窦材治一人，病疟月余，发热未退。一医与白虎汤，热愈甚。窦曰∶公病脾气大虚，而服寒凉，恐伤脾胃。
病患曰∶不服凉药，病何时得退？窦曰∶《内经》云∶疟之始发，其寒也，烈火不能止；其热也，冰水不能遏。当
是时，良工莫能措其手，且扶元气，待其自衰。公元气大虚，服凉药退火，吾恐热未去而元气脱矣。因为之灸
命关，才五七壮，胁中有气下降，三十壮全愈。
子和治陈下一人，病疟三年不愈，止服温热之剂，渐至衰羸。求张治。张见其羸，亦不敢便投寒凉之剂，
张公原自细心。乃取《内经·刺疟论》详之。曰∶诸疟不已，刺十指间出血。正当发时，令刺其十指出血，血止而
寒热立止，咸骇其神。
故息城一男子病疟求治。诊之，两手脉皆沉伏而有力，内有积也，此是肥气。病者曰∶左胁下有肥气，肠
中作痛，积亦作痛，形如覆杯，间发间止，今已三年，祈禳避匿，无所不至，终不能疗。张曰∶此 疟也。以
三花神 丸五七十丸，以冷水送过五六行，次以冷水止之，冷主收敛故也。湿水既尽，一二日，煎白虎汤作顿
啜之，疟犹不愈。候五六日吐之，以常山散去冷痰涎水六七次，若翻浆。次柴胡汤和之，间用妙功丸磨之，疟悉除。
吴中内翰政和丁酉居全椒县，岁疟大作，遇寒多热少，饮食不思。用高良姜麻油炒，干姜炮，各一两为
末，每服五钱，用猪胆汁调成膏子，临发时，热酒调服。或以胆汁和丸，每服四十丸，酒下亦佳。凡救人以百
计。张大亨病此甚，欲致仕，亦服之而愈。大抵寒热发于胆，用猪胆引二姜入胆，去寒而燥脾胃，一寒一热，
所以效也。（《朱氏集验方》、《本草纲目》。）
《野史》云∶卢绛中，病 疟疲瘵，忽梦白衣妇人念曰∶食蔗可愈。及旦，买数梃食之，翌日疾愈。（雄
按∶此即饮食消息之法。）
夔州谭远病疟半年，故人窦藏叟授方，用真阿魏、好丹砂各一两，研匀，米糊和丸，皂子大，每空心人参
汤化服一丸即愈。世人治疟，惟用常山，砒霜毒物，多有所损。此方平易，人所不知。草窗周密云∶此方治疟，
以无根水下，治痢以黄连木香汤下，疟痢多起于积滞故耳。（雄按∶此方甚妙。惜阿魏殊罕真者，但宜为小丸
吞服，调化恐臭烈难入于口矣。）
顾宝光善画，陆溉痛风疟，久不疗，宝光尝诣溉，遂命笔图一狮子像于户外，云∶旦夕当有验。至夜，闻
蟋蟀之声，明日视狮子口，有血淋漓，溉病遂愈。（《姑苏志》。）
张守淳冬月患三疟， 一月，延王孝先诊，王摇首曰∶更十日则不治矣，必用参、附，乃可小减。其父
瞿然，缩舌不敢应。王力持前说，服参、附各一钱，乃至二钱，疟粗损六七，明年初夏始愈。
孙文垣族子应章，三阴疟发于子午卯酉日，（昔人谓少阴疟。）已越四月矣。每发于夜，热多寒少，左脉
微弦，右关大。以二陈加柴胡、黄柏、川芎、当归、黄连，两帖热少轻，饮食不进，四肢懒倦，脾气大虚。
以白术、何首乌各三钱，鳖甲二钱，青皮七分，乌梅一个，一帖而止。
应章之弟，十月发三阴疟，至次年仲春未止。每发于辰戌丑未，脉弦数有力，用白芍、当归各一钱，白术
二钱，柴胡、川芎、甘草、砂仁、桂枝、酒芩各三分，生姜三片，水煎服。再以首乌、鳖甲、白术各三钱，柴
胡一钱，青皮、酒芩、甘草各五分，乌梅一个，生姜三片，临发，五更服，两帖而止。后半月，下体大发疮疖，
以东坡四神丹，调理而痊。（伏暑未尽，方中欠用黄连之故。）
江省吾暮秋患疟，三日一次，发于夜，次年仲春犹未止，遍身疼痛，背脊疼。灸之，仅止一日，后仍发，
面青肌瘦，此邪在足太阳经。（以遍身及背脊疼也。）用麻黄一钱五分，人参、桂枝、白芍、甘草、知母各一钱，
陈皮、贝母各七分，姜、枣煎服，痛减半，疟未止。以首乌、白术各五钱，青蒿一钱，乌梅一个，陈皮二钱，姜
三片水煎，临发之日，五更服。寻常以六君子加黄 、五味、乌梅、草果，调理而愈。
侄孙二水，年三十，体肥，夏月常浸溪中，卧松阴下，至八月，大发寒热，自巳午至天明乃退。饮食不进，
呕吐黄胆汁，胸膈胀闷，舌上干燥生芒刺，沉香色，强硬，以冷水频漱，乃能言语，惟啖西瓜、生藕。先发热
之日，吐血一口，今则大便下血，且咳嗽，此温疟症也。由医未解散，遽用黄 以闭邪气，致成大困。用柴胡、
知母各三钱，石膏七钱，葛根三钱，橘红、竹茹各一钱五分，酒芩、枳实各二钱，甘草、贝母各五分，三帖吐
止。改用二陈汤加柴胡、枳实、黄芩、黄连、花粉、鳖甲、白术、首乌，调理而愈。
喻嘉言治袁继明，素有房劳内伤，偶因小感，自煎姜葱汤表汗，因而发热三日，变成疟疾。脉之，豁大空
虚，且寒不成寒，热不成热，气急神扬。知为元阳衰脱之候，因谓来日疟发，虑大汗不止，难于救药防危。不
以为意。次日五鼓时，病患精神更觉恍惚，扣门请救。及觅参至，疟已先发矣。又恐人参补住疟邪，虽急救无
益也。（此语未善，疟未发时，岂无邪耶？要之，发时不当用药耳。）姑俟疟势稍退，方与服之。服时，已汗出
沾濡。顷之，果大汗不止，昏不知人，口流白沫，灌药难入，直至日暮，白沫转从大孔遗出。乃喜曰∶白沫下行，
可无恐矣。但内虚肠滑，独参不能胜任，急以附子理中汤，连进四小剂，人事方苏，能言。但对面谈事不清，
门外有探病客至，渠忽先知，家人惊以为祟。曰∶此正神魂之离舍耳。今以独参及附子理中，驷马之力追之，
尚在半返未返之界，以故能知宅外之事。再与前药二帖而安。
裕民坊民家淘井，得一瓦枕，枕上有一符，符下有驱疟二篆字，相传为诸葛武侯所制，病疟者枕之即愈。
彼此转相借用，遂为邻人所匿，因讼于官，亦不能得。（《续金陵琐事》。）
陆养愚治崔盐院，八月间患疟，日一发，治疗十日不愈。崔曰∶此病或煎药一二剂，或丸药一服，未有不
止者。今服药一二十剂，而病发转剧，何医之无良也？医者承风进诊，曰∶前日内外之邪尚重，未敢即截，今
邪已去，可以截矣。因进丸药一服，服之呕恶移时，明日果愈。但饮食无味，口每干苦，甫三日而复作。陆诊
时，正值寒战，床帷俱动，面赤戴阳。（戴阳二字欠妥。）汗泄不止，身热如火，其脉洪数无伦，沉按则驶。（
疟发时脉亦难凭。）曰∶此热疟也，与三黄石膏汤。乃谓疟门不载，仍进前丸一服，呕吐不止。至巳午时，疟发
