春夏之交。乍寒乍热。其气忽然蓊郁。忽然发泄。更衣不时。感冒不一。本地人患者不
知。医者无书可考。客寓者每曰水土不服。委之于数而已。其证似风寒头痛寒热。而又恶心
胀闷。似痢非痢。似疟非疟者是也。宜九味羌活汤加减。平胃散、藿香正气散、二陈汤。此
证粤中无时无之。无人觉之。虚弱之体。感而即发。敦浓之人。感不骤发。积久而成。浑浑
漠漠。脉证茫然。难治难愈。
闽粤皆有之。夏秋之时。久雨阴湿。忽然暑热山岚之气。自下蒸上。人在气交之中。有
一种胀闷不可当之势。此即瘴疠时也。人能知觉者。即以玉枢丹。水磨服之。立解。平胃散
加槟榔。亦佳。
粤西于云贵接壤处。有水能毒人。其山产五金。皆有毒。况产五色信石者乎。山坞熬信
水流下溪。人不知误吞。则腹胀绞肠而不救矣。初感而轻。用玉枢丹、紫金锭、行军散、
平胃正气散。亦有得生者。
三四月。草深偃俯。久雨湿烂。而时令蒸郁。其性上炎。一种郁勃之气。入虚人口鼻。
即患瘴闷。轻者用平胃藿香正气散。重者苏合丸、七香丸、诸葛行军散即愈。广东高雷廉。
及广西左右两江皆有之。
五六月。雨水泛溢。有孔雀处。其屎积于木叶茸草间。随涧水流下。人误吞之于炊爨间
必患腹胀而痛闷。轻者正气平胃散调玉枢丹而愈。重者行军散、七香散、紫金锭可治之。
最重者。非药可解。此广西庆远、思恩、太平。近交址处居多。镇远四城州柳州亦有之。
春夏交替之际，天气忽冷忽热，空气突然变得闷热潮湿，又突然发泄散开。人们更换衣物不及时，感受的外邪各不相同。本地人患病习以为常并不知晓，医生也没有书籍可以考证参考。外来寄居的人常常说是水土不服，将其归结为命运所致。这种病症的表现类似风寒引起的头痛、恶寒发热，但又伴有恶心、腹胀闷痛；症状像痢疾却不是痢疾，像疟疾却不是疟疾。治疗适宜用九味羌活汤进行加减，或者使用平胃散、藿香正气散、二陈汤。这种证候在广东地区无时不有，无人察觉。体质虚弱的人，感邪后立即发病；身体敦厚强壮的人，感邪后不会立即发作，而是积久后才形成。此时病情浑浊模糊，脉象和症状茫然不清，难以治疗且不易痊愈。
福建和广东都有这种情况。夏秋时节，长时间下雨导致阴湿，突然出现的暑热和山间岚气，从下方向上方蒸腾。人处于这种气交之中，会有一种胀闷得无法忍受的态势。这就是瘴疠病的时候。人如果能感知到不适，立即用水磨服玉枢丹，立刻就能解除病痛。服用平胃散加槟榔，效果也很好。
粤西与云贵接壤的地方，有水能毒害人。那里的山出产五金（金属矿物），都带有毒性，何况还出产五色信石呢？在山坞中熬炼信石，水流流入溪涧，人们不知道而误吞了它，就会导致腹胀、肠绞痛而无法救治。刚感染时症状较轻，使用玉枢丹、紫金锭、行军散、平胃正气散，也有得以存活的人。
三月四月，草深倒伏，久雨导致腐烂潮湿，时令气候蒸腾郁结，其性质向上炎升。一种郁勃之气，进入虚损之人的口鼻，就会患上瘴闷症。轻症用平胃藿香正气散，重症用苏合丸、七香丸、诸葛行军散即可痊愈。广东的高州、雷州、廉州，以及广西的左江、右江地区都有这种情况。
五月六月，雨水泛滥，有孔雀出没的地方，孔雀的粪便积聚在木叶和茸草之间，随着涧水向下流。人们在炊事做饭时误吞了它，必定会患腹胀、疼痛闷痛。轻症用正气平胃散调服玉枢丹即可痊愈。重症用行军散、七香散、紫金锭可以治疗。最严重的情况，非药物所能解救。这种情况在广西的庆远、思恩、太平，靠近安南（今越南）的地方居多。镇远、四城、州、柳州也有发生。
In the transition between spring and summer, the weather fluctuates suddenly between cold and hot. The air suddenly becomes dense and humid, then suddenly dissipates. People change their clothing irregularly and are exposed to various pathogenic factors. Locals who fall ill are unaware of the nature of the disease, and physicians have no books to consult. Visitors often attribute it to "unacclimatization" (shuitu bufu) and resign themselves to fate. The symptoms resemble wind-cold causing headache and aversion to cold with fever, yet accompanied by nausea, abdominal distension, and oppression. It resembles dysentery but is not dysentery; it resembles malaria but is not malaria. Treatment should employ Jiwei Qianghuo Tang (Nine-Ingredient Immortals' Hair Decoction) with modifications, or Pingwei San (Regularize the Stomach Powder), Huoxiang Zhengqi San (Patchouli Qi-Regulating Powder), or Erchen Tang (Two-Aged Decoction). This condition exists everywhere in Guangdong at all times, yet goes unnoticed. Those with deficient constitutions develop the disease immediately upon infection; those with robust constitutions do not develop it abruptly but accumulate over time until onset. At this stage, the pathology is turbid and obscure, pulse and symptoms are indistinct, making it difficult to treat and cure.
