正疟疾多头痛，病退起床，似无病也。似疟疾，寒不甚，热不深，亦有寒少而热极轻者
有头痛，一日一次，不思饮食，口不知味，倦怠无力，自汗身热，身痛作胀，寒热间作而无
太过，亦有热极而汗，汗至颈或半身而还者，病退不能起床，哑哝不识，杂病多端，难以尽
述，作正疟治之不死变劳，一二三年而愈，祸仍无已。正疟疾作止有时，非若少阳伤寒往来
之无定也，小柴胡汤正治之方。无汗求有汗则止，有汗求无汗则愈。得之于冬，邪舍于肾，
藏之于心，热萦于肺，太阴也，少气烦冤，手足热而呕，脾也。先寒后热，谓之寒疟；先热
后寒，谓之温疟。二者不同，治从乎中，少阳也，渴者燥胜，不渴者湿胜。又经云∶夏伤于
暑，秋生 疟。夏暑汗不出者，秋生 疟，此夏时有伤阳气，以致少阳阳气不舒，皆少阳虚
也。四时之疟，当顺其时令，夏气上行，秋气下行。先寒后热，太阳阳明，白虎汤加桂枝。
天气上行，宜用下行，不宜泻肺，宜泻相火，头来加川芎，背来加桂枝，腰来加年膝，脚来
加木瓜、苡仁，俱用小柴胡为主，兼五苓散。食伤加青皮、草果；身体作胀无汗，人参败毒
散；有汗遍身疼痛，补中益气汤加黄 。久病补而不愈者，作虚损治之，腰足冷痛，二陈加
桂、附，一日一次，传于阴分，宜八珍二陈加柴胡数帖，待传阳易截，不然变劳。久病日日
邪热不退，莫过于益气汤加附子，或十全大补汤。腹胀泄泻，莫忘脾胃，宜加四君子汤。
太阳令人腰痛头重，寒从背起，先寒后热， 然，热止汗出难已，羌活生地汤、小
阳明令人先寒洒淅，洒淅寒甚，久乃热，热去汗出，见日月光火气乃快，白虎汤加桂枝
少阳令人体解，寒不甚，热不甚，恶见人，见则惕惕然，热多汗出甚，小柴胡汤。凡有
太阴令人不乐，好太息，多寒热，汗出，病至乃喜呕，呕出乃衰。四君子汤加陈皮、贝母。
少阴令人呕吐甚，多寒热、热多寒少，欲闭户而处，病难医。小柴胡汤加细辛。
厥阴令人腰痛，少腹痛满，小便不利，如癃状，非癃也，便数，意恐惧，气不足，腹中
悒。延胡苦楝汤，苦柏一两，苦楝二分，附子、桂心各二分，熟地一钱，饥服。
夫疟者，因外感风寒、暑湿，内伤饮食、劳役。或饥饱、色欲过度，以致脾胃不和，痰
脘，盖无痰不成疟。脾胃属土有信，去来不失其时，若移时或早或晚者，是邪无容地，将自
好也。一日一发者，受病浅易治；间日发者，或二日连发住一日者，或间二日者，皆难治。
凡疟疾初发，寒多热少者，但寒不热者，桂附二陈汤。
肉桂 丁香 陈皮 半夏 柴胡 黄芩 渴加炮姜，寒加附子。
热多寒少者，但热不寒者，白虎汤加桂枝。
甘草八分，石膏八钱，知母一钱半，桂枝四分，元米一撮，一二帖必效。如前药不能取
效，用六君子加柴胡、黄芩，血虚加当归、白芍。
疟疾俱宜分利和解，柴胡、半夏、黄芩、甘草，虚加人参，有汗加黄 ，温热太重加五
苓散利之，骨蒸加知母，服至四五帖必愈。或农夫瘴气发疟，宜常山饮吐之，倘吐而不愈，作内
伤施治。
常山饮
常山 槟榔 知母 贝母 水煎，露一宿，来晨温服。
疟有发于夜者，有一二月不愈者，用首乌五钱，青皮二钱，丁香一二钱截之。服之不愈
人参 白术 茯苓 甘草 陈皮 半夏
柴胡（表虚不用） 黄芩 归身（作泄不用） 白芍 嗳气加神曲，口鼻出血加丁香，腹痛
加炮姜，煎服。
夫疟气者，并于阳者阳胜，并于阴者阴胜，阳胜则热，阴胜则寒。盖疟者，是伤于暑，
热气
而并于经中之气分也；并于阴者，卫中之寒邪，下而并于经中之血分也。气为阳为热，营中之
热邪并之，两热相合故发热；血为阴为寒，卫中之寒邪并之，两寒相合故寒。曰阳胜、阴胜
，虽本经之阴阳争胜，是气有以鼓之也。
治疟之法，升其阳使不并于阴，则寒已。升其阳者，是散阳中之寒邪也，柴胡、葛根、
羌活
母、首乌之属，为泻热中之品也。盖并之则病，故分之乃愈也。
久疟是元气虚寒。盖气虚则寒，血虚则热，胃虚则恶寒，脾虚则发热，阴火下流则寒热
交作。或吐痰不食，战栗泄泻，手足厥冷，皆脾胃虚也。但补中益气汤加减自愈。
久疟无汗，用人参一两，生姜四两，煎服；或丁香一钱，人参三钱，此乃不截之截良方
血热而疟一月不愈者，何首乌五钱，青皮二钱，水煎，来日先服。虚加人参、何首乌一
钱五分，陈皮五分，甘草三分，茯苓一钱，知母一钱，乌梅三枚。
久疟胃虚，人参、丁香各二钱，甘草、白术各一钱，煎服。脾虚满闷，不思饮食，吐痰
潮热，俱用补中益气汤加附子。小水不利加黄柏，劳疟加鳖甲。
久疟三五月，或半年不愈者，二陈汤加丁香、人参。疟发时独寒无热，脉迟，用附子一
枚，
虚其表，不若用神曲。大抵疟疾气血两虚，宜八珍、十全调理，然二陈前后俱不可缺。疟关
脉滑小，柴胡加常山、槟榔、青皮、草果截之；紧加干葛、苏叶，数加黄芩、滑石，迟加附
子，不出小柴胡正方加减。久疟呕吐恶心，用人参、陈皮、半夏、丁香四味煎服。用补不效
，久而不愈，湿热为害也，宜平胃散。
三日疟一年半年不愈者，用朱砂、元参各一两，苍术、浓朴各四两，常山，草果各一两
小儿不能服药，用黄丹五钱，生矾三钱，胡椒二钱五分，麝香五厘，共末，好醋调敷男
左女右手心，绢包手掌，药热自汗而愈。一方可效三人。