更甚，热竟日不退。再召诊，因思两番丸药，胃气重伤，且脉较前更弱，不可纯作实热治矣。以白虎汤合建中、
生脉之半投之，一夜二剂，呕哕即止，明日疟不发矣。以清气养荣汤，调理而安。（按∶面戴阳而脉无伦次，
则似理中症矣。乃作实热而与三黄石膏，其说不无可议。戴阳症，下虚上实，脉洪数无伦，沉之则虚微或无，乃
其候也。今身热汗出，脉洪数而沉，按则驶，是浮沉俱有力，正阳明大热之症。其面赤者，乃胃热熏蒸所致，
非戴阳也。案中竟以戴阳为面赤之称，原属称名之误。魏君又泥其说，而以为似理中症，亦未免拘文牵义矣。）
朱远斋医名藉甚，与陆莫逆交，归安令闻其名，屡召不赴，借事系之狱，欲毙之杖下。邑绅十余辈为请，
竟不释。其妻奔号求救，陆亦无计可施。适按台巡湖患疟，医治无效，召陆诊，陆喜曰∶机在是矣。视其脉，
两寸关浮数微弦，按之极弱，两尺沉按紧小。其症不发时，亦倦怠，身常热，有汗，饥而痞闷，不敢食，小腹
胀急，大便欲行不行者已七八日。发时战栗，身极热，烦渴躁扰，且喘急之甚。前医初与发表，后以痞闷，用
二陈、青皮、草果燥热之品，常山亦私有而不应。审其平日极喜浓味，病后禁绝，惟日啖干糕数枚，夫滋润不
进，肠胃已干，重以风热燥削之剂，安得不痞满燥结乎？因思此症，乃肠实胃虚，若以丸剂通其下结，以煎剂
补其中虚，可立已。然必徐为之，方可为远斋地。乃曰∶病无大害，第势正猖獗，必数日方可衰其半，十日则
全愈矣。促进药。曰∶此时病将发。经云无刺 之热，无刺浑浑之脉，无刺漉漉之汗。为其病逆，未可治也。
既定，以清气养荣汤进之，令以火肉进粥二碗。大便未行，以蜜导出燥矢数枚。次日疟减十之三，再进前汤二
剂，已减十之六七。因乘间曰∶症虽减，而脉似未减，此余邪未尽，恐后时有变。某有师兄朱如玉，术高某百
倍，若得此人商治，百无一失。奈渠得罪县尊，现下监禁。按台随令捕官，着归安县请朱。朱得免，及进视，
论病如见。因用润字丸三钱先服，随以前汤方加生脉散，是夜下宿垢极多，明日疟止矣。（上者宜汤，下者宜丸，虚者
宜补，实者宜泻，分类施治，斯两不相妨，亦定法也。）
陆肖愚治沈俊庵，年五十，七月间患疟，日一发，或两发，服药不效。用丸药截之，呕吐竟日，次日疟不
作矣。然饮食日减，倦怠嗜卧。至八月中，复发寒热一二日，仍以药丸截，遂呕泻数日不止，饮食不进，即汤
水亦尽吐出，身热戴阳，语多谵妄。医尚拟二陈、五苓。及诊脉，浮而微细如丝，乃谓曰∶病亟矣，兄药宽缓，
恐无济，今当用附子理中，以冀万一耳。彼医心不然之，又病家见用附子大骇，陆遂辞去，彼医疗治两日而殂。
陆祖愚治朱明宇，因暑月多饮水，又烦劳过度，饮食失节，常彻夜不眠。偶赴酌归感寒，头疼身热，胸膈
不快，自用葱、姜表汗，转成疟疾，间日一发。医用槟榔、柴胡、草果、青皮、干葛、羌活之类，投之辄吐，
及疟发呻吟，烦躁益甚，日久渐危。脉之，气口沉实有力，脐之上下，手不可按，六七日不大便，口干燥，渴
极欲西瓜冷水，曰∶可立起也。因投其所喜，用嫩苏叶、嫩薄荷，捣汁和匀，入井水中与饮，吐止，而有微汗，
甚觉爽利。随以润字丸四钱投之，渴则以前水饮之，薄暮沉睡，至四鼓腹中响，微微作痛，下燥矢七八枚。后
又连行三次，去稠腻甚多，是日微发热懈怠，乃用归、芍、茯苓、知母、贝母、前胡、花粉、人参、甘草等味，
调理数日而安。
吴抑之少年禀弱，多烦劳，患疟，间一日一作。医以参、术大补，家人又以参粥良之，遂痞闷发狂，烦躁
不寐。脉之，左三部弦细而数，右寸关浮弦，按之有力，右尺似有似无，其气血固虚，而风寒积滞则实也。用
柴胡、干葛、黄芩、山楂、浓朴、青皮、陈皮、半夏，一剂，胸膈略舒。数剂，谵妄烦躁悉除，疟发于阳分矣。
其鼻干唇裂不眠，腹中梗块作痛，皆阳明大腑未清也。改用枳实、熟大黄、山楂、甘草，加铁锈水，一服，即下
宿垢十余枚，诸症顿减。但真元衰弱，疟犹未已，以当归、白芍、人参、白术、茯苓、甘草、柴、芩、麦冬、
二母，数剂而愈。
李士材治杨太史，疟发，关脉见弦紧。两发后，苦不可支，且不能忌口，便求截之。曰∶邪未尽而强截之，
未必获效，即使截住，必变他症，不若治法得所，一二剂间，令其自止。升麻、柴胡各二钱，提阳气上升，使
远于阴而寒可止；黄芩、知母各一钱五分，引阴气下降，使远于阳而热自已；以生姜三钱，却邪归正；甘草五
分，和其阴阳。一剂而减半，再剂而竟止。
程武修患疟，每日一发，自巳午时起，直至次日寅卯而热退，不逾一时，则又发矣，已及一月，困顿哀苦，
求速愈。曰∶头痛恶寒，脉浮而大，表症方张，此非失汗，必误截也。果服截疟丸而增剧。此邪未解而遽止之，
邪不能出，教以八剂，四日服尽，决效矣。石膏、黄芩各三钱，抑阳明之热，使其退就阳明，脾胃为夫妻，使
之和合，则无阴阳舛乱之愆，半夏、槟榔各一钱五分，去胸中之痰，苏叶二钱，发越太阴之邪，葛根一钱，断
入阳明之路。甫三剂而疟止，改用小柴胡倍人参，服四剂，补中益气汤，服十剂而痊。
沈相国患疟吐蛔，闷不思食，六脉沉细。李曰∶疟伤太阴，中寒蛔动也。用理中汤加乌梅三个，黄连五分，
进四剂后，胸中豁然，寒热亦减，蛔亦不吐。去黄连，加黄 二钱、生姜五钱，五剂而疟止。盖病患素有寒中
之疾，虽盛暑，寒冷不敢沾唇，故疟发而蛔动也。
陈眉公三日疟，浃岁未瘥。素畏药饵，尤不喜人参。其脉浮之则濡，沉之弱。荣卫俱衰，故迁延不已。因
固请曰∶素不服参，天畀之丰也。今不可缺者，病魔之久也。先服人参钱许，口有津生，腹无烦满，遂以人参一
两，何首乌一两，煎成，入姜汁钟许，一剂，势减七八，再剂疟止。（与景岳何人饮意同。）（《医通》。）
一士人病疟久不愈，有道士来，以枣一枚，按病患口上，咒曰∶我从东方来，路逢一池水，水内一尊龙，
九头十八尾，问他吃什么，专吃疟疾鬼，太上老君急急如律令敕。连咒三遍，将枣纳入口中，令嚼食之，遂愈。
（《二酉余谈》。）
冯楚瞻治徐六御患疟不已，热时，恶心胸胀倍甚。医用柴胡汤加草豆蔻，意其痰食为患耳。乃徐素有鼻衄
