疟疾治法有二,新疟先截后补,久疟先补后截。
凡疟要分早晚治之,如上半日发者,此邪在阳分气位也,先用
平胃散加常山(1)、草果截之。后用平疟养脾丸,调理而安。如下半
日发者,此邪在阴分血位也,轻者以四物汤加桂枝、桃仁、红
花,发出血中寒邪。甚者,以小柴胡汤加升麻、当归提到阳分,
然后以小柴胡汤加常山、草果截之。略愈,以平疟养脾丸调之而
安。
如疟来寒多热少者,以平胃散加常山、桂枝,草果仁截之;
热多寒少者,以白虎汤加常山、草果。青皮截之,寒热相半者,
用小柴胡汤加常山、草果截之。后以平疟养啤丸调之。如大人以
补中益气汤调之。以上数症,皆先截后补也。
如久疟连绵不退者,或二、三日一次,其邪已深,不可妄用
截药,只以平疟养脾丸调之。有汗要无汗,无汗要有汗,其疟易
退。再要避风寒,禁鸡鱼。冷水,无不安者。如犯禁戒,虽九转
灵丹,亦难治也。
凡疟后转作痢疾着,此症多得于夏末秋初,因内有伏阴,多伤
生冷故也。当从(2)虚治,不可妄用通利之药。如平常下痢者,以
香连丸,米汤送下。
如疟痢并作着,以平疟养脾丸。橘皮和中丸相间服之。
如疟后遍身浮肿者。此因汗后受风故也。以胃苓丸加五加
皮、大腹皮,灯心、长流水煎汤治之,大儿加减胃苓汤治之。外用
浴法,于日当午时,向避风处,以温水拂拭遍身,略睡一时,以
被盖之,微汗为度。每日根据此行之,其法甚效。
如疟后腹胀,或喘或不喘者,此因内伤生冷。脾肺俱病故
也。盖脾主胀,喘属肺,以塌气丸消胀,以葶苈丸定喘治之。后
以集圣丸调之。
如疟后腹中有痞着,此疟母也。因多食冷水所致。亦有热而
成者,治以月蟾丸主之。
凡疟后形体黄瘦者,只以集圣丸调之。
疟疾的治疗方法有两种:新发的疟疾,先采用截断疗法,后采用补益疗法;久治不愈的疟疾,先采用补益疗法,后采用截断疗法。
凡是疟疾都要分早晚进行治疗。如果是上半日发作的,这是邪气在阳分气位,先用平胃散(燥湿运脾、行气和胃的方剂)加入常山、草果来截断疟疾。之后用平疟养脾丸调理,即可痊愈。如果是下半日发作的,这是邪气在阴分血位,轻症用四物汤(补血调血的方剂)加入桂枝、桃仁、红花,将血中的寒邪发散出来。重症用小柴胡汤(和解少阳的方剂)加入升麻、当归,将邪气提升到阳分,然后再用小柴胡汤加入常山、草果来截断疟疾。症状稍缓解后,用平疟养脾丸调理而痊愈。
如果疟疾发作时寒多热少,用平胃散加入常山、桂枝、草果仁来截断;热多寒少者,用白虎汤(清热生津的方剂)加入常山、草果、青皮来截断;寒热相等者,用小柴胡汤加入常山、草果来截断。之后用平疟养脾丸调理。如果是成人患者,用补中益气汤(补中益气、升阳举陷的方剂)调理。以上几种情况,都是先截断后补益。
如果是久疟连绵不退,或者两三天发作一次,说明邪气已经深入,不可妄用截疟药物,只用平疟养脾丸调理。治疗原则是“有汗要使其无汗,无汗要使其有汗”,这样疟疾容易消退。此外还要避免风寒,禁止食用鸡肉、鱼类和冷水,没有不能治愈的。如果违反禁忌,即使是九转灵丹,也难以治愈。
凡是疟疾之后转为痢疾的,这种病症多见于夏末秋初,是因为体内有伏匿的阴寒之气,多因损伤生冷食物所致。应当从虚证治疗,不可妄用通利泻下的药物。如果是平常的下痢,用香连丸(清热化湿、行气止痛的方剂),用米汤送服。
如果是疟疾和痢疾同时发作,用平疟养脾丸和橘皮和中丸(理气和中的方剂)交替服用。
如果是疟疾之后全身浮肿,这是因为发汗后受风所致。用胃苓丸(健脾祛湿、行气利水的方剂)加入五加皮、大腹皮、灯心草,用长流水煎汤治疗,儿童则用加减胃苓汤治疗。外用洗浴法,在正午时分,到避风处,用温水擦拭全身,稍微睡一会儿,盖上被子,以微微出汗为度。每天按照这个方法做,疗效很好。
如果是疟疾之后腹胀,或者有喘症或无喘症,这是因为内伤生冷,导致脾肺两脏均患病。因为脾主胀满,喘症属于肺,用塌气丸(降气消胀的方剂)消除胀满,用葶苈丸(泻肺平喘的方剂)定喘治疗。之后用集圣丸(健脾消积的方剂)调理。
There are two treatment methods for malaria: for newly acquired malaria, the method of "interception" (stopping the paroxysm) is used first, followed by tonification; for chronic malaria, tonification is used first, followed by interception.
