余赋性孱弱。幼婴多病。迨丁年尤甚。尝患内伤。诸药罔效。于是悉取内经。难经。甲乙经。
东垣十书。伤寒六书各论。及薛氏等书。至于殊国僻壤。奇方怪疾。皆沿波溯源。推详考索。
循古人之余而为之。不知其已瘳已。人情莫不欲言其所自。知交亲承是谬。推庸多奏效。妄意遂谓
凡病不出伤寒内伤之范围也。壬寅秋。天时热甚。入冬仍不寒。四方疫疠大作。其证似疟而寒热不闲。
似伤寒而三阳经少阴太阴经证齐。似内伤而气口脉不大于人迎。向所妄意以自信者。胥失之矣。
彼以伤寒治者七日逝。以内伤治。以疟治者。先后亦逝。间有染轻本固者。稍淹浃旬。终归不起。至
一发不能言者。其死尤速。惟轻而不服药者。百起一二。即老医宿匠。计与术两穷矣。然天地之大德曰生。
塞极必有以通之者。有宋李
待制之书在也。书名瘴疟卫生方。专是一证。始以风壤阔越。一涉猎而置之。而后乃知其宝也。
论证则辨晰周详。用药则简易平顺。此真妙于治也。且诸书疟部亦尝及瘴疟矣。本末未甚悉。岂
身履其地。传不获习乎。待制造端王张讨润。皆因宦彼地。得其真诠。是书赖以全。予始以一二及十百。
因沿乡曲面流疏远。随手应心。刻期色起矣。予秘之。是以人命为私也。告之同业。惧不能遍。
谋梓以广之。区区之公而已。客有告之者曰。夫疟何有于瘴哉。闽广之间。山深雨淫。积岚为瘴。
黄雾隐天。中人作苦。吾信界在中土。土不同方。风亦殊俗。旷绝千里。岚瘴何从。母乃巧于署名以
炫技乎。余曰。否否。诸疾之作。由天时也。四时之变。由气数也。人身肖天地与气顺逆也。易曰。
观乎天文以察时变。其征在国。国实以人。天气流转。山泽通之。以时验变。以人验时。奥气不藏。
时之变也。物直槎夭。人直疾病。山川不必同。而气至则行之矣。故吾信不必闽广而气类之。此瘴疟之
所由作也。且如癸卯之冬。四山花木盎然。如春甲辰夏仲菊华如秋六月反拥絮。春秋陨霜不杀。
注谓四时失其序。则其施必悖。月令仲夏行秋令。民殃于疫。在昔识之。盖天失其序。 气旁行。
于是乎在迩。年以来冬复大暖。草木禽虫不含不蛰。殆物得气之先。与韩昌黎雪拥蓝关句。李唐
岭南尚雪。今绝无之。驯至洛阳。杜鹃天气。自南而北。不尤信乎。客因领之。予又谓瘴疟于文为疟。
章言疾彰于外。内无实也。为疟如虎。反爪向人也。以疟施无实之人。故多濒于死。李待制之调剂。
思深哉。不揣愚陋。次其源委。附以鄙见。别伤寒内伤诸疟之形似。详药饵之宜用宜禁。验病色之
可治弗治。编曰瘴疟指南。车僭妄之罪固无所逃。然于活人。或有小补。庸有未尽。以俟后之君子。
万历三十七年岁次己酉十月朔信州郑全望撰。
我天性体弱。幼年时多病。到了二十岁（丁年）时病情更加严重。曾经患有内伤，各种药物都没有效果。于是我把《内经》、《难经》、《甲乙经》、李东垣的《十书》、张仲景的《伤寒六书各论》，以及薛己等人的书籍全部找来阅读。对于边远地区的奇特药方和怪异的疾病，我也顺着线索追溯源头，深入推究考察。遵循古人的经验来行事，不知道自己的病是否已经痊愈。人之常情，没有人不想宣扬自己的主张。知己亲友亲身承受了这种谬误，推崇平庸且大多奏效的方法，便妄自认为所有的病都不出伤寒和内伤的范畴。
壬寅年秋季，天气异常炎热，进入冬天仍然不寒冷。各地瘟疫大规模爆发。那些病症像疟疾，但寒热发作没有间歇；像伤寒，但太阳、阳明、少阳三阳经与少阴、太阴经的症状同时出现；像内伤，但气口脉象并不大于人迎脉。过去我所妄自信以为正确的理论，全都失效了。
那些用治疗伤寒的方法治疗的，七天内就去世了；用治疗内伤方法治疗的，以及用治疗疟疾方法治疗的，先后也都去世了。偶尔有感染较轻且体质本固的人，稍微拖延十天半个月，最终也未能挽回生命。至于发病后连话都说不出来的人，死亡尤其迅速。只有病情轻浅且不服药的人，百分之一二能存活下来。即使是老练的医生，在计谋和技术上都已穷尽无奈。然而天地最大的德行是赋予生命，闭塞到极点必然会有通达的办法。宋代李待制的著作还在。那本书名叫《瘴疟卫生方》，专门针对这一类证候。起初因为觉得风土环境差异太大，我只是粗略翻阅后就搁置一旁，后来才知道它的珍贵。
书中论证辨析周详细致，用药简易平顺。这真是精通治疗之道啊。而且其他书籍的疟疾部分也曾提到过瘴疟，但对本末细节叙述得不够详尽，难道是作者未曾亲历其地，导致传承学习有所欠缺吗？李待制曾为端王张讨润诊治，都是因为宦游在那片土地，才获得了真正的精髓，这本书才得以完整流传。我开始只抄录一二处，后来扩展到十处百处，沿着乡曲曲面流传疏远之处，随手记录心得，按期整理，色彩鲜明地呈现出来。我将其秘藏起来，这是把人命当作私有财产。告知同行，又担心不能普及，于是谋划刻印以广泛传播。这只是我一点点的公心罢了。
