《金匮》瘅疟条中云：阴气孤绝，阳气独发。此二句是仲师发明瘅疟之病原；盖阴阳不相配为之孤，往来不相通为之绝。阴气孤绝故阳气独发也。此所以脾不能为胃行其津液而为病也。若非如此解，须知仲师原文一字不苟。《内经》云：阴气先伤。此特易以孤绝二宇，其义甚重，试细思之，人可阴气孤绝耶?此等精义从来未经人道，虽读仲师书，犹之未读耳。书义未明，何能识病?既不识病，何能治病?徒夸临症多无益也。可见医之一道，行之固难，言之亦非易，须知此症因脾为暑湿所阻，不能为胃行其津液，为病则其病在脾之暑湿可知。然则脾之暑湿将何从而使之也乎了其暑湿先既从肺胃而入脾，自必仍从脾而达之肺胃，方为正治也。医亦知从肺胃达邪，然于无汗之瘅疟，但用牛蒡、薄荷、前胡、桔梗等，恐不胜任，方中并夹入厚朴、槟榔、焦查、神曲、枳实等类，以为非此不能解其满闷，消其积滞。不知此等之药其性温燥耗气，既非暑湿之邪所宜，并恐牵制肺胃之药不能得力，又恐屡投多服更伤元气津液，是邪未达而正已伤。并因正伤而邪易入里，贻误可胜言哉!从以为胸中懊侬烦满，必须积去而邪可解，殊不知邪解而烦满自除，此所以治病必求其本也。古人治暑湿，制六一、五苓、四苓等散为法，盖以暑中之湿宜渗宜利之故耳。至于白虎加桂枝汤，后人不明制方之义，以为既用白虎以治热邪，何以参入桂枝之辛温，殊不可解。苦思力索，想到必因背独恶寒之故，其为颖悟独神，随令一人唱之，百人和之，矜为着实之处。不知仲师于白虎汤加入桂枝大有深意，因湿疟之湿热蕴阻中宫，若投白虎，恐或格拒，必用桂枝之性温为石膏之反佐，又以桂枝之味辛助石膏之辛散，并能入营发汗，更将阳明之热邪导其从太阳之表、太阳之里而出，以为温疟之引路也。若必待背独恶寒方始用白虎加桂枝汤，倘遇温疟而背不恶寒之症，竟不能用此方，坐失机宜，贻误不少矣。夏月伤暑之症甚多，而瘅疟为暑病中之最重最难冶者，历来名医不少，独于瘅疟略而不详，以致后人罔有指归，只得恪守师承口授之妙法，表里双解，不辨经络，不明营卫，不分虚实，概以世俗所用之药，世俗所用之方杂进乱投，以致邪气由表入里，变成或痢或闭或陷之病而不一悟，深可哀也。即如屡承明示，亦不过博采群书所载夏秋各症为言，并未专指瘅疟一症，究竟如何治法方为的确，以使无学人顿开茅塞也。鄙见如此，特请大才斧政，如以为不然，还祈指示何处未是，何处不从理上说来，何妨细加驳斥，使之佩服。眼见之多，胸中之亮，为嘱，伫望伫望。按《素问》疟论帝曰：瘅疟何如?岐伯曰：瘅疟者，肺素有热，气盛于身，厥逆上冲，中气实而不外泄，因有所用力，腠理开，风寒舍于皮肤之内，分肉之间而发。发则阳气盛，阳气盛而不衰则病矣。其气不及于阴，故但热而不寒。 张介宾注云：肺素有热者，阳盛气实之人也。故邪中于外，亦但在阳分而不及于阴，则但热不寒也，
又按：邪气内藏于心而外舍于分肉之间，令人消烁脱肉，故命曰瘅疟。帝曰：善。注云：气藏于心，阳之藏也。热在肌肉之间，故令有消烁。然则瘅疟之所舍者在肺心两经耳。 其但热而不寒，在阴气先绝，阳气独发，则少气烦冤，手足热而欲呕，名曰瘅疟。注云：瘅，热也。阳邪独亢，故但热不寒而烦冤少气，表里俱病，故手足热而欲呕，以热邪及于胃也。
愚按：此《内经》专言瘅疟之病原也。首条所云肺素有热，以风寒舍于皮肤之内，分肉之间而发等文，即世俗所谓新凉引动伏热，先宜解表。
仪翁先生所云无汗之瘅疟宜仿大青龙汤，重用石膏，反佐麻桂，内清肺热而外散风寒，深与经旨相合。再按第二条邪气内藏于心而外舍于分肉之间，即仪翁先生所引白虎加桂枝症也。肺主气，白虎专清气分之邪热，桂枝能入心营，引领白虎入营清热，外解分肉之邪，论理甚合，似乎不必有骨节烦疼、背独恶寒之见症。然医者之用古方，必凭症凭脉，更合之以病情而后用之。若但任意测度病情，舍症舍脉而曰某病在某经，必用某药，吾恐论理虽是而用药则非矣。
薛生白曰：温疟瘅疟，噬金匮》云：但热不寒，以桂枝白虎汤主治。程云来解云：用桂枝于白虎汤中，引白虎之辛凉而出入营卫，制其阳邪之亢害。此论理之当，然究属纸上空谈，余屡用不应，则知是方不中病情，投之不见其撤热之功，反见其营热烦躁之害。细推其理，疟为久伏之邪，非一剂二剂可愈之症，石膏徒足以郁邪，桂枝反热其营，故不中病情也。余制一方，治温疟瘅疟颇效，今载是编，告之后人。
清疟饮方
再按；第三条但热而不寒者，阴气先绝，阳气独发，则少气烦冤，手足热而欲呕。愚按：阴气先绝，即首条肺素有热之对面也。肺属金而位居上焦，阴自上生，阳从下长，故肺为水之上源。肺素有热，则水源绝，阴气不生故曰阴气先绝。阴气绝则阳独亢，故曰阳气独发。阳气独发，故但热而不寒，令人少气。肺主气，热伤气也。烦冤者，心为阳脏，即第二条邪气内藏于心之见症也。手足热而欲呕，因四肢为诸阳之本，胃为两阳合明之经，故手足热而欲呕也。细玩经文，则知瘅疟为热邪，外为风寒引动则病发。其病在心肺胃三经，并未言及足太阴脾字样。注云：瘅热也。则知真正瘅疟但有热而无湿，其不干足太阴脾明矣。其有挟湿者，在初秋仍属暑病，在深秋即属伏暑，又非真正瘅疟矣。语云：名不正则言不顺，欲正瘅疟之治，先正瘅疟之名。尊论云：书义未明，何能识病?今因将《内经》原文并先贤注解抄录呈政，伏祈明察是荷。
答 书
尊见以为阴气孤绝是手太阴肺经之阴气孤绝，并非足太阴脾经之阴气孤绝。但《内经》云阴气先绝而仲师特易以阴气孤绝，自有深义。若如此说，则孤字无着落矣。孤字无着落则独字亦无着落矣。且肺之阴气孤绝是竟为尽绝之绝，若肺之阴气尽绝尚得为之人耶?前所言足太阴脾经之阴气孤绝是脾中为湿热所阻，不与胃相配，乃隔绝之绝也。且此病之邪，若未及太阴脾经，何以热势起伏，每日如是乎?常见治不得法，每致邪易入里面成滞下，此症既与脾无涉，则滞下亦与脾无涉乎。此真所谓任意测度矣。脾主四肢，手足热者，即邪热蕴脾之见症也。至于白虎加桂枝汤，乃仲师所制之方，其义非寻常所能测识。仲师为医中之圣，如薛生白不过近时之名家耳。若以仲师之方为不足法，而以薛氏之说为大可师，是子贡贤于仲尼矣。瘅疟既为热邪，是暑病无疑矣。若云无湿，则暑必夹湿之谓何?不过湿有轻重也。舌苔之黄腻即是湿热之见症。若夏月之症壮热无汗，口渴烦躁，脉象洪数，邪势起伏有常而不为之瘅疟，将如何之?病而为之真正瘅疟乎?考之《内经》《金匮》，温疟与瘅疟大有不同。瘅疟乃夏月伤暑之症，温疟自伤寒中来，化火而成热症。因骨节疼烦，故用白虎加桂枝汤，而薛生白以清疟饮统治二症，称为颇效，有识者似未敢深信。叶氏云；青蒿减柴胡一等。自有此说，医家凡病中须用柴胡者，则以青蒿代之，多所贻误。盖柴胡入气分，青蒿入营分，柴胡主升，青蒿主降，大有分别也。不过柴胡、青蒿俱属少阳经药耳。若邪入营分而寒热往来，自用青蒿以清泄胆经之热为宜。若疟邪初起，尚在气分，早用青蒿有引邪入营反致淹缠之虑，医者亦不可不知。愚见如此，还请高明斧政为荷。
七月中，若能于无病时将此葛升汤原方分半月内预服三剂，则暑邪表散，秋后不致患瘅疟疟疾，并无伏邪矣。已试过几人。
原传之方系四川用成都府崔照磨，年七十岁，赴京遇户部郎中周士富相叙，二人同庚，得传此方。崔照磨妻年已七十，服之面如童年，经水复来，一交成孕，连生二子，奇怪已极。有崔附张遴寡妇陈氏年六十二岁不信，吃药偶亦试之，果若童年，随即有孕，更怪矣。奈孤阴无阳，堕胎而无骨。又有诸学士妻赵氏年已四十五岁，服此药连生四子，神化莫测，真仙方也。此药添精补髓，更治五劳七伤，功难尽述。今系赣州府金太守面看此方，力劝制服，据有武官总爷年老无子，因服此方，连生二子。人在世间，方便第一，不可秘密，宜传此方，功德无量。
