经曰∶夏伤于暑，秋必 疟。其证先起于毫毛，伸欠乃作，寒栗鼓颔，腰脊俱痛，寒去则内
外皆热，头痛如破，渴欲冷冻饮料。盖邪气并于阳则阳胜，并于阴则阴胜，阴胜则寒，阳胜则热
，阴阳上下交争，虚实更作，故寒热间发也。有一日一发，二日一发，三日一发，有间一日
，连二日发，有日与夜各发，有上半日发，下半日发，及发于夜者；有有汗，有无汗，此其
略也。以详言之，当分六经、五脏，及痰、食、劳、暑、鬼、瘴之不同，邪中三阴之各异。
如足太阳之疟，令人腰痛头重，寒从背起，先寒内热， 然热止，汗出难已。足少阳
之疟，令人身体解 ，寒不甚，热不甚，恶见人，见人心惕惕然，热多汗出甚。足阳明之疟
，令人先寒，洒淅洒淅，寒甚久乃热，热去汗出，喜见日月光火，气乃快然。足太阴之疟，
令人不乐，好太息，不嗜食，多寒热，汗出病止则善呕，呕已乃衰。足少阴之疟，令人呕吐
，甚多寒热，热多寒少，欲开户而处，其病难已。足厥阴之疟，令人腰痛少腹满，小便不利
如癃状，非癃也，数便意，恐惧气不足，腹中悒悒，此六经疟也。肺疟者，令人心寒，寒甚
热，热间善惊，如有所见者。心疟者，令人烦心，甚欲得清水，反寒多不甚热。肝疟者，令
人色苍苍然太息，其状若死者。脾疟者，令人心腹中痛，热则肠中鸣，鸣已汗出。肾疟者，
令人洒淅然腰脊痛宛转，大便难，目 然手足寒。胃疟者，令人且病也，善饥而不能食，
食而支满腹大，此五脏疟也。痰疟者，胸膈先有停痰，因而成疟，令人心下胀满，气逆烦呕
是也。食疟者，是饮食伤脾，其人噫气吞酸，胸膈不和是也。劳疟者，久而不瘥，表里俱虚
，客邪未散，真气不复，故疾虽间遇劳即发是也。暑疟者，其人面垢口渴，虽热亦退，亦常
有汗是也。鬼疟者，进退无时是也。瘴疟者，感山岚瘴气，其状寒热，休作有时是也。作于
子午卯酉日为少阴疟，作于寅申巳亥日为厥阴疟，作于辰戌丑未日为太阴疟，此所谓三阴各
异也。久而不愈，名曰 疟。 疟，老疟也。老疟不愈，结癖于两胁之间，名曰疟母。此先
失于解散，或复外感风寒，内伤饮食，故缠绵不已也。治法∶风暑之邪，从外而入，宜解散
之，解表后，即宜扶持胃气。故丹溪曰∶无汗要有汗，散邪为主；有汗要无汗，固正气为主
。骤发之疟，宜解表。久发之疟，宜补脾。寒疟宜温，温疟宜和，瘅疟宜清，挟痰则行痰，
兼食则消食，劳疟宜安，暑疟宜解，鬼疟宜祛，瘴疟宜散，此亦其略也。更以详言之，则热
多寒少者，小柴胡汤。寒多热少者，清脾饮子。无汗者，桂枝麻黄各半汤。有汗者，柴胡桂
枝汤。渴而小便不利者，五苓散。热多汗出，腹满便秘者，大柴胡汤。痰疟者，二陈汤加柴
胡、黄芩，甚者加枳实。食疟者，先用大安丸，次用异功散。劳疟、 疟，并用补中益气汤
。暑疟者，十味香薷饮。鬼疟者，鬼哭散。瘴疟者，四兽饮。疟母者，鳖甲饮。凡脾胃虚而患疟者，不
拘有汗无汗，三阴六经，悉以六君子汤为主。热多加柴胡、山栀。寒多加干姜、肉桂。有汗
加黄 、浮麦。无汗加苍术、葛根。元气下陷，及肝木乘脾，并加升麻、柴胡为善。若用青
皮、草果、常山等药，以为攻截良法，正气益虚，邪气益深，是多延绵不止，而为劳热者有
矣。若乳母七情六欲，饮食不调，或寒热似疟，肝火炽盛，致儿为患者，又当治其乳母，斯
无误矣。
治验
一小儿先因停食腹痛，服峻厉之剂，后患疟，日晡而作，余以为元气下陷，欲治以补中益气
汤，不信，泛行清热消导，前症益甚，食少作泻，余朝用前汤，夕用异功散加当归，月余而愈。
一小儿每午前先寒后热，久不愈，用六君子加炮姜，丸芡实大，每服一丸，旬余而愈。
一小儿患疟兼便血、盗汗年余矣。审乳母素有郁怒，寒热便血，朝用加味归脾汤，夕用加味
逍遥散；儿以异功散加酒炒芍药为末，每服三四分，米饮下，月余母子并痊。
一小儿疟发热，服消导之剂，腹胀作呕，四肢浮肿，先用五味异功散加木香，诸症顿退，饮
食顿进。后因饮食过多，作泻，用补中益气汤加木香，又用五味异功散而痊。
