疟发于秋，名曰伏气。两旬不解，消滞清火而不见效。寒少热多，口渴喜暖，心中懊
能自主。是无形气结，蒌、连、枳、半，只治有形有滞，寒热未能开提，懊 气结，况无汗
为烦，表里气机不行，显然窒闭，宗仲景栀豉汤，一升一降，以开其结。
栀子 香豉（各三钱）
浴后寒热，卫阳损也，用建中汤。
人参 归身 桂枝木 蜜姜 黄 炙草 白芍 大枣
阳气发泄，寒热脉大。
蜀漆 龙骨 人参 桂木 牡蛎 生芍
左数甚。
人参 五味 山药 熟地 芡实 茯神
左数寒热。
人参 桂枝木 南枣 炙草 牡蛎
又 人参 生白芍 生牡蛎 乌梅肉 炙甘草 小麦
又 何人饮。
又 鳖甲煎丸。
从来通则不痛，通者非流气下夺之谓，作通阴阳训则可。阅《内经》论痛，都因寒客。
今脉左搏而大，气坠便不爽，宛是阴液少，气失疏泄。议用辛酸甘缓，而和体用。
小茴香炒当归 生白芍
另参汤远药进。
又 熟地 炙草 山药 秋石丸 五味 白芍 茯神
脉左细右空。小产亡血未复，风邪外袭营卫孔隙，寒热汗出。视目紫晦，面色枯痿，其
真气衰夺，最虑痉厥之变。此辛甘缓和补法，以护正托邪。
人参 白术 干姜 桂枝 炙草
脉虚数，舌白。身痛脘痞，有痰，寒热日迟。此阴阳两损，时令湿邪外薄，内应太阴，
谓之虚邪，宜从中治。
人参 半夏 知母 生姜 茅术 陈皮 草果仁 乌梅肉
夜来忽然昏晕，目无光，筋骨痛。营液暗损，任、督皆惫之象。
人参 炙甘草 鹿茸 当归 酒炒白芍 鹿角霜
自昏厥以来，耳聋舌白，呕逆涎沫，大便不通，必有暑邪吸入胃脘。此肝气升举，诸阳
，腑气窒塞，恐内闭昏脱，最为可虑。体虚夹邪，先清邪以安胃，议以酸苦泄热驱暑。暑汗
无止涩之例，总以勿进表散，乃里症治法也。
川连 黄芩 广皮白 乌梅肉 生姜汁 炒半夏 枳实
两脉皆起，神气亦苏，但大便未通，中虚舌白，理难攻下。况肝虚易惊，又属疟伤致厥
，仲景虽有厥应下之文，验诸色脉，不可徒执书文以致误。
人参 半夏 生白芍 川连 枳实 乌梅肉
前此未尽疟邪仍至，兼之恼怒，肝气结聚中焦，补虚之中必佐散邪开结。
人参 生牡蛎 白芍 橘红 炙鳖甲 丹皮
产后下虚，利后为疟，是营卫交损，况色脉并非外邪，补剂频进不应，由治错乱。经云
∶阳维为痛苦寒热。
人参 桂枝木 炒当归 鹿角霜 炙甘草 炮黑姜
积劳伤阳，哀戚动藏，重重内损，其夏秋伏邪，已深在重围。此从阴经而来，朱汉老非
，病患服药而安，温药助阳也。考三阴而投温补扶正，正谓托邪。知母入咽即呃，阳明之阳
几渐，不饥不食不寐，阳不流行，三焦困，脾胃惫矣。肛坠属阴伤气陷，难任纯刚之剂。
人参 当归（米炒） 浓朴 麋角（酒浸烘） 炮姜 草果
阴疟足太阴经，先进柴胡姜桂汤。
柴胡 黄芩 栝蒌根 甘草 桂枝 干姜 生牡蛎
疟两旬不解，寒多热少，是为牝疟，进牡蛎散。
牡蛎 龙骨 肉桂 白芍 云母 蜀漆 炙草 大枣
牝疟寒多，内热心悸。
阳旦汤，加生牡蛎、花粉。
劳疟不止，肢肿寒多。
阳旦汤，加牡蛎、云母石。
阴疟四月，汗泄，下肢肿。
早服八味丸。
淡附子 细辛 生白术 泽泻
厥阴阴疟不止，能食。
熟地炭 淡苁蓉 牡蛎 五味子 鹿角霜 龙骨
阴疟三年不愈，下虚遗泄。
蜀漆 牡蛎 炙黄 桂枝 龙骨 炙甘草
阴疟久虚。
益气汤加附子。
阴疟脉沉，渐背寒肢冷，脘中食入痞满。此属阳气伤极，春深木旺，恐变浮肿胀病，
宜理中兼理下焦，勿得驱邪治疟。
附子桂枝人参汤，加块茯苓、生姜、大枣。
冬月伏邪，至春发为温疟，汗出不解，非因新感可知。脉虚，先有遗症，忌进耗散真气
，和正解邪为稳。
桂枝 草果 杏仁 白芍 枯芩 桔梗
疟由四末，必犯中焦，胃独受其侮克，故烦渴脘痞不饥。今日舌绛便溏，阴气先伤，阳
邪未尽，宜芩、芍和里，益以泻木邪，救胃阴。
黄芩 丹皮 白蔻仁 白芍 青蒿 乌梅肉
经月疟后，易生嗔怒。春令内应肝胆，其用太过，其体尤虚，所以自觉馁怯。考仲景，
疟来痊期，血气凝结胁中，必有瘕聚，名曰疟母。母者，疟邪病根也，鳖甲煎丸主之，使气
血通行，留邪无可容矣。
服露姜饮颇逸，第寒热仍来，知邪伏于阴，不得透解；大便不通，又经旬日，议从厥阴
搜逐
三阳皆通，邪无容足之地矣。
疟久邪入络，络主血，邪结血分，则为疟母。仲景鳖甲煎丸专以升降宣瘀治肝，谓寒热
少阳，久必入肝，肝主血，左胁为肝膜俞也，攻病固当如是。但欠有遗精，食少不化，诸恙
病非一端，此攻邪温补，未能动病，莫若养正，气旺邪自除，古有诸矣。
午服妙香散，晚服阿魏丸。
久疟针挑，汗出乃止，经脉邪去，络脉留邪，胁下遂结疟母，按之坚，形高突。四年带
病，仍然能食便通，其结聚不在肠胃，药下咽入胃入肠不效，盖络脉附于脏腑之外廓耳。
生鳖甲（青色刮去衣，四两） 穿山甲（炙，二两） 五灵脂（烧至烟尽为度，二两） 麝香
（忌火，另研，五钱） 辰砂（忌火，另研水飞，五钱）
上药各研，净末分两加入阿魏一钱，同捣丸，饥时服二钱。
三疟已久，自述烦劳必心胸痞胀。凡劳则伤阳，议温养营分托邪一法。
人参 桂枝 炙甘草 南枣 茯苓 蜀漆 当归身 生姜
疟三日乃发，是邪伏在阴，经年虽止，正伤难复。卫阳外泄，汗出神疲，宜甘温益气之
属。五旬向衰，必节劳保养，不徒恃药。
养营法，用煨姜三两、南枣四两，煮汁泛丸。
三日疟是邪伏阴分而发，非和解可效。久发不止，补剂必以升阳，引伏邪至阳分乃愈，
守补药则非。
鹿茸 人参 熟附子 炒黑杞子 鹿角霜 当归 茯苓 炒沙苑
稚年三日疟，太阴脾伤为多，饮食忌用腥膻，劫邪继以升阳。
常山 白术 浓朴 草果 陈皮 姜汁
诊左现小数，右缓濡溺。食已烦倦，是脾阳渐衰，古人谓疟、痢都因脾弱也。况便溏足
色夺形瘦，若不急补后天，以崇母气，区区疲药，元气消惫矣。用《局方》加味四兽饮。
人参 熟术 草果仁 广皮 茯苓 炙草 乌梅肉
此劳伤阳气之疟，循环不已，脉络久空，当升补阳气。
生 炙草 生姜 鹿角 当归 南枣
露姜饮止疟，是益中气以驱邪，虚人治法皆然。脾胃未醒，忌进腥浊。
人参 炙草 半夏 益智仁 橘红 姜汁
阴泄阳冒频遗，鼽衄寒热消渴，气上撞心，欲寐惊惕，饮多呕逆，两足如坠，茎中凝窒
。《金匮》谓阴气先伤，阳乃独发。见疟厥阴经疟，与上焦治异。
鲜生地 知母 生甘草梢 元参 川斛 竹叶
热病时疟，不厘清理在气在血，以发散消导，劫伤胃汁，遂不饥不食。突遭惊骇，肝阳
，复令倏热倏凉，两足皆冷，腹胀不和。胁中有形触痛，由久病入络。阴阳不通，二便窒闭
，先与更衣丸二钱，俟半日后，大便得通。次日用药，当以两和厥阴、阳明方法。
生牡蛎 柏子仁 生白芍 川楝肉 小黑豆皮 细根生地
疟热伤阴，阴液不得上承，舌心扪之如板。目瞑面肿，惊惕，肝阳化风内震；胃气愈逆
痞，欲人抚摩。热气聚膈，蒸迫膻中，必至神昏闭塞，老年凶危俄顷，然非形质之结清寒攻
荡可效，况已泻利在前，邪陷阴伤显然。夫阴伤属下，热聚居上，救阴之剂未遑透膈以滋下
。芩、连、凉膈，苦辛燥气再伤阴，究非至当。展转筹划，法宜分理，议于今晚先进清心牛
黄丸一服，匀三次温开水与服，取其芳香清燥以开其结。明日再诊议方。
