《全生指迷》论曰∶寒热之病,或寒已而热,或热已而寒。若寒热战栗,头痛如破,身体拘急,数欠、渴欲
饮冷。或先寒而后热,或先热而后寒,或 时而发,或间日而作,至其时便发,发已即如常,此谓之疟。疟脉
自弦,弦数多热;弦迟多寒。此皆得之于冬中风寒之气,藏于骨髓之中,至春阳气大发,邪气不能自出,因遇
大暑,而后与邪气相合而发。热多者,宜解之,与常山汤、栝蒌汤。(方在后。)
《全生指迷》常山汤
常山 知母 甘草(炙。各三两) 麻黄(去节,一两)
上为粗散。每服五钱,水二盏,煎至一盏,去滓。温服,以糜粥一杯,助取汗为度。
《全生指迷》栝蒌汤
栝蒌根(四两) 柴胡(去苗,八两) 人参 黄芩 甘草(炙。各三两)
上为粗末,每服五钱。水二盏,生姜三片、枣一个掰破,煎至一盏,去滓温服。
《全生指迷》论曰∶寒热之病,或寒已而热,或热已而寒。若寒热战栗,头痛如破,身体拘急,数欠、渴欲
饮冷。或先寒而后热,或先热而后寒,或 时而发,或间日而作,至其时便发,发已即如常,此谓之疟。疟脉自
弦,弦数多热,弦迟多寒。此皆得之于冬中风寒之气,寒气藏于骨髓之中,至春阳气大发,邪气不得自出,
因遇大暑,而后与邪气相合而发。寒多者,宜温之,与姜桂汤(方在后)。
《全生指迷》姜桂汤方
干姜 牡蛎(火 通赤) 甘草(炙。各二两) 桂(去皮取心,三两) 柴胡(八两,去苗) 栝
篓根(四两) 黄芩(二两,酒炙尽,用三两)
上为粗末。每服五钱,水二盏,煎至一盏,去滓。温服,不计时候。
《活人书》治疟疾脉浮大,寒热往来,用此吐之。卫州书云∶疟寒多热少者,痰多也。然寒多热少而脉浮,则痰
无疑矣,可吐之也。若脉迟微者,恶寒疟耳,宜柴胡、桂、姜也。祛邪丸方
麻黄(四两,去节,汤泡一、二沸,焙干,秤) 常山 甘草(炙) 大黄 知母(各三两)
上捣,罗为末,炼蜜为丸如梧子大。每服十五丸。面东清净水吞下。(与寒而后热门中《千金》常山
丸。味数同而分两不同。)
《全生指迷》论述道:寒热交替的疾病,有时是寒冷过后出现发热,有时是发热过后出现寒冷。如果伴有寒战发抖、头痛剧烈如破裂感、身体拘挛紧迫、频繁打哈欠、口渴想喝冷水。或者先发冷后发热,或先发冷后发热,或定时发作,或隔日发作,到了那个时间就发作,发作完后就像常人一样,这叫做疟疾(Malaria)。疟疾的脉象自然呈现弦脉(Xian pulse, 端直以长,如按琴弦),脉数(Shu pulse, 一息五至以上)表示多热;脉迟(Chi pulse, 一息不足四至)表示多寒。这些病症都是因为冬天感受了风寒之气,邪气藏在骨髓之中,到了春天阳气大发,邪气不能自行排出,又遇到大暑天气,而后与邪气相合而发作。热多者,适宜用解表法治疗,给予常山汤(Changshan Tang)、栝蒌汤(Gualou Tang)。(方剂在后面。)
《全生指迷》常山汤
常山(Changshan, Dichroae Radix) 知母(Zhimu, Anemarrhenae Rhizoma) 甘草(炙甘草,Gancao, Glycyrrhizae Radix et Rhizoma,蜜炙。各三两) 麻黄(去节,Mahuang, Ephedrae Herba,一两)
将上述药材捣成粗散。每次服用五钱,加水二盏,煎煮至一盏,滤去药渣。温服,并喝一杯稀粥,以帮助发汗为度。
《全生指迷》栝蒌汤
栝蒌根(Gualougen, Trichosanthis Radix,四两) 柴胡(Chaihu, Bupleuri Radix,去苗,八两) 人参(Renshen, Ginseng Radix) 黄芩(Huangqin, Scutellariae Radix) 甘草(炙甘草,Gancao, Glycyrrhizae Radix et Rhizoma,蜜炙。各三两)
将上述药材捣成粗末,每次服用五钱。加水二盏,生姜三片、枣一个掰破,煎煮至一盏,滤去药渣温服。
《全生指迷》论述道:寒热交替的疾病,有时是寒冷过后出现发热,有时是发热过后出现寒冷。如果伴有寒战发抖、头痛剧烈如破裂感、身体拘挛紧迫、频繁打哈欠、口渴想喝冷水。或者先发冷后发热,或先发冷后发热,或定时发作,或隔日发作,到了那个时间就发作,发作完后就像常人一样,这叫做疟疾。疟疾的脉象自然呈现弦脉,脉数表示多热,脉迟表示多寒。这些病症都是因为冬天感受了风寒之气,寒气藏在骨髓之中,到了春天阳气大发,邪气不得自行排出,又遇到大暑天气,而后与邪气相合而发作。寒多者,适宜用温里法治疗,给予姜桂汤(Jianggui Tang)。(方剂在后面。)
《全生指迷》姜桂汤方
