胃实即噫。胃虚即哕。逆者。胃中虚。膈上热也。咳逆为病。古为之哕。近为之呃。乃
胃寒
所生。寒气自逆而呃上。此证最危。间有热呃。已见伤寒证。其有他病发呃者。皆属寒。宜
用半夏一两。生姜两半。水一碗。煎半碗热服。或用丁香十粒。柿蒂十个。切碎。白水盏半
煎。或理中汤加枳壳茯苓各半钱。半夏一钱。不效。更加丁香十粒。
亦有无病。偶然致呃。此缘气逆而生。重者或经一二日。宜小半夏茯苓汤。加枳实半夏
汤。
或用煎汤。泡萝卜子。研取汁。调木香调气散。乘热服。逆气用之。最佳。若胃中寒甚。呃
逆不已。或复加以呕吐。轻剂不能取效。宜丁香煮散。以及附子粳米汤。增炒川椒丁香。每
服各二十三粒。
疟证不一。其名亦殊。初得之。病热正炽。一二发间。未宜遽截。不问寒热多少。且用
清脾
饮。草果饮。或二陈汤。加草果半钱。或生料平胃散。加草果半钱。前胡半钱。亦有非疟非
劳等疾。而自成寒热。乃是痰饮为之。不可不审。去痰行饮。则愈。
初发之际。风寒在表。虽寒热过后。而身体常自疼。常自畏风。宜草果饮。或养胃汤。
每服
加川芎草果各半钱。热少者。进取微汗寒多者宜快脾汤。或养胃汤。每服加草果半钱。服药
后寒仍多者。养胃汤。每服加熟附官桂各半钱。独寒者尤宜。不效。则七枣汤。热多者。宜
驱疟饮。或参苏饮。每服加草果半钱。大热不除。宜小柴胡汤。渴甚。则佐以五苓散。入辰
砂少许。独热无寒。宜小柴胡汤。热虽剧不甚渴者。于本方加桂四分。热多而脾气怯者。柴
朴汤。寒热俱等者。常服。宜如上项二陈汤。平胃散。加料之法。发日进柴胡桂姜汤。候可
截则截之。有独热。用清脾饮效者。内烦增参作一钱重。然恐非特可治独热也。食疟。乃是
饮食伤脾得之。
或疟已成。而犹不忌口。或寒热正作时。吃食。其人噫气吞酸。胸膈不利。宜生料平胃
散。每服加草果半钱。砂仁半钱。仍佐以红丸子。七香散。
暑疟。其人面垢口渴。虽热已退后。无事之时。亦常有汗。宜养胃汤一帖。香薷饮一帖
和
匀作二服。渴甚。汗出多者。加味香薷饮。间进辰砂五苓散。不问未发。其人呕吐痰食俱出
宜多进二陈汤。每服草果加之半钱。又恐伏暑蕴结为痰。宜消暑丸。更于暑疟中求之。有
四五发已后。应诸证。并可截疟丹。未愈再进。
久疟。经年累月。名曰疟母。又名劳疟。不宜十分攻之。所谓久疟不治者。是也。进四
兽饮
间山甲丸。疟愈后调理。宜生料平胃散。每服加人参茯苓各半钱。或用四君子汤。加陈皮
一钱半。即异功散。
外有伤寒。往来寒热如疟。劳病。往来寒热。亦如疟。谓之如疟。非真疟也。然伤寒寒
热如
疟。初必恶风寒。发热。头痛体疼。自太阳经而来。劳病寒热如疟。初必五心发烦热。劳倦
咳嗽。久乃成寒热。与正疟自不同。诸病皆有寒热。如失血痰饮。 瘕积聚。小肠 气。风
寒
暑湿。食伤发劳。劳瘵。疮毒。香港脚。已各见本门。其余不能尽举。应有不如发疟之传为寒
热
者。须问其元有何病。而生寒热。则随病施治。寒热发作有期者。疟也无期者。诸病也。
近世因寒热发作。见其指甲青黑。遂名曰沙。或戛或挑。或灌以油茶。且禁其服药。此
病即是南方瘴气。生料平胃散。加草果槟榔。正宜所治。岂有病而无药哉。
胃气充实则出现嗳气。胃气虚弱则出现呃逆（干呕）。所谓“逆”，是指胃中虚寒，膈上有热。咳逆这一病症，古代称为哕，近代称为呃，多由胃寒引起。寒气上逆导致呃逆发作。此证最为危重。间或有因热引起的呃逆，已在伤寒证候中见过。其他疾病引发的呃逆，都属于寒证。适宜用半夏一两、生姜一两半，加水一碗，煎至半碗，热服。或者用丁香十粒、柿蒂十个，切碎，加白水一盏半煎煮。或者使用理中汤，加入枳壳、茯苓各半钱，半夏一钱。如果无效，再加丁香十粒。也有没有患病而偶然发生呃逆的，这是由于气机逆乱所致。病情重的可能持续一两天，适宜用小半夏茯苓汤，或加枳实半夏汤。或者用煎好的萝卜子汁，调入木香调气散，趁热服用。对于气逆症状，效果最佳。如果胃中寒邪极重，呃逆不止，或者又加上呕吐，轻剂药物不能见效，适宜用丁香煮散，以及附子粳米汤，增加炒川椒和丁香。每次服用各二十三粒。
疟疾的证候不一，名称也各不相同。刚发病时，热势正盛，在一两次发作期间，不宜立即强行截断。不论寒热多少，先用清脾饮、草果饮，或者二陈汤，加入草果半钱。或者用生料平胃散，加入草果半钱、前胡半钱。也有既不是疟疾也不是劳损等病，却自行出现寒热交替的，这是痰饮造成的，不可不仔细审察。去除痰饮，则病愈。