疟久不止，用枣截之，方用丁香、常山各一两，紫苏二两，全蝎三十，枣百枚，水同煮
。人力大者五六枚，弱者三枚，小儿一二枚，临来时嚼服效。
疟久成痞，用大蒜捣烂，加麝少许，敷痞上一日见效。内用马料豆一斗，常煎服，或用
似疟一日一来，来则身胀要打者，属脾虚不足，六君子汤。食嗳加神曲，血虚加归、芍
五分，汗多加黄 七分，吐清痰加五味、肉桂各
三分，恶心加炮姜三
似疟非疟，日久不愈，并久痢中气虚弱，用炮姜、附子、白术数十帖，必中气足而后病
邪不复，若一二帖效而遂已，病必再发。
内伤似疟，一日一次者，用白术五钱，归身三钱，陈皮二钱，乌梅二枚，丁香公母各三
粒。虚加人参五钱，冷水一碗，浸一宿，露过清晨，去渣温服。
又方∶白术五钱，青皮、陈皮各三钱，冷水浸露，来日清晨煎服。
验案
一人疟疾初起，饮酒而睡，睡后即发热，甚至昏愦，至夜方止，小便赤少，间二日一发
，先寒后热，呕吐痰涎，不喜饮食，胃口嘈杂，食即欲呕，体瘦手麻，口渴，喜饮热汤。方用柴
胡七分，益智五分，甘草三分，人参、桂枝、半夏、茯苓、芡实各一钱，煎服效。
一人大疟年余，脉大有力，此顽痰在脾也。精神旺则正气行而病愈，精神衰则邪气胜而
病作。二陈、小柴胡合而用之。
正疟疾多伴有头痛，病退后起床，感觉像没有生病一样。症状类似疟疾，但寒战不严重，发热不深重，也有寒战轻微而发热极轻的情况。有的出现头痛，每天发作一次，不想吃东西，嘴里尝不出味道，疲倦无力，自汗且身体发热，身体疼痛且有胀感，寒热交替发作但没有过于剧烈的表现；也有高热出汗，汗出只到颈部或半身就停止的，病退后不能起床，说话含糊不清、神志不清，杂病很多，难以一一叙述。如果按正疟治疗，不死也会变成虚劳病，经过一两年才能痊愈，祸患仍无休止。正疟疾的发作和停止是有固定时间的，不像少阳伤寒那样往来不定。小柴胡汤是治疗它的正治方剂。无汗时求其出汗则病止，有汗时求其无汗则病愈。这种病得之于冬季，邪气藏在肾中，蕴藏于心，热邪萦绕在肺，涉及太阴经，表现为少气烦闷冤郁，手足发热并呕吐，这是脾经的症状。先寒战后发热，称为寒疟；先发热后寒战，称为温疟。这两种情况不同，治疗要顺应中道，涉及少阳经。口渴的是燥邪胜，不渴的是湿邪胜。又经典说：夏季伤于暑气，秋季发生疟疾。夏季暑天汗出不出来的人，秋季会发生疟疾，这是因为夏季损伤了阳气，导致少阳阳气不舒展，都是少阳虚的表现。四季的疟疾，应当顺应时令，夏气上行，秋气下行。先寒战后发热，属于太阳阳明经病变，用白虎汤加桂枝。天气上行，宜用下行之法，不宜泻肺，宜泻相火，头痛加川芎，背痛加桂枝，腰痛加牛膝，脚痛加木瓜、薏苡仁，都以小柴胡汤为主方，兼用五苓散。饮食所伤加青皮、草果；身体胀满无汗，用人参败毒散；有汗遍身疼痛，用补中益气汤加黄芪。久病补益而不愈的，按虚损治疗，腰足冷痛，用二陈汤加肉桂、附子，一天发作一次的，邪气传入阴分，宜用八珍汤合二陈汤加柴胡数帖，等到邪气传至阳分时容易截断，否则会变成虚劳。久病日日邪热不退，莫过于用补中益气汤加附子，或者十全大补汤。腹胀泄泻，不要忘记调理脾胃，宜加四君子汤。太阳经病变使人腰痛头重，寒气从背部升起，先寒战后发热，淅淅恶寒，热止后汗出难止，用羌活生地汤；阳明经病变使人先寒战洒淅，寒甚，久了才发热，热去后汗出，见到日光月光火气才舒服，用白虎汤加桂枝；少阳经病变使人肢体懈怠，寒不甚，热不甚，厌恶见人，见了就惊恐不安，热多汗出多，用小柴胡汤；太阴经病变使人心情不乐，喜欢叹气，多寒热，汗出，病发时喜欢呕吐，吐出后病情减轻；用四君子汤加陈皮、贝母；少阴经病变使人呕吐严重，多寒热，热多寒少，想关起门来独处，病难医治，用小柴胡汤加细辛；厥阴经病变使人腰痛，少腹疼痛胀满，小便不利，像癃闭但不是癃闭，尿频，心中恐惧，气不足，腹部郁闷。用延胡苦楝汤，苦柏一两，苦楝二分，附子、桂心各二分，熟地黄一钱，空腹服用。
所谓疟疾，是因为外感风寒、暑湿，内伤饮食、劳役。或者饥饱失调、色欲过度，导致脾胃不和，痰湿阻滞，大概没有痰就不会形成疟疾。脾胃属土，讲信用，来去不失时机，如果时间移动或早或晚，那是邪气无处容身，将会自愈。一天发作一次的，受病浅，容易治疗；隔日发作的，或者两天连发停一天的，或者隔两天的，都难治。凡是疟疾初发，寒多热少的，但寒不热的，用桂附二陈汤。肉桂、丁香、陈皮、半夏、柴胡、黄芩，口渴加炮姜，寒重加附子。热多寒少的，但热不寒的，用白虎汤加桂枝。甘草八分，石膏八钱，知母一钱半，桂枝四分，粳米一撮，一二帖必见效。如果前面的药不能取效，用六君子汤加柴胡、黄芩，血虚加当归、白芍。
疟疾都适宜分利和解，用柴胡、半夏、黄芩、甘草，体虚加人参，有汗加黄芪，温热太重加五苓散利水，骨蒸潮热加知母，服至四五帖必愈。或者是农夫感受瘴气引发的疟疾，宜用常山饮催吐，如果吐了还不愈，按内伤施治。常山饮：常山、槟榔、知母、贝母，水煎，露天放置一夜，次日清晨温服。
