疟病者,阴邪闭束,郁其少阳之卫气也。以暑蒸汗泄,寒入汗孔,舍于肠胃之外,经脏之间
,秋伤于风,而疟作矣。其证阴阳交争,阴胜于阳则发寒,阳胜于阴则发热。阳旺而发之
速,则寒少而热多。阳虚而发之迟,则寒多而热少。阳气日盛,则其作日早。阳气日衰,则其作
日晏。阳气退败,不能日与邪争,则间日乃作。如先寒后热,而为寒疟,以柴胡栝蒌干
姜汤主之。如寒多热少,或但寒不热,而为牡疟,以柴胡桂枝干姜汤主之。如先热后寒,而为温疟,
及热多寒少,或但热不
寒,而为瘅疟,统以白虎桂枝柴胡汤主之。如疟证脾湿有寒属虚者,以六君子汤主之。如久疟
不愈,结为 瘕,名曰疟母者,以减味鳖甲煎、丸主之。
柴胡栝蒌干姜汤
柴胡(三钱) 黄芩(二钱) 甘草(二钱) 人参(一钱)
生姜(三钱) 大枣(三枚) 干姜(三钱) 栝蒌(三钱) 水煎大半杯,热服覆衣。呕,加半夏。
柴胡桂枝干姜汤
柴胡(三钱) 甘草(二钱) 人参(一钱) 茯苓(三钱) 桂枝(三钱)
干姜(三钱) 水煎大半杯,热服覆衣。
白虎桂枝柴胡汤
石膏(三钱) 知母(三钱) 甘草(二钱) 粳米(半杯) 桂枝(三钱)
柴胡(三钱) 水煎大半杯,热服覆衣。
六君子汤
人参(三钱) 白术(三钱) 茯苓(三钱) 半夏(三钱) 甘草(二钱) 陈皮
(三钱) 倍加柴胡,并加生姜三片,枣二枚,水煎大半杯,温服。
减味鳖甲煎丸
鳖甲(二两四钱) 柴胡(一两二钱) 黄芩(六钱) 人参(二钱) 半夏(二钱)
甘草(二钱) 桂枝(六钱) 芍药(一两) 丹皮(一两) 桃仁(四钱) 阿胶(六钱) 大黄(六钱) 干姜
(六钱) 葶苈(二钱) 上为末,用清酒一坛,入灶下灰一升,着鳖甲于中,煮令消化,绞汁去渣,
入诸药煎浓,留药末,调和为丸,如梧子大,空腹服七丸,日三服。
疟疾这种病,是由于阴寒邪气闭束,郁滞了少阳经的卫气。因为暑热蒸腾导致汗出,寒邪乘虚进入汗孔,停留在肠胃之外、经络与脏腑之间,若在秋季感受风邪,疟疾就会发作。其症状表现为阴阳之气相互交争:阴气胜过阳气则发冷,阳气胜过阴气则发热。如果阳气旺盛且发作迅速,则恶寒时间短而发热时间长;如果阳气虚弱且发作迟缓,则恶寒时间长而发热时间短。如果阳气日渐强盛,则发作时间一天比一天早;如果阳气日渐衰退,则发作时间一天比一天晚。如果阳气退败,不能每天与邪气抗争,则每隔一天发作一次。
如果是先恶寒后发热,属于寒疟,用柴胡栝蒌干姜汤主治。如果是恶寒多发热少,或者只恶寒不发热,属于牡疟(一种以寒为主的疟疾),用柴胡桂枝干姜汤主治。如果是先发热后恶寒,属于温疟;以及发热多恶寒少,或者只发热不恶寒,属于瘅疟(一种以热为主的疟疾),统一用白虎桂枝柴胡汤主治。如果是疟疾病症伴有脾湿且有寒象,属于虚证,用六君子汤主治。如果是久疟不愈,结聚形成癥块,名叫疟母,用减味鳖甲煎丸主治。
柴胡栝蒌干姜汤
组成:柴胡(三钱)、黄芩(二钱)、甘草(二钱)、人参(一钱)、生姜(三钱)、大枣(三枚)、干姜(三钱)、栝蒌(三钱)。
用法:加水煎煮至大半杯,趁热服用,服药后覆盖衣被以助发汗。若出现呕吐症状,加入半夏。
柴胡桂枝干姜汤
组成:柴胡(三钱)、甘草(二钱)、人参(一钱)、茯苓(三钱)、桂枝(三钱)、干姜(三钱)。
用法:加水煎煮至大半杯,趁热服用,服药后覆盖衣被以助发汗。
白虎桂枝柴胡汤
组成:石膏(三钱)、知母(三钱)、甘草(二钱)、粳米(半杯)、桂枝(三钱)、柴胡(三钱)。
用法:加水煎煮至大半杯,趁热服用,服药后覆盖衣被以助发汗。
六君子汤
组成:人参(三钱)、白术(三钱)、茯苓(三钱)、半夏(三钱)、甘草(二钱)、陈皮(三钱)。
用法:加倍使用柴胡,并加入生姜三片、大枣两枚,加水煎煮至大半杯,温服。
减味鳖甲煎丸
组成:鳖甲(二两四钱)、柴胡(一两二钱)、黄芩(六钱)、人参(二钱)、半夏(二钱)、甘草(二钱)、桂枝(六钱)、芍药(一两)、丹皮(一两)、桃仁(四钱)、阿胶(六钱)、大黄(六钱)、干姜(六钱)、葶苈(二钱)。
制法与用法:将上述药材研为细末。取清酒一坛,放入灶下灰一升,将鳖甲置于其中,煮至鳖甲溶解,过滤去渣取汁。将药末加入药汁中煎煮至浓稠,保留药末,调和制成丸药,大小如梧桐子大。空腹时服用七丸,每日三次。