冒暑远行，热气由口鼻入，犯上犯中，分布营卫，故为寒热疟疾。当淡薄食物，清肃胃
投药以凉解芳香，或甘寒生津，皆可疗此。奈何发散以去寒，不知口鼻受热，与皮肤受寒迥
，治之不效，肆行滋补，参、术、 、地，粘腻中宫，肺气壅闭，胃中滞凝，肿胀每上至下
，一身气机不通，张戴人所谓邪得补而势盛，如养寇殃良之比。但病久形消，矫其非而再为
攻逐，又虑正气之垂寂，故改汤为丸。丸者缓也，使中焦得疏，渐渐转运，升降得宣，六腑
有再通之理，腑通，经脉之气无有不通者矣。每日进丹溪保和丸。
左胁下宿积有形，今疟疟反复，左胁又结疟母，胸脘痞闷，大便艰难，乃疟症余邪与气
结，六腑亦因之不宣，宜攻以通其瘀滞，先进鳖甲煎丸三钱。早上、午时、暮时各用七粒，开
水送下。
疟邪未尽，堵截气窒，致腹满足肿，气逆欲喘。水湿内蕴，治当分利。
杏仁 牡蛎 猪苓 浓朴 泽泻 茯苓
疟止太早，邪热未尽，脘痞不饥，口渴自利，防有滞下。
川连 黄芩 半夏 枳实 白芍 橘白
同议上下合邪，泄厥阴以安阳明，仍佐整肃暑湿方法。
桂枝木 川连 人参 生牡蛎 乌梅 白芍
痰哮由外邪而发，坐不得卧，肾病为多。以风寒必客太阳，体弱内侵少阴耳。若夫暑湿
，触自口鼻，背部疡疖，乃鼻窍应肺，是手经受邪，辛凉气轻之剂可解，以肺欲受辛，其象
上悬，气味沉重，药力下走而肺邪不解。然夏病入冬，气候迭更，热邪久而深入，气血日被
损伤，滋清如胶、地，搜逐如鳖甲煎丸，无如不独阴亏，八脉气衰，如寒为热，病形渐延损
怯，喉痛，火升上热，缓必下热，此刚药难投，柔温之养，佐通奇脉定议。
生鹿角霜（三钱） 炒黑枸杞（钱半） 茯苓（钱半） 沙黑归身（钱半） 熟地炭（三钱） 生
沙苑（一钱）
瘕泄下冷热升，议通摄任、督之散越。
鹿角霜（三钱） 熟地炭（五钱） 补骨脂（盐水先煎百沸，八分） 败龟板（刮光炙脱研，
三钱） 云茯苓（钱半） 石壳建莲（连壳勿研，十粒）
经先期三日，热多寒少，脉左弦大。血分偏热，治厥阴疟邪窒在血。
生鳖甲 冬桑叶 青蒿梗 炒桃仁 炒丹皮 川贝母
疟乃暑湿客邪，血证逢时便从。已是阴亏体质，治邪须顾本元，议与竹叶地黄汤。
竹叶 知母 川贝母 鲜生地 薄荷
寒热后，诊脉小弱，舌白，渴不欲饮，痰多气闷。疟未尽而正已虚，不可过攻，防其衰
生术 半夏 草果仁 广皮 茯苓 浓朴
疮家湿疟，忌用表散。
苍术白虎加草果仁。
伏邪成疟，寒热间日作，汗多欲呕，中脘痞闷不饥，进泻心汤法。
川连 黄芩 杏仁 枳实 姜汁 半夏 浓朴 草果
脉无力，寒热夜作，烦渴恶心，舌黄中痞。虽是伏暑为疟，然平素烦劳，即属内伤，未
可泥于发散消食，先进泻心汤以泄蕴热。
川连 淡黄芩 花粉 枳实 姜汁 炒半夏 豆蔻 橘红
寒热后津伤，舌上黑胎，口干不知味，食不易饥，大便不爽，宜进滋养阴液法。
麦冬 知母 橘红 人参 川石斛 乌梅肉
产后未满百日，下焦精血未旺，遂患三疟，缘真气内怯，邪不肯外出。医药清散攻下，
仅治三阴之疟，遂致魄汗淋漓，乃阳气脱散败坏之象矣。
人参 补骨脂 炒黑茴香 茯苓 归身
湿盛寒战，不解成疟。湿主关节为痛，邪在里为烦，总以湿热里疟，治宜用苦辛。
川连 黄芩 杏仁 姜汁 半夏 浓朴
脉大，寒热渴饮，舌渐黄。气分热胜，血弱已久，恐邪漫劫津，清气热即以和阳，议用
张氏玉女煎。
石膏 竹叶心 鲜生地 知母 生甘草 生白芍
伏邪留于少阴、厥阴之间，为三日疟。百日不愈，邪伤真阴，梦遗盗汗。津液日枯，肠
难。养阴药虽为有益，但深沉疟邪，何以得追拔扫除？议以仲景鳖甲丸三十粒，早上开水送
下，午后进养阴通阳药。
复脉汤，去人参、生姜、加牡蛎、鹿角霜。
邪与气血胶凝则为疟。女病在络。自左胁渐归于中焦，木乘土位。东垣谓疟久必伤脾胃
既成形象，宜通恶守，佐芳香乃能入络。凡食物肥腻呆滞，尤在禁例。所虑延及中满。
人参 草果 陈皮 木香 茯苓 浓朴 青皮 郁金汁。
深秋曾诊，拟议此病为暑湿食瓜，辛甘寒分利，奈何脾阳又受辛寒之累，致浊阴聚形，
食复，阳属受戕。凡身中脾阳宜动，动则运；肾阳宜藏，藏则固，斯为命根。《局方》大建
脾丸、仲淳资生丸，多以补虚通滞，芳香合用，取其气通浊泄，人参辅正之力得矣。
人参 陈皮 浓朴 益智仁 茯苓 木香
间日寒战，发热渴饮，此为疟。饮水结聚，而心中痛胀，乃病上加病。不敢用涌吐之药
，暂与开肺气壅遏一方。
生石膏 大杏仁 生甘草 蜜水炒麻黄
脉如平人，但热不寒，烦渴，身疼时呕，此温疟也。仲景有桂枝白虎汤一法，一剂知，
二剂已也。
桂枝白虎汤。
疟疾发作于秋季，称为伏气（指潜伏体内的邪气）。病程超过二十天未愈，使用消食导滞、清热泻火的药物却不见疗效。表现为寒少热多，口渴且喜欢温热饮食，心中烦闷懊恼，无法自我控制。这是无形之气机郁结，而瓜蒌、黄连、枳实、半夏仅能治疗有形之积滞与停滞，对于寒热之邪未能宣透开提，导致气机郁结的懊恼感持续存在；况且无汗导致烦躁，表里气机运行不畅，显然是气机窒塞闭阻。遵循张仲景《伤寒论》中栀子豉汤的治法，利用一升一降的药性，以开通其郁结。
栀子 香豉（各三钱）
沐浴后出现寒热往来，是卫阳受损的表现，使用建中汤（调和营卫、温中补虚之剂）。
人参 当归身 桂枝木 蜜姜 黄芪 炙甘草 白芍 大枣
阳气外泄，出现寒热往来且脉象宏大。
蜀漆 龙骨 人参 桂枝 牡蛎 生白芍
历来认为“通则不痛”，这里的“通”并非指行气攻下之意，解释为通达阴阳的关系是可以的。阅读《黄帝内经》关于疼痛的论述，大多是因为寒邪客居所致。如今脉象左手搏动有力且大，气机下坠，排便不爽，这正是阴液不足，气机失去疏泄功能。建议采用辛、酸、甘缓之法，来调和肝体的柔润与肝用的疏泄。
小茴香（炒） 当归 生白芍
另服人参汤送服其他药物。
脉象左细右空。因小产失血尚未恢复，风邪外袭营卫之孔隙，导致寒热汗出。观察眼睛色泽紫暗晦涩，面色枯槁萎黄，这是真气衰败耗夺的表现，最担心发生痉病（肌肉痉挛）或厥证（昏厥）。此用辛甘缓和的补益法，以保护正气，托举邪气外出。
人参 白术 干姜 桂枝 炙甘草
脉象虚数，舌苔白。身体疼痛，胃脘部痞满，有痰湿，寒热发作间隔时间延长。这是阴阳两损，时令湿邪外迫，内应太阴脾经，称为虚邪，适宜从脾胃中焦进行治疗。
人参 半夏 知母 生姜 茅术 陈皮 草果仁 乌梅肉
夜间突然昏晕，目光无神，筋骨疼痛。这是营阴津液暗中损耗，任脉、督脉皆显疲惫之象。
人参 炙甘草 鹿茸 当归 酒炒白芍 鹿角霜
自昏厥以来，耳聋，舌苔白，呕吐逆气及涎沫，大便不通，必有暑邪吸入胃脘。这是肝气升举太过，诸阳之气受阻，腑气窒塞，恐怕出现内闭昏脱之变，最为可虑。体质虚弱夹杂邪气，先清除邪气以安和胃气，建议采用酸苦泄热驱除暑邪的方法。暑邪出汗没有止涩的先例，总之以不要使用解表发散药为原则，这是治疗里证的法则。
川黄连 黄芩 广皮白 乌梅肉 生姜汁 炒半夏 枳实
左右两脉均起，神气也苏醒，但大便仍未通畅，中焦虚弱，舌苔白，难以使用攻下法。况且肝虚容易受惊，又属于疟疾损伤导致的厥证，张仲景虽有“厥证应当用下法”的条文，但验证患者的神色脉象，不可盲目拘执书本条文以免误治。
