吴(三二)形体丰肥。素嗜甘美。近起口甜。是脾胃伏热未清。古称脾痹。而不饥不食。多属有诸。
鲜竹茹(二钱) 制半夏(一钱五分) 川连(六分) 枳实(一钱) 橘红(一钱) 黑山栀(一钱五分) 佩
兰叶(一钱五分)
贝(三○)热邪蕴结中焦。不饥不食。口甜。此属脾痹。
佩兰叶(三钱) 制半夏(一钱五分) 枳实(一钱) 竹茹(一钱五分) 橘红(一钱) 川连(四分) 块茯
苓(三钱)
李(十一)暑湿内郁成疟。前投凉解方。牙宣血溢已止。脉象稍平。而寒已减。热未退。脘闷舌白。痰多溲赤。医
者一误于升、柴、苏、菖并用。过于升泄。复缪于鹿角霜温理奇阳。非独不能已疾。转能益疾。致有前日血溢之恙。今
虽小安。而在里之湿热。尚未尽透。兹当以栀豉汤以引里邪出之于表。是亦疟症驱邪之出路。
淡豆豉(一钱五分) 杏仁(三钱) 草郁金(一钱) 黑山栀(一钱五分) 橘红(一钱五分) 滑石(三钱)
连翘(一钱五分) 川贝(去心研,二钱) 栝蒌皮(一钱五分) 加嫩竹叶(十片)
顾(三六)寒热头痛。脘闷频渴。脉弦滑。从少阳开泄。
柴胡(八分) 制半夏(一钱五分) 草果仁(七分) 淡黄芩(一钱) 广皮(一钱) 赤苓(三钱) 浓朴(一
钱)
王(三四)久疟频呕。木邪伤土。阳明厥阴同治。
川连 制半夏 草果仁 淡干姜 黄芩 茯苓 生白芍(一钱五分) 炒焦乌梅肉(五分)
慕(九岁)昨进泄少阳方。疟邪未止。寒少热多。渴饮无度。呕吐脉数。神烦汗泄。面赤。大便四日未解。当此深
秋燥邪。内投苦寒攻胃。冀其疟缓。已属非法。投是辛寒。佐以甘缓。恰符仲景阴气先伤。阳气独发之旨。
鲜生地(五钱) 麦冬(二钱) 粳米(三钱) 知母(一钱) 生石膏(三钱) 生甘草(四分) 卷心竹叶(一
钱五分)
苏(三○)疟来间日。头痛渴饮。此属暑疟。
香薷(七分) 杏仁(三钱) 飞滑石(三钱) 淡黄芩(一钱) 制半夏(一钱五分) 草果仁(八分) 浓朴
(二钱) 赤苓(三钱)
施(十八)寒热已久。左胁瘕聚。邪入肝络矣。
生牡蛎(三钱) 归须(一钱) 炒延胡(一钱) 炙鳖甲(一两) 炒桃仁(一钱) 桂枝(八分) 柴胡(五
分)
虞(十一)面赤痹热。恶心呕吐。神烦汗泄。衄血。脉大。并不渴饮。此属心经热疟。热邪迫于肺胃所致。清心热。
凉肺胃。可不悖矣。
犀角(八分) 丹皮(一钱) 知母(一钱) 细生地(三钱) 元参(一钱五分) 生甘草(三分) 连翘心(一
钱五分) 麦冬(一钱五分) 竹叶(一钱五分)
钱(十二)寒多热少。移早则邪达于阳。跗肿。腹胀。面浮。皆太阴病。宜缓治。
草果仁(煨研,五分) 制半夏(一钱五分) 赤苓(三钱) 浓朴(一钱) 黄芩(一钱) 知母(一钱) 小
青皮(一钱)
钱(八岁)冲年三虐。寒热俱重。邪深而入客于阴。即疟来日迟之谓。非阴虚之谓也。然腹胀。口不烦渴。胃纳颇
减。太阴见症。当温疏里邪。
草果仁(五分) 川桂枝(八分) 生姜(一钱) 知母(一钱) 杏仁(三钱) 茯苓(三钱) 浓朴(一钱) 制
半夏(一钱五分)
吴(三二)形体肥胖。平素喜爱甘甜美味。近来出现口甜的症状。这是脾胃伏热未清的表现。古人称之为脾痹。而不饥饿、不想进食,大多属于这种情况。
鲜竹茹(二钱) 制半夏(一钱五分) 川连(黄连,六分) 枳实(一钱) 橘红(陈皮,一钱) 黑山栀(栀子,一钱五分) 佩兰叶(一钱五分)
贝(三○)热邪蕴结在中焦。不饥饿、不想进食、口甜。这属于脾痹。
佩兰叶(三钱) 制半夏(一钱五分) 枳实(一钱) 竹茹(一钱五分) 橘红(陈皮,一钱) 川连(黄连,四分) 块茯苓(三钱)
李(十一)暑湿内郁形成疟疾。先前投用凉解方后,牙龈出血已止。脉象稍微平稳。但恶寒已减轻,发热未退。脘腹痞闷,舌苔白,痰多,小便赤黄。医生第一次错误地同时使用升麻、柴胡、紫苏、石菖蒲,过于升散泄越;第二次又错误地使用鹿角霜温补奇经之阳。这不仅不能治愈疾病,反而加重病情,导致前日出现出血的病症。现在虽然稍安,但在里的湿热尚未完全透发。此时应当用栀豉汤(栀子豉汤)来引导里邪出于体表。这也是治疗疟疾驱邪的一种出路。
淡豆豉(一钱五分) 杏仁(三钱) 草郁金(郁金,一钱) 黑山栀(栀子,一钱五分) 橘红(陈皮,一钱五分) 滑石(三钱) 连翘(一钱五分) 川贝(去心研碎,二钱) 栝蒌皮(一钱五分) 加嫩竹叶(十片)
