久疟气虚脾胃弱,四兽益气等汤斟,劳疟鳖甲十全补,热除 桂入柴芩。
【注】久患疟疾,形气俱虚,脾胃弱不思食,宜用四兽饮、补中益气等汤,斟酌治之。
久病劳损,气血两虚,而病疟疾者,名曰劳疟。宜用十全大补汤,倍加鳖甲,热盛者除
去黄 、肉桂,加柴胡、黄芩也。
柴胡截疟饮 密佗僧散
诸疟发过三五次,表里皆清截法先,未清截早发不已,已清不截正衰难,截虚柴胡
截疟饮,小柴梅桃槟常山,截实不二佗僧散,烧酒冷调服面南。
【注】凡疟按法治之,发过三五次,表里无证,当先以截疟药截之。若表里未清截早,
则疟疾必复发之不已。表里已清不截,则正衰邪盛而难治也。截不足人之疟,宜用小柴
胡汤加常山、槟榔、乌梅、桃仁、姜、枣煎,并滓露一宿,次日发前一二时小温服,恶心
以糖拌乌梅肉压之。截有余人之疟,宜用不二饮全方,或密佗僧细末,大人七分,小儿
量之,冷烧酒调,面南如前法服之。一服不愈,再服必止,戒鸡、鱼、豆腐、面食、羹
汤、热粥、热物。
疟经年久不愈,疟母成块结癖 ,形实控涎或化滞,攻后余法与前同。
【注】 疟,经年不愈之老疟也。疟母,
久疟腹中成块癖也。形实宜用控涎丹以攻痰饮,或用化滞丸以攻积滞。攻后之余法,与
前所治疟法同也。
桂枝麻黄柴胡四物去杏仁加桃仁汤
疟在夜发三阴疟,桂麻柴物杏易桃,鬼疟尸注多恶梦,恐怖苏合效功高。
【注】疟在夜发,名曰三阴疟疾。初热宜用桂枝汤、麻黄汤、小柴胡汤、四物汤方合
剂,以杏仁易桃仁,增损汗之,汗解之后,余同前法。鬼疟亦多在夜发,由尸气注之,比
三阴疟疾、则夜多恶梦,时生恐怖,宜用苏合香丸治之。
久疟导致气虚、脾胃虚弱,应斟酌使用四兽饮、补中益气汤等方剂。劳疟需以鳖甲配合十全大补汤进行滋补;若热象明显,则去除肉桂,加入柴胡、黄芩。
【注】长期患疟疾,形体与正气均虚弱,脾胃功能弱且食欲不振,适宜使用四兽饮、补中益气汤等,根据具体情况斟酌治疗。
久病导致劳损,气血两虚而患疟疾的,称为劳疟。适宜使用十全大补汤,加倍加入鳖甲;若热势亢盛,则去掉黄柏(原文“黄”疑为黄柏或黄连之省称,此处依常规理解及上下文清热逻辑,结合WHO术语通常指代清热药,但原文仅一字“黄”,暂译为黄柏/黄连类清热药,鉴于后文有黄芩,此处“黄”可能指代黄柏或泛指苦寒药,为严谨起见,保留原意译为“黄柏”或“清热药”,但在标准翻译中,若原文模糊,通常结合语境。此处原文作“热盛者除去黄 、肉桂”,中间有空格,极可能是排版遗漏了“柏”字即黄柏,或者指“黄连”。考虑到十全大补汤中有肉桂温阳,热盛去温药加清热药是常理。故译为:若热势亢盛,则去掉黄柏和肉桂)、肉桂,加入柴胡、黄芩。
柴胡截疟饮、密佗僧散
疟疾发作过三到五次后,若表里证候已清,应先采用截疟法;若表里未清就过早截疟,疟疾必然反复发作不止;若表里已清却不截疟,则正气衰微、邪气强盛而难以治愈。对于正气不足之人患疟,适宜用柴胡截疟饮(由小柴胡汤加乌梅、桃仁、槟榔、常山组成);对于邪气有余之人患疟,适宜用不二饮或密佗僧散,用烧酒调匀,面向南方服用。
【注】凡是疟疾,按照正法治疗,发作过三到五次后,若表里没有其他证候,应当先用截疟药截断疟疾。如果表里证候未清除就过早截疟,那么疟疾必定会复发不止。如果表里证候已清除却不截疟,那么正气衰微、邪气强盛就会难以治疗。对于正气不足之人患疟,适宜用小柴胡汤加上常山、槟榔、乌梅、桃仁、生姜、大枣煎煮,并将药渣露置一夜,次日发病前一两个时辰温热服用,若有恶心症状,可用糖拌乌梅肉压制恶心感。对于邪气有余之人患疟,适宜使用不二饮全方,或者将密佗僧研成细末,成人七分,小儿酌情减量,用冷烧酒调服,面向南方按前述方法服用。一服药后未愈,再服必能止住,忌食鸡、鱼、豆腐、面食、羹汤、热粥、热物。
疟疾经年不愈,形成疟母(腹中结块),若体质壮实,可用控涎丹攻逐痰饮,或用化滞丸攻逐积滞;攻伐之后的后续治法与前文相同。
【注】老疟,是指经过多年不愈的顽固疟疾。疟母,是指久疟在腹中形成的结块癖积。若体质壮实,适宜用控涎丹来攻逐痰饮,或用化滞丸来攻逐积滞。攻伐后的余下治法,与前面所讲的治疟方法相同。
桂枝麻黄柴胡四物汤去杏仁加桃仁汤
疟疾在夜间发作的属于三阴疟,用桂枝汤、麻黄汤、小柴胡汤、四物汤四方合剂,将杏仁替换为桃仁。鬼疟、尸注多伴有恶梦,恐惧不安时,使用苏合香丸疗效显著。
【注】疟疾在夜间发作,称为三阴疟疾。初起发热时,适宜用桂枝汤、麻黄汤、小柴胡汤、四物汤四方合剂,以杏仁替换桃仁,增减发汗药物,汗出病解之后,其余治法同前。鬼疟也多在夜间发作,由尸气传染所致,相比三阴疟疾,夜间多恶梦,时常产生恐怖感,适宜用苏合香丸治疗。
Prolonged malaria leads to Qi deficiency and weak Spleen-Stomach; one should carefully consider using formulas such as Six Beast Decoction (Sishou Yin) or Buzhong Yiqi Tang. For consumptive malaria, supplement with Biejia (Mantis Egg Case) combined with Shiquan Dabu Tang; if heat is prominent, remove Rougui (Cinnamon Twig) and add Chaihu (Bupleuri Radix) and Huangqin (Scutellariae Radix).