在初发之际，风寒在表，虽然寒热过后，身体仍然常常疼痛，常常怕风。适宜用草果饮，或者养胃汤。每服药时加入川芎、草果各半钱。热象较轻的，进取微汗；寒象较重的，宜用快脾汤，或者养胃汤，每服药时加入草果半钱。服药后寒象仍然多的，用养胃汤，每服药时加入熟附子、官桂各半钱。特别适用于只有寒象的情况。如果无效，则用七枣汤。热象较多的，宜用驱疟饮，或者参苏饮，每服药时加入草果半钱。大热不退的，宜用小柴胡汤。口渴严重的，配合五苓散，加入少许辰砂。只有热象没有寒象的，宜用小柴胡汤。热象虽剧烈但口渴不严重的，在本方中加入桂枝四分。热多且脾气虚弱的，用柴朴汤。寒热程度相等的，常服如上所述的二陈汤、平胃散。在发作当天进服柴胡桂姜汤，等到可以截断疟疾的时候再截断。有独热症状，使用清脾饮有效的，将人参增加到一钱重。然而恐怕这不仅仅适用于治疗独热。食疟，是由于饮食损伤脾胃所致。
或者疟疾已经形成，但仍然不忌口，或者在寒热发作时进食，病人出现嗳气吞酸，胸膈不畅。适宜用生料平胃散，每服药时加入草果半钱、砂仁半钱，仍配合红丸子、七香散。
暑疟，病人面色垢浊、口渴，即使热退之后，无事之时也常有汗出。适宜用一帖养胃汤、一帖香薷饮，混合均匀分两次服用。口渴严重、出汗多的，用加味香薷饮。间歇性进服辰砂五苓散。不论是否发作，如果病人呕吐痰食俱出，应多进服二陈汤，每服药时加入草果半钱。又担心伏暑蕴结为痰，适宜用消暑丸，更要在暑疟的治疗中寻求方法。有四五次发作之后，应对各种证候，都可以用截疟丹。未痊愈再进服。
久疟，经年累月，称为疟母，也称为劳疟。不宜过分攻伐。所说的“久疟不治”，就是这个意思。进服四兽饮，间服山甲丸。疟疾痊愈后的调理，适宜用生料平胃散，每服药时加入人参、茯苓各半钱。或者用四君子汤，加入陈皮一钱半，即异功散。
此外有伤寒，往来寒热像疟疾一样，劳病，往来寒热也像疟疾一样，称为“如疟”，并非真正的疟疾。然而伤寒寒热如疟，起初必定恶风寒、发热、头痛体痛，从太阳经传来。劳病寒热如疟，起初必定五心烦热、劳倦咳嗽，久了才变成寒热，与真正的疟疾自然不同。各种疾病都有寒热，如失血、痰饮、瘕积聚、小肠气、风寒暑湿、饮食伤导致的劳损、劳瘵、疮毒、香港脚等，已经在各自门类中见过。其余不能全部列举。所有不像疟疾那样发作而转为寒热的，必须询问原本有什么病，从而产生寒热，然后随病施治。寒热发作有固定时间的，是疟疾；无固定时间的，是其他疾病。近代因为寒热发作，看到指甲青黑，就命名为沙证。或者刮刺，或者挑破，或者灌以油茶，并且禁止其服药。这个病就是南方的瘴气，生料平胃散加入草果、槟榔，正是适宜治疗的。难道有病却没有药吗？
Stomach fullness leads to belching. Stomach deficiency leads to hiccups (diaphragmatic spasm). "Ni" (rebellious Qi) refers to cold in the stomach and heat above the diaphragm. The disease of coughing with rebellious Qi was called "Yue" in ancient times and "E" in recent times, generated by stomach cold. Cold qi rebels upward causing hiccups. This condition is most critical. Occasionally, there are hot hiccups, as seen in Taiyang disease (disease pattern caused by pathogenic factors affecting the Taiyang meridian). Hiccups arising from other diseases all belong to cold patterns. It is suitable to use Banxia (Pinellia Rhizome) 1 liang, Shengjiang (Fresh Ginger) 1.5 liang, add one bowl of water, decoct until half a bowl remains, and take