《巢氏病源》温疟候∶夫温疟与寒疟安舍?温疟者,得之冬中于风寒,寒气藏于骨髓之中,至春则阳气大发,
邪气不能出,因遇大暑,脑髓烁,脉肉消释,腠理发泄,因有所用力,邪气与汗皆出。此病藏于肾,其气先从
内出之于外。如此则阴虚而阳盛,则病衰,气复反入,入则阳虚,阳虚则寒矣。故先热而后寒,名曰温疟。疟
先寒而后热,此由夏伤于暑,汗大出,腠理开发,因遇夏气,济沧之水寒,寒之藏于腠理皮肤之中,秋气伤于
风,则病盛矣。夫寒者,阴气也;风者,阳气也。先伤于寒,而后伤于风,故先寒而后热。先伤于风,而后伤
于寒,故先热而后寒。亦以时作,名曰温疟。夫病疟六、七日,但见热者,温疟也。
《千金》常山汤 治小儿温疟方。
常山(一两,切) 小麦(三合) 淡竹叶(切,一升。《外台》用一握)
上三味,以水一升,煮取五合。一日至七日儿,一合为三服。八日至十五日儿,一合半为三服。十六至二
十日儿,三合为三服。四十日至六十日儿,六合为三服。六十日至百日儿,一服二合半。百日至二百日儿,
一服三合。《外台》方同,但云∶一岁至七、八岁儿增药水,并以此为率。
《千金》又方
上用鹿角末,先发时便服一钱匕。
《千金》又方
上用鳖甲灰,以酒服一钱匕。至发时服三匕,并以火灸身。
《千金》又方
上烧鸡 中黄皮末和乳与服。男雄女雌。
《千金》灸法∶小儿温疟,灸乳下一指三壮。
《巢氏病源》温疟候:温疟与寒疟的区别在哪里?所谓温疟,是冬季感受风寒所致。寒气潜伏在骨髓之中,到了春季阳气大发时,邪气无法排出;若再遇到大暑天气,脑髓被热灼,血脉肌肉消减,腠理(皮肤毛孔)开泄,此时又因用力劳作,邪气随汗液一同外出。这种病根藏于肾,其气机先从内部发出到外部。这样会导致阴虚而阳盛,病情稍衰后,气机又反向内入;气机内入则导致阳虚,阳虚就会感到寒冷。因此表现为先发热而后发冷,称为温疟。
疟疾若先恶寒而后发热,这是因为夏季感受暑邪,大汗淋漓,腠理开发,又遇到冷水寒气侵袭,寒气潜伏在腠理和皮肤之中;秋季又受风邪伤害,病情就会加重。寒属于阴气,风属于阳气。先伤于寒,后伤于风,所以先恶寒而后发热;先伤于风,后伤于寒,所以先发热而后恶寒。这也按时发作,也称作温疟。如果患疟疾六七天,只见到发热症状的,就是温疟。
《千金方》常山汤:治疗小儿温疟的方剂。
常山(一两,切碎) 小麦(三合) 淡竹叶(切碎,一升。《外台秘要》用一把)
以上三味药,用水一升,煮取五合。出生一天至七天的婴儿,每次服用一合,分三次服完。出生八天至十五天的婴儿,每次服用一合半,分三次服完。出生十六天至二十天的婴儿,每次服用三合,分三次服完。出生四十天至六十天的婴儿,每次服用六合,分三次服完。出生六十天至一百天的婴儿,每次服用二合半。出生一百天至二百天的婴儿,每次服用三合。《外台秘要》中的方子相同,只是说一岁至七八岁的儿童增加药水量,并以此类推作为标准。
《千金方》另一个方子:
取鹿角末,在发病时立即服用一钱匕。
《千金方》又一个方子:
取鳖甲灰,用酒送服一钱匕。在发病时服用三钱匕,并用火灸身体。
《千金方》又一个方子:
烧鸡中黄皮成末,调和乳汁给患儿服用。公鸡用于男孩,母鸡用于女孩。
[Source: Chao's Pathogenesis of Diseases, "Warm Malaria" Section] What is the distinction between warm malaria and cold malaria? Warm malaria arises from contracting wind-cold in winter. The cold pathogen hides within the bone marrow. When yang qi expands vigorously in spring, the pathogenic factor cannot exit. If subsequently exposed to intense summer heat, the brain marrow is scorched, vessels and flesh are diminished, and the couli (pores) open and sweat is released. If physical exertion occurs at this time, the pathogen exits along with the sweat. This disease resides in the Kidney; its qi first emerges from the interior to the exterior. Consequently, yin becomes deficient while yang becomes excessive. As the illness wanes, the qi reverses and re-enters the interior. Upon entering, yang becomes deficient, leading to coldness. Thus, it presents with fever first followed by chills, named "warm malaria."
If malaria presents with chills first followed by fever, this results from summerheat injury in summer. Profuse sweating opens the couli. Exposure to cold water during summer allows cold to hide within the couli and skin. Autumn wind then injures the body, exacerbating the disease. Cold belongs to yin qi; wind belongs to yang qi. Injury by cold first, then by wind, results in chills first, then fever. Injury by wind first, then by cold, results in fever first, then chills. It also occurs at specific times and is also called "warm malaria." If malaria persists for six or seven days with only fever present, it is warm malaria.
Qianjin Fang Changshan Decoction: A formula for treating pediatric warm malaria.
Changshan (Dichroa Radix, 1 liang, sliced) Xiaomai (Tritici Fructus, 3 he) Danzhuye (Lophatheri Herba, sliced, 1 sheng. Waitai uses one handful).
The above three ingredients are boiled in 1 sheng of water until reduced to 5 he. For infants aged one day to seven days, administer 1 he divided into three doses. For infants aged eight to fifteen days, administer 1.5 he divided into three doses. For infants aged sixteen to twenty days, administer 3 he divided into three doses. For infants aged forty to sixty days, administer 6 he divided into three doses. For infants aged sixty to one hundred days, administer 2.5 he per dose. For infants aged one hundred to two hundred days, administer 3 he per dose. The formula in Waitai is identical but specifies increasing the water volume for children aged one to seven or eight years, using this as a standard ratio.
Another Qianjin Fang:
Use Luji Mo (Cervi Cornu Degelatinatum powder). Administer one qianbi immediately upon the onset of an attack.
Another Qianjin Fang:
Use Biejia Hui (Testudinis Carapax et Plastrum ash). Administer one qianbi with wine. At the time of the attack, administer three qianbi, and apply moxibustion to the body.
Another Qianjin Fang:
Burn the yellow skin inside the chicken (Jizhong Huangpi), grind into powder, and mix with milk for administration. Use male chickens for boys and female chickens for girls.
Qianjin Moxibustion Method: For pediatric warm malaria, moxa the point located one finger-width below the nipple, applying three moxa cones (zhuang).