疟疾有在夜间发作的，有一两个月不愈的，用何首乌五钱，青皮二钱，丁香一二钱截断它。服用如果不愈，用人参、白术、茯苓、甘草、陈皮、半夏、柴胡（表虚不用）、黄芩、当归身（作泄泻不用）、白芍，嗳气加神曲，口鼻出血加丁香，腹痛加炮姜，煎服。
所谓疟气，并入阳分的则阳胜，并入阴分的则阴胜，阳胜则热，阴胜则寒。大概疟疾，是伤于暑气，热气并入经中的气分；并入阴分的，是卫中的寒邪，下并入经中的血分。气为阳为热，营中的热邪并入之，两热相合所以发热；血为阴为寒，卫中的寒邪并入之，两寒相合所以发冷。说是阳胜、阴胜，虽然是本经的阴阳争胜，是气在鼓动它。
治疗疟疾的方法，升举阳气使其不并入阴分，那么寒症就会停止。升举阳气，就是疏散阳中的寒邪，用柴胡、葛根、羌活、知母、何首乌之类，是泻除热中的药物。大概邪气并合则生病，所以分开它们就好了。
久疟是元气虚寒。大概气虚则寒，血虚则热，胃虚则恶寒，脾虚则发热，阴火下流则寒热交作。或者吐痰不食，战栗泄泻，手足冰冷，都是脾胃虚的表现。只要用补中益气汤加减就能自愈。
久疟无汗，用人参一两，生姜四两，煎服；或者丁香一钱，人参三钱，这是不强行截断却能达到截断效果的良方。血热而疟疾一月不愈的，用何首乌五钱，青皮二钱，水煎，第二天先服。体虚加人参、何首乌一钱五分，陈皮五分，甘草三分，茯苓一钱，知母一钱，乌梅三枚。
久疟胃虚，用人参、丁香各二钱，甘草、白术各一钱，煎服。脾虚满闷，不想吃东西，吐痰潮热，都用补中益气汤加附子。小便不利加黄柏，劳疟加鳖甲。
久疟三五月，或者半年不愈的，用二陈汤加丁香、人参。疟疾发作时独寒无热，脉迟，用附子一枚，如果是表虚，不如用神曲。大抵疟疾气血两虚，宜用八珍汤、十全大补汤调理，然而二陈汤前后都不可以缺少。疟疾脉象滑小，用柴胡加常山、槟榔、青皮、草果截断；脉紧加干葛、苏叶，脉数加黄芩、滑石，脉迟加附子，不出小柴胡汤正方加减的范围。久疟呕吐恶心，用人参、陈皮、半夏、丁香四味煎服。用补法无效，久而不愈，是湿热为害，宜用平胃散。
三日疟一年半年不愈的，用朱砂、玄参各一两，苍术、厚朴各四两，常山、草果各一两。小儿不能服药，用黄丹五钱，生矾三钱，胡椒二钱五分，麝香五厘，共研为末，好醋调敷男左女右手心，绢包手掌，药热自汗而愈。一方可以三人有效。
疟疾久不止，用枣子截断它，方用丁香、常山各一两，紫苏二两，全蝎三十个，大枣百枚，水同煮。体力大的吃五六枚，体弱的吃三枚，小儿吃一二枚，临发作时嚼服有效。
疟疾久成痞块，用大蒜捣烂，加少许麝香，敷在痞块上一天见效。内服马料豆一斗，经常煎服，或者用类似疟疾一日一来，来时身体胀满要打人的，属于脾虚不足，用六君子汤。食积嗳气加神曲，血虚加当归、白芍五分，汗多加黄芪七分，吐清痰加五味子、肉桂各三分，恶心加炮姜三分。
似疟非疟，日久不愈，以及久痢中气虚弱，用炮姜、附子、白术数十帖，必须中气充足而后病邪不再复发，如果一二帖见效就停药，病必定再发。
内伤似疟，一天发作一次的，用白术五钱，当归身三钱，陈皮二钱，乌梅二枚，丁香公母各三粒。体虚加人参五钱，冷水一碗，浸泡一夜，露过清晨，去渣温服。
又一方：白术五钱，青皮、陈皮各三钱，冷水浸露，次日清晨煎服。
验案
一人疟疾初起，饮酒后睡觉，睡后即发热，甚至昏愦，到夜里才停止，小便赤少，隔两天发作一次，先寒战后发热，呕吐痰涎，不喜欢吃东西，胃口嘈杂，吃就想吐，身体瘦手麻，口渴，喜欢喝热汤。方用柴胡七分，益智五分，甘草三分，人参、桂枝、半夏、茯苓、芡实各一钱，煎服有效。
一人患大疟一年多，脉大有力，这是顽痰在脾脏。精神旺盛则正气行而病愈，精神衰弱则邪气胜而病作。将二陈汤、小柴胡汤合而用之。
True malaria often presents with headache. After the illness subsides and the patient rises, they feel as if they are not ill. Symptoms resembling malaria include mild chills, shallow fever, or cases where chills are slight and fever is extremely light. Some present with headache occurring once daily, loss of appetite, inability to taste food, fatigue and weakness, spontaneous sweating with body heat, body pain and distension, alternating chills and fever without excessive severity. Others may experience extreme fever followed by sweating that stops at the neck or half