五十、骨节疼烦，时呕，其脉如平，但热不寒，名曰温疟，白虎加桂枝汤主之。
阴气先伤，阳气独发，故但热不寒，令人消烁肌肉，与伏暑相似，亦温病之类也。彼此实足以相
混，故附于此，可以参观而并见。治以白虎加桂枝汤者，以白虎保肺清金，峻泻阳明独胜之热，使不
消烁肌肉，单以桂枝一味，领邪外出，作向导之官，得热因热用之妙。经云∶“奇治之不治，则偶治之，
偶治之不治，则求其属以衰之”，是也，又谓之复方。
白虎加桂枝汤方（辛凉苦甘复辛温法）
知母（六钱） 生石膏（一两六钱） 粳米（一合） 桂枝木（三钱） 炙甘草（二钱）
水八碗，煮取三碗。先服一碗，得汗为知，不知再服，知后仍服一剂，中病即已。
五一、但热不寒，或微寒多热，舌干口渴，此乃阴气先伤，阳气独发，名曰瘅疟，五汁饮主之。
仲景于瘅疟条下，谓以饮食消息之，并未出
方，调如是重病而不用药，特出饮食二字，重胃气可知。阳明于脏象为阳土，于气运为燥金，病系阴
伤阳独，法当救阴何疑。重胃气，法当救胃阴何疑。制阳土燥金之偏胜，配孤阳之独亢，非甘寒柔
润而何！此喻氏甘寒之论，其超卓无比伦也。叶氏宗之，后世学人，咸当宗之矣。
五汁饮（方见前）
〔加减法〕此甘寒救胃阴之方也。欲清表热。则加竹叶、连翘；欲泻阳明独胜之热，而保肺之化
源，则加知母；欲救阴血，则加生地、元参；欲宣肺气，则加杏仁；欲行三焦开邪出路，则加滑石。
五二、舌白渴饮，咳嗽频仍，寒从背起，伏暑所致，名曰肺疟，杏仁汤主之。
肺疟，疟之至浅者。肺疟虽云易解，稍缓则深，最忌用治疟印板俗例之小柴胡汤，盖肺去少阳
半表半里之界尚远，不得引邪深入也，故以杏仁汤轻宣肺气，无使邪聚则愈。
杏仁汤方（苦辛寒法）
杏仁（三钱） 黄芩（一钱五分） 连翘（一钱五分） 滑石（三钱） 桑叶（一钱五分） 茯苓块（三钱） 白
蔻皮（八分） 梨皮（二钱）
水三杯，煮取二杯，日再服。
五三、热多昏狂，谵语烦渴，舌赤中黄，脉弱而数，名曰心疟，加减银翘散主之；兼秽，舌浊口气
重者，安宫牛黄丸主之。
心疟者，心不受邪，受邪则死，疟邪始受在肺，逆传心包络。其受之浅者，以加减银翘散清肺与膈中之热，领邪出
卫；其受之重其，邪闭心包之窍，则有闭脱之危，故以牛黄丸，清宫城而安君主也。
加减银翘散方（辛凉兼芳香法）
连翘（十分） 银花（八分） 元参（五分） 麦冬（五分，不去心） 犀角（五分） 竹叶（三分）
共为粗末，每服五钱，煎成去渣，点荷叶汁二、三茶匙。日三服。
安宫牛黄丸方（见前）
第五十条：骨节疼痛烦扰，时常呕吐，脉象看似正常，只有发热而没有恶寒，称为温疟，用白虎加桂枝汤主治。
阴气先受损，阳气独自亢盛，所以只有发热而没有恶寒，导致肌肉消瘦枯槁，这与伏暑相似，也属于温病的一类。两者确实容易混淆，所以附记于此，可以参照对照并见。治疗使用白虎加桂枝汤的原因在于：白虎汤能保护肺脏、清肃肺气，猛烈泻除阳明经独盛的邪热，防止其消烁肌肉；单用桂枝这一味药，引导邪气外出，充当向导的角色，体现了“热因热用”的妙处。《内经》说：“奇方治不好，就用偶方；偶方治不好，就寻求与病根相关的药物来削弱它”，说的就是这种情况，这又被称为复方。
白虎加桂枝汤方（辛凉苦甘复辛温法）
知母（六钱） 生石膏（一两六钱） 粳米（一合） 桂枝木（三钱） 炙甘草（二钱）
用水八碗，煮取三碗。先服用一碗，出汗后症状缓解即为见效，若未见效再服，见效后仍继续服用一剂，中病即止。
第五十一条：只有发热没有恶寒，或者微有恶寒但热势重，舌干口渴，这是阴气先受损，阳气独自亢盛，称为瘅疟，用五汁饮主治。
张仲景在瘅疟条下，说通过饮食调养来观察病情，并没有给出具体方剂，调理如此重病却不用药，特意强调“饮食”二字，可知重视胃气的重要性。阳明在脏腑象数中属阳土，在气运中属燥金，病症属于阴伤而阳独亢，治疗方法应当救阴，有何可疑？重视胃气，治疗方法应当救胃阴，有何可疑？制约阳土燥金的偏胜，配伍孤阳的独亢，除了甘寒柔润的药物还能用什么！这是喻嘉言关于甘寒治疗的论述，其高超卓越无与伦比。叶天士遵循此法，后世学人，都应当遵循此法。
五汁饮（方见前文）
〔加减法〕这是甘寒救治胃阴的方子。想要清除表热，则加竹叶、连翘；想要泻除阳明独盛的邪热，并保护肺的化源，则加知母；想要救治阴血，则加生地、元参；想要宣通肺气，则加杏仁；想要疏通三焦开辟邪气出路，则加滑石。
第五十二条：舌苔白且口渴想喝水，咳嗽频繁不断，寒气从背部升起，由伏暑引起，称为肺疟，用杏仁汤主治。
肺疟，是疟疾中病位最浅的。肺疟虽然说是容易解除，但如果稍加拖延则会深入，最忌讳使用治疗疟疾刻板俗套的小柴胡汤，因为肺距离少阳半表半里的界限还很远，不能引邪深入，所以用杏仁汤轻宣肺气，不让邪气聚集就能痊愈。
杏仁汤方（苦辛寒法）
杏仁（三钱） 黄芩（一钱五分） 连翘（一钱五分） 滑石（三钱） 桑叶（一钱五分） 茯苓块（三钱） 白蔻皮（八分） 梨皮（二钱）
