伏暑疟久缠绵，邪无出路，肋下结瘕，此名疟
母。宜用鳖甲饮子、鳖甲煎丸，消痞治疟也。
此言疟邪深伏厥阴，结瘕肋下，是为疟母。以肋乃少阳
胆经所历之处，疟邪初犯，必由少阳渐传厥阴，久必入络，
遂与痰气交凝，凝聚成形。非用鳖甲、地鳖虫、僵蚕、山甲
之飞升走降，贯窜经，则恐不能搜剔幽隐，升泄潜踞。又
兼柴胡、川芎、归须、射干、桃仁，为升降疏泄，四法具
备，则邪无可容，势必越出耳。以上诸条，都因伏暑而成，
故兼收之。学者当更以疟症门，兼参之可也。
伏暑痢积，色白腹痛，里急后重，舌白呕恶，
此邪伏脾胃。宜用藿香正气散加山楂、木香、槟榔、
车前等味，理脾逐湿也。
凡暑伏募原，外感客邪而发者，名为疟症;内伤生冷而
成者，名为痢疾。先贤所谓暑邪在脾，不疟则痢，不痢则
疟。今痢下白积，而兼腹痛，舌白呕恶，乃冷湿伤脾，虽有
里急后重，先宜理气分消。故用正气散加山楂、木香、槟
榔、车前，温脾理湿，分利膀胱，使不酿延血分，而转成赤
痢焉。
伏暑痢积，色赤腹痛，里急后重，此由气伤血。
宜用洁古芍药汤，调气和血也。
上条痢下白积，专伤气分，只宜理气;此条痢已转赤，
伤及血分，非但理气可效。故用洁古芍药汤，藉芩、连苦寒
清旦热，槟、木辛温通气滞，归、芍、桃仁和营止血，大
黄、肉桂沮温通积滞，所谓和其血而痢自止，调其气而后重除
焉。再按痢者，古称滞下，又名肠澼。都由夏秋之间，暑湿
伤脾，阻遏气机，蒸逼蕴酿，而致气不宣化，邪无出路，奔
迫大腑，而粘结滞下也。故初起便兼肠脂浊垢交结而下，不
拘赤白，总有里急后重腹痛下垂之患。然腹痛之中，务要
辨明虚实。其痛随便减者为实，宜通之;如痛不随便减者为
虚，宜补之。里急之状，亦有虚实。以欲痢之时，腹先如
垂，故名里急。其急随痢减者为实，宜疏通为主;如急不随
痢减者为虚，宜固补为先。后重之状，亦有虚实。以痢后不
爽，肛门如坠，故名后重。其实者，因邪火窘迫，宜苦寒以
清之;如在者，以液枯气陷，宜甘温以补之。学者当于气血
虚实之间，谛审其的。温清补泻之法，用得其宜，灵机活
泼，在乎其人耳。
伏暑疟疾日久缠绵难愈，邪气没有出路，胁下结成痞块，这叫做“疟母”。适宜使用鳖甲饮子、鳖甲煎丸，以消除痞块并治疗疟疾。
这里说的是疟邪深伏于厥阴经，在胁下结聚成瘕，这就是疟母。因为胁部是少阳胆经循行的部位，疟邪初次侵犯，必定由少阳逐渐传入厥阴，时间久了必然深入络脉，于是与痰气和血相互凝结，凝聚形成有形之块。如果不使用鳖甲、地鳖虫、僵蚕、穿山甲这些具有升浮沉降、贯通窜透特性的药物，恐怕不能搜剔幽深隐伏的邪气，升发宣泄潜藏的病邪。再加上柴胡、川芎、当归须、射干、桃仁，具备升降疏泄四种治法，那么邪气就无处容身，势必会向外透发而出。以上各条论述，都是因为伏暑引起的，所以一并收录。学者应当参考疟症门的内容，结合参看即可。
伏暑导致的痢疾伴有积滞，大便色白且腹痛，有里急后重感，舌苔白腻且恶心呕吐，这是邪气潜伏在脾胃。适宜使用藿香正气散加入山楂、木香、槟榔、车前子等药味，以调理脾脏、驱逐湿气。
凡是暑气潜伏于募原，因外感客邪而发作的，叫做疟症；因内伤生冷食物而成的，叫做痢疾。先贤所说的“暑邪在脾，不疟则痢，不痢则疟”正是此意。如今痢下白色积滞，兼有腹痛，舌苔白腻且恶心呕吐，这是冷湿损伤了脾脏，虽然有里急后重的症状，但首先应当调理气分以消散病邪。所以使用正气散加入山楂、木香、槟榔、车前子，温补脾脏、调理湿气，分利膀胱，使病邪不蔓延至血分，从而转变成赤痢。
伏暑导致的痢疾伴有积滞，大便色赤且腹痛，有里急后重感，这是由于气分受伤进而波及血分。适宜使用洁古芍药汤，以调和气血。
上一条提到的痢下白色积滞，专门损伤气分，只宜调理气分；这一条提到痢疾已转为红色，伤及血分，不仅仅靠调理气分就能见效。所以使用洁古芍药汤，借助黄芩、黄连的苦寒性质清解郁热，槟榔、木香的辛温性质通气滞，当归、芍药、桃仁调和营血并止血，大黄、肉桂温通以消积滞，这就是所谓“和其血而痢自止，调其气而后重除焉”。再按：痢疾，古代称为“滞下”，又名“肠澼”。都是由夏秋之间，暑湿损伤脾脏，阻遏气机，蒸腾逼迫蕴酿，导致气机不能宣化，邪气没有出路，奔迫大肠，从而粘结滞下所致。所以初起时大便常兼有肠脂浊垢交结而下，无论赤白，总有里急后重、腹痛甚至脱肛的隐患。然而在腹痛之中，务必辨明虚实。疼痛随排便减轻的是实证，适宜用通法；如果疼痛不随排便减轻的是虚证，适宜用补法。里急的症状，也有虚实之分。所谓“里急”，是指在想要排便时，腹部先感到下垂坠胀。这种急迫感随排便减轻的是实证，适宜以疏通为主；如果急迫感不随排便减轻的是虚证，适宜以固补为先。后重的症状，也有虚实之分。所谓“后重”，是指排便后仍不爽快，肛门如坠落感。其实证，是因为邪火窘迫，适宜用苦寒药清解；如果是虚证，是因为津液枯竭、气机下陷，适宜用甘温药补益。学者应当在气血虚实之间，仔细审察确切的病机。温、清、补、泻的方法，运用得当，灵活变通，全在于医者本人。