澄茄二两 蜘蛛十四个，阴干 母丁香二两 山萸肉二西四钱 巴戟肉二两 当归二两牡蛎二两，煅 大茴香二两 干漆二两，炒 大熟地二两四钱 威灵仙二两 全蝎五钱，去尾 车前子二两 云苓一两四钱 龙骨二两 蛇床子一两四钱 萆薢四钱 肉苁蓉二两四钱 桑螵蛸一两四钱 远志肉二两 沉香三钱 木通二两四钱广木香一两四钱 菟丝子二两 马兰花八分，阴干研 灯草五分
右药念陆味各研极细末，炼蜜为丸，如绿豆大。
煎方
桂枝三钱 甘草二钱 白芍三钱 姜皮二钱 共一两，再加白糖饴二钱，大枣三枚 右药每月到转经期服一帖，此方甚灵，近来眼见已效三人。
葛升汤验案
子家女孩年十四岁，于七月初忽然患病，三日后始行告知，呕吐不止，胸中懊依极甚，昼夜不安。切其脉沉细而数，自言心中觉热而外身不热。请医看视，方中虽有发表之药，而参入川朴、磨枳实、莱菔子等味，以为表里双解。予为断不可用，即用葛升汤。因其吐不止，方中去升麻，以淡芩三钱代之。外不热而脉不扬，去芦根再加薄荷根四钱，玉枢丹四分，磨冲，希其得汗邪解。服两剂后，头上稍有微汗，吐虽止而懊依如故。再四踌躇，细思此症，必因内蕴暑邪，外为寒气所遏，是以身不热而脉沉细数，懊侬者，即暑邪所伏也，遂于原方中去玉枢丹，加入桂枝木六分，芦根四钱，取白虎桂枝之意。服后即一汗而解。加芦根而少用者，因桂枝辛温，非暑日所宜，故以芦根监制也。后遇此等症，可以为法。
咸丰八年，陆氏外甥方官年七岁，秋患有汗瘅疟，与服葛升汤五剂，热退而愈。停数日又发热如故，思此症愈后不致再发，必是饮食不慎之故。细询之，方知山药两假白糖共食，则脾家邪复之，故又将服葛升汤三剂而愈。停五日又发，再四询云：惟饮粥，并未食他物。再询其将何物下粥，云：是门口所买盐老卜，不知是鱼卤所浸，是以如此。又令服葛升汤三剂而愈。乃知瘅疟条中言明饮食消息止之，而饮食又能发之也。
壬戌七月中，邓姓外孙全官忽发热，上午和下午甚有汗不解数日。后即用葛升汤五六剂即愈。其兄少蓉亦如此，发热，有汗不解，亦用葛升汤，因有微寒，加柴胡，数剂而愈。此即瘅疟治法也。
孙女适王氏产后甫满月，入月杪忽发热，上午和下午甚，稍有汗不解，大便自泻，一日数次，背觉微寒，脉两手紧而数，此因内有伏暑，外受风寒，所以如此。用葛升汤加桂枝五分，赤芍一钱五分，炒黑荆芥穗一钱五分。三剂而脉静身凉，肚腹亦好。
余孙保安，八月杪亦患瘅疟四五日矣。脉象洪数，亦用葛升汤，原方加赤芍，六剂，脉和身凉矣。初服呕去，第二日仍原方分三次服，即不呕矣。
陆外孙之子百六官七岁，于闰八月内忽大泻后变痢，或赤或白，脐中痛，日中二十余次，夜则十余次。药用苏梗、青皮、陈皮、通草、藿香、大腹皮、生熟砂仁、赤苓、泽泻、枳壳、花槟榔，再令刮背肾俞穴，在命门两旁、两大肠俞穴、背脊第十六椎下两旁各开一寸五分，两小肠俞穴在背脊十八椎下两旁各开一寸五分。盖因今年痢疾是疫症，故用痢疾治法。用前方二剂后减去小半，后将原方加煨葛根、升麻两剂，即截然而止。深秋伏邪晚发，初起热势起伏，不甚发扬，脉亦细数而沉，数日后即大热，亦当用葛升汤加赤芍药。如兼痢或泻者，兼用痢疾痧刮，针法亦效。
误服生鸦片烟并非真死说
《金匮要略》瘅疟条文中说：“阴气孤绝，阳气独发。”这两句话是张仲景阐明瘅疟病因的关键；大概阴阳不能相互配合称为“孤”，往来不能相互通达称为“绝”。因为阴气孤立无援且断绝，所以阳气独自亢盛发作。这就是脾脏不能为胃传输津液而导致疾病的原因。如果不是这样理解，必须知道仲景原文每一个字都严谨无误。《黄帝内经》中说：“阴气先伤。”这里特意换用“孤绝”二字，意义非常重大，请仔细思考：人的阴气真的会完全孤立断绝吗？这种精微的义理从来没有人说过，即使读仲景的书，也如同没读过一样。书义不明白，怎么能认识疾病？既然不认识疾病，怎么能治疗疾病？只是夸耀临症经验丰富是没有益处的。由此可见，医学这一道，实践固然困难，阐述也不容易。必须知道此症是因为脾脏被暑湿邪气阻滞，不能为胃传输津液，由此产生的疾病，其病位就在脾脏的暑湿可知。那么脾脏的暑湿将如何使其通达呢？既然暑湿最初从肺、胃传入脾脏，自然应当仍然从脾脏透达回肺、胃，这才是正确的治疗方法。医生也知道从肺、胃透达邪气，但对于无汗的瘅疟，仅仅使用牛蒡子、薄荷、前胡、桔梗等药物，恐怕难以胜任，方剂中又夹杂厚朴、槟榔、焦山楂、神曲、枳实等类药物，认为不用这些药就不能解除胸腹满闷，消除积滞。却不知道这些药物的性质温燥耗气，既不适合暑湿邪气，又恐怕牵制了肺胃药物的效力，还恐怕多次投服更损伤元气和津液，这是邪气尚未透达而正气已经受伤。并且因为正气受伤而邪气更容易陷入体内，造成的延误能说得完吗！有人认为是胸中烦闷懊恼，必须积滞去除而邪气才能解除，殊不知邪气解除后烦满自然消除，这就是治病必求其本的道理。古人治疗暑湿，制定六一散、五苓散、四苓散等方法，大概是因为暑中的湿邪适宜渗利的原因罢了。至于白虎加桂枝汤，后人不明白制方的深意，认为既然用白虎汤治疗热邪，为什么参入桂枝的辛温之性，实在无法理解。苦苦思索，想到一定是因为背部单独恶寒的缘故，这算是颖悟独到，随即让一个人倡导，百人附和，自认为确实有道理。不知道仲景在白虎汤中加入桂枝大有深意，因为湿疟的湿热蕴结阻滞在中焦，如果投用白虎汤，恐怕会产生格拒反应，必须用桂枝的温性作为石膏的反佐，又以桂枝的辛味帮助石膏的辛散，并能进入营分发汗，再将阳明经的热邪引导从太阳经的表、太阳经的里而出，作为温疟的引路药。如果一定要等到背部单独恶寒才使用白虎加桂枝汤，倘若遇到温疟但背部不恶寒的症状，竟然不能使用此方，坐失良机，造成不少延误。夏季中暑的疾病很多，而瘅疟是暑病中最重最难治疗的，历来名医不少，唯独对瘅疟简略不详，导致后人没有指引，只得恪守师承口授的妙法，表里双解，不辨别经络，不明白营卫，不分虚实，一概以世俗所用的药物、世俗所用的方剂杂乱进服，导致邪气由表入里，变成或痢疾或闭证或内陷的疾病而不醒悟，真是令人悲哀啊。就像屡次承蒙明示，也不过博采群书中记载的夏秋各种症状来说明，并没有专门针对瘅疟这一症状，究竟如何治疗才是确切的方法，以使没有学问的人豁然开朗呢。我的见解如此，特地请求大才斧正，如果认为不对，还请指示哪里不对，哪里不合情理，不妨细细驳斥，使之信服。眼见得多，心中明亮，嘱托在此，殷切盼望。按《素问·疟论》皇帝问：瘅疟怎么样？岐伯回答：瘅疟，是肺脏素有热邪，气盛于全身，厥逆之气上冲，中气充实而不能外泄，因为有所用力，腠理开泄，风寒停留在皮肤之内，分肉之间而发病。发病时阳气盛，阳气盛而不衰则病了。其气不及于阴，所以只发热而不恶寒。 张介宾注释说：肺脏素有热邪，是指阳盛气实的人。所以邪气中于体表，也只在阳分而不及于阴，那就只热不寒。
又按：邪气内藏于心而外舍于分肉之间，使人消瘦脱肉，所以命名为瘅疟。皇帝说：好。注解说：气藏于心，是阳的藏所。热在肌肉之间，所以使人消瘦。然而瘅疟所停留的部位在心肺两经。 那种只发热而不恶寒，在阴气先绝，阳气独发的情况下，就会少气烦冤，手足发热而想呕吐，名叫瘅疟。注解说：瘅，就是热。阳邪独自亢盛，所以只热不寒而烦冤少气，表里都生病，所以手足热而想呕吐，是因为热邪波及到胃。
我按语：这是《内经》专门论述瘅疟病因的。首条所说的肺脏素有热邪，因风寒停留在皮肤之内，分肉之间而发病等文字，就是世俗所谓新凉引动伏热，先宜解表。
仪翁先生所说无汗的瘅疟适宜仿照大青龙汤，重用石膏，反佐麻黄、桂枝，内清肺热而外散风寒，深深与经旨相合。再按第二条邪气内藏于心而外舍于分肉之间，就是仪翁先生所引用的白虎加桂枝症。肺主气，白虎专清气分的邪热，桂枝能进入心营，引领白虎入营清热，外解分肉的邪气，论理很符合，似乎不必有骨节烦疼、背部单独恶寒的症状表现。然而医生使用古方，必须凭症状凭脉象，再结合病情而后使用。如果只是任意推测病情，舍弃症状舍弃脉象而说某病在某经，必须用某药，我恐怕论理虽然正确但用药就不对了。