用水三杯，煮取两杯，每天分两次服用。
第五十三条：热势重且神志昏狂，胡言乱语烦躁口渴，舌质红中间苔黄，脉弱而快，称为心疟，用加减银翘散主治；兼有秽浊之气，舌苔浑浊口气重的，用安宫牛黄丸主治。
心疟，心脏不受邪气侵犯，一旦受邪就会死亡，疟邪最初受于肺，逆传至心包络。受邪较浅的，用加减银翘散清除肺与膈中的热邪，引导邪气出离卫分；受邪较重的，邪气闭阻心包之窍，则有闭证和脱证的危险，所以用牛黄丸，清理清宫以安定君主。
加减银翘散方（辛凉兼芳香法）
连翘（十分） 银花（八分） 元参（五分） 麦冬（五分，不去心） 犀角（五分） 竹叶（三分）
共研为粗末，每次服用五钱，煎成去渣，滴入荷叶汁二、三茶匙。每天服用三次。
安宫牛黄丸方（见前文）
Article 50: Pain and vexation in the bone joints, occasional vomiting, pulse appearing normal, only fever without chills, is named Warm Malaria (Wen Nüe), treated with Baihu Jia Guizhi Tang.
Yin Qi (Vital Energy of Yin) is damaged first, while Yang Qi (Vital Energy of Yang) flares up alone; thus, there is only fever without chills, causing muscles to emaciate. This resembles Fu Shu (Hidden Summerheat), and also belongs to the category of Wen Bing (Warm Diseases). The two are indeed easily confused, so it is appended here for reference and comparison. The reason for treating with Baihu Jia Guizhi Tang is that Baihu Tang protects the Lung and clears Metal (Lung Qi), vigorously draining the excessive heat of the Yangming channel to prevent muscle emaciation. Using only Guizhi (Cinnamon Twig) guides the pathogen outward, acting as a guide officer, embodying the subtlety of "treating heat with heat." The Classics state: "If the odd prescription fails, use the even prescription; if the even prescription fails, seek the related organ/element to subdue it." This applies here, also known as a Compound Prescription (Fu Fang).
Baihu Jia Guizhi Tang Formula (Pungent-Cool Bitter-Sweet combined with Pungent-Warm method)
Zhimu (Anemarrhenae Rhizoma, 6 qian) Sheng Shigao (Gypsum Fibrosum, 1 liang 6 qian) Jingmi (Oryza Sativa, 1 he) Guizhi Mu (Ramulus Cinnamomi, 3 qian) Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma, 2 qian)
Use eight bowls of water, decoct to obtain three bowls. Take one bowl first; if sweating occurs and symptoms resolve, it is effective. If not, take another dose. After effectiveness, continue with one more dose. Stop when the disease is cured.