窦材治疗一位患者，患疟疾一个多月，发热仍未退去。一位医生给予白虎汤（清热生津的方剂），结果热势更加严重。窦材说：“您的病是脾气极度虚弱，却服用寒凉药物，恐怕会损伤脾胃。”
病患说：“不服用凉药，这病什么时候才能好？”窦材说：“《内经》中说：‘疟疾刚开始发作时，其寒冷之象，烈火也不能止住；其发热之象，冰水也不能遏制。’在这个时候，即使是高明的医生也无法施展手脚，只能扶助元气，等待它自然衰退。您现在元气大虚，如果服用凉药退火，我担心热邪未去而元气先脱失。”于是为他灸治命关穴，才灸了五七壮（35-40壮），胁下感觉有气下降，灸满三十壮后完全痊愈。
张子和治疗陈下的一个患者，患疟疾三年不愈，只服用了温热性质的药物，逐渐导致身体消瘦衰弱。请求张子和治疗。张子和见他身体羸弱，也不敢立即投用寒凉药物，张公原本就很细心。于是查阅《内经·刺疟论》。说：“各种疟疾久治不愈，应针刺十指间出血。”正值疟疾发作时，让他针刺十指出血，血止后寒热症状立刻停止，大家都惊叹其神奇。
所以息城有一个男子患疟疾求治。诊察发现，两手脉象都沉伏而有力，体内有积滞，这是“肥气”病。病人说：“左胁下有肥气，肠中作痛，积滞也作痛，形状像倒扣的杯子，时发时止，到现在已经三年了，祈祷、躲避、隐匿，无所不用其极，始终不能治愈。”张子和说：“这是疟疾。”用三花神丸五七十丸，用冷水送服五六行，接着再用冷水止住（因冷主收敛）。待湿水排尽后，一两天内，煎煮白虎汤一次性喝下，疟疾仍然没有痊愈。等到五六天后催吐，用常山散去除冷痰涎水六七次，如同翻浆一般。随后用柴胡汤调和，中间使用妙功丸磨服，疟疾全部消除。
吴中的翰林政和年间丁酉年居住在全椒县，当年疟疾大规模流行，遇寒多而热少，不想饮食。用高良姜用麻油炒，干姜炮制，各一两研为末，每次服用五钱，用猪胆汁调成膏状，在疟疾发作前，用热酒调服。或者用胆汁和药做成丸剂，每次服用四十丸，用酒送下也很好。凡是救活的人以百计。张大亨患此病很严重，想要辞官退休，也服用这个方子而痊愈。大抵寒热发作于胆，用猪胆引导两姜进入胆经，祛除寒气并燥化脾胃，一寒一热，所以有效。（出自《朱氏集验方》、《本草纲目》。）
《野史》记载：卢绛中患疟疾疲瘵，忽然梦见白衣妇人念道：“吃甘蔗可以痊愈。”等到天亮，买了几根甘蔗食用，第二天疾病就好了。（赵献可按语：这就是通过饮食调理身体的方法。）
夔州的谭远患疟疾半年，老朋友窦藏叟传授方子，用真阿魏、好丹砂各一两，研磨均匀，米糊和丸，如皂角子大小，每次空腹用人参汤化开服用一丸即愈。世人治疗疟疾，只用常山，砒霜是有毒之物，多有损害。这个方子平易，人们不知道。草窗周密说：这个方子治疟疾，用无根水下服，治痢疾用黄连木香汤下服，因为疟疾和痢疾多起于积滞的缘故。（赵献可按语：这个方子很妙。可惜阿魏很少有真的，只宜做成小丸吞服，调化恐怕气味臭烈难以入口。）
顾宝光擅长绘画，陆溉患痛风疟疾，很久没有治疗，顾宝光曾经拜访陆溉，于是提笔画了一幅狮子像挂在门外，说：“早晚应当见效。”到了晚上，听到蟋蟀叫声，第二天看狮子口，有血淋漓，陆溉的病就好了。（出自《姑苏志》。）
张守淳冬天患三日疟，一个月，请王孝先诊治，王孝先摇头说：“再过十天就不好治了，必须用参、附子，才可以稍微减轻。”他的父亲惊恐失色，缩着舌头不敢应答。王孝先坚持前面的说法，服用人参、附子各一钱，甚至到二钱，疟疾稍微减轻了六七成，第二年初夏才好。
孙文垣的族孙子应章，在三阴疟于子午卯酉日发作，（古人称为少阴疟。）已经过了四个月了。每次在夜间发作，热多寒少，左脉微弦，右关脉大。用二陈汤加柴胡、黄柏、川芎、当归、黄连，两帖后热势稍轻，但饮食不进，四肢懒倦，脾气大虚。用白术、何首乌各三钱，鳖甲二钱，青皮七分，乌梅一个，一帖就停止了。
应章的弟弟，十月发作三阴疟，到次年仲春仍未停止。每次在辰戌丑未日发作，脉弦数有力，用白芍、当归各一钱，白术二钱，柴胡、川芎、甘草、砂仁、桂枝、酒黄芩各三分，生姜三片，水煎服。再用何首乌、鳖甲、白术各三钱，柴胡一钱，青皮、酒黄芩、甘草各五分，乌梅一个，生姜三片，在发作前的五更天服用，两帖就停止了。半个月后，下身大发疮疖，用东坡四神丹调理而痊愈。（伏暑未尽，方中缺少使用黄连的缘故。）
江省吾暮秋患疟疾，三天一次，在夜间发作，次年仲春仍未停止，遍身疼痛，背脊疼。针灸治疗，仅停止一天，后来仍发作，面色青，肌肉消瘦，这是邪气在足太阳经。（因为遍身及背脊疼的原因。）用麻黄一钱五分，人参、桂枝、白芍、甘草、知母各一钱，陈皮、贝母各七分，姜、枣煎服，疼痛减半，疟疾未止。用何首乌、白术各五钱，青蒿一钱，乌梅一个，陈皮二钱，姜三片水煎，在发作之日，五更天服用。平常用六君子汤加黄 、五味子、乌梅、草果，调理而愈。
侄孙二水，三十岁，身体肥胖，夏天经常浸泡溪水中，躺在松树下，到了八月，大发寒热，从巳午时直到天亮才退。饮食不进，呕吐黄胆汁，胸膈胀闷，舌上干燥生芒刺，颜色沉香色，强硬，用冷水频繁漱口，才能说话，只吃西瓜、生藕。先发热的那天，吐血一口，现在则大便下血，且咳嗽，这是温疟症。由于医生没有解散邪气，急忙用黄芪来闭塞邪气，导致成为大困局。用柴胡、知母各三钱，石膏七钱，葛根三钱，橘红、竹茹各一钱五分，酒黄芩、枳实各二钱，甘草、贝母各五分，三帖后呕吐停止。改用二陈汤加柴胡、枳实、黄芩、黄连、花粉、鳖甲、白术、何首乌，调理而愈。
喻嘉言治疗袁继明，平素有房劳内伤，偶然因为轻微感受外邪，自己煎姜葱汤发汗，因而发热三天，变成疟疾。诊脉，脉象豁大空虚，而且寒不成寒，热不成热，气急神浮。知道这是元阳衰脱的征候，于是对他说第二天疟疾发作时，担心大汗不止，难以用药救治以防危险。他不以为意。第二天五鼓时分，病患精神更加恍惚，敲门求救。等到找到人参时，疟疾已经先发作了。又担心人参补住了疟邪，虽然急救也无益。（这句话不妥，疟疾未发作时，难道没有邪气吗？总之，发作时不应当用药罢了。）姑且等疟疾势头稍退，才给他服药。服药时，已经出汗沾湿衣被。不久，果然大汗不止，昏迷不知人，口流白沫，灌药难入，直到日落，白沫转从肛门流出。于是高兴地说：“白沫下行，可以不用担心了。只是内虚肠滑，独参汤不能胜任，急忙用附子理中汤，连续进服四小剂，人事才苏醒，能说话。只是对面谈话不清楚，门外有探病的客人来到，他忽然预先知道，家人惊以为是鬼祟。他说：“这正是神魂离舍啊。现在用独参汤及附子理中汤，像驷马追奔之力追回神魂，还在半返未返的境界，所以能知道宅外之事。再给前药两帖而安定。”