有位客人告诉我：“疟疾和瘴气有什么关系呢？闽广之间，山深雨多，积聚岚气成为瘴气，黄雾遮蔽天空，中人受苦。我相信界限在中土，地方不同，风俗也不同，旷野千里隔绝，岚瘴从何而来？难道是为了炫耀技艺而巧妙署名吗？”我说：“不对不对。各种疾病的产生，是由天时决定的。四季的变化，是由气数决定的。人身效法天地，与气的顺逆相应。《易经》说：‘观乎天文以察时变。’其征兆在国家，国家实际上是由人构成的。天气流转，山川沼泽与之相通。按时令验证变化，用人验证时令。深奥之气如果不隐藏，就是时令的变化。万物直接遭受夭折，人直接遭受疾病。山川不必相同，但气一到就会运行。所以我相信不必局限于闽广，只要气类相同，这就是瘴疟产生的原因。”
“况且如癸卯年的冬天，四面山上的花木茂盛盎然，如同春天；甲辰年夏末菊花盛开如同秋天；六月反而拥被取暖；春秋季节降霜却不杀伤草木。注解说是四季失去了秩序，那么施化必然悖乱。《月令》说仲夏行秋令，百姓会遭受瘟疫祸殃。古人对此早有认识。大概是天失去了秩序，气旁行无序。近年来冬天又大暖，草木禽虫不收敛不冬眠。大概是物候得到了气的先机，正如韩愈‘雪拥蓝关马不前’的诗句所描述的李唐时期岭南尚且有雪，如今绝迹了。逐渐发展到洛阳杜鹃花开的天气，从南向北推移，这不更令人信服吗？”
客人因此领悟了。我又说，“瘴”字在文中通“障”，意为疾病彰显于外，内部并无实邪。“疟”字像老虎，反爪向人扑来。对体内无实邪的人施用治疟之法，所以很多人濒临死亡。李待制的调理方法，思虑深远啊！我不揣冒昧，梳理其源流委曲，附上我的浅见，辨别伤寒、内伤及各类疟疾的相似形态，详细阐述药物的宜用与禁用，验证病色的可治与不可治，编成《瘴疟指南》。虽然我有僭越狂妄之罪无法逃脱，但对于救人，或许有一点小补。其中未尽之意，留给后来的君子补充。万历三十七年岁次己酉十月初一，信州郑全望撰写。
I was born with a frail constitution. In infancy and childhood, I suffered from frequent illnesses. By the time I reached my twenties (Ding Nian), the condition worsened significantly. I once suffered from internal injury (Neishang, damage to the internal organs due to overwork or improper diet), but various medicines proved ineffective. Consequently, I collected and studied all available texts, including the *Neijing* (Classic of Internal Medicine), *Nanjing* (Classic of Difficult Issues), *Jiayi Jing* (Systematic Classic of Acupuncture and Moxibustion), Li Dongyuan's *Ten Books*, Zhang Zhongjing's *Six Books on Cold Damage Treatise*, as well as works by Xue Ji and others. Regarding strange prescriptions and bizarre diseases from remote regions, I traced their origins and conducted thorough investigations, following the footsteps of ancient masters, though I remained uncertain whether my own ailments had been cured. It is human nature for everyone to wish to proclaim their own insights. My close friends and relatives, having personally experienced the errors in my initial approach, promoted mediocre methods that often yielded results, leading me to rashly conclude that all diseases fall within the scope of Cold Damage (Shanghan) and internal injury.
