周慎斋曰∶治疟之法，升其阳使不并于阴，则寒已，降其阴使不并于阳，则热已。升其
阳者
，是散阳中之寒邪，柴、葛、羌之属，为散寒之品也。降其阴者，是泻营中之热邪，芩、知
、膏之属，为泻热之品也。盖并之则病，分之乃愈也。此盖本之王肯堂之治案，王之外祖母
年八十余，夏患疟，诸舅以年高不堪再发，议欲截之，王曰∶欲一剂而已亦甚易，何必截乎
？乃用柴胡、升麻、羌、防、葛根之辛甘气清，以升阳气，使离于阴而寒自已，以石膏、知
母、黄芩之苦甘寒，引阴气下降，使离于阳而热自已，以猪苓之淡渗，分利阴阳，不得交并
，以穿山甲引之，以甘草和之，果一剂而止。俞惺斋云∶读《灵兰要览》，载此方治疟屡效
，又附随症加减法，最为精当，是金坛得意之作。又谓李士材治程武修蓝本于此，惟以白豆
蔻换穿山甲，亦其善用药处，余按∶近俗治疟多宗倪涵初，似逊此方，然以之治疟，亦不能
尽效，知病有万变，未可执一。比见王孟英《古今医案按选》论此最为精当，云∶此案但言
夏月患疟，而不详脉症，所用升散之药五种，苦寒之药三种，虽为金坛得意之作，余颇不以
为然。后人不审题旨，辄抄墨卷，贻误良多。邹润安云∶据金坛云，是使阴阳相离，非使邪
与阴阳相离也。使邪与阴阳相离犹可，言人身阴阳，可使之相离乎？斯言先得我心，余治门
人张笏山之弟，疟来痞闷欲死，以枳桔汤加柴、芩、橘、半，一饮而瘳，是调其阴阳，而使
阴阳相离也。
《左传》齐侯疥遂 ，《颜氏家训》改疥作 ，谓《说文》 二日一发之疟， 有热疟
。齐侯之病，本是间日一发，渐加重，故为诸侯忧。今北方犹呼 疟， 音皆，俗儒云病疥，令
人恶寒变成疟，此臆说也，疥癣小疾，岂有患疥转作疟乎？余谓人之疾病无常，初患疥癣，
亦所时有，若以疥为 ，则 为热疟， 为二日一发之疟，亦何尝无热乎？
治疟有谓必当用柴胡者，以疟不离乎少阳，非柴胡不能截也。有谓不当概用柴胡者，以
风寒正疟则宜之，若感受风温、湿温、暑热之气而成疟者，不可执以为治也。窃谓疟邪未入少阳
，或无寒但热，或无热但寒，或寒热无定候者，原不得用柴胡，若既见少阳症，必当用柴胡
，以升清肝胆之热，虽因于温热暑湿，亦何碍乎？
周慎斋说：治疗疟疾的方法，是提升阳气使其不与阴气相并合，那么寒战就会停止；降低阴气使其不与阳气相并合，那么发热就会消退。所谓“升其阳”，就是疏散阳分中的寒邪，如柴胡、葛根、羌活等药物，属于散寒类的药材。所谓“降其阴”，就是清泻营血中的热邪，如黄芩、知母、石膏等药物，属于清热类的药材。大概是因为阴阳相并合则发病，分离了才能痊愈。这大概是依据王肯堂的治疗医案。王肯堂的外祖母八十多岁时，夏天患了疟疾，各位舅舅因为老人年事已高，不堪忍受再次发作，商议想要强行截断疟疾（即强行止疟）。王肯堂说：“想要一剂药就治愈也很简单，何必非要强行截断呢？”于是使用柴胡、升麻、羌活、防风、葛根这些辛甘而气味清轻的药物，来升发阳气，使阳气离开阴分，寒战自然停止；使用石膏、知母、黄芩这些苦甘寒的药物，引导阴气下降，使阴气离开阳分，发热自然停止；使用猪苓这种淡味渗利的药物，分利阴阳，使它们不得交相并合；使用穿山甲作为引经药，使用甘草来调和诸药，果然一剂药就停止了疟疾。俞惺斋说：读《灵兰要览》，记载这个方子治疗疟疾屡获奇效，又附有随症状加减的方法，最为精当，这是金坛（指王肯堂，江苏金坛人）得意的作品。又说李士材治疗程武修时，蓝本也是参考了这个方子，只是用白豆蔻换掉了穿山甲，这也是他善于用药的地方。我按语道：近代世俗治疗疟疾大多遵循倪涵初的学说，似乎不如这个方子，然而用它来治疗疟疾，也不能保证完全有效，要知道疾病变化万千，不可固执于一种方法。近来看到王孟英在《古今医案按选》中论述此条最为精当，他说：“这个医案只说了夏天患疟疾，而没有详细记录脉象和症状，所用的升散类药物有五种，苦寒类药物有三种，虽然这是金坛得意的作品，但我颇为不以为然。后人不仔细审题旨，就盲目抄录墨守成规，贻误良多。”邹润安说：根据金坛的说法，这是要使阴阳相互分离，而不是要使邪气与阴阳相互分离。如果说是使邪气与阴阳分离还可以理解，但说人体的阴阳可以使之分离吗？这话正合我的心意。我治疗门人张笏山的弟弟，疟疾发作时胸脘痞闷，痛苦欲死，我用枳桔汤加上柴胡、黄芩、橘皮、半夏，喝了一剂就好了，这就是调理他的阴阳，而使阴阳重新分离（恢复平衡）啊。
《左传》记载齐侯患有疥疮进而转为疟疾，《颜氏家训》中将“疥”改为“瘅”，解释说《说文解字》中“瘅”是隔日发作一次的疟疾，“瘅”是有热的疟疾。齐侯的病，本来是隔日发作一次，逐渐加重，所以让诸侯们担忧。现在北方仍然称呼“瘅”为疟疾，“瘅”音同“皆”，世俗儒生说这是得了疥疮，让人恶寒从而变成疟疾，这是主观臆测的说法。疥癣是小病，哪里有患疥疮转变成疟疾的呢？我认为人的疾病无常，起初患疥癣，也时有发生，如果把“疥”当作“瘅”，那么“瘅”就是热疟，“瘅”是隔日一发的疟疾，难道就没有热症吗？
治疗疟疾有人说必须使用柴胡，因为疟疾离不开少阳经，不用柴胡就不能截断疟疾。也有人说不应该一概使用柴胡，因为风寒引起的正疟适宜用柴胡，如果是感受风温、湿温、暑热之气而形成的疟疾，就不能固执地用柴胡来治疗。我个人认为，疟邪尚未进入少阳经，或者只有寒没有热，或者只有热没有寒，或者寒热发作时间不固定的情况，原本就不应该使用柴胡；如果已经出现了少阳经的症状，就必须使用柴胡，以升发清泄肝胆的热邪，即使是因温热暑湿引起的，又有什么妨碍呢？
