岭南炎方濒海。地卑土薄。故阳气常泄。阴气常亏。四时放花。冬无霜雪。一岁之间。暑热
过半。穷脑久晴。或至摇扇。人居其间。气多上壅。肤多汗出。腠理不密。盖阳不返本而然也。
阳燠既泄。则使人本气不坚。阳不下降。常浮而上。气浮而不坚。则汗府开疏。津液易泄。故内
寒外热。上热下寒之证。所由生也。治当固阳气。实腠理为主。若多用表散之药。则阳气愈虚。
风邪益盛。鲜有不误者矣。确系外邪为患。则当苍术芩连汤解散之。春秋时月。人感山岚瘴雾之
气发寒热。胸膈饱闷。不思饮食。此毒瓦斯从鼻口入内也。治当清上焦。解内毒。行气降痰。不宜
发汗。苍术芩连汤。头痛甚者。去木通、黄连。加 本、葱、豉。若寒温失节。汗身坦露。感冒
风寒之气。气闭发热头痛。此则伤寒类也。但岭南气温易汗。故多类疟。南方气升。得此病者。
卒皆胸满。痰涎壅塞。饮食不进。与北方伤寒只伤表。而里自和者不同。治当解表清热。降气行
痰。苍术羌活汤。若内停饮食。外感风寒者。藿香正气散。若脾气虚弱而寒热作呕。平胃散加半
夏、木香。名不换金正气散。瘴疟寒热往来者。苍术柴胡汤。疟久者。加人参、当归。汗多者。
去苍术易白术加白芍。大凡病久而气虚血弱者必发热。须用四君之类调补脾胃。脾胃一健。气血
自生。若认为血虚而用四物沉阴之剂。则脾土复伤。诸脏皆病。虚证蜂起。反为难治。甚至不救。
疟后变成痢。宜从虚治。补中益气汤。有热。加芩、连。有食。加木香、砂仁。若温暑之月。民
病天行瘟疫热病。治宜清热解毒之剂。苍术白虎汤加人中黄。若时气发热。变为黄病。所谓瘟
黄也。治宜清热利湿。茵陈五苓加人中黄、连、柏。若中气虚寒。四肢厥冷。或浮肿黑黄者。用
理中汤加茵陈、桂、苓。飞畴曰。粤西傍交趾一带。猪鸡之属。俱煮汤泼去。更煮食之。其米亦
然。且不能多食。稍过则胀闷。总由瘴毒渐毓所致。其日出时。有气如兰香。日中时有气如茉莉
香。日没时有气如炊新米香。如此每日三气。急掩口鼻勿语言以避之。其触之者。寒热如疟。三
四日死。元气稍旺者。数日死。当此急服藿香正气、苍术羌活汤。犹可救之。予戚官其地。不
三月而只存一口。乃元气充裕者。然亦病几于危。故仕任及客游其处者。切须知之。否则无不蒙其害者矣。
中雾气者。心内烦闷少气。头痛项急。起则头眩。或身微寒。战掉不安。时复憎寒。心中欲
吐。干呕无物。此清阳之位。受浊阴之邪气也。不可耗气伤津。栀子豉汤加葱白涌散之。头痛甚。
加本。烦闷。加木香、藿香之类。缪仲淳经疏。只用 本、木香水煎服。大抵蒸发之邪。必中
在上在表。故宜涌之。总无关于脏腑也。
岭南地区地处炎热带，濒临海洋。地势低洼，土壤浅薄。因此阳气容易耗散，阴气常常亏损。这里四季开花，冬季没有霜雪。一年之中，暑热天气超过一半。长期干旱久晴，甚至需要摇动扇子纳凉。人们居住在这里，气机多向上壅滞，皮肤多出汗，腠理（皮肤纹理及汗孔）不致密。这主要是因为阳气不能回归本位所致。
阳气既已耗散，就会使人体根本之气不坚固。阳气不能下降，常浮越于上。气机浮越而不坚固，则汗孔开疏，津液容易外泄。所以内寒外热、上热下寒的证候，由此产生。治疗应当以固护阳气、充实腠理为主。如果多用发散解表的药物，则阳气更加虚弱，风邪更加猖獗，很少有不误治的。确系外邪致病，则应当用苍术芩连汤来解散表邪。在春秋季节，人感受山岚瘴雾之气，出现寒热往来、胸膈饱闷、不思饮食的症状，这是毒瓦斯从口鼻进入体内所致。治疗应当清利上焦，解除内毒，行气降痰，不宜使用发汗法。若头痛剧烈者，去掉木通、黄连，加入藁本、葱白、豆豉。
如果寒温失调，身体坦露，感冒风寒之气，导致气机闭塞、发热头痛，这属于伤寒类疾病。但岭南气温较高，容易出汗，所以多表现为类似疟疾的症状。南方地气上升，患此病的人，突然都会感到胸满，痰涎壅塞，饮食不进。这与北方伤寒只伤及体表而里气自和的情况不同。治疗应当解表清热，降气行痰，用苍术羌活汤。如果内有停食，外感风寒者，用藿香正气散。如果脾气虚弱而寒热发作并呕吐，用平胃散加半夏、木香，名为不换金正气散。对于瘴疟寒热往来者，用苍术柴胡汤。疟疾日久者，加人参、当归。汗多者，去掉苍术改用白术，加白芍。大凡病程长久且气虚血弱的人必然发热，必须用四君子汤之类调理补益脾胃。脾胃一旦强健，气血自然生成。如果误认为是血虚而使用四物汤等沉阴滋腻的药物，则会再次损伤脾土，导致诸脏皆病，虚证蜂拥而起，反而难以治疗，甚至导致死亡。
疟疾之后变成痢疾，应当从虚证论治，用补中益气汤。如果有热，加黄芩、黄连；如果有积食，加木香、砂仁。如果在温热暑天的月份，民众患上时行瘟疫热病，治疗宜用清热解毒的方剂，如苍术白虎汤加人中黄。如果时气发热，转变为黄疸病，即所谓的瘟黄，治疗宜清热利湿，用茵陈五苓散加人中黄、黄连、黄柏。如果中气虚寒，四肢厥冷，或者浮肿、黑黄色者，用理中汤加茵陈、桂枝、茯苓。
飞畴说：粤西靠近交趾一带，猪鸡等肉类，都要煮汤泼去（指去除部分毒性或异味），再煮食之。大米也是如此，而且不能多吃，稍过量就会胀闷。这都是因为瘴毒逐渐孕育所致。日出时，有气味像兰花香；日中时，有气味像茉莉花香；日落时，有气味像刚蒸好的米饭香。每天如此三种气，要急忙捂住口鼻不要说话以避开它。那些触犯这种气的人，会出现寒热如疟疾的症状，三四天死亡。元气稍旺盛的人，几天后死亡。遇到这种情况，急忙服用藿香正气散、苍术羌活汤，还可以救治。我的亲戚在那里做官，不到三个月就只剩下一口气了，那是因为他元气充裕的缘故。然而也几乎病危。所以任职或客居那里的人，切须知晓这些，否则无不遭受其害的。
