前论疟邪伏于募原，浅者客三阳经，深者入三阴经。夫脏腑之经，各有界络。邪在某经，即某经疟。因
邪有浅深，舍有远近，行有迟速，故卫气相值，有日发，间一日二日而发之殊。间一日发，与日发者治法同，
病亦易愈。惟间二日为难治，以伏邪深入三阴，故名阴疟也。足太阴脾，足少阴肾，足厥阴肝，其经深远。
三阳疟多发在夏至后，处暑前。三阴疟多发在处暑后，冬至前。发愈晚者去亦迟，以气令收肃故也。其发时
亦不定，有前间一日，忽间二日发者，有前间二日，忽一日夜两发者，有连发二日，中间一日者，有间三日发
不爽者，或不忌口，不节劳，伏邪旁溢界络，皆能致之，否则发期错乱，乃将愈之兆矣。阴疟主治之法，
惟和营调卫兼疏邪，勿期速效用劫剂，如常山饮、七宝饮。每见用常山、巴霜劫痰得效者，面色熏黑，留邪
在里，后多变成痨热鼓胀不治，良可恨悼，因前论治法未尽，而申之。凡通治诸疟，初起宜散邪，露姜煎。
往来寒热，小柴胡汤。寒多者，小柴胡汤加桂枝。寒少热多，清脾饮。湿盛，平胃散。痰多，二陈汤、二
妙丸。湿盛呕泻，平胃散合四苓散，加砂仁、半夏。湿热俱盛，清中驱疟饮。暑热兼湿，香薷饮加黄芩、半夏、
赤茯、滑石。伏暑秋疟，黄芩、知母、花粉、栝蒌、枳壳、竹茹。热疟心下痞结，半夏泻心汤、小陷胸汤加减。
此诸疟通治法。若阴疟邪深，本不在表，三五发后，乘元气未衰，用陈香橼大者全个，挖小盖，入水飞雄黄五
钱，纳盖，铜丝扎好，炭火 ， 时烟出，勿令雄黄走出，存性研末。病者隔夜勿食，明晨开水下，以箸探喉，
吐尽胶痰。再服再吐，半日，饮粥汤吐止。顽痰既去，随服补剂，归脾汤加减，效。如未止，寒热必轻，截
疟饮立效。勿用常山等。延久必虚，专养正却邪，补中益气汤加半夏。如未止，热重于寒，用丹皮、鳖甲、
白芍、当归、何首乌。寒热夜甚，何首乌散加归
身。发时渐晏，大剂补中汤内升麻、柴胡少用。寒从背起，阳虚汗泄，人参、黄 、桂枝、炙草、茯神、大枣、
鹿胶、牡蛎。热盛伤阴，遗精便血，固本丸加白芍、首乌、阿胶。营卫两虚，人参养营汤，或何人饮。脾阳虚，
食不化，六君子汤、四兽饮，俱加砂仁、神曲、谷芽，甚者理中汤。脾阴阳俱虚，归芍六君子汤加首乌。胃阴
虚，不饥不食，人参、玉竹、麦冬、白芍、石斛、薏苡、乌梅、半夏。脾胃两虚，肢寒泄泻，附子理中汤、
参苓白术散。邪入厥阴，呕沫腹痛，蛔动肢厥，半夏泻心汤去参、草、大枣，加牡蛎、白芍、浓朴、乌梅。
久疟肾阴虚，面赤口渴，六味汤加五味、白芍、肉桂。肾水火俱虚，疟久成痨。养营汤吞八味丸。虚人疟母，
不治成胀，四兽饮加鳖甲、当归尾、桂心。元气犹壮，癖积左胁下，鳖甲饮子。不应，何膝煎。疟久邪结血络，
左胁胀痞，连及少腹，治宜通络，守补无效。桃仁、丹皮、鳖甲、归尾、桂心、甲片、延胡。通其血络，痞胀
乃除，再用补剂，自获全愈。
《己任编》曰∶凡疟将发时，与正发之际，勿施治，治亦无效。必待阴阳升极而退，此邪留所客之地，乃
可服药治之。且当未发前二三时，迎而夺之。
凡小儿胎疟，不能服药，用黄丹（五钱）、生明矾（三钱）、胡椒（二钱五分）、麝香（少许）。共研末，
以好醋调敷手心，男左女右，以绢包手掌，药发自汗而愈。
凡小儿未进谷食者，患疟久不止。用冰糖浓煎汤喂之，最验。出徐忠可《金匮》注。
前文论述疟邪潜伏于募原，病位浅的客居在三阳经，病位深的侵入三阴经。脏腑所属的经络，各有其界限和络脉。邪气在哪条经络，就表现为哪条经络的疟疾。因为邪气有深浅之分，病舍有远近之别，运行有快慢之异，所以卫气与邪气相搏结时，发作时间有每日发作、隔一日或隔两日发作的不同。隔一日发作与每日发作的治疗方法相同，病情也较易痊愈。只有隔两日发作的难以治疗，因为伏邪深入三阴经，所以称为阴疟。足太阴脾经、足少阴肾经、足厥阴肝经，其循行部位深远。三阳经的疟疾多发生在夏至之后，处暑之前。三阴经的疟疾多发生在处暑之后，冬至之前。发作时间越晚，病邪离去也越迟，这是因为气候时令收敛肃杀的缘故。其发作时间也不固定，有的先前隔一日发作，忽然变为隔两日发作；有的先前隔两日发作，忽然变为一天一夜发作两次；有的连续发作两天，中间停一天；有的隔三日发作准时不差；或者因不忌口、不节制劳累，导致伏邪旁溢至其他界络，都能造成这种情况，否则发作周期错乱，将是即将痊愈的征兆了。