Malaria should be treated according to the time of onset. If it occurs in the first half of the day, this indicates that the pathogenic factor is in the Yang aspect and Qi level. First, use Pingwei San (Calm the Stomach Powder) added with Changshan (Dichroa Root) and Caoguo (Black Cardamom Fruit) to intercept the malaria. Subsequently, use Pingmie Yangpi Wan (Malaria-Intercepting Spleen-Nourishing Pill) for regulation until recovery. If it occurs in the second half of the day, this indicates that the pathogenic factor is in the Yin aspect and Blood level. For mild cases, use Siwu Tang (Four Substance Decoction) added with Guizhi (Cinnamon Twig), Taoren (Peach Kernel), and Honghua (Safflower) to disperse the cold pathogen from the blood. For severe cases, use Xiaochaihu Tang (Minor Bupleurum Decoction) added with Shengma (Cimicifuga Rhizome) and Danggui (Angelica Sinensis) to raise the pathogen to the Yang aspect, and then use Xiaochaihu Tang added with Changshan and Caoguo to intercept the malaria. After slight improvement, regulate with Pingmie Yangpi Wan until recovery.
If chills predominate over fever during malaria attacks, use Pingwei San added with Changshan, Guizhi, and Caoguo Ren (Cardamom Seed) to intercept. If heat predominates over chills, use Baihu Tang (White Tiger Decoction) added with Changshan, Caoguo, and Qingpi (Aged Tangerine Peel) to intercept. If chills and heat are equal, use Xiaochaihu Tang added with Changshan and Caoguo to intercept. Subsequently, regulate with Pingmie Yangpi Wan. For adult patients, regulate with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). The above conditions all follow the principle of interception first, then tonification.
For chronic malaria that persists without remission, or occurs once every two or three days, the pathogen has penetrated deeply. Do not recklessly use interception drugs; instead, only use Pingmie Yangpi Wan for regulation. The therapeutic principle is to induce sweating if there is none, and stop sweating if there is some; under these conditions, the malaria will easily recede. Additionally, avoid wind and cold, and strictly prohibit the consumption of chicken, fish, and cold water. There is no case that cannot be cured. If these prohibitions are violated, even the Nine-Cycle Spiritual Elixir (Jiuzhuan Lingdan) will be difficult to cure.
When malaria transforms into dysentery afterwards, this condition mostly occurs at the end of summer and beginning of autumn, due to latent Yin-cold within the body and excessive injury from raw and cold foods. It should be treated as a deficiency pattern; do not recklessly use purgative or draining drugs. For ordinary dysentery, use Xianglian Wan (Costus and Coptis Pill), taken with rice soup.
When malaria and dysentery occur simultaneously, take Pingmie Yangpi Wan and Jupi Hezhong Wan (Tangerine Peel Harmonizing the Middle Pill) alternately.
If generalized edema occurs after malaria, this is due to contracting wind after sweating. Treat with Weiling Wan (Stomach and Lingzao Pill) added with Wujia Pi (Acanthopanax Bark), Dafupi (Areca Peel), and Dengxincao (Juncus Effusus), decocted in long-flowing water. For children, use Jiawei Weiling Tang (Modified Stomach and Lingzao Decoction). For external therapy, perform bathing: at noon, in a wind-sheltered place, wipe the whole body with warm water, lie down for a short while, cover with a blanket, and aim for a slight sweat. Perform this daily; the method is very effective.
If abdominal distension occurs after malaria, with or without wheezing, this is due to internal injury from raw and cold foods, affecting both the Spleen and Lung. Since the Spleen governs distension and wheezing belongs to the Lung, use Taqi Wan (Qi-Sinking Pill) to reduce distension and Tingli Wan (Descurainia Pill) to calm wheezing. Subsequently, regulate with Jisheng Wan (Accumulated Sage Pill).
If a mass forms in the abdomen after malaria, this is known as "Malaria Mother" (Nodule caused by chronic malaria). It is caused by excessive consumption of cold water. Some cases arise from heat pathogens; treat primarily with Yuechan Wan (Moon Toad Pill).
For patients who become sallow and emaciated after malaria, regulate solely with Jisheng Wan.