初发之际，病势正炽，一二发间，未宜遽截，不问寒热多少，且以养胃汤、柴平散、清脾饮、草果饮选用。
待四五发后，便应截住，否则发得气虚，病邪愈深而难愈，即于清脾饮加常山。世有砒丹等截药，大毒不可轻
用。若气虚者，虽截不效，愈截愈虚，遂成重疾，戒之！必先与参术一二帖，托住其气，不使下陷，后用他药。
（《统旨》）（按∶此系错凑《要诀》及《丹溪》）
疟疾初宜发散，用汗解之药一二剂。次宜和解，用清热之药一二剂。然后发至四五次，方可行截。（《绳
墨》）
形壮色泽者，病在气分，则通经开郁以取汗。色稍夭者，则补虚取汗。挟痰者，先实其胃，一二日方服劫
药。形弱色枯，则不取汗，亦不可劫，补养以通经调之。形壮而色紫黑，病在血分，则开其涩滞。色枯者，补
血调气。此其常也。至若取汗而不得汗，理血而血不开，非更求药切中病情，直造邪所着处，安能愈乎。（《
推求师意》）
南北异治 东南滨海，海风无常，所食鱼盐，人多停食，故风疟、食疟所由以盛，乌头、草果、陈皮、
半夏施得其宜。西北高旷，隆冬则水冰地裂，盛夏则烁石流金，人多中寒伏暑，故多暑疟、寒疟，柴胡、恒山
故应合用。东南西北，往来其间，病在未分之际，可与藿香正气散、草果饮，是犹养胃例也。（《永类》）
（按∶《微义》论南人脾寒为疟之理，文繁不录。）
和解为主 久病新病皆用柴胡，但久病用少，新病用多，以疟乃少阳经之病居多，而柴胡又少阳经之
引药，且治寒热有功也。（《医镜》）
疟邪外不在皮肤，内不在脏腑，是以汗之而不从外泄，下之而不从里出也。（《医学续记》）
汗吐下 将疗之方，吐下为本，人有强羸，病有轻重，自须临时斟酌，不可一概言之。（《外台》引
许仁则）
凡古人治疟之法，若其久而汗多，腠理开泄，阳不能固者，必补敛之；无汗则腠理致密，邪不能解，必发
散之。故曰有汗者要无汗，扶正为主；无汗者要有汗，散邪为主（按∶此丹溪言）。此大法也。（《景岳》）
惟其取汗，若得汗而体虚，又须重用补剂以助之，俟汗
出通身，下过委中，方是佳兆。仍教以淡食饮，省出入，避风就温，远去帷簿，谨密调养，无有不安。（《格
致余论》）
凡治疟，不求邪之所在，辄行大汗大下，伤人正气者，医之罪也。疟邪在于半表半里，故有寒有热，若大
汗以伤其表，大下以伤其里，是药反增疟矣。倘疟邪伏而未尽，药过再发，更将何法以处之。（《法律》）
凡用吐法，妄施恶劣之药，并各种丸药，伤人脏腑者，医之罪也。吐法止可用清芬之气，透入经络，引出
疟邪，如酒浸常山不用火煎之类。其胆矾、信石等丸，吞入腹中，粘着不行，搅乱肠胃脏腑，究竟无益，戒之
戒之。（同上）
治必助正 疟之为病, 邪正分争，往来不已，有战之义也。治之必先助其正气，或急去其邪气，盖正
旺则邪自解，邪去则正亦安也。今有人体虚患疟，不数日而作渐晏，势渐衰，神气反昏而不可救，非正虚而邪
陷之故欤。（《医学续记》）
常山用否 （大黄为佐） 疾多因中脘有饮，用常山作效者，以其能吐之。（《易简》）盖疟家多蓄
黄水，常山为能破其癖而下其水也。（《直指》）
疟家多蓄痰涎黄水，常山为能吐之利之，是固然尔；其有纯热发疟，或蕴热内实之证，投以常山，大便点
滴而下，似泄不泄，须用北大黄为佐，大泄数行，然后获愈。或曰∶巴豆丸子相根据而行，亦能泄也。是又不然
，巴豆在于下积，苟欲荡涤血热，不可以无大黄。（同上）
如虚弱人，切戒常山，恐成吐伤胃气。（《如宜》）
常山、蜀漆，有劫痰截疟之功，须在表邪发散之后，或疟发七次之后，用之无害。若用之早，必致闭邪，
成膨胀者恒有之。（《汇言》引方龙潭）
疟病虚寒久，用参、术、姜、桂总不能愈者，参、术、姜、桂之内，须加常山，更须加穿山甲，使经络疏
通，疟邪外出，未有不愈者也。（《医学真传》）
常山、蜀漆，生用则上行必吐，酒蒸炒熟用则气稍缓，少用亦不致吐也。得甘草则吐，得大黄则利。（《
本草纲目》）
常山治疟，是其本性。虽善吐人，亦有蒸制得法而不吐者，疟更易愈，其功不在吐痰明矣。亦非吐水之剂，
但能败胃耳。（《准绳》）
若病不甚而用常山，不取其吐利，当以醋久炒之，虽用一二钱，毫不吐也。近有愚者，畏之如螫，盖因未
明常山之性耳。（《沙篆》）
逐水当兼行血 水即水饮也，血即瘀血也，惟水饮所以作寒热，惟瘀血所以增寒热。常山逐水利饮固
也，苟无行血药品佐助其间，何以收十全之效耶。继自今疟家或衄血，或唾血，或大便血丝，或月候适来适去，
皆是血证，当以常山、草果、槟榔、青皮、乌梅、甘草作剂，于内加五灵脂、桃仁为佐，入生姜、浓蜜同煎以
主治之。（《直指》）
截疟法则 （互见治法总说） 凡疟须是发作三五次后，却截之为妙。（《澹寮》）（按∶朱氏曰∶初
患疟疾，未上十次者，不可便截。此说难从。）
发至四五次，方可行截（按∶此本《要诀》），不然截之太早，则腹中作胀，饮食难用，寒热固虽微小，
乍往乍来，不能尽绝，此是截之早也。设或初发一次，就行截者，寒热不能发越，邪气不能屈伸，痰涎妄攻于
上，吐之不出。咽之不下，气急喘盛，昏不知人，闷乱而死。（《绳墨》）
四五发之后，便宜截而除之（按∶《医统》曰∶凡疟数
