《巢氏病源》 疟候∶夫 疟者,夏伤于暑也。其病秋则寒甚,冬则寒轻,春则恶风,夏则多汗。然其蓄作
有时。以疟之始发,先起于毫毛,伸欠乃作,寒栗鼓颔,腰脊痛,寒去则外内皆热,头痛而渴欲饮。何气使然?
此阴阳上下交争,虚实更作,阴阳相移也。阳并于阴,则阴实阳虚。阳明虚则寒栗鼓颔,巨阳虚则腰背头项痛。
三阳俱虚阴气胜,胜则骨寒而痛,寒生于内,故中外皆寒。阳盛则外热,阴虚则内热,内外皆热,则喘而渴欲
饮。此得之夏伤于暑,热气盛,藏之于皮肤之内、肠胃之外,此荣气之所舍,此令汗出空疏,腠理开,因得秋
风,汗出遇风乃得之。及以浴,水气舍于皮肤之内,卫气并居。卫气者,昼日行阳,此气得阳如出;得阴如内
搏,是以日作。其间日而作者,谓其气之舍。泻内搏于阴,阳气独发,阴邪内着,阴与阳争不得出,是以同日而作。
《千金》常山丸 治大人、小儿 疟,说不可具方。
常山 知母 甘草(炙) 大黄(各三分) 麻黄(去根节,一两)
上五味末之,蜜和丸如梧子大,五丸。小儿黍米大三丸,熟水下,渐加至五丸,服瘥为度。(与寒多于热门中《活
人书》祛邪丸,方味都同而分两不同。)
《千金》治大人、小儿肺热,痰聚胸中,来去不定转为疟。其状令人心寒,寒甚则发热,热间则善惊,如有所见
者。常山汤方
常山(三两) 秫米(三百二十粒) 甘草(半两)
上三味 咀,每服三指撮。水一盏,煎至五分,发时连服三服。一法,前件药水七升,煮取三升。分三服,
至发时令三服尽。儿小者,服一合、二合。
《活人书》治疟疾先寒后热,兼治支结。
柴胡(八两) 人参(炙) 半夏(浸七次,切) 黄芩 桂(去皮。以上各三两)
上锉如麻豆大,每服抄五钱匕。水一盏半,姜七片、枣二个,煎至八分去滓。取六厘清汁温服,日三、夜
二。若渴,去半夏加人参、栝蒌根同煎服。
《巢氏病源》疟疾候:所谓疟疾,是因为夏季感受了暑邪。其病症表现为:秋季发作时寒战严重,冬季发作时寒战较轻,春季发作时怕风,夏季发作时多汗。然而,它的发作和休止是有固定时间的。在疟疾刚开始发作时,首先感觉毫毛竖立,接着打哈欠,随后出现寒战、下巴颤抖,腰部脊柱疼痛;当寒气退去后,体内体外都发热,头痛且口渴想喝水。是什么气导致这种情况呢?这是因为阴阳之气上下交争,虚实交替变化,阴阳相互转移所致。阳气并入阴分,则阴实而阳虚。阳明经虚弱则出现寒战、下巴颤抖;巨阳(太阳)经虚弱则腰背头项疼痛。如果三阳经都虚弱,阴气亢盛,阴胜则骨髓寒冷而疼痛,寒气从内而生,所以内外皆寒。阳气亢盛则体表发热,阴液亏虚则体内发热,内外都热,就会气喘且口渴想喝水。这种病是由于夏季感受暑邪,热气旺盛,潜伏在皮肤之内、肠胃之外,这是营气所居之处。此时毛孔开泄,腠理疏松,因而容易受到秋风侵袭,出汗时遇风便得了此病。以及洗澡时,水气停留在皮肤之内,卫气与之并存。卫气白天行于阳分,此邪气遇到阳气就像外出一样;遇到阴气就像向内搏击一样,所以每天发作。如果是隔日发作的,是说邪气潜伏较深,向内搏击于阴分,阳气单独发越,阴邪内着,阴与阳相争不能外出,所以是隔天发作。
《千金方》常山丸:治疗成人、小儿疟疾,具体说明无法详尽列出药方。
药材组成:常山、知母、甘草(炙)、大黄(各三分),麻黄(去根节,一两)。
制法用法:以上五味药研成末,用蜂蜜调和制成梧桐子大小的丸剂,每次服五丸。小儿服用如黍米大小的三丸,用温水送下,逐渐增加至五丸,以病愈为度。(此方与《活人书》祛邪丸在寒多热少的门类中,药物组成完全相同,但剂量不同。)
《千金方》治疗成人、小儿肺热,痰聚积在胸中,来去不定转为疟疾。其症状使人心中感到寒冷,寒甚则发热,热退后容易惊悸,好像看到了什么幻象。常山汤方:
药材组成:常山(三两),秫米(三百二十粒),甘草(半两)。
制法用法:以上三味药切碎,每次取三指撮的药量。用水一盏,煎至五分,在疟疾发作时连续服用三次。另一种方法:前件药水七升,煮取三升。分三次服用,到发作时让患者将三次药服完。幼儿小的,服用一合或二合。
《活人书》治疗疟疾先寒后热,兼治支结证。
药材组成:柴胡(八两),人参(炙),半夏(浸七次,切),黄芩,桂枝(去皮。以上各三两)。
制法用法:锉碎如麻豆大小,每次取五钱匕的药量。用水一盏半,生姜七片、大枣二个,煎至八分,去渣。取六厘清汁温服,每日三次,夜间两次。如果口渴,去掉半夏,加入人参、天花粉同煎服用。
*Chao Shi Bing Yuan* (Source of Diseases by Chao Yuanfang), Malaria Syndrome: The so-called malaria is caused by contracting summer-heat in summer. Its manifestations are as follows: chills are severe when occurring in autumn, mild when in winter, aversion to wind when in spring, and profuse sweating when in summer. However, its paroxysms have a regular schedule. At the onset of malaria, one first feels the hair standing on end, followed by yawning, then chills with trembling of the jaw, pain in the waist and spine; after the cold subsides, both interior and exterior become hot, accompanied by headache and thirst with desire to drink. What qi causes this? This is due to the contention between yin and yang above and below, alternating deficiency and excess, and the shifting of yin and yang. When yang merges into yin, yin becomes full and yang becomes deficient. Deficiency of Yangming channel leads to chills and jaw trembling; deficiency of Juyang (Taiyang) channel leads to pain in the waist, back, head, and neck. If all three yang channels are deficient, yin qi prevails; predominance of yin causes coldness and pain in the bones, with cold generating from within, hence both interior and exterior are cold. Excess of yang leads to external heat, while deficiency of yin fluid leads to internal heat; when both interior and exterior are hot, it results in panting and thirst with desire to drink. This disease arises from summer-heat contracted in summer, where pathogenic heat is abundant and hides inside the skin but outside the stomach and intestines, which is the