Zhou Shenzhai stated: The method for treating malaria (Malaria) is to raise the Yang Qi (Yang energy) so that it does not merge with Yin, then the chills will cease; and to lower the Yin so that it does not merge with Yang, then the fever will subside. "Raising the Yang" refers to dispersing the cold pathogenic factors in the Yang aspect, using herbs such as Chaihu (Bupleuri Radix), Gegen (Puerariae Lobatae Radix), and Qianghuo (Notopterygii Rhizoma et Radix), which are cold-dispersing agents. "Lowering the Yin" refers to purging the heat pathogenic factors in the Ying (Nutritive) level, using herbs such as Huangqin (Scutellariae Radix), Zhimu (Anemarrhenae Rhizoma), and Shigao (Gypsum Fibrosum), which are heat-purging agents. Generally, when Yin and Yang merge, disease occurs; when they separate, recovery ensues. This approach is likely based on the medical case records of Wang Kentang. Wang's maternal grandmother, over eighty years old, suffered from malaria in summer. Her sons-in-law, concerned that her advanced age could not withstand another attack, proposed forcibly arresting the malaria (stopping the paroxysms). Wang said, "It is very easy to cure this with a single dose; why must we forcibly arrest it?" He therefore used Xinhuan (Bupleuri Radix), Shengma (Cimicifugae Rhizoma), Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), and Gegen (Puerariae Lobatae Radix)—herbs with acrid-sweet flavors and clear aromas—to raise the Yang Qi, causing it to separate from Yin, thereby stopping the chills spontaneously. He used Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), and Huangqin (Scutellariae Radix)—herbs with bitter-sweet-cold properties—to guide the Yin downward, causing it to separate from Yang, thereby stopping the fever spontaneously. He used Zhuling (Polypori Umbellati Sclerotium), a bland-draining herb, to differentiate and drain Yin and Yang, preventing their merging. He used Shanjiapia (Manis Squama) as a guiding agent and Gancao (Glycyrrhizae Radix et Rhizoma) to harmonize the formula. Indeed, one dose stopped the malaria. Yu Xingzhai commented: Reading *Linglan Yaolan*, this formula was recorded to be frequently effective for malaria, with additional methods for modification according to symptoms, making it most precise. It is considered Wang Kentang's masterpiece. It is also said that Li Shicai treated Cheng Wuxiu based on this formula, substituting Baidoukou (Amomi Fructus Rotundus) for Shanjiapia, which demonstrates his skill in herbal usage. I note: In recent times, popular treatment of malaria often follows Ni Hanchu's theories, which seems inferior to this formula. However, even using this formula cannot guarantee complete efficacy for all cases, as diseases vary infinitely; one cannot adhere rigidly to a single method. Recently, I saw Wang Mengying's discussion in *Gujin Yi'an Anxuan* regarding this case, which he deemed most appropriate. He stated: "This case only mentions summer-onset malaria without detailing pulse and symptoms. Five