经曰∶夏伤于暑，秋必 疟（ ，老也。俗名三日疟。）夏热已甚，秋阳复收，两热相攻故为
疟。帝曰∶疟先寒而后热者何也？岐伯对曰∶夏伤于大暑，其汗大出，腠理开发，因遇夏气凄怆之
小寒，藏于脉理皮肤之中，秋伤于风，则病成矣。夫寒者，阴气也；风者，阳气也。先伤于寒而后
伤于风，故先寒而后热也。病以时作，名曰寒疟（云云。）《内经》论疟极详，皆谓风寒暑湿之邪
客于脏腑，致阴阳上下交争，虚实更作，阴阳相并相移也。后人始论七情劳役，食积痰饮皆成疟。
所谓无汗要有汗，发散邪为主，带补；有汗要无汗，扶正气为主，带散（发散邪则升，葛、芎、苍
、柴胡之类；扶正气谓小柴、桂枝汤，白虎、桂枝汤之类。犹伤寒有汗，用桂枝疏邪，实表之义。）
又谓伤之浅者近而暴，伤之重者远而缓，为 疟也。疟脉自弦，弦数多热，弦迟多寒，弦紧发汗，
弦迟宜温。疟不宜截早，欲速愈则邪气闭塞，而成他证，为害匪细，有变水肿、鼓胀、诸毒等证。
惟夏秋连日发邪疟四、五次可截（如二、三日发及阴疟，必先发汗散邪，势轻，常山药截亦可。）
主方 苍术 川芎 白芷 羌活 防风 葛根 柴胡（等分） 甘草（减半）加姜、枣煎
服。
无汗加紫苏、细辛、荆芥穗、葱头；有汗加桂枝、槟榔、白芍、白术（土炒）、茯苓，去苍术；
连日发及午前，加黄芩；间日及下午、夜间，加当归、白芍各八分，红花、升麻各三分∶有痰加陈
皮、半夏；有食及不食、胀痛，加山楂、神曲、麦芽、青皮、陈皮、草果、砂仁；暑月加香薷、扁
豆，兼服六一散；口大渴加石膏、知母、麦冬；痞闷加枳实、桔梗；寒、不热加干姜、官桂、良姜
、白术，去麻黄、葛根、柴胡、苍术；寒甚加附子；湿疟，因雨湿身体，重痛，呕胀，加猪苓、泽
泻、白术、茯苓、陈皮、半夏，去葛根、柴胡。服一、二帖后，服清脾饮加猪苓、泽泻，分理阴阳
，疟自止。若不止，惟处暑前一日一发于日间者，三四发之，后行截药。若处暑后间日或三日一发
于夜间者，先根据方服二、三帖。天寒加麻黄，必令汗出。趱至日间，再宜主方加当归、芍药、生地
、知母，少加升麻、红花（酒洗），提至二日至一日，渐渐轻可。如汗多少食，身倦无力，或迁延日久
，气血两虚；或小劳则甚，宜服八珍汤（方见虚损），或十全大补汤。犹有微热，补药加柴胡、黄芩、
苍术、葛根之类，一补一发也。久不已，四兽饮截之。久虚欲吐不吐者，宜藜芦末水调服，以吐为
度；或雄黄、瓜蒂、赤小豆各二分，研服可吐。
清脾饮 治先寒后热，热多寒少，单热不寒者。
黄芩 半夏 青皮 浓朴 茯苓 白术（各一钱） 草果（一钱） 柴胡（一钱五分） 甘草
（五分）
加生姜三片、黑枣一枚，水煎服。
人参养胃汤 治寒多热少及单寒不热者。
苍术（二钱） 陈皮 浓朴（各一钱半） 半夏 茯苓 草果 藿香 人参 炙草（各一钱）
乌梅（一个） 生姜三片，
水煎服。
七宝饮 治诸疟。已服发表散药，提上阳分，渐轻欲截。
常山 浓朴（姜制） 青皮 陈皮 甘草（炙，减半） 槟榔 草果（各一钱）
上酒、水各半，煎首汁，二汁露过夜。当发之日早重温，先首汁，次二汁，面东服。
草果饮 治诸疟通用。
草果 白芷 良姜 青皮 川芎 紫苏 甘草（炙。各等分）
上咀，每服五钱。水盏半，加姜煎。亦寒疟。
四兽饮 截虚疟、久疟。
人参 白术 茯苓 甘草（减半） 陈皮 半夏 草果
上加乌梅、姜、枣、盐少许，拌腌少时，湿纸包煨，香熟煎服。
截疟常山饮 治疟，处暑前连日发四、五次后。
常山 槟榔 乌梅 草果 知母 甘草（炙） 穿山甲（炮）
每服五钱，水盏半煎，露一宿，临发日前二时温服。
黄 鳖甲饮 治疟疾久不愈，胁下痞满，腹中结块，名曰疟母。
鳖甲（醋炙） 草果仁 黄 白术 白芍药 浓朴（制） 槟榔 橘红 川芎 甘草（炙。
各等分）
上咀，每服四钱。水一盏，姜七片，枣一枚，乌梅一个，煎服。
瘴疟，乃山岚气蒸，岭南燥湿不常，人患血乘上焦迷闷，发有哑者，此实热所致。宜凉膈散疏
通大便；小柴胡汤加大黄，或平胃散、五苓散、二陈汤之类调之。
简便方 （截疟） 常山 草果 知母 贝母（各一钱，）好酒半钟，浸过夜，天初明煎滚
数沸，向东服。
七转丹 （连日发宜，三日发忌） 巴豆（肉，研，五钱） 麝香（五分，东方） 白矾（
五钱） 白芷（二钱，西方） 硫黄 雄黄（各五钱，中央） 官桂（五钱） 朱砂（一钱，南方）
青黛（五钱） 黑附（三钱，北方）
上另研细末，各包。按方列净盘预供神前，端阳午时洁诚拜祷，取五家粽尖和丸桐子大。每一
丸发日五更绵裹塞鼻，男左女右，用过醋洗、晒藏，可愈七人。忌妇、丧、鸡、犬。