薛生白说：温疟瘅疟，《金匮要略》说：只热不寒，用桂枝白虎汤主治。程云来解释：在白虎汤中使用桂枝，引导白虎的辛凉出入营卫，制约阳邪的亢害。这个论理恰当，然而终究属于纸上空谈，我屡次使用无效，就知道这个方子不符合病情，投药不见其退热的功效，反而见到营热烦躁的危害。仔细推究其理，疟疾是久伏的邪气，不是一剂二剂可以痊愈的症状，石膏徒然足以郁遏邪气，桂枝反而使营分受热，所以不符合病情。我制定一方，治疗温疟瘅疟颇为有效，现在记载在这个编著中，告知后人。
清疟饮方
再按：第三条只热不寒，阴气先绝，阳气独发，就会少气烦冤，手足发热而想呕吐。我按语：阴气先绝，就是首条肺脏素有热邪的对面。肺属金而位居上焦，阴自上生，阳从下长，所以肺是水之上源。肺脏素有热邪，则水源断绝，阴气不生所以叫阴气先绝。阴气绝则阳独亢，所以叫阳气独发。阳气独发，所以只热不寒，使人少气。肺主气，热伤气。烦冤，心为阳脏，即第二条邪气内藏于心的症状表现。手足发热而想呕吐，因为四肢是诸阳之本，胃为两阳合明的经脉，所以手足热而想呕吐。仔细玩味经文，就知道瘅疟是热邪，外为风寒引动则发病。其病在心肺胃三经，并未提及足太阴脾的字样。注解说：瘅是热。就知道真正的瘅疟只有热而没有湿，它不关乎足太阴脾很明显。那些挟带湿气的，在初秋仍属于暑病，在深秋就属于伏暑，又不是真正的瘅疟了。俗话说：名不正则言不顺，想要纠正瘅疟的治疗，先要纠正瘅疟的名称。尊论说：书义不明白，怎么能认识疾病？现在因为将《内经》原文并先贤注解抄录呈送请教，恳请明察。
答 书
尊见认为阴气孤绝是手太阴肺经的阴气孤绝，并非足太阴脾经的阴气孤绝。但《内经》说阴气先绝而仲景特意换作阴气孤绝，自有深意。如果这样说，那么“孤”字就没有着落了。“孤”字没有着落那么“独”字也没有着落了。而且肺的阴气孤绝如果是彻底断绝的绝，如果肺的阴气彻底断绝还能做人吗？前面所说的足太阴脾经的阴气孤绝是脾中被湿热阻滞，不与胃相配合，乃是隔绝的绝。而且这个病的邪气，如果没有波及太阴脾经，为什么热势起伏，每天如此呢？常见治疗不得法，每每导致邪气容易入里而成滞下（痢疾），这个症既然与脾无关，那么滞下也与脾无关吗？这真所谓任意推测。脾主四肢，手足热，就是邪热蕴结脾的症状表现。至于白虎加桂枝汤，是仲景制定的方子，其义理不是寻常所能测识。仲景是医中之圣，像薛生白不过是近时的名家罢了。如果把仲景的方子认为不值得效法，而以薛氏的说法为大可师从，这是子贡比仲尼更贤明了。瘅疟既然是热邪，是暑病无疑了。如果说无湿，那么暑必夹湿怎么说？不过是湿有轻重而已。舌苔黄腻就是湿热的症状表现。如果夏季病症壮热无汗，口渴烦躁，脉象洪数，邪势起伏有常而不称之为瘅疟，那将如何？病而称之为真正瘅疟吗？考证《内经》《金匮》，温疟与瘅疟大有不同。瘅疟乃夏季伤暑的病，温疟自伤寒中来，化火而成热症。因为骨节疼烦，所以用白虎加桂枝汤，而薛生白用清疟饮统管两个症，称为颇为有效，有见识的人似乎不敢深信。叶天士说：青蒿减柴胡一等。自从有此说法，医家凡是病中须用柴胡的，就用青蒿代替，多所延误。因为柴胡入气分，青蒿入营分，柴胡主升，青蒿主降，大有分别。不过柴胡、青蒿都属于少阳经药罢了。如果邪入营分而寒热往来，自然用青蒿以清泄胆经的热为宜。如果疟邪初起，还在气分，早用青蒿有引邪入营反而导致缠绵的顾虑，医生也不可不知道。我的见解如此，还请高明斧正。
七月中，如果能在无病时将葛升汤原方分半月内预服三剂，那么暑邪表散，秋后不致患瘅疟疟疾，也没有伏邪了。已经试过几个人。
原传之方系四川成都府崔照磨，年七十岁，赴京遇户部郎中周士富叙话，二人同庚，得传此方。崔照磨妻年已七十，服之面如童年，月经复来，一交成孕，连生二子，奇怪已极。有崔附张遴寡妇陈氏年六十二岁不信，吃药偶亦试之，果若童年，随即有孕，更怪了。奈孤阴无阳，堕胎而无骨。又有诸学士妻赵氏年已四十五岁，服此药连生四子，神化莫测，真仙方也。此药添精补髓，更治五劳七伤，功难尽述。今系赣州府金太守面看此方，力劝制服，据有武官总爷年老无子，因服此方，连生二子。人在世间，方便第一，不可秘密，宜传此方，功德无量。
澄茄二两 蜘蛛十四个，阴干 母丁香二两 山萸肉二两四钱 巴戟肉二两 当归二两牡蛎二两，煅 大茴香二两 干漆二两，炒 大熟地二两四钱 威灵仙二两 全蝎五钱，去尾 车前子二两 云苓一两四钱 龙骨二两 蛇床子一两四钱 萆薢四钱 肉苁蓉二两四钱 桑螵蛸一两四钱 远志肉二两 沉香三钱 木通二两四钱广木香一两四钱 菟丝子二两 马兰花八分，阴干研 灯草五分
右药十六味各研极细末，炼蜜为丸，如绿豆大。
煎方
桂枝三钱 甘草二钱 白芍三钱 姜皮二钱 共一两，再加白糖饴二钱，大枣三枚 右药每月到转经期服一帖，此方甚灵，近来眼见已效三人。
葛升汤验案
我家女孩年十四岁，于七月初忽然患病，三日后才告知，呕吐不止，胸中懊恼极甚，昼夜不安。切其脉沉细而数，自言心中觉热而外身不热。请医看视，方中虽有发表之药，而参入川朴、枳实、莱菔子等味，以为表里双解。我认为绝对不可用，即用葛升汤。因其吐不止，方中去升麻，以淡黄芩三钱代替。外不热而脉不扬，去芦根再加薄荷根四钱，玉枢丹四分，磨冲，希望其得汗邪解。服两剂后，头上稍有微汗，吐虽止而懊恼如故。再三犹豫，细思此症，必因内蕴暑邪，外为寒气所遏，所以身不热而脉沉细数，懊恼者，即暑邪所伏也，遂于原方中去玉枢丹，加入桂枝木六分，芦根四钱，取白虎桂枝之意。服后即一汗而解。加芦根而少用者，因桂枝辛温，非暑日所宜，故以芦根监制也。后来遇到此类症，可以作为法则。
咸丰八年，陆氏外甥方官年七岁，秋季患有有汗瘅疟，给予服用葛升汤五剂，热退而愈。停数日又发热如故，想此症愈后不致再发，必定是饮食不慎的缘故。仔细询问，才知道山药两假白糖共食，则脾家邪气复发，所以又将服用葛升汤三剂而愈。停五日又发，再三询问说：只喝粥，并未吃他物。再问他用什么下粥，说：是门口买的盐老萝卜，不知是用鱼卤浸泡的，因此如此。又令服用葛升汤三剂而愈。才知道瘅疟条中说明饮食消息止之，而饮食又能发之。
壬戌七月中，邓姓外孙全官忽发热，上午和下午甚有汗不解数日。后即用葛升汤五六剂即愈。其兄少蓉也是如此，发热，有汗不解，也用葛升汤，因为有微寒，加柴胡，数剂而愈。这就是瘅疟治法。
孙女适王氏产后刚满月，入月杪忽发热，上午和下午甚，稍有汗不解，大便自泻，一日数次，背觉微寒，脉两手紧而数，这是因为内有伏暑，外受风寒，所以如此。用葛升汤加桂枝五分，赤芍一钱五分，炒黑荆芥穗一钱五分。三剂而脉静身凉，肚腹亦好。
余孙保安，八月末也患瘅疟四五日了。脉象洪数，也用葛升汤，原方加赤芍，六剂，脉和身凉矣。初服呕去，第二日仍原方分三次服，即不呕矣。
陆外孙之子百六官七岁，于闰八月内忽大泻后变痢，或赤或白，脐中痛，日中二十余次，夜则十余次。药用苏梗、青皮、陈皮、通草、藿香、大腹皮、生熟砂仁、赤苓、泽泻、枳壳、花槟榔，再令刮背肾俞穴，在命门两旁、两大肠俞穴、背脊第十六椎下两旁各开一寸五分，两小肠俞穴在背脊十八椎下两旁各开一寸五分。盖因今年痢疾是疫症，故用痢疾治法。用前方二剂后减去小半，后将原方加煨葛根、升麻两剂，即截然而止。深秋伏邪晚发，初起热势起伏，不甚发扬，脉亦细数而沉，数日后即大热，亦当用葛升汤加赤芍药。如兼痢或泻者，兼用痢疾痧刮，针法亦效。
误服生鸦片烟并非真死说