阴疟的主要治疗方法，在于调和营卫兼以疏解邪气，不要期望速效而使用劫夺痰邪的峻剂，如常山饮、七宝饮等。常见使用常山、巴豆霜劫除痰邪而暂时见效的，患者面色熏黑，留邪在体内，后来多变成痨热、鼓胀等不治之症，实在令人痛惜。这是因为前文论述治法未尽，故在此补充说明。凡通治各种疟疾，初起宜疏散邪气，可用露姜煎。往来寒热的，用小柴胡汤。寒多者，在小柴胡汤中加入桂枝。寒少热多者，用清脾饮。湿盛者，用平胃散。痰多者，用二陈汤、二妙丸。湿盛且伴有呕吐腹泻者，用平胃散合四苓散，加砂仁、半夏。湿热俱盛者，用清中驱疟饮。暑热兼湿者，用香薷饮加黄芩、半夏、赤茯苓、滑石。伏暑秋疟，用黄芩、知母、花粉、栝蒌、枳壳、竹茹。热疟伴心下痞结者，用半夏泻心汤、小陷胸汤加减。这是各种疟疾的通治方法。
若是阴疟，邪气深重，本不在表，经过三五次发作后，趁着元气尚未衰弱，取大的陈香橼一个，挖去小盖，放入水飞雄黄五钱，盖上盖子，用铜丝扎好，在炭火上煅烧，待烟冒出时停止，不要让雄黄跑掉，存性后研成粉末。病人隔夜禁食，次日清晨用开水送服，用筷子探喉催吐，吐出胶固之痰。再服再吐，半天后喝粥汤止吐。顽痰既去，随即服用补益剂，用归脾汤加减，可获效。如果症状未止，寒热必然减轻，用截疟饮立竿见影。不要用常山等药。拖延日久必致虚弱，应专门扶正祛邪，用补中益气汤加半夏。如果仍未止住，热重于寒，用丹皮、鳖甲、白芍、当归、何首乌。寒热夜间加重，用何首乌散加当归身。发作时间逐渐推迟，在大剂补中汤内减少升麻、柴胡用量。寒气从背部发起，属阳虚汗泄，用人参、黄芪、桂枝、炙甘草、茯神、大枣、鹿角胶、牡蛎。热盛伤阴，出现遗精便血，用固本丸加白芍、首乌、阿胶。营卫两虚，用人参养营汤，或何人饮。脾阳虚，饮食不化，用六君子汤、四兽饮，均加砂仁、神曲、谷芽，严重的用理中汤。脾阴阳俱虚，用归芍六君子汤加首乌。胃阴虚，不觉饥饿不想进食，用人参、玉竹、麦冬、白芍、石斛、薏苡仁、乌梅、半夏。脾胃两虚，四肢发冷泄泻，用附子理中汤、参苓白术散。邪入厥阴，呕吐涎沫腹痛，蛔虫扰动四肢厥冷，用半夏泻心汤去掉人参、甘草、大枣，加牡蛎、白芍、厚朴、乌梅。久疟导致肾阴虚，面赤口渴，用六味地黄汤加五味子、白芍、肉桂。肾中水火俱虚，疟疾日久形成劳损。用养营汤吞服八味丸。体虚之人患疟疾形成疟母，若不治疗会变成鼓胀，用四兽饮加鳖甲、当归尾、桂心。元气尚壮实，癖积在左胁下，用鳖甲饮子。若无效，用何膝煎。疟疾日久邪气结于血络，左胁胀满痞塞，连及少腹，治疗宜疏通络脉，单纯补益无效。用桃仁、丹皮、鳖甲、当归尾、桂心、穿山甲片、延胡索。疏通其血络，痞胀才能消除，再用补益剂，自然获得痊愈。
《己任编》说：凡是疟疾将要发作时，以及正在发作之际，不要进行治疗，治疗也无效。必须等到阴阳之气升极而退，此时邪气停留在其所客居的地方，才可以服药治疗。而且应当在未发作前两三个时辰，迎头痛击以夺取邪气。
凡是小儿胎疟，不能服药，用黄丹（五钱）、生明矾（三钱）、胡椒（二钱五分）、麝香（少许）。共同研成粉末，用好醋调匀敷在手心，男左女右，用绢布包裹手掌，药物促使发汗而愈。
The preceding discussion states that the malaria pathogen lies latent in the *Mu Yuan* (Sea of Origin), where a superficial location involves the Three Yang meridians, and a deep location involves the Three Yin meridians. The meridians of the Zang-Fu organs each