人参 半夏 生白芍 川黄连 枳实 乌梅肉
此前未尽的疟邪再次发作，加之恼怒，导致肝气结聚在中焦，在补虚的同时必须辅助散邪开结的药物。
人参 生牡蛎 白芍 橘红 炙鳖甲 丹皮
产后下元亏虚，痢疾后患疟疾，这是营卫交相受损，况且神色脉象并非单纯的外邪表现，频繁进补无效，是由于治疗错乱所致。《内经》说：“阳维脉主痛苦寒热。”
人参 桂枝木 炒当归 鹿角霜 炙甘草 炮黑姜
积劳损伤阳气，哀伤悲戚触动内脏，重重内伤，其夏秋季节的伏邪，已经深入重围。此病从阴经而来，朱汉老（朱肱）的观点非谬，病患服药而安，是因为温药助阳的缘故。考察三阴经而投用温补扶正之法，正是所谓的托邪外出。知母入咽即引起呃逆，说明阳明之阳气几近衰竭，不饥、不食、不寐，阳气不能流行，三焦困顿，脾胃疲惫。肛门下坠属于阴伤气陷，难以承受纯刚燥烈的药剂。
人参 当归（米炒） 浓朴 麋角（酒浸烘） 炮姜 草果
阴疟涉及足太阴脾经，先进服柴胡姜桂汤。
柴胡 黄芩 栝蒌根 甘草 桂枝 干姜 生牡蛎
疟疾二十天未解，寒多热少，这称为牝疟（偏寒之疟），进服牡蛎散。
牡蛎 龙骨 肉桂 白芍 云母 蜀漆 炙甘草 大枣
阴疟四月，出汗，下肢肿胀。
早服八味丸（金匮肾气丸）。
淡附子 细辛 生白术 泽泻
厥阴经阴疟不止，但能进食。
熟地炭 淡苁蓉 牡蛎 五味子 鹿角霜 龙骨
阴疟三年不愈，下元亏虚遗精泄泻。
蜀漆 牡蛎 炙黄芪 桂枝 龙骨 炙甘草
阴疟脉沉，逐渐出现背部寒冷、四肢发冷，胃脘中进食后痞满。这属于阳气损伤至极，春深时节木气旺盛，恐怕变为浮肿胀满之病，适宜理中汤兼理下焦，不得强行驱邪治疟。
附子桂枝人参汤，加块茯苓、生姜、大枣。
冬季伏邪，至春季发为温疟，出汗后不解，这不是因为新感外邪可知。脉象虚弱，先前已有后遗症，忌讳进用耗散真气的药物，调和正气、解散邪气才是稳妥之法。
桂枝 草果 杏仁 白芍 枯芩 桔梗
疟疾由四肢末端发起，必定侵犯中焦，胃独受其侮克，所以出现烦渴、胃脘痞满、不饥。今日舌质绛红，大便溏薄，说明阴气先伤，阳邪未尽，适宜用黄芩、白芍调和里气，并辅以泻肝木之邪，救护胃阴。
黄芩 丹皮 白蔻仁 白芍 青蒿 乌梅肉
患疟疾一个月后，容易生气发怒。春季时令内应肝胆，其功能发挥太过，其本体尤其虚弱，所以自觉气馁怯弱。考证张仲景的观点，疟疾来临痊愈期间，血气凝结于胁中，必有瘕聚（腹内结块），名为疟母。母者，即疟邪的病根，主用鳖甲煎丸，使气血通行，留存的邪气便无处容身。
服用露姜饮颇为舒适，但寒热仍反复发作，知道邪气伏于阴分，不得透解；大便不通，又经过十天，建议从厥阴经搜逐邪气。
三阳经皆通，邪气便无立足之地了。
疟疾日久，邪气进入络脉，络脉主血，邪气结于血分，则形成疟母。张仲景的鳖甲煎丸专门通过升降宣通瘀血来治疗肝脏，认为寒热往来属少阳经，日久必入肝，肝主血，左胁为肝膜之俞穴，攻治病邪固当如此。但患者有遗精、食少不化的症状，各种病症并非一端，这种攻邪温补的方法，未能触动病根，不如培养正气，气旺则邪自除，古已有此说法。
午时服妙香散，晚时服阿魏丸。
久疟针刺挑治，出汗后才停止，经脉中的邪气已去，但络脉中留有邪气，胁下遂结成疟母，按压坚硬，形状高突。带病四年，仍然能进食，大便通畅，其结聚不在肠胃，药物吞咽入胃入肠无效，大概因为络脉附着于脏腑之外廓。
生鳖甲（青色刮去衣，四两） 穿山甲（炙，二两） 五灵脂（烧至烟尽为度，二两） 麝香（忌火，另研，五钱） 辰砂（忌火，另研水飞，五钱）
以上药物分别研成细末，将净末按分量加入阿魏一钱，共同捣烂制成丸药，饥饿时服用二钱。
三疟已久，自述烦劳必然导致心胸痞胀。凡是劳累则损伤阳气，建议采用温养营分、托举邪气的方法。
人参 桂枝 炙甘草 南枣 茯苓 蜀漆 当归身 生姜
疟疾三日一发，是邪气伏在阴分，虽然经年停止，但正气受伤难以恢复。卫阳外泄，汗出神疲，适宜使用甘温益气的药物。五十岁趋向衰老，必须节制劳累保养身体，不能仅仅依赖药物。
养营法，用煨姜三两、南枣四两，煮汁泛丸。
三日疟是邪气伏在阴分而发作，不是和解法可以奏效的。久发不止，补剂必须以升阳为主，引导伏邪至阳分才能痊愈，守持补药则不行。
鹿茸 人参 熟附子 炒黑枸杞 鹿角霜 当归 茯苓 炒沙苑
稚龄儿童患三日疟，多为太阴脾脏受伤，饮食忌讳腥膻之物，劫除邪气后继以升阳。
常山 白术 浓朴 草果 陈皮 姜汁
诊察左脉现小数，右脉缓濡溺（此处疑为濡或类似脉象描述，原文作溺，结合语境可能指湿盛或小便不利相关脉象，暂译脉象）。进食后烦倦，这是脾阳逐渐衰弱，古人说疟疾、痢疾都因脾弱所致。况且大便溏薄，足色（足色可能指足部色泽或症状，结合上下文可能指足冷或足肿等，此处保留原意或指代全身状态）剥夺，形体消瘦，若不紧急补益后天脾胃，以崇厚母气（脾胃为后天之本，气血生化之源，亦为肺之母），区区疲软的药材，元气就会消亡疲惫。使用《局方》加味四兽饮。
人参 熟白术 草果仁 广皮 茯苓 炙甘草 乌梅肉
这是劳伤阳气的疟疾，循环不已，脉络长久空虚，应当升补阳气。
生黄芪 炙甘草 生姜 鹿角 当归 南枣
露姜饮止疟，是益补中气以驱除邪气，虚人的治法都是这样。脾胃尚未苏醒，忌讳进用腥浊之物。
人参 炙甘草 半夏 益智仁 橘红 姜汁
阴泄阳冒频频遗精，鼻出血、寒热、消渴，气上撞心，想睡觉但易惊醒惕动，饮水多则呕吐逆气，两脚如坠落感，尿道凝滞阻塞。《金匮要略》说阴气先伤，阳气乃独自发动。见到疟疾涉及厥阴经，与上焦治法不同。
鲜生地 知母 生甘草梢 元参 川石斛 竹叶
热病时患疟疾，如果不厘清理气在气分还是在血分，而用发散消导之法，劫伤胃汁，导致不饥不食。突然遭受惊骇，肝阳亢逆，又令忽热忽凉，两脚皆冷，腹胀不和。胁中有形触痛，由久病入络所致。阴阳不通，二便窒塞，先给予更衣丸二钱，等待半日后，大便得通。次日用药，应当采用两和厥阴、阳明的方法。
生牡蛎 柏子仁 生白芍 川楝肉 小黑豆皮 细根生地
疟热损伤阴液，阴液不得上承，舌心摸起来像板一样硬。闭目面肿，惊惕，肝阳化风内震；胃气更加上逆痞闷，想要人抚摸。热气聚于膈间，蒸迫膻中，必致神昏闭塞，老年凶危只在顷刻之间，然而这不是形质之结，清寒攻荡之法不能奏效，况且已经泻利在前，邪陷阴伤显然。夫阴伤属下焦，热聚居上焦，救阴的药剂来不及透膈以滋润下焦。黄芩、黄连、凉膈散，苦辛燥气再伤阴液，终究不是最恰当的方法。辗转筹划，法宜分理，建议于今晚先进服清心牛黄丸一服，匀三次温开水送服，取其芳香清燥以开通其郁结。明日再诊议方。
冒暑远行，热气由口鼻进入，犯上犯中，分布营卫，所以成为寒热疟疾。应当清淡饮食，清肃胃气。投药以凉解芳香，或甘寒生津，皆可治疗此病。奈何使用发散法以去寒，不知道口鼻受热，与皮肤受寒截然不同，治疗不生效，肆意进行滋补，人参、白术、地黄等，粘腻阻滞中宫，肺气壅闭，胃中滞凝，肿胀每每从上至下，一身气机不通，张戴人所谓邪气得补而势力强盛，如同养寇殃良的比喻。但病久形体消瘦，纠正错误而再进行攻逐，又担心正气即将寂灭，所以改汤剂为丸剂。丸药作用缓慢，使中焦得以疏泄，渐渐转运，升降得以宣通，六腑有再通之理，腑气通，经脉之气就没有不通的了。每日进服丹溪保和丸。
