孙 阴气先伤。阳气独发。犹是伏暑内动。当与金匮瘅疟同例。（瘅疟）
竹叶 麦冬 生地 玄参 知母 梨汁 蔗浆
施 发热身痛。咳喘。暑湿外因。内阻气分。有似寒栗。皆肺病也。
竹叶 连翘 薄荷 杏仁 滑石 郁金汁
又 微寒多热。舌心干。渴饮脘不爽。此属瘅疟。治在肺经。
杏仁 石膏 竹叶 连翘 半夏 橘红
程 阴气先伤。阳气独发。有瘅热无寒之虑。
鲜生地 知母 麦冬 竹叶心 滑石
唐 未病。形容先瘦。既病。暮热早凉。犹然行动安舒。未必真正重病伤寒也。但八九日。病来小
愈。骤食粉团腥面。当宗食谷发热。损谷则愈。仲景未尝立方。此腹痛洞泻。食滞阻其肠胃。大
腑不司变化。究其病根。论幼科体具纯阳。瘦损于病前。亦阳亢为消烁。仲景谓瘅疟者。单热
不寒。本条云。阴气孤绝。阳气独发。热灼烦冤。令人消烁肌肉。亦不设方。但云以饮食消息
之。嘉言主以甘寒生津可愈。重后天胃气耳。洞泻既频。津液更伤。苦寒多饵。热仍不已。暮夜
昏谵。自言胸中格拒。腹中不和。此皆病轻药重。致阴阳二气之残惫。法当停药与谷。谅进甘
酸。解其烦渴。方有斟酌。
又 鼻煤。唇裂舌腐。频与芩连。热不肯已。此病本轻。药重于攻击。致流行之气。结闭不行。郁遏
不通。其热愈甚。上则不嗜饮。不纳食。小溲颇利便必管痛。三焦皆闭。神昏螈 有诸。
连翘心（三钱） 鲜石菖蒲汁（一钱半） 川贝母（三钱） 杏仁（二十粒） 射干（二分）
淡竹叶（一钱半）
又 自停狠药。日有向愈之机。胃困则痞闷不欲食。今虽未加餐。已知甘美。皆醒之渐也。童真
无下虚之理。溲溺欲出。尿管必痛。良由肺津胃汁。因苦辛燥热烈气味。劫夺枯槁。肠中无以
营运。庸医睹此。必以分利。所谓泉源既竭。当滋其化源。九窍不和。都属胃病。
麦门冬（二钱） 甜杏仁（四钱） 甜水梨皮（三钱） 蔗浆（一木杓）
张 舌赤。烦汗不寐。肢体忽冷。乃稚年瘅疟。暑邪深入所致。
杏仁 滑石 竹叶 西瓜翠衣 知母 花粉
又 热甚而厥。幼稚疟症皆然。竹叶石膏汤去人参半夏加知母。
某 风温阳疟。（温疟）
杏仁 滑石 连翘 黄芩 青蒿 淡竹叶
丁 脉右数。左小弱。面明。夏秋伏暑。寒露后发。微寒多热。呕逆。身痛。盖素有痰火。暑必挟湿。病
自肺经而起。致气不宣化。不饥不食。频溺短缩。乃热在气分。当与温疟同例。忌葛柴足六经
药。桂枝白虎汤加半夏。
胡 按仲景云。脉如平人。但热无寒。骨节烦疼。微呕而渴者。病名温疟。桂枝白虎汤主之。桂
枝白虎汤。
盖今年夏秋久热。口鼻吸暑。其初暑邪轻小。不致病发。秋深气凉外束。里热欲出。与卫营
二气交行。邪与二气遇触。斯为热起。临解必有微汗者。气邪两泄。然邪不尽。则混处气血
中矣。故圣人立法。以石膏辛寒。清气分之伏热。佐入桂枝。辛甘温之轻扬。引导凉药以通
营卫。兼知母专理阳明独胜之热。而手太阴肺。亦得秋金肃降之司。甘草粳米和胃阴以
生津。此一举兼备。方下自注云。一剂知。二剂已。知者。谓病已知其对症。已者。中病当愈之
称耳。
邓 寒少热多。胸中痞胀。温邪未解。谩言止截。
淡黄芩 炒半夏 姜汁 生白芍 草果 知母 乌梅
又 照前方去半夏姜汁加鳖甲。
吴 间日寒热。目黄口渴。温邪兼雨湿外薄为疟。
滑石 杏仁 白蔻仁 淡黄芩 半夏 郁金
又 脉数。舌红口渴。热邪已入血分。
竹叶 石膏 生地 丹皮 知母 青蒿梗
又 饮食不节。腹中不和。疟邪攻胃。
鲜首乌 乌梅肉 生鳖甲 黄芩 丹皮 草果 知母 送保和丸二钱
又 人参 生谷芽 枳实汁 茯苓 广皮 炒半夏曲
朱 舌黄烦渴。身痛。心腹中热躁。暑热不解为疟。经言暑脉自虚。皆受从前疲药之累瘁。（暑疟）
石膏 知母 生甘草 炒粳米 麦冬 竹叶
何 劳倦伤气。遗泄伤阴。暑邪变疟。炽则烦冤最盛。分解使邪势轻。参术 附。皆固闭邪气也。
草果仁 知母 淡黄芩 川贝母 青蒿 花粉
冯 暑伤气分。上焦先受。河间法至精至妙。后医未读其书。焉能治病臻效。邪深则疟来日迟。
气结必胸中混 如痞。无形之热。渐蒸有形之痰。此消导发散。都是劫津。无能去邪矣。
石膏 杏仁 半夏 浓朴 知母 竹叶
黄 脉数。目 黄。舌心干白黄胎。口中粘腻。脘中痞闷。不思纳谷。由于途次暑风客邪内侵募
原。营卫不和。致发疟疾。夫暑必兼湿。湿也。热也。皆气也气与邪搏。则清浊交混。升降自阻。古
称湿遏必热自生矣。圣帝论病。本乎四气。其论药方。推气味。理必苦降辛通。斯热气痞结可
开。消导攻滞。香燥泄气。置暑热致病之因于不治。不识何解。
川连 黄芩 花粉 桔梗 白蔻仁 郁金
橘红 六一散
又 苦降能驱热除湿。辛通能开气宣浊。已经见效。当减其制。仍祖其意。
川连 桔梗 白蔻仁 浓朴 茵陈 茯苓皮 银花 白通草
胡 间日疟。痰多脘闷。汗多心热。伏暑内炽。忌与风寒表药。
滑石 黄芩 浓朴 杏仁 通草 白蔻 半夏 栝蒌皮 知母
又 黄芩 草果 知母 半夏 生白芍 乌梅
汪（氏） 微冷热多。舌白。脘闷呕恶。暑秽过募原为疟。
杏仁 郁金 滑石 浓朴 黄芩 炒半夏 白蔻 橘红
某 舌白脘闷。寒起四末。渴喜热饮。此湿邪内蕴。脾阳不主宣达。而成湿疟。（湿疟）
浓朴（一钱半） 杏仁（一钱半） 草果仁（一钱） 半夏（一钱半） 茯苓（三钱） 广
皮白（一钱半）
某（二五） 疟止。面浮渐及脘腹。
苡仁 桑白皮 茯苓 大腹皮 姜皮 广皮
某 间疟。寒热俱微。此属湿疟。
杏仁（三钱） 浓朴（一钱） 桂枝木（五分） 飞滑石（三钱） 草果（八分） 炒半夏（一钱半）
茯苓皮（三钱） 绵茵陈（一钱半）
牛（四八） 寒来喜饮热汤。发热后反不渴。间疟已四十日。今虽止。不饥不思食。五味入口皆变。初病
舌白干呕。湿邪中于太阴脾络。湿郁气滞。喜热饮暂通其郁。邪蒸湿中生热。六腑热灼。津不
营运。至大便硬秘。此为气痹湿结。当薄味缓调。令气厘清肃。与脾约似同。但仲景气血兼治。
此病却专伤气分。
炒黄半夏 生益智仁 绵茵陈 广皮 浓朴 茯苓
又 疟止。舌白。不饥。大便旬日不通。此皆留邪堵塞经腑隧道之流行。久延必致腹胀 瘕。
杏仁 白蔻仁 半夏 浓朴 生香附汁 广皮 茯苓皮 接服半硫丸二钱
某 脉右弦左弱。留邪未尽。大便粘稀。最防转痢。较七八日前。势减一二。但去疾务尽。苦辛寒
逐其蕴伏。而通利小便。亦不可少。
草果 知母 浓朴 茯苓 木通 滑石
曹 身痛。舌白口渴。自利。此湿温客气为疟。不可乱投柴葛。仲景有湿家忌汗之律。（湿热）
飞滑石 杏仁 郁金 淡黄芩 白蔻仁 防己
又 湿甚为热。心痛。舌白便溏。治在气分。
竹叶心 麦冬 郁金 菖蒲 飞滑石 橘红 化服牛黄丸
又 心下触手而痛。自利。舌白烦躁。都是湿热阻气分。议开内闭。用泻心汤。
川连 淡黄芩 干姜 半夏 人参 枳实
又 神气稍清。痛处渐下至脐。湿伤在气。热结在血。吐咯带血。犹是上行为逆。热病瘀留。必从
下出为顺。
川连 黄芩 干姜 半夏 人参 枳实 白芍 炒楂肉