作之后，发散和解了，便宜截之），迁延日久，中气大伤，病邪转深，卒难取效。（《六要》）
若用截药吐出黄胶水者，疟自愈也。不可一二日早截，早则邪气闭塞而成坏症；又不可迟截，迟则元气衰
惫而成虚怯。当在三四日就截为好。（《回春》）（按∶《慈航》曰∶须待发之势缓，然后可截也。）
每日如期而至，名曰疟信，此当原症发散，未可直攻，未可截也。或前或后，此正气渐旺，邪将不容，名
曰疟衰，方可截之。（《心医集》）
久病者，不可直截，必用一补一截。（《丹溪》）
人虚弱者，截补兼用也。人壮盛者，宜单截也。（《回春》）
凡截疟之法，方固不少，然亦无必效之方。若以愚见，并及治验，则未尝借于截也。盖有邪者去邪则愈，
若散邪既透，解表已过，则但收拾元气，而气复即愈，惟能于邪正之间，得其攻补之宜，则无不自愈，此截之
最善者也。至于截疟诸方，虽不可执，亦不可无。第有效于此而不效于彼者，亦以人之气血阴阳各有不同故耳。
故凡用截药者，亦当察人之强弱而酌以用之，庶乎得效。然亦惟轻者易截，而重者不易截也。（《景岳》）
服药节度 经曰∶无刺 之热，无刺浑浑之脉，无刺漉漉之汗。为其病逆，未可治也。知此则病方
来与正作与将过，皆不可治，以反伤真气，不可不知。（《三因》）
服药可于未发前，连进数服（按∶《医说》引《类编》曰∶凡病 临发日，逐杯并服，无不神效）。正发
时，不可与之，恐伤胃气。（《续易简方》）
大抵疟之初得，三数日间，如火燎原，不可向迩，波涛
汹涌，未易回澜，当候其稍定而图之，经所谓其盛者可待衰而已。疟方来与正发及将解，不可投药，耗其真气。
投药当于未发以前，两时之先，或遇发日凌晨，空心与之。（《直指》）（按∶《证治提纲》此下又曰∶否则
药病交争，转为深害。）
凡用针药，必于疟未发之前二时，或于疟退之后，其气和而治之，病易愈矣。（《保命歌括》）
予近治疟，每迎其锐而击之，最捷最效，是可见古法之有不必泥者。（《景岳》）
住后禁补 疟疾住后，不可服补药，补之必再作。（《医说》）
病有不可补者，一曰疟疾，二曰狂疾，三曰水气，四曰香港脚。此四疾治得稍愈，切不可服暖药以峻补之。
如平平补药，亦须于本病上有益乃可。（同上引《医余》）
愈后调理 疟愈后调理，宜生料平胃散，每服加人参、茯苓各半钱，或用四君子汤加陈皮一钱半，即
异功散。（《要诀》）
清解诸方 （附兼补方） 清脾汤，治瘅疟，脉来弦数，但热不寒，或热多寒少，膈满能食，口苦舌干，
心烦渴引水，小便黄赤，大腑不利。
青皮（去白） 浓朴（姜制炒） 白术 草果仁 柴胡（去芦）
茯苓（去皮） 半夏（汤泡七次） 黄芩 甘草（炙各等分）
上 咀，每服四钱，水一盏半，姜五片，煎至七分，去滓温服，不拘时候。（《济生》）《粹言》于本方
加槟榔。《活法》秘方露星饮，治久疟成劳，于本方去青皮、浓朴、草果。加槟榔、恒山、秦艽、桂，酒水各
半盏，露星一宿，次早温去滓服。
小柴胡汤与五苓散合和，名柴苓汤，治伤风伤暑疟大效。每服姜三片，麦门冬二十粒去心，地骨皮少许，
煎温服。（《得效》）
柴平汤，疟发时一身尽痛，手足沉重，寒多热少，脉濡者，名曰湿疟，此方主之。（《医方考》）（即小
柴胡合平胃散）
疟病宜分昼发夜发、寒热多少和解之。和解之方，以小柴胡汤、二陈汤二方相合为主。（《保命歌括》）
截疟妙方
柴胡（去芦五钱） 真广陈皮（泡刮去白晒干三钱） 甘草（五分）
水二碗，煎一碗，临发日五更空心温服。已发时不可服。此方初发二三次，元气实者，用之必效。患疟已
久，或元气虚弱者，用之未必效，须用清补汤。（《活幼心法》）（清补汤见后）
疟大渴大热之甚，小柴胡汤去半夏，加知母、麦门冬、黄连。（《丹溪》）
江应宿治李祠部真阳，伤寒变疟，大渴大热，烦躁引饮。都城医投六君加青皮、浓朴、槟榔、草果，十余
日不效。召予诊视，六脉洪数微弦，与小柴胡去半夏，加白虎汤，一剂而渴止，再剂热退而愈。（《类按》）
小柴胡加常山汤（凡疟症三发之后，皆可服，天明时一服，疟未发前一时一服，神效），即小柴胡汤加常
山三钱生用不炒（如服后欲吐者，即以手指探吐，痰吐尽则愈）。（《时方歌括》）
崔氏疗疟会稽赖公常山方。
常山（三两） 石膏（八两碎绵裹） 甘竹叶（一把切） 糯米（一百粒）
上四味切，以水八升，明旦欲服，今晚渍于铜器中，露置星月下高净处，向明取药，于病患房门前。于铜
器里缓火煎取三升，分三服，临发又一服。若即定，不须后服。（《外
台》）
延年疗温疟壮热不能食，知母鳖甲汤方。
知母 鳖甲（炙） 地骨皮（各三两） 常山（二两） 竹叶（切一升） 石膏（四两碎）
上六味切，以水七升，煮取二升五合，去滓分三服。（同上）
鳖甲白术散，治久疟，寒热相等，汗多，腰脊重痛。
鳖甲（醋炙） 常山 白芍药 柴胡（去苗各一两） 白术（二两） 牡蛎（半两火 ）
上件 咀，每服五钱，水二盏，生姜五片，煎至一盏，去滓温服，不拘时候。（《杨氏》）
青蒿散，治疟疾。
甘草 秦艽 柴胡 草果子 青皮 常山 槟榔 青蒿子（各等分） 桃柳枝（各七寸）
