凡疟疾初作，必多寒热，大抵皆属少阳经病。其于初起，当专以散邪为主。若果形气无
伤，而脉证别无他故者，但宜正柴胡饮，或三柴胡饮主之。少者一、二剂，多者三、四剂，
无有不愈。若气体本弱而感邪为疟，即宜四柴胡饮为妙，勿以初起而畏之弗用也。
一、治疟当辨寒热，寒胜者即为阴证，热胜者即为阳证。盖有素禀之寒热，有染触之寒
热，然必其表里俱有热邪，方是火证。若疟至则热，疟止则退，而内无烦热闭结等证，则不
得以火证论治。若内外俱有火证，而邪有不散者，一柴胡饮主之。若邪入阳明，内热之甚，
而邪有未散者，宜柴胡白虎煎。若邪入肝肾，而热极动血者，宜柴芩煎。
一、疟有寒证，如无虚邪，而但以寒邪不能散，或多中寒者，宜二柴胡饮。若以寒胜而
兼气虚，邪有不解者，宜四柴胡饮，或补中益气汤加干姜、官桂。若寒甚热少，脉迟而兼背
恶寒，或多呕恶泄泻者，必用麻桂饮，或大温中饮。
一、中气虚弱不能胜邪，而邪不能解者，病在脾肺气分，宜补中益气汤、五柴胡饮。若
阴虚血液不充而邪不能解者，病在肝肾精分，宜补阴益气煎、归柴饮。此证极多，其效尤捷
。若发时其寒如冰，其热如烙，而面赤如脂，渴欲饮水，而热退即不渴者，以六味地黄汤加
柴胡、芍药、肉桂，大剂一服，即可愈。若元气虚寒之甚，阳不胜阴而邪不能解者，大温中
饮。若元气虚甚，或衰老积弱者，则不必兼用攻邪，只当以正气为主，但使元气不败，则邪
气无有不服，宜大补元煎，或十全大补汤之类主之。而又惟休疟饮为最妙。
一、疟疾屡散之后，取汗既多，而病不能止者。必以过伤正气，而正不胜邪，则虽止微
邪犹然不息，但使元气之虚者一振，散者一收，则无不顿然愈矣，宜三阴煎、五福饮，或小
营煎、休疟饮主之。若有微寒者，宜大营煎，或理中汤。若微有火者，宜一阴煎。若多汗不
收者，宜五阴煎之类主之。
一、疟疾久不能愈者，必其脾肾俱虚，元气不复而然。但察其脉证，尚有微邪不解者，
当专以补中益气汤为主。若邪气已尽而疟有不止者，则当专补元气，以八珍汤、十全大补汤
，或大补元煎之类主之。若肾阴不足，而精不化气者，宜理阴煎最效。若阴邪凝滞而久不愈
者，宜于前药加姜、桂、附子。
一、疟作而呕吐恶食者，虽曰少阳之邪为呕吐，然实由木邪乘胃所致。但解去外邪，呕
当自止，宜柴陈煎，或正柴胡饮加半夏主之。若脾胃气虚而寒邪乘之，则最多呕恶之证，宜
温胃饮、理中汤、养中煎之类主之。若虚寒连及命门，火不生土而作呕者，宜理阴煎、右归
饮之类主之。若兼食滞而作呕者，必多胀满，宜加陈皮、砂仁、山楂、浓朴之类为佐。若兼
火邪者，必多热渴、躁烦、秘结，宜以黄芩、黄连之类为佐；若火在阳明甚者，宜加石膏。若
兼寒者，必胃口怕寒，或吞酸，或嗳腐，或恶心。得热稍可者，宜以姜、桂、附子、吴茱萸
之类为佐。
一、疟疾因劳辄复，连绵不已者，此脾肾虚证。盖肾主骨，肝主筋，脾主四肢，气弱不
胜劳苦，所以即发，但补脾肝肾，使其气强则愈。如十全大补汤、八珍汤、补中益气汤，皆
可酌用。
一、疟疾发散已多，每致阴虚水亏，而烦热多渴者，宜以西瓜汁，或悉尼浆，或冷参汤
，俱可滋阴截疟。无热者，不可强用。
一、疟痢并作而脏平邪浅者，宜胃苓汤加柴胡一、二钱。若寒湿伤脾而疟痢并作者，宜
温胃饮加柴胡，或胃关煎加柴胡亦妙。若湿热伤脾，下及肝肾而暴注热渴，或下纯鲜血者，
宜柴芩煎。
一、疟邪未清，而过食伤脾，以致痞满连绵不已者，宜大小和中饮加柴胡。若因食而成
疟痞者，宜芍药枳术丸，及大小和中饮之类调之。若痞成难消者，须灸章门、水道等穴，炷
宜稍大，多灸，或连灸二三次，方得全愈。
一、古云∶治疟之法，凡将发之时，与正发之际，慎毋勉强施治，即治亦无效，必待阴
阳并极，势平气退之后，然后，察而治之，或于未发二三时之先，迎而夺之，可也。经曰∶
夫疟之未发也，阴未并阳，阳未并阴，因而调之，真气得安，邪气乃亡。故工不能治其已发
，为其气逆也。按此古法，殊似不然，予近治疟，每迎其锐而击之，最捷最妙。是可见古法
之有不必泥者。
凡疟疾初次发作，必然多有寒热交替的症状，大抵都属于少阳经的病证。在疾病初起阶段，治疗应当专门以疏散邪气为主。如果患者形体和正气没有损伤，且脉象与症状没有其他异常，只适宜使用正柴胡饮，或者三柴胡饮来主治。轻者服用一、两剂，重者服用三、四剂，没有不痊愈的。如果患者体质本来虚弱而感染邪气患疟疾，就适宜使用四柴胡饮为妙，不要因为处于初起阶段就畏惧而不敢使用。
一、治疗疟疾应当辨别寒热，寒邪盛的就称为阴证，热邪盛的就称为阳证。大概有先天素体禀赋的寒热差异，也有外感染触的寒热差异，然而必须表里都有热邪，才算是火证。如果疟疾发作时才发热，停止时就退热，而体内没有烦热、便秘等证候，就不能按照火证来论治。如果内外都有火证，而邪气仍然没有解散的，用一柴胡饮主治。如果邪气传入阳明经，内部热势很盛，而邪气尚未解散的，适宜用柴胡白虎煎。如果邪气传入肝肾，而热极导致动血（出血）的，适宜用柴芩煎。
