【歌】疟疾由来匪一端，六经五脏有形参。连朝间日知深浅，阳分邪轻阴分难。风暑感人从外至，内因食
积与停痰。汗多汗少求虚实，弦数弦迟定热寒。实可祛邪行截法，虚宜养正自痊安。先寒后热名寒疟，但热无
寒号曰瘅。温疟从来先作热，若还暑疟汗漫漫。山岚障疟宜祛逐， 疟休吞鬼哭丹。
【论】《内经》云∶夏暑汗不出者，秋成风疟。又云∶夏伤于暑，秋必 疟。盖邪气客于风府，阴阳上下
交争，虚实更作，邪并于巨阳，则阴实阳虚，故寒作，邪并于阳明，阳实阴虚，故热作，此阴阳相移也。邪气
舍于皮肤，与卫气居。卫气者，日行于阳，夜行于阴，此气得阳而外出，得阴而内搏，是以日作，此受之浅也。
其气之舍深，内搏于阴，阳气独发，阴邪内着，阴与阳争，不得出，故间日作，此受之深也。邪与卫气客于六
腑，而有时相失，不能相争，故休数日乃作，此受之最深也。然疟之状不一∶足太阳疟，令人腰痛头重，寒从
背起，先寒后热， 然热，热止，汗出难已。足少阳疟，令人身体解 ，寒不甚，热不甚，恶见人，见人
则惕惕然，热多，汗出甚。足阳明疟，令人先洒淅寒甚，久乃热，热去汗出，喜见日、月光、火气乃快然。足
太阴疟，令人不乐，好太息，不嗜食，多寒热，汗出则善呕，呕已乃
衰。足少阴疟，令人呕吐甚，多寒热，欲闭户牖而处，其病难已。足厥阴疟，令人腰痛，少腹满，小便不利如
癃，非癃也，数便，意恐惧，气不足，腹中悒悒，此六经之疟也。肺疟者，令人心寒，寒甚热，热间善惊，如
有所见。心疟者，令人心烦甚，欲得清水，反寒多，不甚热。肝疟者，令人色苍苍然，好太息，其状若死。脾
疟者，令人寒，腹中痛，热则肠中鸣，鸣已汗出。肾疟者，令人洒洒然，腰脊痛，宛转大便难，目眩眩然，此
五脏之疟也。
东垣云∶寒疟属太阴，热疟属阳明，风疟属少阳，温疟属厥阴。又云∶作于子、午、卯、酉日者属少阴，
作于寅、申、巳、亥日者属厥阴，作于辰、戌、丑、未日者属太阴，盖三日一作故耳。丹溪又有食、痰、风、
暑、老疟、疟母等名，盖不越五脏、六经之所主也。但所感不同者，然因其所挟而立名也，今并及之，以备参考。
善治者，审其受病之浅深，寒热之多少，发作之早晏，时月之炎凉，元气之虚实。浅者发于处暑前，谓之近
而暴者，易治。发于霜降后，谓之远而 者，难治。故 疟不可截，截之转虚，但养正气，气充自已，斟酌调之。
谨按∶疟之为状， 热如炉，振寒如冰，头痛如破，切牙嚼齿，有炎威之势，从病、从虐，故名“疟”。
诸病惟疟近乎邪，故魇法治之亦偶中，然求其原，必内有痰食，外感风寒，故凡初发时，便以消食、化气、开
痰、散风等药大剂服之，后虽发亦轻，不过二发即止矣。
【脉】疟脉多弦，弦而数者多热，宜汗之。弦而迟者多寒，宜温之。弦而紧实者宜下之，弦而虚细者宜补
之，弦而实大者宜吐之。弦短者多食，弦滑者多痰。疟脉迟缓者病自愈，久疟不愈者脉必虚，宜养正祛邪。
外因
若避暑于风凉处，闭其汗孔，热不泄，作风疟、暑疟，皆当发汗。风疟，小柴胡汤加葛根、升麻、苍术、
川芎、白芷、青皮，草果之类。暑疟无汗，小柴胡汤加葛根、香薷，渴加天花粉。暑疟自汗烦渴，柴胡白虎汤。
但热不寒者，柴葛解肌汤。热多寒少，清脾饮。寒多热少，人参养胃汤。
小柴胡汤
治少阳经疟，能和解表里。
柴胡 黄芩 人参 甘草 半夏 生姜
如初疟，去参、甘，加青皮、草果。
按∶上方治疟发时耳聋胁痛，寒热往来，口苦善呕，脉弦者主之。盖柴胡、黄芩能解少阳之邪。半夏、生
姜为呕家圣药。用人参、甘草者，补其中虚，使邪无容地而出矣。
柴胡白虎汤
即小柴胡加石膏、知母。（少阳、阳明二经药也。）
柴葛解肌汤
治三阳经疟，头额、目痛，脉浮洪弦数。
干葛 柴胡 羌活 黄芩 白芷 甘草 桔梗 芍药（无汗去之，汗多倍用。）
上，水煎，加生姜三片，葱白捣汁三匙，热服。
清脾饮
治疟疾热多寒少，脉弦数，口苦咽干，溺赤。
柴胡（一钱二分） 半夏 黄芩 白术（腹胀满者去之） 陈皮（各一钱） 茯苓 浓朴（各八
分） 青皮（七分） 草果（六分） 甘草（四分） 生姜（三片） 大枣（一枚）
按∶右方曰“清脾”者，非清凉之谓，乃攻去其邪，而脾部为之一清也。故用青皮、浓朴消去脾部之痰。
半夏、生姜
燥去脾家之湿，柴、芩清热。术、甘补虚。而草果又能清膏粱之疾也。
内因
恶饮食者，从饮食上得之，必胸满噫气，二陈汤加山楂、枳实、神曲、浓朴、柴胡、青皮。大抵无痰不成
疟，若内伤挟外邪同发，内必生痰。痰滞于中，寒热不已，脉滑者，二陈加柴胡、黄芩、草果、常山以吐之，
吐中就有发散之意。但常山性暴悍，非痰盛气实者，不可用也。
二陈汤（方见痰证。）
虚疟
虚人患疟，饮食少进，四肢无力，汗多，怠惰嗜卧，六君子汤、人参养胃汤。汗多，烦躁而渴，白虎汤加
人参。汗多，不烦渴，柴胡桂枝汤。元气渐虚，不思食而多汗者，四兽饮截之。虚疟久不止，宜养正，不可截，
多服补中益气汤自止。
六君子汤
即四君子加陈皮、半夏。
人参养胃汤
本方加香附、砂仁，名香砂养胃汤。
即平胃合二陈加人参、藿香、草果、乌梅、生姜，煎。
按∶人之饥、饱，皆足以伤胃。胃伤，则荣卫虚而谷气乖，乖则争，争则邪正分，寒热作，而疟成矣。方
中有参、茯、甘草之甘，可以补胃之不足。陈、苍、浓朴之辛，可以平胃之有余。半夏醒脾。藿香开胃。乌梅