费 舌白渴饮。身痛呕恶。大便不爽。诊脉濡小。乃暑湿从口鼻入。湿甚生热。四末扰中。疟发脘
痞胀痹。当以苦辛寒清上彻邪。不可谓遗泄而病。辄与温补助邪。
黄芩 知母 白蔻 郁金 蒌皮 浓朴 杏仁 半夏 姜汁 石膏
又 脉濡。口渴。余热尚炽。
人参 知母 石膏 竹叶 甘草 麦冬
又 热缓。不欲食。津液受烁。当和胃生津。
人参 五味 知母 橘红 炒白芍 半夏曲
张 疮家湿疟。忌用表散。苍术白虎汤加草果。
曹 寒从背起。汗泄甚。面无淖泽。舌色仍白。邪未尽。正先怯心虚痉震。恐亡阳厥脱。议用仲景
救逆法加参。（阳虚）
又 舌绛口渴。汗泄。疟来日晏。寒热过多。身中阴气大伤。刚补勿进。议以何人饮。
人参 何首乌
孙 阳虚之体。伏暑成疟。凉药只宜少用。身麻属气虚。用生姜泻心法。
半夏 生姜汁 茯苓 炙甘草 南枣肉
沈 阳微复疟。
桂枝 当归 黄 防风 鹿角屑 姜汁 南枣
范（五三） 劳疟入阴。夏月阳气发泄。仍然劳苦经营。以致再来不愈。用药以辛甘温理阳为正。但未
易骤效耳。
人参 当归 肉桂 炙草 川蜀漆 生姜 南枣
方 寒甚于背。阳脉衰也。
人参 鹿茸 炒当归 炙草 鹿角霜 官桂 鳖甲煎丸
吴（六一） 背寒。舌白粉胎。知饥食无味。此为无阳。温中下以托邪。
生白术 浓朴 桂枝 附子 草果仁 茯苓
又 照方去茯苓加人参炙草生姜。
程 寒热经月不止。属气弱留邪。以益气升阳。补中益气汤
又 生鹿茸 鹿角霜 人参 归身 茯苓 炙草
生姜
某（氏） 建中法甚安。知营卫二气交馁。夫太阳行身之背。疟发背冷。不由四肢。是少阴之阳不
营太阳。此汗大泄不已矣。孰谓非柴葛伤阳之咎欤。议用桂枝加熟附子汤。人参桂枝汤加熟附子。
华（氏） 二十岁。天癸始通。面黄汗泄。内热外冷。先天既薄。疟伤不复。内经谓阳维为病。苦寒热。
纲维无以振顿。四肢骨节疼痛通。八脉以和补。调经可以却病。
淡苁蓉 鹿角霜 当归 川芎 杜仲 小茴 茯苓 香附
顾（氏） 进护阳方法。诸症已减。寒热未止。乃久病阳虚。脉络未充。尚宜通补为法。
人参 生鹿茸 当归 紫石英 茯苓 炙草 煨姜 大枣
又 经邪不尽。寒热未止。缘疟久营卫气伤。脉络中空乏。屡进补法。仅能填塞络中空隙。不能
驱除蕴伏之邪。拟进养营法。取其养正邪自却之意。
人参 当归 杞子 生白芍 茯神 桂心
炙草 远志 煨姜 南枣
袁（妪） 脉弦缓。寒战甚则呕吐噫气。腹鸣溏泄。是足太阴脾寒也。且苦辛寒屡用不效。俱不对
病。反伤脾胃。
人参 半夏 草果仁 生姜 新会皮 醋炒青皮
又 灵枢经云。中气不足。溲便为变。况老年人惊恐忧劳。深夜不得安寐。遂致寒战疟发。当以
病因而体贴谛视。其为内伤实属七八。见疟通套。已属非法。若云肺疟。则秋凉不发。何传及
于冬令小雪。当以劳疟称之。夫劳必伤阳气。宜乎四末先冷。疟邪伤中。为呕恶腹鸣矣。用露
姜饮。
又 阳陷入阴。必目瞑欲寐。寒则肉腠筋骨皆疼。其 篱护卫太怯。杳不知饥。焉得思谷。老年
人须血气充溢。使邪不敢陷伏。古贤有取升阳法。
嫩毛鹿角 人参 当归 桂枝 炙甘草
又 前议劳伤阳气。当知内损邪陷之理。凡女人天癸既绝之后。其阴经空乏。岂但营卫造偏
之寒热而已。故温脾胃。及露姜治中宫营虚。但畏寒不知热为牝疟。盖牝为阴。身体重者。亦
是阴象。此辛甘理阳。鹿茸自督脉以煦提。非比姜附但走气分之刚暴。驱邪益虚。却在营分。
奇经曰。阳维脉为病发寒热也。
鹿茸 鹿角霜 人参 当归 浔桂 茯苓 炙草
又 正气和营疟战已止。当小其制。
人参 鹿茸 当归 炒杞子 沙苑 茯苓 炙草
某 疟后。脾肾阳虚。便溏畏寒。肢体疲倦。当防肿胀。
附子 白术 茯苓 泽泻 苡仁 生姜 大枣
某 阴疟已乱汗多。
桂枝 牡蛎 生黄 炙草 归身 五味 煨姜 大枣
某 脉沉。舌白。呃忒。时时烦躁。向系阳虚痰饮。疟发三次即止。此邪窒不能宣越。并非邪去病
解。今已变病。阴冱痰浊阻塞于中。致上下气机不相维续。症势险笃。舍通阳一法。无方可拟。
必得中阳流运。疟症复作。庶有愈机。
淡附子（一钱半） 生草果仁（钱半） 生白芍（三钱） 茯苓（三钱） 生浓朴（一钱） 姜汁（五分）
一剂 此冷香真武合剂。
某 伏暑冒凉发疟。以羌防苏葱。辛温大汗。汗多。卫阳大伤。胃津亦被劫干。致渴饮。心烦无寐。
诊脉左弱右促。目微黄。嗜酒必中虚谷少。易于聚湿蕴热。勿谓阳伤骤补。仿内经辛散太过。
当食甘以缓之。（胃阳虚湿聚）
大麦仁 炙草 炒麦冬 生白芍 茯神 南枣
又 药不对症。先伤胃口。宗内经辛苦急。急食甘以缓之。仲景谓之胃减。有不饥不欲食之患。
议用金匮麦门冬汤。苏胃汁以开痰饮。仍佐甘药。取其不损阴阳耳。金匮麦门冬汤。去枣米。
加茯神糯稻根须。
又 脉右大。间日寒热。目 微黄身痛。此平素酒湿。挟时邪流行经脉使然。前因辛温大汗。所
以暂养胃口。今脉症既定。仍从疟门调治。
草果 知母 人参 枳实 黄芩 半夏 姜汁
孙某：阴气先受损，阳气独自亢盛。这属于伏暑在体内扰动，应当参照《金匮要略》中瘅疟（以高热为主、无寒战或寒战轻微的疟疾）的治法。（瘅疟）
竹叶 麦冬 生地 玄参 知母 梨汁 蔗浆
施某：发热伴身体疼痛，咳嗽气喘。这是暑湿作为外因，阻滞于气分，症状类似恶寒战栗，但病位都在肺经。
竹叶 连翘 薄荷 杏仁 滑石 郁金汁
又诊：微有恶寒而热象较重，舌中心干燥，口渴想喝水且胃脘部感觉不适。这属于瘅疟，治疗应针对肺经。
杏仁 石膏 竹叶 连翘 半夏 橘红
程某：阴气先受损，阳气独自亢盛，担心出现只有发热没有恶寒的瘅热证候。
鲜生地 知母 麦冬 竹叶心 滑石
唐某：发病前，形体已经消瘦；发病后，傍晚发热早晨转凉，行动依然安适舒缓，未必是真正的重病伤寒。但是过了八九天，病情稍有好转时，突然吃了粉团和腥面食物，应当遵循“食谷发热，减少饮食则痊愈”的原则。张仲景未曾为此专门立方。现在出现腹痛腹泻，是因为食滞阻塞了肠胃，大肠无法行使变化传导的功能。追根溯源，论述儿科体质具有纯阳的特点，病前消瘦也是由于阳亢消耗所致。张仲景所说的瘅疟，就是单热不寒，本条文中说“阴气孤绝，阳气独发”，热邪灼烧导致烦闷冤屈，使人肌肉消烁，也没有设立方剂，只是说通过饮食调养来恢复。嘉言主张用甘寒生津的方法可以痊愈，重在顾护后天胃气。既然频繁腹泻，津液更加受伤，如果多服苦寒药物，热势仍然不止。到了夜晚出现神志昏乱胡言乱语，自称胸中有格拒感，腹部不和。这都是因为病轻药重，导致阴阳二气残破疲惫。治疗方法应当停药并进食，估计服用甘酸之品，解除烦渴，方为斟酌得当。
又诊：鼻头黑煤色，嘴唇干裂舌头腐烂，频繁使用黄芩黄连，热势不肯消退。这是因为病根本来轻微，用药过重进行攻伐，导致流行之气结闭不通，郁遏不畅，其热势反而更甚。向上表现为不喜欢饮水，不能进食，小便虽然通利但尿道必定疼痛，三焦都闭塞，神志昏迷、抽搐等症状可能出现。