In the autumn of the Renyin year, the weather was exceptionally hot, and winter arrived without coldness. Epidemics broke out widely across the region. The symptoms resembled malaria (Nüe), yet there were no intervals between chills and fever; they resembled Cold Damage, yet symptoms of the three Yang meridians (Taiyang, Yangming, Shaoyang) appeared simultaneously with those of the two Yin meridians (Shaoyin, Taiyin); they resembled internal injury, yet the Qi Kou pulse (radial artery at the wrist, representing interior/viscera) was not larger than the Ying Kou pulse (carotid artery, representing exterior/extremities). My previously held confident theories were entirely invalidated. Those treated according to Cold Damage protocols died within seven days. Those treated for internal injury or malaria also passed away subsequently. Occasionally, patients with mild infection and strong constitutions survived slightly beyond ten days, but ultimately succumbed. For those who lost the ability to speak upon onset, death occurred even more rapidly. Only those with very mild conditions who refrained from taking medicine had a survival rate of one or two percent. Even experienced physicians found their strategies and techniques exhausted. However, the greatest virtue of Heaven and Earth is life; when blockage reaches its extreme, there must be a way through. The book by Li Daizhi of the Song Dynasty still exists. Titled *Zhangnüe Weisheng Fang* (Prescriptions for Health in Malarial Fevers Caused by Miasma), it specifically addresses this syndrome. Initially, I dismissed it due to perceived vast differences in climate and geography, glancing at it only before setting it aside, but later I realized its precious value.
The theoretical discussions are detailed and analytical; the herbal prescriptions are simple, safe, and effective. This truly represents mastery in treatment. Other texts on malaria have mentioned malarial fevers caused by miasma (Zhangnüe), but the details are incomplete. Was this because the authors had not personally visited the region and thus lacked proper transmission? Li Daizhi served Prince Duan and Zhang Taorun, both of whom were posted to these southern lands, allowing them to acquire the true essence of the disease. Thus, this book was preserved. I initially copied one or two passages, then expanded to dozens and hundreds, circulating them through local networks. Recording my insights spontaneously, I compiled them systematically. I kept them secret, regarding human life as private property. When I informed my colleagues, I feared dissemination would be limited, so I planned to print them for wider distribution. This was merely an act of public spirit.
A guest remarked: "What does malaria have to do with miasma? Between Fujian and Guangdong, deep mountains and heavy rains accumulate mist into miasma, yellow fog obscures the sky, causing great suffering. I believe our boundaries lie in the central plains where soil and customs differ, separated by thousands of miles of wilderness. How could such miasma exist? Are you cleverly naming it to show off your skills?" I replied: "No, no. The occurrence of diseases is determined by celestial timing. Changes in the four seasons are governed by the numbers of Qi (vital energy). The human body mirrors Heaven and Earth, responding to the smoothness or reversal of Qi. The *Yijing* (Book of Changes) states: 'Observe the patterns of heaven to understand the changes of time.' These signs manifest in the state, which is fundamentally composed of people. Heavenly Qi circulates, connecting with mountains and marshes. We verify changes by season and seasons by human health. If profound Qi is not concealed, it signifies seasonal change. Direct exposure leads to premature death of flora and fauna, and illness in humans. Mountains and rivers need not be identical; where Qi arrives, it flows. Therefore, I assert that it is not limited to Fujian and Guangdong; wherever the Qi category matches, this is how malarial fevers caused by miasma arise."
"Consider the winter of Guimao: flowers and trees on all hills were lush like spring. In mid-summer of Jiachen, chrysanthemums bloomed like autumn. In June, people bundled up in quilts. Frost fell in spring and autumn but did not kill vegetation. Annotations state that if the four seasons lose their order, their functions become chaotic. The *Yueling* (Monthly Ordinances) says: 'If mid-summer follows autumnal commands, the people will suffer epidemics.' Ancients understood this. It seems Heaven has lost its order, and Qi moves irregularly. In recent years, winters have been unusually warm; plants and animals do not hibernate or store energy. Perhaps organisms sense Qi first, akin to Han Yu's line 'Snow blocks the Blue Pass, horses refuse to advance,' describing snow in Lingnan during the Tang Dynasty, which is now absent. Gradually, the azalea-blooming weather of Luoyang has shifted northward. Does this not confirm my view?"
The guest then understood. I added: "The character 'Zhang' (瘴) phonetically relates to 'Zhang' (障), meaning obstruction or barrier, indicating disease manifests externally while the interior lacks excess pathogenic factors. 'Nüe' (疟) resembles a tiger turning its claws toward a person. Applying malaria treatments to individuals lacking internal excess leads to frequent near-death outcomes. Li Daizhi's regulatory methods were profoundly thoughtful. Presuming my ignorance, I have organized the source and development of this knowledge, appended my humble opinions, distinguished the similar forms of Cold Damage, internal injury, and other malaria types, detailed appropriate and contraindicated herbs, and verified treatable versus untreatable disease colors. I titled this work *Zhangnüe Zhinan* (Guide to Malarial Fevers Caused by Miasma). Although I incur the crime of arrogance and presumption, it may offer slight assistance in saving lives. Any未尽 (unfinished) aspects are left for future scholars. Written on the first day of the tenth month of the Jiyou year, the 37th year of the Wanli reign, by Zheng Quanwang of Xinzhou."