非其时而有其气者,冬气君子当闭藏,而反泄于外,专用补药带表散,如补中益气汤之属。入方∶以竹筒两头留
节,中开一窍,纳大粉草锉碎于中,仍以竹木钉、油灰闭窍,立冬日浸于大粪缸中,待至立春先一日取出,于有风无
日处,干二十一日,愈久益好,却破竹取草为细末,大治阳证疫毒。一云亦治肿毒,并治金疮水调敷之。其脉左寸大
于右寸,浮缓而盛,按之无力。
有风、有暑、有食、有痰、有老疟、有疟母。老疟病者,此系风暑入在阴脏也,用血药引出阳分而散,一补一
发,川芎、红花、当归,加苍术、白术、白芷、黄柏、甘草,煎露一宿,次早服之。无汗要有汗,散邪为主带补。
有汗要无汗,补正气为主带散。散邪发汗,紫苏、麻黄之
属。补正气,人参、黄 之类。有疟母多在胁下,令人多汗、胁痛,以丸药消导。醋煮鳖甲为君,三棱、蓬术、海
粉,醋煮香附、青皮、桃仁、红花、神曲、麦 、随证加减用之。一本自香附以上俱用醋煮。三日一发者,受病一年;
间日发者,受病半年;一日一发者,受病一月;连二日发住一日者,气血俱受病。一日间一日发者,补药带表药,后以
截疟丹截之。在阴分者,用药彻起在阳分,方可截。入方∶川常山、草果、知母、槟榔、乌梅、穿山甲炒,甘草
炙,以水一大碗煎至半碗,露一宿,临发日早,或发前二时,温服之。如吐则顺之。大法暑风必当发汗。夏月多
在风凉处歇,遂闭窍不泄;恶食者,必从饮食上得。疟而虚,须先用参、术一、二帖托住其气,不使下陷,后用他药
治之。内伤挟外邪同发,内必生痰,外必以汗解,二陈汤加草果、常山、柴胡、黄芩之剂。疟而甚者,发寒热,头痛
如破,渴而饮水,自汗,可与人参、黄 、白术、黄芩、黄连、栀子、川芎、苍术、半夏、天花粉等治。久病疟者,
二陈汤加川芎、苍术、柴胡、白术、干葛。一补一发,近午时发者;近午发而汗多烦渴者,黄 三白汤加芩连。寒
多、脉弱、体倦、食少,局方人参养胃汤。疟因劳役,或忧思而作,汗多食少,倦甚懒言语补中益气汤。痰滞胸
满,热多寒少,大便燥实大柴胡汤。疟病能食而痰伏者,小胃丹。疟大渴大热之甚,小柴胡汤去半夏,加知母、麦
门冬、黄连。大率暑疟,多用小柴胡汤、人参白虎汤之类。疟渴,生地黄、麦门冬、天花粉、川牛膝、知母、炒
柏、干葛、生甘草。疟后,白术 半夏(各一两) 黄连(五钱) 白芍药(三钱) 陈皮(五钱) 上末之,粥丸。
久疟不得汗,二陈加槟榔,倍苍。白术。一人疟后手战,此痰郁格涎吐后
好。截疟青蒿丸∶青蒿(一斤) 冬瓜叶(二两) 官桂(二两) 马鞭草(二两) 上将三叶焙干,为末,丸如桐
子大,每一两分四服,当发日前一时服尽。又方∶槟榔 陈皮 白术 常山(以上各二钱) 茯苓 乌梅 浓朴(以上
各一钱) 上作二帖,每服酒水各一盏,煎至半盏,当发前一日进一帖,临发日进一帖,服后少睡片时效。疟必数发
之后,便以截药除之,最为好法。若发得中气虚弱,病邪愈深,或数月、周岁者,虽神医亦不能愈。虽治而暂安,或因
饮食与外邪所伤,又复举发,近世多苦于此,用好常山一两,槟榔五钱为末,面糊丸,如桐子大,每丸当发前一日
两服,即效。或常山饮子亦可。截法,用守真先生丸子,雄黄一两,人参五钱,五月五日用粽子尖为丸,桐子大,于
未发早,面东,井华水送下一丸,忌诸热味。(人参一云人言) 又方大黑豆(七钱) 雄黄(一钱) 轻粉(五
分) 人参(一钱) 薄荷(五分) 甘草(一钱) 上为末,滴水丸如小豆大,鸡鸣时新汲水面东吞一丸。(人参
一云人言) 又罗谦甫方紫河车丸用∶紫河车(一两) 生甘草(五钱) 绿豆(一两) 人言(一钱另研) 上为
细末,每服五分,新汲水少许送下。如隔日发夜服;频日发者,则夜睡深时服。忌荤腥、瓜果、酒面、鱼鸡等肉,并生
冷等物。三两日一发者;受邪气深者,只一服。十岁以上服一字,三岁半字,孕妇勿服。一人年六十,禀
壮味浓,春病疟,先生教以却欲食淡,不听。医与劫药三、五帖而安,旬后又作又与,绵延至冬求治,先生知其久得