连翘心（三钱） 鲜石菖蒲汁（一钱半） 川贝母（三钱） 杏仁（二十粒） 射干（二分） 淡竹叶（一钱半）
又诊：自从停用了猛烈的药物，每天都有向愈的迹象。胃气困顿所以痞闷不想吃东西，现在虽然没有增加餐量，但知道食物甘甜美味，都是胃气苏醒的渐进过程。儿童天真无邪，没有下元虚损的道理。小便欲出时尿管必痛，确实是由于肺津胃汁，被苦辛燥烈的气味劫夺枯槁，肠中没有物质来营运。庸医看到这种情况，一定会用分利小便的方法。所谓水源已经枯竭，应当滋生化之源。九窍不和，都属于胃病。
麦门冬（二钱） 甜杏仁（四钱） 甜水梨皮（三钱） 蔗浆（一木杓）
张某：舌质红赤，烦躁出汗失眠，肢体忽然发冷，这是年幼时的瘅疟，由暑邪深入所致。
杏仁 滑石 竹叶 西瓜翠衣 知母 花粉
又诊：热势极盛而出现四肢厥冷，这是幼稚疟症的常见表现。用竹叶石膏汤去掉人参和半夏，加入知母。
某：风温阳疟。（即温疟）
杏仁 滑石 连翘 黄芩 青蒿 淡竹叶
丁某：脉象右部数，左部小弱，面色明亮。夏秋季节潜伏的暑邪，在寒露节气后发作，微有恶寒而热象重，呕吐逆气，身体疼痛。大概素来有痰火，暑邪必然挟带湿气，病从肺经而起，导致气机不宣化，不思饥饿也不进食，频繁排尿且尿量少短缩，这是热在气分，应当与温疟同例处理。忌用葛根、柴胡以及足六经的药物。用桂枝白虎汤加半夏。
胡某：按张仲景所说，脉象如平人，只有热没有寒，骨节烦疼，微呕且口渴的，病名叫做温疟。主治用桂枝白虎汤。桂枝白虎汤。
大概今年夏秋长时间炎热，口鼻吸入暑邪，起初暑邪轻小，不致病发。深秋天气变凉，外束肌表，里热想要外出，与卫气和营气交互运行，邪气与二气遇触，于是热势兴起。临解之时必有微汗，气邪两泄。然而邪气不尽，就会混杂处于气血之中。所以圣人立法，用石膏的辛寒，清透气分的伏热；佐入桂枝的辛甘温轻扬之性，引导凉药以通达营卫；兼用知母专门调理阳明经独胜的热邪；而手太阴肺经，也得以顺应秋季金气的肃降功能；甘草粳米调和胃阴以生津液。这一举措兼备多方功效。方剂下方自注说：“一剂知，二剂已。”“知”的意思是病已知其对症，“已”的意思是中病应当痊愈的称呼。
邓某：寒少热多，胸中痞胀，温邪未解，不要空谈止截疟疾。
淡黄芩 炒半夏 姜汁 生白芍 草果 知母 乌梅
又诊：照前方去掉半夏和姜汁，加入鳖甲。
吴某：间日寒热，目黄口渴，温邪兼雨湿外迫而成疟。
滑石 杏仁 白蔻仁 淡黄芩 半夏 郁金
又诊：脉数，舌红口渴，热邪已经进入血分。
竹叶 石膏 生地 丹皮 知母 青蒿梗
又诊：饮食不节制，腹中不和，疟邪攻击胃部。
鲜首乌 乌梅肉 生鳖甲 黄芩 丹皮 草果 知母 送服保和丸二钱
朱某：舌苔黄，烦躁口渴，身体疼痛，心腹中热躁动，暑热不解成为疟疾。经文说暑脉自虚，都是受从前疲药（指过度使用发散或攻伐药物）的累及损伤。（暑疟）
石膏 知母 生甘草 炒粳米 麦冬 竹叶
何某：劳倦伤气，遗精泄精伤阴，暑邪变为疟疾，炽盛时烦闷最盛。分解使邪势减轻，人参、白术、附子，都是固闭邪气的药物。
草果仁 知母 淡黄芩 川贝母 青蒿 花粉
冯某：暑邪伤气分，上焦先受邪，河间（刘完素）的法度至精至妙，后世医生未读其书，怎么能治病达到效果？邪气深则疟疾发作日期推迟。气结必然胸中混浊如痞块。无形的热，逐渐蒸腾有形的痰，这种消导发散的方法，都是劫夺津液，无能去除邪气了。
石膏 杏仁 半夏 浓朴 知母 竹叶
黄某：脉数，目黄，舌中心干白黄苔，口中粘腻，胃脘中痞闷，不想进食。这是由于途中暑风客邪内侵募原，营卫不和，导致发作疟疾。夫暑必兼湿，湿也好，热也好，都属于气。气与邪搏结，则清浊交混，升降自然受阻。古人称湿遏必热自生矣。圣帝论病，本乎四气，其论药方，推气味，理必苦降辛通，这样热气痞结才可开散。消导攻滞，香燥泄气，置暑热致病之因于不治，不识是何解释。
川连 黄芩 花粉 桔梗 白蔻仁 郁金 橘红 六一散
又诊：苦降能驱热除湿，辛通能开气宣浊。已经见效，应当减量，仍遵循其意旨。
川连 桔梗 白蔻仁 浓朴 茵陈 茯苓皮 银花 白通草
胡某：间日疟，痰多胃脘闷，汗多心热，伏暑内炽，忌用风寒表药。
滑石 黄芩 浓朴 杏仁 通草 白蔻 半夏 栝蒌皮 知母
汪氏：微冷多热，舌白，胃脘闷呕恶，暑秽经过募原成为疟疾。
杏仁 郁金 滑石 浓朴 黄芩 炒半夏 白蔻 橘红
某：舌白胃脘闷，寒冷从四肢末端起，口渴喜欢热饮，这是湿邪内蕴，脾阳不主宣达，而成湿疟。（湿疟）
浓朴（一钱半） 杏仁（一钱半） 草果仁（一钱） 半夏（一钱半） 茯苓（三钱） 广皮白（一钱半）
某（25岁）：疟疾停止，面部浮肿渐渐波及胃脘腹部。
苡仁 桑白皮 茯苓 大腹皮 姜皮 广皮
某：间日疟，寒热都轻微，这属于湿疟。
杏仁（三钱） 浓朴（一钱） 桂枝木（五分） 飞滑石（三钱） 草果（八分） 炒半夏（一钱半） 茯苓皮（三钱） 绵茵陈（一钱半）
牛某（48岁）：寒冷来时喜欢喝热汤，发热后反而不渴，间日疟已经四十天，现在虽然停止，但不饥饿不想吃东西，五味入口都变了味道。初病时舌白干呕，湿邪中于太阴脾络，湿郁气滞，喜欢热饮暂时通其郁结，邪蒸湿中生热，六腑热灼，津液不营运，到大便硬秘，这是气痹湿结，应当清淡饮食缓慢调理，令气厘清肃，与脾约证相似。但张仲景气血兼治，此病却专伤气分。
炒黄半夏 生益智仁 绵茵陈 广皮 浓朴 茯苓
又诊：疟疾停止，舌白，不饥饿，大便十天不通，这都是留邪堵塞经腑隧道之流行，久延必致腹胀瘕积。
杏仁 白蔻仁 半夏 浓朴 生香附汁 广皮 茯苓皮 接服半硫丸二钱
某：脉右弦左弱，留邪未尽，大便粘稀，最防止转为痢疾。比七八日前，势头减少一二，但去疾务尽，苦辛寒逐其蕴伏，而通利小便，也不可少。
草果 知母 浓朴 茯苓 木通 滑石
曹某：身体疼痛，舌白口渴，自利（自行腹泻），这是湿温客气为疟，不可乱投柴胡葛根。张仲景有湿家忌汗的戒律。（湿热）
飞滑石 杏仁 郁金 淡黄芩 白蔻仁 防己
又诊：湿甚为热，心痛，舌白便溏，治疗在气分。
竹叶心 麦冬 郁金 菖蒲 飞滑石 橘红 化服牛黄丸
又诊：心下触手而痛，自利，舌白烦躁，都是湿热阻气分，议开内闭，用泻心汤。
川连 淡黄芩 干姜 半夏 人参 枳实
又诊：神气稍清，痛处渐下至脐，湿伤在气，热结在血，吐咯带血，犹是上行为逆，热病瘀留，必从下出为顺。
川连 黄芩 干姜 半夏 人参 枳实 白芍 炒楂肉
费某：舌白渴饮，身痛呕恶，大便不爽，诊脉濡小，乃暑湿从口鼻入，湿甚生热，四末扰中，疟发胃脘痞胀痹，当以苦辛寒清上彻邪，不可谓遗泄而病，辄与温补助邪。
黄芩 知母 白蔻 郁金 蒌皮 浓朴 杏仁 半夏 姜汁 石膏
又诊：脉濡，口渴，余热尚炽。
人参 知母 石膏 竹叶 甘草 麦冬
又诊：热缓，不欲食，津液受烁，当和胃生津。