裕民坊百姓淘井，得到一个瓦枕，枕上有一符，符下有驱疟两个篆字，相传为诸葛武侯所制，患疟疾的人枕着它就痊愈。彼此转相借用，于是被邻居藏匿，因此告到官府，也不能得到。（出自《续金陵琐事》。）
陆养愚治疗崔盐院，八月间患疟疾，一天发作一次，治疗十天不愈。崔说：“这个病要么煎药一二剂，要么丸药一服，没有不止住的。现在服药一二十剂，而病情发作反而加剧，为什么医生不好呢？”医生顺着风向进诊，说：“前日内外之邪还重，不敢立即截断，现在邪气已去，可以截断了。”于是进服丸药一服，服药后呕吐恶心持续一段时间，第二天果然好了。但饮食无味，口中每干苦，刚三天又发作。陆养愚诊脉时，正值寒战，床帷都动，面赤戴阳。（“戴阳”二字不妥。）汗泄不止，身热如火，其脉洪数无比，沉取则急促。（疟疾发作时脉象也难以凭信。）说：“这是热疟，给予三黄石膏汤。”又说疟疾门不载此方，仍进前丸一服，呕吐不止。到巳午时，疟疾发作更甚，热整天不退。再次召诊，想到两次丸药，胃气重伤，且脉较之前更弱，不可纯作实热治疗了。用白虎汤合建中汤、生脉散的半量投予，一夜两剂，呕哕即止，第二天疟疾不发。用清气养荣汤，调理而安。（按语：面戴阳而脉无伦次，则像是理中汤证了。乃作实热而与三黄石膏汤，其说不无可议。戴阳症，下虚上实，脉洪数无伦，沉取则虚微或无，是其征候。现在身热汗出，脉洪数而沉，按之则急促，是浮沉俱有力，正是阳明大热之症。其面赤者，乃胃热熏蒸所致，非戴阳也。案中竟以戴阳为面赤之称，原属称名之误。魏君又拘泥其说，而以为似理中症，亦未免拘文牵义矣。）
朱远斋医名很大，与陆养愚莫逆之交，归安县令听说他的名声，多次召请不赴，借事将他系狱，想在杖刑下杀死他。邑中士绅十几人为他求情，竟然不放。他的妻子奔走号哭求救，陆养愚也无计可施。适逢按台巡湖患疟疾，医治无效，召陆养愚诊治，陆养愚高兴地说：“机会在这里了。”视其脉，两寸关浮数微弦，按之极弱，两尺沉取紧小。其症不发作时，也倦怠，身常热，有汗，饥而痞闷，不敢食，小腹胀急，大便欲行不行者已七八天。发作时战栗，身极热，烦渴躁扰，且喘急得很厉害。前医起初给予发表药，后来因痞闷，用二陈、青皮、草果等燥热之品，常山也私下使用而不效。审察他平日极喜浓味，病后禁绝，只每天吃几块干糕，滋润不进，肠胃已干，再加上风热燥削之剂，怎么能不痞满燥结呢？于是想这个症，是肠实胃虚，如果用丸剂通其下结，用煎剂补其中虚，可以立即痊愈。然而必须慢慢为之，才为朱远斋留余地。于是说：“病无大害，只是势头正猖獗，必数日方可衰其半，十日则全愈了。”催促进药。说：“此时病将发。经云无刺 之热，无刺浑浑之脉，无刺漉漉之汗。为其病逆，未可治也。”既定，用清气养荣汤进服，令用火肉进粥二碗。大便未行，用蜜导法导出燥屎数枚。第二天疟疾减十分之三，再进前汤两剂，已减十分之六七。趁机说：“症虽减，而脉似未减，此余邪未尽，恐后时有变。我有师兄朱如玉，医术比我高明百倍，若得此人商量治疗，百无一失。奈他得罪县尊，现下监禁。”按台随即令捕官，着归安县请朱远斋。朱远斋得免，及进视，论病如见。于是用润字丸三钱先服，随以前汤方加生脉散，是夜下宿垢极多，第二天疟疾止了。（上者宜汤，下者宜丸，虚者宜补，实者宜泻，分类施治，斯两不相妨，亦定法也。）
陆肖愚治疗沈俊庵，五十岁，七月间患疟疾，一天发作一次，或两次，服药不效。用丸药截断，呕吐整天，第二天疟疾不作。然而饮食日减，倦怠嗜卧。到八月中，复发寒热一两天，仍以药丸截断，遂呕吐腹泻数天不止，饮食不进，连汤水也尽吐出，身热戴阳，言语多谵妄。医生还打算用二陈、五苓。及诊脉，浮而微细如丝，于是对他说：“病危急了，兄的药宽缓，恐怕无济于事，现在当用附子理中汤，以冀万一。”那个医生心里不以为然，又病家见用附子大惊骇，陆养愚遂辞去，那个医生治疗两天而死。
陆祖愚治疗朱明宇，因暑月多饮水，又烦劳过度，饮食失节，常常彻夜不眠。偶然赴宴归来感寒，头疼身热，胸膈不快，自用葱、姜发汗，转成疟疾，间日一发。医生用槟榔、柴胡、草果、青皮、干葛、羌活之类，投之辄吐，及疟疾发作呻吟，烦躁益甚，日久渐危。诊脉，气口沉实有力，脐之上下，手不可按，六七天不大便，口干燥，渴极欲西瓜冷水，说：“可以立起也。”于是投其所喜，用嫩苏叶、嫩薄荷，捣汁和匀，入井水中与饮，呕吐停止，而有微汗，甚觉爽利。随即用润字丸四钱投予，渴则以前水饮之，薄暮沉睡，至四鼓腹中响，微微作痛，下燥屎七八枚。后又连行三次，去稠腻甚多，当日微发热懈怠，于是用归、芍、茯苓、知母、贝母、前胡、花粉、人参、甘草等味，调理数日而安。
吴抑之少年禀赋弱，多烦劳，患疟疾，隔一日一作。医生用参、术大补，家人又以参粥喂他，遂痞闷发狂，烦躁不寐。诊脉，左三部弦细而数，右寸关浮弦，按之有力，右尺似有似无，其气血固虚，而风寒积滞则实也。用柴胡、干葛、黄芩、山楂、浓朴、青皮、陈皮、半夏，一剂，胸膈略舒。数剂，谵妄烦躁悉除，疟疾发于阳分了。其鼻干唇裂不眠，腹中梗块作痛，皆阳明大腑未清也。改用枳实、熟大黄、山楂、甘草，加铁锈水，一服，即下宿垢十余枚，诸症顿减。但真元衰弱，疟疾犹未已，用当归、白芍、人参、白术、茯苓、甘草、柴、芩、麦冬、二母，数剂而愈。
李士材治疗杨太史，疟疾发作，关脉见弦紧。两次发作后，痛苦不堪，且不能忌口，便求截断。说：“邪气未尽而强行截断，未必获效，即使截住，必变他症，不如治法得当，一二剂间，令其自止。”升麻、柴胡各二钱，提阳气上升，使远离阴而寒可止；黄芩、知母各一钱五分，引阴气下降，使远离阳而热自已；用生姜三钱，驱邪归正；甘草五分，和其阴阳。一剂而减半，再剂而竟止。