warm. Alternatively, use Dingxiang (Clove) 10 grains, Shidi (Persimmon Calyx) 10 pieces, chop finely, add one and a half bowls of plain water, and decoct. Or use Lizhong Tang (Regulate the Middle Decoction), add Zhike (Aurantium Fructus) and Fuling (Poria) each 0.5 qian, Banxia 1 qian. If ineffective, add Dingxiang 10 more grains. There are also cases where hiccups occur occasionally without illness, due to rebellious Qi. Severe cases may last one or two days; Xiaobanxia Fuling Tang (Minor Pinellia and Poria Decoction) or Zhi Shi Banxia Tang (Immature Bitter Orange and Pinellia Decoction) is suitable. Or use radish seed juice prepared by decoction, mixed with Muxiang Tiaoqi San (Costus Qi-Regulating Powder), taken while hot. For rebellious Qi, this is best. If stomach cold is severe, hiccups persist, or vomiting is added, mild agents cannot be effective. Dingxiang Zhusan (Clove Boiled Powder) and Fuzi Jingmi Tang (Aconite and Rice Decoction) with added Chao Chuanjiao (Fried Sichuan Pepper) and Dingxiang are suitable. Take 23 grains of each per dose.
Malaria patterns vary, and their names differ. At the onset, when heat is intense, it is not advisable to abruptly arrest the attack during the first one or two episodes. Regardless of the degree of cold or heat, initially use Qingpi Yin (Clear Spleen Infusion), Caoguo Yin (Tsaiko Root Infusion), or Erchen Tang (Two Aged Substances Decoction) with Caoguo (Tsaiko Fruit) 0.5 qian added. Or use Shengliao Pingwei San (Raw Material Stabilize the Stomach Powder) with Caoguo 0.5 qian added, or Qianhu (Peucedani Radix) 0.5 qian added. Some conditions present with alternating cold and heat but are neither malaria nor consumption; these are caused by Phlegm-Fluid retention and must be carefully examined. Removing phlegm and fluids will cure the disease.