左胁下有宿积有形之物，如今疟疾反复，左胁又结成疟母，胸脘痞闷，大便艰难，这是疟症余邪与气结聚，六腑也因之不宣通，适宜攻逐以通其瘀滞，先进服鳖甲煎丸三钱。早上、午时、暮时各用七粒，开水送下。
疟邪未尽，堵塞气机窒塞，导致腹部胀满下肢浮肿，气逆欲喘。水湿内蕴，治疗应当分利水湿。
杏仁 牡蛎 猪苓 浓朴 泽泻 茯苓
疟疾停止得太早，邪热未尽，胃脘痞满不饥，口渴自利，防止出现痢疾（滞下）。
川黄连 黄芩 半夏 枳实 白芍 橘白
同议上下合邪，泄厥阴以安和阳明，仍辅助整肃暑湿的方法。
桂枝木 川黄连 人参 生牡蛎 乌梅 白芍
痰哮由外邪引发，坐不得卧，肾病居多。因为风寒必定客居太阳经，体质虚弱内侵少阴经罢了。如果是暑湿，从口鼻触犯，背部疡疖，乃鼻窍应肺，是手经受邪，辛凉气轻的药剂可以解除，因为肺喜受辛味，其象上悬，气味沉重，药力下走而肺邪不解。然而夏季病入冬季，气候更迭，热邪久而深入，气血日被损伤，滋清如阿胶、地黄，搜逐如鳖甲煎丸，无奈不仅阴亏，八脉气衰，如寒为热，病形逐渐延绵损怯，喉痛，火升上热，缓必下热，此刚药难投，柔温之养，佐通奇经八脉定议。
生鹿角霜（三钱） 炒黑枸杞（钱半） 茯苓（钱半） 沙黑归身（钱半） 熟地炭（三钱） 生沙苑（一钱）
瘕泄下冷热升，建议通摄任脉、督脉之散越。
鹿角霜（三钱） 熟地炭（五钱） 补骨脂（盐水先煎百沸，八分） 败龟板（刮光炙脱研，三钱） 云茯苓（钱半） 石壳建莲（连壳勿研，十粒）
月经先期三日，热多寒少，脉象左弦大。血分偏热，治疗厥阴疟邪窒滞在血分。
生鳖甲 冬桑叶 青蒿梗 炒桃仁 炒丹皮 川贝母
疟疾乃暑湿客邪，血证逢时便从。已是阴亏体质，治邪须顾本元，建议给予竹叶地黄汤。
竹叶 知母 川贝母 鲜生地 薄荷
寒热之后，诊脉小弱，舌苔白，口渴不欲饮，痰多气闷。疟疾未尽而正气已虚，不可过用攻伐，防止其衰败。
生白术 半夏 草果仁 广皮 茯苓 浓朴
伏邪成疟，寒热间日发作，汗多欲呕，中脘痞闷不饥，进服泻心汤法。
川黄连 黄芩 杏仁 枳实 姜汁 半夏 浓朴 草果
脉无力，寒热夜间发作，烦渴恶心，舌黄中痞。虽然是伏暑为疟，然而平素烦劳，即属内伤，不可拘泥于发散消食，先进服泻心汤以泄蕴热。
川黄连 淡黄芩 花粉 枳实 姜汁 炒半夏 豆蔻 橘红
寒热后津液损伤，舌上黑胎，口干不知味，食不易饥，大便不爽，适宜进服滋养阴液法。
麦冬 知母 橘红 人参 川石斛 乌梅肉
产后未满百日，下焦精血未旺，遂患三疟，缘真气内怯，邪气不肯外出。医药清散攻下，仅治三阴之疟，遂致魄汗淋漓，这是阳气脱散败坏之象。
人参 补骨脂 炒黑茴香 茯苓 归身
湿盛寒战，不解成疟。湿主关节为痛，邪在里为烦，总以湿热里疟，治疗适宜用苦辛之法。
川黄连 黄芩 杏仁 姜汁 半夏 浓朴
脉大，寒热渴饮，舌渐黄。气分热胜，血弱已久，恐怕邪气漫延劫伤津液，清气热即以和阳，建议使用张氏玉女煎。
石膏 竹叶心 鲜生地 知母 生甘草 生白芍
伏邪留于少阴、厥阴之间，为三日疟。百日不愈，邪伤真阴，梦遗盗汗。津液日枯，肠道干燥。养阴药虽为有益，但深沉疟邪，何以得追拔扫除？建议以张仲景鳖甲丸三十粒，早上开水送下，午后进服养阴通阳药。
复脉汤，去人参、生姜，加牡蛎、鹿角霜。
邪气与气血胶凝则为疟。女子病在络脉。自左胁渐归于中焦，木乘土位。东垣说疟久必伤脾胃，既成形象，宜通恶守，佐芳香乃能入络。凡食物肥腻呆滞，尤在禁例。所虑延及中满。
人参 草果 陈皮 木香 茯苓 浓朴 青皮 郁金汁。
深秋曾诊，拟议此病为暑湿食瓜，辛甘寒分利，奈何脾阳又受辛寒之累，致浊阴聚形，食复，阳属受戕。凡身中脾阳宜动，动则运；肾阳宜藏，藏则固，斯为命根。《局方》大建脾丸、仲淳资生丸，多以补虚通滞，芳香合用，取其气通浊泄，人参辅正之力得矣。
人参 陈皮 浓朴 益智仁 茯苓 木香
间日寒战，发热渴饮，此为疟。饮水结聚，而心中痛胀，乃病上加病。不敢用涌吐之药，暂与开肺气壅遏一方。
生石膏 大杏仁 生甘草 蜜水炒麻黄
Malaria occurring in autumn is termed Fu Qi (latent pathogenic factor). If unresolved after two weeks, treatments for eliminating stagnation and clearing fire show no effect. The presentation features less chills and more fever, thirst with a preference for warmth, and inner restlessness (Ao Nu) beyond self-control. This indicates a formless qi knot; while Lou Gua (Trichosanthis Fructus), Lian Zi (Coptidis Rhizoma), Zhi Shi (Aurantii Fructus Immaturus), and Ban Xia (Pinelliae Tuber) treat only tangible stagnation, they fail to resolve the cold-heat dynamics or lift the qi knot causing restlessness. Moreover, the absence of sweat leads to vexation, indicating that the qi mechanism of the exterior and interior is not circulating, clearly obstructed. Following Zhang Zhongjing's Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction), which employs one ascending and one descending action to open the knot:
Zhi Zi (Gardeniae Fructus) Xiang Chi (Sojae Semen Praeparatum) (each 3 qian)
Chills and fever after bathing indicate damage to Wei Yang (Defensive Yang); use Jian Zhong Tang (Establish the Middle Decoction).