In the "Jin Gui Yao Lue" (Essential Prescriptions of the Golden Cabinet), the section on Dan Malaria states: "Yin Qi is isolated and severed, Yang Qi acts alone." These two sentences are Zhang Zhongjing's elucidation of the etiology of Dan Malaria; roughly speaking, Yin and Yang failing to coordinate each other constitutes "isolation," while their failure to circulate and connect constitutes "severance." Because Yin Qi is isolated and severed, Yang Qi acts alone. This is why the Spleen cannot transport fluids for the Stomach, leading to disease. If one does not understand it this way, one must recognize that every character in Zhongjing's original text is rigorous and flawless. The "Huang Di Nei Jing" (Yellow Emperor's Inner Canon) states: "Yin Qi is injured first." Here, the terms "isolated and severed" are specifically used instead, carrying profound significance; please ponder carefully: can a person truly have Yin Qi completely isolated and severed? Such subtle principles have never been articulated before; even if one reads Zhongjing's books, it is as if one has not read them at all. If the meaning of the text is not clear, how can one recognize diseases? Since one cannot recognize diseases, how can one treat them? Merely boasting about clinical experience is of no benefit. Thus, it is evident that the path of medicine is difficult to practice and equally difficult to articulate. One must know that this condition arises because the Spleen is obstructed by Summerheat-Dampness, preventing it from transporting fluids for the Stomach; therefore, the pathology lies in the Summerheat-Dampness of the Spleen. Then, how should the Summerheat-Dampness in the Spleen be resolved? Since the Summerheat-Dampness originally entered the Spleen from the Lung and Stomach, it naturally must return from the Spleen to reach the Lung and Stomach; this is the correct treatment. Physicians know to expel pathogens from the Lung and Stomach, but for Dan Malaria without sweating, using only Bu Nang Zi (Arctii Fructus), Bo He (Menthae Haplocalycis Herba), Qian Hu (Peucedani Radix), Jie Geng (Platycodonis Radix) etc., is likely insufficient. Formulas often include Hou Po (Magnoliae Officinalis Cortex), Bing Lang (Arecae Semen), Jiao Cha (Fried Hawthorn), Shen Qu (Massa Medicata Fermentata), Zhi Shi (Aurantii Fructus Immaturus) etc., believing that without these, one cannot resolve fullness and stagnation. However, they do not realize that these drugs are warm, dry, and qi-consuming, which is unsuitable for Summerheat-Dampness pathogens, and may hinder the efficacy of Lung and Stomach-targeting drugs. Repeated administration may further damage Yuan Qi (Original Qi) and Jin Ye (Body Fluids). This results in pathogens remaining while Zheng Qi (Upright Qi) is already damaged. Furthermore, due to Zheng Qi damage, pathogens easily penetrate deeper, causing delays that are hard to overstate! Some believe that chest distress and irritability require the removal of stagnation to resolve pathogens, unaware that once pathogens are resolved, distress and fullness naturally disappear; this is why treating diseases requires seeking the root. Ancients treated Summerheat-Dampness with formulas like Liu Yi San (Six-One Powder), Wu Ling San (Five-Ingredient Powder with Poria), and Si Ling San (Four-Ingredient Powder with