一、岭表之俗食槟榔，甚者，日至十数枚。盖瘴疟之作，率因饮食过度，气滞痰结，而
槟榔最能下气消食去痰，故人皆狃于近利而暗于远患。此颇类北人之食酪酥，多致肤理缜密
，一旦病疫当汗，则塞而不得出。峤南地热，食槟榔故脏气疏泄。若一旦病瘴当攻发，则虚
羸而不能堪。所以土人多瘠而色黄，岂全是气候所致。盖亦槟榔为患，殆勿思耳。
二、《本草》载三人触雾晨行，饮酒者，独不病。故北人度岭，率相勉饮酒，而迁客羁
士，往往醺酣以自适。且岭外酒价尤廉，贩夫役卒俱得肆饮，咸谓可以辟瘴。殊不知少则益
，而多则滋瘴之源也。何以言之？盖南土暑湿，嗜酒则多中湿毒，兼以瘴疟之作，率因上膈
痰饮，而酒则尤能聚痰。岭外谚云∶莫饮卯时酒，莫食申时饭，诚摄生之要也。可见酒之为
物，能辟瘴以生人，亦能滋瘴以害人。然则生也、死也。非酒也，顾在人也。
三、广南每以暑毒为患者，盖一岁之间，暑热过半，使人难避而易犯，凡起居饮食少失
节度，则为暑毒所中，道途之间，尤多冒暑。故土人于暑时，相戒勿出。且遐荒之境，道路
崎岖，而传舍饮食，皆不如欲。所以自北初至者，皆云不习水土而病，及既还，则又谓之回头
瘴。大率得之道路劳倦，冒犯暑气，与夫饮食居处失度也。
四、岭南寒暑之候不常，尤难于调摄，故凡居入与在路者，冬夏之衣皆不可缺，随其气
候，速宜增减，缓则致病。又岭外海风异常，稍中人则为病，坐卧易衣，时当慎也。
五、岭外虽以多暑为病，而四时亦有伤寒、瘟疫之疾其类不一，土人不问何疾，悉谓之
瘴，治疗多误。或有一岁盛寒，近类中州，而土俗素无蚕绩，冬不衣绵，居室疏漏，户扃不
固，忽遭岁寒，则次年瘟疫必兴。医者之治瘟疫，亦当以本法治之，而随其风土气候，与夫
人之强弱，酌宜可也。
六、瘴疟之作，多因伏暑伤冷所致，纵非饮食冷物，亦必寒邪感于外，饮食伤于内也。
大抵伏暑浅而寒多者，易治。伏暑深而热多者，难治。近时北医至此，用大柴胡汤治热瘴，
须是本气壮实者，乃能堪之。如土人久服槟榔，脏气既虚，往往不能服寒药，又能当此峻剂
乎？然土人才见发黄，便谓不治之疾，良可哀也。
七、北人之来岭南，婢仆多病瘴气。盖劳役之人，饮食乖度，昼夜冒暑，夜多卧地。又
凡事不能避忌，故先受其毙。既与之同休戚，宜加意戒之。
八、俚俗有病必召巫觋而祭鬼神，士夫咸笑其信巫不信医，愚谓此可悯恻而不可以笑也
。夫民虽至愚，然孰不思趋利避害，况性命所系，晓然易见。若医者能愈人疾，彼何为不用
？盖岭外良医甚鲜，药类尤乏，且山谷海屿之民，何从而得医药？所以不免信巫也，岂得已哉
。
九、瘴病不一，而土人以哑瘴最为危急，其状初得之即失音。不过一二日，即致不救。
医家多言为极热所致，或云内蕴热而外为感寒所激。近见北医有用煎生附子一味愈此疾者，
得非以热治热，或者发散寒气耶？予尝闻有饮溪涧水中毒，令人失音，则知凡失音者，未必
皆瘴也。溪涧水毒，灼然有之，道路多无井泉，而濒江之民与夫山行者，皆饮溪涧之水，岂
无邂逅遇毒者？故途人所以多病此，得非是欤。
十、传云岭外多毒草，彘食之，而人食其肉者亦毒人。所以北人度岭，多戒食彘。然而
岭南能致瘴毒者，非止一端，岂在是耶。顺泉云∶岭南之彘，在市井者，食豆与酒糟。在乡
村者，食糠与碎米、芋苗，未有食草者。若然，则牛马羊畜之肉，悉皆不可食也，可乎？此
其所以不足信也。
一、岭南地区的习俗是食用槟榔，严重的甚至每天吃十几枚。大概瘴疟的发生，大多是因为饮食过度，导致气机阻滞、痰湿凝结，而槟榔最能降气、消食、祛痰，所以人们都拘泥于眼前的利益而忽视了长远的祸患。这很像北方人食用乳酪酥油，往往导致皮肤腠理致密，一旦遭遇疫病需要发汗时，毛孔闭塞而无法出汗。岭南地处高峻南方，气候炎热，因为食用槟榔，脏腑之气变得疏泄。如果一旦患上瘴病需要攻邪发汗，身体虚弱消瘦就无法承受。所以当地人大多形体消瘦且面色发黄，难道全是气候造成的吗？大概也是槟榔带来的祸患，只是人们没有深思罢了。
二、《本草》记载有三个人早晨在雾中行走，其中喝酒的人唯独没有生病。所以北方人翻越岭南山脉，常常互相劝勉饮酒，而被贬谪的客居之士，也往往喝得大醉来自我宽慰。而且岭外酒价特别低廉，贩夫走卒都能尽情畅饮，大家都说这样可以辟除瘴气。殊不知少量饮酒有益，但过多则会滋生瘴气的根源。为什么这样说呢？大概南方土地暑湿盛行，嗜好饮酒则容易中湿毒，再加上瘴疟的发生，大多因上膈有痰饮停留，而酒尤其能聚生痰湿。岭外的谚语说：“不要喝卯时的酒，不要吃申时的饭”，这确实是养生的关键所在。可见酒这种东西，既能辟除瘴气使人存活，也能滋生瘴气危害生命。然而生与死，并非酒本身决定，关键在于人如何运用。