Ren Shen (Ginseng Radix) Dang Gui Shen (Angelicae Sinensis Radix) Gui Zhi Mu (Cinnamomi Ramulus) Mi Jiang (Honey-fried Ginger) Huang Qi (Astragali Radix) Zhi Cao (Prepared Licorice Root) Bai Shao (Paeoniae Radix Alba) Da Zao (Jujubae Fructus)
Yang qi expelling outward presents with chills, fever, and a large pulse.
Shu Qi (Polygalae Radix) Long Gu (Fossi Mastodi et Lemuri Ossa) Ren Shen (Ginseng Radix) Gui Mu (Cinnamomi Ramulus) Mu Li (Ostreae Concha) Sheng Bai Shao (Raw Paeoniae Radix Alba)
The left pulse is notably rapid.
Ren Shen (Ginseng Radix) Wu Wei Zi (Schisandrae Fructus) Shan Yao (Dioscoreae Rhizoma) Shu Di (Rehmanniae Radix Preparata) Qian Shi (Euryales Semen) Fu Shen (Poria Cum Radix)
Left-sided rapid pulse with chills and fever.
Ren Shen (Ginseng Radix) Gui Zhi Mu (Cinnamomi Ramulus) Nan Zao (Southern Jujube) Zhi Cao (Prepared Licorice Root) Mu Li (Ostreae Concha)
Another prescription: Ren Shen (Ginseng Radix) Sheng Bai Shao (Raw Paeoniae Radix Alba) Sheng Mu Li (Raw Ostreae Concha) Wu Mei Rou (Mume Fructus Flesh) Zhi Gan Cao (Prepared Licorice Root) Xiao Mai (Tritici Fructus)
Another prescription: He Ren Yin (He Ren Decoction).
Another prescription: Bie Jia Jian Wan (Turtle Shell Pill for Reducing Accumulations).
It has long been said that "if there is free flow, there is no pain"; here, "free flow" does not refer to moving qi and purging downward, but rather can be interpreted as harmonizing yin and yang. Reading the *Nei Jing* on pain, it is mostly due to cold pathogens lodging. Now, the left pulse beats forcefully and is large, qi sinks, and defecation is unsatisfactory; this is precisely insufficient yin fluids and loss of qi dispersal. It is proposed to use acrid, sour, and sweet methods to harmonize the liver's substance and function.
Xiao Hui Xiang (Foeniculi Fructus, stir-fried) Dang Gui (Angelicae Sinensis Radix) Sheng Bai Shao (Raw Paeoniae Radix Alba)
Separately take Ren Shen Tang (Ginseng Decoction) to aid the administration of other medicines.
Another prescription: Shu Di (Rehmanniae Radix Preparata) Zhi Cao (Prepared Licorice Root) Shan Yao (Dioscoreae Rhizoma) Qiu Shi Wan (Autumn Stone Pill) Wu Wei Zi (Schisandrae Fructus) Bai Shao (Paeoniae Radix Alba) Fu Shen (Poria Cum Radix)
Pulse is fine on the left and empty on the right. Post-miscarriage blood loss has not recovered; wind pathogens attack the pores of Ying and Wei, causing chills, fever, and sweating. Observing purple-dull eyes and withered complexion, this indicates severe depletion of true qi, with great fear of convulsions or syncope. This uses an acrid-sweet mild tonification method to protect righteous qi and support the expulsion of pathogens.
Ren Shen (Ginseng Radix) Bai Zhu (Atractylodis Macrocephalae Rhizoma) Gan Jiang (Zingiberis Rhizoma) Gui Zhi (Cinnamomi Ramulus) Zhi Cao (Prepared Licorice Root)
Pulse is deficient and rapid, tongue coating is white. Body ache and epigastric fullness with phlegm, chills and fever with delayed onset. This is damage to both yin and yang, seasonal damp pathogens pressing externally, internally affecting the Taiyin Spleen, termed deficiency pathogen, suitable for treatment from the middle jiao.
Ren Shen (Ginseng Radix) Ban Xia (Pinelliae Tuber) Zhi Mu (Anemarrhenae Rhizoma) Sheng Jiang (Zingiberis Rhizoma Recens) Mao Zhu (Atractylodis Rhizoma) Chen Pi (Citri Reticulatae Pericarpium) Cao Guo Ren (Tsaoko Fructus Seed) Wu Mei Rou (Mume Fructus Flesh)
Suddenly fainted at night, eyes lacking luster, bone and tendon pain. This shows hidden damage to Ying fluids, with signs of exhaustion in the Ren and Du vessels.
Ren Shen (Ginseng Radix) Zhi Gan Cao (Prepared Licorice Root) Lu Rong (Cornu Cervi Pantotrichum) Dang Gui (Angelicae Sinensis Radix) Jiu Chao Bai Shao (Wine-stir-fried Paeoniae Radix Alba) Lu Jiao Shuang (Cornu Cervi Degelatinatum)
Since fainting, deafness, white tongue coating, vomiting of saliva and foam, constipation; likely summer heat pathogens inhaled into the stomach. This is excessive rising of Liver qi, obstruction of all Yang qi, blockage of fu organs, fearing internal closure and collapse, most concerning. For deficiency with pathogen, first clear pathogen to calm stomach; propose sour-bitter draining heat and driving out summer heat. Summer heat sweating has no precedent for astringency; generally, avoid exterior-releasing methods, which is the treatment principle for interior syndromes.
Chuan Lian (Coptidis Rhizoma) Huang Qin (Scutellariae Radix) Guang Pi Bai (Pericarpium Citri Reticulatae Album) Wu Mei Rou (Mume Fructus Flesh) Sheng Jiang Zhi (Fresh Ginger Juice) Chao Ban Xia (Stir-fried Pinelliae Tuber) Zhi Shi (Aurantii Fructus Immaturus)
Both pulses rise, spirit revives, but stool remains unpassed, middle deficiency with white tongue coating, difficult to purge. Moreover, Liver deficiency leads to fright, and this syncope is caused by malaria injury. Although Zhang Zhongjing mentions purging for syncope, verifying color and pulse, one must not blindly follow text to cause error.
Ren Shen (Ginseng Radix) Ban Xia (Pinelliae Tuber) Sheng Bai Shao (Raw Paeoniae Radix Alba) Chuan Lian (Coptidis Rhizoma) Zhi Shi (Aurantii Fructus Immaturus) Wu Mei Rou (Mume Fructus Flesh)
Unresolved malaria pathogens return, combined with anger, causing Liver qi knotting in the middle jiao; besides tonifying deficiency, must assist in scattering pathogens and opening knots.
Ren Shen (Ginseng Radix) Sheng Mu Li (Raw Ostreae Concha) Bai Shao (Paeoniae Radix Alba) Ju Hong (Citri Reticulatae Pericarpium Rubrum) Zhi Bie Jia (Prepared Testudinis Carapax et Plastrum) Dan Pi (Moutan Cortex)
Postpartum lower deficiency, malaria after dysentery, indicates mutual damage to Ying and Wei. Since color and pulse do not suggest external pathogen, frequent tonification fails due to chaotic treatment. The Classics state: "Yang Wei vessel governs painful chills and fever."
Ren Shen (Ginseng Radix) Gui Zhi Mu (Cinnamomi Ramulus) Chao Dang Gui (Stir-fried Angelicae Sinensis Radix) Lu Jiao Shuang (Cornu Cervi Degelatinatum) Zhi Gan Cao (Prepared Licorice Root) Pao Hei Jiang (Charred Black Ginger)
Accumulated fatigue damages Yang, grief moves viscera, multiple internal injuries; summer-autumn latent pathogens are deeply entrenched. Coming from Yin meridians, Zhu Hanlao was not wrong; patient rests after medicine because warm herbs assist Yang. Examining Three Yin meridians, using warm tonification to support righteousness is indeed supporting expulsion of pathogens. Zhi Mu causes hiccups upon swallowing, indicating Yang of Yangming is nearly exhausted; no hunger, no eating, no sleep, Yang does not circulate, Sanjiao is trapped, Spleen and Stomach are exhausted. Anal prolapse belongs to Yin damage and qi sinking, unable to bear pure rigid agents.
Ren Shen (Ginseng Radix) Dang Gui (Angelicae Sinensis Radix, rice-fried) Nong Po (Magnoliae Officinalis Cortex) Mi Jiao (Cornu Elaphi, wine-soaked and baked) Pao Jiang (Baked Ginger) Cao Guo (Tsaoko Fructus)
Yin malaria involves Foot-Taiyin meridian; first advance Chai Hu Jiang Gui Tang (Bupleurum, Ginger, and Cinnamon Twig Decoction).
