周梦觉曰∶儒者读书十年，穷理十年，自谓于医已通三昧。及其视病，两相龃龉，不归责药肆之假，便诿咎染病
之真。与之强辨无庸也，请试之治疟。夫疟病之浅而显者也，最易足以验医之得失。世之用劫药，而侥幸以成功者，
不在此论。如果堂堂之阵，正正之师，而百战百胜焉，庶可悬壶都市，负笼乡邦；犹是投之罔效，屡易其方，古籍
糠，空披万卷，寒窗灯案，辜负十年。经曰∶邪气客于风府，循膂而下，其气上行，九日出于缺
盆。余读经文，而知疟脉之所以弦也。躯壳之内，肿腑以外，属半表半里，而邪居之，宜脉之弦，与少阳同。是故
风无常府，以所中处为府，其中顶骨也。三阳之脉，皆上于头。阳明之脉，循发际至额颅，邪气并于阳明，令人
头痛，洒淅寒甚，久乃热，则为阳明之疟。少阳之脉，上抵头角，下耳后，邪气并于少阳，令人头痛、寒不甚，热
不甚，恶见人，则为少阳之疟。至于太阳之脉，从巅入络脑，还出别下项，正过风府处，故头痛、腰重、体重、寒
从背起。所以中于阳者，太阳之疟居多，其中 骨也。三阴之脉，皆发于足太阳之脉，上膝股内入腹。邪气并
入太阴，令人足软，不嗜饮食，多寒热，则为太阴之疟。厥阴之脉，入毛中，绕阴器，邪气并入厥阴，令人足软，
小腹满，小便不利则为厥阴之疟。至于少阴之脉，上股后廉直贯膂，正当风府处，故足软，呕吐甚，多寒热，热多
寒少。所以中于阴者，少阴之疟居多。其中于阳也，阳气渐入于阴分，日下一节，其行也迟。故其作也，日晏一日，
难愈。其中于阴也，阴气转入阳分，日下二节，其行也速。故其作也，日早一日，易愈。治之之法，疟在三阳，则
以三阳治之，疟在三阴，则以三阴治之。倘弦化脉虚有汗，但辅其正气，而邪自除。则统阴阳而温补之，未有不
随手而效者。机要曰∶疟有中三阳者，有中三阴者，其症各殊，同《伤寒论》。知治伤寒，则知治疟。余谓第
知治伤寒，犹不足以治疟。知伤寒矣，而知邪客风府，则足以治疟矣。所同于伤寒者症，所异于伤寒者脉。伤寒
之脉，随阴阳变迁，疟症之脉，一弦字贯澈。知所以治伤寒，而于阴阳胜复之理，邪正交战之时，脏腑行径之穴，
无不灼知之矣。业医者欲验一己之功修，请自试之治疟。
梦觉阳明经症疟疾方
葛根（一钱） 升麻（五分） 黄芩（一钱） 白芍（一钱） 草果（一钱） 炙草（一钱）
生姜（一钱） 大枣（一枚）
梦觉阳明腑症疟疾方
大黄（一钱） 芒硝（一钱） 槟榔（一钱） 浓朴（五分） 炙甘草（一钱） 生姜（一钱） 大枣（一枚）
梦觉少阳疟疾方
青皮（七分） 浓朴（七分） 柴胡（一钱） 黄芩（一钱） 茯苓（一钱） 半夏（七分） 白芍（一钱）
草果（一钱） 炙甘草（一钱） 生姜（一钱） 大枣（青皮引）
梦觉太阳经症疟疾方
麻黄（一钱） 桂枝（一钱） 杏仁（一钱） 炙草（一钱） 生姜（一钱） 大枣（一枚）
梦觉太阳腑症疟疾方
焦术（一钱） 茯苓（一钱） 猪苓（一钱） 泽泻（一钱） 草果（一钱） 炙甘草（一钱） 生姜（一钱）
大枣（一枚）
梦觉三阴疟疾方（附子理中汤加草果）
玉竹（一钱） 焦术（一钱） 干姜（七分） 草果（一钱） 炙甘草（一钱） 附片（三分） 生姜（一钱）
大枣（一枚）
梦觉虚症疟疾方 统治虚疟。
黄 （一钱） 焦术（一钱） 附子（三分） 首乌（一钱） 当归（一钱） 玉竹（一钱） 草果（一钱）
茯苓（一钱） 炙甘草（一钱） 生姜（一钱） 大枣（一枚）
涂蔚生曰∶周梦觉之疟疾症治，固已精美完善。然考其所本，多半出自仲景。不过仲景简而赅，而梦觉繁而
详。实则本仲景之法以为治，即无不治之疟，亦无治不能愈之疟。盖疟，系风寒由外之油膜，以入内之油膜者。而
仲景之治疟，则根据少阳以为治，必使邪之由外而入者，仍由外而出。今人不查此中原理，动以截止为能事，每至旋愈
旋复，即以其不能根本解决也。予每以仲景之法治疟，凡遇疟之一二剂不能全愈者，必劝其多服数剂，使其卒归于
愈，愈而不复。今将其原文摘入，虽为治疟者之备考，夫亦曰存古云耳。
张仲景曰∶疟脉自弦，弦数者，多热；弦迟者，多寒；弦小
紧者下差。弦迟者，可温之，弦紧者，可发汗针灸也；浮大者，可吐之；弦数者，风发也，以饮食消息之。
唐容川曰∶《内经》言疟邪藏于风府，旁连募原。募即膜也，膜之原在脐下，即三焦之连网矣。三焦、膀胱
皆肾之府，三焦为阳府，而化水行于里，则为小便；膀胱为阴府，而化气于表，则为卫气。《内经》就疟所发言，
责在卫气，故邪在太阳之风府。仲景就疟之所留言，故责在三焦膜原。是以疟症，未有小水清利者，三焦之决渎病也。
仲景以少阳立论，其义在此，正与《内经》互相发明。后人不知三焦，至谓仲景之证与《内经》不合，谬矣。
张仲景曰∶病疟以月一日发，当十五日愈。设不瘥，当月尽解。如其不瘥，当云何？曰此结为 瘕，名曰疟母。
当急治之，宜鳖甲煎丸。
鳖甲煎丸
鳖甲（炙一钱） 射干（一钱） 黄芩（一钱） 柴胡（一钱） 鼠妇（一钱） 干姜（一钱） 大黄（一钱）
桂枝（七分） 石苇（一钱去毛） 浓朴（一钱） 紫葳（即凌霄一钱） 半夏（七分） 阿胶（一钱）
芍药（一钱） 丹皮（一钱） 虫（一钱） 葶苈（一钱） 人参（一钱） 瞿麦（一钱） 蜂窠（一钱）
赤硝（一钱） 蜣螂（熬，一钱） 桃仁（二钱）
上二十三味为末，取 灶下灰一斗，清酒一斛五升，俟酒尽一半，着鳖甲于中，煮令泛烂如胶漆，绞取汁，纳
诸药煎为丸如梧子大，空心服七丸，日三服（《千金》用鳖甲十二片，又有海藻三分，大戟一分。无鼠妇，赤硝二味）
唐容川曰∶夫疟邪本伏于营血之中，卫气会而始发，故久则营血结聚而为疟母。卫气不通，而为留痰。是血
为疟母之主，痰属卫气所生，乃疟母之兼有者也。故治疟母，以攻利营血为主，而行痰降气为辅。知此则知仲景此
方，破血之药，所以独多，总是治营以通卫也。
涂蔚生曰∶各家之对于疟症，所以先寒后热，以及结成疟母
之理，虽不乏精细辨论，而能理由充足，不致令人疑虑者，殊少其人。以余度之，疟症即系邪气伏居少阳油膜之
上，而下焦化生之气，亦必须循油膜上行而外达，以为护卫。今以邪气之阻，不得外达，而为护卫，故始而恶寒
特甚。迨至邪正交战既久，纷争已毕，终系邪气势弱，而正气势强。孰知正气愈郁结，而勃发愈猛，故继而发热特