一、疟疾有寒证，如果没有虚邪，只是单纯因为寒邪不能消散，或者中寒严重的，适宜用二柴胡饮。如果因为寒邪盛而兼有气虚，邪气未能解除的，适宜用四柴胡饮，或者补中益气汤加入干姜、官桂。如果寒甚热少，脉迟并且兼有背部恶寒，或者多呕吐、恶心、泄泻的，必须用麻桂饮，或者大温中饮。
一、中气虚弱不能胜任驱邪，而邪气不能解除的，病位在脾肺气分，适宜用补中益气汤、五柴胡饮。如果阴虚血液不充盈而邪气不能解除的，病位在肝肾精分，适宜用补阴益气煎、归柴饮。这种证候非常多见，疗效尤其快捷。如果发作时冷如冰，热如烙铁，面色红赤如脂膏，口渴想喝水，但热退后就不渴的，用六味地黄汤加入柴胡、芍药、肉桂，大剂量一次服用，即可痊愈。如果元气虚寒非常严重，阳气不胜阴邪而邪气不能解除的，用大温中饮。如果元气极度虚弱，或者年老衰老积弱的人，则不必兼用攻邪的药物，只应当以扶助正气为主，只要使元气不崩溃，那么邪气就没有不服从的，适宜用大补元煎，或者十全大补汤之类的方剂主治。而这其中又以休疟饮最为奇妙。
一、疟疾经过多次发散治疗后，出汗既多，而病仍不能停止的。必然是因为过度损伤了正气，导致正气不胜邪气，那么即使是很微小的邪气也依然不息，只要使亏损的元气得以振奋，耗散的元气得以收敛，就没有不立刻痊愈的，适宜用三阴煎、五福饮，或者小营煎、休疟饮主治。如果有轻微寒象的，适宜用大营煎，或者理中汤。如果微有火象的，适宜用一阴煎。如果多汗不能收敛的，适宜用五阴煎之类的方剂主治。
一、疟疾长久不能痊愈的，必然是脾肾都虚弱，元气不复原所致。只要观察其脉象和症状，还有微邪未解除的，应当专门以补中益气汤为主。如果邪气已经清除而疟疾仍不止的，则应当专门补益元气，用八珍汤、十全大补汤，或者大补元煎之类的方剂主治。如果肾阴不足，而精气不能化生为气的，适宜用理阴煎效果最好。如果阴邪凝滞而长久不愈的，适宜在前面的药物中加入生姜、肉桂、附子。
一、疟疾发作而出现呕吐、厌恶饮食的，虽然说是少阳经的邪气导致呕吐，但实际上是由肝木之邪乘袭胃腑所致。只要解除了外邪，呕吐自然会停止，适宜用柴陈煎，或者正柴胡饮加入半夏主治。如果脾胃气虚而寒邪乘袭，则最多出现呕吐恶心的证候，适宜用温胃饮、理中汤、养中煎之类的方剂主治。如果虚寒连及命门，火不生土而导致呕吐的，适宜用理阴煎、右归饮之类的方剂主治。如果兼有食积停滞而导致呕吐的，必然多有胀满，适宜加入陈皮、砂仁、山楂、厚朴之类的药物作为佐使。如果兼有火邪的，必然多有热渴、烦躁、便秘，适宜以黄芩、黄连之类的药物作为佐使；如果火邪在阳明经严重的，适宜加入石膏。如果兼有寒邪的，必然胃口怕冷，或者吞酸，或者嗳出腐臭气味，或者恶心。得热稍能缓解的，适宜以生姜、肉桂、附子、吴茱萸之类的药物作为佐使。
一、疟疾因为劳累辄复发，连绵不断的，这是脾肾虚损的证候。大概肾主骨，肝主筋，脾主四肢，气弱不能胜任劳苦，所以就会立即发作，只要补益脾肝肾，使其气强盛就能痊愈。如十全大补汤、八珍汤、补中益气汤，都可以酌情使用。
一、疟疾发散治疗过多，每每导致阴虚水亏，而烦热多渴的，适宜用西瓜汁，或者悉尼浆（注：此处原文可能指某种特定饮品或笔误，依原文直译），或者冷参汤，都可以滋阴截疟。没有热象的，不可强行使用。
一、疟疾和痢疾同时发作而脏腑平和、邪气浅表的，适宜用胃苓汤加入柴胡一、二钱。如果寒湿损伤脾脏而疟疾和痢疾同时发作的，适宜用温胃饮加入柴胡，或者胃关煎加入柴胡也很奇妙。如果湿热损伤脾脏，下及肝肾而出现急骤腹泻、热渴，或者下纯鲜血的，适宜用柴芩煎。
一、疟邪没有清除干净，而过量饮食损伤脾脏，以致痞满连绵不断的，适宜用大小和中饮加入柴胡。如果因为饮食而成疟疾痞块的，适宜用芍药枳术丸，以及大小和中饮之类的方剂调理。如果痞块形成难以消除的，必须灸章门、水道等穴位，艾炷宜稍大，多灸，或者连续灸二三次，才能完全痊愈。
一、古语说：治疗疟疾的方法，凡是即将发作的时候，以及正在发作之际，千万不要勉强施治，即使治疗也没有效果，必须等到阴阳之气都达到极点，形势平稳、气机衰退之后，然后观察并治疗，或者在发作前两三个小时之前，迎击而夺取其邪气，是可以的。《内经》说：疟疾尚未发作时，阴气未并与阳气，阳气未并与阴气，因此调治它，真气得以安宁，邪气乃亡。所以高明的医生不能治疗已经发作的疟疾，是因为此时气机逆乱。按此古法，似乎不太正确，我最近治疗疟疾，每每迎着邪气的锐气而攻击它，最快捷最奇妙。由此可见古法中有不必拘泥的地方。