感染山中雾气的人，心中烦闷少气，头痛项强，起身则头晕目眩，或者身体微寒，颤抖不安，时常憎恶寒冷，心中想吐，干呕无物。这是清阳之位受到浊阴邪气的侵犯。不可耗气伤津，应用栀子豉汤加葱白涌吐发散。头痛严重者，加藁本。烦闷者，加木香、藿香之类。缪仲淳《名医方论》中，只用藁本、木香水煎服。大抵蒸发之邪，必定中于上部、在体表，所以适宜用涌吐法。总之与脏腑无关。
The Lingnan region is located in a hot and humid zone, bordering the sea. The terrain is low-lying, and the soil is shallow. Therefore, Yang Qi (Yang Energy) tends to dissipate, while Yin Qi (Yin Energy) is often deficient. Flowers bloom throughout the four seasons, and there is no frost or snow in winter. For more than half of the year, the weather is hot and sultry. Prolonged drought and clear skies may even necessitate fanning oneself. People living in this environment often experience upward stagnation of Qi, excessive sweating, and loose pores (Cou Li). This occurs primarily because Yang Qi fails to return to its root.
Once Yang Qi has dissipated, the body's fundamental Qi becomes insecure. Yang Qi fails to descend and floats upward instead. When Qi floats and lacks stability, the sweat gates open, and Body Fluids (Jin Ye) are easily lost. Consequently, syndromes characterized by internal cold and external heat, or upper heat and lower cold, arise from this mechanism. Treatment should focus on consolidating Yang Qi and strengthening the pores. If dispersing and releasing-the-exterior herbs are overused, Yang Qi will become further depleted, and Wind Pathogens will flourish; few cases will not be mishandled. If it is indeed an external pathogen causing the illness, Cangzhu Qinlian Tang (Atractylodes and Scutellaria Decoction) should be used to resolve the exterior.
During spring and autumn, when people contract mountain miasma and fog, they develop alternating chills and fever, chest and epigastric fullness, and loss of appetite. This is due to toxic vapors entering through the nose and mouth. Treatment should clear the Upper Jiao (Upper Burner), resolve internal toxins, move Qi, and descend phlegm. Sweating methods are contraindicated. For severe headache, remove Tong Cao (Tetrapanax Pith) and Huanglian (Coptis Rhizome), and add Gu Ben (Ligusticum Sinense), Cong Bai (Scallion White), and Dou Chi (Fermented Soybean).