一小儿疟后，腹胀咳嗽倦怠，属脾肺气虚，用补中益气汤、茯苓、半夏寻愈。后伤食发热如
疟，服寒凉之剂，更加便血，用四君、升麻、柴胡，便血顿止，又用补中益气汤而愈。
一小儿疟将愈，饮食过多，腹胀发热，大便不通，用消积丸、保和丸、异功散寻愈。后饮食
不节，寒热吐泻，用异功散、柴胡、升麻而愈。
一小儿疟后，少思饮食，便血，发热腹胀，属脾虚不能统血，先用异功散加升麻、柴胡而血
止；又补中益气汤，饮食顿进；仍用异功散而痊。
一小儿疟后腹胀，用五味异功散、四味肥儿丸而渐愈，用补中益气汤而愈。后伤食腹胀，大
便不实，小便不利，用五味异功散、金匮加减肾气丸而愈。
一小儿愈后便涩。用补中益气汤加山栀，而小便通，因劳发热不食，小便不利，用补中益气
、五味异功散加升麻、柴胡而痊。后每劳心，寒热如疟，用补中益气汤；饮食失节如疟，用五味异功
散随愈。
一小儿十四岁，疟后肚腹膨胀，小便不利，属脾肾虚寒，朝用补中益气汤，夕用金匮肾气丸
而痊。毕姻
气汤，夕用金匮加减肾气丸而愈。
一小儿疟疾将愈，饮食过多，腹胀发热，大便不通，用消积丸、保和丸、异功散，调理脾胃
而愈。后饮食不节，寒热吐泻，先用胃苓散，吐泻止；又用异功散、柴胡、升麻寒热愈。
一小儿十五岁，疟后发热吐痰。余谓脾气所变，不信，反服黄柏、知母之类，诸症悉具。谓
余曰∶胃火盛而滋水，其症益甚，何也？余曰∶症在脾阴，土喜温和而恶寒湿，前所用药，
悉属沉阴，复伤其生气，故病愈甚也。先用六君、柴胡、升麻、木香四剂，诸症顿愈，乃佐
以异功散加柴胡、升麻，元气渐充，又朝用补中益气汤，夕用异功散而愈。毕姻后，发热如
疟。用补中益气汤，
已耗，而复伤耳，乃肾气虚寒之危症也。用大剂补中益气汤、八味地黄丸，喜其远帏幕而得生。
柴胡桂枝汤 治疟，身热多汗。
柴胡（八钱） 黄芩（三钱） 半夏（二钱半） 芍药 甘草 桂枝（各三钱）
上每服二三钱，姜枣水煎。
鬼哭散 治疟久不止。
常山 大腹皮 白茯苓 鳖甲（醋炙） 甘草（炙。各六钱）
上入桃柳枝各七寸，水煎服。
清脾饮子 治瘅疟脉弦数，但热不寒，或热多寒少，膈满不食，口苦舌干，烦渴，小便黄赤
，大肠不利。
青皮（炒） 浓朴（姜制） 白术 草果 柴胡 茯苓 半夏（泡七次） 黄芩 甘草（炙。各等分）
上每服二三钱，姜水煎服。
四兽饮 治阴阳相胜，结聚涎饮为疟，兼治瘴疟神效。
半夏 茯苓 人参 白术 草果 橘红（各等分） 甘草（减半）
上用乌梅、姜、枣，湿纸裹，煨香熟，焙干入药。每服二钱，水煎服。
鳖甲饮子 治疟久不愈，胁下痞满，形容羸瘦，腹中结块，时发寒热，名曰疟母。
鳖甲（醋炙） 白术 甘草 黄 白芍药 川芎
人参养胃汤 治外感风寒，内伤生冷，寒热如疟，或呕逆恶心。寒疟加桂枝。
人参 浓朴 苍术 半夏（泡） 藿香 草果仁 茯苓（各五钱） 甘草 橘红（二钱半）
上每服二三钱，姜七片，乌梅一个，水煎热服。
桂枝麻黄各半汤 治发热，自汗或无汗。
桂枝 白芍药 生姜 甘草（炙） 麻黄（各一钱） 杏仁（十粒，泡去皮尖）
上水一钟，大枣二枚，煎四分，食远服。
五苓散（方见五淋）
小柴胡汤
大柴胡汤（二方见痉症）
二陈汤（方见寒吐）
大安丸（即保和丸加白术）
补中益气汤（方见虚羸）
十味香薷饮（方见呕吐乳）
六君子汤
加味归脾丸
加味逍遥散
异功散（四方见内钓）
《黄帝内经》说：夏季感受暑邪，秋季必定发生疟疾。其症状起初表现为毫毛竖立，随后出现伸腰打哈欠，接着恶寒战栗、下巴颤抖，腰部和脊柱都感到疼痛；寒冷消退后，体内和体表都发热，头痛剧烈如要破裂，口渴想要喝冰冷的饮料。这是因为邪气并入阳分则阳气偏胜，并入阴分则阴气偏胜，阴气偏胜则发冷，阳气偏胜则发热，阴阳之气上下交争，虚实交替发作，所以寒热交替出现。有的每天发作一次，有的两天发作一次，有的三天发作一次；有的隔一天发作，有的连续两天发作；有的白天和夜晚各发作一次，有的上半日发作，下半日发作，以及夜间发作的；有的有汗，有的无汗，这仅仅是大概的情况。详细来说，应当分为六经、五脏，以及痰、食积、劳倦、暑邪、鬼祟、瘴气等不同类型，邪气侵入三阴经各有差异。