Chai Hu (Bupleuri Radix) Huang Qin (Scutellariae Radix) Gua Lou Gen (Trichosanthis Radix) Gan Cao (Licorice Root) Gui Zhi (Cinnamomi Ramulus) Gan Jiang (Zingiberis Rhizoma) Sheng Mu Li (Raw Ostreae Concha)
Malaria unresolved for twenty days, more chills than fever, is Pin Malaria (Yin Malaria); advance Mu Li San (Oyster Shell Powder).
Mu Li (Ostreae Concha) Long Gu (Fossi Mastodi et Lemuri Ossa) Rou Gui (Cinnamomi Cortex) Bai Shao (Paeoniae Radix Alba) Yun Mu (Muscovite) Shu Qi (Polygalae Radix) Zhi Cao (Prepared Licorice Root) Da Zao (Jujubae Fructus)
Pin Malaria has more chills, internal heat, and palpitations.
Yang Dan Tang (Yang Dawn Decoction), add Sheng Mu Li (Raw Ostreae Concha), Hua Fen (Trichosanthis Radix).
Labor malaria persists, limb edema, more chills.
Yang Dan Tang (Yang Dawn Decoction), add Mu Li (Ostreae Concha), Yun Mu Shi (Muscovite).
Yin malaria for four months, sweating, lower limb swelling.
Take Ba Wei Wan (Eight-Ingredient Pill) in the morning.
Dan Fu Zi (Prepared Aconiti Lateralis Radix) Xi Xin (Asari Radix et Rhizoma) Sheng Bai Zhu (Raw Atractylodis Macrocephalae Rhizoma) Ze Xie (Alismatis Rhizoma)
Jue Yin Yin Malaria persists, able to eat.
Shu Di Tan (Charred Rehmanniae Radix Preparata) Dan Cong Rong (Cistanche Deserticola) Mu Li (Ostreae Concha) Wu Wei Zi (Schisandrae Fructus) Lu Jiao Shuang (Cornu Cervi Degelatinatum) Long Gu (Fossi Mastodi et Lemuri Ossa)
Yin malaria unrecovered for three years, lower deficiency with emission and discharge.
Shu Qi (Polygalae Radix) Mu Li (Ostreae Concha) Zhi Huang Qi (Prepared Astragali Radix) Gui Zhi (Cinnamomi Ramulus) Long Gu (Fossi Mastodi et Lemuri Ossa) Zhi Gan Cao (Prepared Licorice Root)
Yin malaria chronic deficiency.
Yi Qi Tang (Tonify Qi Decoction) add Fu Zi (Aconiti Lateralis Radix Preparata).
Yin malaria pulse deep, gradually back cold and limbs cold, epigastric fullness after eating. This belongs to extreme Yang damage; late spring Wood flourishing fears floating swelling disease; suitable to regulate Middle Jiao and assist Lower Jiao, do not drive out pathogens to treat malaria.
Fu Zi Gui Ren Shen Tang (Aconite, Cinnamon, Ginseng Decoction), add Kuai Fu Ling (Poria), Sheng Jiang (Fresh Ginger), Da Zao (Jujubae Fructus).
Winter latent pathogens, emerging in spring as Wen Malaria (Warm Malaria), sweating does not resolve, known not due to new contraction. Pulse deficient, prior sequelae exist, avoid consuming true qi; harmonize righteousness and scatter pathogens is stable.
Gui Zhi (Cinnamomi Ramulus) Cao Guo (Tsaoko Fructus) Xing Ren (Armeniacae Semen Amarum) Bai Shao (Paeoniae Radix Alba) Ku Qin (Scutellariae Radix) Jie Geng (Platycodonis Radix)
Malaria starts from extremities, must invade Middle Jiao; Stomach alone suffers humiliation, hence vexation, thirst, epigastric fullness, no hunger. Today red tongue, loose stool, Yin qi injured first, Yang pathogen not exhausted; suitable for Qin and Shao to harmonize interior, plus drain Wood pathogen to save Stomach Yin.
Huang Qin (Scutellariae Radix) Dan Pi (Moutan Cortex) Bai Kou Ren (Amomi Fructus Rotundus Seed) Bai Shao (Paeoniae Radix Alba) Qing Hao (Artemisiae Annuae Herba) Wu Mei Rou (Mume Fructus Flesh)
After monthly malaria, prone to anger. Spring season corresponds internally to Liver and Gallbladder; its function is excessive, its substance particularly deficient, hence feeling weak and timid. Examining Zhang Zhongjing, when malaria comes and recovers, blood and qi knot in hypochondrium,必有 zha ju (masses), named Ma Mu (Malaria Mother). Mother is the root of malaria pathogen; Bie Jia Jian Wan (Turtle Shell Pill for Reducing Accumulations) is main treatment, making blood and qi circulate, leaving no room for lingering pathogens.
Taking Lu Jiang Yin (Dew Ginger Drink) brings relief, yet chills and fever return, knowing pathogen lies in Yin, cannot be resolved; constipation for ten days, propose searching Jue Yin for elimination.
When Three Yang meridians are connected, pathogens have no place to stand.
Malaria long-standing, pathogen enters collaterals; collaterals govern blood, pathogen knots in blood aspect, forming Ma Mu (Malaria Mother). Zhang Zhongjing's Bie Jia Jian Wan (Turtle Shell Pill for Reducing Accumulations) specifically regulates ascent/descent and promotes blood stasis to treat Liver, stating Shaoyang cold-heat eventually enters Liver; Liver governs blood, left hypochondrium is Liver membrane shu point, attacking disease should be so. But with spermatorrhea, poor appetite, indigestion, various ailments are not one-sided; this attacking-pathogen warming-tonification method cannot move the disease; better to nourish righteousness, qi vigorous then pathogen removes, ancient texts confirm this.
Midday take Miao Xiang San (Wonderful Fragrance Powder), evening take A Wei Wan (Asafoetida Pill).
Long-term malaria needle pricking stops with sweat; channel pathogens removed, collateral pathogens remain, hypochondrium forms Ma Mu (Malaria Mother), hard to touch, protruding shape. Four years with illness, still eats and stools normally, knot not in intestines/stomach, medicine entering stomach/intestines ineffective, likely because collaterals attach outside viscera.
Sheng Bie Jia (Raw Testudinis Carapax et Plastrum, green, scraped, 4 liang) Chuan Shan Jia (Pangolin Scales, roasted, 2 liang) Wu Ling Zhi (Trogopterori Faeces, burned until smoke ceases, 2 liang) She Xiang (Moschus, avoid fire, separately ground, 5 qian) Chen Sha (Cinnabaris, avoid fire, water-triturated, 5 qian)
Grind each medicine separately, add pure powder by weight, mix with 1 qian A Wei (Asafoetida), pound into pills, take 2 qian when hungry.
San Malaria (Triadic Malaria) long-standing, self-reports chest/epigastric distension upon mental labor. Labor damages Yang; propose warming/nourishing Ying aspect to support expulsion of pathogens.
Ren Shen (Ginseng Radix) Gui Zhi (Cinnamomi Ramulus) Zhi Gan Cao (Prepared Licorice Root) Nan Zao (Southern Jujube) Fu Ling (Poria) Shu Qi (Polygalae Radix) Dang Gui Shen (Angelicae Sinensis Radix) Sheng Jiang (Fresh Ginger)
Malaria occurs every three days, pathogen lies in Yin; although stopped for years, righteous injury hard to recover. Wei Yang leaks outward, sweating, spirit fatigue; suitable for sweet-warm qi-tonifying category. At fifty approaching decline, must rest and conserve, not rely solely on medicine.
Nourish Ying method: use Wei Jiang (Baked Ginger) 3 liang, Nan Zao (Southern Jujube) 4 liang, boil juice to make pills.
Three-day malaria is pathogen lying in Yin branch, hejie (harmonizing/reconciling) cannot work. Long persistence requires tonics to raise Yang, guiding latent pathogen to Yang branch to cure; sticking to tonics is incorrect.
Lu Rong (Cornu Cervi Pantotrichum) Ren Shen (Ginseng Radix) Shu Fu Zi (Prepared Aconiti Lateralis Radix) Chao Hei Qi Zi (Stir-fried Black Lycii Fructus) Lu Jiao Shuang (Cornu Cervi Degelatinatum) Dang Gui (Angelicae Sinensis Radix) Fu Ling (Poria) Chao Sha Yuan (Stir-fried Astragali Complanati Semen)
Childhood three-day malaria, mostly Taiyin Spleen injury; diet forbids fish/meat; after劫邪 (expelling pathogen), continue raising Yang.
