巢氏云∶疟疾者、由夏伤于暑，客于皮肤，至秋因劳动血气，腠理虚而邪气乘之，动前暑热、正邪相击，阴阳交争，
阳盛则热，阴盛则寒，阴阳更盛更虚，故发寒热，阴阳相离，则寒热俱歇，若邪动气至，交争复发。小儿未能触冒于暑，
而亦病疟者，乃乳母持抱解脱，不避风寒者也。夫风邪所伤，客于皮肤，而痰饮积于脏腑，致令血气不和，阴阳交争，
若真气胜则邪气退，邪气未尽，故发疟也；邪气虽退，阴血尚虚，邪干于真气，脏腑热气未散，故余热往来也；其病
正发，寒热交争之时，热气乘脏则燥而渴，留饮停滞成癖，结于胁下，故瘥后胁下结硬也；若引饮不止，小便涩者，则
变
成癖也；寒热往来，而热乘五脏，气积不泄，故烦满，寒热相搏，而击于脏气，故腹痛也。寒多热少无汗者，桂枝麻黄
各半汤；有汗多者、柴胡桂枝汤；汗多渴者，白虎加桂汤；小便赤热多而渴者，小柴胡汤；疟未散者，鬼哭散止之；寒
少热多者，可服清脾汤；养胃汤，治脾胃冷弱者，四兽饮亦可服。其截疟丸子、切不可用砒霜者，但可服有常山者，有
阿魏者，真能散痞癖也。热多汗出而渴腹疼者、大柴胡汤加葛根可也。其疟后加之冷证痞癖结块者，木香丸主之；烦闷
者，五苓散；有热甚者，白虎汤，或加桂，或加人参。时行壮热者，柴胡石膏汤亦可服；头疼甚者、葱白加甘草亦可服；
知母麻黄汤，亦治疟之奇剂也。
桂枝麻黄各半汤 见第五十三问。
白虎加桂汤 见第五十八问白虎汤。
小柴胡汤 见第二十九问。
柴胡桂枝汤
柴胡（八钱） 黄芩（二钱） 半夏（二钱半） 芍药 甘草 桂枝（各三钱）
上锉散，每服三钱，姜三片，枣一枚，煎食前服。
鬼哭散 治止疟疾。
常山 大腹皮 白茯苓 鳖甲（酸炙） 甘草（炙、各等分）
上除鳖甲甘草炙外，三件不得见火，用桃柳枝七寸同煎，临发。略吐涎不妨，只用常山、白茯苓、甘草亦效。
清脾汤 治瘴疟脉来弦数，但热不寒，或热多寒少，膈满不食，口苦舌干，烦渴饮水，小便赤黄，大便欠利。
青皮 浓朴（姜制，炒） 白术 草果（去） 柴胡 茯苓 半夏（汤泡七次） 黄芩 甘草（炙、各等分）
上锉散，每服三钱，水一盏，生姜二片，煎六分，去滓温服，不拘时。
四兽饮 治五脏气虚、喜怒不节，劳逸兼并，致阴阳相胜，结聚痰饮，与卫气相搏，发为疟疾。兼治瘴疟，
最有神效，常服温中快膈。
半夏 茯苓 人参 白术 草果 橘红（各等分） 甘草（减半）
上锉散，每服三钱，乌梅、姜、枣各一，水一盏煎服。
胡黄连散 治小儿疟。
人参 胡黄连 草果 槟榔 甘草 柴胡（各等分）
上锉散，水一盏，煎三分服。
养胃汤 治外感风寒，内伤生冷，温中快膈，能辟山岚瘴气，寒疟，脾胃虚寒。
浓朴 苍术（制） 半夏（泡、各一两） 藿香 草果仁 茯苓 人参（各半两） 甘草（炙） 橘红（各二钱半）
上锉散，每服三钱，水一盏，姜七片，乌梅一个，煎六分，去滓热服。兼治冷冻饮料伤脾，发为疟疾。或中脘虚寒，呕
逆恶心。寒疟加桂。
又方
陈皮（去白、三钱半） 甘草（炙） 浓朴（制） 半夏（各三钱、泡） 人参 草果（各二钱） 白茯苓（四钱）
藿香（七钱、洗） 青皮（去瓤） 莪术 三棱（煨） 大腹皮（各一钱半） 苍术 乌梅（各五钱）
上锉散，每服三钱，姜枣煎服。
经效疟丹 治疟母结癖，寒热无已。
真阿魏 雄黄（各二钱半） 朱砂（一钱半）
上沸汤泡阿魏研散，雄朱和之，稀面糊丸梧桐子大，每服一丸，人参汤候冷，空心服。瘴疟桃枝煎冷服。临发磨一
丸，敷鼻头口畔。
大柴胡汤加干葛 见第二十九问大柴胡汤。
木香丸 见第四十六问。
五苓散 见第五十二问。
白虎汤 见第五十八问。
柴胡石膏汤 见第五十二问。
葱白汤 见第五十一问。
知母麻黄汤 治伤寒瘥后，或十数日，或半月二十日，终不惺惺，常昏沉，似失精神，语言错缪，又无寒热，
医或作鬼祟，或作风痰，多般治之不瘥。或朝夕潮热颊赤，或有寒热似疟。都般发汗不尽，余毒在心胞络间所致。