Whenever malaria first occurs, there is invariably chills and fever alternating. Generally, it belongs to the Shaoyang (Lesser Yang) channel disease. In the initial stage, treatment should focus primarily on dispersing pathogenic factors. If the patient's physical constitution and vital energy are undamaged, and the pulse and symptoms show no other abnormalities, only Zheng Chaihu Yin (Correct Bupleurum Decoction) or San Chaihu Yin (Three Bupleurum Decoction) should be used. For mild cases, one or two doses suffice; for severe cases, three or four doses will cure it without exception. If the patient's constitution was originally weak and contracted malaria due to pathogenic invasion, Si Chaihu Yin (Four Bupleurum Decoction) is excellent; do not refrain from using it simply because it is the initial stage.
1. When treating malaria, one must distinguish between chills and heat. Predominance of chills indicates a Yin syndrome (Yin Syndrome), while predominance of heat indicates a Yang syndrome (Yang Syndrome). There are differences in innate constitutional cold/heat and those acquired through external infection. However, only when both exterior and interior have heat pathogens is it considered a Fire syndrome (Fire Syndrome). If fever occurs only during the malaria attack and subsides when it stops, without internal symptoms such as irritability or constipation, it cannot be treated as a Fire syndrome. If there are Fire syndromes both internally and externally, yet the pathogen remains unresolved, Yi Chaihu Yin (One Bupleurum Decoction) should be used. If the pathogen has entered the Yangming (Yang Brightness) channel with severe internal heat but remains unresolved, Chaihu Baihu Jian (Bupleurum and White Tiger Decoction) is appropriate. If the pathogen has entered the Liver and Kidney channels, causing extreme heat that disturbs the blood, Chai Qin Jian (Bupleurum and Scutellaria Decoction) is indicated.