of the body. After the episode, the patient cannot rise from bed, speaks incoherently, and appears confused. There are many miscellaneous diseases involved, difficult to describe fully. If treated as true malaria, death can be avoided, but it may transform into *Lao* (consumptive disease), taking one to two years to heal, yet the affliction remains endless. True malaria has fixed times for onset and cessation, unlike Shaoyang Shanghan (Cold Damage affecting the Shaoyang channel) which comes and goes irregularly. Xiao Chai Hu Tang (Minor Bupleurum Decoction) is the standard treatment formula. If there is no sweat, inducing sweat will stop the condition; if there is sweat, stopping sweat will cure it. This disease originates in winter, with pathogens lodging in the Kidney, storing in the Heart, and heat lingering in the Lung, involving the Taiyin (Spleen/Lung) channel. It manifests as shortness of breath, vexation and oppression, heat in the hands and feet, and vomiting, indicating Spleen involvement. Chills preceding fever is called Han Nue (Cold Malaria); fever preceding chills is called Wen Nue (Warm Malaria). These two differ, and treatment should follow the middle path, involving the Shaoyang channel. Thirst indicates Dryness prevailing; no thirst indicates Dampness prevailing. The classics state: "Summer injury by Summerheat leads to Autumn Malaria." Those who do not sweat during summer heat will develop malaria in autumn because summer damages Yang Qi, causing Shaoyang Yang Qi to fail to circulate freely, all pointing to Shaoyang Deficiency. Malaria in the four seasons should follow the seasonal timing: Summer Qi moves upward, Autumn Qi moves downward. Chills preceding fever belongs to Taiyang and Yangming channels; use Bai Hu Tang (White Tiger Decoction) plus Guizhi (Cinnamon Twig). Since Heaven's Qi moves upward, downward-moving methods are appropriate; one should not drain the Lung but rather drain Ministerial Fire. For headache, add Chuanxiong (Szechwan Lovage Rhizome); for back pain, add Guizhi; for waist pain, add