Chronic malaria caused by latent summerheat lingers for a long time, with the pathogenic factor having no outlet. A mass forms under the hypochondrium, known as "Mamo" (Malaria Mother). It is appropriate to use Biejia Yinzi (Turtle Shell Decoction) and Biejia Jianwan (Turtle Shell Pill for Reducing Stagnation) to dissipate the stagnation and treat malaria.
This refers to the malaria pathogen deeply lodged in the Jueyin Liver Meridian, forming a mass under the hypochondrium, which constitutes Mamo. Since the hypochondrium is the pathway of the Shaoyang Gallbladder Meridian, when the malaria pathogen first invades, it must gradually transmit from Shaoyang to Jueyin. Over time, it inevitably enters the collaterals, where it condenses with phlegm and qi, forming a tangible mass. Without using ascending and descending, penetrating and circulating herbs such as Biejiaruo (Turtle Shell), Dibiechong (Ground Beetle), Jiangcan (Bombyx Batryticatus), and Shanjiachuan (Pangolin Scales), it may be impossible to search out and eliminate the hidden pathogens and ascend/release the lurking evil. Furthermore, combining Chaihu (Bupleurum Root), Chuanxiong (Sichuan Lovage Rhizome), Guixu (Angelica Sinensis Root Tip), Shegan (Belamcanda Rhizome), and Taoren (Peach Seed) provides methods of ascending, descending, diffusing, and purging. With these four methods fully employed, the pathogen has no place to reside and will inevitably emerge outward. The above discussions all arise from latent summerheat, so they are collected together. Scholars should also refer to the section on Malaria Syndrome for comprehensive reference.