[Note] Long-standing malaria results in depletion of both form and Qi, with weak Spleen-Stomach function and loss of appetite. It is appropriate to use Six Beast Decoction (Sishou Yin) or Buzhong Yiqi Tang, adjusting according to the specific condition.
When chronic illness causes consumption, leading to dual deficiency of Qi and Blood, resulting in malaria, it is termed Consumptive Malaria (Lao Nue). It is appropriate to use Shiquan Dabu Tang (Ten Significant Decoction), doubling the dosage of Biejia (Mantis Egg Case); if heat is excessive, remove Huangbai (Phellodendri Cortex) [Note: Original text says "Huang", context implies a bitter-cold herb like Huangbai or Huanglian, here translated as Huangbai based on standard pairing with Rougui removal for heat] and Rougui (Cinnamon Twig), adding Chaihu (Bupleuri Radix) and Huangqin (Scutellariae Radix).
Chaihu Ji Nue Yin (Bupleurum Antimalarial Decoction), Mituoseng San (Mituo Seng Powder)
After malaria has attacked three to five times, if the exterior and interior are clear, the method of interception should be applied first. If interception is performed too early while the exterior and interior are not yet clear, the malaria will inevitably recur continuously. If the exterior and interior are clear but interception is not performed, the healthy Qi will decline while pathogenic factors flourish, making it difficult to treat. For patients with deficient healthy Qi suffering from malaria, Chaihu Ji Nue Yin (composed of Xiaochaihu Tang plus Changshan, Binglang, Wumei, Tao Ren) is suitable. For patients with excess pathogenic factors, Bu'er Yin or Mituoseng San is suitable, mixed with roasted wine and taken facing south.
[Note] Generally, after treating malaria according to correct principles, once it has attacked three to five times and there are no remaining exterior or interior symptoms, antimalarial interception drugs should be used first. If interception is attempted before the exterior and interior pathogens are cleared, the malaria will surely recur incessantly. If the exterior and interior are cleared but interception is not done, the decline of healthy Qi and flourishing of pathogens will make treatment difficult. For those with insufficient healthy Qi, use Xiaochaihu Tang (Minor Bupleurum Decoction) added with Changshan (Radix Dichroae), Binglang (Arecae Semen), Wumei (Fructus Mume), Tao Ren (Persicae Semen), Shengjiang (Zingiberis Rhizoma Recens), and Dazao (Jujubae Fructus). Boil and let the dregs stand exposed overnight; take warm one to two hours before the next attack the following day. To counteract nausea, mix Wumei flesh with sugar. For those with excess pathogens, use the complete formula of Bu'er Yin, or fine powder of Mituoseng, 7 fen for adults, adjusted for children, mixed with cold roasted wine and taken facing south as described above. If one dose is ineffective, a second dose will certainly stop it. Avoid chicken, fish, tofu, wheat products, soups, hot congee, and hot foods.
If malaria persists for years without cure, a mass known as Malaria Mother (Nue Mu) forms in the abdomen. If the constitution is strong, use Kongxian Dan (Control Phlegm Pill) to attack phlegm-fluids, or Huazhi Wan (Eliminate Stasis Pill) to attack accumulation; subsequent treatments after purgation are the same as previously described.
[Note] Old malaria refers to stubborn malaria that has persisted for years. Malaria Mother refers to the masses and accumulations formed in the abdomen due to prolonged malaria. If the constitution is strong, Kongxian Dan is suitable to purge phlegm-fluids, or Huazhi Wan is suitable to purge stagnation. The remaining treatment methods after purgation are the same as the malaria treatments mentioned earlier.
Guizhi Mahuang Chaihu Siwu Tang minus Xingren plus Tao Ren Decoction
Malaria occurring at night belongs to the Three Yin malaria. Use a combined formula of Guizhi Tang, Mahuang Tang, Xiaochaihu Tang, and Siwu Tang, replacing Xingren (Armeniacae Semen Amarum) with Tao Ren (Persicae Semen). Ghost malaria and Shi Zhu often involve bad dreams; when accompanied by terror, Suhexiang Wan (Styrax Pill) yields high efficacy.
[Note] Malaria occurring at night is called Three Yin Malaria. In the initial stage of fever, it is appropriate to use a combined formula of Guizhi Tang, Mahuang Tang, Xiaochaihu Tang, and Siwu Tang, replacing Xingren with Tao Ren, adjusting diaphoretic herbs. After sweating resolves the condition, the remaining treatment follows previous methods. Ghost malaria also mostly occurs at night, caused by transmission of corpse-qi. Compared to Three Yin malaria, it involves more bad dreams at night and frequent feelings of terror; it is appropriate to treat with Suhexiang Wan (Styrax Pill).