人参 五味 知母 橘红 炒白芍 半夏曲
曹某：寒冷从背起，汗泄甚，面无淖泽，舌色仍白，邪未尽，正先怯心虚痉震，恐亡阳厥脱。议用张仲景救逆法加人参。（阳虚）
又诊：舌绛口渴，汗泄，疟来日晏（发作时间推迟），寒热过多，身中阴气大伤，刚补勿进。议以何人饮。
人参 何首乌
孙某：阳虚之体，伏暑成疟，凉药只宜少用。身麻属气虚，用生姜泻心法。
半夏 生姜汁 茯苓 炙甘草 南枣肉
范某（53岁）：劳疟入阴，夏月阳气发泄，仍然劳苦经营，以致再来不愈。用药以辛甘温理阳为正，但未易骤效耳。
人参 当归 肉桂 炙草 川蜀漆 生姜 南枣
方某：寒甚于背，阳脉衰也。
人参 鹿茸 炒当归 炙草 鹿角霜 官桂 鳖甲煎丸
吴某（61岁）：背寒，舌白粉胎，知饥食无味，此为无阳。温中下以托邪。
生白术 浓朴 桂枝 附子 草果仁 茯苓
又诊：照方去茯苓加人参炙草生姜。
某氏：建中法甚安，知营卫二气交馁。夫太阳行身之背，疟发背冷，不由四肢，是少阴之阳不营太阳，此汗大泄不已矣。孰谓非柴葛伤阳之咎欤。议用桂枝加熟附子汤。人参桂枝汤加熟附子。
华氏：二十岁，天癸始通，面黄汗泄，内热外冷，先天既薄，疟伤不复。内经谓阳维为病，苦寒热。纲维无以振顿，四肢骨节疼痛通，八脉以和补，调经可以却病。
淡苁蓉 鹿角霜 当归 川芎 杜仲 小茴 茯苓 香附
顾氏：进护阳方法，诸症已减，寒热未止，乃久病阳虚，脉络未充，尚宜通补为法。
人参 生鹿茸 当归 紫石英 茯苓 炙草 煨姜 大枣
又诊：经邪不尽，寒热未止，缘疟久营卫气伤，脉络中空乏，屡进补法，仅能填塞络中空隙，不能驱除蕴伏之邪。拟进养营法，取其养正邪自却之意。
人参 当归 杞子 生白芍 茯神 桂心 炙草 远志 煨姜 南枣
袁氏（老妇）：脉弦缓，寒战甚则呕吐噫气，腹鸣溏泄，是足太阴脾寒也。且苦辛寒屡用不效，俱不对病，反伤脾胃。
人参 半夏 草果仁 生姜 新会皮 醋炒青皮
又诊：灵枢经云，中气不足，溲便为变。况老年人惊恐忧劳，深夜不得安寐，遂致寒战疟发。当以病因而体贴谛视，其为内伤实属七八，见疟通套，已属非法。若云肺疟，则秋凉不发，何传及于冬令小雪。当以劳疟称之。夫劳必伤阳气，宜乎四末先冷，疟邪伤中，为呕恶腹鸣矣。用露姜饮。
又诊：阳陷入阴，必目瞑欲寐，寒则肉腠筋骨皆疼，其篱护卫太怯，杳不知饥，焉得思谷。老年人须血气充溢，使邪不敢陷伏。古贤有取升阳法。
嫩毛鹿角 人参 当归 桂枝 炙甘草
又诊：前议劳伤阳气，当知内损邪陷之理。凡女人天癸既绝之后，其阴经空乏，岂但营卫造偏之寒热而已。故温脾胃，及露姜治中宫营虚，但畏寒不知热为牝疟。盖牝为阴，身体重者，亦是阴象。此辛甘理阳，鹿茸自督脉以煦提，非比姜附但走气分之刚暴，驱邪益虚，却在营分。奇经曰，阳维脉为病发寒热也。
鹿茸 鹿角霜 人参 当归 浔桂 茯苓 炙草
又诊：正气和营疟战已止，当小其制。
人参 鹿茸 当归 炒杞子 沙苑 茯苓 炙草
某：疟后，脾肾阳虚，便溏畏寒，肢体疲倦，当防肿胀。
附子 白术 茯苓 泽泻 苡仁 生姜 大枣
某：阴疟已乱汗多。
桂枝 牡蛎 生黄芪 炙草 归身 五味 煨姜 大枣
某：脉沉，舌白，呃忒，时时烦躁，向系阳虚痰饮，疟发三次即止，此邪窒不能宣越，并非邪去病解，今已变病，阴冱痰浊阻塞于中，致上下气机不相维续，症势险笃，舍通阳一法，无方可拟。必得中阳流运，疟症复作，庶有愈机。
淡附子（一钱半） 生草果仁（钱半） 生白芍（三钱） 茯苓（三钱） 生浓朴（一钱） 姜汁（五分） 一剂 此冷香真武合剂。
某：伏暑冒凉发疟，以羌防苏葱，辛温大汗，汗多，卫阳大伤，胃津亦被劫干，致渴饮，心烦无寐。诊脉左弱右促，目微黄，嗜酒必中虚谷少，易于聚湿蕴热，勿谓阳伤骤补，仿内经辛散太过，当食甘以缓之。（胃阳虚湿聚）
大麦仁 炙草 炒麦冬 生白芍 茯神 南枣
又诊：药不对症，先伤胃口，宗内经辛苦急，急食甘以缓之，仲景谓之胃减，有不饥不欲食之患。议用金匮麦门冬汤。苏胃汁以开痰饮，仍佐甘药，取其不损阴阳耳。金匮麦门冬汤。去枣米，加茯神糯稻根须。
又诊：脉右大，间日寒热，目微黄身痛，此平素酒湿，挟时邪流行经脉使然。前因辛温大汗，所以暂养胃口，今脉症既定，仍从疟门调治。
草果 知母 人参 枳实 黄芩 半夏 姜汁
Sun: Yin qi is damaged first, while Yang qi acts alone and hyperactive. This is due to latent summerheat stirring internally; it should be treated according to the same principle as Dan Malaria (a type of malaria characterized by high fever without chills) in the *Jin Gui Yao Lue*.
Zhu Ye (Bamboo Leaf), Maidong (Ophiopogon Tuber), Shengdi (Rehmannia Root), Xuanshen (Scrophularia Root), Zhimu (Anemarrhena Rhizome), Li Zhi (Pear Juice), Zhe Jiang (Sugarcane Juice).
Shi: Fever with body pain, coughing and wheezing. Summer-dampness acts as an external pathogen, obstructing the Qi level internally. The symptoms resemble chills, but the pathology resides in the Lung meridian.
Zhu Ye (Bamboo Leaf), Lian Qiao (Forsythia Fruit), Bo He (Mint Herb), Xing Ren (Apricot Seed), Hua Shi (Talcum), Yu Jin Zhi (Curcuma Juice).
Second consultation: Slight chills with predominant heat, dryness at the center of the tongue, thirst with desire to drink, and discomfort in the epigastrium. This belongs to Dan Malaria; treatment should target the Lung meridian.