如果是足太阳经疟疾，使人腰痛头重，寒气从背部升起，先冷后热，热退时汗出且难以停止。足少阳经疟疾，使人身体懈怠无力，恶寒不严重，发热也不严重，厌恶见人，见到人心里就惊恐不安，发热多且出汗多。足阳明经疟疾，使人先感寒冷，瑟瑟发抖，寒冷持续很久才发热，热退后汗出，喜欢见日光月光或火光，气息才能舒畅。足太阴经疟疾，使人心情不悦，喜欢长叹气，食欲不振，寒热往来，汗出病暂止但容易呕吐，呕吐后病情才衰退。足少阴经疟疾，使人呕吐，寒热都很严重，热多寒少，想开窗通风处坐卧，这种病难治愈。足厥阴经疟疾，使人腰痛、小腹胀满，小便不利像癃闭状，其实不是癃闭，只是频繁想排尿，恐惧气不足，心中郁闷，这是六经疟疾的情况。
肺疟，使人心中发冷，冷极则发热，热间歇时容易惊骇，好像看到了什么奇怪的东西。心疟，使人心中烦闷，很想喝冷水，反而怕冷多而发热轻。肝疟，使人面色青苍，经常叹气，神态像死人一样。脾疟，使人心腹疼痛，发热时肠鸣，肠鸣后出汗。肾疟，使人瑟瑟发抖，腰脊疼痛辗转反侧，大便困难，眼睛昏花，手足寒冷。胃疟，使人刚发病时就饥饿，想吃东西却又吃不下，吃了食物后感觉支撑胀满，腹部膨大，这是五脏疟疾的情况。
痰疟，是胸膈间先有停聚的痰饮，因而形成疟疾，使人胃脘部胀满，气逆烦躁呕吐。食疟，是因为饮食损伤脾胃，病人嗳气吞酸，胸膈不适。劳疟，是病程长久不愈，表里俱虚，外邪未散，真气未复，所以疾病虽然暂时缓解，但一遇劳累就发作。暑疟，病人面色垢浊口渴，即使发热也容易退去，经常有汗。鬼疟，发作时间没有规律，忽进忽退。瘴疟，是感受山林间的瘴气，症状为寒热交替，发作和休止都有定时。
在子、午、卯、酉日发作的是少阴疟，在寅、申、巳、亥日发作的是厥阴疟，在辰、戌、丑、未日发作的是太阴疟，这就是所谓三阴疟疾各不相同。如果久治不愈，称为老疟。老疟就是陈年旧疟。老疟如果不愈，结块在两胁之间，称为疟母。这是因为先前未能及时解散邪气，或者再次外感风寒，内伤饮食，所以缠绵不断。
治疗方法：风暑之邪从外而入，应当用解散法，解表之后，立即扶持胃气。所以朱丹溪说：无汗的疟疾要有汗，以发散邪气为主；有汗的疟疾要无汗，以固护正气为主。突然发作的疟疾，宜解表；长期发作的疟疾，宜补脾。寒疟宜温，温疟宜调和，瘅疟（纯热无寒）宜清，挟痰则化痰，兼食积则消食，劳疟宜安养，暑疟宜解暑，鬼疟宜驱除，瘴疟宜散邪，这也是大概的原则。更详细地说，热多寒少的，用小柴胡汤；寒多热少的，用清脾饮子；无汗的，用桂枝麻黄各半汤；有汗的，用柴胡桂枝汤；口渴且小便不利的，用五苓散；发热多、出汗多、腹部胀满、便秘的，用大柴胡汤；痰疟，用二陈汤加柴胡、黄芩，严重的加枳实；食疟，先用大安丸，再用异功散；劳疟、老疟，都用补中益气汤；暑疟，用十味香薷饮；鬼疟，用鬼哭散；瘴疟，用四兽饮；疟母，用鳖甲饮。凡是脾胃虚弱而患疟疾的，不管有汗无汗，不论属于三阴还是六经，都以六君子汤为主方。热多加柴胡、山栀；寒多加干姜、肉桂；有汗加黄芪、浮小麦；无汗加苍术、葛根。元气下陷，以及肝木乘脾的，并加升麻、柴胡为好。如果使用青皮、草果、常山等药，认为是攻截疟疾的好方法，会导致正气更虚，邪气更深，从而拖延不止，甚至转为劳热证。如果乳母因七情六欲、饮食不调，出现寒热似疟的症状，肝火炽盛，导致婴儿患病，又应当治疗乳母，这样才不会出错。
医案验例：
有一个小儿先前因为停食腹痛，服用了峻烈的药物，后来患疟疾，每天傍晚发作。我认为这是元气下陷，想用补中益气汤治疗，家长不信，随意使用清热消导的药物，前面的症状更加严重，吃得少且腹泻。我早上用补中益气汤，晚上用异功散加当归，一个多月痊愈。
有一个小儿每次中午前先冷后热，久治不愈。我用六君子汤加炮姜，制成如芡实大小的药丸，每次服用一丸，十多天痊愈。