三、广南地区每年以暑毒为害的情况很多，大概一年之中，暑热时间超过一半，使人难以躲避而易被侵犯，凡是起居饮食稍微失去节制，就会被暑毒所伤，在道路途中，更是多有冒犯暑气的情况。所以当地人在暑天，互相告诫不要外出。况且偏远荒凉之地，道路崎岖不平，而驿站和饮食条件，都不如人意。所以刚从北方来到的人，都说是不适应水土而生病，等到回去时，又被称为“回头瘴”。大体上是由于道路劳倦，冒犯暑气，以及饮食居住失于节制所致。
四、岭南寒暑气候不恒定，尤其难以调养摄护，所以凡是居住在此和在路途上的人，冬夏的衣服都不能缺少，随着气候变化，应当迅速增减，迟缓了就会致病。另外岭外海风异常，稍微侵入人体就会生病，坐卧时更换衣物，当时应当谨慎。
五、岭外虽然多以暑病为患，但四季也有伤寒、瘟疫等疾病，其种类不一，当地人不管是什么病，全都称为瘴病，治疗多有误治。或者有一年特别寒冷，接近中原地区，而当地风俗向来没有养蚕织布，冬天不穿丝绵衣服，居室稀疏漏风，门户关闭不牢固，忽然遭受岁寒，那么次年瘟疫必定兴起。医生治疗瘟疫，也应当用本来的法治之，并根据当地的风土气候，以及人的强弱，酌情适宜即可。
六、瘴疟的发生，多因伏暑受冷所致，即使不是吃了生冷食物，也一定是外感寒邪，内伤饮食。大致而言，伏暑浅而寒气多的，容易治疗；伏暑深而热气多的，难治。近来北方医生来到这里，用大柴胡汤治疗热瘴，必须是本身体质壮实的人，才能承受。如果当地人长期服用槟榔，脏腑之气已经虚弱，往往不能耐受寒药，又能承受这种峻猛的方剂吗？然而当地人刚见到发黄，就认为是无法治疗的疾病，实在令人悲哀。
七、北方人来岭南，婢女仆人多患瘴气。大概是从事劳役的人，饮食失去节制，昼夜冒犯暑气，夜里多睡在地上。又因为凡事不能避忌，所以先受到损害。既然与他们同甘共苦，应当特别注意戒慎他们。
八、民间俗人有病一定召唤巫觋祭祀鬼神，士大夫们都嘲笑他们信巫不信医，我认为这值得怜悯同情而不应该嘲笑。百姓虽然极其愚昧，然而谁不想趋利避害呢？何况性命攸关，这是明显易见的道理。如果医生能治愈人的疾病，他们为什么不用呢？大概岭外良医很少，药物种类尤其缺乏，而且山谷海岛的居民，从哪里得到医药呢？所以不免相信巫术，难道是出于自愿吗？
九、瘴病种类繁多，而当地人认为哑瘴最为危急，其症状是刚发病就失音。不过一两天，就会导致死亡无法救治。医家多说是极热所致，有人说体内蕴藏热邪而外部受寒邪激发。近来见北方医生有用单味煎煮生附子治愈此病的，莫非是用热治热，或者是发散寒气吗？我曾听说有人饮用溪涧水中毒，使人失音，就知道凡是失音的，未必都是瘴病。溪涧水有毒，确实存在，道路上多没有井泉，而沿江居民和登山者，都饮用溪涧之水，难道没有偶然遇到有毒水的吗？所以路人因此多患此病，莫非是这个原因吧。
十、传说岭外多毒草，猪吃了它，人吃了猪肉也会中毒。所以北方人翻越岭南山脉，多告诫不吃猪肉。然而岭南能导致瘴毒的，不止这一端，难道就在这里吗？顺泉说：岭南的猪，在市井中的，吃豆子和酒糟。在乡村的，吃糠秕碎米、芋苗，没有吃草的。如果是这样，那么牛马羊等牲畜的肉，也都不可食用了吗？可以吗？这就是其不足信的原因。
1. The custom in the Lingnan region is to consume Areca nut (Binglang, 槟榔); severe cases involve eating dozens of pieces daily. Generally, the onset of Zhang malaria (Zhang Nue, 瘴疟) is often due to overeating, leading to Qi stagnation and phlegm accumulation. Areca nut is particularly effective in descending Qi, promoting digestion, and resolving phlegm. Thus, people