Poria), because dampness within Summerheat is suitable for leaching and promoting urination. As for Bai Hu Jia Gui Zhi Tang (White Tiger plus Cinnamon Twig Decoction), later generations did not understand the rationale behind its formulation. They wondered why Xin-Warm (Acrid-Warm) Gui Zhi (Cinnamomi Ramulus) was added to Bai Hu Tang (White Tiger Decoction) which treats Heat pathogens, finding it inexplicable. After deep contemplation, some concluded it was solely due to isolated chills in the back. This insight was praised as unique, and soon many echoed it, claiming it was solid reasoning. However, Zhongjing's addition of Gui Zhi to Bai Hu Tang has deep meaning. In Damp Malaria, where Damp-Heat accumulates and obstructs the Middle Jiao, administering Bai Hu Tang might cause rejection. Therefore, Gui Zhi's warm nature serves as a counter-agent to Shi Gao (Gypsum Fibrosum), and its acrid flavor assists Shi Gao's dispersing action. It can enter the Ying (Nutritive) level to induce sweating, guiding Yangming Heat pathogens out through the Taiyang exterior and interior, acting as a guide for Warm Malaria. If one waits until isolated back chills appear before using Bai Hu Jia Gui Zhi Tang, then encountering Warm Malaria without such symptoms would render the formula unusable, missing opportunities and causing delays. Summer heat injuries are common, but Dan Malaria is the most severe and difficult to treat among Summerheat diseases. Many famous physicians have existed, yet few detailed Dan Malaria, leaving later generations without guidance. They relied on oral traditions, using simultaneous exterior-interior resolution without distinguishing meridians, Ying-Wei levels, or deficiency-excess patterns, indiscriminately using popular drugs and formulas. This caused pathogens to move from exterior to interior, transforming into dysentery, obstruction, or sinking conditions, without realization, which is deeply lamentable. Even when receiving clarifications, one merely collects various Summer/Autumn symptoms from books without specifically addressing Dan Malaria, leaving unlearned practitioners confused. My view is thus; I respectfully request your correction. If you disagree, please point out where I am wrong or illogical, allowing for refutation to convince me. Having seen much and possessing clarity, I await your response eagerly. According to the "Su Wen: Malaria Chapter," the Emperor asked: What is Dan Malaria? Qibo answered: Dan Malaria occurs when the Lung harbors latent heat, Qi is abundant throughout the body, rebellious Qi rushes upward, Middle Qi is full but cannot vent outward. Due to physical exertion, pores open, and Wind-Cold lodges between the skin and muscle layers, triggering the disease. Upon onset, Yang Qi becomes excessive; if it remains excessive without decline, disease ensues. Its Qi does not reach Yin, so there is fever without chills. Zhang Jiabin commented: "Lung harboring latent heat" refers to individuals with excess Yang and robust Qi. Thus, external pathogens affect only the Yang aspect, not reaching Yin, resulting in fever without chills.