程武修患疟疾，每日一发，从巳午时起，直至次日寅卯而热退，不超过一时，则又发作了，已及一月，困顿哀苦，求速愈。说：“头痛恶寒，脉浮而大，表症方张，这不是失汗，必是误截。”果然服截疟丸而增剧。此邪未解而遽止之，邪不能出，教以八剂，四日服尽，决效矣。石膏、黄芩各三钱，抑阳明之热，使其退就阳明，脾胃为夫妻，使之和合，则无阴阳舛乱之愆，半夏、槟榔各一钱五分，去胸中之痰，苏叶二钱，发越太阴之邪，葛根一钱，断入阳明之路。甫三剂而疟止，改用小柴胡倍人参，服四剂，补中益气汤，服十剂而痊。
沈相国患疟疾吐蛔虫，闷不思食，六脉沉细。李士材说：“疟疾伤太阴，中寒蛔动也。”用理中汤加乌梅三个，黄连五分，进四剂后，胸中豁然，寒热亦减，蛔亦不吐。去黄连，加黄芪二钱、生姜五钱，五剂而疟止。盖病患素有寒中之疾，虽盛暑，寒冷不敢沾唇，故疟发而蛔动也。
陈眉公患三日疟，一年未愈。平素畏药饵，尤不喜人参。其脉浮之则濡，沉之弱。荣卫俱衰，故迁延不已。于是坚决请求说：“平素不服参，天赋丰厚也。现在不可缺者，病魔之久也。”先服人参许，口有津生，腹无烦满，遂以人参一两，何首乌一两，煎成，入姜汁钟许，一剂，势减七八，再剂疟止。（与景岳何人饮意同。）（出自《医通》。）
一士人患疟疾久不愈，有道士来，用枣一枚，按在病患口上，咒曰：“我从东方来，路逢一池水，水内一尊龙，九头十八尾，问他吃什么，专吃疟疾鬼，太上老君急急如律令敕。”连咒三遍，将枣纳入口中，令嚼食之，遂愈。（出自《二酉余谈》。）
Dou Cai treated a patient who had suffered from malaria for over a month, with fever persisting. A physician prescribed Baihu Tang (White Tiger Decoction), but the heat intensified. Dou Cai said, "Your condition involves severe deficiency of Spleen Qi, and taking cold-natured medicines may damage the Spleen and Stomach."
The patient asked, "If I do not take cooling medicines, when will this illness subside?" Dou Cai replied, "As stated in the *Neijing* (Classic of Internal Medicine): 'When malaria first manifests, its coldness cannot be stopped by raging fire; its heat cannot be restrained by ice water.' At such times, even skilled physicians find it difficult to intervene directly; instead, one should support the Yuan Qi (Original Qi) and wait for it to decline naturally. Your Yuan Qi is currently severely deficient. If you use cold medicines to clear the heat, I fear the heat may remain while your Yuan Qi collapses." Consequently, he moxaed the Mingguan acupoint. After only 35-40 moxibustion cones (zhuang), the patient felt qi descending from the hypochondrium. After completing 30 zhuang, the patient was completely cured.
Zi He treated a patient named Chen Xia, who had suffered from malaria for three years without success, having taken only warm-tonifying medicines, which gradually led to emaciation. Seeking treatment from Zhang Zihe, Zhang observed his frailty and dared not immediately prescribe cold-purging medicines, as Zhang was known for his caution. He consulted the *Cimai Lun* (Treatise on Acupuncture for Malaria) in the *Neijing*. He stated, "For various recalcitrant malaria cases, prick the spaces between the ten fingers to bleed." During an acute attack, he pricked the tips of the ten fingers until bleeding ceased, after which the chills and fever stopped immediately. Everyone marveled at the efficacy.