上以常山、秦艽、柴胡、草果子、青皮、甘草为末，每服用水一盏半，入桃柳枝、青蒿子，加乌梅一枚，
煎八分放冷一服，半夜一服，只是预先一夜一服。（《朱氏》）（按∶此系《圣济》治疟祛劳汤之变，彼有鳖
甲等，然此方为优。）
《全生指迷论》曰∶若其人翕翕如热，淅淅如寒，无有时度，支节如解，手足酸疼，头目昏运，此由荣卫
虚弱，外为风邪相乘，搏于阳则发热，搏于阴则发寒，又不治成劳气，宜荆芥散。
荆芥穗 人参 白术 当归（切洗焙） 黄 芍药 桂（去皮各一两） 柴胡（去苗二两） 甘草（炙
半两）
上为粗末，每服五钱，水二盏，煎至一盏，去滓温服。（《幼幼》）
加味四君子汤，治久疟热多寒少不止。（《兰室》）
（即四君子汤加柴胡、薄荷、黄芩各等分。）
补阳消疟丹，疟疾本是常症，只可以平常消导而发散之，今忽为下利等症，则变轻为重，欲发汗则身已亡
阴，欲祛邪则下已便物，顾上则虑下，顾下则碍上，倘仍以常法治之。奏功实少，今用人参一两，鳖甲一两，
白术三两，茯苓一两，当归一两，白芍三两，柴胡一钱，枳壳一钱，槟榔一钱，水煎服。（《石室秘 》）
溃邪诸方 （按∶此诸方除初二首外，多系截疟之治，但截疟更有用柴胡、用吐法、用大黄、用人参、
用附子等诸剂，今散列各类，临处之际，宜参互适用。）清脾汤，治胃疟发作有时。（按∶此原载疟疾证候，
今不录。）
浓朴（四两姜制炒） 乌梅（打去仁） 半夏（汤去滑） 青皮 良姜（各二两） 草果（去皮一两）
甘草（炙半两）
上为锉散，每服四钱，水二盏，姜三片，枣一枚，煎七分去滓，未发前并三服，忌生冷油腻时果。此药温
脾化痰，治胸膈痞闷，心腹胀满，噫醋吞酸，自可常服。（《三因》）（《得效》名小清脾汤。）
疟疾初发时，病势正盛，在一两次发作期间，不宜立即强行截断。无论寒热症状轻重如何，都应先选用养胃汤、柴平散、清脾饮或草果饮进行治疗。
待发作四五次后，才应当进行截断治疗。否则，频繁发作会导致正气虚弱，病邪深入而难以治愈。此时可在清脾饮中加入常山（一种具有涌吐和截疟作用的药材）。世间有使用砒霜等制成的截疟药物，毒性极大，不可轻易使用。如果患者气虚，即使强行截断也无效，反而越截越虚，最终导致重症，务必警惕！必须先服用一两帖含人参、白术的药物，以扶持正气，防止其下陷，然后再使用其他药物。（《统旨》）（按：此段文字系拼凑《要诀》及《丹溪》的内容。）
疟疾初期适宜发散，使用解表发汗的药物一二剂。其次适宜和解，使用清热药物一二剂。然后等到发作四五次后，方可进行截断治疗。（《绳墨》）
形体壮实、面色光泽者，病在气分，应通过疏通经络、开郁结的方法来取汗。面色稍显枯槁者，应通过补虚的方法来取汗。兼有痰湿者，应先充实胃气，经过一两天后再服用劫夺病邪的药物。形体虚弱、面色枯黄者，不采用取汗法，也不可用劫药，应采用补养的方法配合疏通经络来调理。形体壮实但面色紫黑者，病在血分，应开通涩滞。面色枯槁者，应补血调气。这是常规治法。至于那些试图取汗却不得汗，调理血液却血行不畅的情况，如果不寻求更精准对症的药物，直击病邪所在之处，怎么能痊愈呢？（《推求师意》）
南北异治：东南沿海地区，海风无常，人们多食用鱼盐，容易导致食积停滞，因此风疟、食疟较为盛行，使用乌头、草果、陈皮、半夏等药物若得当则有效。西北高地空旷，隆冬时节水结冰地开裂，盛夏时节酷热难耐，人们多受寒邪侵袭或伏暑内蕴，因此暑疟、寒疟较多，柴胡、恒山（即常山）应当合用。对于在东南西北各地往来居住的人，病情尚未明确分类时，可使用藿香正气散、草果饮，这类似于养胃的法则。（《永类》）（按：《微义》论述南方人因脾寒致疟的道理，文字繁琐未录。）
和解为主：无论是久病还是新病都使用柴胡，但久病用量少，新病用量多。因为疟疾多属于少阳经的病证，而柴胡又是少阳经的引经药，且对治疗寒热往来有功效。（《医镜》）
疟邪外不在皮肤，内不在脏腑，所以发汗不能从体表排出，攻下不能从体内排出。（《医学续记》）
汗、吐、下三法：作为治疗的方案，吐法和下法是根本。但人有强弱之分，病有轻重之别，必须根据当时情况斟酌处理，不可一概而论。（《外台》引许仁则）
凡是古人治疗疟疾的方法，如果病程长久且出汗多，腠理（皮肤毛孔）开泄，阳气不能固守的，必须采用补益收敛的方法；如果没有汗，说明腠理致密，邪气无法解散，必须采用发散的方法。所以说，有汗者要使无汗，以扶正为主；无汗者要有汗，以散邪为主（按：这是朱丹溪的观点）。这是基本大法。（《景岳全书》）
关于取汗，如果得汗后身体虚弱，又必须重用补剂来辅助，直到汗出遍全身，下行至委中穴以下，这才是佳兆。仍嘱咐患者饮食清淡，减少外出，避风保暖，远离帷帐闷热之处，谨慎严密地调养，没有不安稳的。（《格致余论》）
凡是治疗疟疾，不探求病邪所在之处，就随意使用大汗、大下的方法，损伤人体正气的，是医生的罪过。疟邪位于半表半里之间，所以既有寒又有热。如果大汗会损伤体表，大下会损伤体内，这样用药反而会增加疟疾的症状。倘若疟邪潜伏而未除尽，用药后再次发作，又将用什么方法来处置呢？（《医宗必读》）