have their own boundaries and collaterals. Wherever the pathogen resides in a meridian, it manifests as malaria of that specific meridian. Because the pathogen has varying depths, the residence has varying distances, and the movement has varying speeds, when the Defensive Qi (*Wei Qi*) intersects with the pathogen, the onset varies between daily attacks, attacks every other day, or attacks every two days. Attacks every other day and daily attacks share the same treatment method, and the disease is also easier to cure. Only attacks every two days are difficult to treat, because the latent pathogen has penetrated deeply into the Three Yin meridians; hence it is named Yin Malaria. The Foot-Taiyin Spleen Meridian, Foot-Shaoyin Kidney Meridian, and Foot-Jueyin Liver Meridian have profound pathways. Yang-Malaria mostly occurs after the Summer Solstice and before the Limit of Heat (Chu Shu). Yin-Malaria mostly occurs after the Limit of Heat and before the Winter Solstice. The later the onset, the slower the departure of the pathogen, due to the收肃 (contracting and purifying) nature of the seasonal Qi. The onset time is also irregular: some who previously attacked every other day suddenly attack every two days; some who previously attacked every two days suddenly attack twice within one day and night; some attack continuously for two days with a one-day interval in between; some attack every three days without fail; or, due to lack of dietary restrictions or overexertion, causing the latent pathogen to overflow into collateral boundaries, all can cause this. Otherwise, chaotic onset periods indicate that the disease is about to heal.
