论曰足太阳疟之状,内经谓令人腰痛头重,寒从背起,先寒后热, 然。热止汗
出难已,刺 中出血,盖膀胱经下抵腰中,上巅络脑,故腰痛头重,寒从背起也。经虚受邪
,故先寒后热也。热止汗出难已,以真气不胜邪故也。
治足太阳疟寒热。柴胡汤方
柴胡(去苗) 常山(锉) 鳖甲(去裙 醋炙令黄色) 知母(焙) 青蒿(干者) 甘
草(炙锉) 枳壳(去瓤
上八味,粗捣筛,每服三钱匕,水一盏,入柳枝心七枚,葱白二寸细切,同煎至七分去
滓,空腹温服,发前再服。
治足太阳疟,腰痛头重,寒热互作。酒煎饮方
常山(一两) 鳖甲(去裙 醋炙令黄一两) 知母(三分) 白头翁(三分) 桂(去
粗皮半两) 青蒿(一握) 甘草(生三分) 桃李枝头心(各七枚) 葱薤(白各七茎)
柴胡(去苗三分)
上一十二味。细锉如麻豆大,每服五钱匕,以酒一盏半,浸一宿,平旦煎取一盏去滓,
空腹顿服,当吐痰出,再煎滓服。
治足太阳疟,腰痛头重,寒多热少。柴胡桂姜汤方
柴胡(去苗八两) 桂枝(去粗皮二两) 黄芩(去黑心三两) 栝蒌根(四两) 牡
蛎(熬) 甘草(炙) 干
上七味 咀,每服五钱匕,水二盏,煎至一盏,去滓温服日三,初服微烦,汗出愈。
治足太阳疟。牡蛎汤方
牡蛎(熬四两) 麻黄(去根节煎掠去沫焙四两) 甘草(炙二两) 蜀漆(三两若无
常山代之)
上四味。 咀,每用五钱匕,水二盏,煎至一盏,去滓温服,若吐勿更服。
论述说:足太阳疟疾的症状表现,在《内经》中记载为使人腰痛、头重,寒气从背部升起,先出现寒战随后发热,并且发热时伴有烦躁不安。热退后出汗难以停止,治疗应针刺委中穴出血。这是因为膀胱经向下抵至腰部中间,向上到达头顶并联络脑部,所以会出现腰痛和头重,寒气从背部升起的症状。由于经脉虚弱而受邪气侵袭,所以先寒后热。热退后出汗难以停止,是因为真气不能战胜邪气所致。
治疗足太阳疟疾寒热往来的柴胡汤方:
柴胡(去除苗),常山(切碎),鳖甲(去除裙边,用醋炙烤至黄色),知母(焙干),青蒿(干燥者),甘草(炙烤后切碎),枳壳(去除瓤)。
以上八味药,粗捣筛过,每次服用三钱匕,用水一盏,加入柳枝心七枚,葱白二寸细切,一同煎煮至七分,去渣,空腹温服,发作前再服一次。
治疗足太阳疟疾,腰痛头重,寒热交替发作的酒煎饮方:
常山(一两),鳖甲(去除裙边,用醋炙烤至黄色一两),知母(三分),白头翁(三分),桂(去除粗皮半两),青蒿(一握),甘草(生用三分),桃李枝头心(各七枚),葱薤(葱白和薤白各七茎),柴胡(去除苗三分)。
以上十二味药。细切如麻豆大小,每次服用五钱匕,用酒一盏半,浸泡一夜,清晨煎取一盏,去渣,空腹顿服,应当吐出痰液,再将药渣煎服。
治疗足太阳疟疾,腰痛头重,寒多热少。柴胡桂姜汤方:
柴胡(去除苗八两),桂枝(去除粗皮二两),黄芩(去除黑心三两),栝蒌根(四两),牡蛎(熬制),甘草(炙烤),干姜(未列出具体用量,依原文结构推断为药材之一,但原文此处缺失具体剂量描述,仅列名,按原文翻译为“干姜”)。
以上七味药,咬碎,每次服用五钱匕,用水二盏,煎至一盏,去渣温服,每日三次,初服时轻微烦躁,出汗后痊愈。
治疗足太阳疟疾。牡蛎汤方:
牡蛎(熬制四两),麻黄(去除根节,煎煮掠去浮沫,焙干四两),甘草(炙烤二两),蜀漆(三两,如果没有可用常山代替)。
以上四味药。咬碎,每次用五钱匕,用水二盏,煎至一盏,去渣温服,如果呕吐则不要继续服用。
Commentary states: The manifestations of Taiyang malaria are described in the *Neijing* as causing lower back pain, heaviness of the head, cold sensation arising from the back, preceded by chills followed by fever, accompanied by irritability. After the fever subsides, sweating is difficult to stop; treatment involves pricking the Weizhong (BL40) acupoint to bleed. This is because the Bladder Meridian descends to the middle of the waist, ascends to the vertex, and connects with the brain; thus, lower back pain, head heaviness, and cold arising from the back occur. Due to meridian deficiency allowing pathogenic factors to invade, chills precede fever. The difficulty in stopping sweating after fever subsides is due to the True Qi being unable to overcome the pathogenic factors.