汗,惟胃气未完,时天大寒,又触冒为寒热,非补不可。以一味白术为末,粥丸,与二斤令其饥时,且未与食,取一
二百丸热汤下,只以白糜粥调养,尽此药,当大汗而安。已而果然如此者多,但药略有加减耳。一人久疟腹胀,脉不数
而微弦,重取则来不滑利,轻取则无力,遂与三和汤索氏者
三倍,加白术入姜汁服之,数服,而小便利一、二行,腹胀稍减,又随小便短少,作血气两虚治,于药中入人参、牛
膝、当归身,作大剂,服四十余帖而愈。一妇人病疟,间两日一发,饮食绝少,经脉不行已三月矣。诊其脉,两手俱
无,见其梳妆不异平时,言语行步并无倦怠。因悟经不行非无血也,乃痰所碍而不行也;无脉者,非血衰少而脉绝,实
由积痰生热结伏,而脉不见耳。当作实热治之,遂以三花神 丸与之。旬日后食稍进,脉亦稍出,一月后六脉俱出,但
带微弦,疟犹未愈。盖胃气既全,春深经血自旺,便自可愈,不必服药。教以淡滋味,节饮食之法,半月,疟愈而经
亦行矣。一老人患疟半载,脉之两尺俱数而有力,色稍枯,盖因服四兽饮等剂,中焦湿热下流,伏结于肾,以致肾
火上运于肺,故疟嗽俱作,用参、术、芩、连、升麻、柴胡调中,一、二日与黄柏丸服之,两夜梦交通,此肾中热解无
忧,次日疟嗽顿止。一富人年壮病疟,自卯时寒,至酉方热,至寅初休,一日一夜止苏一时,因思必为入房感寒所
致。用参、术大补,附子行经,加散寒以取汗。数日不得汗,病如前。因误足腑之道远,药力难及,用苍术、芎、桃
枝煎汤以器盛之,扶坐浸足至膝,一食顷以前,所服之药饮之,其汗通身大出,病即愈。久病者,不可直截,必用一
补一发,凡砒霜等药不可轻服,以其有毒故也。在阴分者,难治;在阳分者,易治。疟母必用毒药消之,行气削
坚为主。东垣谓寒疟属太阳当汗;热疟属阳明当下;寒热疟属少阳当和。在三阴即不分,总为温疟,此言甚是。但三
阴经之说不明,作于子午卯酉日少阴疟,寅申巳亥日厥阴疟,辰戌丑未日太阴疟。其脉弦,热则弦而带数;寒则弦而
带迟。亦有久病此,而脉极虚,微而无力,似乎不弦,然必
于虚微之中,见弦,但不搏手耳,细察可见。
当气候反常,非其时而有其气时,冬季本应闭藏,阳气反而外泄。治疗时应专用补药兼带解表散邪之品,如补中益气汤之类的方剂。
入方:取竹筒两头保留节段,中间开一孔窍,将大粉草锉碎放入其中,再用竹木钉和油灰封住孔窍。在立冬之日将其浸入大粪缸中,等到立春前一天取出,放在有风无日之处,晾干二十一日,放置越久越好。然后破竹取出甘草研为细末,可大力治疗阳证疫毒。另一种说法是也能治疗肿毒,并用清水调敷于金疮(刀伤)处。其脉象表现为左寸脉大于右寸脉,浮缓而盛大,重按无力。
疟疾的病因包括风、暑、食积、痰饮、老疟(久治不愈的疟疾)、疟母(疟疾日久形成的胁下痞块)。老疟病患者,这是由于风暑之邪侵入阴脏所致,需用血分药引出至阳分而消散,采用一补一发之法,药用川芎、红花、当归,加苍术、白术、白芷、黄柏、甘草,煎煮后露天放置一夜,次日清晨服用。无汗者要使有汗,以散邪为主兼带补益;有汗者要使无汗,以补正气为主兼带散邪。散邪发汗可用紫苏、麻黄之类。补正气用人参、黄芪之类。疟母多在胁下,导致多汗、胁痛,需用丸药消导。以醋煮鳖甲为君药,配伍三棱、蓬术(莪术)、海粉,醋煮香附、青皮、桃仁、红花、神曲、麦冬,随证加减使用。另一版本中,从香附以上的药物均用醋煮。三日发作一次的,受病一年;隔日发作一次的,受病半年;每日发作一次的,受病一个月;连续两天发作停一天者,气血均受病。一日发作一次、一日停止一次者,用补药兼带表药,随后用截疟丹截断疟疾。病在阴分的,用药将其透达至阳分,方可截断。
