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Malaria (Nue) refers to chronic malaria that has persisted for a long time. It occurs every three days, with the pathogenic qi deeply entrenched and firmly fixed, making it difficult to expel rapidly. Some patients suffer from it for years without recovery, also known as San Yin Malaria (Malaria involving the Three Yin meridians). Generally speaking, for malaria affecting the Three Yang meridians, sweating and harmonizing methods are appropriate; for those affecting the Three Yin meridians, warming and purging/drainage methods are appropriate. In severe cases, only emesis or purgation can eradicate the root of the disease. If there is a mass under the hypochondrium, it is called "Malaria Mother" (Nue Mu), which should be treated primarily with Biejia Wan (Turtle Shell Pill).

Qianjin Fang Changshan Wan:
Changshan (Dichroa Radix, 3 liang) Biejia (Tartaric Testudinis Carapax et Plastrum, 2 liang, roasted) Zhimu (Anemarrhenae Rhizoma, 1 liang) Gancao (Glycyrrhizae Radix et Rhizoma, 5 qian)
Process into honey pills the size of Sophora seeds. Take ten pills with wine before the onset of fever. Take one dose at the onset of symptoms, and another dose during the peak of the attack.

Biejia Wan:
Biejia (Tartaric Testudinis Carapax et Plastrum) Xiangfu (Cyperi Rhizoma) [each 2 liang] Sanleng (Sparganii Rhizoma) Pengzhu (Curcumae Rhizoma) [each 1 liang] Changshan (Dichroa Radix, 1 liang) Awei (Ferulae Resina, 2 qian)
Soak all ingredients in vinegar and Shenqu (Medicated Leaven) paste to make pills. Take fifty pills the size of Sophora seeds with warm water. Stop when the accumulation is reduced by half.

Ren Zhai stated: Why does malaria persist for a long time without ceasing? Because there is a root cause. The root causes are phlegm-fluid retention, water-dampness, and blood stasis. Patients with malaria often accumulate phlegm-saliva and yellow fluids. If these stagnate in the epigastrium, Changshan can induce vomiting to expel them; if they knot into masses between the ribs, Changshan can break down the masses and guide them downward. In cases of pure heat without chills, or internal excess heat syndromes, administering Changshan may result in scanty bowel movements that seem like diarrhea but are not. In such cases, Beida Huang (Rhei Radix et Rhizoma) must be used as an assistant herb. Strong purgation several times is required before recovery can be achieved. Furthermore, in postpartum women, blood stasis flowing into the collaterals can cause chills and fever resembling malaria, typically occurring in the evening. During attacks, body pain feels like being beaten with a stick. Formulas that unblock the meridians and invigorate blood are suitable. Lujiaoxie (Cervi Cornus Degelatinati Calceus) combined with blood-invigorating herbs stops pain miraculously.

Diseases caused by evil qi have one pathology but five names. Symptoms include alternating chills and fever, dripping discomfort, depression and silence, and general malaise. Or abdominal pain and distension urgency, inability to breathe freely, qi rushing upward to the heart and chest, and attacking both hypochondria; or raised lumps, or pulling pain in the lower back and spine. This refers to diseases that develop rapidly, like flying creatures, named Fei Shi (Flying Corpse); those that linger and do not dissipate, coming and going unpredictably, named Dun Shi (Escaping Corpse); those deeply entrenched in the zang-fu organs, named Chen Shi (Sunken Corpse); those triggered by wind, named Feng Shi (Wind Corpse); and those hidden for years without removal, named Fu Shi (Hidden Corpse). Although there are five names, they are all caused by ghostly evil qi and share the same nature. They can be treated with a unified method.

Xionghuang Wan: Treats sudden invasion by Fei Shi, causing abdominal pain and distension urgency, qi rushing to the heart and chest, attacking the hypochondria, raised lumps, or pulling pain in the waist and spine.
Xionghuang (Realgar, ground) Dasuan (Allii Sativi Bulbus) [each 1 liang]
Pound these two ingredients into pills the size of a bullet. Take one pill per dose, dissolved in hot wine. If not cured, take again.

Jili Zi Wan: Treats the same conditions as above.
Jili Zi (Tribuli Fructus, stir-fried to remove spines, 2 liang)
Grind into powder, make into small bean-sized pills with honey. Take twenty pills after meals with warm water.

Muxiang Wan:
Muxiang (Aucklandiae Radix) Dingxiang (Caryophylli Flos) [each 3 fen] Guijianyu (Spatholobi Caulis) Jiegeng (Platycodonis Radix) Danggui (Angelicae Sinensis Radix) Chenpi (Citri Reticulatae Pericarpium, white part removed, stir-fried) Zisu (Perillae Folium, lightly stir-fried) [each 1 liang] Baibinglang (Arecae Semen, baked, 14 pieces) Taoren (Persicae Semen, peel and tip removed, double-kernel removed, stir-fried until yellow, 14 pieces)
Pound and sieve the above ingredients. Take 5 qian per dose, decoct in water and take warm at any time, twice daily.