甚。设使邪随汗出，则疟可冀愈。否则，病患设为健壮，化生正气迅利，则正气之团结亦速，出与邪争亦急。今病
者之体有强弱，化生之气有迟缓，故疟有一日一发，间日一发。营血之行，以卫气为转移，今卫气屡为邪气郁阻，
而营血不能随其郁阻，经火炼以为郁滞，而为疟母焉。夫疟母名者，以邪气纵随正气纷争尽出。而此血之凝滞，
与邪伏居油膜无异，仍可使疟疾发生焉。故主鳖甲 虫大黄桃仁等味，攻血者，以攻利之。浓朴葶苈等味，理气
者，以疏散之。然犹虑邪未尽除也，仍用柴胡桂枝以解之，人参以托之。血虚受伤也，兼用阿胶白芍以固之。余
则清热涤水之味，务使其邪气尽除，不至血痰交结而为疟母焉。此说此见，不知有合圣意否，尚希国内高明医士
随时教正是幸。
张仲景曰∶阴气孤绝，阳气独发，则热而少气、烦冤，手足热而欲吐，名曰瘅疟。若但热不寒者，邪气内藏于
心，外舍分肉之间，令人消瘦肌肉。
唐容川曰∶阴气指少阴心肾也。心肾之阴虚，故热而少气，心中烦冤。邪气能入于心，而内藏于心，皆少阴阴
气孤绝之证也。阳气指太阳膀胱也，水中之阳，化气为热，以卫周身。今独有阳气则纯热，合于阳明，则为手足热。
合于三焦，则欲呕。外合于腠理分肉之间，则令肌肉消烁。治少阴，宜鸡子黄汤。治太阳，宜白虎汤。后世如清
瘟败毒饮一方，可以兼治。
按《史记·仓公传》风瘅客脬，言瘅邪客居膀胱。此瘅疟亦发于膀胱，与牡疟正相对，牡疟是邪在心也。
张仲景曰∶温疟者，其脉如平，身无寒但热，骨节烦疼。时
呕，白虎加桂枝汤主之。
白虎汤加桂枝
知母（一钱） 石膏（一钱） 甘草（一钱） 粳米（一钱） 桂枝（七分）
唐容川曰∶身无寒但热，为白虎汤之正证。加桂枝者，以有骨节烦疼症，则有伏寒在于筋节，故用桂枝以逐
之也。
张仲景曰∶疟多寒者，名曰牡疟，蜀漆散主之。
蜀漆散
蜀漆（一钱，烧去腥） 云母（一钱，烧二日夜） 龙骨（各等分。上三味，杵为散。未发前，以浆水服半钱匕）
附《外台秘要》三方∶
牡蛎汤 治牡疟。
牡蛎（一钱） 麻黄（一钱） 甘草（一钱） 蜀漆（一钱）
注意∶蜀漆即常山苗也。
柴胡去半夏加栝蒌蒌根汤 治疟病发渴者，亦治劳疟。
柴胡（一钱） 人参（一钱） 黄芩（一钱） 甘草（一钱） 栝蒌根（一钱） 生姜（一钱） 大枣（一枚）
柴胡桂姜汤 治疟多寒微有热，或但寒不热，服一剂如神。
柴胡（一钱） 桂枝（七分） 干姜（一钱） 栝蒌根（一钱） 黄苓（一钱） 牡蛎（一钱）
周梦觉说：读书人读书十年，探究医理十年，自以为已经通晓了医学的精髓。等到他们诊治疾病时，却往往与实际情况相抵触，不是责怪药铺卖假药，就推卸说是染病的真实原因。跟他们强辩是没有用的，请试着用治疗疟疾来检验。疟病是浅显易见的病症，最能验证医生医术的高下。世上那些使用劫夺正气之药而侥幸成功的人，不在这里讨论。如果是堂堂正正的阵容，正规严谨的军队，能够百战百胜，才可以悬挂壶标志在都市行医，背着药笼在乡里受人尊敬；如果投药毫无效果，屡次更换方剂，即使把古籍当作糠秕一样抛弃，空读万卷书，寒窗灯下的苦读也就辜负了十年的光阴。《内经》说：邪气客居在风府穴，沿着脊柱向下，其气上行，九天后出于缺盆穴。我阅读经文，从而知道了疟疾病脉象之所以呈弦脉的原因。躯壳之内，脏腑之外，属于半表半里的部位，邪气居于此处，所以脉象应当呈现弦脉，这与少阳病的脉象相同。因此，风没有固定的府舍，以邪气所中的部位为府，其中顶骨（枕骨）处即是。三阳经的脉气，都上达头部。阳明经的脉气，循行发际至额颅，邪气并入阳明经，使人头痛，洒淅恶寒严重，时间久了才发热，这就是阳明经的疟疾。少阳经的脉气，上抵头角，下行耳后，邪气并入少阳经，使人头痛，恶寒不重，发热也不重，害怕见人，这就是少阳经的疟疾。至于太阳经的脉气，从头顶入络于脑，复出别行下项，正好经过风府穴，所以出现头痛、腰重、身体沉重、寒冷从背部升起。所以中于阳经的，多是太阳经的疟疾，邪气侵犯的是顶骨。三阴经的脉气，都起于足太阳膀胱经，上行膝股内侧进入腹部。邪气并入太阴脾经，使人两脚软弱，不喜欢饮食，多寒热交替，这就是太阴经的疟疾。厥阴肝经的脉气，进入阴毛中，环绕阴器，邪气并入厥阴经，使人两脚软弱，小腹胀满，小便不利，这就是厥阴经的疟疾。至于少阴肾经的脉气，沿大腿后廉直贯脊柱，正当风府处，所以出现两脚软弱，呕吐严重，多寒热交替，热多寒少。所以中于阴经的，多是少阴经的疟疾。邪气中于阳经，阳气逐渐进入阴分，每天下行一节，它的运行迟缓。所以发作时间，一天比一天晚，难以痊愈。邪气中于阴经，阴气转入阳分，每天下行二节，它的运行迅速。所以发作时间，一天比一天早，容易痊愈。治疗的方法，疟疾在三阳经，就用三阳经的方法治疗；疟疾在三阴经，就用三阴经的方法治疗。如果弦脉转化为虚脉且有汗出，只需辅助正气，邪气自然消除。那么统摄阴阳进行温补治疗，没有不随手见效的。《金匮要略心典》机要篇说：疟疾有中三阳经的，有中三阴经的，症状各不相同，同《伤寒论》的道理一致。懂得治疗伤寒，就懂得治疗疟疾。我认为只知道治疗伤寒，还不足以治疗疟疾。懂得了伤寒，并且知道邪气客居在风府穴，就足以治疗疟疾了。与伤寒相同的是症状，与伤寒不同的是脉象。伤寒的脉象，随着阴阳的变化而变化；疟疾的症状，一个“弦”字贯穿始终。懂得如何治疗伤寒，对于阴阳胜复的道理，邪正交战的时候，脏腑运行的路径穴位，没有不透彻了解的。从事医疗工作的人想要验证自己的功修，请从尝试治疗疟疾开始。
周梦觉阳明经症疟疾方
葛根（一钱） 升麻（五分） 黄芩（一钱） 白芍（一钱） 草果（一钱） 炙甘草（一钱）
生姜（一钱） 大枣（一枚）
周梦觉阳明腑症疟疾方
大黄（一钱） 芒硝（一钱） 槟榔（一钱） 厚朴（五分） 炙甘草（一钱） 生姜（一钱） 大枣（一枚）
周梦觉少阳疟疾方
青皮（七分） 厚朴（七分） 柴胡（一钱） 黄芩（一钱） 茯苓（一钱） 半夏（七分） 白芍（一钱）
草果（一钱） 炙甘草（一钱） 生姜（一钱） 大枣（青皮引）
周梦觉太阳经症疟疾方
麻黄（一钱） 桂枝（一钱） 杏仁（一钱） 炙甘草（一钱） 生姜（一钱） 大枣（一枚）