Niuxi (Achyranthes Root); for foot pain, add Mugua (Chaenomeles Fruit) and Yiren (Coix Seed). Use Xiao Chai Hu Tang as the main formula, combined with Wu Ling San (Five-Ingredient Powder with Poria). For dietary injury, add Qingpi (Aurantii Fructus Pericarpium) and Caoguo (Tsaoko Cardamom); for body distension without sweat, use Renshen Baidu San (Ginseng Detoxification Powder); for generalized body pain with sweat, use Buzhong Yiqi Tang (Middle-Boosting Qi-Invigorating Decoction) plus Huangqi (Astragalus Root). For chronic illness unresponsive to tonification, treat as Xu Sun (Deficiency Injury). For cold pain in waist and feet, use Er Chen Tang (Two-Cured Decoction) plus Rougui (Cinnamon Bark) and Fuzi (Aconite Root). For daily episodes where pathogens transmit to the Yin aspect, use Bazhen Er Chen Tang (Eight-Treasure and Two-Cured Decoction) plus Chaihu (Bupleurum Root) for several doses. Wait until pathogens transmit to the Yang aspect to easily intercept them; otherwise, it transforms into Lao. For chronic daily persistent pathogenic heat, Buyi Tang (Benefit Qi Decoction) plus Fuzi, or Shiquan Dabu Tang (Perfect Ten Tonifying Decoction) are best. For abdominal distension and diarrhea, remember to regulate the Spleen and Stomach; add Sijunzi Tang (Four-Gentlemen Decoction). Taiyang channel disorders cause lower back pain and heavy head, cold rising from the back, chills preceding fever, shivering, and difficulty stopping sweat after fever ceases; use Qianghuo Shengdi Tang (Notopterygium and Rehmannia Decoction). Yangming channel disorders cause initial shivering and severe cold, followed by heat later, with relief upon exposure to sunlight, moonlight, or fire after sweating; use Bai Hu Tang plus Guizhi. Shaoyang channel disorders cause limb flaccidity, mild chills and fever, aversion to people, palpitations upon seeing people, abundant heat and sweat; use Xiao Chai Hu Tang. Taiyin channel disorders cause depression, frequent sighing, frequent chills and fever, sweating, nausea upon onset, and improvement after