凡是使用吐法，胡乱施用恶劣的药物以及各种丸药，损伤脏腑的，是医生的罪过。吐法只可用清芬之气，透入经络，引出疟邪，如用酒浸泡常山而不需火煎之类。像胆矾、信石等制成的丸药，吞入腹中，粘着不动，搅乱肠胃脏腑，终究没有益处，务必戒除！（同上）
治疗必助正气：疟疾这种病，是邪气与正气相互争斗，往来不已，如同交战一样。治疗时必须先扶助正气，或者急去邪气。大概正气旺盛则邪气自然解除，邪气去除则正气也能安宁。现在有人体质虚弱患疟，没几天发作逐渐推迟，势头渐衰，神气反而昏沉不可救药，这不是正气虚弱而邪气陷入的缘故吗？（《医学续记》）
常山的使用与否（大黄为佐）：疾病多因中脘有水饮停聚，使用常山有效的，是因为它能引起呕吐。（《易简方》）大概疟疾患者多蓄积黄水，常山能破除积聚并引导水液下行。（《直指方》）
疟疾患者多蓄积痰涎和黄水，常山能使其呕吐和泻下，这固然正确；但对于纯热发作的疟疾，或内有蕴热实证的病例，投用常山后，大便只是点滴而下，似泄非泄，必须用北大黄作为佐药，使其大量泻下数次，然后才能痊愈。有人说：巴豆丸也能顺势泻下。这又不对了，巴豆主要针对下焦积滞，如果想要荡涤血分热毒，不能没有大黄。（同上）
如果是虚弱的人，务必戒除使用常山，恐怕会造成呕吐损伤胃气。（《如宜方》）
常山、蜀漆，有劫夺痰涎、截断疟疾的功效，必须在表邪发散之后，或疟疾发作七次之后使用，才不会有害。如果使用过早，必然导致闭阻邪气，形成胀满病的常有发生。（《汇言》引方龙潭）
疟病虚寒日久，使用人参、白术、干姜、肉桂总不能痊愈的，在人参、白术、干姜、肉桂之内，必须加入常山，还必须加入穿山甲，使经络疏通，疟邪外出，没有不痊愈的。（《医学真传》）
常山、蜀漆，生用则上行必然引起呕吐，酒蒸炒熟后用则药性稍缓，少量使用也不会引起呕吐。遇到甘草则引起呕吐，遇到大黄则引起泻下。（《本草纲目》）
常山治疗疟疾，是其本性。虽然善于使人呕吐，但也有蒸制得当而不呕吐的，疟疾更容易痊愈，其功效不在于吐痰是很明显的。它也不是吐水的药剂，只会败坏胃气罢了。（《准绳》）
如果病情不重而使用常山，不取其吐利作用，应当用醋长时间炒制，即使使用一两钱，也完全不引起呕吐。近来有愚昧之人，对它害怕如被蝎子蜇咬，这是因为不明白常山的药性罢了。（《沙篆》）
逐水应当兼行血：水即水饮，血即瘀血。只有水饮才会导致寒热交替，只有瘀血才会加重寒热。常山逐水利饮固然有效，但如果不用行血的药品在其中辅助，怎么能收到十全的效果呢？从此以后，疟疾患者如果出现鼻衄、唾血、大便带血丝，或月经刚来刚去等情况，都是血证，应当以常山、草果、槟榔、青皮、乌梅、甘草组成方剂，在里面加入五灵脂、桃仁作为佐药，放入生姜、浓蜜同煎主治。（《直指方》）
截疟法则（互见于治法总说）：凡是疟疾必须发作三五次后，再截断才是妙法。（《澹寮方》）（按：朱氏说：初患疟疾，未发作十次之前，不可立即截断。这种说法难以遵从。）
发作到四五次，才可以进行截断（按：这原本出自《要诀》），不然截断太早，会导致腹部胀气，饮食难进，寒热虽然轻微，但忽往忽来，不能完全断绝，这就是截断太早。假设初次发作一次，就进行截断，寒热不能发散，邪气不能屈伸，痰涎妄动上攻，想吐吐不出，想咽咽不下，气急喘促，昏迷不知人事，闷乱而死。（《绳墨》）
发作四五次之后，就应当截断并清除病邪（按：《医统》说：凡是疟疾多次发作之后，发散和解治疗后，就应当截断），拖延日久，中气大伤，病邪转深，突然很难见效。（《六要》）
如果使用截药吐出黄胶水的，疟疾就会自愈。不可一二天就早截，早则邪气闭塞而成坏症；也不可迟截，迟则元气衰惫而成虚怯。应当在三四天就截断为好。（《回春方》）（按：《慈航》说：必须等到发作之势缓和，然后才可截断。）
每天如期而至，名叫“疟信”，此时应当顺着病症发散，不可直接攻伐，不可截断。或提前或延后发作，这是正气逐渐旺盛，邪气将不容纳，名叫“疟衰”，才可以截断。（《心医集》）
久病患者，不可直接截断，必须用一补一截的方法。（《丹溪心法》）
人体虚弱者，截疟与补益兼用。人体壮实者，宜单独截断。（《回春方》）
凡是截疟的方法，方剂固然不少，但也并没有必定有效的方子。依我愚见，并结合治疗经验，其实未曾借助于截断疗法。大概有邪气的去除邪气就能痊愈，如果散邪已经透彻，解表已经完成，那么只需收拾元气，气复即愈。只要在邪正之间，掌握攻补的适宜时机，就没有不自愈的，这是截断最好的方法。至于各种截疟方剂，虽然不可固执，也不可没有。只是有的对此有效而对彼无效，也是因为人的气血阴阳各有不同缘故。所以凡是使用截药的人，也应当观察人的强弱而酌情使用，庶几能够见效。然而也只有轻症容易截断，而重症不易截断。（《景岳全书》）
服药节度：经书说：不要针刺高热之时，不要针刺脉象浑混乱杂之时，不要针刺大汗淋漓之时。因为这些情况病势逆乱，不可治疗。知道这一点，就知道病方来、正发作、将过去时，都不可治疗，以免反伤真气，不可不知道。（《三因极一病证方论》）