Xing Ren (Apricot Seed), Shi Gao (Gypsum Fibrosum), Zhu Ye (Bamboo Leaf), Lian Qiao (Forsythia Fruit), Ban Xia (Pinellia Tuber), Ju Hong (Citrus Reticulata Pericarpium).
Cheng: Yin qi is damaged first, while Yang qi acts alone and hyperactive. There is a concern of developing pure heat without chills (Dan Re).
Xian Sheng Di (Fresh Rehmannia Root), Zhimu (Anemarrhena Rhizome), Maidong (Ophiopogon Tuber), Zhu Ye Xin (Heart of Bamboo Leaf), Hua Shi (Talcum).
Tang: Before illness onset, the physique was already emaciated; after onset, there is evening fever and morning coolness, yet movement remains comfortable and leisurely. It is not necessarily a severe cold disease. However, after eight or nine days, when the condition slightly improved, sudden consumption of rice cakes and fishy/flour foods occurred. One should follow the principle that "food-induced fever resolves by reducing food intake." Zhang Zhongjing did not prescribe a specific formula for this. Currently, abdominal pain and diarrhea occur because food stagnation blocks the intestines and stomach, preventing the Large Intestine from performing its transformative functions. Tracing the root cause, pediatric constitutions possess "Pure Yang"; pre-illness emaciation is also due to Yang hyperactivity consuming essence. Zhang Zhongjing described Dan Malaria as single heat without chills, stating "Yin qi is isolated and extinct, Yang qi acts alone," where heat scorching causes vexation and muscle emaciation, yet no formula was provided, only advice to recover through dietary management. Jiayan advocated using sweet-cold herbs to generate fluids for recovery, emphasizing the protection of post-heaven Stomach Qi. Since frequent diarrhea has further injured fluids, administering many bitter-cold herbs will not stop the heat. At night, confusion and delirium appear, with complaints of chest obstruction and abdominal disharmony. These result from heavy medication for a mild disease, exhausting both Yin and Yang Qi. The method should be to stop medication and eat grains. Presumably, administering sweet-and-sour substances can resolve vexation and thirst, which would be appropriate.
Second consultation: Black soot-like deposits on the nose, cracked lips, and ulcerated tongue. Frequent use of Huang Qin (Scutellaria Root) and Huang Lian (Coptis Rhizome) fails to subdue the heat. This is because the original disease was mild, but the medication was too aggressive, causing the circulating Qi to knot and block, leading to stagnation and worsening heat. Upward, it manifests as aversion to drinking and inability to eat; downward, although urination is free, there is urethral pain. The Triple Burner is closed, potentially leading to coma and convulsions.
Lian Qiao Xin (Heart of Forsythia Fruit, 3 qian), Xian Shi Chang Pu Zhi (Fresh Acorus Rhizome Juice, 1.5 qian), Chuan Bei Mu (Fritillaria Cirrhosa Bulb, 3 qian), Xing Ren (Apricot Seed, 20 grains), She Gan (Belamcanda Rhizome, 2 fen), Dan Zhu Ye (Light Bamboo Leaf, 1.5 qian).
Third consultation: Since stopping harsh medications, there is daily tendency toward recovery. Stomach distress causes fullness and anorexia; although meal quantity hasn't increased, the patient now perceives food as sweet and delicious, indicating gradual awakening of Stomach Qi. Children possess innocence and lack lower-jiao deficiency. Pain in the urethra upon urination is indeed due to Lung fluids and Stomach juices being depleted by bitter, pungent, dry, and hot flavors. The intestines lack material to transport. Quacks seeing this would likely use diuretics. As the saying goes, when the springhead is exhausted, one must nourish the source of transformation. All orifices disharmony belongs to Stomach disease.
Mai Men Dong (Ophiopogon Tuber, 2 qian), Tian Xing Ren (Sweet Apricot Seed, 4 qian), Tian Shui Li Pi (Sweet Water Pear Peel, 3 qian), Zhe Jiang (Sugarcane Juice, 1 wooden spoon).
Zhang: Red tongue, vexation, sweating, insomnia, sudden cold limbs. This is childhood Dan Malaria caused by deep invasion of summerheat pathogens.
Xing Ren (Apricot Seed), Hua Shi (Talcum), Zhu Ye (Bamboo Leaf), Xi Gua Cui Yi (Watermelon Rind Green Layer), Zhimu (Anemarrhena Rhizome), Hua Fen (Trichosanthes Root).
Second consultation: Extreme heat with厥 (cold extremities); this is common in pediatric malaria. Use Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction), removing Ren Shen (Ginseng Root) and Ban Xia (Pinellia Tuber), adding Zhimu (Anemarrhena Rhizome).
Certain case: Wind-Warmth Yang Malaria (i.e., Wen Malaria / Warm Malaria).
Xing Ren (Apricot Seed), Hua Shi (Talcum), Lian Qiao (Forsythia Fruit), Huang Qin (Scutellaria Root), Qing Hao (Artemisia Annua Herba), Dan Zhu Ye (Light Bamboo Leaf).
Ding: Pulse is rapid on the right, small and weak on the left; complexion is bright. Latent summerheat from summer and autumn manifests after Cold Dew solar term. Symptoms include slight chills, predominant heat, vomiting/reversal of Qi, and body pain. Likely having phlegm-fire constitution, summerheat inevitably carries dampness. The disease originates in the Lung meridian, causing Qi failure to diffuse and transform. Anorexia and undigested food retention, frequent short urination indicate heat at the Qi level. Treat similarly to Wen Malaria. Avoid Ge Gen (Pueraria Root), Chai Hu (Bupleurum Root), and formulas targeting the Six Meridians. Use Gui Zhi Bai Hu Tang (Cinnamon Twig and White Tiger Decoction) plus Ban Xia (Pinellia Tuber).
Hu: According to Zhang Zhongjing, if the pulse resembles a normal person, with only heat without chills, painful joints, slight vomiting, and thirst, the disease is named Wen Malaria. Gui Zhi Bai Hu Tang (Cinnamon Twig and White Tiger Decoction) is indicated.
Generally, prolonged heat in summer and autumn leads to inhalation of summerheat via mouth and nose. Initially, the pathogen is light and does not cause immediate illness. In late autumn, cool air binds externally, while internal heat seeks to exit. Interaction between the pathogen and Ying-Wei (Nutritive-Defensive) Qi generates heat. Resolution requires slight sweating to vent Qi and Pathogen. If the pathogen is not fully expelled, it mixes within Blood and Qi. Thus, sages established laws: Shi Gao (Gypsum Fibrosum) clears latent heat in the Qi level with its acrid-cold nature; Gui Zhi (Cinnamon Twig) guides cooling herbs to unblock Ying-Wei with its acrid-sweet-warm light ascending nature; Zhimu (Anemarrhena Rhizome) specifically manages excess heat in the Yangming channel; Hand-Taiyin Lung benefits from autumn Metal's descending function; Gan Cao (Licorice Root) and Jing Mi (Rice) harmonize Stomach Yin to generate fluids. This approach achieves multiple goals. The formula note states: "One dose brings improvement, two doses cure." "Improvement" means the diagnosis matches the syndrome; "Cure" means hitting the disease appropriately.
Deng: Less chills, more heat, chest fullness/stuffiness. Warm pathogen unresolved; do not merely discuss stopping malaria.
Dan Huang Qin (Light Scutellaria Root), Chao Ban Xia (Stir-fried Pinellia Tuber), Jiang Zhi (Ginger Juice), Sheng Bai Shao (Raw White Peony Root), Cao Guo (Tsaoko Fruit), Zhimu (Anemarrhena Rhizome), Wu Mei (Mume Fruit).
Second consultation: From previous formula, remove Ban Xia and Jiang Zhi, add Bie Jia (Tartaric Shell).
Wu: Alternating day chills and fever, yellow eyes, thirst. Warm pathogen combined with rain-dampness pressing externally causes malaria.
Hua Shi (Talcum), Xing Ren (Apricot Seed), Bai Kou Ren (White Cardamom Seed), Dan Huang Qin (Light Scutellaria Root), Ban Xia (Pinellia Tuber), Yu Jin (Curcuma Root).
Second consultation: Rapid pulse, red tongue, thirst. Heat pathogen has entered the Blood level.
Zhu Ye (Bamboo Leaf), Shi Gao (Gypsum Fibrosum), Sheng Di (Rehmannia Root), Dan Pi (Moutan Bark), Zhimu (Anemarrhena Rhizome), Qing Hao Geng (Artemisia Annua Stem).
Third consultation: Irregular diet, abdominal disharmony, Malaria pathogen attacking Stomach.
Xian Shou Wu (Fresh Polygonum Multiflorum Root), Wu Mei Rou (Mume Fruit Flesh), Sheng Bie Jia (Raw Tartaric Shell), Huang Qin (Scutellaria Root), Dan Pi (Moutan Bark), Cao Guo (Tsaoko Fruit), Zhimu (Anemarrhena Rhizome). Take Bao He Wan (Preserve Harmony Pill) 2 qian with water.