周梦觉太阳腑症疟疾方
焦白术（一钱） 茯苓（一钱） 猪苓（一钱） 泽泻（一钱） 草果（一钱） 炙甘草（一钱） 生姜（一钱）
大枣（一枚）
周梦觉三阴疟疾方（附子理中汤加草果）
玉竹（一钱） 焦白术（一钱） 干姜（七分） 草果（一钱） 炙甘草（一钱） 附片（三分） 生姜（一钱）
大枣（一枚）
周梦觉虚症疟疾方 统治虚疟。
黄芪（一钱） 焦白术（一钱） 附子（三分） 首乌（一钱） 当归（一钱） 玉竹（一钱） 草果（一钱）
茯苓（一钱） 炙甘草（一钱） 生姜（一钱） 大枣（一枚）
涂蔚生说：周梦觉对疟疾的辨证治疗，确实精美完善。然而考察他所依据的来源，多半出自张仲景。不过是张仲景简练而概括，而周梦觉繁琐而详细。实际上本于张仲景的方法来治疗，就没有治不好的疟疾，也没有治不能痊愈的疟疾。大概疟疾，是风寒由外部的油膜，侵入内部的油膜。而张仲景治疗疟疾，则是根据少阳经来治疗，必须使由外而入的邪气，仍然由外而出。现在的人不查考其中的原理，动不动就以截断病程为能事，往往导致刚刚痊愈又复发，就因为不能从根本上解决。我每次用张仲景的方法治疗疟疾，凡是遇到服用一二剂不能全愈的，一定劝患者多服几剂，使其最终归于痊愈，痊愈后不再复发。现在将其原文摘录进来，虽然是给治疗疟疾者的备考资料，也不过是说保存古法罢了。
张仲景说：疟疾的脉象自呈弦脉，弦数脉的，多热；弦迟脉的，多寒；弦小紧脉的，用下法较好。弦迟脉的，可以用温法；弦紧脉的，可以用发汗或针灸治疗；浮大脉的，可以用吐法；弦数脉的，是风热所致，通过饮食调理来观察病情。
唐容川说：《内经》说疟邪藏匿于风府穴，旁边连接募原。募就是膜的意思，膜的根源在脐下，就是三焦的连网。三焦和膀胱都是肾的府库，三焦是阳府，化水运行于体内，就成为小便；膀胱是阴府，化气于体表，就成为卫气。《内经》针对疟疾所说的，责任在于卫气，所以邪气在太阳经的风府穴。张仲景针对疟疾留下的论述，所以责任在于三焦膜原。因此疟疾症状，没有小便清利的，这是三焦决渎功能失常的病证。张仲景以少阳经立论，意义就在这里，正与《内经》互相发明。后人不知道三焦，以至于说张仲景的证候与《内经》不合，这是错误的。
张仲景说：患疟疾如果在农历初一发病，应当在十五天痊愈。假设没好，应当在当月月底解除。如果还没好，该怎么办？回答说：这会结为癥瘕，名叫疟母。应当紧急治疗它，适宜用鳖甲煎丸。
鳖甲煎丸
鳖甲（炙一钱） 射干（一钱） 黄芩（一钱） 柴胡（一钱） 鼠妇（一钱） 干姜（一钱） 大黄（一钱）
桂枝（七分） 石苇（一钱去毛） 厚朴（一钱） 紫葳（即凌霄花一钱） 半夏（七分） 阿胶（一钱）
芍药（一钱） 丹皮（一钱） 廑虫（一钱） 葶苈（一钱） 人参（一钱） 瞿麦（一钱） 蜂窠（一钱）
赤硝（一钱） 蜣螂（熬，一钱） 桃仁（二钱）
以上二十三味药研为末，取灶下灰一斗，清酒一斛五升，等酒煮去一半，放入鳖甲在其中，煮至泛烂如胶漆状，绞取汁液，纳入诸药煎煮制成梧桐子大小的丸药，空腹服用七丸，每日三次（《千金方》用鳖甲十二片，又有海藻三分，大戟一分。无鼠妇、赤硝两味）。
唐容川说：疟邪原本潜伏在营血之中，卫气与之交会才开始发作，所以久了营血结聚而形成疟母。卫气不通，形成留痰。所以血是疟母的主因，痰属于卫气所生，是疟母的兼有之物。所以治疗疟母，以攻利营血为主，而行痰降气为辅。懂得这一点就知道张仲景这个方子，破血的药之所以独多，总是为了治营以通卫。
涂蔚生说：各家对于疟疾先寒后热，以及结成疟母的原理，虽然不乏精细辩论，但理由充足不致令人疑虑的，特别少。依我推测，疟疾就是邪气伏居在少阳油膜之上，而下焦化生的气，也必须循着油膜上行而外达，作为护卫。现在因为邪气的阻碍，不能外达作为护卫，所以起初特别怕冷。等到邪正交战既久，纷争已毕，终归是邪气势弱，而正气势强。谁知道正气越郁结，勃发就越猛烈，所以继而特别发热。假如邪气随汗排出，那么疟疾可以希望痊愈。否则，病患如果身体健壮，化生正气迅利，那么正气的团结也迅速，出来与邪争竞也急切。现在病人的体质有强弱，化生的气有迟缓，所以疟疾有一日一发，间日一发。营血的运行，随卫气转移，现在卫气屡被邪气郁阻，而营血不能随其郁阻，经过火炼成为郁滞，而形成疟母。所谓疟母这个名字，是因为邪气纵然随正气纷争尽出，但这血的凝滞，与邪气伏居油膜无异，仍可使疟疾发生。所以主用鳖甲、廑虫、大黄、桃仁等味，攻血的，用来攻利它。厚朴、葶苈等味，理气的，用来疏散它。然而还担心邪气未尽除，仍用柴胡、桂枝来解表，用人参来托举。血虚受伤，兼用阿胶、白芍来固护。其余清热涤水的药味，务必使其邪气尽除，不至血痰交结而形成疟母。这种说法和见解，不知是否符合圣人的意旨，尚希望国内高明的医士随时指教，这是我的荣幸。
张仲景说：阴气孤绝，阳气独发，则发热而气短、烦闷冤屈，手足发热且想呕吐，名叫瘅疟。如果只发热不恶寒，邪气内藏于心，外舍于分肉之间，使人消瘦肌肉。
唐容川说：阴气指少阴心肾。心肾的阴虚，所以发热而气短，心中烦闷冤屈。邪气能入于心，而内藏于心，都是少阴阴气孤绝的证候。阳气指太阳膀胱，水中的阳气，化气为热，以护卫周身。现在独有阳气则纯热，合于阳明经，则手足发热。合于三焦，则想呕吐。外合于腠理分肉之间，则令肌肉消烁。治疗少阴，适宜用鸡子黄汤。治疗太阳，适宜用白虎汤。后世如清瘟败毒饮一方，可以兼治。
按《史记·仓公传》说风瘅客居膀胱，言瘅邪客居膀胱。此瘅疟也发于膀胱，与牡疟正相对，牡疟是邪在心。
张仲景说：温疟，其脉象如平人，身体无寒但发热，骨节烦疼，时而呕吐，白虎加桂枝汤主治。
白虎汤加桂枝
知母（一钱） 石膏（一钱） 甘草（一钱） 粳米（一钱） 桂枝（七分）
唐容川说：身无寒但发热，是白虎汤的正证。加桂枝的，是因为有骨节烦疼的症状，则有伏寒在于筋节，所以用桂枝来驱逐它。
蜀漆散
蜀漆（一钱，烧去腥） 云母（一钱，烧二日夜） 龙骨（各等分。上三味，杵为散。未发前，以浆水服半钱匕）
附《外台秘要》三方：
牡蛎汤 治牡疟。
牡蛎（一钱） 麻黄（一钱） 甘草（一钱） 蜀漆（一钱）
