凡人向有他病 羸，或久疟，或内伤瘀血，或吐血便血咳血，男子遗精白浊、精
气枯涸，女人崩漏带下、血枯经闭之类，以致肌肉消烁，邪火独存，故脉近于数也。此际稍感
疫气，医家病家，见其谷食暴绝，更加胸膈痞闷、身疼发热，彻夜不寐，指为原病加重，误
以绝谷为脾虚，以身痛为血虚，以不寐为神虚，遂投参、术、归、地、茯神、枣仁之类，愈
进愈危。知者稍以疫法治之，发热减半，不时得睡，谷食稍进，但数脉不去，肢体时疼，胸
胁锥痛，过期不愈。医以杂药频试，补之则邪火愈炽，泻之则损脾坏胃，滋之则胶邪愈固，
散之则经络益虚，疏之则精气愈耗，守之则日消近死。盖但知其伏邪已溃，表里分传，里证
虽除，不知正气衰微，不能托出，表邪留而不去，因与血脉合而为一，结为痼疾也。肢体时
疼者，邪与荣气搏也；脉数身热不去者，邪火并郁也；胁下锥痛者，火邪结于膜膈也；过期
不愈者，凡疫邪交卸，近在一七，远在二七、甚至三七，过此不愈者，因非其治，不为坏证
即为痼疾也。夫痼疾者，所谓客邪胶固于血脉，主客交浑，最难得解，且愈久益固，治法当乘其大肉未消、真元
未败，急用三甲散，多有得生者。更附加减法，随其素而调之。
三甲散
鳖甲 龟甲（并用酥炙黄为末，各一钱，如无酥，各以醋炙代之） 穿山甲（土炒黄为末，五分）
蝉蜕
） 虫（三个，干者擘碎，鲜者捣烂和酒少许，取汁入汤药同服，其渣入诸药同煎）
白芍药（酒炒，七分） 当归（五分） 甘草（三分）
水二钟煎八分，沥渣温服。若素有老疟或瘅疟者，加牛膝一钱，何首乌一钱；胃弱欲作泻
者，宜九蒸九晒；若素有郁痰者，加贝母一钱；有老痰者，加栝蒌霜五分；善呕者，勿用；
若咽干作痒者，加花粉、知母各五分；若素燥咳者，加杏仁（捣烂）一钱五分；若素有内伤瘀
血者，倍 虫，如无 虫，以干漆（炒烟尽为度，研末）五分，及桃仁（捣烂）一钱
代之，服后病减半勿服，当尽调理法。
凡是原本患有其他疾病，身体瘦弱的人，或者长期患疟疾，或者体内有瘀血停滞，或者有吐血、便血、咳血等症状，男子出现遗精、白浊导致精气枯竭干涸，女子出现崩漏、带下、血枯经闭等情况，从而导致肌肉消瘦萎缩，邪火独自留存，所以脉象接近数脉。这个时候稍微感染了疫气，医生和病人家属，看到他们突然停止进食，再加上胸膈部痞塞闷胀、身体疼痛发热，整夜无法入睡，就认为是原来的旧病加重了，错误地把停食当作脾虚，把身痛当作血虚，把失眠当作神气虚弱，于是投用人参、白术、当归、地黄、茯神、酸枣仁之类的药物，病情越是进补就越危险。懂行的人稍微用治疗疫病的方法处理，发热减半，不时能够入睡，饮食稍有好转，但是数脉没有消失，肢体时常疼痛，胸胁像锥刺一样疼痛，过了期限也没有痊愈。医生频繁尝试各种杂药，补益则邪火更加炽盛，泻下则损伤脾胃，滋润则使邪气胶结牢固，发散则经络更加虚弱，疏通则精气更加耗散，固守原法则日渐消瘦接近死亡。大概只知道伏匿的邪气已经溃散，表里分传，里证虽然清除，却不知道正气衰微，不能托举邪气外出，表邪停留而不去除，因而与血脉结合为一体，结成顽固的疾病。肢体时常疼痛的，是邪气与营气搏结；脉数身热不消退的，是邪火并聚郁滞；胁下锥刺样疼痛的，是火邪结于膜膈之间；过了期限不痊愈的，凡是疫邪交接替换，近的在一七天，远的在二七天，甚至三七天，超过这个时间还不痊愈的，是因为治疗方法不对，不是变成坏证就是成为痼疾。所谓痼疾，就是所说的客邪胶着牢固在血脉中，主客交浑，最难得以解除，而且时间越久越坚固，治疗方法应当趁着大肉尚未消瘦、真元尚未败坏的时候，紧急使用三甲散，大多能够存活。再附加加减法，根据患者平素体质进行调理。
三甲散
鳖甲、龟甲（都用酥油炙烤至黄色后研成粉末，各一钱，如果没有酥油，各用醋炙代替）、穿山甲（土炒至黄色后研成粉末，五分）、䗪虫（三个，干的掰碎，鲜的捣烂并加少许酒，取汁液加入汤药中同服，其药渣与其他药物同煎）、白芍药（酒炒，七分）、当归（五分）、甘草（三分）。
用水两钟煎煮至八分，滤去药渣温服。如果平素有老疟或瘅疟的，加牛膝一钱，何首乌一钱；胃弱想要腹泻的，宜用九蒸九晒制的药材；如果平素有郁痰的，加贝母一钱；有老痰的，加栝蒌霜五分；容易呕吐的，不要用此方；如果咽喉干燥发痒的，加天花粉、知母各五分；如果平素燥咳的，加杏仁（捣烂）一钱五分；如果平素有内伤瘀血的，加倍使用䗪虫，如果没有䗪虫，用干漆（炒至烟尽为度，研末）五分，以及桃仁（捣烂）一钱来代替，服用后病情减半就不要继续服用，应当完全按照调理方法处理。
Any person who previously suffered from other diseases, was emaciated (emaciation), or had long-term malaria (malaria), or internal injury with blood stasis (blood stasis due to trauma or disease), or hematemesis (vomiting blood), melena (blood in stool), or hemoptysis (coughing up blood); men suffering from spermatorrhea (involuntary emission of semen) and leukorrhea (white discharge), leading to exhaustion of essence and qi; women suffering from metrorrhagia (uterine bleeding not during menstruation), leukorrhea, blood deficiency amenorrhea (amenorrhea due to blood deficiency), etc., resulting in wasting of muscles, with pathogenic fire remaining alone, thus the pulse approaches rapidity (rapid pulse). At this time, if slightly infected by epidemic qi (epidemic pathogen), physicians and patients' families, seeing the sudden cessation of grain and food intake, plus chest and diaphragm fullness and oppression (chest stuffiness), body pain, fever, and insomnia throughout the night, would mistakenly attribute it to the aggravation of the original disease. They erroneously interpreted the lack of appetite as spleen deficiency (spleen qi deficiency), body pain as blood deficiency (blood insufficiency), and insomnia as spirit deficiency (shen deficiency). Consequently, they administered herbs such as Renshen (Ginseng Root), Baizhu (Atractylodis Rhizoma), Danggui (Angelicae Sinensis Radix), Dihuang (Rehmanniae Radix), Fushen (Poria with Hostwood), and Suanzaoren (Ziziphi Spinosomi Semen). The more tonification was applied, the more critical the condition became. Those knowledgeable treated it slightly according to epidemic disease methods: fever halved, sleep occurred occasionally, and food intake