Fourth consultation: Ren Shen (Ginseng Root), Sheng Gu Ya (Raw Grain Sprout), Zhi Shi Zhi (Immature Bitter Orange Juice), Fu Ling (Poria), Guang Pi (Tangerine Peel), Chao Ban Xia Qu (Stir-fried Pinellia Fermented Curd).
Zhu: Yellow tongue coating, vexation, thirst, body pain, heat/restlessness in heart and abdomen. Unresolved summerheat becomes malaria. Classics state summerheat pulse is naturally deficient; all are due to prior exhaustion from harsh medications. (Shu Malaria / Summerheat Malaria)
Shi Gao (Gypsum Fibrosum), Zhimu (Anemarrhena Rhizome), Sheng Gan Cao (Raw Licorice Root), Chao Jing Mi (Stir-fried Rice), Mai Dong (Ophiopogon Tuber), Zhu Ye (Bamboo Leaf).
He: Labor fatigue injures Qi; emission/injury injures Yin. Summerheat transforms into malaria. When blazing, vexation is most severe. Decomposing reduces pathogen force. Ren Shen (Ginseng Root), Bai Zhu (Atractylodes Macrocephala Rhizome), Fu Zi (Prepared Aconite Root) all seal and close the pathogen.
Cao Guo Ren (Tsaoko Seed), Zhimu (Anemarrhena Rhizome), Dan Huang Qin (Light Scutellaria Root), Chuan Bei Mu (Fritillaria Cirrhosa Bulb), Qing Hao (Artemisia Annua Herba), Hua Fen (Trichosanthes Root).
Feng: Summerheat injures Qi level, Upper Jiao affected first. Hejian’s methods are exquisite. Later doctors who haven’t read his books cannot achieve efficacy. Deep pathogen delays malaria onset. Qi knotting causes chest turbidity like痞 (fullness). Formless heat gradually steams formless phlegm. Such resolving and dispersing methods only deplete fluids and fail to remove pathogens.
Shi Gao (Gypsum Fibrosum), Xing Ren (Apricot Seed), Ban Xia (Pinellia Tuber), Nong Po (Magnolia Bark), Zhimu (Anemarrhena Rhizome), Zhu Ye (Bamboo Leaf).
Huang: Rapid pulse, yellow eyes, dry white-yellow coating at tongue center, sticky mouth, epigastric fullness, anorexia. Due to journey exposure to summerwind-pathogen invading Mu Yuan (Diaphragmatic Origin), Ying-Wei disharmony causes malaria. Summerheat must carry dampness. Both damp and heat belong to Qi. Qi fighting pathogen mixes clear and turbid, blocking ascent/descent. Ancients said damp suppression generates heat. Sage discusses diseases based on Four Qi, medicines based on Flavor/Nature. Logic requires bitter-descending and acrid-unblocking to open heat-damp knots. Resolving stagnation with aromatic-dryness drains Qi, ignoring the cause of summerheat-disease. Explanation unknown.
Chuan Lian (Coptis Chinensis Rhizome), Huang Qin (Scutellaria Root), Hua Fen (Trichosanthes Root), Jie Geng (Platycodon Root), Bai Kou Ren (White Cardamom Seed), Yu Jin (Curcuma Root), Ju Hong (Citrus Reticulata Pericarpium), Liu Yi San (Six-to-One Powder).
Second consultation: Bitter-descending drives heat/damp; acrid-unblocks opens Qi/turbidity. Effective, reduce dosage, maintain intent.
Chuan Lian (Coptis Chinensis Rhizome), Jie Geng (Platycodon Root), Bai Kou Ren (White Cardamom Seed), Nong Po (Magnolia Bark), Yin Chen (Artemisia Capillaris Herba), Fu Ling Pi (Poria Peel), Yin Hua (Honeysuckle Flower), Bai Tong Cao (Tetrapanax Pith).
Hu: Alternating day malaria, much phlegm, epigastric stuffiness, much sweat, heart heat. Latent summerheat blazing internally. Avoid wind-cold exterior-releasing drugs.
Hua Shi (Talcum), Huang Qin (Scutellaria Root), Nong Po (Magnolia Bark), Xing Ren (Apricot Seed), Tong Cao (Tetrapanax Pith), Bai Kou (White Cardamom), Ban Xia (Pinellia Tuber), Gua Lou Pi (Trichosanthes Peel), Zhimu (Anemarrhena Rhizome).
Second consultation: Huang Qin (Scutellaria Root), Cao Guo (Tsaoko Fruit), Zhimu (Anemarrhena Rhizome), Ban Xia (Pinellia Tuber), Sheng Bai Shao (Raw White Peony Root), Wu Mei (Mume Fruit).
Wang (Shi): Slight cold, predominant heat, white tongue, epigastric fullness, nausea/vomiting. Summer-turbidity passes through Mu Yuan to become malaria.
Xing Ren (Apricot Seed), Yu Jin (Curcuma Root), Hua Shi (Talcum), Nong Po (Magnolia Bark), Huang Qin (Scutellaria Root), Chao Ban Xia (Stir-fried Pinellia Tuber), Bai Kou (White Cardamom), Ju Hong (Citrus Reticulata Pericarpium).
Certain case: White tongue, epigastric fullness, cold starting from four extremities, thirst preferring hot drinks. Dampness pathogen retained internally, Spleen Yang fails to diffuse, resulting in Damp Malaria. (Shi Malaria / Damp Malaria)
Nong Po (Magnolia Bark, 1.5 qian), Xing Ren (Apricot Seed, 1.5 qian), Cao Guo Ren (Tsaoko Seed, 1 qian), Ban Xia (Pinellia Tuber, 1.5 qian), Fu Ling (Poria, 3 qian), Guang Pi Bai (Tangerine Peel White Layer, 1.5 qian).
Certain case (25 years old): Malaria stopped, facial edema spreading to epigastrium/abdomen.
Yi Yi Ren (Coix Seed), Sang Bai Pi (Mulberry Root Bark), Fu Ling (Poria), Da Fu Pi (Areca Peel), Jiang Pi (Ginger Peel), Guang Pi (Tangerine Peel).
Certain case: Alternating malaria, mild chills and fever. Belongs to Damp Malaria.
Xing Ren (Apricot Seed, 3 qian), Nong Po (Magnolia Bark, 1 qian), Gui Zhi Mu (Cinnamon Twig Wood, 0.5 fen), Fei Hua Shi (Fly Talcum, 3 qian), Cao Guo (Tsaoko Fruit, 0.8 fen), Chao Ban Xia (Stir-fried Pinellia Tuber, 1.5 qian), Fu Ling Pi (Poria Peel, 3 qian), Mian Yin Chen (Cotton Artemisia Capillaris Herba, 1.5 qian).
Niu (48 years old): Likes hot soup when cold comes; no thirst after fever. Alternating malaria lasted 40 days. Now stopped, but anorexia, taste distortion. Initial white tongue, dry retching. Dampness invaded Taiyin Spleen collaterals. Damp stagnates Qi, hot drinks temporarily unblock. Pathogen steams damp generating heat, burning Six Fu organs, fluids fail to circulate, leading to hard constipation. This is Qi obstruction and Damp knotting. Treat with bland diet slowly to clear Qi. Similar to Pi Yue (Splee Constriction), but Zhang Zhongjing treats Qi and Blood together; this disease specifically injures Qi level.
Chao Huang Ban Xia (Stir-fried Yellow Pinellia Tuber), Sheng Yi Zhi Ren (Raw Alpinia Oxyphylla Fruit), Mian Yin Chen (Cotton Artemisia Capillaris Herba), Guang Pi (Tangerine Peel), Nong Po (Magnolia Bark), Fu Ling (Poria).
Second consultation: Malaria stopped, white tongue, anorexia, ten-day constipation. Retained pathogen blocks meridians/fu-organs. Prolonged leads to abdominal distension/masses.
Xing Ren (Apricot Seed), Bai Kou Ren (White Cardamom Seed), Ban Xia (Pinellia Tuber), Nong Po (Magnolia Bark), Sheng Xiang Fu Zhi (Fresh Cyperus Rotundus Juice), Guang Pi (Tangerine Peel), Fu Ling Pi (Poria Peel). Follow with Ban Shou Wan (Half Sulfur Pill) 2 qian.
Certain case: Right pulse wiry, left weak. Retained pathogen incomplete, sticky loose stool. Fear turning into Dysentery. Condition reduced compared to 7-8 days ago. Must eliminate pathogen completely. Bitter-pungent-cold expels hidden pathogen; promoting urination is essential.