Malaria is a disease caused by the closure of Yin pathogenic factors, which stagnates the Wei Qi (Defensive Qi) of the Shaoyang (Lesser Yang) channel. Due to summer heat steaming and causing sweating, cold pathogens enter through the sweat pores and lodge outside the stomach and intestines, between the meridians and zang-fu organs. If wind pathogens are contracted in autumn, malaria will manifest. The symptoms involve the struggle between Yin and Yang: when Yin prevails over Yang, chills occur; when Yang prevails over Yin, fever occurs. If Yang is vigorous and the onset is rapid, there is less chills and more fever. If Yang is deficient and the onset is slow, there is more chills and less fever. As Yang qi grows stronger day by day, the attacks occur earlier each day. As Yang qi declines day by day, the attacks occur later each day. If Yang qi retreats and weakens, unable to contend with the pathogen daily, the disease manifests every other day.
If chills precede fever, it is classified as Cold Malaria (Han Nue), treated primarily with Chaihu Gualou Ganjiang Tang (Bupleurum, Trichosanthes, and Dried Ginger Decoction). If chills are predominant with little or no fever, it is classified as Mu Malaria (Mu Nue, a type of malaria characterized predominantly by chills), treated primarily with Chaihu Guizhi Ganjiang Tang (Bupleurum, Cinnamon Twig, and Dried Ginger Decoction). If fever precedes chills, it is classified as Warm Malaria (Wen Nue); if fever is predominant with little or no chills, it is classified as Dan Malaria (Dan Nue, a type of malaria characterized predominantly by heat), all treated primarily with Baihu Guizhi Chaihu Tang (White Tiger, Cinnamon Twig, and Bupleurum Decoction). If the malaria syndrome involves Spleen dampness with cold signs and belongs to deficiency patterns, it is treated primarily with Liujunzi Tang (Six Gentlemen Decoction). If malaria persists for a long time without healing and forms a mass, known as Malaria Mother (Nuo Mu), it is treated primarily with Jianwei Biejia Jian Wan (Modified Turtle Shell Pill).
