治时行疟之通剂（此三阳经疟也。《机要》曰∶疟有中三阳者，有中三阴者，其证各殊。
同伤寒也，在太阳谓之寒疟，治多汗之；在阳明谓之热疟，治多下之；在少阳谓之风疟，宜
和之
疟，
宜毒
自
连
疟
争
弊
则
肺
柴胡 麻黄（去节） 泽泻（各三钱）
此足少阳药也。吴鹤皋曰∶病有三在，在表、在里及在半表半里也。疟邪藏于分肉之间
，邪
邪由
以治
（严用和）
治疟疾热多寒少，口苦嗌干，小便赤涩，脉来弦数（热多，阳胜也；口苦嗌干，肝胆火
也
青皮 浓朴（醋炒） 柴胡 黄芩（炒） 半夏（姜制） 茯苓 白术（土炒） 甘草
（炙） 草果。加姜煎。一方加槟榔。大渴加麦冬、知母；疟不止加酒炒常山（一钱）、乌
梅（二个。常山劫痰截疟，乌梅敛
此足少阳、太阴药也。疟为肝胆之邪，然多因脾胃受伤而起，脾属湿土，重感于湿，湿
生热，热生痰，故见前证也。脾既受病，木又克之，故用青皮、柴胡以破滞而伐肝（柴胡疏
上焦肝气，青皮疏下焦肝气）；半夏、浓朴以行痰而平胃（浓朴平胃，半夏燥痰。古云无痰
不作疟）；茯苓用以渗湿；黄芩用以清热；草果辛热，能散太阴之积寒，除痰而截疟能清膏
粱之痰，盖先去其害脾者；而以白术、甘草调而补之也（此即小柴胡汤加减，从温脾诸方而
一变也。虚疟忌用。吴鹤皋曰∶清脾非清凉之谓，乃攻去其邪，而脾部为之一清也。刘宗浓
因草果之辛热而讥焉，是未达严用和氏之精矣。张子和曰∶世医以疟为脾寒，甚者归之祟怪，
良可笑也。刘宗浓曰∶暑盛阳极，伏阴在内，人或纳凉澡浴，寒客肌肉之间，或饥饱劳役，
内伤而病作，肌肉属脾，发则恶寒战栗，乃谓之脾寒耳，实由风寒湿 ，邪郁腠理，夏时毛
窍疏通，而不为病，至秋气收敛之际，表邪不能发越，故进退不已，往来寒热，势如凌虐人
之状，所以名疟，即四时之伤寒也，十二经皆能为病，古方多兼理内伤取效，由脾胃和，精
气通，阴阳和解，诸邪悉散，实非脾病也，世用发表解肌、温经散寒等法，亦未尝执于燥脾
劫剂也。昂按∶脾虚恶寒，胃虚恶热，寒热间作，脾亦有之，不独少阳也。虽十二经脏皆能
为疟，而脾胃受伤者实多，故仲景小柴胡汤人参、甘草、半夏、姜枣，皆脾胃药，其治少阳，
独柴胡一味而已，严氏宗之，故以小柴胡加减而立清脾饮，是明从脾胃论治矣；刘氏之论，
亦主脾胃内伤，乃不敢翻子和之案，以为非脾病，恐不然也。又古方用辟邪丹、雄朱丸治鬼
疟，盖杂病多
【清脾饮】
治疗时行疟疾的通用方剂（这是三阳经疟疾。《机要》说：疟疾有侵犯三阳经的，有侵犯三阴经的，它们的证候各不相同。如同伤寒病一样，在太阳经称为寒疟，治疗多用发汗法；在阳明经称为热疟，治疗多用攻下法；在少阳经称为风疟，适宜用和解法）。
柴胡、麻黄（去节）、泽泻（各三钱）
这是足少阳经的药物。吴鹤皋说：病邪有三种所在，即在表、在里以及在半表半里之间。疟邪潜伏于分肉之间……（原文此处有残缺/乱码，略过不可读部分）……以治……
（严用和方）
治疗疟疾热多寒少，口苦咽干，小便赤涩，脉象弦数（热多，是阳气胜；口苦咽干，是肝胆火旺）。
青皮、浓朴（醋炒）、柴胡、黄芩（炒）、半夏（姜制）、茯苓、白术（土炒）、甘草（炙）、草果。加生姜煎服。另一版本加槟榔。大渴加麦冬、知母；疟疾不止加酒炒常山（一钱）、乌梅（二个。常山劫痰截疟，乌梅敛……）。
这是足少阳、太阴经的药物。疟疾是肝胆之邪，然而多因脾胃受伤而起。脾属湿土，再次感受湿邪，湿生热，热生痰，所以出现前面的证候。脾既已受病，肝木又克制它，所以用青皮、柴胡来破滞气而伐肝（柴胡疏解上焦肝气，青皮疏解下焦肝气）；半夏、浓朴来行痰浊而平胃气（浓朴平胃，半夏燥痰。古语说无痰不作疟）；茯苓用来渗利湿气；黄芩用来清热；草果辛热，能散太阴经的积寒，除痰并截疟，能清除膏粱厚味产生的痰，大概是先去其伤害脾胃的因素；然后用白术、甘草调和并补益脾胃（这就是小柴胡汤的加减方，从温脾诸方变化而来。虚疟忌用。吴鹤皋说：清脾不是指清凉的意思，而是攻去邪气，使脾部得以清净。刘宗浓因为草果的辛热而讥讽它，这是没有通达严用和医理的精深之处。