论曰内经谓足少阴肾疟,在经则令人呕吐甚,多寒热,热多寒少,欲闭户牖而处,其病
难已,在脏则令人洒洒然。腰脊痛宛转,大便难,目 然,手足寒,刺足太阳少阴,盖肾
脉入肺中,肺脉环胃口,故使人呕,阴虚则阳气偏,故热多,若夫酒淅腰脊痛,大便难,目
手足寒,特以脏气内虚,机关不利,故为此证也。
治肾疟令人洒洒然,腰脊痛,大便难,目 ,手足寒。乌梅丸方
乌梅肉(炒一两半) 常山(锉三分) 豉(一合炒) 桃仁(汤浸去皮尖双仁炒研一
两) 虎头骨(酥炙半两) 附子(炮裂去皮脐半两) 肉苁蓉(酒浸切焙半两) 知母(切
焙一分) 麝香(研一钱) 桂(去粗皮一分)
上一十味。捣研拌匀,炼蜜和丸,梧桐子大。每服空腹米饮下二十丸,未发时服。
治肾疟。苁蓉丸方
肉苁蓉(酒浸切焙半两) 乌梅肉(炒半两) 桃仁(汤浸去皮尖炒研三分) 常山(锉
三分) 豉(炒三分) 升麻(半两) 桂(去粗皮半两) 甘草(炙半两)
上八味,捣研和匀。炼蜜丸梧桐子大。每未发日,空腹温酒下二十丸,米饮亦得,至发
时,更服二十丸。
治肾疟。天雄丸方
天雄(炮裂去皮脐一两半) 铅丹(研三分) 人参(三分)
上三味。捣研和匀,炼蜜丸如梧桐子大。每服五丸,未发日空腹米饮下,日三五服。
治足少阴疟,呕吐寒热。人参汤方
人参 常山(锉各半两) 甘草(生锉三分) 灯心(五十茎) 陈橘皮(汤浸去白焙)
茶末(各一分)
上六味,粗捣筛,每服五钱匕,水一盏半,煎至七分去滓,入酒半盏相和,未发前顿服
,以吐为效,未吐再服。
治足少阴疟呕吐。半夏散方
半夏(汤洗去滑为末生姜汁和作饼曝干再为末) 阿魏(细研各一两)
上二味,同研匀,每服二钱匕,温酒一盏调下,未发日顿服。
治足少阴疟呕吐。半夏散方
半夏(汤洗去滑生姜汁制焙) 干姜(炮各半两) 绿矾(研一钱)
上三味。捣研和匀,每服半钱匕,未发日,以醋汤调下。
论述说:《内经》记载足少阴肾疟,在经络层面会导致人剧烈呕吐,伴有严重的寒热交替症状,其中发热多于恶寒,患者想要关闭门窗独处;这种病情难以治愈。在脏腑层面,则使人感到寒冷战栗。腰部及脊柱疼痛且转动困难,大便排泄困难,眼睛昏花不明,手足冰冷。治疗应针刺足太阳经和足少阴经的穴位。这是因为肾脉进入肺中,肺脉环绕胃的胃口部位,所以导致人呕吐;阴气虚弱则阳气偏盛,所以发热较多。至于那些如酒渍般寒冷的腰脊痛、大便难、眼睛昏花、手足寒等症状,仅仅是因为脏气内部虚弱,关节机关运行不利,从而产生这些证候。
治疗肾疟引起的寒冷战栗、腰脊痛、大便难、眼睛昏花、手足寒。乌梅丸方:
乌梅肉(炒制一两半)、常山(锉碎三分)、豆豉(一合,炒制)、桃仁(热水浸泡去皮尖及双仁,炒制后研磨一两)、虎头骨(用酥油炙烤半两)、附子(炮裂,去皮脐半两)、肉苁蓉(酒浸切块焙干半两)、知母(切块焙干一分)、麝香(研细一钱)、桂枝(去除粗皮一分)。
以上十味药。捣碎研磨均匀,用炼蜜调和制成丸剂,大小如梧桐子。每次空腹时米汤送服二十丸,在发作前服用。
治疗肾疟。苁蓉丸方:
肉苁蓉(酒浸切块焙干半两)、乌梅肉(炒制半两)、桃仁(热水浸泡去皮尖,炒制后研磨三分)、常山(锉碎三分)、豆豉(炒制三分)、升麻(半两)、桂枝(去除粗皮半两)、甘草(炙制半两)。
以上八味药,捣碎研磨混合均匀。用炼蜜制成梧桐子大小的丸剂。每次在发作日前,空腹用温酒送服二十丸,米汤也可以,到了发作时,再服用二十丸。
治疗肾疟。天雄丸方:
天雄(炮裂,去皮脐一两半)、铅丹(研细三分)、人参(三分)。
以上三味药。捣碎研磨混合均匀,用炼蜜制成梧桐子大小的丸剂。每次服用五丸,在发作日前空腹用米汤送服,每天服用三到五次。
治疗足少阴疟疾,呕吐寒热。人参汤方:
人参、常山(锉碎各半两)、甘草(生锉三分)、灯心草(五十茎)、陈皮(热水浸泡去除白色部分焙干)、茶末(各一分)。
以上六味药,粗捣筛过,每次取五钱匕,加水一盏半,煎煮至七分,去渣滓,加入半盏酒混合,在发作前一次性服用,以出现呕吐为见效,若未呕吐可再次服用。
治疗足少阴疟疾呕吐。半夏散方:
半夏(热水洗去滑腻,研为末,用生姜汁调和做成饼状晒干后再研为末)、阿魏(细研各一两)。
以上两味药,共同研磨均匀,每次服用二钱匕,用一盏温酒调服,在发作日一次性服用。
治疗足少阴疟疾呕吐。半夏散方:
半夏(热水洗去滑腻,生姜汁制后焙干)、干姜(炮制各半两)、绿矾(研细一钱)。
以上三味药。捣碎研磨混合均匀,每次服用半钱匕,在发作日,用醋汤调服。
Discussion: The *Neijing* (Classic of Internal Medicine) states that Shaoyin Kidney Malaria (*Shao Yin Shen Nie*), when affecting the meridians, causes severe vomiting and significant chills and fever, with heat predominating over cold. Patients desire to stay in closed rooms away from light and air; this condition is difficult to cure. When affecting the zang organs, it causes shivering and aversion to cold. Symptoms include pain in the lower back and spine with difficulty turning, difficult defecation, blurred vision, and cold hands and feet. Treatment involves needling points on the Foot-Taiyang Bladder meridian and Foot-Shaoyin Kidney meridian. This is because the Kidney meridian enters the Lung, and the Lung meridian circles the stomach opening; thus, vomiting occurs. Yin deficiency leads to Yang hyperactivity, resulting in more heat. As for the symptoms of coldness like wine soaking in the lower back and spine, difficult defecation, blurred vision, and cold extremities, these are specifically due to internal deficiency of organ qi and dysfunction of the joints/mechanisms, giving rise to these syndromes.
To treat Shaoyin Kidney Malaria presenting with shivering, lower back and spinal pain, difficult defecation, blurred vision, and cold hands and feet. Wu Mei Wan Formula:
Wumei flesh (Stir-fried 1 liang 5 qian), Changshan (Crushed 3 fen), Chishao/Douchi (1 he, stir-fried), Tao Ren (Soaked in hot water, skin and pointed ends removed, twin kernels discarded, stir-fried and ground 1 liang), Hutou Gu (Roasted with butter 0.5 liang), Fuzi (Pao-processed, skin and navel removed 0.5 liang), Roushoucong (Soaked in wine, sliced and dried 0.5 liang), Zhi Mu (Sliced and dried 1 fen), Shexiang (Ground 1 qian), Guizhi (Bark removed 1 fen).
The above ten ingredients are crushed, ground, and mixed uniformly. Honey is refined and used to bind the powder into pills the size of Sophora seeds (*Sophorae Semen*). Take 20 pills orally with rice decoction on an empty stomach before the onset of symptoms.
To treat Shaoyin Kidney Malaria. Congrong Wan Formula:
Roushoucong (Soaked in wine, sliced and dried 0.5 liang), Wumei flesh (Stir-fried 0.5 liang), Tao Ren (Soaked in hot water, skin and pointed ends removed, stir-fried and ground 3 fen), Changshan (Crushed 3 fen), Douchi (Stir-fried 3 fen), Shengma (0.5 liang), Guizhi (Bark removed 0.5 liang), Gancao (Honey-roasted 0.5 liang).
The above eight ingredients are crushed, ground, and mixed uniformly. Honey is refined and used to bind the powder into pills the size of Sophora seeds. On the day before the expected attack, take 20 pills orally with warm wine on an empty stomach; rice decoction is also acceptable. At the time of the attack, take another 20 pills.
To treat Shaoyin Kidney Malaria. Tianxiong Wan Formula:
Tianxiong (Pao-processed, skin and navel removed 1 liang 5 qian), Qiandan (Ground 3 fen), Renshen (3 fen).
The above three ingredients are crushed, ground, and mixed uniformly. Honey is refined and used to bind the powder into pills the size of Sophora seeds. Take 5 pills orally with rice decoction on an empty stomach on the day before the attack, 3 to 5 times a day.
To treat Foot-Shaoyin Malaria with vomiting and chills/fever. Renshen Tang Formula:
Renshen, Changshan (Crushed, each 0.5 liang), Gancao (Raw, crushed 3 fen), Dengxin (50 stems), Chenpi (Soaked in hot water, white pith removed, dried), Chamomile/Tea end (each 1 fen).
The above six ingredients are coarsely crushed and sifted. Take 5 qian-bi per dose, add 1.5 cups of water, decoct until 0.7 cup remains, strain, mix with 0.5 cup of wine, and take all at once before the onset. Vomiting indicates efficacy; if no vomiting occurs, administer again.
To treat Foot-Shaoyin Malaria with vomiting. Banxia San Formula:
Banxia (Washed in hot water to remove slipperiness, ground to powder, mixed with fresh ginger juice to form cakes, sun-dried, then ground to powder), Aswei (Finely ground, each 1 liang).
The above two ingredients are ground together uniformly. Take 2 qian-bi per dose, mix with 1 cup of warm wine, and take all at once on the day before the attack.
To treat Foot-Shaoyin Malaria with vomiting. Banxia San Formula:
Banxia (Washed in hot water to remove slipperiness, processed with fresh ginger juice and dried), Ganjiang (Pao-processed, each 0.5 liang), Lvfan (Ground 1 qian).
The above three ingredients are crushed, ground, and mixed uniformly. Take 0.5 qian-bi per dose, mix with vinegar-infused water, and take on the day before the attack.