The main treatment principle for Yin Malaria is to harmonize Ying (Nutritive) and Wei (Defensive) Qi while dispersing the pathogen. Do not expect rapid results by using drastic agents that forcibly expel phlegm, such as Changshan Yin (Rangoon Creeper Decoction) or Qibao Yin (Seven Treasures Decoction). It is common to see cases where using Changshan (Radix Dichroae) and Bafang (Croton Seed) to forcibly expel phlegm yields temporary effect, but the patient's face becomes darkened, the pathogen remains inside, and later often transforms into consumptive fever or drum distension, which are incurable. This is truly regrettable. Since the previous discussion on treatment methods was incomplete, I elaborate here. For general treatment of various malarias at the initial stage, disperse the pathogen using Lujiang Jian (Dew-Soaked Ginger Decoction). For alternating chills and fever, use Xiaochaihu Tang (Minor Bupleurum Decoction). For those with more chills than heat, add Guizhi (Ramulus Cinnamomi) to Xiaochaihu Tang. For those with less chills and more heat, use Qingpi Yin (Clear the Spleen Decoction). For excessive dampness, use Pingwei San (Calm the Stomach Powder). For excessive phlegm, use Erchen Tang (Two Aged Substances Decoction) or Ermiao Wan (Two Marvels Pill). For excessive dampness with vomiting and diarrhea, combine Pingwei San with Siling San (Four Ling Powder), adding Shaoren (Fructus Amomi Rotundus) and Banxia (Rhizoma Pinelliae Preparata). For simultaneous excess of dampness and heat, use Qingzhong Qumie Yin (Clear the Middle and Expel Malaria Decoction). For summerheat-heat combined with dampness, use Xiangru Yin (Elsholtzia Decoction) added with Huangqin (Radix Scutellariae), Banxia, Chifuling (Poria with Red Sandalwood), and Huashi (Talcum). For latent summerheat autumn malaria, use Huangqin, Zhimu (Rhizoma Anemarrhenae), Huafen (Radix Platycodi), Gualou (Fructus Trichosanthis), Zhike (Fructus Aurantii), and Zhuru (Spiraxis Bambusae). For heat-malaria with epigastric fullness and obstruction, modify Banxia Xiexin Tang (Pinellia Decoction to Drain the Epigastrium) or Xiao Xianxiong Tang (Minor Chest-Piercing Decoction). These are the general treatment methods for various malarias.
If it is Yin Malaria, the pathogen is deep and originally not in the exterior. After three to five attacks, taking advantage of the fact that the Original Qi (*Yuan Qi*) has not yet declined, take a large Chen Xiangyuan (aged Citrus medica fruit), hollow out a small lid, insert Wufei Xionghuang (Water-ground Realgar) five qian, replace the lid, bind tightly with copper wire, and roast over charcoal fire until smoke appears, ensuring the realgar does not escape. Preserve the nature (calcine) and grind into powder. The patient should fast overnight. On the next morning, take with warm water, induce vomiting by probing the throat with chopsticks, until thick phlegm is expelled. Administer again to induce vomiting again. After half a day, drink congee soup to stop vomiting. Once stubborn phlegm is removed, immediately administer tonic formulas, modifying Guipi Tang (Restore the Spleen Decoction), which will be effective. If symptoms do not cease, the chills and fever must have lightened; use Jiemie Yin (Malaria-Cutting Decoction) for immediate effect. Do not use Changshan etc. Prolonged illness inevitably leads to deficiency; specialize in nourishing righteousness and expelling pathogenic factors, using Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Banxia. If it still does not cease, and heat outweighs chills, use Danpi (Cortex Moutan), Biejia (Carapax et Plastrum Testudinis), Baishao (Radix Paeoniae Alba), Danggui (Radix Angelicae Sinensis), and Heshouwu (Radix Polygoni Multiflori Preparata). If chills and fever are severe at night, use Heshouwu San (Heshouwu Powder) added with Dangguishen (Radix Angelicae Sinensis root portion). If the onset time gradually delays, use Shengma (Rhizoma Cimicifugae) and Chaihu (Radix Bupleuri) in smaller doses