张子和说：世间的医生把疟疾当作脾寒，严重的归咎于鬼神作祟，实在可笑。刘宗浓说：暑气盛极阳极，伏阴在内，有人纳凉洗澡，寒邪客居肌肉之间，或者饥饱劳役，内伤而发病，肌肉属于脾，发作时恶寒战栗，所以称之为脾寒耳，实际上是由风寒湿邪郁闭腠理，夏季毛窍疏通而不发病，到了秋季气机收敛之际，表邪不能发散，所以进退不已，往来寒热，态势如同凌虐人一样，所以名为疟，即四时的伤寒病，十二经都能为此病，古方多兼理内伤取效，因为脾胃和，精气通，阴阳和解，诸邪悉散，实际上并不是脾的病。世人使用发表解肌、温经散寒等方法，也未曾执着于燥脾劫痰的药剂。汪昂按语：脾虚恶寒，胃虚恶热，寒热交替发作，脾也有这种情况，不独少阳经如此。虽然十二经脏腑都能为疟，但脾胃受伤的确实很多，所以仲景的小柴胡汤中人参、甘草、半夏、姜枣，都是脾胃药，其治疗少阳，唯独柴胡一味而已，严氏遵循此法，所以用小柴胡汤加减而立清脾饮，这是明确从脾胃论治了；刘氏的论述，也主张脾胃内伤，却不敢推翻张子和的观点，认为不是脾病，恐怕不对吧。另外古方用辟邪丹、雄朱丸治疗鬼疟，大概杂病多……）
[Qingpi Yin]
A general formula for treating epidemic malaria (This refers to malaria affecting the three Yang meridians. *Jiyao* states: Malaria can affect the three Yang meridians or the three Yin meridians, and their manifestations differ. Similar to Shanghan disease, when in the Taiyang meridian it is called Cold Malaria, treated mostly with sweating methods; when in the Yangming meridian it is called Heat Malaria, treated mostly with purgative methods; when in the Shaoyang meridian it is called Wind Malaria, treated with harmonizing methods).
Chaihu (Bupleuri Radix), Mahuang (Ephedrae Herba, de-stemmed), Zexie (Alismatis Rhizoma) (each 3 qian).
These are herbs for the Foot-Shaoyang meridian. Wu Hegao stated: Pathogenic factors have three locations: in the exterior, in the interior, and at the half-exterior half-interior level. The malaria pathogen hides between the muscle layers... [text fragment omitted due to corruption] ...to treat...
(From Yan Yonghe)
Treats malaria with more heat than chills, bitter taste in the mouth, dry throat, scanty and painful urination, and a wiry and rapid pulse (More heat indicates Yang excess; bitter taste and dry throat indicate Liver-Gallbladder fire).