服药可以在未发作前，连续进服几剂（按：《医说》引《类编》说：凡是疟疾临发作日，逐杯并服，无不神效）。正发作时，不可给药，恐怕损伤胃气。（《续易简方》）
大抵疟疾初得，三数日间，如火燎原，不可靠近，波涛汹涌，不易平息，应当等待其稍微安定再图谋治疗，经书所谓“其盛者可待衰而已”。疟疾方来、正发作及将解时，不可投药，耗损真气。投药应当在未发作以前，两个时辰之前，或者遇发作日凌晨，空腹给予。（《直指方》）（按：《证治提纲》在此之下又说：否则药病交争，转为更深重的危害。）
凡是使用针药，必须在疟疾未发作前两小时，或在疟疾退去之后，此时气和顺而治疗，病容易痊愈。（《保命歌括》）
我最近治疗疟疾，每每迎着病势锐气而击之，最为快捷有效，由此可见古法中有不必拘泥的地方。（《景岳全书》）
住后禁补：疟疾停止后，不可服用补药，补之必然复发。（《医说》）
有病不可补的，一是疟疾，二是狂疾，三是水气，四是香港脚（脚气）。这四种疾病治疗得稍有好转，切不可服用暖药峻补。即使是平平的补药，也必须对本病有益才行。（同上引《医余》）
愈后调理：疟疾痊愈后的调理，宜用生料平胃散，每服加人参、茯苓各半钱，或用四君子汤加陈皮一钱半，即异功散。（《要诀》）
清解诸方（附兼补方）：清脾汤，治疗瘅疟，脉来弦数，但热不寒，或热多寒少，胸膈痞满能食，口苦舌干，心烦渴欲饮水，小便黄赤，大便不利。
青皮（去白）、厚朴（姜制炒）、白术、草果仁、柴胡（去芦）、茯苓（去皮）、半夏（汤泡七次）、黄芩、甘草（炙，各等分）。
以上切碎，每服四钱，水一盏半，姜五片，煎至七分，去渣温服，不拘时候。（《济生方》）《粹言》在本方加槟榔。《活法》秘方露星饮，治疗久疟成劳，在本方去青皮、厚朴、草果。加槟榔、恒山、秦艽、桂枝，酒水各半盏，露置一夜，次日早晨温去渣服。
小柴胡汤与五苓散合和，名叫柴苓汤，治疗伤风伤暑疟疾大效。每服姜三片，麦门冬二十粒去心，地骨皮少许，煎温服。（《得效方》）
柴平汤，疟疾发作时一身尽痛，手足沉重，寒多热少，脉濡者，名叫湿疟，此方主治。（《医方考》）（即小柴胡汤合平胃散）
疟病宜分昼发夜发、寒热多少进行和解治疗。和解的方剂，以小柴胡汤、二陈汤两方相合为主。（《保命歌括》）
截疟妙方
柴胡（去芦五钱）、真广陈皮（泡刮去白晒干三钱）、甘草（五分）。
水二碗，煎一碗，临发作日五更时分空腹温服。已发作时不可服。此方初发二三次，元气实者，用之必效。患疟已久，或元气虚弱者，用之未必效，须用清补汤。（《活幼心法》）（清补汤见后）
疟疾大渴大热甚者，小柴胡汤去半夏，加知母、麦门冬、黄连。（《丹溪心法》）
江应宿治疗李祠部真阳，伤寒变疟，大渴大热，烦躁引饮。都城医生投予六君子汤加青皮、厚朴、槟榔、草果，十余日不效。召我去诊视，六脉洪数微弦，用小柴胡汤去半夏，加白虎汤，一剂而渴止，再剂热退而愈。（《类案》）
小柴胡加常山汤（凡疟症三发之后，皆可服，天明时一服，疟未发前一小时一服，神效），即小柴胡汤加常山三钱生用不炒（如服后欲吐者，即以手指探吐，痰吐尽则愈）。（《时方歌括》）
崔氏治疗疟疾会稽赖公常山方。
常山（三两）、石膏（八两碎绵裹）、甘竹叶（一把切）、糯米（一百粒）。
以上四味切碎，以水八升，明晨欲服时，今晚浸泡于铜器中，露置星月下高净处，向明取药，置于病患房门前。于铜器里慢火煎取三升，分三服，临发作时再服一服。如果即刻定止，不需后服。（《外台秘要》）
延年治疗温疟壮热不能食，知母鳖甲汤方。
知母、鳖甲（炙）、地骨皮（各三两）、常山（二两）、竹叶（切一升）、石膏（四两碎）。
以上六味切碎，以水七升，煮取二升五合，去渣分三服。（同上）
鳖甲白术散，治疗久疟，寒热相等，汗多，腰脊重痛。
鳖甲（醋炙）、常山、白芍药、柴胡（去苗各一两）、白术（二两）、牡蛎（半两煅）。
以上切碎，每服五钱，水二盏，生姜五片，煎至一盏，去渣温服，不拘时候。（《杨氏家藏方》）
青蒿散，治疗疟疾。
甘草、秦艽、柴胡、草果子、青皮、常山、槟榔、青蒿子（各等分）、桃柳枝（各七寸）。
以上以常山、秦艽、柴胡、草果子、青皮、甘草为末，每服用水一盏半，入桃柳枝、青蒿子，加乌梅一枚，煎八分放冷一服，半夜一服，只是预先一夜一服。（《朱氏集验方》）（按：此系《圣济总录》治疟祛劳汤的变方，彼方有鳖甲等，然此方为优。）
《全生指迷论》说：如果有人翕翕发热，淅淅恶寒，没有定时，肢体如解，手足酸疼，头目昏运，这是由于营卫虚弱，外为风邪相乘，搏于阳则发热，搏于阴则发寒，又不治疗会成劳气，宜用荆芥散。
荆芥穗、人参、白术、当归（切洗焙）、黄芪、芍药、桂枝（去皮各一两）、柴胡（去苗二两）、甘草（炙半两）。
以上为粗末，每服五钱，水二盏，煎至一盏，去渣温服。（《幼幼新书》）
加味四君子汤，治疗久疟热多寒少不止。（《兰室秘藏》）
（即四君子汤加柴胡、薄荷、黄芩各等分。）
补阳消疟丹，疟疾本是常症，只可以用平常消导而发散之，如今忽然出现下利等症状，则变轻为重，想发汗则身已亡阴，想祛邪则下已便物，顾上则虑下，顾下则碍上，倘若仍以常法治之，奏功实少，今用人参一两，鳖甲一两，白术三两，茯苓一两，当归一两，白芍三两，柴胡一钱，枳壳一钱，槟榔一钱，水煎服。（《石室秘录》）