This occurs in both Fujian and Guangdong. During summer and autumn, prolonged rain creates dampness and yin moisture. Suddenly, summer heat and mountain mist rise from below. Humans existing within this qi interaction experience an unbearable sensation of distension and oppression. This is the time of zhangli (miasma pestilence). If one perceives the discomfort, taking Yushu Dan (Jade Pivot Pill) ground in water provides immediate relief. Pingwei San added with Areca Seed (Binglang) is also effective.
In western Guangdong, bordering Yunnan and Guizhou, there is water that can poison people. The mountains produce metallic minerals, all of which are toxic; how much more so the five-colored realgar (Xinshi)? When realgar is smelted in mountain hollows, the runoff flows into streams. Unaware people may accidentally ingest it, leading to abdominal distension and intestinal colic that proves fatal. In the early, mild stages, using Yushu Dan, Zijin Ding (Purple Gold Tablet), Xingjun San (Army-Marching Powder), or Pingwei Zhengqi San can save lives.
In March and April, tall grass lies flat, rotting due to prolonged rain. The seasonal climate is steaming and stagnant, its nature rising upward. A stifling qi enters the nose and mouth of those with deficiency, causing zhangmen (miasma oppression). Mild cases are cured with Pingwei Huoxiang Zhengqi San; severe cases are cured with Suhé Wan (Storax Pill), Qixiang Wan (Seven-Fragrance Pill), or Zhuge Xingjun San (Zhuge's Army-Marching Powder). This occurs in Gaoleilian (Gaozhou, Leizhou, Lianzhou) in Guangdong, and the Left and Right Jiang rivers in Guangxi.
In May and June, rainwater floods. Where peacocks reside, their feces accumulate among leaves and moss, flowing down with stream water. Accidental ingestion during cooking leads to abdominal distension, pain, and oppression. Mild cases are cured by combining Zhengqi Pingwei San with Yushu Dan. Severe cases can be treated with Xingjun San, Qixiang San, or Zijin Ding. The most severe cases cannot be resolved by medicine. This is common in Qingyuan, Si'en, and Taiping in Guangxi, near Annam (Vietnam). It also occurs in Zhenyuan, Sicheng, Zhou, and Liuzhou.