疟（三日一发∶）由风寒感深，故发迟，必主方。减葛加苏、槟、陈、半、葱；冬加麻黄，
食加楂、芽。大发汗，从头至足不畅再汗，次柴葛解肌汤加陈、半、苓、槟；次清脾饮加猪苓、泽泻
、陈皮自止。如减轻未止，用酒煮常山等药截无害；如不发汗，散邪，即用常山截，有一、二年尤
肿胀而毙。单用参补亦闭门遂盗。虚老，参、术。
古籍记载：夏季感受暑邪，秋季必定发生疟疾（“疟”字由“虐”和“老”组成，意为病势凶险且病程迁延。俗称三日疟）。夏季天气酷热，到了秋季阳气收敛，两股热邪相互搏击，因此形成疟疾。黄帝问：疟疾先出现寒战而后发热的原理是什么？岐伯回答说：夏季遭受大暑之邪，汗液大量排出，腠理（皮肤毛孔及肌肉纹理）开泄，此时若遇到夏季凄冷的小寒之气，寒气便潜伏在脉理和皮肤之中；到了秋季又感受风邪，疾病就形成了。寒邪属于阴气，风邪属于阳气。先受寒邪侵袭，后受风邪侵袭，所以先出现寒战而后发热。疾病按时发作，称为寒疟（此处省略后续论述）。《内经》对疟疾的论述非常详尽，都认为风寒暑湿等邪气客居于脏腑，导致阴阳之气上下交争，虚实交替变化，阴阳相互搏结、转移。后人开始论述七情（喜、怒、忧、思、悲、恐、惊）、劳役过度、食积、痰饮等也能导致疟疾。所谓无汗时要使其有汗，以发散邪气为主，兼用补法；有汗时要使其无汗，以扶助正气为主，兼用散邪法（发散邪气可用升麻、葛根、川芎、苍术、柴胡等药物；扶助正气可用小柴胡汤、桂枝汤、白虎加桂枝汤等方剂。这就像伤寒病中有汗的情况，使用桂枝汤疏解邪气、实固肌表的道理一样。）又说，感邪浅的发病近而急骤，感邪重的发病远而缓慢，这就是疟疾的特点。疟疾的脉象自呈弦象，弦数脉多主热，弦迟脉多主寒，弦紧脉宜用发汗法，弦迟脉宜用温法。治疗疟疾不宜过早截断，如果追求速愈而强行截疟，会导致邪气闭塞，从而产生其他病证，危害不小，可能演变为水肿、鼓胀、各种毒证等。只有在夏秋季节连续几天发作四到五次的邪疟，才可以截断（如两三天发作一次以及阴疟，必须先发汗散邪，病情轻者，常用山药等药截疟也可以。）
主方：苍术、川芎、白芷、羌活、防风、葛根、柴胡（各等分），甘草（减半量），加生姜、大枣煎服。
无汗者加紫苏、细辛、荆芥穗、葱头；有汗者加桂枝、槟榔、白芍、白术（土炒）、茯苓，去掉苍术；
连续几天发作及午前发作，加黄芩；隔日发作及下午、夜间发作，加当归、白芍各八分，红花、升麻各三分；有痰者加陈皮、半夏；有食积及不消化、胀痛者，加山楂、神曲、麦芽、青皮、陈皮、草果、砂仁；暑月加香薷、扁豆，兼服六一散；口大渴加石膏、知母、麦冬；痞闷加枳实、桔梗；寒重热轻者加干姜、官桂、良姜、白术，去掉麻黄、葛根、柴胡、苍术；寒甚加附子；湿疟，因雨湿身体沉重疼痛、呕吐胀满，加猪苓、泽泻、白术、茯苓、陈皮、半夏，去掉葛根、柴胡。服用一、二帖后，服用清脾饮加猪苓、泽泻，分理阴阳，疟疾自然停止。如果不停止，只有处暑前一日在日间发作一次的，发作三四次后，再进行截疟治疗。如果在处暑后隔日或三日发作且在夜间发作的，先根据原方服用二、三帖。天寒加麻黄，必须令其出汗。拖延至日间发作时，再适宜用主方加当归、芍药、生地、知母，少加升麻、红花（酒洗），将发作时间从两天提至一天，渐渐减轻即可。如果出汗多少不一、食欲减退、身体疲倦无力，或者迁延日久，导致气血两虚；或者稍加劳累症状加重，适宜服用八珍汤（方剂见虚损篇），或十全大补汤。如果还有微热，在补药中加入柴胡、黄芩、苍术、葛根等，这是补益与发散并用的方法。久治不愈，用四兽饮截断。久病体虚想吐却吐不出来的，适宜用藜芦末水调服，以吐出为度；或者用雄黄、瓜蒂、赤小豆各二分，研末服用也可催吐。
清脾饮：治疗先寒后热，热多寒少，单热不寒者。
黄芩、半夏、青皮、厚朴、茯苓、白术（各一钱），草果（一钱），柴胡（一钱五分），甘草（五分）。
加生姜三片、黑枣一枚，水煎服。
人参养胃汤：治疗寒多热少及单寒不热者。
苍术（二钱），陈皮、厚朴（各一钱半），半夏、茯苓、草果、藿香、人参、炙甘草（各一钱），乌梅（一个），生姜三片。
水煎服。
七宝饮：治疗各种疟疾。已经服用发表散邪药物，将邪气提至阳分，病情渐轻欲截断时。
常山、厚朴（姜制）、青皮、陈皮、甘草（炙，减半）、槟榔、草果（各一钱）。
以上药物用酒、水各半煎煮第一遍汁液，第二遍汁液露天放置过夜。在疟疾发作当天早晨重新温热，先喝第一遍汁液，再喝第二遍汁液，面向东方服用。
草果饮：治疗各种疟疾通用。
草果、白芷、良姜、青皮、川芎、紫苏、甘草（炙。各等分）。
以上药物切碎，每服五钱。用水一盏半，加生姜煎服。也适用于寒疟。