Chaihu Decoction for treating Taiyang malaria with alternating chills and fever:
Chaihu (Radix Bupleuri, remove seedlings), Changshan (Cortex Dichroae, cut into pieces), Biejia (Carapax et Plastrum Testudinis, remove skirt edge, stir-fry with vinegar until yellow), Zhimu (Rhizoma Anemarrhenae, roast), Qinghao (Herba Artemisiae Annuae, dried), Gancao (Radix Glycyrrhizae, stir-fry and cut into pieces), Zhike (Pericarpium Citri Reticulatae, remove pulp).
The above eight ingredients are coarsely crushed and sieved. Each dose consists of 3 qianbi (approx. 9-15g depending on historical standard, here kept as unit), boiled in one zhan (approx. 200ml) of water, with seven willow branch hearts and two cun (approx. 6cm) of scallion white finely cut. Simmer together until reduced to 7/10 volume, strain, and take warm on an empty stomach. Take another dose before the onset of symptoms.
Jiu Jian Yin (Wine-Decoction Drink) for treating Taiyang malaria with lower back pain, head heaviness, and alternating chills and fever:
Changshan (Cortex Dichroae, 1 liang), Biejia (Carapax et Plastrum Testudinis, remove skirt edge, stir-fry with vinegar until yellow, 1 liang), Zhimu (Rhizoma Anemarrhenae, 3 fen), Baitouweng (Radix Pulsatillae, 3 fen), Gui (Cortex Cinnamomi, remove rough bark, 0.5 liang), Qinghao (Herba Artemisiae Annuae, one handful), Gancao (Radix Glycyrrhizae, raw, 3 fen), Taoli Zhitou Xin (Hearts of peach and plum branches, each 7 pieces), Congxie (Scallion white and Rhizoma Allii Macrostemonis, each 7 stems), Chaihu (Radix Bupleuri, remove seedlings, 3 fen).
The above twelve ingredients are finely cut to the size of hemp seeds. Each dose consists of 5 qianbi, soaked overnight in 1.5 zhan of wine. In the morning, simmer to obtain one zhan, strain, and take all at once on an empty stomach. Phlegm should be vomited out. The dregs can be re-decocted and taken.
Chaihu Guijiang Tang (Bupleurum and Cinnamon Twig Decoction) for treating Taiyang malaria with lower back pain, head heaviness, more chills than fever:
Chaihu (Radix Bupleuri, remove seedlings, 8 liang), Guizhi (Ramulus Cinnamomi, remove rough bark, 2 liang), Huangqin (Radix Scutellariae, remove black heart, 3 liang), Gualougen (Radix Trichosanthis, 4 liang), Muli (Concha Ostreae, calcined), Gancao (Radix Glycyrrhizae, stir-fried), Ganjiang (Rhizoma Zingiberis, quantity omitted in source text but listed as ingredient).
The above seven ingredients are chewed/crushed. Each dose consists of 5 qianbi, boiled in two zhan of water until reduced to one zhan. Strain and take warm, three times daily. Mild irritability upon initial administration indicates the onset of cure through sweating.
Muli Tang (Oyster Shell Decoction) for treating Taiyang malaria:
Muli (Concha Ostreae, calcined, 4 liang), Mahuang (Herba Ephedrae, remove root joints, boil and skim foam, roast, 4 liang), Gancao (Radix Glycyrrhizae, stir-fried, 2 liang), Shuqi (Herba Perillae frutescentis var. crispae or similar, 3 liang; if unavailable, substitute with Changshan).
The above four ingredients are crushed. Each dose consists of 5 qianbi, boiled in two zhan of water until reduced to one zhan. Strain and take warm. If vomiting occurs, do not continue administration.