Qingpi (Citri Reticulatae Pericarpium Viride), Nongpo (Magnoliae Officinalis Cortex, vinegar-fried), Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix, stir-fried), Banxia (Pinelliae Rhizoma, ginger-processed), Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma, earth-fried), Gancao (Glycyrrhizae Radix et Rhizoma, honey-roasted), Caoguo (Tsao-ko Fructus). Decoct with fresh ginger. Another version adds Binglang (Arecae Semen). For excessive thirst, add Maidong (Ophiopogonis Radix) and Zhimu (Anemarrhenae Rhizoma); if malaria persists, add Jiuchangshan (Stemonae Radix, wine-fried, 1 qian) and Wumei (Mume Fructus, 2 pieces. Changshan seizes phlegm to arrest malaria, Wumei astringes...).
These are herbs for the Foot-Shaoyang and Foot-Taiyin meridians. Malaria is a pathogen of the Liver and Gallbladder, yet it often arises from damage to the Spleen and Stomach. The Spleen belongs to Wet Earth; secondary contraction of dampness generates heat, and heat generates phlegm, hence the aforementioned symptoms. Once the Spleen is diseased, Wood overacts on it. Therefore, Qingpi and Chaihu are used to break stagnation and subdue the Liver (Chaihu soothes the Liver Qi in the Upper Jiao, Qingpi soothes the Liver Qi in the Lower Jiao); Banxia and Nongpo are used to move phlegm and calm the Stomach (Nongpo calms the Stomach, Banxia dries phlegm. Ancient saying: "No phlegm, no malaria"); Fuling is used to leach out dampness; Huangqin is used to clear heat; Caoguo is acrid and hot, capable of dispersing accumulated cold in the Taiyin, resolving phlegm, and arresting malaria. It can clear phlegm generated from rich foods, presumably removing factors that harm the Spleen first; then Baizhu and Gancao are used to harmonize and tonify (This is a modification of Xiaochaihu Tang, a variation from formulas warming the Spleen. Contraindicated in deficiency malaria. Wu Hegao said: "Qingpi" does not mean cooling; it means attacking and removing pathogens so that the Spleen region becomes clear. Liu Zongnong mocked this due to the acrid-hot nature of Caoguo, failing to understand the profundity of Yan Yonghe’s theory. Zhang Zihe said: Physicians of the world regard malaria as Spleen cold, attributing severe cases to demonic influence, which is laughable. Liu Zongnong said: When summer heat is extreme and Yang reaches its peak, Yin lies hidden within. If one seeks coolness or bathes, cold pathogens lodge in the muscles; or if injured by hunger, fullness, or labor, internal injury causes disease onset. Muscles belong to the Spleen; upon attack, there is aversion to cold and shivering, hence termed "Spleen Cold." In reality, it is caused by wind-cold-damp pathogens depressing the cou-li (skin pores). In summer, pores are open and no disease occurs; in autumn, when Qi converges, exterior pathogens cannot be vented, leading to alternating progression and regression, with alternating chills and fever, resembling persecution. Hence named "Malaria," which is essentially Shanghan of the four seasons. All twelve meridians can manifest this disease. Ancient formulas often achieved efficacy by addressing internal injuries simultaneously. Because the Spleen and Stomach harmonized, essence and Qi flowed, Yin and Yang reconciled, and all pathogens dispersed, it is actually not a Spleen disease. People use methods such as releasing the exterior, resolving the muscle layer, warming meridians, and dispersing cold, without strictly adhering to drying-Spleen or seizing-phlegm agents. Wang Ang notes: Spleen deficiency causes aversion to cold, Stomach deficiency causes aversion to heat, and alternating chills and fever can occur in the Spleen, not just the Shaoyang. Although all twelve meridians and zang-fu organs can cause malaria, damage to the Spleen and Stomach is indeed common. Thus, in Zhongjing’s Xiaochaihu Tang, Renshen, Gancao, Banxia, Jiang, and Zao are all Spleen-Stomach herbs; for treating Shaoyang, only Chaihu is specific. Yan followed this principle, establishing Qingpi Yin by modifying Xiaochaihu Tang, clearly indicating treatment from the perspective of the Spleen and Stomach. Liu’s discussion also emphasizes internal injury to the Spleen and Stomach, yet he dared not overturn Zihe’s case regarding it not being a Spleen disease, which is perhaps incorrect. Additionally, ancient formulas used Pixie Dan and Xionzhu Wan to treat Gui Malaria (Ghost Malaria), generally for miscellaneous diseases...)