四兽饮：截断虚疟、久疟。
人参、白术、茯苓、甘草（减半）、陈皮、半夏、草果。
以上药物加乌梅、生姜、大枣、少许盐，拌匀腌制片刻，用湿纸包裹煨熟，香气溢出后煎服。
截疟常山饮：治疗疟疾，在处暑前连续几天发作四、五次之后。
常山、槟榔、乌梅、草果、知母、甘草（炙）、穿山甲（炮制）。
每服五钱，用水一盏半煎煮，露天放置一夜，在发作日前两小时温热服用。
鳖甲饮：治疗疟疾久不愈，胁下痞满，腹中结块，名为疟母。
鳖甲（醋炙）、草果仁、黄芪、白术、白芍药、厚朴（制）、槟榔、橘红、川芎、甘草（炙。各等分）。
以上药物切碎，每服四钱。用水一盏，生姜七片，大枣一枚，乌梅一个，煎服。
瘴疟，是由于山岚雾气蒸腾，岭南地区燥湿无常，人患此病则血气上乘上焦导致迷闷，有的患者甚至失音，这是实热所致。适宜用凉膈散疏通大便；或小柴胡汤加大黄，或平胃散、五苓散、二陈汤等方剂调理。
简便方（截疟）：常山、草果、知母、贝母（各一钱），好酒半钟，浸泡过夜，天刚亮时煮沸几滚，面向东方服用。
七转丹（连日发作适宜，三日发作禁忌）：巴豆（去肉，研，五钱），麝香（五分，东方），白矾（五钱），白芷（二钱，西方），硫黄、雄黄（各五钱，中央），官桂（五钱），朱砂（一钱，南方），青黛（五钱），黑附子（三钱，北方）。
以上药物分别研成细末，各自包装。按照方位排列在干净的盘子上预先供奉在神前，端午节午时洁净诚心拜祷，取五家粽子的尖端混合制成梧桐子大小的丸药。每一丸在发作日五更时分用绵裹塞入鼻孔，男左女右，用过之后用醋清洗、晒干收藏，可以治愈七个人。忌接触妇女、丧事、鸡、狗。
疟疾（三日一发）：由于风寒感邪深重，所以发作延迟，必须用主方。减少葛根，加入苏叶、槟榔、陈皮、半夏、葱白；冬季加麻黄，有食积加山楂、麦芽。大发汗，如果从头至足汗出不畅，再次发汗，接着用柴葛解肌汤加陈皮、半夏、茯苓、槟榔；再用清脾饮加猪苓、泽泻、陈皮，疟疾自然停止。如果减轻但未停止，用酒煮常山等药截断无害；如果不发汗散邪，直接用常山截疟，有一两年后尤其容易肿胀而死。单纯用人参补益也是闭门留寇。对于虚弱年老的人，用人参、白术。
The ancient texts state: "In summer, one is injured by heat; in autumn, malaria (malaria, derived from 'nue' meaning cruel and 'lao' meaning chronic, commonly known as tertian malaria) will inevitably occur. Summer heat is extreme, and in autumn the yang qi retracts; the conflict between these two heats results in malaria. The Yellow Emperor asked: Why does malaria begin with chills followed by fever? Qibo replied: In summer, one is injured by intense heat, causing profuse sweating and the opening of couli (skin pores and interstices). If one then encounters the chilling cold of early summer, the cold qi hides within the meridians and skin. In autumn, injury by wind completes the disease formation. Cold is yin qi; wind is yang qi. Injury by cold first, then by wind, leads to chills first and fever later. When the illness occurs at regular intervals, it is called cold malaria (further details omitted). The *Neijing* discusses malaria extensively, stating that pathogenic factors such