干姜(Ganjiang, Zingiberis Rhizoma) 牡蛎(Muli, Ostreae Concha,火煅至通红) 甘草(炙甘草,Gancao, Glycyrrhizae Radix et Rhizoma,蜜炙。各二两) 桂枝(Guizhi, Cinnamomi Ramulus,去皮取心,三两) 柴胡(Chaihu, Bupleuri Radix,八两,去苗) 栝楼根(Gualougen, Trichosanthis Radix,四两) 黄芩(Huangqin, Scutellariae Radix,二两,酒炙尽,用三两)
将上述药材捣成粗末。每次服用五钱,加水二盏,煎煮至一盏,滤去药渣。温服,不拘时候。
《活人书》治疗疟疾脉象浮大,寒热往来,用此法催吐。卫州的书说:疟疾寒多热少的,是痰多所致。然而寒多热少且脉浮,则无疑是痰证,可以催吐。如果脉象迟微,则是恶寒疟,适宜用柴胡、桂枝、干姜等药物。祛邪丸方
麻黄(Mahuang, Ephedrae Herba,四两,去节,热水浸泡一两次沸腾,焙干,称重) 常山(Changshan, Dichroae Radix) 甘草(炙甘草,Gancao, Glycyrrhizae Radix et Rhizoma,蜜炙) 大黄(Dahuang, Rhei Radix et Rhizoma) 知母(Zhimu, Anemarrhenae Rhizoma,各三两)
将上述药材捣碎,过筛为细末,炼蜜制成梧桐子大小的丸剂。每次服用十五丸。面向东方,用清净水送下。(与寒而后热门中的《千金方》常山丸相比,药味数量相同但剂量不同。)
Quan Sheng Zhi Mi (Guide to the Mystery of Complete Life) states: Diseases involving alternating cold and heat may present as cold followed by heat, or heat followed by cold. If accompanied by chills and tremors, severe headache as if splitting, bodily stiffness and tightness, frequent yawning, and thirst with a desire to drink cold fluids, it indicates a specific pattern. Whether the cold precedes the heat, or the heat precedes the cold; whether it occurs at fixed intervals or every other day, manifesting precisely at the appointed time and resolving to normalcy afterward, this is termed Malaria (Nue). The pulse in Malaria is naturally Xian (String-like); a Shu (Rapid) pulse indicates excess Heat, while a Chi (Slow) pulse indicates excess Cold. These conditions arise from Wind-Cold pathogens contracted in winter, which hide within the Marrow. When Yang Qi flourishes in spring, the pathogenic factor cannot exit spontaneously. Upon encountering intense summer heat, it combines with the pathogen to manifest. For cases with more Heat, resolution via diaphoresis is appropriate, using Changshan Tang (Dichroa Decoction) or Gualou Tang (Trichosanthes Root Decoction). (Prescriptions follow below.)