vomiting; use Sijunzi Tang plus Chenpi (Aged Tangerine Peel) and Beimu (Fritillaria Bulb). Shaoyin channel disorders cause severe vomiting, frequent chills and fever (more heat than cold), desire to stay indoors behind closed doors, and difficult treatment; use Xiao Chai Hu Tang plus Xixin (Asarum). Jueyin channel disorders cause lower back pain, lower abdominal fullness and pain, dysuria resembling Long (dysuria/retention) but not true Long, frequent urination, fear, Qi deficiency, and abdominal gloominess; use Yanhu Kulian Tang (Corydalis and Melia Decoction): Kubai 1 liang, Kulian 2 fen, Fuzi and Guixin (Cinnamon Heart) each 2 fen, Shudi (Prepared Rehmannia Root) 1 qian, taken on an empty stomach.
Malaria arises from external contraction of Wind-Cold or Summerheat-Dampness, and internal injury from diet or overwork. Irregular eating, sexual excess, etc., lead to Spleen-Stomach disharmony and Phlegm obstruction; indeed, "no Phlegm, no Malaria." The Spleen and Stomach belong to Earth and are trustworthy, arriving and departing on time. If the timing shifts early or late, it means the pathogen has no place to reside and will self-resolve. Daily attacks indicate shallow disease, easy to treat; every-other-day attacks, or two days on one day off, or every three days, are difficult to treat. For early-stage malaria with more chills than heat, or only chills without heat, use Guifu Erchen Tang (Cinnamon-Aconite Two-Cured Decoction): Rougui (Cinnamon Bark), Dingxiang (Clove), Chenpi, Banxia (Pinellia Tuber), Chaihu, Huangqin (Scutellaria Root). Add Paojiang (Roasted Ginger) for thirst, Fuzi for cold. For more heat than chills, or only heat without chills, use Bai Hu Tang plus Guizhi: Gancao (Licorice Root) 8 fen, Shigao (Gypsum) 8 qian, Zhimu (Anemarrhena Rhizome) 1.5 qian, Guizhi 4 fen, Yuanmi (Rice grain) a pinch. One to two doses should be effective. If previous medicines fail, use Liujunzi Tang (Six-Gentlemen Decoction) plus Chaihu and Huangqin; add Danggui (Angelica Sinensis) and Baishao (White Peony Root) for Blood Deficiency.