as wind, cold, summerheat, and dampness lodge in the zang-fu organs, causing a struggle between yin and yang above and below, alternating deficiency and excess, and mutual blending and shifting of yin and yang. Later physicians discussed how the seven emotions (joy, anger, worry, thought, grief, fear, fright), overwork, food stagnation, and phlegm-fluid retention can also cause malaria. It is said: For those without sweat, induce sweating; the primary goal is to disperse pathogens, supplemented by tonification. For those with sweat, stop sweating; the primary goal is to support healthy qi, supplemented by dispersing pathogens (Dispersing pathogens involves ascending agents like Shengma, Gegen, Chuanxiong, Cangzhu, and Chaihu; supporting healthy qi involves formulas like Xiao Chai Hu Tang, Gui Zhi Tang, Bai Hu Jia Gui Zhi Tang. This is similar to the principle of using Gui Zhi Tang to release exterior pathogens and secure the surface in Taiyang syndrome with sweating.) Furthermore, shallow injury manifests near and abruptly, while heavy injury manifests distant and slowly, which characterizes malaria. The pulse in malaria is naturally wiry (Xian). Wiry and rapid indicates more heat; wiry and slow indicates more cold. Wiry-tight pulse warrants diaphoresis; wiry-slow pulse warrants warming. Malaria should not be arrested too early. Seeking a quick cure by forcibly arresting the parasite causes pathogenic closure, leading to other syndromes, which is harmful, potentially evolving into edema, drum distension, or various toxic syndromes. Only for epidemic malaria occurring continuously for four to five days in summer and autumn can it be arrested (For intermittent malaria occurring every two or three days, or Yin malaria, diaphoresis to disperse pathogens must be performed first; for mild cases, simple herbs like Dioscorea can be used to arrest it.)