入方:川常山、草果、知母、槟榔、乌梅、炒穿山甲、炙甘草,用水一大碗煎至半碗,露天放置一夜,发病当日早晨,或发病前两小时,温服。如果服药后呕吐,则顺其势处理。大法则是暑风疟必当发汗。夏季多在风凉处休息,导致腠理闭塞而不泄;厌恶饮食者,必定是从饮食上得病。疟疾而虚弱的,须先用人参、白术一两帖托住其气,不使下陷,然后再用其他药物治疗。内伤兼外邪同时发作,内部必然生痰,外部必须通过发汗解除,可用二陈汤加草果、常山、柴胡、黄芩等药剂。疟疾严重的,出现寒热往来、头痛如裂、口渴饮水、自汗,可用人参、黄芪、白术、黄芩、黄连、栀子、川芎、苍术、半夏、天花粉等治疗。久病疟疾,用二陈汤加川芎、苍术、柴胡、白术、干葛。一补一发,近午时发作的;近午发作且汗多烦渴的,用黄芪三白汤加黄芩、黄连。寒多、脉弱、体倦、食少,用局方人参养胃汤。疟疾因劳役,或忧思而起,汗多食少,倦怠甚懒言语,用补中益气汤。痰滞胸满,热多寒少,大便燥实,用大柴胡汤。疟病能进食但痰伏者,用小胃丹。疟疾大渴大热严重的,用小柴胡汤去半夏,加知母、麦门冬、黄连。大率暑疟,多用小柴胡汤、人参白虎汤之类。疟疾口渴,用地黄、麦门冬、天花粉、川牛膝、知母、炒黄柏、干葛、生甘草。疟疾之后,用白术、半夏(各一两)、黄连(五钱)、白芍药(三钱)、陈皮(五钱),研为细末,米粥泛丸。久疟不得汗,用二陈汤加槟榔,倍用苍术、白术。一人疟疾后手颤抖,这是痰郁格拒涎沫,吐后好转。
截疟青蒿丸:青蒿(一斤)、冬瓜叶(二两)、官桂(二两)、马鞭草(二两)。先将前三味药焙干,研为细末,制成梧桐子大小的丸药,每一两分为四次服用,在发病前一小时服完。又一方:槟榔、陈皮、白术、常山(以上各二钱)、茯苓、乌梅、浓朴(以上各一钱)。制成两帖,每服用酒和水各一盏,煎至半盏,在发病前一天进服一帖,发病当天进服一帖,服药后稍睡片刻见效。疟疾必须经过数次发作后,便用截药去除,这是最好的方法。如果发作导致中气虚弱,病邪愈深,或数月、周岁者,即使是神医也不能治愈。虽然治疗暂时安定,或因饮食与外邪所伤,又再次发作,近代人多为此苦恼。用好常山一两,槟榔五钱研为细末,面糊丸,梧桐子大小,每丸在发病前一天服两次,即见效。或者常山饮子也可以。截法,用守真先生的丸子,雄黄一两,人参五钱,五月五日利用粽子尖为丸,梧桐子大小,在未发病前,面向东方,井华水送下一丸,忌食各种热性食物。(人参一说为人言/砒霜)又一方:大黑豆(七钱)、雄黄(一钱)、轻粉(五分)、人参(一钱)、薄荷(五分)、甘草(一钱)。研为细末,滴水丸如小豆大小,鸡鸣时新汲水面向东方吞服一丸。(人参一说为人言/砒霜)又罗谦甫方紫河车丸用:紫河车(一两)、生甘草(五钱)、绿豆(一两)、人言(砒霜,一钱另研)。研为细末,每服五分,新汲水少许送下。如果是隔日发作夜间服;频日发作者,则在夜睡深时服。忌荤腥、瓜果、酒面、鱼鸡等肉,以及生冷等物。三两日发作一次的;受邪气深的,只服一服。十岁以上服一字,三岁半字,孕妇勿服。
一人年六十,体质壮实口味浓厚,春季患疟疾,先生教导他戒欲食淡,他不听。医生给予劫药三、五帖而安顿,旬日后又发作,又给予,绵延至冬季求治,先生知道他久已出汗,只是胃气未恢复,当时天气大寒,又触冒寒冷导致寒热,非补不可。用一味白术研为细末,米粥泛丸,给二斤让他饥饿时,暂不给食物,取一二百丸用热汤送下,只用白糜粥调养,吃完此药,应当大汗而安。后来果然如此的多,只是药物略有加减罢了。一人久疟腹胀,脉不数而微弦,重取则来不滑利,轻取则无力,于是给予三倍量的三和汤(索氏版),加白术入姜汁服用,数服后,小便通利一、二次,腹胀稍减,又随小便短少,作血气两虚治疗,于药中加入人参、牛膝、当归身,做大剂,服四十余帖而愈。
一妇人患疟,间两日发作一次,饮食极少,月经不行已三月了。诊其脉,两手俱无脉,见其梳妆不异平时,言语行步并无倦怠。因而领悟到经血不行并非无血,乃是痰所阻碍而不行也;无脉者,并非血衰少而脉绝,实由积痰生热结伏,而脉不见耳。当作实热治疗,于是用三花神祐丸与之。旬日后饮食稍进,脉亦稍出,一月后六脉俱出,但带微弦,疟疾犹未愈。盖胃气既全,春深经血自旺,便自可愈,不必服药。教导她淡滋味、节饮食的方法,半月,疟疾愈而月经也行了。