顾(三六)寒热交替,头痛,脘腹痞闷,频繁口渴。脉象弦滑。从少阳经开泄治疗。
柴胡(八分) 制半夏(一钱五分) 草果仁(七分) 淡黄芩(一钱) 广皮(陈皮,一钱) 赤苓(赤茯苓,三钱) 浓朴(厚朴,一钱)
王(三四)久疟频繁呕吐。肝木邪气损伤脾土。阳明经与厥阴经同治。
川连(黄连) 制半夏 草果仁 淡干姜 黄芩 茯苓 生白芍(一钱五分) 炒焦乌梅肉(五分)
慕(九岁)昨天进服泄少阳的方剂,疟邪未止。恶寒少而发热多,极度口渴饮水,呕吐,脉数,神志烦躁,出汗,面色红赤,大便四天未解。正值深秋燥邪当令,体内投用苦寒攻胃之法,期望疟疾缓解,已经属于非法治疗。现投用辛寒之品,佐以甘缓之药,恰好符合张仲景“阴气先伤,阳气独发”的宗旨。
鲜生地(五钱) 麦冬(二钱) 粳米(三钱) 知母(一钱) 生石膏(三钱) 生甘草(四分) 卷心竹叶(一钱五分)
苏(三○)疟疾每隔一日发作一次,头痛,口渴饮水。这属于暑疟。
香薷(七分) 杏仁(三钱) 飞滑石(三钱) 淡黄芩(一钱) 制半夏(一钱五分) 草果仁(八分) 浓朴(厚朴,二钱) 赤苓(赤茯苓,三钱)
施(十八)寒热症状已久,左胁下有瘕聚(积块),邪气已进入肝络。
生牡蛎(三钱) 归须(当归须,一钱) 炒延胡(延胡索,一钱) 炙鳖甲(一两) 炒桃仁(一钱) 桂枝(八分) 柴胡(五分)
虞(十一)面赤,痹热,恶心呕吐,神志烦躁,出汗,鼻衄(流鼻血),脉大,并不口渴饮水。这属于心经热疟。由热邪迫于肺胃所致。清心热,凉肺胃,就不会违背治疗原则了。
犀角(八分) 丹皮(牡丹皮,一钱) 知母(一钱) 细生地(细生地,三钱) 元参(玄参,一钱五分) 生甘草(三分) 连翘心(一钱五分) 麦冬(一钱五分) 竹叶(一钱五分)
钱(十二)恶寒多而发热少。若发作时间提前,则邪气达于阳分。足背浮肿,腹胀,面部浮肿,都属于太阴病。宜缓治。
草果仁(煨研,五分) 制半夏(一钱五分) 赤苓(赤茯苓,三钱) 浓朴(厚朴,一钱) 黄芩(一钱) 知母(一钱) 小青皮(一钱)
钱(八岁)童年患三次疟疾,寒热都重。邪气深入客居于阴分。这就是所谓疟疾发作时间推迟的意思。并非指阴虚。然而腹胀,口中不烦渴,胃纳颇减,是太阴见症。应当温疏里邪。
草果仁(五分) 川桂枝(八分) 生姜(一钱) 知母(一钱) 杏仁(三钱) 茯苓(三钱) 浓朴(厚朴,一钱) 制半夏(一钱五分)
Wu (32) The patient has a robust and plump physique. He has a long-standing preference for sweet and delicious foods. Recently, he developed a sweet taste in the mouth. This indicates that latent heat in the Spleen and Stomach has not been cleared. In ancient texts, this is referred to as Pi Bi (Spleen Bi, obstruction of the spleen). Symptoms such as lack of appetite and anorexia are commonly associated with this condition.
Fresh Zhu Ru (Bambusa Textilis Culm, 2 qian) Zhi Ban Xia (Pinellia Rhizoma Preparatum, 1.5 qian) Chuan Lian (Coptis Chinensis Rhizoma, 6 fen) Zhi Shi (Aurantii Fructus Immaturus, 1 qian) Ju Hong (Citri Reticulatae Pericarpium Rubrum, 1 qian) Hei Shan Zhi (Gardeniae Fructus, 1.5 qian) Pei Lan Ye (Eupatorii Herba, 1.5 qian)