In Xicheng, a man sought treatment for malaria. His pulse was deep, hidden, yet forceful in both hands, indicating internal accumulation, specifically a condition called "Feiqi" (Fat Qi). The patient reported, "I have Feiqi under my left hypochondrium, causing pain in the intestines and the mass itself. It resembles an inverted cup, appearing intermittently for three years. I have tried prayers, avoidance, and hiding, but nothing worked." Zhang Zihe diagnosed it as malaria. He administered Sanhua Shen Wan (Three-Flower Divine Pill), 50-70 pills, washed down with cold water several times, followed by more cold water to stop the flow (as cold promotes consolidation). After the damp-cold residue was expelled, within one or two days, he drank a single dose of Baihu Tang, but the malaria persisted. Five or six days later, he induced vomiting using Changshan San (Daphne Bark Powder) to expel cold phlegm and fluid six or seven times, resembling churned curds. Subsequently, Chaihu Tang (Bupleurum Decoction) was used to harmonize, interspersed with Miaogong Wan, until the malaria was completely eradicated.
During the Dingyou year of the Zhengde era, an Hanlin academician resided in Quanjiao County, where malaria was rampant. Symptoms included predominant chills with slight fever and loss of appetite. He prepared Gao Liang Jiang (Galangal Rhizome) stir-fried with sesame oil and Gan Jiang (Pounded Ginger) roasted, each one liang, ground into powder. Each dose was five qian, mixed with pig bile into a paste, and taken with hot wine before the onset of the attack. Alternatively, pills made with bile could be taken with wine. This method saved hundreds, including Zhang Daheng, whose severe case resolved after taking it. Generally, chills and fever originate in the Gallbladder; pig bile guides the two gingers into the Gallbladder channel, dispelling cold and drying the Spleen and Stomach. The combination of cold and heat properties accounts for its efficacy. (From *Zhu Shi Ji Yan Fang* and *Ben Cao Gang Mu*.)
*Ye Shi* (Unofficial History) records: Lu Jiangzhong suffered from malaria and wasting syndrome. He dreamed of a woman in white chanting, "Eating sugarcane will cure you." Upon waking, he bought several stalks and ate them; by the next day, he was cured. (Zhao Xianke notes: This is a method of dietary regulation.)