Malaria generally requires separation, draining, and harmonization using Chaihu, Banxia, Huangqin, and Gancao. Add Renshen (Ginseng) for deficiency, Huangqi for sweating, Wu Ling San for severe heat-dampness, Zhimu for bone-steaming fever. Four to five doses should cure it. For farmers with miasma-induced malaria, use Changshan Yin (Dichroa Decoction) to induce vomiting. If vomiting fails, treat as internal injury. Changshan Yin: Changshan (Dichroa Root), Binglang (Areca Seed), Zhimu, Beimu. Decoct in water, leave exposed overnight, warm and take next morning.
For malaria starting at night or lasting one to two months, use Shouwu (Polygonum Multiflorum) 5 qian, Qingpi 2 qian, Dingxiang 1-2 qian to intercept. If ineffective, use Renshen, Baizhu (Atractylodes Macrocephala Rhizome), Fuling (Poria), Gancao, Chenpi, Banxia, Chaihu (avoid if exterior deficiency), Huangqin, Dangguishen (Angelica Sinensis root heart; avoid if diarrhea), Baishao. Add Shenqu (Medicated Leaven) for belching, Dingxiang for nose/mouth bleeding, Paojiang for abdominal pain.
Regarding Malaria Qi: merging with Yang leads to Yang excess (Heat); merging with Yin leads to Yin excess (Cold). Malaria is caused by Summerheat injury, where Heat Qi merges with the Qi aspect of the meridians. Merging with Yin involves Cold pathogens in the Wei (Defensive) level descending to merge with the Blood aspect of the meridians. Qi is Yang and Hot; when Ying (Nutritive) Heat merges with it, two heats combine causing fever. Blood is Yin and Cold; when Wei Cold merges with it, two colds combine causing chills. Although termed Yang/Yin excess, it is essentially the struggle of Yin and Yang within the meridian, driven by Qi.
Treatment methods for malaria involve raising Yang so it does not merge with Yin, thus stopping chills. Raising Yang means dispersing Cold in Yang, using Chaihu, Gegen (Kudzu Root), Qianghuo (Notopterygium Rhizome), Zhimu, Shouwu, etc., which are heat-draining agents. Separation cures what merging causes.
Chronic malaria indicates Yuan Qi (Original Qi) deficiency and Cold. Qi deficiency causes Cold; Blood deficiency causes Heat. Stomach deficiency causes aversion to cold; Spleen deficiency causes fever. Downward flow of Minster Fire causes alternating chills and fever. Vomiting phlegm, anorexia, tremors, diarrhea, and cold extremities all indicate Spleen-Stomach deficiency. Buzhong Yiqi Tang with modifications will self-cure.
For chronic malaria without sweat, use Renshen 1 liang, Shengjiang (Fresh Ginger) 4 liang, decoct and drink. Or Dingxiang 1 qian, Renshen 3 qian; this is a good prescription for interception without forced suppression. For blood-heat malaria lasting a month, use Shouwu 5 qian, Qingpi 2 qian, decoct and take first thing next day. For deficiency, add Renshen, Shouwu 1.5 qian, Chenpi 5 fen, Gancao 3 fen, Fuling 1 qian, Zhimu 1 qian, Wumei (Dark Plum) 3 pieces.
For chronic malaria with Stomach deficiency, use Renshen and Dingxiang each 2 qian, Gancao and Baizhu each 1 qian, decoct and drink. For Spleen deficiency with fullness, anorexia, phlegm vomiting, and tidal fever, use Buzhong Yiqi Tang plus Fuzi. Add Huangbai (Phellodendron Bark) for difficult urination, Biejia (Turtle Shell) for Labor Malaria.