之酸，可使收阴。草果之温，可使消滞焉。
补中益气汤（方见内伤。）
白虎汤（方见火证。）
四兽饮
治虚疟久不愈。
即六君子汤加草果、乌梅、生姜、大枣等分，煎服。
实疟
暴疟寒热往来，脉弦数，必热多也，清脾饮。脉弦迟，必寒多，七宝饮。发五、六次不止，不二饮截之。
无汗要有汗，发散为主，小柴胡去人参，加葛根、苍术、青皮、苏叶。大便不通，大柴胡汤下之。
七宝饮
治一切疟疾及山岚瘴气寒热如疟。
常山 草果 槟榔 浓朴（姜炒） 青皮 陈皮 甘草（各等分）
每服五钱，水、酒同煎，露一宿，稍温，空心向东服。
不二饮
截阴疟、老疟神效。
柴胡 黄芩 常山 槟榔 知母 芍药 青皮 甘草
上，用短水白酒二钟，煎八分，发前五个时服。忌热茶、汤、饭一日，只可食温、凉者。
按∶上二方，惟脉来浮大弦滑者可用，盖浮为表，大为阳，弦为饮，滑为实故也。若脉来沉细涩微者，
与之则逆矣，慎之！慎之！
大柴胡汤
即小柴胡去人参、甘草，加大黄、枳实。
瘴疟
瘴疟者，感山岚瘴气作疟，实者藿香正气散，虚者人参养胃汤。
藿香正气散（方见霍乱。）
疟
疟者，三日一发，或连二日发，间一日者。或作于霜降后，或下午阴分，俱不可截，柴胡养阴汤、黄
鳖甲汤、补中益气汤、四兽饮皆可服之。
柴胡养阴汤（秘方）
治阴分虚，邪气盛，无汗而疟者。
柴胡（四钱） 当归（二钱） 陈皮（二钱） 知母（一钱）
黄 鳖甲汤（秘方）
治阴阳俱虚，正不胜邪，多汗而疟者。
黄 （二钱，蜜炙） 陈皮（一钱，炒） 鳖甲（一钱，炙） 何首乌（三钱，蒸熟，忌铁）
疟母
疟久不止，必生疟母。在胁下，大如杯，令人面色痿黄，寒热不已，用川芎、芍药、柴胡各一钱，人参
五分，水煎，送下鳖甲丸二钱，外以阿魏膏贴之，神效。
鳖甲丸（秘方）
治久疟不愈，胁下有块，俗名疟母。
鳖甲（酒炙，半斤） 蓬术（醋煮，三两） 青皮（醋煮三两） 穿山甲（土炒，二两）
上为末，用醋煮当归为膏，拌前药丸如黍米大，每服二钱，煎药送下。
【歌诀】疟疾的成因并非单一，需参照六经和五脏的表现来辨别。发作连续或隔日可知病情的深浅，阳分邪气轻浅而阴分邪气难治。风邪和暑邪从外部侵袭人体，内因则是饮食积滞与痰饮停聚。汗多汗少要探求虚实的本质，脉象弦数主热、弦迟主寒以定性质。实证可用祛除邪气的截疟法，虚证宜扶正养正自然痊愈。先恶寒后发热的称为寒疟，只有发热没有恶寒的称为瘅疟。温疟向来是先发热，若是暑疟则汗出淋漓。山岚瘴气所致的疟疾适宜用祛逐之法，疟疾休止期可吞服鬼哭丹。
【论述】《黄帝内经》说：夏季暑热时不出汗的人，秋天会形成风疟。又说：夏天被暑邪所伤，秋天必定患疟疾。大概是因为邪气客居在风府穴，导致阴阳上下交争，虚实交替出现。当邪气并入太阳经（巨阳），则阴实阳虚，所以表现为恶寒；邪气并入阳明经，则阳实阴虚，所以表现为发热，这是阴阳相互转移的结果。邪气停留在皮肤，与卫气同居。卫气白天行于阳分，夜晚行于阴分，此气得到阳气则外出体表，得到阴气则内搏体内，因此每日发作，这是受邪较浅的情况。如果邪气停留较深，内搏于阴分，阳气单独发散，阴邪内着，阴与阳相争，阳气不得外出，所以隔日发作，这是受邪较深的情况。邪气与卫气客居在六腑，有时失去联系，不能相互抗争，所以休息几天才发作，这是受邪最深的情况。然而疟疾的症状并不单一：足太阳经疟疾，使人腰痛头重，寒气从背部升起，先恶寒后发热，发热时身体拘急，热退后出汗难以停止。足少阳经疟疾，使人身体懈怠无力，恶寒不严重，发热也不严重，厌恶见人，见到人则惊恐不安，发热较多，出汗很多。足阳明经疟疾，使人先感到凛冽寒冷，很久之后才发热，热退后出汗，喜欢见到日光、月光或火气，感到舒适。足太阴经疟疾，使人心情不悦，喜欢叹气，食欲不振，多有寒热往来，出汗后容易呕吐，呕吐后病情稍减。足少阴经疟疾，使人呕吐严重，多有寒热往来，想关上门窗独处，这种病难以治愈。足厥阴经疟疾，使人腰痛，小腹胀满，小便不利像癃闭一样，其实不是癃闭，而是频繁小便，心中恐惧，气不足，腹部郁闷不适，这就是六经疟疾的情况。肺疟，使人心脏寒冷，寒冷严重时发热，热间歇时容易惊悸，好像看到了什么。心疟，使人心烦意乱，想要喝冷水，反而恶寒多，发热不明显。肝疟，使人面色青苍，喜欢叹气，状态如同死一般。脾疟，使人畏寒，腹部疼痛，发热时肠中鸣响，鸣响后出汗。肾疟，使人洒洒然畏寒，腰脊疼痛，翻身困难且大便艰难，头晕目眩，这就是五脏疟疾的情况。
李东垣说：寒疟属于太阴，热疟属于阳明，风疟属于少阳，温疟属于厥阴。又说：在子、午、卯、酉日发作的属于少阴，在寅、申、巳、亥日发作的属于厥阴，在辰、戌、丑、未日发作的属于太阴，这是因为三日一发的缘故。朱丹溪又有食疟、痰疟、风疟、暑疟、老疟、疟母等名称，大概都不超出五脏、六经的主管范围。只是感受不同，根据其兼夹因素而立名，现在一并列出，以备参考。善于治疗的人，审察受病的深浅，寒热的多少，发作的早晚，时令的冷暖，元气的虚实。受邪浅的在处暑前发作，称为近而暴发，容易治疗。在霜降后发作的，称为远而缓慢，难治。所以久疟不可强行截断，截断反而导致正气更虚，只需养护正气，气充盛自然痊愈，斟酌调理即可。谨按：疟疾的症状，发热如火炉，恶寒如冰雪，头痛欲裂，咬牙嚼齿，有炎威之势，从“病”字旁，从“虐”字，故名“疟”。各种疾病中只有疟疾最接近邪祟，所以用魇魔法治疗也偶尔有效，但探究其根源，必定内有痰食，外感风寒，所以凡是初发时，就用消食、化气、开痰、散风等药物大剂量服用，后来即使再发作也很轻微，不过两次就会停止。