within a large dose of Buzhong Tang (Tonify the Middle Decoction). If cold starts from the back, indicating Yang deficiency with sweating, use Renshen (Radix Ginseng), Huangqi (Radix Astragali), Guizhi, Zhigancao (Prepared Licorice Root), Fushen (Poria with Pine Root), Dazao (Fructus Jujubae), Lujiao jiao (Colla Corii Asini), and Muli (Concha Ostreae). If intense heat injures Yin, leading to seminal emission and bloody stool, use Guben Wan (Solidify the Root Pill) added with Baishao, Shouwu, and Ejiao (Colla Corii Asini). For dual deficiency of Ying and Wei, use Renshen Yangying Tang (Ginseng Nourishing Ying Decoction) or Heren Yin (He-Ren Decoction). For Spleen-Yang deficiency with indigestion, use Liujunzi Tang (Six Gentlemen Decoction) or Six Beasts Decoction, both added with Shaoren, Shenqu (Massa Medicata Fermentata), and Guya (Sprouted Grain); for severe cases, use Lizhong Tang (Regulate the Middle Decoction). For dual deficiency of Spleen-Yin and Yang, use GuiShao Liujunzi Tang (Angelica and White Peony Six Gentlemen Decoction) added with Shouwu. For Stomach-Yin deficiency with no hunger and no appetite, use Renshen, Yuzhu (Rhizoma Polygonati Odorati), Maidong (Radix Ophiopogonis), Baishao, Shihu (Caulis Dendrobii), Yiyiren (Semen Coicis), Wumei (Fructus Mume), and Banxia. For dual deficiency of Spleen and Stomach with cold limbs and diarrhea, use Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction) or Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder). When pathogen enters Jueyin, with vomiting of saliva, abdominal pain, moving roundworms, and cold limbs, use Banxia Xiexin Tang removing Renshen, Gancao, and Dazao, adding Muli, Baishao, Houpo (Cortex Magnoliae Officinalis), and Wumei. For long-standing malaria causing Kidney-Yin deficiency with red face and thirst, use Liuwei Dihuang Tang (Six-Ingredient Pill with Rehmannia) added with Wuweizi (Fructus Schisandrae), Baishao, and Rougui (Cortex Cinnamomi). For dual deficiency of Kidney-Water and Fire, where malaria becomes chronic consumption, swallow Bawei Wan (Eight-Ingredient Pill) with Yangying Tang. For deficient persons with malaria mass (malaria tumor), if untreated it becomes distension, use Six Beasts Decoction added with Biejia, Dangguiwei (Tail of Angelica Sinensis), and Guixin (Heart of Cinnamon Twig). If Original Qi is still robust, with accumulation under the left hypochondrium, use Biejia Yinzi (Turtle Shell Decoction). If ineffective, use HeXi Jian (He-Xi Decoction). For long-standing malaria where pathogen knots in blood collaterals, causing left hypochondriac fullness and obstruction extending to the lower abdomen, treatment should focus on unblocking collaterals; pure tonification is ineffective. Use Taoren (Semen Persicae), Danpi, Biejia, Dangguiwei, Guixin, Jiapian (Plastrum Testudinis), and Yanhusuo (Rhizoma Corydalis). Unblocking the blood collaterals removes the fullness and obstruction; subsequently using tonics will lead to complete recovery.
*Jiren Bian* states: Whenever malaria is about to onset or during active onset, do not administer treatment, as it will be ineffective. Wait until the Yin and Yang Qi reach their peak and recede, so that the pathogen stays in its occupied location, then medication can be administered. Moreover, two to three hours before onset, intercept and seize the pathogen.
For pediatric congenital malaria where oral medication is impossible, use Huangdan (Lead Oxide) five qian, Sheng Mingfan (Raw Alum) three qian, Hujiao (Black Pepper) two qian five fen, and Shexiang (Musk) a small amount. Grind together into powder, mix with good vinegar, and apply to the palm. Apply to the left hand for males and right hand for females, wrap the palm with silk cloth. The medicine induces sweating, leading to recovery.
For infants who have not yet consumed solid food, suffering from persistent malaria, use rock sugar boiled in concentrated decoction to feed them; this is highly effective. From Xu Zhongke’s commentary on *Jingui Yaolue*.