Cao Guo (Tsaoko Fruit), Zhimu (Anemarrhena Rhizome), Nong Po (Magnolia Bark), Fu Ling (Poria), Mu Tong (Akebia Stem), Hua Shi (Talcum).
Cao: Body pain, white tongue, thirst, spontaneous diarrhea. Wet-Warm guest pathogen causes malaria. Do not indiscriminately use Chai Hu (Bupleurum Root) and Ge Gen (Pueraria Root). Zhang Zhongjing has rule: Damp patients avoid sweating. (Shi Re / Damp-Heat)
Fei Hua Shi (Fly Talcum), Xing Ren (Apricot Seed), Yu Jin (Curcuma Root), Dan Huang Qin (Light Scutellaria Root), Bai Kou Ren (White Cardamom Seed), Fang Ji (Stephania Root).
Second consultation: Excess damp generates heat, heart pain, white tongue, loose stool. Treatment at Qi level.
Zhu Ye Xin (Heart of Bamboo Leaf), Mai Dong (Ophiopogon Tuber), Yu Jin (Curcuma Root), Chang Pu (Acorus Rhizome), Fei Hua Shi (Fly Talcum), Ju Hong (Citrus Reticulata Pericarpium). Take Niu Huang Wan (Calculus Bovis Pill) dissolved.
Third consultation: Tenderness under hand at epigastrium, spontaneous diarrhea, white tongue, vexation. All indicate Damp-Heat blocking Qi level. Propose opening internal closure using Xie Xin Tang (Drain the Epigastrium Decoction).
Chuan Lian (Coptis Chinensis Rhizome), Dan Huang Qin (Light Scutellaria Root), Gan Jiang (Dried Ginger), Ban Xia (Pinellia Tuber), Ren Shen (Ginseng Root), Zhi Shi (Immature Bitter Orange).
Fourth consultation: Spirit slightly clear, pain moves down to umbilicus. Damp injures Qi, Heat knots in Blood. Vomiting/coughing blood indicates upward reversal (adverse). Heat-stasis must exit downward (favorable).
Chuan Lian (Coptis Chinensis Rhizome), Huang Qin (Scutellaria Root), Gan Jiang (Dried Ginger), Ban Xia (Pinellia Tuber), Ren Shen (Ginseng Root), Zhi Shi (Immature Bitter Orange), Bai Shao (White Peony Root), Chao Zha Rou (Stir-fried Hawthorn Meat).
Fei: White tongue, thirst, body pain, nausea/vomiting, unsatisfactory stool. Pulse soft-small. Summer-damp enters mouth/nose. Excess damp generates heat, disturbing middle from extremities. Malaria causes epigastric fullness/stiffness. Use bitter-pungent-cold to clear upper and penetrate pathogen. Do not attribute emission to disease and give warm-tonics aiding pathogen.
Huang Qin (Scutellaria Root), Zhimu (Anemarrhena Rhizome), Bai Kou (White Cardamom), Yu Jin (Curcuma Root), Lou Pi (Trichosanthes Peel), Nong Po (Magnolia Bark), Xing Ren (Apricot Seed), Ban Xia (Pinellia Tuber), Jiang Zhi (Ginger Juice), Shi Gao (Gypsum Fibrosum).
Second consultation: Soft pulse, thirst, residual heat still blazing.
Ren Shen (Ginseng Root), Zhimu (Anemarrhena Rhizome), Shi Gao (Gypsum Fibrosum), Zhu Ye (Bamboo Leaf), Gan Cao (Licorice Root), Mai Dong (Ophiopogon Tuber).
Third consultation: Heat缓和 (moderated), anorexia, fluids scorched. Harmonize Stomach, generate fluids.
Ren Shen (Ginseng Root), Wu Wei Zi (Schisandra Berry), Zhimu (Anemarrhena Rhizome), Ju Hong (Citrus Reticulata Pericarpium), Chao Bai Shao (Stir-fried White Peony Root), Ban Xia Qu (Pinellia Fermented Curd).
Zhang: Malaria in skin-disease patient. Avoid exterior-releasing. Cang Zhu Bai Hu Tang (Atractylodes Macrocephala and White Tiger Decoction) plus Cao Guo (Tsaoko Fruit).
Cao: Cold starts from back, profuse sweating, dull complexion, white tongue. Pathogen not gone, Zheng (Upright Qi) weakens, heart deficiency causes spasms/tremors. Fear Yang collapse/Jue cold. Propose Zhang Zhongjing’s Jiu Ni Fa (Rescue Deviation Method) plus Ren Shen (Ginseng Root). (Yang Xu / Yang Deficiency)
Second consultation: Crimson tongue, thirst, sweating, delayed malaria onset, excessive chills/fever. Body Yin greatly injured. Do not use rigid tonics. Propose He Ren Yin (He Shou Wu and Ginseng Decoction).
Ren Shen (Ginseng Root), He Shou Wu (Polygonum Multiflorum Root).
Sun: Yang-deficient constitution, latent summerheat becomes malaria. Cold herbs should be used sparingly. Body numbness belongs to Qi deficiency. Use Sheng Jiang Xie Xin Fa (Ginger Drain Epigastrium Method).
Ban Xia (Pinellia Tuber), Sheng Jiang Zhi (Ginger Juice), Fu Ling (Poria), Zhi Gan Cao (Honey-fried Licorice Root), Nan Zao Rou (Southern Date Flesh).
Shen: Yang微弱 (weak) recurrence of malaria.
Gui Zhi (Cinnamon Twig), Dang Gui (Angelica Sinensis Root), Huang Qi (Astragalus Root), Fang Feng (Saposhnikovia Root), Lu Jiao Xie (Deer Antler Chips), Jiang Zhi (Ginger Juice), Nan Zao (Southern Date).
Fan (53 years old): Lao Malaria (Chronic/Fatigue Malaria) enters Yin. Summer Yang dissipates, yet labor continues, causing recurrence. Medication should focus on acrid-sweet-warm to regulate Yang, though effect is not immediate.
Ren Shen (Ginseng Root), Dang Gui (Angelica Sinensis Root), Rou Gui (Cinnamon Bark), Zhi Cao (Honey-fried Licorice), Chuan Shu Qi (Sichuan Veratrum), Sheng Jiang (Fresh Ginger), Nan Zao (Southern Date).
Fang: Severe cold on back, Yang pulse declines.
Ren Shen (Ginseng Root), Lu Rong (Deer Antler Glue), Chao Dang Gui (Stir-fried Angelica Sinensis Root), Zhi Cao (Honey-fried Licorice), Lu Jiao Shuang (Deer Antler Frost), Guan Gui (Cassia Bark), Bie Jia Jian Wan (Tartaric Shell Pill for Removing Masses).
Wu (61 years old): Back cold, white powdery tongue coating, hungry but food tastes bland. This is "No Yang." Warm middle/lower to support pathogen expulsion.
Sheng Bai Zhu (Raw Atractylodes Macrocephala Rhizome), Nong Po (Magnolia Bark), Gui Zhi (Cinnamon Twig), Fu Zi (Prepared Aconite Root), Cao Guo Ren (Tsaoko Seed), Fu Ling (Poria).
Second consultation: From formula, remove Fu Ling, add Ren Shen, Zhi Cao, Sheng Jiang.
Cheng: Chills/fever lasting months, belongs to Qi weakness with retained pathogen. Tonify Qi, raise Yang. Bu Zhong Yi Qi Tang (Tonify Middle and Augment Qi Decoction).
Second consultation: Sheng Lu Rong (Raw Deer Antler Glue), Lu Jiao Shuang (Deer Antler Frost), Ren Shen (Ginseng Root), Gui Shen (Angelica Sinensis Root Tip), Fu Ling (Poria), Zhi Cao (Honey-fried Licorice), Sheng Jiang (Fresh Ginger).
Certain case: Jian Zhong Fa (Establish Middle Method) is very safe. Know Ying-Wei Qi interaction failure. Taiyang runs along the back; malaria back cold not from limbs indicates Shaoyin Yang failing to nourish Taiyang. Profuse sweating continues. Is this not blame of Chai/Ge injuring Yang? Propose Gui Zhi Jia Shu Fu Zi Tang (Cinnamon Twig Decoction plus Prepared Aconite). Ren Shen Gui Zhi Tang (Ginseng and Cinnamon Twig Decoction) plus Shu Fu Zi (Prepared Aconite).
Hua (Shi): Age 20, Tian Gui (Menstruation) just started. Yellow face, sweating, internal heat/external cold. Innate essence thin, malaria injury unrecovered. *Nei Jing* says Yang Wei disease suffers chills/fever. Framework unable to振奋 (invigorate), limb/joint pain. Eight extraordinary vessels need harmonizing tonification; regulating menses can dispel disease.