【脉诊】疟疾的脉象多呈弦脉，弦而数的脉象多属热，适宜用发汗法。弦而迟的脉象多属寒，适宜用温法。弦而紧实的脉象适宜用泻下法，弦而虚细的脉象适宜用补法，弦而实大的脉象适宜用吐法。脉短的多为食积，脉滑的多为痰饮。疟脉迟缓表示病将自愈，久疟不愈者脉必虚，宜扶正祛邪。
外因
如果在风凉处避暑，闭塞汗孔，热气无法宣泄，形成风疟、暑疟，都应当发汗。风疟，用小柴胡汤加葛根、升麻、苍术、川芎、白芷、青皮、草果等药。暑疟无汗，用小柴胡汤加葛根、香薷，口渴加天花粉。暑疟自汗且烦躁口渴，用柴胡白虎汤。只有发热没有恶寒的，用柴葛解肌汤。热多寒少的，用清脾饮。寒多热少的，用人参养胃汤。
小柴胡汤
治疗少阳经疟疾，能和解表里。
组成：柴胡、黄芩、人参、甘草、半夏、生姜。
如果是初次发作的疟疾，去掉人参、甘草，加入青皮、草果。
按语：上方主治疟疾发作时耳聋胁痛，寒热往来，口苦善呕，脉弦者。因为柴胡、黄芩能解除少阳之邪。半夏、生姜是止呕的圣药。用人参、甘草是为了补益中焦虚弱，使邪气无处容身而排出。
柴胡白虎汤
即小柴胡汤加石膏、知母。（这是少阳、阳明二经的药物。）
柴葛解肌汤
治疗三阳经疟疾，头额、眼睛疼痛，脉浮洪弦数。
组成：干葛、柴胡、羌活、黄芩、白芷、甘草、桔梗、芍药（无汗时去掉芍药，汗多时加倍使用）。
上药水煎，加生姜三片，葱白捣汁三匙，热服。
清脾饮
治疗疟疾热多寒少，脉弦数，口苦咽干，尿赤。
组成：柴胡（一钱二分）、半夏、黄芩、白术（腹胀满者去掉）、陈皮（各一钱）、茯苓、浓朴（各八分）、青皮（七分）、草果（六分）、甘草（四分）、生姜（三片）、大枣（一枚）。
按语：右方名为“清脾”，并非清凉之意，而是攻去邪气，使脾部得以清净。所以用青皮、浓朴消除脾部的痰湿。半夏、生姜燥除脾家的湿气，柴胡、黄芩清热。白术、甘草补虚。而草果又能清除膏粱厚味引起的疾病。
内因
厌恶饮食的，是从饮食方面得的病，必然胸满嗳气，用二陈汤加山楂、枳实、神曲、浓朴、柴胡、青皮。大抵无痰不成疟，如果内伤夹杂外邪同时发作，内部必然生痰。痰停滞在中焦，寒热不已，脉滑的，用二陈汤加柴胡、黄芩、草果、常山以催吐，吐法中就有发散的意思。但是常山药性暴烈，如果不是痰盛气实的患者，不可使用。
虚疟
体虚之人患疟疾，饮食减少，四肢无力，汗多，倦怠嗜卧，用六君子汤、人参养胃汤。汗多，烦躁且口渴，用白虎汤加人参。汗多，不烦躁口渴，用柴胡桂枝汤。元气逐渐虚弱，不思饮食且多汗的，用四兽饮截断疟疾。虚疟久不止，宜扶正，不可截断，多服用补中益气汤自然会停止。
人参养胃汤
本方加香附、砂仁，名为香砂养胃汤。
即平胃散合二陈汤加人参、藿香、草果、乌梅、生姜，煎服。
按语：人的饥饿、过饱，都足以损伤胃气。胃受伤，则营卫虚弱而谷气乖乱，乖乱则相争，相争则邪正分离，寒热发作，从而形成疟疾。方中有参、茯、甘草的甘味，可以补胃之不足。陈皮、苍术、浓朴的辛味，可以平复胃之有余。半夏醒脾。藿香开胃。乌梅的酸味，可使收敛阴气。草果的温性，可使消除积滞。
四兽饮
治疗虚疟久不愈。
即六君子汤加草果、乌梅、生姜、大枣等分，煎服。
实疟
暴发疟疾寒热往来，脉弦数，必定热多，用清脾饮。脉弦迟，必定寒多，用七宝饮。发作五、六次不止，用不二饮截断。
无汗要有汗，以发散为主，用小柴胡汤去人参，加葛根、苍术、青皮、苏叶。大便不通，用大柴胡汤泻下。
七宝饮
治疗一切疟疾及山岚瘴气引起的寒热如疟疾。
组成：常山、草果、槟榔、浓朴（姜炒）、青皮、陈皮、甘草（各等分）。
每服五钱，水、酒同煎，露天放置一夜，稍温，空腹面向东方服用。
不二饮
截断阴疟、老疟神效。
组成：柴胡、黄芩、常山、槟榔、知母、芍药、青皮、甘草。
上药，用短量白酒二钟，煎至八分，发作前五个时辰服用。忌热茶、汤、饭一日，只可吃温、凉的食物。
按语：上方两个方子，只有脉象浮大弦滑者可用，因为浮为表，大为阳，弦为饮，滑为实。如果脉象沉细涩微，与之则逆乱了，务必谨慎！务必谨慎！
瘴疟
瘴疟，是感受山岚瘴气引发的疟疾，实证用藿香正气散，虚证用人参养胃汤。
藿香正气散（方剂见霍乱章节）
疟（注：原文此处可能有缺字，根据上下文推测指久疟或特定类型疟疾，通常指三日疟或间日疟等迁延不愈者，结合下文“三日一发”）
疟疾若三日一发，或连发两日，或隔日发作。或在霜降后发作，或下午阴分发作，都不可截断，柴胡养阴汤、黄鳖甲汤、补中益气汤、四兽饮都可以服用。
柴胡养阴汤（秘方）
治疗阴分虚，邪气盛，无汗而患疟疾。
组成：柴胡（四钱）、当归（二钱）、陈皮（二钱）、知母（一钱）。
黄鳖甲汤（秘方）
治疗阴阳俱虚，正气不胜邪气，多汗而患疟疾。
组成：黄 （二钱，蜜炙）、陈皮（一钱，炒）、鳖甲（一钱，炙）、何首乌（三钱，蒸熟，忌铁器）。
疟母
疟疾久不止，必然生成疟母。位于胁下，大小如杯，使人面色萎黄，寒热不已，用川芎、芍药、柴胡各一钱，人参五分，水煎，送服鳖甲丸二钱，外用阿魏膏贴敷，神效。