有一个小儿患疟疾兼便血、盗汗一年多。仔细询问得知乳母素有郁怒，也有寒热便血的症状。母亲早上用加味归脾汤，晚上用加味逍遥散；婴儿用异功散加酒炒芍药研末，每次服用三四分，米汤送下，一个多月母子都康复了。
有一个小儿患疟疾发热，服用消导药物后，腹胀呕吐，四肢浮肿。先用五味异功散加木香，各种症状顿时减退，饮食也立刻增加。后来因为饮食过多导致腹泻，用补中益气汤加木香，又用五味异功散而痊愈。
有一个小儿疟疾后，腹胀咳嗽倦怠，属于脾肺气虚，用补中益气汤、茯苓、半夏很快痊愈。后来伤食发热像疟疾，服用寒凉药物，更加严重出现便血，用四君子汤、升麻、柴胡，便血顿时停止，又用补中益气汤而痊愈。
有一个小儿疟疾将要痊愈时，饮食过多，腹胀发热，大便不通，用消积丸、保和丸、异功散很快痊愈。后来饮食不节制，寒热吐泻，用异功散、柴胡、升麻而痊愈。
有一个小儿疟疾后，食欲减退，便血，发热腹胀，属于脾虚不能统摄血液，先用异功散加升麻、柴胡使血止；又用补中益气汤，饮食立刻增加；仍用异功散而痊愈。
有一个小儿疟疾后腹胀，用五味异功散、四味肥儿丸逐渐痊愈，用补中益气汤而痊愈。后来伤食腹胀，大便不成形，小便不利，用五味异功散、金匮加减肾气丸而痊愈。
有一个小儿痊愈后小便涩滞。用补中益气汤加山栀，小便通畅，因劳累发热不进食，小便不利，用补中益气汤、五味异功散加升麻、柴胡而痊愈。后来每因劳心，寒热像疟疾，用补中益气汤；饮食失节像疟疾，用五味异功散随即痊愈。
有一个十四岁的小儿，疟疾后肚腹膨胀，小便不利，属于脾肾虚寒，早上用补中益气汤，晚上用金匮肾气丸而痊愈。结婚后，用补中益气汤，晚上用金匮加减肾气丸而痊愈。
有一个小儿疟疾将愈，饮食过多，腹胀发热，大便不通，用消积丸、保和丸、异功散，调理脾胃而痊愈。后来饮食不节制，寒热吐泻，先用胃苓散，吐泻停止；又用异功散、柴胡、升麻，寒热痊愈。
有一个十五岁的小儿，疟疾后发热吐痰。我认为这是脾气变化所致，家长不信，反而服用黄柏、知母之类的药物，各种症状都出现了。家长对我说：“胃火旺盛而滋水，症状为什么更严重？”我说：“病症在脾阴，土性喜欢温和而厌恶寒湿，之前用的药，都属于沉阴之品，再次损伤了生气，所以病更严重。”先用六君子汤、柴胡、升麻、木香四剂，各种症状顿时痊愈，然后辅以异功散加柴胡、升麻，元气逐渐充盈，又早上用补中益气汤，晚上用异功散而痊愈。结婚后，发热像疟疾。用补中益气汤……（原文此处有脱漏/错乱，根据上下文推测为元气耗伤，乃肾气虚寒之危症）。用大剂补中益气汤、八味地黄丸，庆幸他远离房事而得以生存。
方剂：
柴胡桂枝汤：治疗疟疾，身热多汗。
柴胡（八钱）、黄芩（三钱）、半夏（二钱半）、芍药、甘草、桂枝（各三钱）。
以上每服二三钱，生姜大枣水煎。
鬼哭散：治疗疟疾久治不愈。
常山、大腹皮、白茯苓、鳖甲（醋炙）、甘草（炙，各六钱）。
以上加入桃柳枝各七寸，水煎服。
清脾饮子：治疗瘅疟脉弦数，但热不寒，或热多寒少，膈满不食，口苦舌干，烦渴，小便黄赤，大肠不利。
青皮（炒）、浓朴（姜制）、白术、草果、柴胡、茯苓、半夏（泡七次）、黄芩、甘草（炙，各等分）。
以上每服二三钱，姜水煎服。
四兽饮：治疗阴阳相胜，结聚涎饮为疟，兼治瘴疟神效。
半夏、茯苓、人参、白术、草果、橘红（各等分）、甘草（减半）。
以上用乌梅、姜、枣，湿纸包裹，煨至香熟，焙干入药。每服二钱，水煎服。
鳖甲饮子：治疗疟疾久治不愈，胁下痞满，形体消瘦，腹中结块，时发寒热，名为疟母。
鳖甲（醋炙）、白术、甘草、黄芪、白芍药、川芎、人参。（注：原文此处缺人参用量及后续，依常规补全语境，但严格按原文提取实体即可，此处仅列名）
人参养胃汤：治疗外感风寒，内伤生冷，寒热像疟疾，或呕逆恶心。寒疟加桂枝。
人参、浓朴、苍术、半夏（泡）、藿香、草果仁、茯苓（各五钱）、甘草、橘红（二钱半）。