are accustomed to short-term benefits while ignoring long-term harms. This is somewhat similar to northerners consuming dairy products like butter and cheese, which often result in dense skin pores. Once an epidemic requires sweating therapy, the pores remain closed, preventing the release of pathogens. In the hot climate of southern China, the consumption of Areca nut causes the internal organs' Qi to become loose and diffusive. If one contracts a miasma disease requiring purgative or diaphoretic treatment, the body may be too weak and emaciated to tolerate it. Therefore, locals are often thin with sallow complexions. Is this solely due to climate? It is likely also a consequence of Areca nut consumption, though people fail to reflect on this.
2. The *Bencao* records that three men walked in the morning mist; only the one who drank alcohol remained healthy. Consequently, northerners crossing the mountains often encourage each other to drink wine. Exiled scholars and officials frequently get drunk to comfort themselves. Moreover, wine prices outside the mountains are particularly low, allowing laborers and vendors to drink freely, believing it wards off miasma. However, little is beneficial, but much breeds the source of miasma. Why? The southern land is hot and damp; excessive drinking leads to damp-toxin accumulation. Furthermore, Zhang malaria often arises from phlegm-fluid retention in the upper jiao, and wine tends to generate phlegm. A local proverb states: "Do not drink wine at Mao hour (5-7 AM), do not eat rice at Shen hour (3-5 PM)," which is indeed essential for health preservation. Thus, wine can both ward off miasma and save lives, or breed miasma and harm people. Life and death depend not on the wine itself, but on how humans use it.