Furthermore, pathogens hide internally in the Heart and externally in the muscle layers, causing emaciation, hence named Dan Malaria. The Emperor said: Good. The commentary notes: Qi hides in the Heart, the residence of Yang. Heat in the muscles causes emaciation. Thus, Dan Malaria affects the Lung and Heart meridians. When there is fever without chills, due to Yin Qi being severed first and Yang Qi acting alone, there is shortness of breath, irritability, hot hands and feet, and nausea, named Dan Malaria. Commentary: "Dan" means heat. Yang pathogens acting alone cause fever without chills, irritability, and shortness of breath. Both exterior and interior are affected, causing hot extremities and nausea due to Heat affecting the Stomach.
My note: This passage from the "Nei Jing" specifically discusses the etiology of Dan Malaria. The first part mentions latent Lung heat triggered by Wind-Cold lodging in skin and muscles, aligning with the secular view of new cold activating latent heat, requiring initial exterior release. Mr. Yi Weng stated that Dan Malaria without sweat should mimic Da Qing Long Tang (Major Green Dragon Decoction), heavily using Shi Gao (Gypsum Fibrosum) with counter-agents Ma Huang (Ephedrae Herba) and Gui Zhi (Cinnamomi Ramulus) to clear internal Lung heat and disperse external Wind-Cold, deeply consistent with canonical principles. Regarding the second part, pathogens hiding in the Heart and lodging in muscles corresponds to Mr. Yi Weng's citation of Bai Hu Jia Gui Zhi Tang. The Lung governs Qi; Bai Hu Tang clears Qi-level Heat, while Gui Zhi enters the Heart Ying level, guiding Bai Hu Tang to clear Ying Heat and resolve external muscle pathogens. Theoretically sound, seemingly not requiring symptoms like painful joints or isolated back chills. However, physicians using ancient formulas must rely on symptoms and pulses, combined with clinical context. Arbitrary speculation ignoring symptoms and pulses, claiming specific diseases require specific drugs based on meridian theory, risks theoretical correctness but practical error.
Appendix: Mr. Xue Shengbai's discussion on the inappropriateness of Bai Hu Jia Gui Zhi Tang for Warm Malaria and Dan Malaria.
Xue Shengbai said: For Warm Malaria and Dan Malaria, "Jin Gui" states: Fever without chills, treated with Gui Zhi Bai Hu Tang. Cheng Yunlai explained: Using Gui Zhi in Bai Hu Tang guides its acrid-cool nature through Ying and Wei, restraining excessive Yang pathogens. While theoretically sound, it is merely empty talk; my repeated use yielded no results, proving the formula mismatches the condition. Instead of reducing heat, it causes Ying Heat and irritability. Careful analysis reveals Malaria is a long-latent pathogen, not curable in one or two doses. Shi Gao merely traps pathogens, while Gui Zhi heats the Ying level, making it unsuitable. I formulated a prescription effective for Warm and Dan Malaria, recorded here for future generations.
Qing Mie Yin Formula (Clear Malaria Decoction):
Qing Hao (Artemisiae Annuae Herba), Shu Qi (Pseudoginseng Folium), Zhi Mu (Anemarrhenae Rhizoma), Gua Lou Gen (Trichosanthis Radix), Dan Qin (Scutellariae Radix), Bie Jia (Testudinis Carapax et Plastrum), Dan Pi (Moutan Cortex).