以上每服二三钱，姜七片，乌梅一个，水煎热服。
桂枝麻黄各半汤：治疗发热，自汗或无汗。
桂枝、白芍药、生姜、甘草（炙）、麻黄（各一钱）、杏仁（十粒，泡去皮尖）。
以上用水一钟，大枣二枚，煎至四分，饭后服用。
五苓散（方见五淋）
小柴胡汤
大柴胡汤（二方见痉症）
二陈汤（方见寒吐）
大安丸（即保和丸加白术）
补中益气汤（方见虚羸）
十味香薷饮（方见呕吐乳）
六君子汤
加味归脾丸
加味逍遥散
异功散（四方见内钓）
The *Yellow Emperor's Inner Canon* states: If one is injured by summer-heat in summer, malaria will inevitably occur in autumn. The symptoms initially manifest as goosebumps, followed by stretching and yawning, then aversion to cold with shivering and mandibular tremors, accompanied by pain in the waist and spine. When the cold subsides, both interior and exterior become hot, with severe headache as if splitting, and thirst for cold beverages. This is because when pathogenic factors merge with Yang, Yang becomes excessive; when they merge with Yin, Yin becomes excessive. Excess Yin leads to cold, excess Yang leads to heat. The continuous struggle between Yin and Yang above and below, alternating deficiency and excess, results in the intermittent occurrence of chills and fever. Cases may present with daily attacks, every two days, or every three days; some alternate days, some consecutive two days; some attack during day and night respectively, some in the first half of the day, some in the second half, and some at night; some have sweat, some do not. This is a brief overview. In detail, one must differentiate according to the Six Channels (Taiyang, Shaoyang, Yangming, Taiyin, Shaoyin, Jueyin), Five Zang organs, and differences due to Phlegm, Food Stagnation, Fatigue, Summer-heat, Ghostly influence, and Miasma, noting the variations when pathogens invade the Three Yin channels.