Tan Yuan from Kuizhou suffered from malaria for half a year. His friend Dou Cangsou prescribed a formula using genuine Asafoetida (Wei) and real Cinnabar (Dansha), one liang each, ground together and bound with rice paste into pills the size of soap beans. Taken one pill dissolved in Ginseng decoction on an empty stomach, it cured him. People usually treat malaria with Changshan (Daphne), but Realgar (Pishuang) is toxic and damaging. This formula is simple and unknown to many. Zhou Mi (Caowang) stated that this formula treats malaria with "rootless water" (rainwater) and dysentery with Coptis and Aucklandia decoction, as both diseases often arise from stagnation. (Zhao Xianke notes: This formula is excellent. However, true Asafoetida is rare; it is better to swallow small pills whole, as dissolving them releases a pungent odor difficult to tolerate.)
Gu Baoguang, a skilled painter, visited Lu Gai, who suffered from gouty malaria for a long time. Gu painted a lion portrait outside Lu's house, saying, "It will show effect soon." That night, crickets were heard chirping. The next day, blood was found dripping from the lion's mouth, and Lu Gai recovered. (From *Gusu Zhi*.)
Zhang Shouchun contracted tertian malaria in winter. Wang Xiaoxian diagnosed him, shaking his head, saying, "In ten days, it will be incurable unless treated with Ginseng and Aconite to reduce symptoms slightly." Zhang's father was terrified. Wang insisted, prescribing one qian of Ginseng and Aconite, increasing to two qian. The malaria reduced by 60-70%, and he recovered the following early summer.
Sun Wen Yuan's nephew, Ying Zhang, suffered from Yin-type malaria occurring on Zi, Wu, Mao, and You days (known as Shaoyin malaria) for four months. Attacks occurred at night with more heat than cold. The left pulse was slightly wiry, and the right Guan pulse was large. Two doses of Erchen Tang added with Bupleurum, Phellodendron, Ligusticum, Angelica, and Coptis reduced the heat slightly but caused poor appetite, lethargy, and severe Spleen Qi deficiency. One dose of Atractylodes, Polygonum multiflorum, Turtle Shell, Tangerine Peel, and Mume fruit stopped the attacks.
Ying Zhang's brother developed Yin-type malaria in October, lasting until mid-spring. Attacks occurred on Chen, Xu, Chou, and Wei days with a wiry, rapid, and forceful pulse. He took White Peony, Angelica, Atractylodes, Bupleurum, Ligusticum, Licorice, Amomum, Cinnamon Twig, and Wine-fried Scutellaria with ginger. Later, he took Polygonum multiflorum, Turtle Shell, Atractylodes, Bupleurum, Tangerine Peel, Wine-fried Scutellaria, Licorice, Mume fruit, and ginger, taken at dawn before the attack. Two doses stopped the malaria. Half a month later, he developed severe boils on the lower body, which healed with Dongpo Sishen Dan. (The lingering summer-heat required Coptis, which was omitted.)
Jiang Shengwu contracted malaria in late autumn, occurring every three nights, persisting until mid-spring. He suffered from generalized pain, especially in the back. Moxibustion provided only temporary relief. His face was blue, and he was emaciated, indicating pathogenic factors in the Foot-Taiyang channel. He took Ephedra, Ginseng, Cinnamon Twig, White Peony, Licorice, Anemarrhena, Citrus Peel, and Fritillaria with ginger and jujube. Pain halved, but malaria persisted. He then took Polygonum multiflorum, Atractylodes, Qinghao, Mume fruit, Citrus Peel, and ginger, taken at dawn on attack days. He was eventually managed with Liu Junzi Tang added with Huangqi, Schisandra, Mume fruit, and Cyperus.
His great-nephern, Ershui, aged thirty, was obese. After swimming in streams and sleeping under pines in summer, he developed severe chills and fever in August from noon until dawn. He had no appetite, vomited yellow bile, experienced chest fullness, dry tongue with prickles, and a hard, dark-yellow tongue requiring frequent rinsing with cold water to speak. He only ate watermelon and raw lotus root. He hematemesis during the initial fever and now had hematochezia and cough. This was Warm Malaria due to failure to resolve the exterior and premature use of Astragalus trapping the pathogen. He took Bupleurum, Anemarrhena, Gypsum, Pueraria, Citrus Peel, Bamboo Shavings, Wine-fried Scutellaria, and Immature Bitter Orange. Vomiting stopped after three doses. He was then managed with Erchen Tang added with Bupleurum, Immature Bitter Orange, Scutellaria, Coptis, Trichosanthes Root, Turtle Shell, Atractylodes, and Polygonum multiflorum.
Yu Jiayan treated Yuan Jiming, who had chronic kidney-yin deficiency from sexual excess. After a minor external contraction, he self-administered Ginger and Scallion decoction to induce sweating, leading to three days of fever and subsequent malaria. The pulse was vast and empty. He exhibited indistinct chills and heat, shortness of breath, and floating spirit. Yu identified this as collapse of Original Yang. He warned that massive sweating might occur during the next attack. The patient ignored this. At dawn the next day, the patient was delirious. By the time Ginseng was obtained, the malaria had started. Yu feared Ginseng might trap the pathogen but waited until the malaria subsided slightly before administering it. The patient sweated profusely upon taking it, became unconscious, foamed at the mouth, and eventually excreted foam from the anus. Yu noted this downward movement was auspicious. Since the interior was deficient with loose bowels, Dushen Tang (Single Ginseng Decoction) was insufficient. He urgently administered Fuzi Lizhong Tang (Aconite and Magnolia Bark Decoction) four times. The patient revived but remained confused, perceiving visitors before they entered. Yu explained this as the soul wandering. Two more doses restored stability.
In Yumin Fang, villagers digging a well found a tile pillow inscribed with a charm to drive away malaria, attributed to Zhuge Liang. Patients claimed it cured them. It was borrowed among neighbors until stolen, leading to a lawsuit. (From *Xu Jinling Suoshi*.)