知母 麻黄（去节） 甘草（炙） 芍药 黄芩（各半两） 桂枝（去皮、半两、盛暑可减半）
上锉散，每服三钱，水一盏，煎七分，去滓温服，令微汗。若心烦不眠，欲饮水，当稍稍与之，令胃气和即愈。未
汗须再服，大小加减。
巢元方说：疟疾，是由于夏季感受暑邪，邪气潜伏在皮肤之间，到了秋季因为体力劳动导致气血波动，腠理（皮肤纹理及汗孔）空虚，邪气趁机侵入。此时体内残留的暑热与外来邪气相互搏击，阴阳之气发生交争。阳气偏盛则表现为发热，阴气偏盛则表现为恶寒。由于阴阳之气交替盛衰、虚实变化，所以出现寒热往来的症状；当阴阳之气暂时分离时，寒热症状就会停止；如果邪气再次触动正气，交争就会重新发作。
小儿并没有直接触犯暑邪，却也患上疟疾，这是因为乳母在怀抱或照顾孩子时，让孩子脱去衣物，没有避开风寒侵袭所致。风邪伤害人体，客居于皮肤，同时痰饮积聚在脏腑内，导致气血不和，阴阳交争。如果人体的真气强盛，邪气就会退却，但如果邪气没有完全清除，就会引发疟疾；即使邪气已经退却，但阴血仍然虚弱，邪气干扰真气，脏腑内的热气尚未消散，所以会出现余热往来的症状；在疾病正发、寒热交争的时候，热气侵犯内脏会导致口干舌燥而口渴；如果留滞的痰饮停滞形成癖积，结聚在胁下，所以在病愈后会出现胁下硬块；如果饮水不止，小便涩痛，则会演变成癖积；寒热往来，且热气侵犯五脏，气机郁积不能宣泄，所以会出现烦闷胀满；寒热相互搏结，冲击脏气，所以会出现腹痛。
对于寒多热少且无汗的情况，使用桂枝麻黄各半汤；对于有汗多的情况，使用柴胡桂枝汤；对于汗多且口渴的情况，使用白虎加桂枝汤；对于小便赤热且多、口渴的情况，使用小柴胡汤；对于疟疾未散的情况，用鬼哭散来制止；对于寒少热多的情况，可以服用清脾汤；养胃汤用于治疗脾胃虚寒弱的情况，四兽饮也可以服用。那些截疟丸子中，切不可使用砒霜，只可服用含有常山或阿魏的药物，它们确实能消散痞积和癖块。对于热多、出汗且口渴、腹痛的情况，大柴胡汤加葛根是可以使用的。对于疟疾之后出现的冷证、痞积结块的情况，以木香丸为主治；出现烦闷的，用五苓散；热势严重的，用白虎汤，或者加桂枝，或者加人参。如果是时行壮热的情况，柴胡石膏汤也可以服用；头痛严重的，葱白加甘草也可以服用；知母麻黄汤，也是治疗疟疾的神奇方剂。
桂枝麻黄各半汤：详见第五十三问。
白虎加桂枝汤：详见第五十八问中的白虎汤。
小柴胡汤：详见第二十九问。
柴胡桂枝汤
组成：柴胡（八钱）、黄芩（二钱）、半夏（二钱半）、芍药、甘草、桂枝（各三钱）。
制法用法：以上药物切碎成散剂，每次服用三钱，加入生姜三片、大枣一枚，煎煮后在饭前服用。
鬼哭散：用于治疗并止住疟疾。
组成：常山、大腹皮、白茯苓、鳖甲（经醋炙处理）、甘草（炙，以上各等分）。
制法用法：除了鳖甲和甘草需要炙制外，其余三味药不得见火，用七寸长的桃柳枝一同煎煮，在疟疾发作前服用。服药后略微吐出涎水不要紧，仅使用常山、白茯苓、甘草也有效。
清脾汤：用于治疗瘴疟，脉象弦数，只有发热没有恶寒，或者热多寒少，胸膈满闷不想进食，口苦舌干，烦躁口渴想喝水，小便赤黄，大便不畅。
组成：青皮、浓朴（姜制，炒）、白术、草果（去壳）、柴胡、茯苓、半夏（开水泡七次）、黄芩、甘草（炙，以上各等分）。
制法用法：以上药物切碎成散剂，每次服用三钱，用水一盏，生姜两片，煎至六分，滤去药渣温服，不拘泥于固定时间。
四兽饮：用于治疗五脏气虚、喜怒情绪不节制、劳逸过度，导致阴阳相胜，痰饮结聚，与卫气相搏，从而引发疟疾。兼治瘴疟，效果显著，经常服用可以温中快膈。
组成：半夏、茯苓、人参、白术、草果、橘红（以上各等分）、甘草（减半量）。
制法用法：以上药物切碎成散剂，每次服用三钱，加入乌梅一个、生姜一片、大枣一枚，用水一盏煎服。
胡黄连散：用于治疗小儿疟疾。
组成：人参、胡黄连、草果、槟榔、甘草、柴胡（以上各等分）。