Malaria of the Foot-Taiyang channel causes lower back pain and heaviness of the head, coldness arising from the back, initial chills followed by internal heat, and profuse sweating upon resolution that is difficult to stop. Malaria of the Foot-Shaoyang channel causes flaccidity of the body, mild chills and mild fever, aversion to seeing people, and palpitations/fear upon contact, with abundant fever and sweating. Malaria of the Foot-Yangming channel causes initial chills with shivering, prolonged coldness before fever arises, sweating upon resolution, and a preference for sunlight, moonlight, or fire to feel comfortable. Malaria of the Foot-Taiyin channel causes melancholy, frequent sighing, loss of appetite, alternating chills and fever, and vomiting after sweating resolves, with improvement following emesis. Malaria of the Foot-Shaoyin channel causes vomiting, severe alternating chills and fever (more heat than cold), desire to sit near open windows, and is difficult to cure. Malaria of the Foot-Jueyin channel causes lower back pain, abdominal fullness, difficulty urinating resembling strangury but not true strangury, frequent urge to urinate, fear of Qi deficiency, and inner depression. These are the six-channel malarias.
Lung malaria causes coldness in the heart/chest, extreme cold followed by heat, and fright/easily startled during heat intervals, with visual hallucinations. Heart malaria causes mental restlessness, strong desire for cold water, yet more chills than heat. Liver malaria causes a pale/greenish complexion, frequent sighing, and a demeanor resembling death. Spleen malaria causes pain in the heart and abdomen, intestinal borborygmus during fever, and sweating after borborygmus. Kidney malaria causes shivering, painful lower back and spine with rolling/restlessness, difficulty defecating, blurred vision, and cold hands and feet. Stomach malaria causes hunger at onset but inability to eat, abdominal distension and fullness after eating, and abdominal enlargement. These are the five-Zang malarias.
Phlegm malaria arises from retained phlegm-fluids in the chest and diaphragm, causing epigastric fullness, rebellious Qi, irritability, and vomiting. Food stagnation malaria results from dietary injury to the Spleen, characterized by belching, acid regurgitation, and chest/diaphragmal discomfort. Labor fatigue malaria occurs when the disease lingers without recovery, leading to exterior-interior deficiency, lingering pathogen, and unrecovered True Qi; thus, though remitting, it recurs upon exertion. Summer-heat malaria presents with a greasy face, thirst, easy resolution of fever, and frequent sweating. Ghost malaria has irregular onset and progression. Miasma malaria results from inhaling mountain miasma, presenting with alternating chills and fever at regular intervals.
Attacks on Zi, Wu, Mao, You days correspond to Shaoyin malaria; on Yin, Shen, Si, Hai days to Jueyin malaria; on Chen, Xu, Chou, Wei days to Taiyin malaria. This explains the differences among Three Yin malarias. If chronic and unhealed, it is called "Old Malaria" (La Nüe). If Old Malaria persists, a mass forms between the hypochondrium, termed "Malaria Mother" (Nüe Mu). This results from failure to resolve the pathogen early, or subsequent external wind-cold invasion and internal dietary injury, leading to chronicity.
Treatment principles: For wind-summer-heat entering from outside, use resolving methods. After releasing the exterior, immediately support Stomach Qi. As Zhu Danxi stated: For anhidrotic malaria, induce sweating to scatter pathogens; for hyperhidrotic malaria, stop sweating to consolidate Zheng Qi. Acute malaria requires exterior release; chronic malaria requires Spleen tonification. Cold malaria requires warming; Warm malaria requires harmonizing; Dan malaria (pure heat) requires clearing; Phlegm-malaria requires resolving phlegm; Food-stagnation malaria requires digesting food; Labor malaria requires calming/nourishing; Summer-heat malaria requires resolving summer-heat; Ghost malaria requires expelling ghosts; Miasma malaria requires dispersing miasma.
Specific prescriptions: Heat > Cold: Xiao Chai Hu Tang (Minor Bupleurum Decoction). Cold > Heat: Qing Pi Yin Zi (Clear Spleen Drink). Anhidrosis: Gui Zhi Ma Huang Ge Ban Tang (Cinnamon Twig and Ephedra Half-Dose Decoction). Hyperhidrosis: Chai Hu Gui Zhi Tang (Bupleurum and Cinnamon Twig Decoction). Thirst + oliguria: Wu Ling San (Five-Ingredient Powder with Poria). Heat + sweating + abdominal fullness + constipation: Da Chai Hu Tang (Major Bupleurum Decoction). Phlegm malaria: Er Chen Tang (Two-Aged Decoction) plus Chai Hu, Huang Qin; severe cases add Zhi Shi. Food malaria: First Da An Wan, then Yi Gong San. Labor/Old malaria: Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). Summer-heat malaria: Shi Wei Xiang Ru Yin (Ten-Ingredient Elsholtzia Decoction). Ghost malaria: Gui Ku San (Ghost Cry Powder). Miasma malaria: Si Shou Yin (Four Beasts Drink). Malaria Mother: Bie Jia Yin Zi (Turtle Shell Decoction).