一老人患疟半年,诊其脉两尺俱数而有力,面色稍枯,这是因为服用四兽饮等药剂,中焦湿热下流,伏结于肾,以致肾火上运于肺,故疟嗽俱作,用参、术、芩、连、升麻、柴胡调中,一、二日与黄柏丸服之,两夜梦交,此肾中热解无忧,次日疟嗽顿止。
一富人年壮患疟,自卯时恶寒,至酉时才发热,至寅初才休止,一日一夜只清醒一时,因而思考必定是入房感寒所致。用人参、白术大补,附子行经,加散寒药以取汗。数日不得汗,病如前。因误走足腑之道远,药力难及,用苍术、川芎、桃枝煎汤以器盛之,扶坐浸足至膝,一顿饭功夫以前,服下所服的药,其汗通身大出,病即愈。久病者,不可直截,必用一补一发,凡砒霜等药不可轻服,以其有毒故也。在阴分的,难治;在阳分的,易治。疟母必用毒药消之,行气削坚为主。东垣谓寒疟属太阳当汗;热疟属阳明当下;寒热疟属少阳当和。在三阴即不分,总为温疟,此言甚是。但三阴经之说尚不明确,作于子午卯酉日者为少阴疟,寅申巳亥日者为厥阴疟,辰戌丑未日者为太阴疟。其脉弦,热则弦而带数;寒则弦而带迟。也有久病此症,而脉极虚,微而无力,似乎不弦,然而必须在虚微之中,见弦,但不搏手耳,细察可见。
When the climate is abnormal and there is qi contrary to the season, in winter, yang qi should be stored and conserved, but instead it leaks outward. Treatment should exclusively use tonifying medicines combined with exterior-releasing agents, such as those in Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction).
Prescription: Take a bamboo tube, retaining the nodes at both ends, and open a hole in the middle. Place crushed large licorice root (Gancao) inside, then seal the hole with bamboo or wooden pegs and oil paste. On the day of Start of Winter (Lidong), immerse it in a cesspit. Retrieve it on the day before Start of Spring (Lichun), and dry it for twenty-one days in a place with wind but no direct sunlight; the longer it is kept, the better. Then break the bamboo, retrieve the licorice, and grind it into a fine powder. This can effectively treat Yang-pattern epidemic toxins. Another claim is that it also treats swelling toxins and can be applied externally to traumatic injuries (Jinchuang) mixed with water. The pulse presents as the left Cun position larger than the right Cun position, floating, moderate, and vigorous, but weak upon deep pressure.