制法用法：以上药物切碎成散剂，用水一盏，煎至三分服。
养胃汤：用于治疗外感风寒、内伤生冷，具有温中快膈的作用，能辟除山岚瘴气，适用于寒疟、脾胃虚寒。
组成：浓朴、苍术（制）、半夏（泡，以上各一两）、藿香、草果仁、茯苓、人参（以上各半两）、甘草（炙）、橘红（以上各二钱半）。
制法用法：以上药物切碎成散剂，每次服用三钱，用水一盏，生姜七片、乌梅一个，煎至六分，滤去药渣热服。兼治因冷冻饮料损伤脾脏引发的疟疾，或者中脘虚寒引起的呕吐恶心。寒疟可加桂枝。
又一方：
陈皮（去白，三钱半）、甘草（炙）、浓朴（制）、半夏（各三钱，泡）、人参、草果（各二钱）、白茯苓（四钱）、藿香（七钱，洗）、青皮（去瓤）、莪术、三棱（煨）、大腹皮（各一钱半）、苍术、乌梅（各五钱）。
制法用法：以上药物切碎成散剂，每次服用三钱，用生姜和大枣煎服。
经效疟丹：用于治疗疟母结癖，寒热症状无止境。
组成：真阿魏、雄黄（各二钱半）、朱砂（一钱半）。
制法用法：用沸水泡阿魏研成散状，将雄黄和朱砂与之混合，用稀面糊制成梧桐子大小的丸药。每次服用一丸，用人参汤候冷后空腹服用。瘴疟可用桃枝煎汤冷服。在发作前磨一丸敷在鼻头和口旁。
大柴胡汤加干葛：详见第二十九问中的大柴胡汤。
木香丸：详见第四十六问。
五苓散：详见第五十二问。
白虎汤：详见第五十八问。
柴胡石膏汤：详见第五十二问。
葱白汤：详见第五十一问。
知母麻黄汤：用于治疗伤寒病愈后，或者十几天，或者半个月到二十天，始终精神不振，常常昏沉，好像失去了精神，言语错乱，又没有寒热症状，医生有时误认为是鬼祟作怪，有时认为是风痰，用多种方法治疗都不见效。或者早晚潮热脸颊发红，或者有寒热像疟疾一样。这都是因为发汗不彻底，余毒在心包络间所致。
组成：知母、麻黄（去节）、甘草（炙）、芍药、黄芩（以上各半两）、桂枝（去皮，半两，盛夏季节可减半）。
制法用法：以上药物切碎成散剂，每次服用三钱，用水一盏，煎至七分，滤去药渣温服，令其微微出汗。如果心烦失眠，想喝水，应当少量给予，使胃气调和即可痊愈。如果没有出汗需要再服用，根据大小便情况进行加减。
Chao Yuanfang stated: Malaria (Nüe Ji) is caused by summer-heat pathogen injuring the body in summer, lodging in the skin. By autumn, due to physical exertion causing fluctuations in Qi and Blood, the Cou Li (skin texture and pores) become deficient, allowing the pathogen to invade. The residual summer-heat within interacts with the external pathogen, leading to a struggle between Yin and Yang. When Yang is predominant, heat manifests; when Yin is predominant, cold manifests. Due to the alternating excess and deficiency of Yin and Yang, chills and fever occur. When Yin and Yang temporarily separate, the chills and fever cease; if the pathogen stirs again, the struggle re-emerges.