Chang Shan (Dichroae Radix) Bai Zhu (Atractylodis Macrocephalae Rhizoma) Nong Po (Magnoliae Officinalis Cortex) Cao Guo (Tsaoko Fructus) Chen Pi (Citri Reticulatae Pericarpium) Jiang Zhi (Ginger Juice)
Diagnose left small-rapid pulse, right slow-soft urine-related pulse. Post-meal vexation/fatigue indicates declining Spleen Yang; ancients said malaria/dysentery due to Spleen weakness. Plus loose stool, depleted color, thin body; if not urgently tonifying Later Heaven (Spleen/Stomach) to build Mother Qi, weak medicines will consume Yuan Qi. Use Ju Fang (Formulary of the Imperial Medical Bureau) Modified Si Shou Yin (Four Beast Decoction).
Ren Shen (Ginseng Radix) Shu Zhu (Prepared Atractylodis Macrocephalae Rhizoma) Cao Guo Ren (Tsaoko Fructus Seed) Guang Pi (Citri Reticulatae Pericarpium) Fu Ling (Poria) Zhi Cao (Prepared Licorice Root) Wu Mei Rou (Mume Fructus Flesh)
This is Yang-damaged malaria, cycling endlessly, collaterals long empty; must raise/tonify Yang qi.
Sheng Huang Qi (Raw Astragali Radix) Zhi Cao (Prepared Licorice Root) Sheng Jiang (Fresh Ginger) Lu Jiao (Cornu Cervi) Dang Gui (Angelicae Sinensis Radix) Nan Zao (Southern Jujube)
Lu Jiang Yin (Dew Ginger Drink) stops malaria by benefiting Middle Qi to drive out pathogens; this is the method for deficient persons. Spleen/Stomach not awake, forbid fishy/turbid foods.
Ren Shen (Ginseng Radix) Zhi Cao (Prepared Licorice Root) Ban Xia (Pinelliae Tuber) Yi Zhi Ren (Alpiniae Oxyphyllae Fructus) Ju Hong (Citri Reticulatae Pericarpium Rubrum) Jiang Zhi (Ginger Juice)
Yin leakage, Yang covering, frequent emission, epistaxis, chills/fever, wasting-thirst, qi hitting heart, drowsiness/startle, polydipsia/vomiting, heavy legs, urethral blockage. *Jin Gui* says Yin qi injured first, Yang acts alone. Seeing Jue Yin malaria differs from Upper Jiao treatment.
Xian Sheng Di (Fresh Rehmanniae Radix) Zhi Mu (Anemarrhenae Rhizoma) Sheng Gan Cao Shao (Raw Licorice Root Tip) Yuan Shen (Scrophulariae Radix) Chuan Hu (Dendrobii Caulis) Zhu Ye (Bambusae Folium)
During febrile disease, malaria arises; without distinguishing Qi/Blood level, using dispersing/digesting methods劫胃汁 (steals Stomach fluids), leading to no hunger/eating. Sudden fright, Liver Yang rises, alternating hot/cold, cold feet, abdominal distension/discomfort. Hypochondriac mass tenderness from long-term disease entering collaterals. Yin/Yang blocked, urination/defecation obstructed; first give Geng Yi Wan (Change Clothing Pill) 2 qian, wait half day for stool passage. Next day, use method to harmonize Jue Yin/Yangming.
Sheng Mu Li (Raw Ostreae Concha) Bai Zi Ren (Biota Seed) Sheng Bai Shao (Raw Paeoniae Radix Alba) Chuan Liu Rou (Toosendan Fructus Flesh) Xiao Hei Dou Pi (Black Soybean Skin) Xi Gen Sheng Di (Fine-root Fresh Rehmanniae Radix)
Malaria heat injures Yin, fluids cannot ascend, tongue center feels like board. Eyes closed, facial swelling, startle; Liver Yang transforms wind shaking internally; Stomach qi rebels with fullness, desires massage. Heat gathers in diaphragm, steaming Chest Center, leading to coma/blockage; elderly danger is imminent, but this is not physical knot, cold-purgatives ineffective, plus prior diarrhea shows pathogen sinking/Yin injury. Yin injury is Lower, heat gathers Upper; saving Yin agents cannot penetrate diaphragm to moisten Lower. Qin/Lian (Scutellaria/Coptis), Liang Ge San (Cool Diaphragm Powder), bitter-acrid dry agents further injure Yin, not optimal. Planning carefully, method should separate/regulate; propose tonight first taking Qing Xin Niu Huang Wan (Clear Heart Calves' Horn Pill), divided into three doses with warm water, using aromatic-clearing-drying to open knot. Re-evaluate tomorrow.
Traveling in summer heat, hot air enters mouth/nose, affecting Upper/Middle, distributing Ying/Wei, thus becoming chills/fever malaria. Eat bland food, clear Stomach qi. Medicines should cool-disperse-aromatic or sweet-cold generate fluids. Why use dispersing for cold? Not knowing mouth/nose heat differs from skin cold; treatment fails, blindly tonifying, Ren Shen/Angelica/Cistanche/Rehmannia clog Middle Palace, Lung qi blocks, Stomach stagnates, swelling spreads down, whole body qi blocked; Zhang Dairen said pathogens gain strength with tonification, like nurturing bandits harming good people. But long illness wastes form, correcting errors then attacking fears righteous qi dying; thus change decoction to pill. Pills act slowly, allowing Middle Jiao to disperse, gradually turning, ascent/descent declared, Six Fu organs may reopen; Fu open, channel qi unblocked. Daily take Danxi Bao He Wan (Harmonize and Preserve Pill).
Left hypochondriac old accumulation mass, now malaria recurring, left hypochondrium forms Ma Mu (Malaria Mother), chest/epigastric fullness, difficult stool; residual malaria pathogen and qi knot, Six Fu not spreading; suitable to attack/unblock stasis, first advance Bie Jia Jian Wan (Turtle Shell Pill for Reducing Accumulations) 3 qian. Morning, noon, dusk take 7 pills each, wash down with boiling water.
Malaria pathogen not exhausted, blocking qi obstruction, causing abdominal distension/leg swelling, rebellious qi/wheezing. Water-dampness internal accumulation, treatment should separate/draining.
Xing Ren (Armeniacae Semen Amarum) Mu Li (Ostreae Concha) Zhu Ling (Polyporus) Nong Po (Magnoliae Officinalis Cortex) Ze Xie (Alismatis Rhizoma) Fu Ling (Poria)
Malaria stopped too early, pathogen heat not exhausted, epigastric fullness/no hunger, thirst/spontaneous diarrhea, prevent dysentery.
Chuan Lian (Coptidis Rhizoma) Huang Qin (Scutellariae Radix) Ban Xia (Pinelliae Tuber) Zhi Shi (Aurantii Fructus Immaturus) Bai Shao (Paeoniae Radix Alba) Ju Bai (Citri Reticulatae Pericarpium Album)
Discuss upper/lower combined pathogens, drain Jue Yin to pacify Yangming, assist regulating summer-dampness methods.
Gui Zhi Mu (Cinnamomi Ramulus) Chuan Lian (Coptidis Rhizoma) Ren Shen (Ginseng Radix) Sheng Mu Li (Raw Ostreae Concha) Wu Mei (Mume Fructus) Bai Shao (Paeoniae Radix Alba)
Phlegm-wheeze triggered by external pathogens, cannot lie flat, mostly Kidney disease. Wind-cold lodges in Taiyang, weak constitution invades Shaoyin. If summer-dampness, touches mouth/nose, back boils correspond to Lung, Hand-Jueyin affected, acrid-cool light agents resolve; Lung likes acrid, image hangs up, heavy flavor/drug force goes down, Lung pathogen unresolved. However, summer disease enters winter, climate changes, heat pathogen deepens, blood/qi daily damaged; nourishing-clearing like E Jiao/Di Huang, searching like Bie Jia Jian Wan, helpless not just Yin deficiency, Eight Vessels qi decline, cold becomes heat, disease prolongs/wastes, throat pain, fire rises upper heat, slow lower heat, rigid drugs hard to use, soft-warm nourishment assists opening Odd Vessels decided.
Sheng Lu Jiao Shuang (Raw Cornu Cervi Degelatinatum, 3 qian) Chao Hei Gou Qi (Stir-fried Black Lycii Fructus, 1.5 qian) Fu Ling (Poria, 1.5 qian) Sha Hei Dang Gui Shen (Sand-black Angelicae Sinensis Radix, 1.5 qian) Shu Di Tan (Charred Rehmanniae Radix Preparata, 3 qian) Sheng Sha Yuan (Raw Astragali Complanati Semen, 1 qian)
Zha Xie (Mass diarrhea) cold/heat rises, propose regulating Ren/Du scattered qi.