Zhengwen Fang (Steaming and Compress Formula): Treats Dun Shi, Fei Shi, and wind-toxin swelling flowing into the head, face, and four limbs.
Jiezi (Brassicae Semis Mustardae, steamed ripe, dried, 1 jin)
Grind into powder, mix evenly with 2 liang of Qiedan (Minii Oxidum Rubrum). Divide into two portions, place in breathable leather bags, steam until hot, and apply as a compress to painful areas.

Shexiang San: Treats sudden invasion of evil qi, causing stabbing pain in the heart and abdomen.
Shexiang (Moschus, 1 fen) Xijiaoxie (Rhinocerotis Cornu, shaved) Muxiang (Aucklandiae Radix) [each 0.5 liang]
Grind into powder. Take 2 qian per dose, mixed with hot water on an empty stomach, twice daily. If symptoms persist, take again.

Another Prescription: Jiugen (Allii Tuberosi Radix, one handful, chopped) Wumei (Mume Fructus, 14 pieces) Wuzhuyu (Evodiae Fructus, soaked in water, dried, 2.5 liang)
Add 5 sheng of water, boil. Place the patient's comb inside. Boil three times. If the comb floats, the patient will live; if it sinks, the patient will die. Decoct to 3 sheng. Drink frequently.
Note: Combs have the function of dredging and venting. Floating belongs to Yang, sinking belongs to Yin. Yang governs opening, while Yin governs closing. Sudden death due to external pathogens involves violent addition of evil qi and temporary closure of all Yang qi. Receiving Yang qi leads to opening and life; receiving Yin qi leads to closure and death.

The Ben Shi Fang states: Fei Shi wanders in the skin, penetrates the zang-fu organs, and causes stabbing pain upon each attack, changing unpredictably. Dun Shi attaches to bones and enters flesh, attacking and piercing blood vessels. Each attack cannot be approached; seeing funerals or hearing mourning cries triggers it. Feng Shi jumps wildly in the four limbs, with unknown pain locations. Each attack brings drowsiness, triggered by wind and snow. Chen Shi wraps around bones and knots in organs, impacting the heart and hypochondria. Each attack causes severe twisting pain, triggered by cold. Zhu Shi (注尸 - Tethered Corpse) causes heaviness of the whole body, mental confusion, constant feeling of fainting and exhaustion. Each solar term change triggers major illness. All these should be treated with Taiyi Shening Dan (Great One Divine Spirit Cinnabar Pill), Suhexiang Wan (Styrax Pill), and by chopping Ren Dong Ye (Lonicerae Japonicae Caulis) into several hu, boiling it thick, extracting the juice, and refining it into pills the size of chicken eggs. Take one pill, three times daily.

When I was in Huizhou City, I once prepared a batch of Shening Dan. In the Gengshen year, a woman in my family dreamed of two dark-skinned servants, one in front and one behind, holding an object. The one in front asked, "Has it arrived?" The one behind replied, "It has arrived." Suddenly there was a loud noise, and she became sleep-paralyzed (Ya). Upon waking, she felt unbearable pain in one spot of her heart and was dizzy for about an hour. I suddenly remembered that Shening Dan treats this symptom, so I took three pills for her to ingest. Then I went to the prefecture office. When I returned shortly after, the woman was already healthy. She said that after taking the medicine, the pain stopped and her spirit cleared, and she is now normal. Later, acquaintances who felt slight evil qi took one or two doses, and all were effective. This formula is recorded in the Qianjin Fang and is a key medicine for treating Wind-Stroke (Zhong Feng). However, in recent times, it is rare to obtain Zengqing (Azurite) and Cishi (Magnetitum), making it difficult to prepare.

Taiyi Shening Dan: Treats Ke Wu (External Intrusion) Cholera, abdominal pain and distension, Shi Zhu (Tethered Corpse) aversion to wind, mania and delirium, Gu Du (Poisonous Worms) and demons.
Xionghuang (Realgar, fried in oil for seven days) Cihuang (Orpiment) Zhusha (Cinnabaris) Cishi (Magnetitum) Zengqing (Azurite) [each 1 liang] Jinyashi (Calamina, 6 qian)
Grind each ingredient finely. Soak Cihuang, Xionghuang, and Zhusha in vinegar for three days. Soak Zengqing in good wine in a copper vessel, seal with paper, and expose to sun for seven days; if cloudy, dry with fire. Grind the six ingredients together uniformly. Fill a clay pot with the medicine to about one-third full, using this as a standard for the size of the crucible. First, seal the seams with Chishizhi powder (Hematitum), then reinforce externally with Liuyi Ni (Six-One Mud). Wait until completely dry. On a sunny day auspicious for hexagrams, make three mud pillars, five cun high, stable like tripod legs. Place the crucible on them. Put three jin of charcoal underneath, gradually adding charcoal to maintain a total of five jin, keeping it only at the bottom of the pot, not exceeding the rim. Process for five days. After cooling, soak the crucible in cold water until thoroughly cooled. Peel off the mud, gently open the crucible. The essence of the medicine, displaying five colors, will be entirely on the lid. There may also be three colors; pure white is the best grade. Grind finely, make into pills with jujube meat, the size of millet seeds. Take one pill per dose with rice drink. If the patient has locked jaw, pry open the front teeth and administer. The patient will awaken.