鳖甲丸（秘方）
治疗久疟不愈，胁下有肿块，俗名疟母。
组成：鳖甲（酒炙，半斤）、蓬术（醋煮，三两）、青皮（醋煮三两）、穿山甲（土炒，二两）。
上药研为末，用醋煮当归为膏，拌和前药制成如黍米大小的丸药，每服二钱，煎药送下。
[Verse] The etiology of malaria is not singular; it must be differentiated by referencing the manifestations of the Six Channels (Six Meridians) and the Five Zang Organs. Continuous or every-other-day attacks indicate the depth of the disease; pathogenic factors in the Yang aspect are light and easy to treat, while those in the Yin aspect are difficult. Wind and Summerheat pathogens invade from the exterior, while internal causes involve food stagnation and retained phlegm. Excessive or scanty sweating helps determine deficiency or excess; a wiry and rapid pulse indicates heat, while a wiry and slow pulse indicates cold. Excess patterns can be treated with pathogen-dispelling interception methods, while deficiency patterns should be managed by nourishing righteousness (Zheng Qi) for natural recovery. Chills preceding fever is named Cold Malaria; fever without chills is called Dan Malaria. Warm Malaria typically begins with fever, whereas Summerheat Malaria presents with profuse sweating. Malaria caused by mountain miasma requires dispelling and purging methods; during remission periods, Guiku Dan (Ghost Cry Pill) may be swallowed.
[Dissertation] The *Neijing* (Inner Canon) states: "Those who do not sweat during summer heat will develop Wind Malaria in autumn." It also says: "Injury by summer heat in summer leads to Malaria in autumn." Generally, pathogenic factors lodge at the Fengfu point (GV16), causing struggle between Yin and Yang above and below, with alternating deficiency and excess. When pathogens merge into the Taiyang Channel (Giant Yang), Yin becomes full and Yang deficient, resulting in chills; when they merge into the Yangming Channel, Yang becomes full and Yin deficient, resulting in fever. This is the shifting of Yin and Yang. Pathogens reside in the skin and coexist with Defensive Qi (Wei Qi). Defensive Qi travels through the Yang aspects during the day and the Yin aspects at night. When this Qi obtains Yang, it moves outward to the surface; when it obtains Yin, it struggles inward. Thus, it