注意：蜀漆即常山苗也。
柴胡去半夏加栝蒌根汤 治疟病发渴者，亦治劳疟。
柴胡（一钱） 人参（一钱） 黄芩（一钱） 甘草（一钱） 栝蒌根（一钱） 生姜（一钱） 大枣（一枚）
柴胡桂姜汤 治疟多寒微有热，或但寒不热，服一剂如神。
柴胡（一钱） 桂枝（七分） 干姜（一钱） 栝蒌根（一钱） 黄芩（一钱） 牡蛎（一钱）
Zhou Mengjue said: Scholars study for ten years and probe into principles for another ten years, believing themselves to have mastered the essence of medicine. Yet when they treat patients, their actions often contradict reality; they either blame pharmacies for selling fake drugs or attribute the illness to its genuine causes. It is useless to argue with them strongly; let us try testing them by treating malaria. Malaria is a superficial and obvious disease, most capable of verifying a physician's competence. Those who use harsh drugs to forcibly stop symptoms and achieve success by luck are not discussed here. If one has a dignified formation and an upright army, winning every battle, then one can hang a medical pot in the city and carry a medicine basket in the countryside; if treatments prove ineffective and prescriptions are changed repeatedly, even discarding ancient texts as chaff and vainly reading ten thousand volumes, the hard work at the cold window and lamp desk would have wasted ten years. The Classic says: "Pathogenic factors lodge in the Fengfu point (Wind Palace acupoint), descend along the spine, and their qi ascends, emerging from the Quepen point (Missing Basin acupoint) after nine days." Reading this scripture, I understood why the pulse in malaria is wiry (Xian). Inside the body shell but outside the viscera lies the half-exterior half-interior region, where pathogens reside; thus the pulse should be wiry, similar to Shaoyang diseases. Therefore, wind has no fixed palace; the site of invasion becomes the palace, such as the occipital bone. The meridians of the three Yangs all ascend to the head. The Yangming meridian runs from the hairline to the forehead and skull; when pathogenic factors merge with Yangming, it causes headache, severe aversion to cold, and later fever, constituting Yangming malaria. The Shaoyang meridian ascends to the temporal angle and descends behind the ear; when pathogens merge with Shaoyang, it causes headache, mild aversion to cold, mild fever, and fear of people, constituting Shaoyang malaria. As for the Taiyang meridian, it enters the brain from the vertex, emerges separately down the neck, passing exactly through Fengfu; thus it causes headache, heavy waist, heavy body, and cold starting from the back. Hence, invasions of the Yang meridians are mostly Taiyang