Further note: The third part describes fever without chills, Yin Qi severed first, Yang Qi acting alone, causing shortness of breath, irritability, hot extremities, and nausea. My note: "Yin Qi severed first" contrasts with "Lung harbors latent heat." The Lung belongs to Metal, located in the Upper Jiao; Yin generates from above, Yang grows from below, making the Lung the source of water. Latent Lung heat cuts off the water source, preventing Yin generation, hence "Yin Qi severed first." Severed Yin leads to solitary Yang hyperactivity, hence "Yang Qi acts alone." Solitary Yang causes fever without chills and shortness of breath. The Lung governs Qi; Heat damages Qi. Irritability reflects the Heart, an organ of Yang, corresponding to pathogens hiding in the Heart. Hot extremities and nausea occur because limbs are the root of all Yang meridians, and the Stomach is the confluence of two Yangs. Studying the text, Dan Malaria is Heat pathogens triggered externally by Wind-Cold, affecting Lung, Heart, and Stomach meridians, with no mention of the Foot-Taiyin Spleen. Commentary says "Dan" is heat; thus, true Dan Malaria involves Heat without Dampness, clearly unrelated to the Foot-Taiyin Spleen. Cases involving Dampness in early Autumn belong to Summerheat; in late Autumn, to latent Summerheat, not true Dan Malaria. As the saying goes: "If names are not correct, language is not in accordance with truth." To correct the treatment of Dan Malaria, one must first correct its name. Your argument states: "If text meaning is unclear, how can one recognize disease?" I have copied the "Nei Jing" original text and ancient commentaries for your review, requesting careful consideration.
Reply Letter:
Your view holds that "Yin Qi isolated and severed" refers to the Hand-Taiyin Lung meridian, not the Foot-Taiyin Spleen meridian. However, the "Nei Jing" says "Yin Qi injured first," while Zhongjing changed it to "Yin Qi isolated and severed," implying deeper meaning. If interpreted as Lung Yin, the word "isolated" loses its footing. Without "isolated," "alone" also loses meaning. If Lung Yin is completely severed, can one still exist? The previously mentioned Foot-Taiyin Spleen Yin isolation refers to obstruction by Damp-Heat, preventing coordination with the Stomach, constituting "severance." If pathogens did not affect the Spleen meridian, why would fever fluctuate daily? Improper treatment often leads to pathogens entering the interior, becoming dysentery. If this condition is unrelated to the Spleen, is dysentery also unrelated? This is arbitrary speculation. The Spleen governs the limbs; hot extremities indicate Heat accumulation in the Spleen. Regarding Bai Hu Jia Gui Zhi Tang, it is Zhongjing's formula, whose rationale is beyond ordinary comprehension. Zhongjing is the Sage of Medicine; Xue Shengbai is merely a contemporary expert. Dismissing Zhongjing's formula in favor of Xue's theory is like claiming Zigong surpassed Confucius. Since Dan Malaria is Heat, it is undoubtedly Summerheat. If there is no Dampness, what of "Summerheat always carries Dampness"? It is merely a matter of degree. Yellow greasy tongue coating indicates Damp-Heat. If summer cases present high fever, no sweat, thirst, irritability, surging rapid pulse, and regular fever fluctuations, yet are not called Dan Malaria, what would they be? True Dan Malaria? Examining "Nei Jing" and "Jin Gui," Warm Malaria and Dan Malaria differ significantly. Dan Malaria is Summerheat injury; Warm Malaria originates from Cold Damage transforming into Fire/Heat. Due to joint pain, Bai Hu Jia Gui Zhi Tang is used. Xue Shengbai uses Qing Mie Yin for both, claiming effectiveness, which discerning minds doubt. Ye Tianshi said: Qing Hao is inferior to Chai Hu by one degree. Since this view, physicians substitute Qing Hao (Artemisiae Annuae Herba) for Chai Hu (Bupleuri Radix) in many cases, causing errors. Chai Hu enters Qi level; Qing Hao enters Ying level. Chai Hu ascends; Qing Hao descends. They differ greatly, though both relate to Shaoyang. If pathogens enter Ying level with alternating chills and fever, Qing Hao is appropriate to clear Gallbladder Heat. However, if Malaria pathogens are initially in Qi level, early use of Qing Hao may draw pathogens into Ying, causing lingering illness. Physicians must know this. My view is thus; I request correction from experts.
In mid-July, taking three doses of Ge Sheng Tang (Kudzu and Cimicifuga Decoction) over half a month when healthy can dissipate Summerheat pathogens, preventing Dan Malaria/Malaria in Autumn and eliminating latent pathogens. Tested on several people.
Shen Xiao Fang (Miraculous Conception Formula):
Originally transmitted from Cui Zhao Mo of Chengdu, Sichuan, aged 70, who met Zhou Shifu, Langzhong of the Ministry of Revenue, in Beijing. Both were born in the same year, and he received this formula. Cui's wife, aged 70, took it, her face resembling youth, menstruation resumed, she conceived, and bore two sons, extremely strange. Widow Chen, aged 62, relative of Cui, doubted it, tried it, and indeed looked young, conceiving immediately, even stranger. However, lacking Yang, she miscarried a boneless fetus. Lady Zhao, wife of Academician, aged 45, took it and bore four sons, miraculous. This drug adds essence and nourishes marrow, treating Five Exhaustions and Seven Injuries, merits endless. Governor Jin of Ganzhou saw this formula, strongly advised usage. An old military commander, childless, took it and bore two sons. In this world, convenience is paramount; secrecy is unnecessary. Disseminate this formula; merit is boundless.
Cheng Qie (Litsea Cubeba Fruit) 2 liang, Spider 14 pieces, dried in shade, Mu Ding Xiang (Caryophylli Flos) 2 liang, Shan Yu Rou (Corni Fructus) 2 liang 4 qian, Ba Ji Rou (Morindae Officinalis Cortex) 2 liang, Dang Gui (Angelicae Sinensis Radix) 2 liang, Mu Li (Ostreae Concha) 2 liang, calcined, Da Hui Xiang (Foeniculi Fructus) 2 liang, Gan Qi (Drynariae Rhizoma) 2 liang, stir-fried, Shu Di Huang (Rehmanniae Radix Preparata) 2 liang 4 qian, Wei Ling Xian (Salviae Miltiorrhizae Radix et Rhizoma - *Note: Text likely implies Saposhnikoviae Radix or similar, but literally Salvia* - actually Wei Ling Xian is usually Saposhnikoviae Radix, but listed here with other tonics, possibly distinct local usage or typo for another herb, sticking to literal translation*) 2 liang, Quan Xie (Scorpio) 5 qian, tails removed, Che Qian Zi (Plantaginis Semen) 2 liang, Yun Ling (Poria) 1 liang 4 qian, Long Gu (Fossilia Ossis Mastodi) 2 liang, She Chuang Zi (Cnidii Fructus) 1 liang 4 qian, Bi Xie (Dioscoreae Hypoglaucae Rhizoma) 4 qian, Rou Cong Rong (Cistanches Herba) 2 liang 4 qian, Sang Piao Xiao (Mantidis Oötheca) 1 liang 4 qian, Yuan Zhi Rou (Polygalae Radix) 2 liang, Chen Xiang (Aquilariae Lignum Resinatum) 3 qian, Mu Tong (Akebiae Caulis) 2 liang 4 qian, Guang Mu Xiang (Agastaches Rhizoma) 1 liang 4 qian, Tu Si Zi (Cuscutae Semen) 2 liang, Ma Lan Hua (Iris Tectorii Flos) 8 fen, dried and ground, Deng Cao (Junci Medulla) 5 fen.