manifests daily, indicating shallow infection. If pathogens lodge deeply, struggling internally within the Yin, Yang Qi alone flares up, Yin pathogens adhere internally, and Yin-Yang struggle prevents Yang from exiting, resulting in every-other-day attacks, indicating deep infection. If pathogens and Defensive Qi lodge in the Six Fu Organs but sometimes lose contact and cannot struggle, attacks occur after several days of rest, indicating the deepest infection. However, malaria symptoms vary: Taiyang Malaria causes lower back pain and heavy head, chills starting from the back, preceded by chills then fever, rigidity during fever, and difficult-to-stop sweating after fever subsides. Shaoyang Malaria causes body laxity, mild chills and fever, aversion to people, palpitations upon seeing people, more fever, and profuse sweating. Yangming Malaria causes severe initial shivering cold, followed by fever after a long time, sweating after fever subsides, and relief upon exposure to sunlight, moonlight, or fire warmth. Taiyin Malaria causes dissatisfaction, frequent sighing, loss of appetite, frequent chills and fever, vomiting after sweating, and slight improvement after vomiting. Shaoyin Malaria causes severe vomiting, frequent chills and fever, desire to stay behind closed doors and windows, and is difficult to cure. Jueyin Malaria causes lower back pain, abdominal fullness, urinary difficulty resembling strangury (but actually frequent urination), fear, Qi deficiency, and abdominal oppression. These are the Six Channel Malariae. Lung Malaria causes heart coldness, severe chills followed by fever, fright during fever intervals, and visual hallucinations. Heart Malaria causes severe mental restlessness, desire for cold water, more chills than fever. Liver Malaria causes pale-green complexion, frequent sighing, and a state resembling death. Spleen Malaria causes chills, abdominal pain, intestinal rumbling during fever, and sweating after rumbling. Kidney Malaria causes shivering cold, lower back and spine pain, difficulty turning over and defecating, dizziness, and blurred vision. These are the Five Zang Malariae.
