论曰伤寒变成疟者,因病瘥后,外邪未散,真脏尚虚,因为劳事,致二气交争,阴胜则
振寒,阳胜则发热,阴阳更胜,即往来寒热,休作有时也,一日再发者,得汗必解,若伤寒
八九日得之,热多寒少,其人不呕,清便自调者,欲自愈也,或阳明证烦热汗出,日晡所发
热者,脉浮宜解表,脉实宜攻里,又有妇人热入血室,发热而更作寒者,当详辨之。
治伤寒后变成疟病,寒热躁渴。知母升麻汤方
知母 石膏 升麻(各一两) 蜀漆 常山 甘草(炙各一分) 乌梅(去核半两)
上七味,粗捣筛,每服五钱匕,水一盏半,煎至八分,去滓食后温服。
治伤寒后变成疟,口干烦渴。二黄汤方
麻黄(去根节) 大黄(锉炒) 栝蒌根(各一两) 甘草(炙锉半两)
上四味,粗捣筛,每服五钱匕,水一盏半,煎至八分,去滓食后温服。
治伤寒后变成疟,寒热躁渴。升麻前胡汤方
升麻 前胡(去芦头各一两半) 知母(焙) 芍药(各三两) 朴硝 山栀子仁 木
通(锉) 乌梅(去
上九味,粗捣筛,每服五钱匕,水一盏半,入生姜一枣大拍碎,同煎至七分,去滓入生
地黄汁二合,更煎一沸,食后温服。
治伤寒后变成疟,痰毒壅脾肺,面色萎黄,寒热时作,人参常山汤方
人参 常山(各半两) 甘草(生) 陈橘皮(汤浸去白焙各一分) 灯心(一十茎)
上五味,细锉拌匀,用水二盏,酒一盏,同煎至两盏,去滓入好茶末二钱匕,分作两服,
温服取吐即瘥。
治伤寒后变成劳疟,久不瘥。黄芩鳖甲汤方
黄芩(去黑心) 柴胡(去苗) 山栀子仁 乌梅(去核各半两) 鳖甲(去裙 醋炙
一两) 甘草(炙一分)
上六味,粗捣筛,每服五钱匕,用童子小便一盏半,入桃柳尖各七个,生姜一枣大拍碎
,豉半合,同浸一宿,平旦煎至七分,去滓入生地黄汁一合,搅匀更煎一沸,温服不拘时。
治伤寒后肝疟,由邪热客于足厥阴经所成,颜色苍苍战掉,或似热劳。蜀漆鳖甲丸方
鳖甲(去裙 醋炙) 蜀漆 知母(焙) 乌梅(去核) 苦参 常山 葳蕤(各一两)
豉(一合熬) 石膏(二两) 细辛(去苗叶) 甘草(炙各三分)
上一十一味,捣罗为末,炼蜜和捣数百下,丸如梧桐子大,每服十五丸,空心温酒下,
晚再服。
治伤寒后心疟,令人烦热不止,饮水多常渴。常山石膏汤方
常山 鳖甲(去裙 醋炙) 犀角屑 蜀漆(各一两) 甘草(炙) 乌梅(去核各一
分) 栀山子仁
上八味,粗捣筛,每服五钱匕,水一盏半,入豉三七粒,淡竹叶二七片,生姜一枣大拍
碎,同煎至八分,去滓食后温服,日二。
治伤寒后脾疟,脾脏受热,或渴或不渴,热气内伤,不得大便,腹中热痛,身寒汗出。
常山丸方
常山(二两) 知母(焙) 鳖甲(去裙 醋炙各一两) 甘草(炙半两)
上四味,捣罗为末,炼蜜和捣数百下,丸如梧桐子大,每服十五丸,未发前温酒下,发
时再服。
治伤寒后肺疟,痰热聚于胸膈,令人心寒,甚则发热,热则惊,如有所见者。三味汤方
常山(一两) 秫米(半匙) 甘草(炙锉一分)
上三味,粗捣筛,每服五钱匕,水一盏半,入生姜一枣大拍碎,同煎至八分,去滓临发
时温服。
治伤寒后肾疟,令人凄凄,腰脊痛而宛转,大便难,手足寒,常山柴胡汤方
常山 柴胡(去苗) 麦门冬(去心焙各一两) 乌梅(去核) 半夏(汤洗七遍炒
干) 槟榔(锉) 枳
上七味,粗捣筛,每服三钱匕,水一盏,入生姜一枣大拍碎,淡竹叶二七片,豉二七粒
,同煎至七分,去滓临发时温服。
治伤寒后变成疟疾,或阴气结伏心下,成块,或膨满呕逆喘促,面黑唇青,四肢逆冷,
饮食不下,气结食毒,并宜服此。太一护命丸方
阳起石 硫黄 附子(炮裂去皮脐各一两) 金星石 银星石 白石英 紫石英 礞石
滑石 硝石 凝水石(烧赤) 磁石(火烧醋淬) 太阴玄精石 坩埚子(累经销金银者) 不
灰木(各半两) 丹砂(一分) 巴豆(四十九粒去皮心出油) 杏仁(四十九粒汤去皮尖
双仁)
上一十八味,捣研为末,再同研极细,用阿魏一分,与糯米粥同和匀,丸如樱桃大,每
服一丸,麸炭火内烧赤,取出用两只盏子合在内,候冷细研,以生姜米饮下,未知再服。
治伤寒后寒热不退,变疟,时作。茯苓饮方
赤茯苓(去黑皮) 鳖甲(去裙 醋炙) 地骨皮(各二两) 柴胡(去苗) 知母(焙
各一两半) 枳壳(去瓤麸炒一两)
上六味,锉如麻豆大,每服五钱匕,以水一盏半,煎取七分,去滓入生地黄汁一合,食
后良久温服,如人行五六里再服。