Chaihu Gualou Ganjiang Tang (Bupleurum, Trichosanthes, and Dried Ginger Decoction)
Ingredients: Chai Hu (Bupleuri Radix, 3 qian), Huang Qin (Scutellariae Radix, 2 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 2 qian), Ren Shen (Ginseng Radix, 1 qian), Sheng Jiang (Zingiberis Rhizoma Recens, 3 qian), Da Zao (Jujubae Fructus, 3 pieces), Gan Jiang (Zingiberis Rhizoma, 3 qian), Gua Lou (Trichosanthis Fructus, 3 qian).
Preparation and Administration: Decoct in water until half a cup remains. Take hot and cover with clothing to induce sweating. If vomiting occurs, add Ban Xia (Pinelliae Rhizoma).
Chaihu Guizhi Ganjiang Tang (Bupleurum, Cinnamon Twig, and Dried Ginger Decoction)
Ingredients: Chai Hu (Bupleuri Radix, 3 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 2 qian), Ren Shen (Ginseng Radix, 1 qian), Fu Ling (Poria, 3 qian), Gui Zhi (Cinnamomi Ramulus, 3 qian), Gan Jiang (Zingiberis Rhizoma, 3 qian).
Preparation and Administration: Decoct in water until half a cup remains. Take hot and cover with clothing to induce sweating.
Baihu Guizhi Chaihu Tang (White Tiger, Cinnamon Twig, and Bupleurum Decoction)
Ingredients: Shi Gao (Gypsum Fibrosum, 3 qian), Zhi Mu (Anemarrhenae Rhizoma, 3 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 2 qian), Jing Mi (Oryza Sativa, half cup), Gui Zhi (Cinnamomi Ramulus, 3 qian), Chai Hu (Bupleuri Radix, 3 qian).
Preparation and Administration: Decoct in water until half a cup remains. Take hot and cover with clothing to induce sweating.
Liujunzi Tang (Six Gentlemen Decoction)
Ingredients: Ren Shen (Ginseng Radix, 3 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 3 qian), Fu Ling (Poria, 3 qian), Ban Xia (Pinelliae Rhizoma, 3 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 2 qian), Chen Pi (Citri Reticulatae Pericarpium, 3 qian).
Preparation and Administration: Double the amount of Chai Hu (Bupleuri Radix), and add three slices of Sheng Jiang (Zingiberis Rhizoma Recens) and two Da Zao (Jujubae Fructus). Decoct in water until half a cup remains. Take warm.
Jianwei Biejia Jian Wan (Modified Turtle Shell Pill)
Ingredients: Bie Jia (Testudinis Carapax et Plastrum, 2 liang 4 qian), Chai Hu (Bupleuri Radix, 1 liang 2 qian), Huang Qin (Scutellariae Radix, 6 qian), Ren Shen (Ginseng Radix, 2 qian), Ban Xia (Pinelliae Rhizoma, 2 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 2 qian), Gui Zhi (Cinnamomi Ramulus, 6 qian), Shao Yao (Paeoniae Radix Alba, 1 liang), Dan Pi (Moutan Cortex, 1 liang), Tao Ren (Persicae Semen, 4 qian), E Jiao (Colla Corii Asini, 6 qian), Da Huang (Rhei Radix et Rhizoma, 6 qian), Gan Jiang (Zingiberis Rhizoma, 6 qian), Ting Li (Lepidii Semen, 2 qian).
Preparation and Administration: Grind the above herbs into fine powder. Take one jar of clear wine, add one sheng of ash from the stove bottom, place Bie Jia (Testudinis Carapax et Plastrum) inside, and boil until the turtle shell dissolves. Strain the juice and remove dregs. Add the herbal powder to the juice and decoct until thick. Retain the powder, mix to form pills the size of wutong seeds. Take seven pills on an empty stomach, three times daily.