Li Dongyuan stated: Cold Malaria belongs to Taiyin, Heat Malaria to Yangming, Wind Malaria to Shaoyang, and Warm Malaria to Jueyin. He also said: Attacks on Zi, Wu, Mao, You days belong to Shaoyin; attacks on Yin, Shen, Si, Hai days belong to Jueyin; attacks on Chen, Xu, Chou, Wei days belong to Taiyin, due to the three-day cycle. Zhu Danxi added names such as Food Malaria, Phlegm Malaria, Wind Malaria, Summerheat Malaria, Chronic Malaria, and Mother Malaria, which generally fall under the governance of the Five Zang and Six Channels. They are named based on different pathogenic combinations. Listed here for reference. Skilled practitioners assess the depth of infection, degree of chills/fever, timing of onset, seasonal temperature, and constitution strength. Shallow infections occurring before the End of Heat solar term are called "near and acute," and are easy to treat. Infections occurring after the Frost Descent solar term are called "distant and chronic," and are difficult to treat. Therefore, chronic malaria should not be forcibly intercepted, as this worsens deficiency; instead, nourish Zheng Qi until it is sufficient for self-recovery, adjusting carefully. Note: Malaria symptoms include fever like a furnace, chills like ice, splitting headache, teeth grinding, and intense heat. The character "Malaria" (Nue) combines "Disease" (Bing) and "Tyrannical/Cruel" (Nue), hence the name. Among diseases, only Malaria closely resembles demonic influence, so exorcism methods occasionally work. However, the root cause is internal phlegm/food and external wind/cold. At first onset, large doses of herbs for digesting food, moving Qi, resolving phlegm, and dispersing wind should be taken. Subsequent attacks will be mild and cease within two episodes.
[Pulse Diagnosis] Malaria pulses are mostly wiry. Wiry and rapid indicates heat, suitable for diaphoresis. Wiry and slow indicates cold, suitable for warming. Wiry, tight, and full indicates excess, suitable for purgation. Wiry, deficient, and fine indicates deficiency, suitable for tonification. Wiry and large/full indicates excess, suitable for emesis. Short pulse indicates food retention; slippery pulse indicates phlegm. Slow and relaxed malaria pulse indicates spontaneous recovery; persistent malaria pulse is deficient, requiring tonification of Zheng Qi and expulsion of pathogens.
External Causes
If cooling off in windy/cool places closes pore openings, preventing heat release, it forms Wind Malaria or Summerheat Malaria, both requiring diaphoresis. For Wind Malaria, use Xiao Chai Hu Tang (Minor Bupleurum Decoction) plus Gegen (Kudzu Root), Shengma (Cimicifuga Rhizome), Cangzhu (Atractylodis Rhizoma), Chuanxiong (Ligusticum Rhizome), Baizhi (Angelicae Dahuricae Radix), Qingpi (Citri Reticulatae Pericarpium Viride), Caoguo (Tsaoko Fructus), etc. For Summerheat Malaria without sweat, use Xiao Chai Hu Tang plus Gegen, Xiangru (Elsholtzia Herba); add Tianhuafen (Trichosanthis Radix) if thirsty. For Summerheat Malaria with spontaneous sweating, irritability, and thirst, use Chaihu Baihu Tang (Bupleurum and White Tiger Decoction). For fever without chills, use Chaige Jieji Tang (Bupleurum and Kudzu Muscle-Releasing Decoction). For more heat than chills, use Qingpi Yin (Spleen-Clearing Drink). For more chills than heat, use Renshen Yangwei Tang (Ginseng Stomach-Nourishing Decoction).