If there is irregularity in cold and warmth, exposure of the body, and contraction of Wind-Cold, leading to Qi closure, fever, and headache, this falls under the category of Shanghan (Cold Damage). However, due to the warm climate in Lingnan which promotes sweating, these cases often resemble Malaria. In the South, Earth Qi rises; patients with this condition suddenly experience chest fullness, phlegm-saliva obstruction, and inability to eat. This differs from Northern Shanghan, where only the exterior is injured while the interior remains harmonious. Treatment should release the exterior, clear heat, descend Qi, and move phlegm, using Cangzhu Qianghuo Tang (Atractylodes and Notopterygium Decoction). For cases with internal food retention and external Wind-Cold contraction, Huoxiang Zhengqi San (Agastache Powder for Regulating the Qi) is indicated. For Spleen Qi deficiency presenting with alternating chills/fever and vomiting, Pingwei San (Stomach-Pacifying Powder) added with Banxia (Pinellia Tuber) and Muxiang (Aucklandia Root), named Buhuanjin Zhengqi San (Non-Exchanging Gold Upright Qi Powder), is used. For malaria-like alternating chills and fever caused by miasma, Cangzhu Chaihu Tang (Atractylodes and Bupleurum Decoction) is prescribed. For chronic malaria, add Renshen (Ginseng Root) and Danggui (Angelica Sinensis Root). For excessive sweating, replace Cangzhu with Baizhu (Atractylodes Macrocephala Rhizome) and add Shaoyao (Peony Root). Generally, prolonged illness with Qi and Blood deficiency inevitably leads to fever; Si Jun Zi Tang (Four Gentlemen Decoction) and similar formulas should be used to regulate and tonify the Spleen and Stomach. Once the Spleen and Stomach are strong, Qi and Blood will generate naturally. If one mistakenly assumes Blood deficiency and uses Chenyin (heavy and yin-nourishing) agents like Si Wu Tang (Four Substances Decoction), the Spleen Earth will be further damaged, leading to dysfunction of all Zang-Fu organs, a surge of deficiency syndromes, difficulty in treatment, and potentially death.
If dysentery develops after malaria, it should be treated as a deficiency syndrome using Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). If heat is present, add Huangqin (Scutellaria Root) and Huanglian (Coptis Rhizome); if food stagnation exists, add Muxiang (Aucklandia Root) and Sharen (Amomum Fruit). During warm and summer months, when the populace suffers from epidemic febrile diseases, treatment should employ heat-clearing and detoxifying agents, such as Cangzhu Baihu Tang (Atractylodes and White Tiger Decoction) added with Renzhonghuang (Human Coprolite). If seasonal heat transforms into jaundice, known as Wenyellow (Epidemic Jaundice), treatment should clear heat and promote dampness drainage using Yinchin Wuling San (Artemisia Capillaris and Five-Ingredient Poria Powder) added with Renzhonghuang, Lian (Huanglian), and Bo (Huangbai). If there is Middle Jiao Qi deficiency and cold, with cold limbs or edema and blackish-yellow complexion, Lizhong Tang (Regulate the Middle Decoction) added with Yinchin (Artemisia Capillaris), Guizhi (Cinnamon Twig), and Fuling (Poria) is used.
Fei Chou stated: In the western Guangdong area near Cochinchina, meats such as pork and chicken must be boiled, the broth discarded, and then cooked again before eating. Rice is treated similarly and should not be eaten in large quantities, as excess causes bloating and fullness. This is entirely due to the gradual accumulation of miasma toxins. At sunrise, the air smells like orchids; at noon, like jasmine; and at sunset, like freshly steamed rice. One must urgently cover the nose and mouth and refrain from speaking to avoid these three daily airs. Those who inhale them suffer from malaria-like chills and fever and die within three to four days. Those with slightly robust Yuan Qi (Original Qi) may survive a few days longer. In such emergencies, urgent administration of Huoxiang Zhengqi San or Cangzhu Qianghuo Tang can still save the patient. My relative served as an official there and survived only barely after three months, solely because his Original Qi was abundant. Nevertheless, he nearly died. Therefore, officials serving or travelers visiting that region must be fully aware of this; otherwise, all will suffer its harm.
Those infected by mountain mist experience inner restlessness, shortness of breath, headache, neck stiffness, dizziness upon rising, slight aversion to cold, trembling and unease, frequent chilling sensations, nausea, and dry retching without substance. This indicates that the position of Clear Yang has been invaded by turbid Yin pathogens. Methods that consume Qi and damage fluids are contraindicated. Instead, Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) added with Cong Bai (Scallion White) should be used to induce vomiting and disperse the pathogen. For severe headache, add Gu Ben (Ligusticum Sinense). For restlessness, add Muxiang (Aucklandia Root) and Huoxiang (Pogostemon Herb). Miao Zhongchun, in his *Jingshu*, used only Gu Ben and Muxiang decocted in water. Generally, evaporated pathogens strike the upper part and the exterior; therefore, inducing vomiting is appropriate. Ultimately, this condition does not involve the Zang-Fu organs.