Main Formula: Cangzhu, Chuanxiong, Baizhi, Qianghuo, Fangfeng, Gegen, Chaihu (equal parts), Gancao (half dose), add Jiang (fresh ginger) and Zao (jujube), decoct and take.
For no sweat: add Zisu, Xixin, Jingjie Sui, Congtou.
For sweat: add Guizhi, Binglang, Shaoyao, Baizhu (soil-fried), Fuling; remove Cangzhu.
For continuous days and morning onset: add Huangqin.
For alternate days and afternoon/night onset: add Danggui and Shaoyao (each 8 fen), Honghua and Shengma (each 3 fen).
For phlegm: add Chenpi and Banxia.
For food stagnation, indigestion, bloating, and pain: add Shanzha, Shenqu, Maiya, Qingpi, Chenpi, Caoguo, Sharen.
For summer months: add Xiangru and Biandou, take Liuyi San concurrently.
For severe thirst: add Shigao, Zhimu, Maidong.
For chest stuffiness: add Zhishi and Jiegeng.
For severe cold and mild heat: add Ganjiang, Guanzi, Liangjiang, Baizhu; remove Mahuang, Gegen, Chaihu, Cangzhu.
For severe cold: add Fuzi.
For damp malaria (body heaviness, pain, vomiting, and fullness due to rain/dampness): add Zhuling, Zexie, Baizhu, Fuling, Chenpi, Banxia; remove Gegen, Chaihu. After taking one or two doses, take Qing Pi Yin added with Zhuling and Zexie to differentiate yin and yang, and malaria will cease spontaneously. If it does not cease, for cases occurring once during the day before Chushu (End of Heat), after three or four occurrences, proceed to arrest the malaria. For cases occurring every other day or every third day at night after Chushu, first take the main formula for two or three doses. In cold weather, add Mahuang to ensure sweating. If delayed to daytime occurrence, use the main formula added with Danggui, Shaoyao, Shengdi, Zhimu, and a small amount of Shengma and Honghua (wine-washed) to advance the onset from every two days to every day, gradually lightening the condition. If sweating is irregular, appetite is poor, body is fatigued and weak, or the condition persists long-term causing dual deficiency of qi and blood; or if slight exertion exacerbates symptoms, take Bazhen Tang (see Deficiency Syndrome chapter) or Shiquan Dabu Tang. If slight heat remains, add Chaihu, Huangqin, Cangzhu, Gegen to the tonifying formula, combining tonification with dispersion. For chronic non-resolving cases, use Six Beast Drink (Sishou Yin) to arrest. For chronic deficiency with retching but no vomit, take Lili powder mixed with water until vomiting occurs; or use Xionghuang, Gouti, and Chi Xiaodou (each 2 fen) ground into powder to induce vomiting.
Qing Pi Yin: Treats malaria starting with chills then fever, where heat exceeds chills, or pure heat without chills.
Huangqin, Banxia, Qingpi, Houpo, Fuling, Baizhu (each 1 qian), Caoguo (1 qian), Chaihu (1.5 qian), Gancao (0.5 qian).
Add three slices of fresh ginger and one black jujube, decoct in water and take.
Renshen Yangwei Tang: Treats malaria with more chills than heat, or pure chills without heat.
Cangzhu (2 qian), Chenpi, Houpo (each 1.5 qian), Banxia, Fuling, Caoguo, Huoxiang, Renshen, Zhi Gancao (each 1 qian), Wumei (one fruit), three slices of fresh ginger.
Decoct in water and take.
Qibao Yin: Treats various types of malaria. Used after administering exterior-releasing and pathogen-dispersing medicines, lifting pathogens to the Yang level, when symptoms lighten and arrest is desired.