For chronic malaria lasting 3-5 months or half a year, use Er Chen Tang plus Dingxiang and Renshen. If malaria presents with only cold, no heat, and slow pulse, use one piece of Fuzi. If exterior is deficient, better to use Shenqu. Generally, malaria involves both Qi and Blood deficiency; regulate with Bazhen Tang or Shiquan Dabu Tang, but Er Chen Tang should never be omitted. For slippery-small malaria pulse, use Chaihu plus Changshan, Binglang, Qingpi, Caoguo to intercept; tight pulse adds Gegen and Ziye (Perilla Leaf); rapid pulse adds Huangqin and Huashi (Talc); slow pulse adds Fuzi. All fall within modifications of Xiao Chai Hu Tang. For chronic vomiting and nausea, use Renshen, Chenpi, Banxia, Dingxiang decocted. If tonification fails and it persists, it is Damp-Heat harm; use Pingwei San (Stomach-Calming Powder).
For three-day malaria lasting half a year, use Zhusha (Cinnabar), Xuanshen (Scrophularia Root) each 1 liang, Cangzhu (Atractylodes Rhizome), Houpo (Magnolia Bark) each 4 liang, Changshan, Caoguo each 1 liang. For children unable to take medicine, use Huangdan (Lead Oxide) 5 qian, Shengfan (Alum) 3 qian, Hujiao (Pepper) 2.5 qian, Shexiang (Musk) 0.5 li. Grind to powder, mix with good vinegar, apply to left palm for males, right palm for females, wrap hand in silk. When medicine warms and induces sweat, it heals. One dose works for three people.
For persistent malaria, use dates to intercept. Formula: Dingxiang, Changshan each 1 liang, Zisu (Perilla Leaf) 2 liang, Quanxie (Scorpion) 30, Dates 100. Boil together. Strong adults eat 5-6, weak adults 3, children 1-2. Chew and take just before onset for effect.
For chronic malaria forming a mass, mash Garlic, add little Musk, apply to mass for effect in one day. Internally, boil Ma Liaodou (Horse Bean) one dou frequently.
For symptoms resembling malaria coming daily with body distension and urge to hit, it belongs to Spleen deficiency. Use Liujunzi Tang. Add Shenqu for food stagnation/belching, Danggui/Baishao for Blood deficiency (0.5 fen), Huangqi for excessive sweat (0.7 fen), Wumei/Rougui for clear phlegm vomiting (0.3 fen each), Paojiang for nausea (0.3 fen).
For non-malaria resembling malaria persisting long, or chronic dysentery with Middle Qi deficiency, use Paojiang, Fuzi, Baizhu for dozens of doses. Only when Middle Qi is sufficient will pathogens not return. If effective in 1-2 doses and stopped, the disease will relapse.
Internal injury resembling malaria, daily occurrence: Baizhu 5 qian, Dangguishen 3 qian, Chenpi 2 qian, Wumei 2 pieces, Dingxiang (male/female) 3 grains each. For deficiency, add Renshen 5 qian. Soak in one bowl cold water overnight, expose to dew until dawn, strain and warm drink.
Another formula: Baizhu 5 qian, Qingpi, Chenpi each 3 qian. Soak in cold water and expose, decoct next morning.
Case Record
One person had early-stage malaria, drank alcohol and slept, then developed fever, even becoming confused, resolving at night. Urine was red and scanty, every other day attack, chills preceding fever, vomiting phlegm-saliva, anorexia, gastric discomfort, nausea after eating, thin body, numb hands, thirst preferring hot drinks. Formula: Chaihu 0.7 fen, Yizhi (Alpinia Oxyphylla Fruit) 0.5 fen, Gancao 0.3 fen, Renshen, Guizhi, Banxia, Fuling, Qianshi (Euryale Seed) each 1 qian. Decoct and drink; effective.
One person had severe malaria for over a year, large and forceful pulse, indicating stubborn Phlegm in the Spleen. When Spirit is vigorous, Righteous Qi circulates and disease heals; when Spirit declines, Pathogenic Qi prevails and disease acts. Combine Er Chen Tang and Xiao Chai Hu Tang.