Children who contract malaria without directly being exposed to summer-heat do so because their wet nurses, while holding or caring for them, allow them to shed clothing without avoiding wind and cold pathogens. Wind pathogen damages the body, lodging in the skin, while phlegm-fluids accumulate in the Zang-Fu organs, causing disharmony of Qi and Blood and a struggle between Yin and Yang. If the True Qi is strong, the pathogen retreats; however, if the pathogen is not fully cleared, malaria occurs. Even if the pathogen has retreated, if Yin-Blood remains deficient, the pathogen interferes with the True Qi, and the heat in the Zang-Fu has not dissipated, resulting in lingering heat and alternating symptoms. During the active phase of the disease, when chills and fever struggle, heat invading the Zang organs causes dryness and thirst. If retained fluids stagnate and form masses (Pi), knotting under the hypochondrium, hardness under the hypochondrium may persist after recovery. If excessive drinking continues and urination is difficult, it transforms into Pi masses. Alternating chills and fever, where heat invades the Five Zang organs, leads to Qi accumulation without discharge, causing irritability and fullness. The struggle between cold and heat striking the Zang Qi results in abdominal pain.
For cases with more chills than fever and no sweating, Guizhi Mahuang Ge Ban Tang (Cinnamon Twig and Ephedra Half-Dose Decoction) is used. For cases with profuse sweating, Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction) is used. For cases with profuse sweating and thirst, Baihu Jia Guizhi Tang (White Tiger plus Cinnamon Twig Decoction) is used. For cases with red, hot, frequent urination and thirst, Xiaochaihu Tang (Minor Bupleurum Decoction) is used. For malaria that has not dispersed, Gui Ku San (Ghost Cry Powder) is used to stop it. For cases with less chills and more fever, Qingpi Tang (Clear Spleen Decoction) can be taken. Yangwei Tang (Stomach Nourishing Decoction) treats cold weakness of the Spleen and Stomach; Six Beast Drink (Sishou Yin) can also be taken. Regarding malaria-intercepting pills, Bi Shuang (Realgar/Arsenic compounds) must absolutely not be used; only those containing Changshan (Dichroa Root) or Awei (Asafetida) should be taken, as they truly dissipate masses and Pi. For cases with more heat, sweating, thirst, and abdominal pain, Dachaihu Tang (Major Bupleurum Decoction) added with Gegen (Kudzu Root) is suitable. For post-malaria cold syndromes with mass formation, Muxiang Wan (Aucklandia Pill) is the primary treatment. For irritability, Wuling San (Five-Ingredient Powder with Poria) is used. For severe heat, Baihu Tang (White Tiger Decoction) is used, either with added Guizhi (Cinnamon Twig) or Renshen (Ginseng). For epidemic high fever, Chaihu Shigao Tang (Bupleurum and Gypsum Decoction) can be taken. For severe headache, Congbai (Scallion White) added with Gancao (Licorice) can be taken. Zhimu Mahuang Tang (Anemarrhena and Ephedra Decoction) is also a miraculous formula for treating malaria.
Guizhi Mahuang Ge Ban Tang: See Question 53.
Baihu Jia Guizhi Tang: See Baihu Tang in Question 58.
Xiaochaihu Tang: See Question 29.
Chaihu Guizhi Tang
Ingredients: Chai Hu (8 qian), Huang Qin (2 qian), Ban Xia (2.5 qian), Shao Yao, Gan Cao, Gui Zhi (each 3 qian).
Preparation and Administration: Crush into a powder. Take 3 qian per dose, with 3 slices of fresh ginger and one jujube. Decoct and take before meals.
Gui Ku San: Treats and stops malaria.
Ingredients: Chang Shan, Da Fu Pi, Bai Fu Ling, Bie Jia (vinegar-fried), Gan Cao (fired, each in equal parts).
Preparation and Administration: Excluding the vinegar-fried Bie Jia and fired Gan Cao, the other three ingredients must not be exposed to fire. Decoct together with seven-cun long peach or willow branches. Take before the onset of malaria. Mild expectoration of saliva is acceptable. Using only Chang Shan, Bai Fu Ling, and Gan Cao is also effective.
Qingpi Tang: Treats Zhang Malaria with wiry and rapid pulse, fever without chills, or more fever than chills, chest fullness, anorexia, bitter taste, dry tongue, irritability, thirst, red-yellow urine, and incomplete bowel movements.
Ingredients: Qing Pi, Hou Po (ginger-processed, fried), Bai Zhu, Cao Guo (de-shelled), Chai Hu, Fu Ling, Ban Xia (soaked in boiling water seven times), Huang Qin, Gan Cao (fired, each in equal parts).