Chanshan, Houpo (ginger-processed), Qingpi, Chenpi, Gancao (roasted, half dose), Binglang, Caoguo (each 1 qian).
Decoct with half wine and half water for the first extraction; leave the second extraction exposed overnight. On the day of onset, warm early in the morning. Drink the first extraction first, then the second, facing east.
Caoguo Yin: General formula for various malaria.
Caoguo, Baizhi, Liangjiang, Qingpi, Chuanxiong, Zisu, Gancao (roasted. Equal parts).
Coarsely crush. Take 5 qian per dose. Decoct with one and a half cups of water and ginger. Also suitable for cold malaria.
Sishou Yin (Six Beast Drink): Arrests deficiency malaria and chronic malaria.
Renshen, Baizhu, Fuling, Gancao (half dose), Chenpi, Banxia, Caoguo.
Add Wumei, Jiang, Zao, and a little salt. Mix and marinate briefly. Wrap in wet paper and roast until fragrant. Decoct and take.
Jiemie Chanshan Yin: Treats malaria after four to five consecutive days of onset before Chushu.
Chanshan, Binglang, Wumei, Caoguo, Zhimu, Gancao (roasted), Chuanshanjia (fried).
Take 5 qian per dose. Decoct with one and a half cups of water. Leave exposed overnight. Warm and take two hours before the expected onset.
Biejia Yin: Treats persistent malaria with hypochondriac fullness and abdominal masses, named Nuomu (Malaria Mother).
Biejia (vinegar-roasted), Caoguoren, Huangqi, Baizhu, Shaoyao, Houpo (processed), Binglang, Juhong, Chuanxiong, Gancao (roasted. Equal parts).
Coarsely crush. Take 4 qian per dose. Decoct with one cup of water, seven slices of ginger, one jujube, and one wumei.
Zhang Nian (Miasma Malaria) is caused by mountain miasma steaming, where dryness and dampness are irregular in Lingnan. Patients suffer from blood rushing to the upper jiao causing confusion and stupor; some lose their voice. This is caused by excess heat. Use Liang Ge San to unblock the bowels; or Xiao Chai Hu Tang added with Dahuang; or regulate with Pingwei San, Wuling San, Erchen Tang, etc.
Simple Formula (Arrest Malaria): Chanshan, Caoguo, Zhimu, Beimu (each 1 qian). Soak in half a cup of good wine overnight. Boil vigorously at dawn. Take facing east.
Qizhuan Dan (Suitable for consecutive days, contraindicated for every-third-day): Badou (kernel, ground, 5 qian), Shexiang (5 fen, East), Baifan (5 qian), Baizhi (2 qian, West), Liuhuang, Xionghuang (each 5 qian, Center), Guanzi (5 qian), Zhusha (1 qian, South), Qingdai (5 qian), Heifu (3 qian, North).
Grind each ingredient separately into fine powder and package individually. Arrange on a clean plate according to directions, offer before deities. On the Noon hour of Duanwu Festival, pray sincerely. Mix with tips of zongzi from five families to form pills the size of tung seeds. On the day of onset, at fifth watch (early morning), wrap one pill in cotton and insert into the nostril (left for men, right for women). After use, wash with vinegar, dry, and store. Can cure seven people. Avoid contact with women, funerals, chickens, and dogs.
Malaria (every third day): Due to deep invasion of wind-cold, onset is delayed. Must use the Main Formula. Reduce Gegen, add Zisu, Binglang, Chenpi, Banxia, Congbai. Add Mahuang in winter; add Shanzha, Maiya for food stagnation. Induce heavy sweating. If sweat does not flow freely from head to toe, sweat again. Then use Chaige Jieli Tang added with Chenpi, Banxia, Fuling, Binglang. Then Qing Pi Yin added with Zhuling, Zexie, Chenpi; malaria will stop. If symptoms lighten but persist, arrest with wine-boiled Chanshan etc. without harm. If no sweating/pathogen dispersal is done, and Chanshan is used directly to arrest, swelling may develop after one or two years leading to death. Using only Renshen for tonification is like locking the door to keep thieves inside. For deficient and elderly patients, use Renshen and Baizhu.