At the initial stage, Wind-Cold is on the exterior. Even after the cold and heat pass, the body often aches and feels aversion to wind. Caoguo Yin or Yangwei Tang (Nourish Stomach Decoction) is suitable. Add Chuanxiong (Ligusticum Rhizome) and Caoguo each 0.5 qian per dose. For less heat, induce slight sweating; for more cold, use Kuaipi Tang (Speedy Spleen Decoction) or Yangwei Tang, adding Caoguo 0.5 qian per dose. If cold persists after taking medicine, use Yangwei Tang, adding Shu Fuzi (Prepared Aconite) and Guigui (Cinnamon Twig) each 0.5 qian per dose. This is especially suitable for pure cold patterns. If ineffective, use Qizao Tang (Seven Jujube Decoction). For more heat, use Qumie Yin (Expel Malaria Infusion) or Shen Su Yin (Ginseng and Perilla Infusion), adding Caoguo 0.5 qian per dose. For persistent high fever, use Xiao Chaihu Tang (Minor Bupleurum Decoction). For severe thirst, assist with Wuling San (Five Ingredient Powder) with a small amount of Chen Sha (Cinnabar). For pure heat without cold, use Xiao Chaihu Tang. For severe heat without significant thirst, add Guizhi (Cinnamon Twig) 4 fen to the base formula. For heat predominance with weak Spleen Qi, use Chaipo Tang (Bupleurum and Magnolia Decoction). For equal degrees of cold and heat, regularly administer the aforementioned Erchen Tang or Pingwei San. On the day of attack, advance Chaihu Gui Jiang Tang (Bupleurum, Cinnamon, and Ginger Decoction); arrest the malaria when appropriate. For pure heat, Qingpi Yin is effective; increase Renshen (Ginseng) to 1 qian. However, this may not apply exclusively to pure heat. Food malaria results from dietary injury to the Spleen.
If malaria has formed but dietary restrictions are ignored, or if food is eaten during the cold-heat episode, the patient experiences belching, acid regurgitation, and chest/diaphragm discomfort. Shengliao Pingwei San is suitable, adding Caoguo 0.5 qian and Sharen (Amomum Fruit) 0.5 qian per dose, assisted by Hong Wanzi (Red Pill) and Qixiang San (Seven Fragrances Powder).
Summerheat malaria presents with a greasy face and thirst. Even after the fever subsides, sweating occurs frequently during rest. One dose of Yangwei Tang and one dose of Xiangru Yin (Elsholtzia Infusion) should be mixed evenly and taken in two doses. For severe thirst and profuse sweating, use Jiawei Xiangru Yin (Modified Elsholtzia Infusion). Intermittently advance Chen Sha Wuling San (Cinnabar Five Ingredient Powder). Regardless of whether an attack is imminent, if the patient vomits phlegm and food, advance Erchen Tang frequently, adding Caoguo 0.5 qian per dose. Concerning latent summerheat condensing into phlegm, Xiaoshu Wan (Relieve Summerheat Pill) is suitable; seek methods within the treatment of summerheat malaria. After four or five episodes, to address various symptoms, Jiemie Dan (Arrest Malaria Pellet) can be used. Advance again if not cured.
Chronic malaria lasting years is called Nuomu (Malaria Mother) or Laonue (Consumption Malaria). Do not attack too aggressively. This corresponds to the saying "chronic malaria is difficult to treat." Advance Sishe Yin (Four Beasts Infusion) and intersperse Shanji Wan (Hedgehog/ Pangolin Pill). Post-malaria regulation uses Shengliao Pingwei San, adding Renshen and Fuling each 0.5 qian per dose. Or use Sijunzi Tang (Four Gentlemen Decoction) with Chenpi (Tangerine Peel) 1.5 qian added, which is Yigong San (Extraordinary Merit Powder).
Additionally, Shanghan (Cold Damage) presenting with alternating cold and heat like malaria, and Laobing (Chronic Disease) with similar alternating symptoms, are called "Ru Nue" (Like Malaria), not true malaria. Shanghan alternating cold and heat begins with aversion to wind and cold, fever, headache, and body pain, originating from the Taiyang channel. Laobing alternating cold and heat begins with vexation and heat in the five centers, fatigue, and cough, eventually developing into alternating cold and heat, differing from true malaria. Various diseases have cold and heat, such as blood loss, phlegm-fluid, masses, Small Intestine Qi, Wind-Cold, Summerheat-Dampness, food injury leading to consumption, Tuberculosis, sores/toxins, and Beriberi, as seen in their respective sections. Others cannot be fully listed. For conditions turning into cold and heat unlike malaria, inquire about the original disease causing the cold and heat, and treat according to the disease. Malaria has periodic attacks; other diseases do not. In recent times, seeing black-blue nails during cold-heat attacks led to the name "Sha" (Sand/Poison). Treatments include scraping, pricking, or pouring tea oil, while forbidding medication. This disease is Southern Miasma. Shengliao Pingwei San with Caoguo and Binglang (Areca Seed) is precisely suitable for treatment. How can there be disease without medicine?