Lu Yangyu treated Cui Yanyuan, who had daily malaria in August for ten days without improvement. Cui complained that previous treatments always worked quickly. The physician admitted that earlier pathogens were strong, preventing immediate interception, but now could be stopped. A pill was given, causing vomiting. The malaria stopped the next day, but the patient lost appetite and had a bitter, dry mouth. Three days later, it relapsed. During Lu's examination, the patient had severe chills shaking the bed curtains, flushed face (labeled "Daiyang" or Floating Yang), continuous sweating, high fever, and a surging, rapid pulse that accelerated upon deep pressure. Lu diagnosed Heat Malaria and prescribed Sanhuang Shigao Tang. The patient refused, taking the previous pill again, worsening vomiting. By midday, fever persisted. Lu realized the pills damaged Stomach Qi and the pulse weakened. He combined Baihu Tang, Jianzhong Tang, and Shengmai San. Vomiting stopped overnight, and malaria did not recur. He was managed with Qingqi Yangying Tang. (Commentary: The diagnosis of Daiyang was questionable; the pulse indicated Yangming Heat rather than deficiency-cold.)
Zhu Yuanzhai, a famous physician, was imprisoned by the magistrate of Gui'an. Lu Yangyu was summoned to treat the governor's malaria. Lu saw an opportunity to save Zhu. The governor's pulse was superficial and wiry but weak on pressure, with deep, tight, small pulses in the Chi position. Symptoms included fatigue, low-grade fever, sweating, abdominal fullness, and constipation. Attacks involved shivering, high fever, thirst, and agitation. Previous doctors used dispersing and drying herbs, failing. Lu diagnosed intestinal excess and stomach deficiency. He prescribed Qingqi Yangying Tang and advised eating fatty meat congee. Honey suppositories expelled dry feces. Malaria reduced significantly. To save Zhu, Lu suggested consulting his imprisoned master, Zhu Ruyu. Zhu was released, examined the patient, and prescribed Runzi Wan followed by the previous formula with Shengmai San. Massive stool discharge occurred that night, and malaria stopped the next day. (Principles: Upper disorders suit decoctions, lower disorders suit pills, deficiency suits tonification, excess suits purgation.)
Lu Xiaoyu treated Shen Jun'an, aged fifty, with daily or bi-daily malaria in July. Pills caused vomiting. Malaria stopped, but appetite declined. In August, chills and fever returned. More pills caused prolonged vomiting and diarrhea. The patient became delirious with a flushed face ("Daiyang"), sweating, and a thread-like pulse. The attending doctor planned Erchen and Wuling San. Lu diagnosed critical deficiency and prescribed Fuzi Lizhong Tang. The family and other doctors objected. Lu left. The patient died after two days of alternative treatment.
Lu Zuyu treated Zhu Mingyu, who drank cold water excessively in summer, overworked, and had irregular diet, leading to insomnia. After catching a cold returning from a banquet, he self-treated with Ginger and Scallion, developing intermittent malaria. Doctors used heavy dispersing herbs, causing vomiting. The patient became delirious and critical. Pulse was deep, forceful, and solid. Abdomen was tender, constipated for six days, with extreme thirst for cold water. Lu gave him Mint and Perilla juice mixed with well water. Vomiting stopped, slight sweat appeared. He then administered Runzi Wan. Dry feces were passed. He was managed with tonifying and clearing herbs.
Wu Yizhi, young and weak, suffered from alternating-day malaria. Doctors used heavy tonics (Ginseng and Atractylodes), and family fed him Ginseng porridge. He became manic, restless, and insomniac. Pulse was wiry and rapid on the left, floating and wiry on the right upper/middle, weak on the right lower. While Qi and Blood were deficient, Wind-Cold and stagnation were excess. He took Bupleurum, Pueraria, Scutellaria, Hawthorn, Magnolia Bark, Tangerine Peel, and Pinellia. Chest discomfort relieved. Delirium ceased. Malaria shifted to the Yang level. Nasal dryness and abdominal masses indicated Yangming bowel retention. He took Immature Bitter Orange, Prepared Rhubarb, Hawthorn, Licorice, and Iron Rust Water. Massive stool discharge occurred. Symptoms reduced. Finally, he took Angelica, White Peony, Ginseng, Atractylodes, Poria, Licorice, Bupleurum, Scutellaria, Ophiopogon, and Fritillaria to recover.
Li Shicai treated Grand Secretary Yang, who had malaria with wiry-tight Guan pulses. After two attacks, he was exhausted and demanded immediate cessation. Li warned that forcing cessation without resolving pathogens causes complications. Instead, he prescribed Ma Huang, Chai Hu to raise Yang and stop cold; Huang Qin, Zhi Mu to descend Yin and stop heat; Sheng Jiang to guide pathogens back; and Licorice to harmonize. One dose halved symptoms; two doses stopped it.
Cheng Wuxiu had daily malaria from noon until next morning, lasting a month. Headache and aversion to wind with a floating-large pulse indicated exterior syndrome, likely worsened by premature interception. He took Bajia Tang (Eight Agents Decoction) containing Gypsum, Scutellaria, Pinellia, Areca Seed, Perilla Leaf, and Pueraria. Malaria stopped after three doses. He was then managed with Xiao Chaihu Tang (modified) and Buzhong Yiqi Tang.
Grand Chancellor Shen had malaria with vomiting of roundworms, no appetite, and deep-thin pulses. Li diagnosed Taiyin injury with Cold moving worms. He prescribed Lizhong Tang added with Mume fruit and Coptis. After four doses, chest cleared, chills/heat reduced, worm vomiting stopped. Coptis was removed, Astragalus and Ginger added. Five doses stopped malaria. The patient had chronic internal cold.
Chen Meigong had tertian malaria for a year, fearing medicine, especially Ginseng. Pulse was soft on superficial pressure and weak on deep pressure, indicating deficiency of Ying and Wei. Despite his refusal, he took one qian of Ginseng, producing saliva and no fullness. He then took one liang of Ginseng and Polygonum multiflorum with Ginger Juice. Symptoms reduced by 70-80% after one dose; malaria stopped after two. (Similar to Jingyue's Heren Yin.)
A scholar with chronic malaria was cured by a Taoist priest who chanted over a date held to his mouth, commanding a dragon to eat the malaria demon. The scholar chewed and swallowed the date and recovered. (From *Er You Yu Tan*.)
Feng Chuzhan treated Xu Liuyu with persistent malaria, severe nausea and chest distension during fever. Doctors used Chaihu Tang with Cardamom, suspecting phlegm-food retention. Xu had a history of epistaxis...