Bei (30) Heat pathogen is constrained and accumulated in the Middle Jiao (Middle Burner). There is a lack of appetite, anorexia, and a sweet taste in the mouth. This belongs to Pi Bi (Spleen Bi).
Pei Lan Ye (Eupatorii Herba, 3 qian) Zhi Ban Xia (Pinellia Rhizoma Preparatum, 1.5 qian) Zhi Shi (Aurantii Fructus Immaturus, 1 qian) Zhu Ru (Bambusa Textilis Culm, 1.5 qian) Ju Hong (Citri Reticulatae Pericarpium Rubrum, 1 qian) Chuan Lian (Coptis Chinensis Rhizoma, 4 fen) Kuai Fu Ling (Poria, 3 qian)
Li (11) Summer-heat and dampness are internally constrained, leading to Nue (Malaria). Previously, a cooling and resolving formula was administered, which stopped the bleeding from the gums (Ya Xuan). The pulse has slightly stabilized. However, while chills have decreased, fever persists. There is epigastric stuffiness, a white tongue coating, excessive phlegm, and dark urine. The physician made an error initially by simultaneously using Sheng Ma (Cimicifugae Rhizoma), Chai Hu (Bupleuri Radix), Zi Su (Perillae Folium), and Chang Pu (Acori Tatarinowii Rhizoma), resulting in excessive ascending and dispersing action. Subsequently, another error was made by using Lu Jiao Shuang (Cornu Cervi Pantotrichum Preparatum) to warm and regulate the extraordinary Yang meridians. This not only failed to cure the disease but exacerbated it, causing the bleeding episode mentioned earlier. Although there is slight relief now, the damp-heat inside the interior has not yet fully manifested outward. At this stage, Zhi Chi Tang (Gardeniae and Fermented Soybean Decoction) should be used to guide the interior pathogens out to the exterior. This is also a pathway for expelling pathogens in the treatment of Nue (Malaria).