malaria, affecting the occipital bone. The meridians of the three Yins all originate from the Foot-Taiyang bladder meridian, ascending through the inner knee and thigh into the abdomen. When pathogens merge with Taiyin, it causes weak legs, loss of appetite, and alternating chills and fever, constituting Taiyin malaria. The Jueyin liver meridian enters the pubic region and surrounds the genitalia; when pathogens merge with Jueyin, it causes weak legs, lower abdominal fullness, and difficult urination, constituting Jueyin malaria. Regarding the Shaoyin kidney meridian, it runs straight up the posterior aspect of the thigh along the spine, right at Fengfu; thus it causes weak legs, severe vomiting, and alternating chills and fever with more heat than cold. Hence, invasions of the Yin meridians are mostly Shaoyin malaria. When pathogens invade the Yang, yang qi gradually enters the yin division, descending one segment daily; its movement is slow. Thus, attacks occur later each day and are hard to cure. When pathogens invade the Yin, yin qi turns into the yang division, descending two segments daily; its movement is fast. Thus, attacks occur earlier each day and are easy to cure. The treatment method is: if malaria is in the three Yang meridians, treat according to the three Yang meridians; if in the three Yin meridians, treat according to the three Yin meridians. If the wiry pulse transforms into a deficient pulse with sweating, only assist the healthy qi, and the pathogen will eliminate itself. Then, warming and tonifying both yin and yang will surely yield immediate results. The Essentials state: "Malaria involves the three Yang or the three Yin, with distinct symptoms, consistent with the Treatise on Cold Damage." Knowing how to treat cold damage allows one to know how to treat malaria. I say that merely knowing how to treat cold damage is insufficient for treating malaria. One must understand cold damage and know that pathogens lodge in Fengfu to sufficiently treat malaria. What is common with cold damage is the symptoms; what differs is the pulse. The pulse in cold damage changes with yin and yang shifts; the pulse in malaria is characterized by a single "wiry" quality throughout. Understanding how to treat cold damage leads to thorough knowledge of the principles of yin-yang victory and defeat, the timing of pathogen-healthy qi battles, and the pathways of the viscera. Physicians wishing to verify their own cultivation should start by trying to treat malaria.