溃邪诸方（按：此诸方除初二首外，多系截疟之治，但截疟更有用柴胡、用吐法、用大黄、用人参、用附子等诸剂，今散列各类，临处之际，宜参互适用。）清脾汤，治疗胃疟发作有时。（按：此原载疟疾证候，今不录。）
厚朴（四两姜制炒）、乌梅（打去仁）、半夏（汤去滑）、青皮、良姜（各二两）、草果（去皮一两）、甘草（炙半两）。
以上为锉散，每服四钱，水二盏，姜三片，枣一枚，煎七分去渣，未发前并服三服，忌生冷油腻时果。此药温脾化痰，治胸膈痞闷，心腹胀满，噫醋吞酸，自可常服。（《三因方》）（《得效方》名小清脾汤。）
At the initial onset of malaria, when the pathogenic force is at its peak, it is not advisable to abruptly arrest the attacks during the first one or two episodes. Regardless of the degree of chills and fever, one should initially select from Yangwei Tang (Stomach-Nourishing Decoction), Chai Ping San (Bupleurum and Pingwei Powder), Qingpi Yin (Clearing Spleen Infusion), or Caoguo Yin (Tsaoko Fruit Infusion) for treatment.
After four or five episodes, it becomes appropriate to arrest the attacks. Otherwise, frequent recurrence will deplete Qi, causing the pathogen to sink deeper and become difficult to cure. At this stage, Changshan (Dichroa Root) can be added to Qingpi Yin. There are antimalarial medicines made from arsenic (Pi Dan) in the world; these are highly toxic and must not be used lightly. If the patient has Qi deficiency, even if attempts are made to arrest the attacks, they will be ineffective, leading to further depletion and eventually severe illness. This must be guarded against! One must first administer one or two doses containing Renshen (Ginseng Root) and Baizhu (Atractylodes Macrocephala Rhizome) to support and anchor the Qi, preventing it from sinking, before using other medications. (From *Zongzhi*) [Note: This passage is a compilation of excerpts from *Yaojue* and *Danxi*.]
In the early stage of malaria, dispersal (diaphoresis) is suitable; use diaphoretic herbs for one or two doses. Subsequently, harmonization is suitable; use heat-clearing herbs for one or two doses. Only after four or five episodes should one proceed to arrest the attacks. (From *Shengmo*)