abode of Ying Qi (Nutritive Qi). At this time, pores are open and interstices loose, making one susceptible to autumn wind; getting wet with sweat and exposed to wind leads to the disease. Similarly, during bathing, water qi stays within the skin, coexisting with Wei Qi (Defensive Qi). Wei Qi travels through the yang channels during the day; when this pathogen encounters yang, it acts like going out; when encountering yin, it acts like attacking inward, thus causing daily paroxysms. In cases of every-other-day paroxysms, it is because the pathogen resides deeply, attacking inwardly into yin, while yang qi alone flares up, and yin pathogen adheres internally. Yin and yang contend but cannot exit, thus causing every-other-day paroxysms.
Qianjin Fang Changshan Wan: Treats malaria in adults and children. Detailed prescription instructions are not fully listed here.
Ingredients: Changshan (Dichroa Root), Zhi Mu (Anemarrhenae Rhizoma), Gancao (Licorice Root, honey-fried), Dahuang (Rhubarb Root and Rhizome) (each 3 fen); Mahuang (Ephedrae Herba, roots and joints removed, 1 liang).
Preparation and Administration: Powder the above five herbs, mix with honey to form pills the size of wu zi (Cibotii Semen), each pill being large as a wu zi. Take 5 pills. For children, take 3 pills the size of shu mi (Sorghum Grain), administered with warm water. Gradually increase to 5 pills, continuing until the disease resolves. (This formula has the same ingredients as the Quxie Wan in Huoren Shu under the category of "more chills than fever," but differs in dosage.)
Qianjin Fang treats lung heat in adults and children, where phlegm accumulates in the chest, coming and going unpredictably and transforming into malaria. Symptoms include a sensation of cold in the heart, severe chills leading to fever, and palpitations or fright after the fever subsides, with visual hallucinations. Changshan Tang Formula:
Ingredients: Changshan (Dichroa Root, 3 liang), Shumi (Sorghum Grain, 320 grains), Gancao (Licorice Root, 0.5 liang).
Preparation and Administration: Coarsely crush the above three herbs. Each dose consists of an amount held between three fingers. Add one cup of water, decoct until reduced to two-fifths of the original volume. Administer continuously for three doses at the time of paroxysm. Another method: Decoct seven cups of water with the aforementioned herbs to obtain three cups. Divide into three doses; ensure all three doses are consumed by the time of the paroxysm. For small children, administer one he or two he.
Huoren Shu treats malaria characterized by initial chills followed by fever, and also treats Zhijie syndrome (constraint and knotting).
Ingredients: Chaihu (Bupleuri Radix, 8 liang), Renshen (Ginseng Radix et Rhizoma, honey-fried), Banxia (Pinelliae Rhizoma, soaked seven times and sliced), Huangqin (Scutellariae Radix), Guizhi (Cinnamomi Ramulus, bark removed) (the above four each 3 liang).
Preparation and Administration: Cut into pieces the size of hemp seeds. Each dose takes five qian bi (a measure using a five-qian spoon). Add one and a half cups of water, seven slices of fresh ginger, and two jujubes. Decoct until reduced to eight-tenths, strain. Take six li of the clear liquid, warm, three times daily and twice at night. If there is thirst, remove Banxia and add Ren Shen and Gualougen (Trichosanthis Radix) to decoct together.