妊娠患疟，无论胎息月数多少，总以安胎为主。而世之所谓安胎，无过黄芩、白术、不知黄芩
乃治热盛胎动不宁，白术乃治脾虚胎气不固。若气虚下陷，误用黄芩；气滞壅逆，误用白术，为害何
可胜言。故善治胎产症者，必审孕妇形体之肥瘦，气血之偏盛。若形色苍，肌肉 坚者，必多湿
多痰，无论何疾，必显湿热本病，脉多滑实有力，绝无虚寒脉弱之候。可峻用豁痰理气药，治其
本质，然后兼客邪见症而为制剂。治宜二陈汤，随经加透表药，或合小柴胡用之。盖柴胡为疟疾之
向导，故多用之。然有自汗过多，尺中微弱，或热盛，手足清，始终不用柴胡，而用建中、桂、芍
收功者，或见烦渴脉实，大便六、七日不通，阳明腑实，又宜凉膈去硝、黄，加鲜首乌调之。大
抵病邪初发，元气未耗，疏风涤痰，消导饮食，在所必需。然必宜大剂白术，培护中土。以脾胃
为一身之津梁，土浓自能载物。其最可虑，在三、四发至六、七发，其势最剧，若过半月，虽淹缠
不止，邪热渐衰，可无胎陨之虞也。或有疟久，气血虚败而小产
者，此皆失于调治也。若六、七发后不止，即当和营健脾。若禀质柔脆，虽有风邪，不得纯用表
药，以风药性散，能使胎气上逆，而为呕逆、喘胀、膈塞、痞满之患。虽有实滞，不得过用降
泄之味，能引邪气下陷，致胎坠不安，而为泄利不食、小腹疼重之患矣。若疫疟毒盛势剧，急与凉膈、
承气、黄连解毒救之。瘟疟 不爽，烦热大渴，或壮热无寒，或先热后寒者，当与桂枝、
白虎、人参白虎，撤其在里之热，不可与夏、秋 疟比例而推也。盖有是症，用是药，有故无陨，
惟在速祛邪毒以救胎息之燔灼。若迟疑未决，救无及矣。又有气血虚损，其疟由虚致，不因
暑气而作，如《经》云∶阳微恶寒，阴弱发热。或风寒因虚而乘之。若寒热不已，重蒸其胎，
胎亦受伤而坠。宜轻解表邪，兼大补气血以主之。更有患胎疟者，一遇有胎，疟病即发，此人素有
肝火，遇孕则水养胎元，肝虚血燥，寒热往来，似疟非疟也。以逍遥散清肝火，养肝血，兼六味
丸以滋化源，寒热自退。余常用加减丹溪安胎饮，治孕疟甚觉稳妥，从未用截药，而孕症未尝不愈也。
加减丹溪安胎饮 治孕妇疟疾。
白术（土炒） 当归 熟地（各二钱） 川芎 条芩（各八分） 制半夏（七分） 人参（一钱）
藿香（五分） 草果 青皮（各三分） 紫苏 广皮 炙草（各四分） 乌梅（二枚） 姜（一片）
妊娠期间患疟疾，无论怀孕月份多少，治疗总以安胎为基本原则。然而世间所谓的安胎方法，不过是用黄芩和白术。殊不知黄芩是用于治疗热盛导致胎动不安的，白术是用于治疗脾虚导致胎气不固的。如果气虚下陷，误用黄芩；气滞壅逆，误用白术，其危害不可胜言。所以善于治疗胎产病症的人，必定要审察孕妇体形的肥瘦，气血的偏盛情况。如果面色苍老、肌肉坚硬的，必定多湿多痰，无论什么疾病，必然显现湿热本质，脉象多滑实有力，绝无虚寒脉弱的征候。可以峻猛使用豁痰理气的药物，治疗其本质，然后再兼顾外感邪气引起的症状来制定方剂。治疗适宜用二陈汤（燥湿化痰、理气和中的基础方），根据经络加入透表药，或者合用小柴胡汤（和解少阳的主方）使用。因为柴胡是治疗疟疾的向导药，所以多用之。但是如果有自汗过多、尺脉微弱，或者热盛、手足清冷，始终不用柴胡，而用建中汤（温中补虚）、桂枝（发散风寒、温通经脉）、白芍（养血敛阴、柔肝止痛）收功的；或者见到烦渴、脉实、大便六七天不通，属于阳明腑实证，又适宜用凉膈散（泻火通便、清上泄下）去掉芒硝、大黄，加鲜首乌（何首乌的新鲜块根，具有解毒、截疟、润肠功效）来调理。大抵病邪初发，元气未耗，疏风涤痰、消导饮食，在所必需。但必须适宜用大剂量白术，培护中土（脾胃）。因为脾胃是一身的津液输布枢纽，土气浓厚自然能承载万物。最可忧虑的是，在发作三、四次到六、七次时，病情最剧烈，如果超过半个月，虽然缠绵不止，但邪热逐渐衰减，就可以没有胎堕的危险了。或者有疟疾日久，气血虚败而导致小产的，这都是失于调治的结果。如果在六、七次发作后仍不止，就应当调和营血、健脾益气。如果禀赋体质柔弱脆嫩，虽然有风邪，不得纯用解表药，因为风药性散，能使胎气上逆，而产生呕逆、喘胀、膈塞、痞满的病患。虽然有实滞，不得过用降泄的药物，能引邪气下陷，导致胎坠不安，而产生泄利不食、小腹疼痛沉重的病患。如果是疫疟毒盛势剧，急用凉膈散、承气汤（攻下热结的主方）、黄连解毒汤（清热解毒）来救治。瘟疟（感受温热疫毒之邪所致的疟疾）不爽，烦热大渴，或者壮热无寒，或者先热后寒的，应当给予桂枝汤（解肌发表、调和营卫）、白虎汤（清热生津）、人参白虎汤（清热益气生津），撤除其在里的热邪，不可与夏秋季节的普通疟疾比例而推论。因为有这种症状，就用这种药，有病因就不会伤害胎儿，只在于迅速祛除邪毒以拯救被火热燔灼的胎息。如果迟疑不决，就来不及救治了。又有气血虚损，其疟疾由虚所致，不因暑气而发作，如《内经》所说：阳气微弱则恶寒，阴气虚弱则发热。或者是风寒因虚而乘袭人体。如果寒热不已，反复蒸灼胎儿，胎儿也会受伤而坠落。适宜轻解表邪，兼以大补气血为主治。更有患胎疟的，一遇到怀孕，疟病即发，这个人素来有肝火，遇到怀孕则阴血养胎元，导致肝虚血燥，出现寒热往来，似疟非疟。用逍遥散（疏肝解郁、养血健脾）清肝火、养肝血，兼用六味地黄丸（滋补肝肾）以滋生化之源，寒热自然消退。我常用加减丹溪安胎饮，治疗孕疟觉得很稳妥，从未用截疟药，而妊娠病症未尝不愈。
加减丹溪安胎饮 治疗孕妇疟疾。
白术（土炒） 当归 熟地黄（各二钱） 川芎 黄芩（条芩，各八分） 制半夏（七分） 人参（一钱）
藿香（五分） 草果 青皮（各三分） 紫苏 陈皮 炙甘草（各四分） 乌梅（二枚） 生姜（一片）
During pregnancy, if malaria occurs, regardless of the number of months of gestation, the primary principle is to stabilize the fetus. However, what is commonly referred to as "stabilizing the fetus" in the world involves nothing more than Huangqin (Scutellariae Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma). It is unknown that Huangqin is used to treat restless fetal movement caused by excessive heat, while Baizhu is used to treat insecure fetal qi due to Spleen deficiency. If Qi deficiency with sinking occurs, and Huangqin is mistakenly used; or if Qi stagnation with rebellion occurs, and Baizhu is mistakenly used, the harm would be incalculable. Therefore, those