1. Malaria can present with Cold syndromes. If there is no deficiency pathogen, but merely cold pathogen that fails to disperse, or if there is significant middle-jiao cold, Er Chaihu Yin (Two Bupleurum Decoction) is suitable. If cold predominance is accompanied by Qi deficiency and the pathogen remains unresolved, Si Chaihu Yin (Four Bupleurum Decoction) or Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Ganjiang (Dried Ginger) and Guigui (Cinnamon Twig) should be used. If chills are severe with little heat, the pulse is slow, and there is aversion to cold on the back, or frequent vomiting, nausea, and diarrhea, Magui Yin (Ephedra and Cinnamon Decoction) or Da Wenzhong Yin (Great Warm the Middle Decoction) must be used.
1. If Spleen and Stomach Qi is weak and unable to overcome the pathogen, resulting in unresolved illness, the pathology lies in the Qi aspect of the Spleen and Lung. Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) or Wu Chaihu Yin (Five Bupleurum Decoction) is indicated. If Yin deficiency leads to insufficient Blood, preventing pathogen resolution, the pathology lies in the Essence aspect of the Liver and Kidney. Buyin Yiqi Jian (Nourish Yin and Augment Qi Decoction) or Guichai Yin (Angelica and Bupleurum Decoction) is indicated. This type of case is very common and responds particularly quickly. If during an attack the body feels as cold as ice and as hot as a branding iron, the face is red like grease, thirst exists with desire to drink water, but thirst ceases when the fever breaks, Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) added with Chaihu (Bupleurum Root), Shaoyao (Peony Root), and Rougui (Cinnamon Bark) in a large single dose can effect a cure. If Yuanqi (Original Qi) is extremely deficient and cold, with Yang unable to overcome Yin, Da Wenzhong Yin (Great Warm the Middle Decoction) is used. If Yuanqi is severely deficient, or in cases of old age and chronic debility, attacking the pathogen should be avoided; instead, tonifying healthy Qi is paramount. As long as Yuanqi does not collapse, the pathogen will submit. Dabu Yuanyuan Jian (Great Tonify Original Source Decoction) or Shiquan Dabu Tang (Ten Complete Great Tonification Decoction) are indicated. Among these, Xiumie Yin (Malaria-Restoring Decoction) is the most excellent.
1. After repeated dispersing treatments for malaria, excessive sweating occurs, yet the disease persists. This is due to over-damage of healthy Qi, where healthy Qi cannot overcome the pathogen. Even minor pathogens remain active. If the deficient Yuanqi is revitalized and dispersed Qi is gathered, immediate recovery is assured. Sanyin Jian (Three Yin Decoction), Wufu Yin (Five Blessings Decoction), Xiaoying Jian (Small Nourishing Decoction), or Xiumie Yin (Malaria-Restoring Decoction) are indicated. If there is slight cold, Daying Jian (Great Nourishing Decoction) or Lizhong Tang (Regulate the Middle Decoction) is suitable. If there is slight heat, Yiyin Jian (One Yin Decoction) is suitable. If sweating is profuse and uncontrolled, Wuyin Jian (Five Yin Decoction) is indicated.
1. Malaria that persists for a long time is due to dual deficiency of the Spleen and Kidney and failure of Yuanqi (Original Qi) to recover. If pulse and symptoms indicate minor unresolved pathogens, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) should be the primary treatment. If pathogens are cleared but malaria continues, pure tonification of Yuanqi is required, using Bazhen Tang (Eight Treasures Decoction), Shiquan Dabu Tang (Ten Complete Great Tonification Decoction), or Dabu Yuanyuan Jian (Great Tonify Original Source Decoction). If Kidney Yin is insufficient and Essence fails to transform into Qi, Liyin Jian (Regulate Yin Decoction) is most effective. If Yin pathogens are stagnant and persistent, add Jiang (Ginger), Gui (Cinnamon), and Fuzi (Prepared Aconite Root) to the previous formulas.