Dan Dou Chi (Sojae Semens Praeparatum, 1.5 qian) Xing Ren (Armeniacae Semen Amarum, 3 qian) Cao Yu Jin (Curcumae Radix, 1 qian) Hei Shan Zhi (Gardeniae Fructus, 1.5 qian) Ju Hong (Citri Reticulatae Pericarpium Rubrum, 1.5 qian) Hua Shi (Talcum, 3 qian) Lian Qiao (Forsythiae Fructum, 1.5 qian) Chuan Bei (Fritillariae Cirrhosae Bulbus, decentered and ground, 2 qian) Gua Lou Pi (Trichosanthis Pericarpium, 1.5 qian) Add fresh Zhu Ye (Bambusae Folium, 10 leaves)
Gu (36) Alternating chills and fever, headache, epigastric stuffiness, frequent thirst. The pulse is wiry and slippery. Treatment should focus on releasing and draining from the Shaoyang (Lesser Yang) channel.
Chai Hu (Bupleuri Radix, 8 fen) Zhi Ban Xia (Pinellia Rhizoma Preparatum, 1.5 qian) Cao Guo Ren (Tsaoko Fructus, 7 fen) Dan Huang Qin (Scutellariae Radix, 1 qian) Guang Pi (Citri Reticulatae Pericarpium, 1 qian) Chi Ling (Poria cum Rosa, 3 qian) Nong Po (Magnoliae Officinalis Cortex, 1 qian)
Wang (34) Chronic Nue (Malaria) with frequent vomiting. Wood (Liver) pathogen damages Earth (Spleen/Stomach). Treatment should address both the Yangming (Yang Brightness) and Jueyin (Terminal Yin) channels.
Chuan Lian (Coptis Chinensis Rhizoma) Zhi Ban Xia (Pinellia Rhizoma Preparatum) Cao Guo Ren (Tsaoko Fructus) Dan Gan Jiang (Zingiberis Rhizoma Recens, lightly processed) Huang Qin (Scutellariae Radix) Fu Ling (Poria) Sheng Bai Shao (Paeoniae Radix Alba, raw, 1.5 qian) Chao Jiao Wu Mei Rou (Mume Fructus, stir-fried until charred, 5 fen)
Mu (9 years old) Yesterday, a formula to drain Shaoyang (Lesser Yang) was administered, but the Malaria pathogen has not ceased. Chills are few, fever is prominent. There is extreme thirst with drinking, vomiting, rapid pulse, mental restlessness, sweating, red face, and no bowel movement for four days. Given the dryness pathogen of late autumn, administering bitter-cold stomach-purging herbs internally to expect relief from malaria is inappropriate. Now, acrid-cold herbs are administered, assisted by sweet-moderating herbs, which aligns precisely with Zhang Zhongjing’s principle: "Yin qi is injured first, Yang qi acts alone."
Xian Sheng Di (Rehmanniae Radix Nova, fresh, 5 qian) Mai Dong (Ophiopogonis Radix, 2 qian) Jing Mi (Oryza Sativa, 3 qian) Zhi Mu (Anemarrhenae Rhizoma, 1 qian) Sheng Shi Gao (Gypsum Fibrosum, raw, 3 qian) Sheng Gan Cao (Glycyrrhizae Radix et Rhizoma, raw, 4 fen) Juan Xin Zhu Ye (Bambusae Folium, heart-shaped, 1.5 qian)
Su (30) Malaria occurs every other day, accompanied by headache and thirst with drinking. This belongs to Shu Nue (Summer-heat Malaria).