Preparation and Administration: Crush into a powder. Take 3 qian per dose, with one cup of water and two slices of fresh ginger. Decoct until reduced to 60%, strain, and take warm at any time.
Sishou Yin: Treats Qi deficiency of the Five Zang organs, unregulated emotions, overwork or lack of exercise, leading to Yin-Yang imbalance, phlegm-fluid accumulation, and struggle with Wei Qi, causing malaria. Also treats Zhang Malaria with great efficacy. Regular use warms the middle and relieves chest oppression.
Ingredients: Ban Xia, Fu Ling, Ren Shen, Bai Zhu, Cao Guo, Ju Hong (each in equal parts), Gan Cao (half amount).
Preparation and Administration: Crush into a powder. Take 3 qian per dose, with one myrobalan, one slice of ginger, and one jujube. Decoct with one cup of water.
Huhuanglian San: Treats pediatric malaria.
Ingredients: Ren Shen, Hu Huang Lian, Cao Guo, Bing Lang, Gan Cao, Chai Hu (each in equal parts).
Preparation and Administration: Crush into a powder. Decoct with one cup of water until reduced to 30% and take.
Yangwei Tang: Treats external wind-cold invasion and internal injury from raw/cold foods. It warms the middle, relieves chest oppression, dispels mountain miasma, and treats cold malaria and Spleen-Stomach deficiency-cold.
Ingredients: Hou Po, Cang Zhu (processed), Ban Xia (soaked, each 1 liang), Huo Xiang, Cao Guo Ren, Fu Ling, Ren Shen (each 0.5 liang), Gan Cao (fired), Ju Hong (each 2.5 qian).
Preparation and Administration: Crush into a powder. Take 3 qian per dose, with one cup of water, seven slices of ginger, and one myrobalan. Decoct until reduced to 60%, strain, and take hot. It also treats malaria caused by spleen injury from frozen drinks, or vomiting/nausea due to Middle Jiao deficiency-cold. Add Gui Zhi for cold malaria.
Another Prescription:
Chen Pi (de-white, 3.5 qian), Gan Cao (fired), Hou Po (processed), Ban Xia (each 3 qian, soaked), Ren Shen, Cao Guo (each 2 qian), Bai Fu Ling (4 qian), Huo Xiang (7 qian, washed), Qing Pi (de-pith), E Zhu, San Leng (roasted), Da Fu Pi (each 1.5 qian), Cang Zhu, Wu Mei (each 5 qian).
Preparation and Administration: Crush into a powder. Take 3 qian per dose, decoct with ginger and jujube.
Jingxiao Madan: Treats Malaria Mother (masses) and Pi, with endless chills and fever.
Ingredients: Zhen A Wei, Xiong Huang (each 2.5 qian), Zhu Sha (1.5 qian).
Preparation and Administration: Soak A Wei in boiling water and grind into powder. Mix with Xiong Huang and Zhu Sha. Form pills using thin flour paste, sized like paulownia seeds. Take one pill per dose with cooled Ginseng decoction on an empty stomach. For Zhang Malaria, take with cooled peach branch decoction. Before onset, grind one pill and apply to the nose tip and around the mouth.
Dachaihu Tang added with Gan Ge: See Dachaihu Tang in Question 29.
Muxiang Wan: See Question 46.
Wuling San: See Question 52.
Baihu Tang: See Question 58.
Chaihu Shigao Tang: See Question 52.
Congbai Tang: See Question 51.
Zhimu Mahuang Tang: Treats conditions after recovery from Shanghan (Cold Damage), whether ten days, half a month, or twenty days later, where the patient remains listless, often drowsy, lacking spirit, speaking erroneously, without chills or fever. Physicians sometimes mistake this for ghost possession or wind-phlegm, and various treatments fail. Or there is tidal fever in the morning and evening with red cheeks, or chills and fever resembling malaria. This is caused by incomplete sweating, leaving residual toxins in the Pericardium Collaterals.
Ingredients: Zhi Mu, Ma Huang (nodes removed), Gan Cao (fired), Shao Yao, Huang Qin (each 0.5 liang), Gui Zhi (bark removed, 0.5 liang; reduce by half in midsummer).
Preparation and Administration: Crush into a powder. Take 3 qian per dose, with one cup of water. Decoct until reduced to 70%, strain, and take warm to induce slight sweating. If there is heart vexation, insomnia, and desire for water, give small amounts gradually until Stomach Qi harmonizes and recovery occurs. If no sweat occurs, administer again, adjusting based on major/minor changes.