For patients with robust physique and lustrous complexion, where the disease resides in the Qi level, sweat should be induced by unblocking meridians and resolving stagnation. For those with slightly sallow complexions, sweat should be induced by tonifying deficiency. In cases complicated by phlegm-dampness, the Stomach Qi should first be fortified; after one or two days, then administer drugs that seize and expel the pathogen. For patients with weak physique and withered complexion, sweating methods should not be used, nor should seizing drugs be employed; instead, nourishment should be combined with meridian regulation. For those with robust physique but purple-black complexion, where the disease resides in the Blood level, stasis and stagnation should be opened. For those with withered complexion, Blood should be tonified and Qi regulated. These are the standard approaches. However, in cases where sweating fails to produce perspiration, or blood regulation fails to move blood, unless more precise medications are sought to directly target the location of the pathogen, how can recovery be achieved? (From *Qiuqiu Shiyi*)
Treatment varies by North and South: In coastal southeastern regions, sea winds are unpredictable, and people often consume fish and salt, leading to food stagnation. Consequently, Wind Malaria and Food Malaria are prevalent; Wutou (Aconite Lateralis Radix Preparata), Caoguo (Tsaoko Cardamomum Fructus), Chenpi (Citri Reticulatae Pericarpium), and Banxia (Pinelliae Tuber) are effective when used appropriately. In the northwest highlands, winters are freezing with cracked earth, and summers are scorching; people often suffer from cold invasion or latent summerheat. Thus, Summerheat Malaria and Cold Malaria are common; Chaihu (Bupleuri Radix) and Hengshan (Changshan/Dichroa Root) should be used together. For individuals traveling between southeast and northwest, when the disease pattern is undifferentiated, Huoxiang Zhengqi San (Agaricus Powder for Regulating the Middle and Resolving Pathogens) or Caoguo Yin can be used, similar to the principle of nourishing the Stomach. (From *Yonglei*) [Note: *Wei Yi* discusses the mechanism of spleen-cold causing malaria in southerners; the text is too lengthy to include.]