Zhou Mengjue's Formula for Yangming Meridian Malaria
Puerariae Radix (Ge Gen, 1 qian), Cimicifugae Rhizoma (Sheng Ma, 5 fen), Scutellariae Radix (Huang Qin, 1 qian), Paeoniae Radix Alba (Bai Shao, 1 qian), Tsaoko Fructus (Cao Guo, 1 qian), Glycyrrhizae Radix et Rhizoma Praeparata (Zhi Gan Cao, 1 qian), Zingiberis Rhizoma Recens (Sheng Jiang, 1 qian), Jujubae Fructus (Da Zao, 1 piece).
Zhou Mengjue's Formula for Yangming Fu-Organ Malaria
Rhei Radix et Rhizoma (Da Huang, 1 qian), Natrii Sulfas (Mang Xiao, 1 qian), Arecae Semen (Bing Lang, 1 qian), Magnoliae Officinalis Cortex (Hou Po, 5 fen), Glycyrrhizae Radix et Rhizoma Praeparata (Zhi Gan Cao, 1 qian), Zingiberis Rhizoma Recens (Sheng Jiang, 1 qian), Jujubae Fructus (Da Zao, 1 piece).
Zhou Mengjue's Formula for Shaoyang Malaria
Citri Reticulatae Pericarpium Viride (Qing Pi, 7 fen), Magnoliae Officinalis Cortex (Hou Po, 7 fen), Bupleuri Radix (Chai Hu, 1 qian), Scutellariae Radix (Huang Qin, 1 qian), Poria (Fu Ling, 1 qian), Pinelliae Rhizoma (Ban Xia, 7 fen), Paeoniae Radix Alba (Bai Shao, 1 qian), Tsaoko Fructus (Cao Guo, 1 qian), Glycyrrhizae Radix et Rhizoma Praeparata (Zhi Gan Cao, 1 qian), Zingiberis Rhizoma Recens (Sheng Jiang, 1 qian), Jujubae Fructus (Da Zao, 1 piece; Qing Pi as guide).
Zhou Mengjue's Formula for Taiyang Meridian Malaria
Ephedrae Herba (Ma Huang, 1 qian), Cinnamomi Ramulus (Gui Zhi, 1 qian), Armeniacae Semen Amarum (Xing Ren, 1 qian), Glycyrrhizae Radix et Rhizoma Praeparata (Zhi Gan Cao, 1 qian), Zingiberis Rhizoma Recens (Sheng Jiang, 1 qian), Jujubae Fructus (Da Zao, 1 piece).
Zhou Mengjue's Formula for Taiyang Fu-Organ Malaria
Atractylodis Rhizoma Usticum (Jiao Zhu, 1 qian), Poria (Fu Ling, 1 qian), Polyporus (Zhu Ling, 1 qian), Alismatis Rhizoma (Ze Xie, 1 qian), Tsaoko Fructus (Cao Guo, 1 qian), Glycyrrhizae Radix et Rhizoma Praeparata (Zhi Gan Cao, 1 qian), Zingiberis Rhizoma Recens (Sheng Jiang, 1 qian), Jujubae Fructus (Da Zao, 1 piece).
Zhou Mengjue's Formula for Three-Yin Malaria (Fuzi Lizhong Tang plus Tsaoko Fructus)
Polygonati Odorati Rhizoma (Yu Zhu, 1 qian), Atractylodis Rhizoma Usticum (Jiao Zhu, 1 qian), Zingiberis Rhizoma (Gan Jiang, 7 fen), Tsaoko Fructus (Cao Guo, 1 qian), Glycyrrhizae Radix et Rhizoma Praeparata (Zhi Gan Cao, 1 qian), Aconiti Lateralis Radix Praeparata (Fu Pian, 3 fen), Zingiberis Rhizoma Recens (Sheng Jiang, 1 qian), Jujubae Fructus (Da Zao, 1 piece).
Zhou Mengjue's Formula for Deficiency-Type Malaria (General formula for deficiency malaria)
Astragali Radix (Huang Qi, 1 qian), Atractylodis Rhizoma Usticum (Jiao Zhu, 1 qian), Aconiti Radix Praeparata (Fu Zi, 3 fen), Polygoni Multiflori Radix (Shou Wu, 1 qian), Angelicae Sinensis Radix (Dang Gui, 1 qian), Polygonati Odorati Rhizoma (Yu Zhu, 1 qian), Tsaoko Fructus (Cao Guo, 1 qian), Poria (Fu Ling, 1 qian), Glycyrrhizae Radix et Rhizoma Praeparata (Zhi Gan Cao, 1 qian), Zingiberis Rhizoma Recens (Sheng Jiang, 1 qian), Jujubae Fructus (Da Zao, 1 piece).