Dysentery with accumulation caused by latent summerheat presents with white stool, abdominal pain, tenesmus, white tongue coating, and nausea/vomiting. This indicates the pathogen is latent in the Spleen and Stomach. It is appropriate to use Huoxiang Zhengqi San (Agaricus Powder for Rectifying the Qi) added with Shanzha (Hawthorn Fruit), Muxiang (Aucklandiae Radix), Binglang (Areca Seed), Cheqianzi (Plantago Seed), etc., to regulate the Spleen and expel dampness.
Whenever summerheat lies dormant in the Moyuan (Sea of Origin) and erupts due to external invading pathogens, it is called Malaria Syndrome; if it arises from internal injury caused by cold and raw food, it is called Dysentery. As the sages said, "Summerheat pathogen in the Spleen results either in malaria or dysentery, but not both simultaneously." Currently, the passage of white accumulation in stool, accompanied by abdominal pain, white tongue coating, and nausea/vomiting, indicates that cold-dampness has injured the Spleen. Although there is tenesmus, one should first regulate the Qi aspect to dissipate the pathogen. Therefore, Zhengqi San is used with additions of Shanzha, Muxiang, Binglang, and Cheqian to warm the Spleen, regulate dampness, and separate fluids via the Bladder, preventing the pathogen from spreading into the Blood aspect and turning into bloody dysentery.
Dysentery with accumulation caused by latent summerheat presents with red stool, abdominal pain, and tenesmus. This occurs because the Qi aspect is injured and subsequently affects the Blood aspect. It is appropriate to use Jiegou Shaoyao Tang (Jiegu's Peony Decoction) to harmonize Qi and nourish Blood.
The previous case of white accumulation in stool specifically injures the Qi aspect and only requires regulating Qi; this case involves red stool, indicating injury to the Blood aspect, where merely regulating Qi is ineffective. Thus, Jiegou Shaoyao Tang is used. Huangqin (Scutellaria Root) and Huanglian (Coptis Rhizome) use their bitter-cold nature to clear stagnant heat; Binglang and Muxiang use their acrid-warm nature to move Qi stagnation; Danggui (Angelica Sinensis Root), Shaoyao (Peony Root), and Taoren (Peach Seed) harmonize Ying (Nutritive) level and stop bleeding; Dahuang (Rhubarb Root) and Rougui (Cinnamon Bark) provide warmth and unblock to resolve accumulation. This is what is meant by "harmonizing the Blood stops dysentery naturally, regulating the Qi eliminates tenesmus." Furthermore, Dysentery was anciently called "Zhixia" (Stagnant Downward Flow) or "Changpi" (Intestinal Diarrhea). It is caused by summerheat-dampness injuring the Spleen during summer and autumn, obstructing Qi mechanism, steaming and fermenting, leading to failure of Qi transformation and lack of pathogen outlet. The pathogens rush to the Large Intestine, causing binding and stagnation. Hence, initially, the stool often contains intestinal mucus and turbid matter mixed together, regardless of color (red or white), always presenting with tenesmus, abdominal pain, and even rectal prolapse. However, within abdominal pain, one must distinguish between Excess and Deficiency. Pain that alleviates after defecation is Excess, suitable for purgative methods; pain that does not alleviate after defecation is Deficiency, suitable for tonifying methods. Tenesmus also has Excess and Deficiency types. "Tenesmus" refers to the sensation of heaviness and drooping in the abdomen before the urge to defecate. If the urgency alleviates with defecation, it is Excess, primarily treated with dredging methods; if the urgency persists despite defecation, it is Deficiency, primarily treated with consolidating and tonifying methods. "Heaviness in the anus" (Houzhang) also has Excess and Deficiency types. "Houzhang" refers to the feeling of incomplete evacuation and anal heaviness after defecation. In Excess cases, caused by pathogenic fire constraining the bowels, bitter-cold herbs should be used to clear heat; in Deficiency cases, caused by fluid depletion and Qi sinking, sweet-warm herbs should be used to tonify. Scholars must carefully examine the exact pathology regarding Qi/Blood and Excess/Deficiency. The appropriate application of warming, clearing, tonifying, and purging methods, along with flexible adaptation, depends entirely on the practitioner.