Article 51: Only fever without chills, or slight chills with heavy heat, dry tongue and thirst, indicates Yin Qi was damaged first and Yang Qi flared up alone, named Dan Nüe (Crimson Malaria), treated with Wuzhi Yin.
Jingue (Zhang Zhongjing) under the Dan Nüe article stated to manage it through diet and observation, without providing a specific formula. Treating such a severe illness without medicine emphasizes the word "diet," highlighting the importance of Stomach Qi. Yangming corresponds to Yang Earth in Zang-Fu imagery and Dry Metal in Qi dynamics. The pathology involves Yin damage and solitary Yang hyperactivity; the method must be to nourish Yin, beyond doubt. Emphasizing Stomach Qi implies the method must be to nourish Stomach Yin, beyond doubt. To counteract the excess of Yang Earth and Dry Metal, and to balance the solitary hyperactivity of Yang, what else but Sweet-Cool and Moistening herbs! This refers to Yu's theory of Sweet-Cool treatment, which is unparalleled in its excellence. Ye Tianshi followed this, and later scholars should all follow it.
Wuzhi Yin (Formula seen previously)
[Modifications] This is a Sweet-Cool formula to rescue Stomach Yin. To clear exterior heat, add Zhuye (Phyllostachys Nitida Leaf) and Lianqiao (Forsythiae Fructus); to drain the excessive heat of Yangming and protect the source of Lung transformation, add Zhimu; to rescue Yin blood, add Shengdi (Rehmanniae Radix) and Yuan Shen (Scrophulariae Radix); to diffuse Lung Qi, add Xingren (Armeniacae Semen Amarum); to open the Sanjiao and provide an exit for pathogens, add Huashi (Talcum).
Article 52: White tongue coating, thirst with desire to drink, frequent coughing, cold sensation rising from the back, caused by hidden summerheat, named Fei Nüe (Lung Malaria), treated with Xingren Tang.
Fei Nüe is the shallowest form of malaria. Although Fei Nüe is said to be easy to resolve, if delayed slightly it becomes deep. It is most taboo to use the stereotypical Xiaochaihu Tang (Minor Bupleurum Decoction) for treating malaria, because the Lung is far from the boundary of Shaoyang's half-exterior and half-interior, so one must not lead the pathogen deeper. Therefore, Xingren Tang lightly diffuses Lung Qi, preventing pathogen aggregation leads to recovery.
Xingren Tang Formula (Bitter-Pungent Cold method)
Xingren (Semen Armeniacae Amarum, 3 qian) Huangqin (Scutellariae Radix, 1 qian 5 fen) Lianqiao (Forsythiae Fructus, 1 qian 5 fen) Huashi (Talcum, 3 qian) Sangye (Mori Folium, 1 qian 5 fen) Fuling Kuai (Poria, 3 qian) Baikou Pi (Pericarpium Amomi Rotundus, 8 fen) Lipi (Pericarpium Pyri, 2 qian)
Use three cups of water, decoct to obtain two cups. Take twice daily.
Article 53: Heavy heat with confusion and mania, delirious speech, irritability and thirst, red tongue with yellow center coating, weak and rapid pulse, named Xin Nüe (Heart Malaria), treated with Jiawei Yinqiao San; if accompanied by turbid qi and heavy breath odor, Angong Niuhuang Wan is used.
In Xin Nüe, the Heart does not accept pathogens; if it accepts them, death ensues. The malaria pathogen initially enters the Lung and transmits reversely to the Pericardium. For shallow infection, Jiawei Yinqiao San clears heat in the Lung and Diaphragm, leading the pathogen out of the Wei level. For severe infection, the pathogen blocks the orifices of the Pericardium, posing risks of closure or collapse syndromes; thus, Niuhuang Wan is used to clear the Palace City and pacify the Monarch.
Jiawei Yinqiao San Formula (Pungent-Cool combined with Aromatic method)
Lianqiao (Forsythiae Fructus, 10 fen) Yinhua (Lonicerae Japonicae Flos, 8 fen) Yuan Shen (Scrophulariae Radix, 5 fen) Maidong (Ophiopogonis Radix, 5 fen, do not remove heart) Xijiao (Rhinocerotis Cornu, 5 fen) Zhuye (Phyllostachys Nitida Leaf, 3 fen)
Grind into coarse powder. Take 5 qian per dose, decoct, strain, and add 2-3 teaspoons of Helianthus Tuberosus juice (He Ye Zhi). Take three times daily.
Angong Niuhuang Wan Formula (See previously)