论述说:伤寒转变为疟疾,是因为病初愈后,外邪尚未消散,五脏真气依然虚弱,此时如果从事劳累之事,导致阴阳二气相互争斗。阴气偏胜则出现畏寒战栗,阳气偏胜则出现发热,阴阳交替偏胜,就表现为忽冷忽热、发作有定时。一天发作两次的,出汗后必然痊愈。如果是伤寒八九日后出现的,热多寒少,患者没有呕吐,大小便正常,这是想要自愈的征兆。或者出现阳明病的烦热汗出,傍晚时分发热的,脉象浮的适宜用解表法,脉象实的适宜用攻里法。又有妇女热邪陷入血室,发热且反复出现恶寒的,应当详细辨别。
治疗伤寒后转变为疟疾,出现寒热、烦躁口渴症状的。知母升麻汤方
知母、石膏、升麻(各一两)、蜀漆、常山、甘草(炙,各一分)、乌梅(去核,半两)
以上七味药,粗捣筛过,每次服用五钱匕,用水一盏半,煎煮至八分,去掉药渣,饭后温服。
治疗伤寒后转变为疟疾,口干烦躁口渴的。二黄汤方
麻黄(去根节)、大黄(锉碎炒制)、栝蒌根(各一两)、甘草(炙,锉碎,半两)
以上四味药,粗捣筛过,每次服用五钱匕,用水一盏半,煎煮至八分,去掉药渣,饭后温服。
治疗伤寒后转变为疟疾,寒热、烦躁口渴的。升麻前胡汤方
升麻、前胡(去芦头,各一两半)、知母(焙干)、芍药(各三两)、朴硝、山栀子仁、木通(锉碎)、乌梅(去核)
以上九味药,粗捣筛过,每次服用五钱匕,用水一盏半,加入生姜一块如枣大拍碎,一同煎煮至七分,去掉药渣,加入生地黄汁二合,再煮沸一次,饭后温服。
治疗伤寒后转变为疟疾,痰毒壅滞脾肺,面色萎黄,寒热不时发作的。人参常山汤方
人参、常山(各半两)、甘草(生用)、陈橘皮(汤浸去白焙干,各一分)、灯心草(十茎)
以上五味药,细锉拌匀,用水二盏,酒一盏,一同煎煮至两盏,去掉药渣,加入好茶末二钱匕,分两次服用,温服以催吐为度,吐后病愈。
治疗伤寒后转变为劳疟,久治不愈的。黄芩鳖甲汤方
黄芩(去黑心)、柴胡(去苗)、山栀子仁、乌梅(去核,各半两)、鳖甲(去裙边,醋炙,一两)、甘草(炙,一分)
以上六味药,粗捣筛过,每次服用五钱匕,用童子小便一盏半,加入桃柳尖各七个,生姜一块如枣大拍碎,豆豉半合,一同浸泡一夜,清晨煎煮至七分,去掉药渣,加入生地黄汁一合,搅匀再煮沸一次,随时温服。
治疗伤寒后肝疟,由邪热客居于足厥阴经所造成,面色青苍颤抖,或类似虚劳。蜀漆鳖甲丸方
鳖甲(去裙边,醋炙)、蜀漆、知母(焙干)、乌梅(去核)、苦参、常山、葳蕤(各一两)、豆豉(一合熬制)、石膏(二两)、细辛(去苗叶)、甘草(炙,各三分)
以上十一味药,捣碎过筛成粉末,炼蜜调和捣击数百下,制成梧桐子大小的丸剂,每次服用十五丸,空腹时用温酒送下,晚上再服一次。
治疗伤寒后心疟,使人烦热不止,饮水多且经常口渴。常山石膏汤方
常山、鳖甲(去裙边,醋炙)、犀角屑、蜀漆(各一两)、甘草(炙)、乌梅(去核,各一分)、山栀子仁
以上八味药,粗捣筛过,每次服用五钱匕,用水一盏半,加入豆豉二十一粒,淡竹叶十四片,生姜一块如枣大拍碎,一同煎煮至八分,去掉药渣,饭后温服,每日两次。
治疗伤寒后脾疟,脾脏受热,有时口渴有时不渴,热气内伤,大便不通,腹中热痛,身体发冷出汗。常山丸方
常山(二两)、知母(焙干)、鳖甲(去裙边,醋炙,各一两)、甘草(炙,半两)
以上四味药,捣碎过筛成粉末,炼蜜调和捣击数百下,制成梧桐子大小的丸剂,每次服用十五丸,在疟疾发作前用温酒送下,发作时再服一次。
治疗伤寒后肺疟,痰热聚集于胸膈,使人心寒,严重时发热,发热则惊悸,如有幻觉所见。三味汤方
常山(一两)、秫米(半匙)、甘草(炙,锉碎,一分)
以上三味药,粗捣筛过,每次服用五钱匕,用水一盏半,加入生姜一块如枣大拍碎,一同煎煮至八分,去掉药渣,在疟疾发作时温服。
治疗伤寒后肾疟,使人感到凄惨,腰脊疼痛且辗转反侧,大便困难,手足寒冷。常山柴胡汤方
常山、柴胡(去苗)、麦门冬(去心焙干,各一两)、乌梅(去核)、半夏(汤洗七遍炒干)、槟榔(锉碎)、枳实
以上七味药,粗捣筛过,每次服用三钱匕,用水一盏,加入生姜一块如枣大拍碎,淡竹叶十四片,豆豉二十一粒,一同煎煮至七分,去掉药渣,在疟疾发作时温服。
治疗伤寒后转变为疟疾,或者阴气结伏在心下,形成痞块,或者胀满呕吐逆气喘息急促,面色发黑嘴唇青紫,四肢逆冷,饮食难进,气结食毒,都适宜服用此药。太一护命丸方
阳起石、硫黄、附子(炮裂去皮脐,各一两)、金星石、银星石、白石英、紫石英、礞石、滑石、硝石、凝水石(烧红)、磁石(火烧醋淬)、太阴玄精石、坩埚子(长期熔炼金银的)、不灰木(各半两)、丹砂(一分)、巴豆(四十九粒去皮心去油)、杏仁(四十九粒汤去皮尖双仁)