Dan Cong Rong (Cistanche Deserticola), Lu Jiao Shuang (Deer Antler Frost), Dang Gui (Angelica Sinensis Root), Chuan Xiong (Ligusticum Chuanxiong Rhizome), Du Zhong (Eucommia Bark), Xiao Hui (Fennel Fruit), Fu Ling (Poria), Xiang Fu (Cyperus Rotundus Rhizome).
Gu (Shi): Advance protecting Yang method, symptoms reduced, chills/fever persist. Long-term Yang deficiency, meridians not filled. Continue tonifying/unblocking method.
Ren Shen (Ginseng Root), Sheng Lu Rong (Raw Deer Antler Glue), Dang Gui (Angelica Sinensis Root), Zi Shi Ying (Hematite), Fu Ling (Poria), Zhi Cao (Honey-fried Licorice), Wei Jiang (Baked Ginger), Da Zao (Jujube).
Second consultation: Channel pathogen not gone, chills/fever persist. Due to long-term malaria injuring Ying-Wei Qi, meridians empty. Repeated tonification only fills gaps, cannot expel hidden pathogen. Propose Yang Ying Fa (Nourish Nutritive Method), taking advantage of "nourishing Zheng makes pathogen retreat."
Ren Shen (Ginseng Root), Dang Gui (Angelica Sinensis Root), Qi Zi (Goji Berry), Sheng Bai Shao (Raw White Peony Root), Fu Shen (Poria with Hostwood), Gui Xin (Cinnamon Heart), Zhi Cao (Honey-fried Licorice), Yuan Zhi (Polygala Root), Wei Jiang (Baked Ginger), Nan Zao (Southern Date).
Yuan (Elderly Woman): Wiry-slow pulse, severe chills causing vomiting/belching, borborygmus, loose stool. Foot-Taiyin Spleen Cold. Bitter-pungent-cold failed repeatedly, mismatching disease, injuring Spleen/Stomach.
Ren Shen (Ginseng Root), Ban Xia (Pinellia Tuber), Cao Guo Ren (Tsaoko Seed), Sheng Jiang (Fresh Ginger), Xin Hui Pi (Xinhui Tangerine Peel), Cu Chao Qing Pi (Vinegar-stir-fried Citrus Aurantium Peel).
Second consultation: *Ling Shu* says insufficient Middle Qi causes urine/stool changes. Elderly fear/worry/labor, sleepless late night, causing chills/malaria. Investigate cause carefully. Internal injury accounts for 70-80%. Treating malaria generically is illegal. If Lung Malaria, autumn coolness wouldn't transmit to Winter Solstice/Snow Small. Call it Lao Malaria. Fatigue injures Yang, hence extremities cold first. Malaria pathogen injures middle, causing vomiting/borborygmus. Use Lu Jiang Yin (Dew Ginger Drink).
Third consultation: Yang sinks into Yin, eyes close wanting sleep. Cold makes flesh/skin/bones ache. Defense too weak, no hunger/thirst for grain. Elderly need abundant Blood/Qi to prevent pathogen sinking. Ancients used Sheng Yang Fa (Raise Yang Method).
Nen Mao Lu Jiao (Young Hair Deer Antler), Ren Shen (Ginseng Root), Dang Gui (Angelica Sinensis Root), Gui Zhi (Cinnamon Twig), Zhi Gan Cao (Honey-fried Licorice).
Fourth consultation: Previous discussion on fatigue injuring Yang, understand internal damage/pathogen sinking. After women's Tian Gui ends, Yin channels empty, not just Ying-Wei imbalance chills/fever. Thus warming Spleen/Stomach and Lu Jiang treating Middle Palace Ying deficiency. Only chills without heat is Pin Malaria (Yin Malaria). Pin is Yin; heavy body is also Yin sign. Acrid-sweet regulates Yang; Lu Rong warms from Du Mai (Governing Vessel), unlike Jiang/Fu which only move Qi aggressively. Expelling pathogen benefits Ying level. Extraordinary Vessels say Yang Wei disease causes chills/fever.
Lu Rong (Deer Antler Glue), Lu Jiao Shuang (Deer Antler Frost), Ren Shen (Ginseng Root), Dang Gui (Angelica Sinensis Root), Xun Gui (Yunnan Cassia), Fu Ling (Poria), Zhi Cao (Honey-fried Licorice).
Fifth consultation: Zheng Qi harmonizes Ying, malaria chills stopped. Reduce dosage.
Ren Shen (Ginseng Root), Lu Rong (Deer Antler Glue), Dang Gui (Angelica Sinensis Root), Chao Qi Zi (Stir-fried Goji Berry), Sha Yuan (Astragalus Complanatus Seed), Fu Ling (Poria), Zhi Cao (Honey-fried Licorice).
Certain case: Post-malaria, Spleen/Kidney Yang deficiency, loose stool, aversion to cold, limb fatigue. Prevent swelling.
Fu Zi (Prepared Aconite Root), Bai Zhu (Atractylodes Macrocephala Rhizome), Fu Ling (Poria), Ze Xie (Alisma Rhizome), Yi Yi Ren (Coix Seed), Sheng Jiang (Fresh Ginger), Da Zao (Jujube).
Certain case: Yin Malaria disrupted, much sweating.
Gui Zhi (Cinnamon Twig), Mu Li (Oyster Shell), Sheng Huang Qi (Raw Astragalus Root), Zhi Cao (Honey-fried Licorice), Gui Shen (Angelica Sinensis Root Tip), Wu Wei Zi (Schisandra Berry), Wei Jiang (Baked Ginger), Da Zao (Jujube).
Certain case: Deep pulse, white tongue, hiccups, occasional vexation. Previously Yang deficiency with Phlegm-Fluid. Malaria stopped after three attacks. Pathogen blocked, unable to diffuse, not resolved. Disease changed. Yin cold/phlegm-turbidity blocks middle, disrupting upper/lower Qi connection. Critical condition. Only Tong Yang (Unblock Yang) method applicable. Must get Middle Yang flowing; malaria recurrence may offer cure chance.
Dan Fu Zi (Light Prepared Aconite Root, 1.5 qian), Sheng Cao Guo Ren (Raw Tsaoko Seed, 1.5 qian), Sheng Bai Shao (Raw White Peony Root, 3 qian), Fu Ling (Poria, 3 qian), Sheng Nong Po (Raw Magnolia Bark, 1 qian), Jiang Zhi (Ginger Juice, 0.5 fen). One dose. This is Leng Xiang Zhen Wu He Ji (Cold Fragrant Zhen Wu Combined Agent).
Certain case: Latent summerheat exposed to cold causes malaria. Used Qiang Huo (Notopterygium Root), Fang Feng (Saposhnikovia Root), Su Ye (Perilla Leaf), Cong Bai (Scallion White). Acrid-warm profuse sweating. Much sweat, Wei Yang greatly injured, Stomach fluids robbed dry. Causes thirst, vexation, insomnia. Left pulse weak, right rapid. Eyes slightly yellow. Alcoholism implies Middle deficiency/grain scarcity, prone to damp-heat accumulation. Do not assume Yang injury requires sudden tonification. Imitate *Nei Jing*: excessive acrid-dispersal requires sweet food to moderate. (Stomach Yang Deficiency with Damp Accumulation)
Da Mai Ren (Barley Grain), Zhi Cao (Honey-fried Licorice), Chao Mai Dong (Stir-fried Ophiopogon Tuber), Sheng Bai Shao (Raw White Peony Root), Fu Shen (Poria with Hostwood), Nan Zao (Southern Date).
Second consultation: Medicine mismatches syndrome, first injures Stomach appetite. Follow *Nei Jing*: bitter/pungent urgency requires sweet food to moderate. Zhang Zhongjing calls this Stomach reduction, causing anorexia. Propose Jin Gui Mai Men Dong Tang (Golden Cabinet Ophiopogon Decoction). Revive Stomach juice to open phlegm-fluid, assist with sweet herbs to preserve Yin/Yang balance. Jin Gui Mai Men Dong Tang. Remove Zao (Jujube) and Mi (Rice), add Fu Shen (Poria with Hostwood) and Nuo Dao Gen Xu (Glutinous Rice Root Tuft).
Third consultation: Right pulse large, alternating chills/fever, eyes slightly yellow, body pain. Chronic alcohol-damp combined with seasonal pathogen circulating channels. Previously acrid-warm profuse sweating temporarily nourished Stomach. Now pulse/syndrome fixed, treat from Malaria category.
Cao Guo (Tsaoko Fruit), Zhimu (Anemarrhena Rhizome), Ren Shen (Ginseng Root), Zhi Shi (Immature Bitter Orange), Huang Qin (Scutellaria Root), Ban Xia (Pinellia Tuber), Jiang Zhi (Ginger Juice).