瘅，单也，言独热而无寒也。经云∶阴气孤绝，阳气独发，则热而少气烦冤，手足热而
欲呕
，名曰瘅疟。此以阳脏而病阳证，与诸疟证亦不同，其治之之法有三∶一者热气内蓄，而表
有客寒，则当散以辛凉。一者客邪已解，而蕴热独盛，则当清以苦寒或甘寒。一者邪火虽盛
，而气血已衰，真阴已耗急，急宜壮水固原也。
《备急》竹叶常山汤 治瘅疟及温疟。
常山（三两） 淡竹叶（一握） 小麦（一升）
水五升，煮一宿，明旦煮取二升，分温三服。
疟多寒者，名曰牡疟，《金匮》云然也。然牡当作牝，传写之误耳。卫州书云∶疟多寒
者，
痰多也，痰为水类，能遏绝其阳气于里，使不得外达，故寒多不热，虽热亦不甚也。用蜀漆
散者，吐去其痰，阳气一伸，其疾自愈。夫牡属阳，牝属阴，寒多为阴，故宜曰牝。
牡蛎汤
牡蛎 麻黄（各四两） 蜀漆（三两） 甘草（二两）
上先取蜀漆三过去腥，水八斗煮蜀漆、麻黄等得六升，去沫内余药，煮取二升，吐勿复
饮之。
痰疟由夏月乘凉饮冷，及卧湿地、饥饱失时、脾胃不和、痰积中脘所致。其脉弦滑，其
证胸
痞呕吐，或时眩晕者是也。微则消之，甚而实者，蜀漆、常山之类，攻而去之。虚者四兽饮
之属，补而逐之。
常山散
常山一两锉碎，以好酒浸一宿，瓦器煮干为末，每服二钱，水一盏，煎半盏，去滓停冷
，五更服之，不吐不泻效。
四兽饮
半夏 茯苓 人参 草果 陈皮 甘草（减半） 乌梅肉 白术（各等分）
上 咀，同姜、枣等分，以盐少许淹服食顷，浓皮纸煨令香熟，焙干，每服半两，水煎
，未发前并进三服。
Dan (Candid Malaria), meaning "single," refers to a condition characterized by fever alone without chills. The Classics state: "When Yin Qi is isolated and cut off, and Yang Qi erupts alone, there will be fever, shortness of breath, mental restlessness and oppression, heat in the hands and feet, and a desire to vomit; this is named Dan Malaria." This arises from a constitution with excess Yang suffering from a Yang syndrome, which differs from other malaria syndromes. Its treatment methods are threefold: First, if heat accumulates internally while external pathogenic cold lingers on the exterior, it should be dispersed using acrid-cool agents. Second, if the external pathogen has been resolved but internal latent heat remains excessive, it should be cleared using bitter-cold or sweet-cool agents. Third, although the pathogenic fire is vigorous, if Qi and Blood have already declined and True Yin is severely depleted, urgent measures must be taken to strengthen Water and secure the root (nourish Kidney Yin to consolidate primal Qi).
Zhuye Changshan Tang (Bamboo Leaf and Dichroa Decoction) from *Beiji Fang* treats Dan Malaria and Wen Malaria.
Herbs: Changshan (Dichroae Radix, 3 liang), Danye Zhu (Lophatheri Herba, one handful), Xiaomai (Tritici Fructus, 1 sheng).
Preparation: Add 5 sheng of water, boil overnight. In the morning, decoct until 2 sheng remain. Divide into three warm doses.
Malaria with predominant chills is named Mu Malaria, as stated in *Jingui Yaolue*. However, "Mu" should be "Pin," an error in transcription. Medical texts from Weizhou state: Malaria with abundant chills is due to Phlegm-Dampness. Phlegm belongs to the category of Water; it can obstruct Yang Qi within, preventing it from reaching the exterior. Consequently, chills are prominent while fever is absent or mild even when present. The use of Shuqi San aims to induce vomiting to expel Phlegm; once Yang Qi extends freely, the disease heals spontaneously. "Mu" belongs to Yang, while "Pin" belongs to Yin. Since abundant chills indicate a Yin pattern, it should correctly be called Pin Malaria.
Muli Tang (Oyster Shell Decoction)
Herbs: Muli (Ostreae Concha), Mahuang (Ephedrae Herba) (each 4 liang); Shuqi (Perillae Folium et Radix, 3 liang); Gancao (Glycyrrhizae Radix et Rhizoma, 2 liang).
Preparation: First, process Shuqi three times to remove its fishy odor. Add 8 dou of water and decoct Shuqi and Mahuang until 6 sheng remain. Skim off the foam, add the remaining herbs, and decoct until 2 sheng remain. If vomiting occurs after administration, do not drink the remainder.
Tan Malaria (Phlegm Malaria) is caused by exposure to cool air and consumption of cold drinks in summer, sleeping on damp ground, irregular eating habits leading to Spleen-Stomach disharmony, and Phlegm accumulation in the Middle Jiao. The pulse is wiry and slippery. Symptoms include chest fullness and distension, vomiting, and occasional vertigo. For mild cases, resolve the phlegm via digestion-promoting methods. For severe, excess patterns, attack and eliminate it using herbs like Shuqi and Changshan. For deficiency patterns, tonify and drive out phlegm using formulas such as Six Beasts Yin.
Changshan San (Dichroa Powder)
Herbs: Changshan (Dichroae Radix, 1 liang), crushed, soaked in good wine overnight, then boiled dry in a clay vessel and ground into powder.
Administration: Take 2 qian per dose, add 1 zhan of water, decoct until half a zhan remains. Strain and let cool. Administer at Wugeng time (early morning, 3–5 AM). Efficacy is indicated by the absence of vomiting or diarrhea.
Six Beasts Yin (Si Shou Yin)
Herbs: Banxia (Pinelliae Rhizoma), Fuling (Poria), Renshen (Ginseng Radix), Caoguo (Tsao-ko Fructus), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma, reduced dosage), Wu Mei Rou (Mume Fructus), Baizhu (Atractylodis Macrocephalae Rhizoma) (equal parts).
Preparation: Coarsely crush the herbs. Mix with equal parts of fresh ginger and jujube. Marinate briefly with a little salt. Wrap in thick paper and bake/roast until fragrant and cooked. Dry thoroughly. Take 0.5 liang per dose, decoct in water. Administer three doses consecutively before the onset of the malaria attack.