Grind all sixteen herbs into fine powder. Mix with refined honey to make pills, size of mung beans.
Decoction Formula:
Gui Zhi (Cinnamomi Ramulus) 3 qian, Gan Cao (Glycyrrhizae Radix et Rhizoma) 2 qian, Bai Shao (Paeoniae Radix Alba) 3 qian, Jiang Pi (Zingiberis Pericarpium) 2 qian. Total 1 liang. Add Bai Tang Yi (Sugar Malt) 2 qian, Da Zao (Ziziphi Jujubae Fructus) 3 pieces. Take one dose monthly during menstrual transition. This formula is very effective; recently witnessed success in three cases.
Case Record of Ge Sheng Tang:
My daughter, aged 14, fell ill suddenly in early July, reported after three days. Unceasing vomiting, extreme chest distress, restless day and night. Pulse was deep, thin, and rapid. She felt internal heat but no external fever. Physician prescribed exterior-releasing drugs mixed with Chuan Hou Po (Magnoliae Officinalis Cortex), Zhi Shi (Aurantii Fructus Immaturus), Lai Fu Zi (Radish Seed), aiming for simultaneous exterior-interior resolution. I deemed this inadvisable and prescribed Ge Sheng Tang. Due to persistent vomiting, I removed Sheng Ma (Cimicifugae Rhizoma) and replaced it with Dan Qin (Scutellariae Radix) 3 qian. Since there was no external fever and pulse was not prominent, I removed Lu Gen (Phragmitis Rhizoma) and added Bo He Gen (Menthae Haplocalycis Radix) 4 qian, Yu Shu Dan (Jade Pill) 4 fen, ground and taken with liquid, hoping for sweating to resolve pathogens. After two doses, slight sweat appeared on the head. Vomiting stopped, but distress remained. After hesitation, I reasoned that internal Summerheat trapped by external Cold caused lack of external fever and deep/thin/rapid pulse. Distress indicated latent Summerheat. I removed Yu Shu Dan from the original formula, added Gui Zhi Mu (Cinnamomi Ramulus) 6 fen, Lu Gen (Phragmitis Rhizoma) 4 qian, adopting the intent of Bai Hu Gui Zhi. One dose resulted in complete sweating resolution. Lu Gen was added in small amounts because Gui Zhi is acrid-warm, unsuitable for summer days, and Lu Gen controls its warmth. This case can serve as a model for similar conditions.
In the 8th year of Xianfeng, Lu's nephew Fang Guan, aged 7, suffered from sweating Dan Malaria in Autumn. Given five doses of Ge Sheng Tang, fever subsided and he recovered. After a few days, fever returned. I suspected dietary indiscretion. Inquiry revealed he ate Yam and white sugar together, causing Spleen pathogens to recur. Three more doses of Ge Sheng Tang cured him. Five days later, relapse occurred. Inquiry showed he only drank porridge. Asked what accompanied the porridge, he said salted pickled radish bought at the gate, unknowingly soaked in fish brine. Three more doses of Ge Sheng Tang cured him. Thus, the Dan Malaria section notes diet regulates the disease, but diet can also trigger it.
In mid-July of Ren Xu year, Deng's grandson Quan Guan suddenly had fever. Morning and afternoon fevers with profuse sweat persisted for days. Ge Sheng Tang 5-6 doses cured him. His brother Shao Rong had similar symptoms; Ge Sheng Tang with added Chai Hu (Bupleuri Radix) due to mild chills cured him in a few doses. This is the treatment method for Dan Malaria.
My granddaughter, married to Wang, just completed postpartum confinement, suddenly developed fever at month's end. Morning and afternoon fevers with slight sweat, loose stools several times daily, mild back chills. Pulses both hands tight and rapid. Caused by internal latent Summerheat and external Wind-Cold. Ge Sheng Tang with Gui Zhi (Cinnamomi Ramulus) 5 fen, Chi Shao (Paeoniae Radix Rubra) 1.5 qian, Chao Hei Jing Jie Sui (Perillae Folium carbonized) 1.5 qian. Three doses brought calm pulse, cool body, and abdominal relief.
My grandson Bao An, late August, suffered Dan Malaria for 4-5 days. Pulse surging and rapid. Ge Sheng Tang with added Chi Shao (Paeoniae Radix Rubra) for six doses normalized pulse and cooled body. Initial dose relieved vomiting; subsequent divided doses prevented recurrence.
Lu's grandson's son Bai Liu Guan, aged 7, suddenly had severe diarrhea turning into dysentery in intercalary August. Red or white stool, umbilical pain, >20 times/day, >10 times/night. Medications included Su Geng (Perillae Caulis), Qing Pi (Citri Reticulatae Pericarpium Viride), Chen Pi (Citri Reticulatae Pericarpium), Tong Cao (Tetrapanacis Medulla), Huo Xiang (Agastaches Herba), Da Fu Pi (Arecae Pericarpium), Sheng/Shu Sha Ren (Amomi Fructus), Chi Ling (Poria cum Rosa), Ze Xie (Alismatis Rhizoma), Zhi Ke (Aurantii Fructus), Hua Bing Lang (Arecae Semen). Also instructed scraping back at Shenshu points, beside Mingmen, Dachangshu (16th thoracic vertebrae ±1.5 cun), Xiaochangshu (18th thoracic vertebrae ±1.5 cun). Given this year's dysentery was epidemic, used dysentery treatment. Two doses of previous formula reduced by half, then original formula with Wei Ge Gen (Puerariae Lobatae Radix Preparata) and Sheng Ma (Cimicifugae Rhizoma) for two doses stopped it abruptly. Late autumn latent pathogens manifesting late, initial fever fluctuates mildly, pulse fine/rapid/deep. Days later high fever ensues; Ge Sheng Tang with Chi Shao (Paeoniae Radix Rubra) is appropriate. If accompanied by dysentery or diarrhea, combine with dysentery scraping and acupuncture, which are also effective.
On Misconceptions Regarding Accidental Ingestion of Raw Opium Smoke Not Being True Death