Xiang Ru (Elsholtziae Herba, 7 fen) Xing Ren (Armeniacae Semen Amarum, 3 qian) Fei Hua Shi (Talcum, washed, 3 qian) Dan Huang Qin (Scutellariae Radix, 1 qian) Zhi Ban Xia (Pinellia Rhizoma Preparatum, 1.5 qian) Cao Guo Ren (Tsaoko Fructus, 8 fen) Nong Po (Magnoliae Officinalis Cortex, 2 qian) Chi Ling (Poria cum Rosa, 3 qian)
Shi (18) Chills and fever have persisted for a long time. There is a mass (Jia Ju) in the left hypochondrium, indicating the pathogen has entered the Liver collaterals.
Sheng Mu Li (Ostreae Concha, raw, 3 qian) Gui Xu (Angelicae Sinensis Radix, root hairs, 1 qian) Chao Yan Hu (Corydalis Rhizoma, stir-fried, 1 qian) Zhi Bie Jia (Testudinis Carapax et Plastrum, honey-fried, 1 liang) Chao Tao Ren (Persicae Semen, stir-fried, 1 qian) Gui Zhi (Cinnamomi Ramulus, 8 fen) Chai Hu (Bupleuri Radix, 5 fen)
Yu (11) Red face, Bi Re (obstructive heat), nausea, vomiting, mental restlessness, sweating, nasal hemorrhage (Nu Xue), large pulse, yet no thirst or desire to drink. This belongs to Xin Jing Re Nue (Heart Channel Heat Malaria). It is caused by heat pathogen pressing upon the Lung and Stomach. Clearing Heart heat and cooling Lung and Stomach will not deviate from the correct treatment principles.
Xi Jiao (Rhinocerotis Cornu, 8 fen) Dan Pi (Moutan Cortex, 1 qian) Zhi Mu (Anemarrhenae Rhizoma, 1 qian) Xi Sheng Di (Rehmanniae Radix, fine variety, 3 qian) Yuan Shen (Scrophulariae Radix, 1.5 qian) Sheng Gan Cao (Glycyrrhizae Radix et Rhizoma, raw, 3 fen) Lian Qiao Xin (Forsythiae Fructum, heart, 1.5 qian) Mai Dong (Ophiopogonis Radix, 1.5 qian) Zhu Ye (Bambusae Folium, 1.5 qian)
Qian (12) Chills are more severe than fever. If the onset shifts earlier, the pathogen reaches the Yang aspect. Edema of the dorsum of the foot, abdominal distension, and facial edema all belong to Taiyin (Greater Yin) disease. Treatment should be gradual.
Cao Guo Ren (Tsaoko Fructus, roasted and ground, 5 fen) Zhi Ban Xia (Pinellia Rhizoma Preparatum, 1.5 qian) Chi Ling (Poria cum Rosa, 3 qian) Nong Po (Magnoliae Officinalis Cortex, 1 qian) Huang Qin (Scutellariae Radix, 1 qian) Zhi Mu (Anemarrhenae Rhizoma, 1 qian) Xiao Qing Pi (Citri Reticulatae Pericarpium Viride, 1 qian)
Qian (8 years old) In childhood, suffered three episodes of Nue (Malaria), with severe chills and fever. The pathogen is deep and resides in the Yin aspect. This refers to the delayed onset of malaria attacks, not Yin deficiency. However, abdominal distension, no烦渴 (restless thirst), and reduced gastric appetite are signs of Taiyin (Greater Yin). Treatment should warm and disperse the interior pathogen.
Cao Guo Ren (Tsaoko Fructus, 5 fen) Chuan Gui Zhi (Cinnamomi Ramulus, 8 fen) Sheng Jiang (Zingiberis Rhizoma Recens, fresh, 1 qian) Zhi Mu (Anemarrhenae Rhizoma, 1 qian) Xing Ren (Armeniacae Semen Amarum, 3 qian) Fu Ling (Poria, 3 qian) Nong Po (Magnoliae Officinalis Cortex, 1 qian) Zhi Ban Xia (Pinellia Rhizoma Preparatum, 1.5 qian)