以上十八味药,捣碎研细成粉末,再次共同研磨极细,用阿魏一分,与糯米粥混合均匀,制成樱桃大小的丸剂,每次服用一丸,在麸炭火中烧红,取出后用两只碗扣住在内,待冷却后细细研磨,用生姜米饮送下,若未见效可再服。
治疗伤寒后寒热不退,变为疟疾,时常发作的。茯苓饮方
赤茯苓(去黑皮)、鳖甲(去裙边,醋炙)、地骨皮(各二两)、柴胡(去苗)、知母(焙干,各一两半)、枳壳(去瓤麸炒,一两)
以上六味药,锉碎如麻豆大小,每次服用五钱匕,用水一盏半,煎取七分,去掉药渣,加入生地黄汁一合,饭后很久温服,如人行走五六里的时间后再服。
Discussion states: When typhoid fever transforms into malaria, it is because after the initial recovery, external pathogens have not yet dissipated and the true qi of the zang organs remains deficient. If labor is undertaken at this time, it causes a conflict between yin and yang. When yin prevails, there is chills and trembling; when yang prevails, there is fever. The alternating prevalence of yin and yang results in alternating chills and fever with regular intervals. If it occurs twice a day, sweating will lead to resolution. If it occurs eight or nine days after typhoid fever, with more heat than cold, no vomiting, and normal bowel movements, it indicates an impending self-healing. Alternatively, if Yangming syndrome symptoms such as irritability, heat, and sweating appear, with fever occurring in the late afternoon (dusk), a floating pulse indicates the suitability for exterior-releasing methods, while a solid pulse indicates the suitability for interior-purging methods. Furthermore, in women where heat enters the blood chamber (xue shi), causing fever and recurring chills, careful differentiation is required.
Treatment for malaria transforming from typhoid fever, presenting with chills, fever, restlessness, and thirst. Zhimu Shengma Decoction (Anemarrhena and Cimicifuga Decoction)
Zhimu (Anemarrhenae Rhizoma), Shigao (Gypsum Fibrosum), Shengma (Cimicifugae Rhizoma) (each 1 liang); Shuqi (Perillae Folium variant/Changshan related herb), Changshan (Dichroae Radix), Gancao (Licorice Root, honey-fried) (each 1 fen); Wumei (Mume Fructus, pitted) (0.5 liang).