ascending/dispersing herbs and three bitter-cold herbs were used. Although this is Wang Kentang's prized work, I am somewhat skeptical. Later generations, failing to examine the context carefully, blindly copy these texts, causing much harm." Zou Run'an said: According to Wang Kentang, the goal is to make Yin and Yang separate, not to separate the pathogen from Yin and Yang. If it meant separating the pathogen from Yin and Yang, that would be acceptable, but can human Yin and Yang be made to separate? This statement resonates with my own views. I treated the younger brother of my disciple Zhang Hushan, who suffered from severe chest and epigastric stuffiness and near-death distress during malaria attacks. I used Zhijie Tang (Bitter Orange and Magnolia Bud Decoction) added with Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), Juhong (Citri Reticulatae Pericarpium Rubrum), and Banxia (Pinelliae Rhizoma). One dose cured him. This illustrates regulating Yin and Yang to restore their separation (balance).
The *Zuo Zhuan* records that the Duke of Qi had scabies which turned into malaria. The *Yanshi Jiaxun* changes "scabies" to "dan" (feverish malaria), explaining that in the *Shuowen Jiezi*, "dan" refers to every-other-day malaria, and "dan" implies hot malaria. The Duke of Qi's illness was originally every-other-day onset, gradually worsening, causing concern among the feudal lords. In northern China today, "dan" is still called malaria. Some vulgar scholars claim that scabies causes aversion to cold, leading to malaria; this is speculative. Scabies and tinea are minor ailments; how could scabies transform into malaria? I argue that human diseases are unpredictable. While initial scabies or tinea occurs, if one equates "scabies" with "dan," then "dan" is hot malaria, and "dan" is every-other-day malaria. Does every-other-day malaria lack heat?
Some argue that Chaihu (Bupleuri Radix) must be used for malaria because malaria involves the Shaoyang (Lesser Yang) channel, and only Chaihu can arrest it. Others argue against universal use of Chaihu, stating it is suitable for regular malaria caused by wind-cold, but inappropriate for malaria caused by wind-warmth, damp-warmth, or summer-heat. I believe: If the malaria pathogen has not entered the Shaoyang channel, or if there is cold without heat, heat without cold, or irregular alternating chills and fever, Chaihu should originally not be used. However, if Shaoyang symptoms have appeared, Chaihu must be used to ascend and clear the heat of the Liver and Gallbladder. Even if caused by warmth, heat, or dampness, what harm would there be?