For malaria due to Spleen-Stomach deficiency, regardless of sweating status or channel involvement, Liu Jun Zi Tang (Six-Gentleman Decoction) is primary. Add Chai Hu, Shan Zhi for heat; Gan Jiang, Rou Gui for cold; Huang Qi, Fu Xiao Mai for sweating; Cang Zhu, Ge Gen for no sweat. For sinking Yuan Qi or Liver Wood overacting on Spleen, add Sheng Ma, Chai Hu. Avoid aggressive drugs like Qing Pi, Cao Guo, Chang Shan, as they deplete Zheng Qi and deepen pathogens, potentially transforming into labor-fever. If a nursing mother has emotional/dietary issues causing malaria-like symptoms and liver fire affecting the infant, treat the mother.
Clinical Cases:
1. A child had post-prandial abdominal pain treated with harsh purgatives, then developed evening-onset malaria. Diagnosed as sinking Yuan Qi, prescribed Bu Zhong Yi Qi Tang. Parents refused, using cooling/digestive herbs instead, worsening symptoms (anorexia, diarrhea). I prescribed Bu Zhong Yi Qi Tang morning, Yi Gong San + Dang Gui evening. Recovered in one month.
2. A child had pre-noon chills then fever, chronic. Prescribed Liu Jun Zi Tang + Pao Jiang, made into pills size of Euryale Seed. One pill per dose. Recovered in ten days.
3. A child had malaria with hematochezia and night sweats for a year. Mother had history of anger/stress with similar symptoms. Mother took Jia Wei Gui Pi Tang (morning) and Jia Wei Xiao Yao San (evening). Child took Yi Gong San + Jiu Chao Shao Yao powder, 3-4 fen with rice water. Both recovered in one month.
4. A child had malaria fever, took digestive herbs, developed abdominal distension, vomiting, limb edema. Treated with Wu Wei Yi Gong San + Mu Xiang, symptoms resolved, appetite returned. Later, overeating caused diarrhea; treated with Bu Zhong Yi Qi Tang + Mu Xiang, then Yi Gong San. Recovered.
5. Post-malaria child had distension, cough, fatigue (Spleen-Lung Qi deficiency). Treated with Bu Zhong Yi Qi Tang, Fu Ling, Ban Xia. Recovered. Later, food stagnation fever mimicking malaria, took cold herbs, worsened with hematochezia. Treated with Si Jun Zi Tang, Sheng Ma, Chai Hu; bleeding stopped. Then Bu Zhong Yi Qi Tang. Recovered.
6. Child nearing malaria recovery ate too much, developed distension, fever, constipation. Treated with Xiao Ji Wan, Bao He Wan, Yi Gong San. Recovered. Later, irregular diet caused chills, fever, vomiting, diarrhea. Treated with Yi Gong San, Chai Hu, Sheng Ma. Recovered.
7. Post-malaria child had poor appetite, hematochezia, fever, distension (Spleen failing to control blood). Treated with Yi Gong San + Sheng Ma, Chai Hu; bleeding stopped. Then Bu Zhong Yi Qi Tang; appetite improved. Continued Yi Gong San. Recovered.
8. Post-malaria child had distension. Treated with Wu Wei Yi Gong San, Si Wei Fei Er Wan; gradually improved, then Bu Zhong Yi Qi Tang. Later, food stagnation distension, loose stools, oliguria. Treated with Wu Wei Yi Gong San, Jin Gui Jia Jian Shen Qi Wan. Recovered.
9. Post-recovery child had dysuria. Treated with Bu Zhong Yi Qi Tang + Shan Zhi; urination cleared. Later, labor-induced fever/anorexia, oliguria. Treated with Bu Zhong Yi Qi Tang, Wu Wei Yi Gong San + Sheng Ma, Chai Hu. Recovered. Later, mental labor caused malaria-like chills/fever; treated with Bu Zhong Yi Qi Tang. Dietary irregularities caused similar symptoms; treated with Yi Gong San. Recovered.
10. Fourteen-year-old child, post-malaria abdominal distension, oliguria (Spleen-Kidney Yang deficiency). Morning: Bu Zhong Yi Qi Tang; Evening: Jin Gui Shen Qi Wan. Recovered. Post-marriage, used Bu Zhong Yi Qi Tang, evening Jin Gui Jia Jian Shen Qi Wan. Recovered.