The above seven ingredients are coarsely crushed and sifted. Each dose consists of 5 qianbi, decocted in 1.5 sheng of water until reduced to 0.8 sheng. Strain and take warm after meals.
Treatment for malaria transforming from typhoid fever, presenting with dry mouth, irritability, and thirst. Erhuang Decoction (Two Huangs Decoction)
Mahuang (Ephedrae Herba, de-rooted and joint-free), Dahuang (Rhei Radix et Rhizoma, sliced and stir-fried), Gualougen (Trichosanthis Radix) (each 1 liang); Gancao (Licorice Root, honey-fried, sliced) (0.5 liang).
The above four ingredients are coarsely crushed and sifted. Each dose consists of 5 qianbi, decocted in 1.5 sheng of water until reduced to 0.8 sheng. Strain and take warm after meals.
Treatment for malaria transforming from typhoid fever, presenting with chills, fever, restlessness, and thirst. Shengma Qianhu Decoction (Cimicifuga and Peucedanum Decoction)
Shengma (Cimicifugae Rhizoma), Qianhu (Peucedani Radix, de-rhizome) (each 1.5 liang); Zhimu (Anemarrhenae Rhizoma, roasted), Shaoyao (Paeoniae Radix) (each 3 liang); Puxiao (Natrii Sulfas), Shanzhizi Ren (Gardeniae Semen), Mutong (Akebiae Caulis, sliced), Wumei (Mume Fructus, pitted).
The above nine ingredients are coarsely crushed and sifted. Each dose consists of 5 qianbi, decocted in 1.5 sheng of water with one date-sized piece of crushed fresh ginger until reduced to 0.7 sheng. Strain, add 2 he of fresh Rehmanniae Juice, boil once more, and take warm after meals.
Treatment for malaria transforming from typhoid fever, with phlegm-toxin obstructing the spleen and lungs, sallow complexion, intermittent chills and fever. Renshen Changshan Decoction (Ginseng and Dichroa Decoction)
Renshen (Ginseng Radix), Changshan (Dichroae Radix) (each 0.5 liang); Gancao (Licorice Root, raw); Chenjupi (Citri Reticulatae Pericarpium, soaked in water, white part removed, dried) (each 1 fen); Dengxin (Junci Medulla) (10 stems).