1. Vomiting and food aversion during malaria attacks are often attributed to Shaoyang (Lesser Yang) pathogens affecting the Stomach, but actually result from Wood (Liver) pathogens invading the Stomach. Resolving the exterior pathogen usually stops the vomiting spontaneously. Chaichen Jian (Bupleurum and Chenpi Decoction) or Zheng Chaihu Yin (Correct Bupleurum Decoction) added with Banxia (Pinellia Tuber) is indicated. If Spleen and Stomach Qi deficiency allows Cold pathogens to invade, leading to frequent vomiting and nausea, Wenwei Yin (Warm the Stomach Decoction), Lizhong Tang (Regulate the Middle Decoction), or Yangzhong Jian (Nourish the Middle Decoction) are indicated. If deficiency-cold extends to the Mingmen (Gate of Life), with Fire failing to generate Earth (Spleen/Stomach), causing vomiting, Liyin Jian (Regulate Yin Decoction) or Yougui Yin (Right Restoration Decoction) are indicated. If accompanied by food stagnation causing vomiting, abdominal fullness is likely; add Chenpi (Tangerine Peel), Sharen (Amomum Fruit), Shanzha (Hawthorn Fruit), and Houpo (Magnolia Bark) as assistants. If accompanied by Fire pathogens, heat-thirst, restlessness, and constipation occur; add Huangqin (Scutellaria Root) and Huanglian (Coptis Rhizome) as assistants. If Fire is severe in the Yangming (Yang Brightness) channel, add Shigao (Gypsum). If accompanied by Cold, cold sensation in the stomach region, acid regurgitation, belching of rotten smells, or nausea occur. Relief with warmth suggests adding Jiang (Ginger), Gui (Cinnamon), Fuzi (Prepared Aconite Root), and Wuzhuyu (Evodia Fruit) as assistants.
1. Malaria recurring immediately after exertion and persisting continuously indicates Spleen and Kidney deficiency. The Kidney governs bones, the Liver governs sinews, and the Spleen governs the four limbs. Weak Qi cannot withstand labor, triggering recurrence. Tonifying the Spleen, Liver, and Kidneys strengthens Qi and cures the disease. Shiquan Dabu Tang (Ten Complete Great Tonification Decoction), Bazhen Tang (Eight Treasures Decoction), and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) may be used酌情ly.
1. Excessive dispersing treatments for malaria often lead to Yin deficiency and fluid depletion, causing irritability, heat, and thirst. Watermelon juice, Xini Jiang (Sydney Pulp - *Note: Likely a specific local remedy or textual variant*), or Lengshen Tang (Cold Ginseng Decoction) can nourish Yin and arrest malaria. They should not be forced upon patients without heat signs.
1. When malaria and dysentery occur together with harmonious viscera and shallow pathogens, Weiling Tang (Stomach and Ping Decoction) added with 1-2 qian of Chaihu (Bupleurum Root) is indicated. If Cold-Dampness injures the Spleen causing simultaneous malaria and dysentery, Wenwei Yin (Warm the Stomach Decoction) added with Chaihu (Bupleurum Root), or Weiguan Jian (Stomach Gate Decoction) added with Chaihu (Bupleurum Root) is excellent. If Damp-Heat injures the Spleen, descending to the Liver and Kidney, causing acute watery diarrhea, heat-thirst, or passage of pure bright red blood, Chai Qin Jian (Bupleurum and Scutellaria Decoction) is indicated.
1. If malaria pathogens are not cleared and overeating injures the Spleen, causing persistent epigastric fullness and obstruction, Da Xiao Hezhong Yin (Large and Small Harmonize the Middle Decoctions) added with Chaihu (Bupleurum Root) is indicated. If food-induced malaria obstruction occurs, Shaoyao Zhizhu Wan (Peony and Immortelle Pill) and Da Xiao Hezhong Yin (Large and Small Harmonize the Middle Decoctions) are used for regulation. If the obstruction is formed and difficult to dissipate, moxibustion at Zhangmen (LR13) and Shuidao (ST28) acupoints is necessary. The moxa cones should be slightly larger, applied frequently, or continued for two to three sessions for complete recovery.
1. Ancient texts state: Regarding malaria treatment, when symptoms are about to start or are actively occurring, one must not forcibly apply treatment; even if done, it is ineffective. One must wait until Yin and Yang extremes pass, the situation stabilizes, and Qi recedes, then observe and treat. Alternatively, intercepting the pathogen two to three hours before onset is acceptable. The Classics say: "Before malaria starts, Yin has not merged with Yang, and Yang has not merged with Yin. Therefore, regulating it then allows True Qi to settle and Pathogens to perish." Thus, skilled physicians cannot treat already-onset malaria because Qi is reversed. According to this ancient method, it seems incorrect. In my recent practice, I intercept the pathogen while it is at its peak, which is fastest and most effective. This shows that ancient methods need not be rigidly adhered to.