improved slightly, but the rapid pulse remained, limbs ached intermittently, and chest/hypochondriac pain felt like needle pricks, failing to heal after the expected period. Physicians frequently tried miscellaneous medicines: tonifying intensified the pathogenic fire; purging damaged the spleen and stomach; moistening made the pathogen more firmly adherent; dispersing further weakened the meridians; unblocking further depleted essence and qi; maintaining the status quo led to daily wasting and near-death. It is generally known that the latent pathogen has溃散 (scattered), transmitting between exterior and interior; although interior symptoms are cleared, it is unknown that righteous qi (zheng qi) is weak and cannot push out the pathogen. Exterior pathogens remain and do not depart, merging with blood vessels to form one entity, resulting in stubborn disease (stubborn illness). Intermittent limb pain indicates pathogen battling with Ying Qi (nutritive qi); persistent rapid pulse and fever indicate pathogenic fire gathering and stagnating; hypochondriac stabbing pain indicates fire pathogen knotting in the membrane diaphragm (membrane partition); failure to heal after the period indicates that for epidemic pathogens to exchange/resolve, it takes near 7 days, far 14 days, or even 21 days. If it does not heal beyond this, it is due to incorrect treatment, resulting either in complicated syndrome (bad syndrome) or stubborn disease. Stubborn disease refers to external pathogens firmly adhering in blood vessels, where host and guest become indistinguishable (host-guest entanglement), which is hardest to resolve, and becomes more fixed over time. Treatment should be undertaken while flesh is not yet wasted and true yuan (original qi) is not yet failed, urgently using Sanjia San (Three Shells Powder), with many surviving. Further modifications should be added, adjusting according to the patient's constitution.
Sanjia San (Three Shells Powder)
Biejia (Trionycis Carapax), Guijia (Testudinis Carapax) (both roasted with rendered animal fat until yellow and powdered, each 1 qian; if no fat, roast with vinegar instead), Chuanshanjia (Manis Squama) (soil-roasted until yellow and powdered, 5 fen), E chong (Asiatic Ground Beetle) (3 specimens, dry ones broken, fresh ones mashed with a little wine, juice extracted and added to decoction, dregs boiled with other herbs), Baishao Yao (Paeoniae Radix Alba) (wine-fried, 7 fen), Danggui (Angelicae Sinensis Radix, 5 fen), Gancao (Glycyrrhizae Radix et Rhizoma, 3 fen).
Decoct in 2 zhong of water until 8 fen remains, strain dregs and take warm. If there is chronic malaria or hot malaria (dan malaria), add Niuxi (Achyranthis Bidentatae Radix) 1 qian, Heshouwu (Polygoni Multiflori Radix) 1 qian; if spleen/stomach weakness leads to diarrhea, use nine-steamed nine-dried preparations; if there is stagnant phlegm, add Beimu (Fritillariae Thunbergii Bulbus) 1 qian; if there is old phlegm, add Gualou Shuang (Trichosanthis Fructus Pulvis) 5 fen; if prone to vomiting, do not use; if throat is dry and itchy, add Huafen (Trichosanthis Radix) and Zhimu (Anemarrhenae Rhizoma) each 5 fen; if prone to dry cough, add Xingren (Armeniacae Semen Amarum, mashed) 1.5 qian; if there is internal injury with blood stasis, double the dose of E chong; if E chong is unavailable, substitute with Ganqi (Dry Resin of Commiphora, stir-baked until smoke ceases, powdered) 5 fen and Taoren (Persicae Semen, mashed) 1 qian. After taking, if symptoms halve, stop administration and proceed with conditioning methods.