Tu Weisheng said: Zhou Mengjue's syndrome differentiation and treatment of malaria are indeed exquisite and complete. However, examining his sources, they are mostly derived from Zhang Zhongjing. It is simply that Zhang Zhongjing was concise and comprehensive, while Zhou Mengjue was detailed and elaborate. In essence, by following Zhang Zhongjing's methods, there is no malaria that cannot be cured, nor any case that cannot recover. Generally, malaria is caused by wind-cold entering from the external oil membranes into the internal oil membranes. Zhang Zhongjing's treatment of malaria is based on the Shaoyang meridian, ensuring that pathogens entering from the exterior exit via the exterior. Modern practitioners, unaware of this principle, often focus on abruptly stopping symptoms, leading to recurrence because the root cause is not resolved. Whenever I use Zhang Zhongjing's methods to treat malaria, if one or two doses do not fully cure it, I advise the patient to take several more doses until recovery is complete and sustained. I have excerpted the original text here as a reference for those treating malaria, preserving ancient methods.
Zhang Zhongjing said: The pulse in malaria is naturally wiry. Wiry and rapid indicates much heat; wiry and slow indicates much cold; wiry, small, and tight suggests purgation is better. Wiry and slow can be treated with warming; wiry and tight can be treated with sweating or acupuncture; floating and large can be treated with emesis; wiry and rapid indicates wind-heat, which should be managed through dietary adjustments.
Tang Rongchuan said: The Neijing states that malaria pathogens hide in Fengfu and connect to the Mu Yuan (Membrane Source). Mu means membrane; the source of membranes is below the navel, which is the connecting network of the San Jiao (Triple Burner). Both San Jiao and Bladder are the residences of the Kidney. San Jiao is the Yang residence, transforming water that flows internally to become urine; Bladder is the Yin residence, transforming qi externally to become Wei Qi (Defensive Qi). The Neijing attributes malaria to Wei Qi issues, hence the pathogen is in the Taiyang meridian's Fengfu point. Zhang Zhongjing's commentary focuses on the San Jiao Membrane Source. Therefore, in malaria symptoms, clear urination is absent due to San Jiao dysfunction. Zhang Zhongjing's theory based on Shaoyang aligns with the Neijing. Later generations ignored the San Jiao, mistakenly claiming Zhang Zhongjing contradicted the Neijing.
Zhang Zhongjing said: If malaria starts on the first day of the lunar month, it should heal in fifteen days. If not healed, it should resolve by the end of the month. If still not healed, what then? Answer: This forms a mass called "Malaria Mother" (Nuo Mu). It requires urgent treatment with Biejia Jian Wan (Softshell Turtle Pill).
Biejia Jian Wan (Softshell Turtle Pill)
Trionycis Carapax et Plastron (Bie Jia, 1 qian, roasted), Belamcandae Rhizoma (She Gan, 1 qian), Scutellariae Radix (Huang Qin, 1 qian), Bupleuri Radix (Chai Hu, 1 qian), Psoraleae Fructus (Shu Fu, 1 qian), Zingiberis Rhizoma (Gan Jiang, 1 qian), Rhei Radix et Rhizoma (Da Huang, 1 qian), Cinnamomi Ramulus (Gui Zhi, 7 fen), Asteris Herba (Shi Wei, 1 qian, de-haired), Magnoliae Officinalis Cortex (Hou Po, 1 qian), Campsis Radix (Zi Wei, 1 qian), Pinelliae Rhizoma (Ban Xia, 7 fen), Ecorii Colla (E Jiao, 1 qian), Paeoniae Radix (Shao Yao, 1 qian), Moutan Cortex (Dan Pi, 1 qian), Echinospermi Semen (Jin Chong, 1 qian), Lepidii Semen (Ting Li, 1 qian), Ginseng Radix (Ren Shen, 1 qian), Dianthi Herba (Qu Mai, 1 qian), Vespa Nidus (Feng Ke, 1 qian), Natrii Nitras (Chi Xiao, 1 qian), Scarabaeus (Qiang Lang, 1 qian, roasted), Persicae Semen (Tao Ren, 2 qian).
Grind the above twenty-three ingredients into powder. Take one dou of ash from the kitchen stove and five sheng of clear wine. Boil until half the wine remains, add the softshell turtle carapace, and boil until it dissolves like glue. Strain the juice, add the other medicines, and decoct to form pills the size of mulberry seeds. Take seven pills on an empty stomach, three times a day. (Note: Qianjin Fang uses twelve pieces of Bie Jia, plus 3 fen of Sargassum and 1 fen of Euphorbia. No Shu Fu or Chi Xiao.)
Tang Rongchuan said: Malaria pathogens lie dormant in Ying Blood (Nutritive Blood). They manifest when Wei Qi meets them. Over time, Ying Blood coagulates to form Malaria Mother. Blocked Wei Qi generates phlegm. Thus, blood is the main component of Malaria Mother, while phlegm, generated by Wei Qi, is secondary. Treatment focuses on resolving blood stasis, assisted by moving phlegm and directing qi downward. Understanding this reveals why Zhang Zhongjing's formula contains many blood-breaking herbs: it treats Ying to unblock Wei.
