases malaria section and are not repeated here. If heat is severe and risks disturbing the fetus, treat similarly to cold damage heat diseases: apply Baoyaozi (Stemonae Tubera) or Fulonggan (Dragon's Liver) around the navel.