Xiao Chai Hu Tang (Minor Bupleurum Decoction)
Treats Shaoyang Channel Malaria, harmonizing interior and exterior.
Ingredients: Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), Renshen (Ginseng Radix), Gancao (Glycyrrhizae Radix), Banxia (Pinelliae Rhizoma), Shengjiang (Zingiberis Rhizoma Recens).
For initial malaria, remove Renshen and Gancao, add Qingpi and Caoguo.
Note: This formula treats deafness, hypochondriac pain, alternating chills and fever, bitter taste, vomiting, and wiry pulse during malaria attacks. Chaihu and Huangqin resolve Shaoyang pathogens. Banxia and Shengjiang are holy medicines for vomiting. Renshen and Gancao tonify middle Jiao deficiency, leaving no room for pathogens.
Chaihu Baihu Tang (Bupleurum and White Tiger Decoction)
Is Xiao Chai Hu Tang plus Shigao (Gypsum Fibrosum) and Zhimu (Anemarrhenae Rhizoma). (Medicines for Shaoyang and Yangming channels.)
Chaige Jieji Tang (Bupleurum and Kudzu Muscle-Releasing Decoction)
Treats Three Yang Channel Malaria, with forehead/eye pain and floating, surging, wiry, rapid pulse.
Ingredients: Gange (Puerariae Lobatae Radix), Chaihu, Qianghuo (Notopterygii Rhizoma et Radix), Huangqin, Baizhi, Gancao, Jiegeng (Platycodonis Radix), Shaoyao (Paeoniae Radix). Remove Shaoyao if no sweat; double dose if profuse sweat.
Decoct with water, add three slices of Shengjiang and three spoons of scallion white juice, take hot.
Qingpi Yin (Spleen-Clearing Drink)
Treats Malaria with more heat than chills, wiry-rapid pulse, bitter taste, dry throat, red urine.
Ingredients: Chaihu (1.2 qian), Banxia, Huangqin, Baizhu (remove if abdominal fullness), Chenpi (Citri Reticulatae Pericarpium, each 1 qian), Fuling (Poria), Houpo (Magnoliae Officinalis Cortex, each 0.8 qian), Qingpi (0.7 qian), Caoguo (0.6 qian), Gancao (0.4 qian), Shengjiang (3 slices), Dazao (Jujubae Fructus, 1 piece).
Note: "Qingpi" does not mean cooling, but clearing the spleen by expelling pathogens. Qingpi and Houpo eliminate spleen phlegm-damp. Banxia and Shengjiang dry spleen dampness. Chai and Qin clear heat. Baizhu and Gancao tonify deficiency. Caoguo clears diseases from rich foods.
Internal Causes
Aversion to food indicates dietary origin, with chest fullness and belching. Use Erchen Tang (Two-Aged Decoction) plus Shanzha (Crataegi Fructus), Zhishi (Aurantii Fructus Immaturus), Shenqu (Massa Medicata Fermentata), Houpo, Chaihu, Qingpi. Generally, no phlegm means no malaria. If internal injury combines with external pathogens, internal phlegm generates. Phlegm stagnating in the middle causes persistent chills/fever; slippery pulse indicates using Erchen Tang plus Chaihu, Huangqin, Caoguo, Changshan (Dichroae Radix) to induce emesis, which has a dispersing effect. Changshan is harsh; do not use unless phlegm is abundant and Qi is strong.
Erchen Tang (See Phlegm Syndrome section)
Deficiency Malaria
In deficient patients with malaria, reduced diet, limb weakness, profuse sweating, lethargy: use Liujunzi Tang (Six-Gentlemen Decoction) or Renshen Yangwei Tang. Profuse sweating with irritability/thirst: Baihu Tang (White Tiger Decoction) plus Renshen. Profuse sweating without irritability/thirst: Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction). Gradual Yuan Qi deficiency, anorexia, profuse sweating: use Sishou Yin (Four-Beast Drink) to intercept. Persistent deficiency malaria should be nourished, not intercepted; prolonged use of Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) stops it spontaneously.
Liujunzi Tang
Is Sijunzi Tang plus Chenpi and Banxia.
Renshen Yangwei Tang
Adding Xiangfu (Cyperi Rhizoma) and Sharen (Amomi Fructus) to this formula makes Xiangsha Yangwei Tang.
It is Pingwei San combined with Erchen Tang, plus Renshen, Huoxiang (Agastaches Herba), Caoguo, Wumei (Mume Fructus), Shengjiang, decocted.