Quan Sheng Zhi Mi Changshan Tang (Dichroa Decoction)
Changshan (Dichroae Radix), Zhimu (Anemarrhenae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, each 3 liang), Mahuang (Ephedrae Herba, nodes removed, 1 liang).
Grind into coarse powder. Take 5 qian per dose, add 2 zhan of water, decoct until 1 zhan remains, strain, and take warm. Drink one cup of millet porridge to assist sweating.
Quan Sheng Zhi Mi Gualou Tang (Trichosanthes Root Decoction)
Gualougen (Trichosanthis Radix, 4 liang), Chaihu (Bupleuri Radix, remove seedlings, 8 liang), Renshen (Ginseng Radix), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, each 3 liang).
Grind into coarse powder. Take 5 qian per dose, add 2 zhan of water, 3 slices of fresh ginger, and one broken jujube. Decoct until 1 zhan remains, strain, and take warm.
Quan Sheng Zhi Mi states: Diseases involving alternating cold and heat may present as cold followed by heat, or heat followed by cold. If accompanied by chills and tremors, severe headache as if splitting, bodily stiffness and tightness, frequent yawning, and thirst with a desire to drink cold fluids, it indicates a specific pattern. Whether the cold precedes the heat, or the heat precedes the cold; whether it occurs at fixed intervals or every other day, manifesting precisely at the appointed time and resolving to normalcy afterward, this is termed Malaria. The pulse in Malaria is naturally Xian (String-like); a Shu (Rapid) pulse indicates excess Heat, while a Chi (Slow) pulse indicates excess Cold. These conditions arise from Wind-Cold pathogens contracted in winter, where Cold Qi hides within the Marrow. When Yang Qi flourishes in spring, the pathogenic factor cannot exit spontaneously. Upon encountering intense summer heat, it combines with the pathogen to manifest. For cases with more Cold, warming therapy is appropriate, using Jianggui Tang (Ginger and Cinnamon Decoction). (Prescription follows below.)
Quan Sheng Zhi Mi Jianggui Tang (Ginger and Cinnamon Decoction)
Ganjiang (Zingiberis Rhizoma), Muli (Ostreae Concha, calcined until red-hot), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried, each 2 liang), Guizhi (Cinnamomi Ramulus, bark removed, heartwood taken, 3 liang), Chaihu (Bupleuri Radix, 8 liang, remove seedlings), Gualougen (Trichosanthis Radix, 4 liang), Huangqin (Scutellariae Radix, 2 liang, wine-fried completely, use 3 liang).
Grind into coarse powder. Take 5 qian per dose, add 2 zhan of water, decoct until 1 zhan remains, strain, and take warm. Time of administration is not restricted.
Huoren Shu (Book of Vitality) treats Malaria with a floating and large pulse, alternating cold and heat, using emesis. Books from Weizhou state that Malaria with more cold than heat is due to excessive Phlegm. However, if there is more cold than heat and a floating pulse, Phlegm is undoubtedly the cause, and emesis is indicated. If the pulse is slow and faint, it is merely Malaria with aversion to cold, suitable for treatment with Chaihu, Guizhi, and Ganjiang. Quxie Wan (Evil-Expelling Pill) Prescription
Mahuang (Ephedrae Herba, 4 liang, nodes removed, soaked in boiling water for one or two boils, dried by roasting, weighed), Changshan (Dichroae Radix), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Dahuang (Rhei Radix et Rhizoma), Zhimu (Anemarrhenae Rhizoma, each 3 liang).
Pound, sieve into fine powder, and refine honey to form pills the size of white mustard seeds. Take 15 pills per dose. Face east and swallow with clear water. (Compared to Changshan Wan in Qianjin Fang under the section "Cold Preceding Heat," the ingredients are the same but dosages differ.)