The above five ingredients are finely sliced and mixed evenly. Decoct in 2 sheng of water and 1 sheng of wine until reduced to 2 sheng. Strain, add 2 qianbi of fine tea powder, divide into two doses, take warm to induce vomiting, which leads to cure.
Treatment for labor malaria transforming from typhoid fever, chronic and unhealed. Huangqin Biejia Decoction (Scutellaria and Turtle Shell Decoction)
Huangqin (Scutellariae Radix, de-blackened), Chaihu (Bupleuri Radix, de-seedling), Shanzhizi Ren (Gardeniae Semen), Wumei (Mume Fructus, pitted) (each 0.5 liang); Biejia (Testudinis Carapax et Plastrum, de-skirt, vinegar-processed) (1 liang); Gancao (Licorice Root, honey-fried) (1 fen).
The above six ingredients are coarsely crushed and sifted. Each dose consists of 5 qianbi, soaked overnight in 1.5 sheng of urine from a young boy, along with 7 peach tips, 7 willow tips, one date-sized piece of crushed fresh ginger, and 0.5 he of fermented soybean (Chi). Decoct in the morning until reduced to 0.7 sheng. Strain, add 1 he of fresh Rehmanniae Juice, mix well, boil once more, and take warm at any time.
Treatment for liver malaria transforming from typhoid fever, caused by pathogenic heat lodging in the Foot Jueyin Meridian, presenting with pale-green complexion and trembling, or resembling consumptive disease. Shuqi Biejia Pill (Perilla/Dichroa and Turtle Shell Pill)
Biejia (Testudinis Carapax et Plastrum, de-skirt, vinegar-processed), Shuqi, Zhimu (Anemarrhenae Rhizoma, roasted), Wumei (Mume Fructus, pitted), Kushen (Sophorae Flavescentis Radix), Changshan (Dichroae Radix), Weirui (Polygonati Odorati Rhizoma) (each 1 liang); Chi (Fermented Soybean, 1 he, roasted), Shigao (Gypsum Fibrosum) (2 liang); Xixin (Asari Radix et Rhizoma, de-seedling and leaf), Gancao (Licorice Root, honey-fried) (each 3 fen).
The above eleven ingredients are pounded into powder. Mix with refined honey and pound hundreds of times to form pills the size of paulownia seeds. Take 15 pills each time with warm wine on an empty stomach, and repeat in the evening.
Treatment for heart malaria transforming from typhoid fever, causing persistent irritability and heat, excessive drinking, and constant thirst. Changshan Shigao Decoction (Dichroa and Gypsum Decoction)
Changshan (Dichroae Radix), Biejia (Testudinis Carapax et Plastrum, de-skirt, vinegar-processed), Xijiao Xie (Rhinocerotis Cornu, shaved), Shuqi (each 1 liang); Gancao (Licorice Root, honey-fried), Wumei (Mume Fructus, pitted) (each 1 fen); Shanzhizi Ren (Gardeniae Semen).
The above eight ingredients are coarsely crushed and sifted. Each dose consists of 5 qianbi, decocted in 1.5 sheng of water with 21 grains of fermented soybean (Chi), 14 slices of light bamboo leaves (Danzhuye), and one date-sized piece of crushed fresh ginger until reduced to 0.8 sheng. Strain and take warm after meals, twice daily.
Treatment for spleen malaria transforming from typhoid fever, heat affecting the spleen, with variable thirst, internal injury by heat qi, constipation, abdominal heat pain, body chills, and sweating. Changshan Pill (Dichroa Pill)
Changshan (Dichroae Radix) (2 liang), Zhimu (Anemarrhenae Rhizoma, roasted), Biejia (Testudinis Carapax et Plastrum, de-skirt, vinegar-processed) (each 1 liang), Gancao (Licorice Root, honey-fried) (0.5 liang).
The above four ingredients are pounded into powder. Mix with refined honey and pound hundreds of times to form pills the size of paulownia seeds. Take 15 pills with warm wine before the onset of malaria, and again during the attack.