skilled in treating pregnancy and childbirth disorders must examine the mother's body shape (fat or thin) and the predominance of Qi and Blood. If the complexion is darkish and muscles are firm, there is likely excessive dampness and phlegm. Regardless of the disease, it will manifest as a fundamental pathology of damp-heat, with a pulse that is slippery, solid, and forceful, absolutely lacking signs of deficiency-cold and weak pulse. One can boldly use herbs that resolve phlegm and regulate Qi to treat the root cause, and then combine this with symptoms caused by external pathogens to formulate the prescription. The treatment should preferably use Erchen Tang (Two-Cured Decoction), adding exterior-releasing herbs according to the meridians, or combining it with Xiaochaihu Tang (Minor Bupleurum Decoction). This is because Chaihu (Bupleuri Radix) acts as a guide for treating malaria, so it is often used. However, if there is excessive spontaneous sweating and a weak Chi pulse, or excessive heat with cold hands and feet, Chaihu should never be used; instead, Jizhong Tang (Middle-Building Decoction), Guizhi (Cinnamomi Ramulus), and Baishao (Paeoniae Radix Alba) should be used to conclude the treatment. Or, if irritability, thirst, a solid pulse, and constipation for six or seven days occur, indicating Yangming Fu-organ excess syndrome, Liangge San (Cooling the Diaphragm Powder) without Mangxiao (Natrii Sulfas) and Dahuang (Rhei Radix et Rhizoma), plus fresh Shouwu (Polygoni Multiflori Caulis/Fresh Root), should be added for regulation. Generally, when the pathogenic factor first appears and Yuanqi (Original Qi) is not yet depleted, dispersing wind, resolving phlegm, and promoting digestion are essential. However, a large dose of Baizhu is necessary to nourish and protect the Middle Jiao (Spleen and Stomach). Since the Spleen and Stomach are the hub for fluid metabolism in the body, abundant Earth element naturally supports and carries things. The most concerning situation is between the third to fourth episode up to the sixth to seventh episode, where the condition is most severe. If it persists beyond half a month, although lingering, the pathogenic heat gradually declines, and there is no longer fear of fetal abortion. There may be cases where prolonged malaria leads to miscarriage due to exhaustion of Qi and Blood, which results from improper treatment. If after six or seven episodes the malaria does not cease, one should harmonize Ying (Nutritive) Qi and strengthen the Spleen. If the constitution is delicate and fragile, even if Wind pathogen is present, pure exterior-releasing herbs should not be used, because Wind herbs have a dispersing nature that can cause Fetal Qi to rebel upwards, leading to vomiting, wheezing, chest oppression, and fullness. Even if there is excess stagnation, overuse of descending and purgative flavors should be avoided, as they can draw pathogenic factors downward, causing fetal instability and leading