The etiologies of malaria include Wind, Summerheat, Food Stagnation, Phlegm-Fluid, chronic malaria (Lao Nue), and malaria mass (Nue Mu - subcostal mass formed after prolonged malaria). Chronic malaria patients suffer from Wind and Summerheat pathogens invading the Yin organs. Use blood-invigorating herbs to draw the pathogen out to the Yang level and dissipate it, employing a method of one tonification followed by one release. Herbs include Chuanxiong Honghua Danggui (Ligusticum, Safflower, Angelica Sinensis), added with Cangzhu Baizhu Baizhi Huangbai Gancao (Atractylodes Lancea, Atractylodes Macrocephala, Angelica Dahurica, Phellodendron, Licorice). Decoct and leave exposed overnight, taken early the next morning. For those without sweat, induce sweating; prioritize releasing pathogens while accompanying with tonification. For those with sweat, stop sweating; prioritize tonifying righteous qi while accompanying with releasing pathogens. To release pathogens and induce sweating, use Zisu Mahuang (Perilla Leaf, Ephedra). To tonify righteous qi, use Renshen Huangqi (Ginseng, Astragalus). Malaria masses are mostly located under the hypochondrium, causing excessive sweating and hypochondriac pain; treat with pill formulations for resolution and guidance. Use Vinegar-processed Turtle Shell (Biejia) as the sovereign herb, combined with Sanleng Ezhu (Burreed Rhizome, Curcuma Zedoaria), Haifen (Sea Sponge), Vinegar-processed Xiangfu Qingpi Taohong Honghua Shenqu Maidong (Cyperus, Tangerine Peel, Peach Kernel, Safflower, Medicated Leaven, Ophiopogon), adjusted according to symptoms. In another version, all herbs from Xiangfu upwards are vinegar-processed. Those attacking every three days have been ill for one year; those attacking every other day have been ill for half a year; those attacking daily have been ill for one month; those attacking two days and resting one day indicate both Qi and Blood are diseased. Those attacking one day and resting one day are treated with tonics accompanied by exterior-releasing drugs, subsequently using Jie Nue Dan (Malaria-Cutting Pill) to cut off the malaria. If the disease is in the Yin level, use medication to bring it up to the Yang level before it can be cut off.
Prescription: Chuan Changshan Cao Guo Zhimu Binglang Wumei Chao Chuanshanjia Zhi Gancao (Changshan, Tsaoko Cardamom, Anemarrhena, Areca Seed, Mume Fruit, Processed Pangolin Scale, Processed Licorice). Decoct in one large bowl of water until half remains, leave exposed overnight. On the morning of the attack, or two hours before the attack, take warm. If vomiting occurs, follow the trend. The general principle is that Summerheat-Wind malaria must be treated by inducing sweating. In summer, resting in cool breezy places causes pores to close and prevents excretion; aversion to food indicates the disease originated from diet. For malaria with deficiency, first use Renshen Baizhu (Ginseng, Atractylodes Macrocephala) for one or two doses to support the Qi and prevent sinking, then treat with other medications. When internal injury combines with external pathogens, phlegm inevitably forms internally, and the exterior must be resolved through sweating. Use Er Chen Tang plus Caoguo Changshan Chaihu Huangqin (Tsaoko Cardamom, Changshan, Bupleurum, Scutellaria). For severe malaria presenting with alternating chills and fever, headache as if splitting, thirst with desire to drink, and spontaneous sweating, use Renshen Huangqi Baizhu Huangqin Huanglian Zhizi Chuanxiong Cangzhu Banxia Tianhuafen (Ginseng, Astragalus, Atractylodes Macrocephala, Scutellaria, Coptis, Gardenia, Ligusticum, Atractylodes Lancea, Pinellia, Trichosanthes Root). For chronic malaria, use Er Chen Tang plus Chuanxiong Cangzhu Chaihu Baizhu Genge (Ligusticum, Atractylodes Lancea, Bupleurum, Atractylodes Macrocephala, Pueraria). One tonification and one release: for attacks near midday; for attacks near midday with excessive sweating, irritability, and