Note: Hunger and overeating damage Stomach Qi. Damaged Stomach leads to weak Ying/Wei and disordered Grain Qi. Disordered Qi struggles, separating evil and righteous Qi, causing chills/fever and malaria. Ginseng, Fuling, Gancao sweeten to tonify Stomach insufficiency. Chenpi, Cangzhu, Houpo pungent to balance Stomach excess. Banxia awakens Spleen. Huoxiang opens Stomach. Wumei sour to gather Yin. Caoguo warm to dissolve stagnation.
Buzhong Yiqi Tang (See Internal Injury section)
Baihu Tang (See Fire Syndrome section)
Sishou Yin (Four-Beast Drink)
Treats persistent deficiency malaria.
Is Liujunzi Tang plus equal parts Caoguo, Wumei, Shengjiang, Dazao, decocted and taken.
Excess Malaria
Acute malaria with alternating chills/fever, wiry-rapid pulse, likely more heat: Qingpi Yin. Wiry-slow pulse, likely more chills: Qibao Yin (Seven-Treasure Drink). Persisting after 5-6 attacks: Bu'er Yin (Non-Two Drink) to intercept.
No sweat requires sweating; focus on dispersion. Use Xiao Chai Hu Tang minus Renshen, plus Gegen, Cangzhu, Qingpi, Ziyeh (Perillae Folium). Constipation: Da Chaihu Tang (Major Bupleurum Decoction) to purge.
Qibao Yin
Treats all malaria and mountain miasma chills/fever resembling malaria.
Ingredients: Changshan, Caoguo, Binglang (Arecae Semen), Houpo (stir-fried with ginger), Qingpi, Chenpi, Gancao (equal parts).
Take 5 qian, decoct with water and wine, leave exposed overnight, take slightly warm on empty stomach facing east.
Bu'er Yin
Divine efficacy for intercepting Yin Malaria and Chronic Malaria.
Ingredients: Chaihu, Huangqin, Changshan, Binglang, Zhimu, Shaoyao, Qingpi, Gancao.
Decoct with two cups of short-measure white wine to 80%, take five hours before attack. Avoid hot tea/soup/rice for one day; eat only warm/cool food.
Note: These two formulas are only suitable for floating, large, wiry, slippery pulses. Floating is exterior, large is Yang, wiry is fluid retention, slippery is excess. If pulse is sinking, fine, choppy, or faint, using these is contraindicated. Be cautious!
Da Chaihu Tang
Is Xiao Chai Hu Tang minus Renshen and Gancao, plus Dahuang (Rhei Radix et Rhizoma) and Zhishi.
Zhang Malaria (Miasma Malaria)
Caused by mountain miasma. Excess pattern: Huoxiang Zhengqi San (Agastache and Magnolia Decoction). Deficiency pattern: Renshen Yangwei Tang.
Huoxiang Zhengqi San (See Cholera Section)
[Missing Character] Malaria
Malaria occurring every three days, or two consecutive days, or every other day. Or occurring after Frost Descent, or in the afternoon Yin aspect. Cannot be intercepted. Chaihu Yangyin Tang, Huangbiajia Tang, Buzhong Yiqi Tang, Sishou Yin are all applicable.
Chaihu Yangyin Tang (Secret Formula)
Treats Yin deficiency with strong pathogens, no sweat, and malaria.
Ingredients: Chaihu (4 qian), Danggui (Angelicae Sinensis Radix, 2 qian), Chenpi (2 qian), Zhimu (1 qian).
Huangbiajia Tang (Secret Formula)
Treats dual Yin/Yang deficiency, righteous Qi unable to overcome pathogens, profuse sweating, and malaria.
Ingredients: Huangqi (Astragali Radix, 2 qian, honey-fried), Chenpi (1 qian, stir-fried), Biejia (Testudinis Carapax et Plastrum, 1 qian, roasted), Heshouwu (Polygoni Multiflori Radix, 3 qian, steamed, avoid iron).
Mother Malaria
Persistent malaria inevitably generates Mother Malaria. Located in the hypochondrium, cup-sized, causing sallow complexion and persistent chills/fever. Use Chuanxiong, Shaoyao, Chaihu (each 1 qian), Renshen (0.5 qian), decocted to swallow 2 qian of Biejia Wan (Turtle Shell Pill). Applyawei Gao (Asafoetida Plaster) externally. Divine efficacy.
Biejia Wan (Secret Formula)
Treats persistent malaria with hypochondriac mass, commonly called Mother Malaria.
Ingredients: Biejia (half jin, wine-roasted), Pengzhu (Curcumae Rhizoma, vinegar-boiled, 3 liang), Qingpi (vinegar-boiled, 3 liang), Chuanshanjia (Manis Squama, earth-roasted, 2 liang).
Grind to powder. Use vinegar-boiled Danggui as paste to bind pills sized like millet seeds. Take 2 qian per dose, delivered with decoction.