to diarrhea, anorexia, and heavy pain in the lower abdomen. If epidemic malaria with intense toxicity occurs, urgently administer Liangge San, Chengqi Tang (Chengqi Decoction), or Huanglian Jiedu Tang (Coptis Decoction to Relieve Toxicity) to save the patient. For Wenmalaria (Plague Malaria) presenting with discomfort, irritability, excessive heat, and great thirst, or high fever without chills, or fever preceding chills, Gui Zhi Tang (Cinnamon Twig Decoction), Baihu Tang (White Tiger Decoction), or Renshen Baihu Tang (Ginseng White Tiger Decoction) should be given to withdraw the internal heat. This cannot be compared or deduced from ordinary summer-autumn malaria. Because there are specific symptoms, specific medicines are used; if there is a cause, there will be no damage to the fetus. The key lies in rapidly expelling pathogenic toxins to rescue the fetus from burning heat. If hesitation occurs, it will be too late to save. Furthermore, there are cases of Qi and Blood deficiency where malaria arises from deficiency, not triggered by summer heat, as stated in the Classics: "Yang deficiency leads to aversion to cold, Yin deficiency leads to fever." Or Wind-Cold takes advantage of deficiency to invade. If chills and fever persist, repeatedly steaming the fetus, the fetus will also be injured and abort. Lightly releasing exterior pathogens combined with substantial tonification of Qi and Blood should be the main treatment. There are also cases of "Fetal Malaria," where upon becoming pregnant, the malaria immediately attacks. These individuals usually have Liver Fire. Upon pregnancy, Yin blood nourishes the Fetal Source, leading to Liver deficiency and dry Blood, resulting in alternating chills and fever, resembling but not being true malaria. Xiaoyao San (Free and Easy Wanderer Powder) is used to clear Liver Fire and nourish Liver Blood, combined with Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) to nourish the source of transformation, so that chills and fever naturally subside. I frequently use Modified Danxi An Tai Yin (Modified Danxi Fetus-Stabilizing Decoction) to treat pregnant malaria, finding it very stable and effective. I have never used antimalarial/astringent herbs, yet the pregnancy condition has always healed.
Modified Danxi Fetus-Stabilizing Decoction treats maternal malaria.
Baizhu (Earth-fried) 2 qian, Danggui (Angelicae Sinensis Radix) 2 qian, Shudi (Rehmanniae Radix Preparata) 2 qian, Chuanxiong (Ligustici Chuanxiong Rhizoma) 8 fen, Tiaoqin/Huangqin (Scutellariae Radix) 8 fen, Zhibanxia (Pinelliae Rhizoma Preparatum) 7 fen, Renshen (Ginseng Radix) 1 qian, Huoxiang (Agastaches Herba) 5 fen, Caoguo (Tsaoko Fructus) 3 qian, Qingpi (Citri Reticulatae Pericarpium Viride) 3 qian, Zisu (Perillae Folium) 4 qian, Guangpi/Chenpi (Citri Reticulatae Pericarpium) 4 qian, Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata) 4 qian, Wumei (Mume Fructus) 2 pieces, Jiang/Shengjiang (Zingiberis Rhizoma Recens) 1 slice.