Treatment for lung malaria transforming from typhoid fever, phlegm-heat gathering in the chest and diaphragm, causing heart chills, severe fever, palpitations upon fever, and visual hallucinations. Sanwei Decoction (Three Ingredients Decoction)
Changshan (Dichroae Radix) (1 liang), Shumi (Sorghum Grain) (half spoon), Gancao (Licorice Root, honey-fried, sliced) (1 fen).
The above three ingredients are coarsely crushed and sifted. Each dose consists of 5 qianbi, decocted in 1.5 sheng of water with one date-sized piece of crushed fresh ginger until reduced to 0.8 sheng. Strain and take warm at the time of malaria onset.
Treatment for kidney malaria transforming from typhoid fever, causing despondency, lower back and spine pain with tossing and turning, difficult defecation, and cold hands and feet. Changshan Chaihu Decoction (Dichroa and Bupleurum Decoction)
Changshan (Dichroae Radix), Chaihu (Bupleuri Radix, de-seedling), Maimendong (Ophiopogonis Radix, de-heart, roasted) (each 1 liang), Wumei (Mume Fructus, pitted), Banxia (Pinelliae Rhizoma, washed seven times in water, stir-fried dry), Binglang (Arecae Semen), Zhishi (Aurantii Fructus Immaturus).
The above seven ingredients are coarsely crushed and sifted. Each dose consists of 3 qianbi, decocted in 1 sheng of water with one date-sized piece of crushed fresh ginger, 14 slices of light bamboo leaves (Danzhuye), and 21 grains of fermented soybean (Chi) until reduced to 0.7 sheng. Strain and take warm at the time of malaria onset.
Treatment for malaria transforming from typhoid fever, or where yin qi knots below the heart forming a mass, or distension, vomiting, regurgitation, panting, black face, blue lips, cold limbs, inability to eat, qi stagnation, and food toxicity. Taiyi Huming Pill (Supreme One Protecting Life Pill)
Yangqishi (Actinolite), Liuhuang (Sulfur), Fuzi (Aconiti Lateralis Radix Praeparata, cracked, skin and umbilicus removed) (each 1 liang); Jin Xingshi (Venus Stone), Yin Xingshi (Silver Star Stone), Bai Yingshi (White Quartz), Zi Yingshi (Purple Quartz), Mengshi (Calamine), Huashi (Talcum), Xiaoshi (Natrii Sulfas), Ningshuishi (Stalactite, fired red), Cishi (Magnetitum, fired and quenched in vinegar), Taiyin Xuanjingshi (Taiyin Black Crystal), Guozuo (Crucible used for smelting gold and silver repeatedly), Buhui Mu (Non-ash Wood) (each 0.5 liang); Dansha (Cinnabar) (1 fen); Badou (Crotonis Fructus, 49 seeds, skin and heart removed, oil expressed); Xingren (Armeniacae Semen Amarum, 49 seeds, skin and tip removed, double-kernel).
The above eighteen ingredients are pounded and ground into powder, then re-ground extremely fine. Mix with 1 fen of Asafetida (awei) and glutinous rice porridge to form pills the size of cherries. Take one pill each time, roast red in bran charcoal fire, remove, cover with two bowls to cool, grind finely, and take with fresh ginger and rice drink. Repeat if necessary.
Treatment for unresolved chills and fever after typhoid fever, transforming into malaria with intermittent attacks. Fuling Yin (Poria Drink)
Chifuling (Poria with Red Cortex, de-black skin), Biejia (Testudinis Carapax et Plastrum, de-skirt, vinegar-processed), Digupi (Lycii Cortex, 2 liang each); Chaihu (Bupleuri Radix, de-seedling), Zhimu (Anemarrhenae Rhizoma, roasted) (each 1.5 liang); Zhike (Aurantii Fructus, de-albedo, bran-fried) (1 liang).
The above six ingredients are sliced like hemp seeds. Each dose consists of 5 qianbi, decocted in 1.5 sheng of water until reduced to 0.7 sheng. Strain, add 1 he of fresh Rehmanniae Juice, take warm long after meals, and repeat after walking about five to six li.