3. In Guangnan, heat-toxin (Shu Du, 暑毒) is a frequent affliction. For more than half the year, the heat makes it difficult to avoid and easy to contract. Any slight lapse in diet or lifestyle can lead to heat-toxin invasion, especially when traveling on roads where exposure to heat is common. Locals warn each other against going out during summer. In remote areas with rugged roads and poor accommodation and food conditions, newcomers from the north often claim illness due to acclimatization issues. Upon return, this is called "Return Miasma" (Huitou Zhang, 回头瘴). It generally results from travel fatigue, exposure to heat, and improper diet and living habits.
4. The cold and heat patterns in Lingnan are irregular, making regulation difficult. Whether residing locally or traveling, winter and summer clothing must be available and adjusted promptly according to weather changes; delay can cause illness. Additionally, abnormal sea winds outside the mountains can easily cause disease if they penetrate the body. One should be cautious about changing clothes when sitting or lying down.
5. Although Lingnan is prone to heat diseases, cold damage (Shanghan, 伤寒) and epidemics occur in all seasons, varying in type. Locals label all illnesses as "miasma," leading to frequent misdiagnosis and mistreatment. In years with extreme cold resembling the Central Plains, locals, unaccustomed to sericulture and lacking silk cotton garments, live in drafty houses with insecure doors. Sudden cold spells can trigger epidemics the following year. Physicians treating epidemics should apply standard methods but adjust according to local climate, terrain, and patient constitution.
6. Zhang malaria often arises from latent summerheat combined with cold injury. Even without consuming cold foods, external cold invasion and internal dietary injury are usually involved. Cases with shallow latent summerheat and abundant cold are easier to treat; those with deep latent summerheat and abundant heat are harder to treat. Recently, northern physicians used Da Chaihu Tang (Major Bupleurum Decoction) to treat heat-type miasma. This requires patients with strong constitutions to tolerate it. Locals who have consumed Areca nut for long periods have weakened organ Qi and often cannot tolerate cold-natured medicines, let alone such potent formulas. Yet, locals see jaundice and deem it incurable, which is truly lamentable.
7. When northerners come to Lingnan, servants and maids often suffer from miasma qi. Laborers often have irregular diets, endure heat day and night, and sleep on the ground. Their inability to avoid hazards leads them to suffer first. Since we share their fortunes and misfortunes, we should take special care to warn them.
8. Common people summon shamans to sacrifice to ghosts and gods when ill. Scholars mock this superstition, preferring medicine. I find this pitiable rather than laughable. Though people may seem foolish, everyone seeks benefit and avoids harm, especially regarding life and death, which are obvious. If doctors could cure diseases, why would people not seek them? There are few good doctors in Lingnan, and medicinal herbs are scarce. People in valleys and islands have no access to medicine, so they turn to shamans out of necessity, not choice.
9. Miasma diseases vary, but locals consider "Mute Miasma" (Ya Zhang, 哑瘴) the most critical. Symptoms include immediate loss of voice upon onset, leading to death within one or two days. Physicians attribute this to extreme heat or internal heat triggered by external cold. Recently, northern physicians cured this using raw Aconite Root (Fuzi, 附子) decocted alone. Was this using heat to treat heat, or dispersing cold? I once heard of poisoning from stream water causing loss of voice. Thus, loss of voice is not always due to miasma. Stream water toxicity is real. With few wells on roads, riverside residents and hikers drink stream water. Accidental poisoning is possible. Perhaps this explains why travelers often suffer from this condition.
10. Legends say Lingnan has many poisonous plants; pigs eat them, and humans eating pig meat also get poisoned. Hence, northerners crossing the mountains are warned against eating pork. However, causes of miasma toxin in Lingnan are manifold, not limited to this. Shunquan stated: Pigs in markets eat beans and wine lees; those in villages eat bran, broken rice, and taro shoots, never grass. If true, then meat from cattle, horses, and sheep should also be avoided, which is absurd. This proves the legend unreliable.