thirst, use Huangqi Sanbai Tang plus Qinlian (Astragalus Three Whites Decoction plus Scutellaria and Coptis). For chills predominating, weak pulse, fatigue, and poor appetite, use Ju Fang Renshen Yangwei Tang (Official Formula Ginseng Stomach-Nourishing Decoction). Malaria caused by overwork or worry, with excessive sweating, poor appetite, severe fatigue, and reluctance to speak, is treated with Bu Zhong Yi Qi Tang. For phlegm stagnation in the chest with fullness, more heat than cold, and dry hard stool, use Da Chai Hu Tang (Major Bupleurum Decoction). For malaria where the patient can eat but phlegm is latent, use Xiao Wei Dan (Minor Stomach Pill). For severe malaria with extreme thirst and heat, use Xiao Chai Hu Tang removing Banxia, adding Zhimu Maidong Huanglian (Anemarrhena, Ophiopogon, Coptis). Generally, Summerheat malaria uses Xiao Chai Hu Tang and Renshen Baihu Tang (Ginseng White Tiger Decoction). For malaria thirst, use Shengdiye Maidong Tianhuafen Chuan Niuxi Zhimu Chao Bai Genge Sheng Gancao (Rehmannia, Ophiopogon, Trichosanthes Root, Cyathula, Anemarrhena, Processed Phellodendron, Pueraria, Raw Licorice). Post-malaria, use Baizhu Banxia (each 1 liang), Huanglian (5 qian), Shaoyao (3 qian), Chenpi (5 qian), grind to powder, and form pills with congee. For chronic malaria without sweat, use Er Chen Tang plus Binglang, doubling Cangzhu and Baizhu. One patient had hand tremors after malaria; this was due to phlegm stagnation blocking saliva, improving after expectoration.
Jie Nue Qinghao Wan (Malaria-Cutting Artemisia Pill): Qinghao (1 jin), Donggua Ye (2 liang), Guanzi Gui (2 liang), Mabiancao (2 liang). Dry the first three leaves by roasting, grind to powder, make pills like paulownia seeds. Divide one liang into four doses, finish taking them one hour before the expected attack. Another formula: Binglang, Chenpi, Baizhu, Changshan (each 2 qian), Fuling, Wumei, Houpo (each 1 qian). Make two doses. Each dose decocted with one cup of wine and one cup of water until half remains. Take one dose the day before the attack, and one dose on the day of the attack. Sleep briefly after taking; effect follows. It is best to use cutting medicine after several attacks to remove the pathogen. If the attack depletes Middle Qi and the pathogen goes deeper, lasting months or years, even a divine physician cannot cure it. Although treatment may provide temporary relief, recurrence due to diet or external pathogens is common in modern times. Use good quality Changshan (1 liang) and Binglang (5 qian), grind to powder, make pills with wheat paste like paulownia seeds. Take two pills the day before the attack; effective immediately. Or use Changshan Yinzi. For cutting methods, use Mr. Shouzhen's pills: Xionghuang (1 liang), Renshen (5 qian). On the fifth day of the fifth lunar month, make pills using the tip of a zongzi (sticky rice dumpling), size of paulownia seeds. Take one pill early before the attack, facing East, swallowed well-water. Avoid all hot-natured foods. (Renshen is sometimes said to be Renyan/Arsenic). Another formula: Daheidou (7 qian), Xionghuang (1 qian), Qingfen (5 fen), Renshen (1 qian), Bohe (5 fen), Gancao (1 qian). Grind to powder, make pills with drops of water like small beans. Swallow one pill at cockcrow, facing East, with fresh well-water. (Renshen is sometimes said to be Renyan/Arsenic). Another formula by Luo Qianfu, Zijieche Wan: Zijieche (1 liang), Sheng Gancao (5 qian), Ludou (1 liang), Renyan (Arsenic, 1 qian, separately ground). Grind to fine powder. Take 5 fen each time, swallowed with a little fresh well-water. If attacking every other day, take at night; if frequent attacks, take during deep sleep. Avoid meat, fruits, alcohol, noodles, fish, chicken, and raw/cold items. For attacks every three days or deeply infected pathogens, only one dose is needed. Over ten years old take one zi character dose, three years old take half zi character dose. Pregnant women should not take it.