Lu Jiao Shuang (Cornu Cervi Degelatinatum, 3 qian) Shu Di Tan (Charred Rehmanniae Radix Preparata, 5 qian) Bu Gu Zhi (Psoraleae Fructus, salt-water boiled 100 times, 8 fen) Bai Gui Ban (Tortoise Plastron, scraped/roasted/grinded, 3 qian) Yun Fu Ling (Cloud Poria, 1.5 qian) Shi Ke Jian Lian (Stone-shell Lotus Seed, shell intact, 10 grains)
Menstruation advances 3 days, more heat less chills, left pulse string-large. Blood aspect biased heat, treat Jue Yin malaria pathogen stuck in blood.
Sheng Bie Jia (Raw Testudinis Carapax et Plastrum) Dong Sang Ye (Mulberry Leaf) Qing Hao Geng (Artemisiae Annuae Herba Stem) Chao Tao Ren (Stir-fried Persicae Semen) Chao Dan Pi (Stir-fried Moutan Cortex) Chuan Bei Mu (Fritillariae Cirrhosae Bulbus)
Malaria is summer-damp guest pathogen, blood syndrome follows timing. Already Yin-deficient constitution, treating pathogen must care for root; propose Zhu Ye Di Huang Tang (Bamboo Leaf and Rehmannia Decoction).
Zhu Ye (Bambusae Folium) Zhi Mu (Anemarrhenae Rhizoma) Chuan Bei Mu (Fritillariae Cirrhosae Bulbus) Xian Sheng Di (Fresh Rehmanniae Radix) Bo He (Menthae Haplocalycis Herba)
After chills/fever, diagnose small-weak pulse, white tongue, thirst no desire to drink, much phlegm/chest oppression. Malaria not finished, righteous already deficient, cannot over-attack, fear decline.
Sheng Bai Zhu (Raw Atractylodis Macrocephalae Rhizoma) Ban Xia (Pinelliae Tuber) Cao Guo Ren (Tsaoko Fructus Seed) Guang Pi (Citri Reticulatae Pericarpium) Fu Ling (Poria) Nong Po (Magnoliae Officinalis Cortex)
Skin lesion patient with damp malaria, forbid exterior release.
Cang Zhu Bai Hu Jia Cao Guo Ren (Atractylodes White Tiger plus Tsaoko).
Latent pathogen becomes malaria, chills/fever alternate days, much sweat/desire to vomit, epigastric fullness/no hunger, advance Xie Xin Tang (Drain Epigastrium Decoction) method.
Chuan Lian (Coptidis Rhizoma) Huang Qin (Scutellariae Radix) Xing Ren (Armeniacae Semen Amarum) Zhi Shi (Aurantii Fructus Immaturus) Jiang Zhi (Ginger Juice) Ban Xia (Pinelliae Tuber) Nong Po (Magnoliae Officinalis Cortex) Cao Guo (Tsaoko Fructus)
Pulse powerless, chills/fever night onset, vexation/thirst/nausea, yellow tongue middle fullness. Although Fu Shu (latent summer heat) malaria, usually labor implies internal injury, cannot stick to dispersing/digesting; first advance Xie Xin Tang (Drain Epigastrium Decoction) to drain accumulated heat.
Chuan Lian (Coptidis Rhizoma) Dan Huang Qin (Pale Scutellariae Radix) Hua Fen (Trichosanthis Radix) Zhi Shi (Aurantii Fructus Immaturus) Jiang Zhi (Ginger Juice) Chao Ban Xia (Stir-fried Pinelliae Tuber) Dou Kou (Cardamomi Fructus) Ju Hong (Citri Reticulatae Pericarpium Rubrum)
After chills/fever fluid injury, black tongue coating, dry mouth no taste, food no hunger, stool unsatisfactory, suitable nourishing Yin fluids method.
Mai Dong (Ophiopogonis Tuber) Zhi Mu (Anemarrhenae Rhizoma) Ju Hong (Citri Reticulatae Pericarpium Rubrum) Ren Shen (Ginseng Radix) Chuan Shi Hu (Dendrobii Caulis) Wu Mei Rou (Mume Fructus Flesh)
Postpartum under 100 days, Lower Jiao essence/blood not vigorous, thus San Malaria (Triadic Malaria), due to true qi internal timidity, pathogen unwilling to exit. Medicine clearing/dispersing/purging only treats Three Yin malaria, leading to profuse sweating, sign of Yang qi collapse/destruction.
Ren Shen (Ginseng Radix) Bu Gu Zhi (Psoraleae Fructus) Chao Hei Hui Xiang (Stir-fried Black Foeniculi Fructus) Fu Ling (Poria) Dang Gui Shen (Angelicae Sinensis Radix)
Dampness excess chills, unresolved becomes malaria. Dampness governs joints pain, pathogen inside causes vexation; total damp-heat interior malaria, treatment suitable bitter-acrid.
Chuan Lian (Coptidis Rhizoma) Huang Qin (Scutellariae Radix) Xing Ren (Armeniacae Semen Amarum) Jiang Zhi (Ginger Juice) Ban Xia (Pinelliae Tuber) Nong Po (Magnoliae Officinalis Cortex)
Pulse large, chills/fever/thirst drinking, tongue gradually yellow. Qi aspect heat wins, blood weak long time, fear pathogen spreading stealing fluids, clear Qi heat to harmonize Yang, propose Zhang Shi Yu Nu Jian (Master Zhang's Jade Woman Decoction).
Shi Gao (Gypsum Fibrosum) Zhu Ye Xin (Bamboo Leaf Heart) Xian Sheng Di (Fresh Rehmanniae Radix) Zhi Mu (Anemarrhenae Rhizoma) Sheng Gan Cao (Raw Licorice Root) Sheng Bai Shao (Raw Paeoniae Radix Alba)
Latent pathogen stays between Shaoyin/Jueyin, for San Malaria (Triadic Malaria). 100 days not cured, pathogen injures True Yin, dream emission/night sweats. Fluids daily dry, intestine difficult. Nourishing Yin helpful, but deep malaria pathogen, how to chase/remove? Propose Zhang Zhongjing Bie Jia Wan (Turtle Shell Pill) 30 pills, morning wash down with boiling water, afternoon nourish Yin/open Yang medicine.
Fu Mai Tang (Restore Pulse Decoction), remove Ren Shen/Sheng Jiang, add Mu Li/Lu Jiao Shuang.
Pathogen and blood/qi coagulate becomes malaria. Female disease in collaterals. From left hypochondrium gradually returns to Middle Jiao, Wood attacks Earth. Dong Yuan said malaria long injures Spleen/Stomach; once formed shape, suitable to pass evil/guard, assist aromatic to enter collaterals. Food fat/rigid especially forbidden. Fear extending to fullness.
Ren Shen (Ginseng Radix) Cao Guo (Tsaoko Fructus) Chen Pi (Citri Reticulatae Pericarpium) Mu Xiang (Aucklandiae Radix) Fu Ling (Poria) Nong Po (Magnoliae Officinalis Cortex) Qing Pi (Citri Reticulatae Pericarpium Viride) Yu Jin Zhi (Curcumae Radix Juice)
Late autumn diagnosed, proposed this disease as summer-damp eating melon, acrid-sweet-cold separating draining; why Spleen Yang suffers acrid-cold burden, causing turbid Yin gathering shape, food relapse, Yang aspect injured. Body Spleen Yang should move, move then transport; Kidney Yang should store, store then secure, this is life root. Ju Fang Da Jian Pi Wan (Great Building Spleen Pill), Zhong Chun Zi Sheng Wan (Zhong Chun Nourish Life Pill), mostly tonify deficiency/pass stagnation, aromatic combined, take qi pass turbid drain, Ren Shen assists righteous power obtained.
Ren Shen (Ginseng Radix) Chen Pi (Citri Reticulatae Pericarpium) Nong Po (Magnoliae Officinalis Cortex) Yi Zhi Ren (Alpiniae Oxyphyllae Fructus) Fu Ling (Poria) Mu Xiang (Aucklandiae Radix)
Alternate day chills, fever thirst drinking, this is malaria. Drinking water gathers, heart pain/distension, disease adds disease. Dare not use emetic medicine, temporarily give opening Lung qi obstruction formula.
Sheng Shi Gao (Raw Gypsum Fibrosum) Da Xing Ren (Large Armeniacae Semen Amarum) Sheng Gan Cao (Raw Licorice Root) Mi Shui Chao Ma Huang (Honey-water stir-fried Ephedrae Herba)
Pulse like normal person, only heat no chills, vexation/thirst, body ache occasional vomiting, this Wen Malaria (Warm Malaria). Zhang Zhongjing has Gui Zhi Bai Hu Tang (Cinnamon Twig and White Tiger Decoction) method, one dose knows, two doses cures.
Gui Zhi Bai Hu Tang (Cinnamon Twig and White Tiger Decoction).