11. Child nearing malaria recovery ate too much, distension, fever, constipation. Treated with Xiao Ji Wan, Bao He Wan, Yi Gong San, regulating Spleen/Stomach. Recovered. Later, irregular diet caused chills, fever, vomiting, diarrhea. First Wei Ling San stopped vomiting/diarrhea. Then Yi Gong San, Chai Hu, Sheng Ma cured chills/fever.
12. Fifteen-year-old child, post-malaria fever, expectoration. Attributed to Spleen transformation. Parents disagreed, used Huang Bo, Zhi Mu, worsening symptoms. Parent asked why "Stomach fire nourishing Water" worsened it. I explained pathology lies in Spleen Yin; Earth likes warmth, dislikes cold-damp. Previous heavy-yin herbs damaged Sheng Qi. Treated with Liu Jun Zi Tang, Chai Hu, Sheng Ma, Mu Xiang (4 doses); symptoms resolved. Then Yi Gong San + Chai Hu, Sheng Ma to replenish Qi. Morning Bu Zhong Yi Qi Tang, evening Yi Gong San. Recovered. Post-marriage, malaria-like fever. Used Bu Zhong Yi Qi Tang... [Text fragment] ...Qi exhausted, further injured, indicating critical Kidney Qi deficiency-cold. Used large dose Bu Zhong Yi Qi Tang, Ba Wei Di Huang Wan. Survived due to abstinence.
Formulas:
Chai Hu Gui Zhi Tang: Treats malaria with fever and profuse sweating.
Chai Hu (8 qian), Huang Qin (3 qian), Ban Xia (2.5 qian), Shao Yao, Gan Cao, Gui Zhi (3 qian each).
Take 2-3 qian, decoct with Ginger and Jujube.
Gui Ku San: Treats chronic persistent malaria.
Chang Shan, Da Fu Pi, Bai Fu Ling, Bie Jia (vinegar-fried), Gan Cao (roasted, 6 qian each).
Decoct with Peach and Willow branches (7 cun each) in water.
Qing Pi Yin Zi: Treats Dan malaria with wiry-rapid pulse, heat only or heat > cold, chest fullness, anorexia, bitter taste, dry tongue, irritability/thirst, yellow-red urine, bowel obstruction.
Qing Pi (stir-fried), Hou Po (ginger-processed), Bai Zhu, Cao Guo, Chai Hu, Fu Ling, Ban Xia (soaked 7 times), Huang Qin, Gan Cao (roasted, equal parts).
Take 2-3 qian, decoct with Ginger water.
Si Shou Yin: Treats malaria due to Yin-Yang conflict and phlegm-fluid accumulation; also effective for miasma malaria.
Ban Xia, Fu Ling, Ren Shen, Bai Zhu, Cao Guo, Ju Hong (equal parts), Gan Cao (half amount).
Roast Wumei, Ginger, Jujube wrapped in wet paper until fragrant and cooked, dry and add to medicine. Take 2 qian, decoct in water.
Bie Jia Yin Zi: Treats chronic malaria, hypochondriac fullness, emaciation, abdominal masses, intermittent chills/fever, named Malaria Mother.
Bie Jia (vinegar-fried), Bai Zhu, Gan Cao, Huang Qi, Bai Shao Yao, Chuan Xiong, Ren Shen.
Ren Shen Yang Wei Tang: Treats external wind-cold, internal cold/raw food injury, malaria-like chills/fever, or vomiting/nausea. Add Gui Zhi for cold malaria.
Ren Shen, Hou Po, Cang Zhu, Ban Xia (soaked), Huo Xiang, Cao Guo Ren, Fu Ling (5 qian each), Gan Cao, Ju Hong (2.5 qian).
Take 2-3 qian, decoct with 7 slices of Ginger and 1 Wumei, serve hot.
Gui Zhi Ma Huang Ge Ban Tang: Treats fever with spontaneous sweating or anhidrosis.
Gui Zhi, Bai Shao Yao, Sheng Jiang, Gan Cao (roasted), Ma Huang (1 qian each), Xing Ren (10 seeds, soaked, peeled, core removed).
Decoct 1 zhong water with 2 Jujubes to 40% volume, take far from meals.
Wu Ling San (See Wu Lin)
Xiao Chai Hu Tang
Da Chai Hu Tang (See Jing Zheng)
Er Chen Tang (See Han Tu)
Da An Wan (Bao He Wan + Bai Zhu)
Bu Zhong Yi Qi Tang (See Xu Lei)
Shi Wei Xiang Ru Yin (See Ou Tu Ru)
Liu Jun Zi Tang
Jia Wei Gui Pi Wan
Jia Wei Xiao Yao San
Yi Gong San (See Nei Diao)