One patient, sixty years old, robust constitution and rich diet, contracted malaria in spring. Mr. Zhu advised abstinence from sexual activity and bland diet, but he did not listen. Physicians gave "robbery" (harsh/expelling) medicines for three to five doses, bringing relief, but it recurred ten days later. This continued until winter when he sought treatment again. Mr. Zhu knew he had sweated profusely long ago, but his Stomach Qi was not yet restored. Due to severe cold weather and exposure to cold causing chills and fever, tonification was necessary. He used only Baizhu (Atractylodes Macrocephala) ground to powder, made into pills with congee, giving two jin. Instructed to take it when hungry, without prior food intake, swallowing 100-200 pills with hot water, and maintaining diet with thin congee. After finishing the medicine, profuse sweating occurred and he recovered. Many cases followed this pattern, with slight variations in herbs. One patient had chronic malaria with abdominal distension. Pulse was not rapid but slightly wiry; heavy pressure felt unsmooth, light pressure felt weak. Thus, San He Tang (Suo Shi version) was given at triple dosage, added with Baizhu and ginger juice. After several doses, urination increased by one or two times, and abdominal distension decreased slightly. As urine became scanty, it was treated as Qi and Blood deficiency. Added Renshen, Niuxi, Dangguishen (Ginseng, Achyranthes, Angelica Sinensis root body) in large doses. After forty-plus doses, he recovered.
One woman suffered from malaria attacking every two days, ate very little, and menstruation had stopped for three months. Her pulse was absent in both hands. However, she dressed normally, spoke and walked without fatigue. Realizing that amenorrhea was not due to lack of blood but obstruction by phlegm, and absence of pulse was not due to blood depletion but blockage by accumulated phlegm generating heat, he treated it as Excess Heat. He gave Sanhua Shenyu Wan (Three Flowers Divine Expulsion Pill). Ten days later, appetite improved and pulse appeared slightly. After one month, all six pulses were palpable, though slightly wiry. Malaria had not yet ceased. Since Stomach Qi was restored, deep spring energy would naturally strengthen the menses, so recovery would occur without further medication. He taught her to eat bland flavors and regulate diet. Half a month later, malaria ceased and menstruation resumed.
An elderly man suffered from malaria for half a year. His Chi positions were rapid and forceful, complexion slightly withered. This was because he had taken Si Shou Yin (Four Beasts Decoction) and similar formulas, causing damp-heat in the Middle Jiao to flow downward and settle in the Kidney. Consequently, Kidney Fire rose to the Lung, causing both malaria and cough. He was treated with Renshen, Baizhu, Huangqin, Huanglian, Shengma, Chaihu to harmonize the center. After one or two days, he took Huangbai Wan (Phellodendron Pills). He experienced nocturnal emissions for two nights, indicating Kidney heat was resolved and there was no cause for worry. The next day, malaria and cough stopped abruptly.
A wealthy young man suffered from malaria. Chills started at Mao hour (5-7 AM), heat started at You hour (5-7 PM), and subsided at Yin hour (3-5 AM). He was awake for only one hour in a full day-night cycle. He deduced it was caused by sexual activity followed by cold invasion. He used Renshen and Baizhu for major tonification, Fuzi to circulate channels, and cold-dispelling herbs to induce sweating. After several days, no sweat occurred, and the condition remained unchanged. Because he mistakenly traveled far via foot paths, the medicinal power could not reach the extremities. He decocted Cangzhu, Chuanxiong, and Taozhi (Peach Twig) in a vessel, sat and immersed his feet to the knees. Within the time of one meal, he drank the previously prepared medicine. Profuse whole-body sweating ensued, and the disease was cured. For chronic diseases, direct cutting is not advisable; one must use one tonification and one release. Arsenic and other toxic drugs should not be taken lightly due to their toxicity. Disease in the Yin level is difficult to treat; disease in the Yang level is easy to treat. Malaria mass must be dissolved with toxic drugs, prioritizing Qi-moving and hardness-reducing actions. Dong Yuan stated: Cold malaria belongs to Taiyang and should be treated by sweating; Heat malaria belongs to Yangming and should be treated by purging; Alternating chills and fever malaria belongs to Shaoyang and should be treated by harmonizing. In the Three Yin levels, they are not distinguished and are collectively called Warm Malaria; this statement is correct. However, the theory of Three Yin meridians is unclear. Malaria occurring on Zi, Wu, Mao, You days is Shaoyin Malaria; on Yin, Shen, Si, Hai days is Jueyin Malaria; on Chen, Xu, Chou, Wei days is Taiyin Malaria. The pulse is wiry; if heat, wiry and rapid; if cold, wiry and slow. There are also cases of chronic illness where the pulse is extremely deficient, faint, and weak, seemingly not wiry. However, within the deficiency and faintness, a wiry quality must be seen, though it does not strike the finger forcefully. Careful observation can reveal it.