Tu Weisheng said: Various schools debate the mechanism of initial chills followed by fever and the formation of Malaria Mother, but few provide convincing explanations. I speculate that malaria pathogens lodge on the Shaoyang oil membranes. Qi generated by the Lower Jiao must ascend along these membranes to reach the exterior as defense. Pathogens block this ascent, causing severe initial chills. After prolonged struggle between pathogen and healthy qi, the pathogen weakens and healthy qi strengthens. However, the more constrained the healthy qi, the more violently it erupts, causing intense subsequent fever. If pathogens exit with sweat, malaria may heal. Otherwise, if the patient is robust and generates healthy qi quickly, the conflict is urgent. Variations in daily or alternate-day attacks depend on the patient's constitution and qi generation speed. Ying Blood flow follows Wei Qi. When Wei Qi is blocked, Ying Blood stagnates, forming Malaria Mother. Even if pathogens exit, the blood stasis remains like dormant pathogens, allowing recurrence. Thus, Bie Jia, Jin Chong, Da Huang, and Tao Ren attack blood stasis. Hou Po and Ting Li regulate qi. Chai Hu and Gui Zhi release the exterior, while Ren Shen supports. E Jiao and Bai Shao nourish blood. Other clearing and draining herbs ensure pathogens are eliminated without forming Malaria Mother. I hope this view aligns with sage wisdom and welcomes correction from esteemed physicians.
Zhang Zhongjing said: When Yin qi is isolated and Yang qi alone flares, fever occurs with shortness of breath, vexation, hot hands and feet, and nausea, named Dan Malaria (Febrile Malaria). If there is only heat without cold, the pathogen hides internally in the Heart and externally in the muscle spaces, causing muscle wasting.
Tang Rongchuan said: Yin qi refers to Shaoyin Heart and Kidney. Yin deficiency causes fever, shortness of breath, and mental vexation. Pathogens entering the Heart indicate Shaoyin Yin isolation. Yang qi refers to Taiyang Bladder. Water-derived Yang transforms into heat to defend the body. Unchecked Yang causes pure heat; merging with Yangming causes hot limbs; merging with San Jiao causes vomiting; merging with skin and muscles causes wasting. Treat Shaoyin with Ji Zi Huang Tang (Chicken Egg Yolk Decoction); treat Taiyang with Baihu Tang (White Tiger Decoction). Later formulas like Qingwen Baidu Yin can treat both.
According to Records of the Grand Historian, wind-dan lodges in the Bladder. Dan Malaria also originates in the Bladder, opposite to Mu Malaria (Cold Malaria), which involves the Heart.
Zhang Zhongjing said: Wen Malaria (Warm Malaria) presents with a normal pulse, no chills but fever, painful joints, and occasional vomiting. Baihu Jia Guizhi Tang (White Tiger Plus Cinnamon Twig Decoction) is indicated.
Baihu Tang Plus Cinnamon Twig
Anemarrhenae Rhizoma (Zhi Mu, 1 qian), Gypsum Fibrosum (Shi Gao, 1 qian), Glycyrrhizae Radix et Rhizoma (Gan Cao, 1 qian), Oryza Sativa (Jing Mi, 1 qian), Cinnamomi Ramulus (Gui Zhi, 7 fen).
Tang Rongchuan said: Fever without chills is the primary indication for Baihu Tang. Gui Zhi is added for painful joints, indicating latent cold in the sinews/joints, which Gui Zhi expels.
Zhang Zhongjing said: Malaria with predominant chills is named Mu Malaria (Cold Malaria), treated with Shuqi San.
Shuqi San
Schizonepetae Spica (Shu Qi, 1 qian, roasted to remove fishy odor), Yunmu (Cloud Mother, 1 qian, roasted for two days/nights), Longgu (Dragon Bone, equal parts). Grind into powder. Take half a qian bi with grain water before onset.
Appendix: Three Formulas from Waitai Miyao:
Muli Tang (Oyster Shell Decoction) for Mu Malaria.
Ostrea Concha (Mu Li, 1 qian), Ephedrae Herba (Ma Huang, 1 qian), Glycyrrhizae Radix et Rhizoma (Gan Cao, 1 qian), Schizonepetae Spica (Shu Qi, 1 qian). Note: Shu Qi is the sprout of Dangschen (Dangshan/Costus root).
Chaihu Qu Banxia Gua Lou Gen Tang (Bupleurum Decoction minus Pinellia plus Trichosanthes Root) for malaria with thirst, also for Labor Malaria.
Bupleuri Radix (Chai Hu, 1 qian), Ginseng Radix (Ren Shen, 1 qian), Scutellariae Radix (Huang Qin, 1 qian), Glycyrrhizae Radix et Rhizoma (Gan Cao, 1 qian), Trichosanthis Radix (Gua Lou Gen, 1 qian), Zingiberis Rhizoma Recens (Sheng Jiang, 1 qian), Jujubae Fructus (Da Zao, 1 piece).
Chaihu Guijiang Tang (Bupleurum Plus Cinnamon Twig and Ginger Decoction) for malaria with much cold and slight heat, or only cold without heat. One dose works miraculously.
Bupleuri Radix (Chai Hu, 1 qian), Cinnamomi Ramulus (Gui Zhi, 7 fen), Zingiberis Rhizoma (Gan Jiang, 1 qian), Trichosanthis Radix (Gua Lou Gen, 1 qian), Scutellariae Radix (Huang Qin, 1 qian), Ostrea Concha (Mu Li, 1 qian).