Harmonization as the Main Approach: Both chronic and acute malaria utilize Chaihu (Bupleuri Radix). However, chronic cases use smaller doses, while acute cases use larger doses. This is because malaria predominantly affects the Shaoyang (Lesser Yang) Meridian, and Chaihu serves as a guiding herb for the Shaoyang Meridian, being effective in treating alternating chills and fever. (From *Yijing*)
The malaria pathogen is neither on the exterior skin nor within the interior organs; therefore, diaphoresis does not expel it from the exterior, and purgation does not expel it from the interior. (From *Yixue Xuji*)
Diaphoresis, Emesis, and Purgation: As treatment protocols, emesis and purgation are fundamental. However, due to variations in human constitution (strong vs. weak) and disease severity, decisions must be made based on the specific situation at hand and cannot be generalized. (Cited in *Waitai Mi Yao* from Xu Renze)
Regarding ancient methods for treating malaria: If the disease is prolonged with excessive sweating, causing pores (Cou Li) to open and Yang Qi to fail to consolidate, tonification and astringency are required. If there is no sweating, indicating dense pores where the pathogen cannot resolve, dispersal is required. Thus, it is said: For those with sweating, aim to stop sweating, focusing on supporting the Righteous Qi; for those without sweating, aim to induce sweating, focusing on expelling the Pathogen. [Note: This is Zhu Danxi's view.] This is the general principle. (From *Jingyue Quanshu*)
Regarding inducing sweat: If sweat is produced but the body is weak, heavy tonifying agents must be used to assist. When sweat permeates the entire body and flows down past the Weizhong (BL-40) acupoint, it is a favorable sign. Patients should be instructed to eat bland foods, reduce outings, avoid wind, seek warmth, stay away from stuffy curtains, and maintain careful nursing. Under such conditions, stability will be achieved. (From *Gezhi Yulun*)
Any physician who treats malaria without identifying the location of the pathogen and indiscriminately uses strong diaphoresis or purgation, thereby damaging the body's Righteous Qi, commits a medical error. The malaria pathogen resides in the half-exterior/half-interior region, presenting both chills and fever. Strong diaphoresis damages the exterior, and strong purgation damages the interior; such medication only exacerbates the malaria. If the pathogen remains latent and the medication triggers another episode, what method will remain to treat it? (From *Yizong Bidu*)
Any physician who employs emesis using harsh, inferior drugs or various pills that damage the Zang-Fu organs commits a medical error. Emesis should only utilize clear, aromatic vapors that penetrate the meridians to draw out the malaria pathogen, such as Changshan soaked in wine without boiling. Pills made from Vitriol (Danfan) or Realgar/Arsenic (Xinshi), when swallowed, stick in the abdomen, disrupt the intestines and organs, and ultimately provide no benefit. Beware! (Ibid.)
Treatment Must Support Righteous Qi: Malaria involves a struggle between Pathogenic and Righteous Qi, with continuous alternation, resembling battle. Treatment must first support the Righteous Qi or urgently eliminate the Pathogen. Generally, when Righteous Qi is strong, the Pathogen resolves itself; when the Pathogen is gone, the Righteous Qi is secure. Now, consider a person with weak constitution suffering from malaria; after a few days, the attacks become delayed, the momentum declines, but the spirit becomes confused and incurable. Is this not due to deficient Righteous Qi allowing the Pathogen to sink inward? (From *Yixue Xuji*)
Use of Changshan (with Dahuang as Assistant): Diseases often arise from fluid retention in the Epigastrium. Changshan is effective because it induces vomiting. (From *Yijian Fang*) Generally, malaria patients accumulate "yellow water"; Changshan breaks up accumulations and guides fluids downward. (From *Zhizhi Fang*)
It is true that malaria patients accumulate phlegm-saliva and yellow water, and Changshan induces vomiting and purgation; however, in cases of pure heat malaria or internal heat excess, administering Changshan results only in scanty, incomplete stools. In such cases, Beidahuang (Rhubarb Root and Rhizome) must be added as an assistant to induce significant purgation several times before recovery occurs. Some argue that Baiduo (Croton Seed) pills also cause purgation. This is incorrect. Baiduo targets lower jiao accumulation; to cleanse blood-heat, Dahuang is indispensable. (Ibid.)
For weak individuals, Changshan must be strictly avoided, as it may cause vomiting and damage Stomach Qi. (From *Ruyi Fang*)
Changshan and Shuji (Changshan buds) have the power to seize phlegm and arrest malaria. They should only be used after the exterior pathogen has been dispersed or after seven malaria episodes. Early use inevitably traps the pathogen, often leading to abdominal distension. (From *Huiyan*, citing Fang Longtan)
In chronic malaria with deficiency-cold, if Renshen, Baizhu, Ganjiang (Dried Ginger), and Rougui (Cinnamon Bark) fail to cure, Changshan must be added to these formulas. Furthermore, Shanzhujia (Pangolin Scales) must be added to unblock the meridians, allowing the malaria pathogen to exit externally. Such cases invariably recover. (From *Yixue Zhuan*)
Changshan and Shuji, when used raw, tend to ascend and induce vomiting. When steamed with wine and stir-fried, their action is milder, and small doses do not induce vomiting. With Gancao (Licorice Root), vomiting is induced; with Dahuang, purgation is induced. (From *Bencao Gangmu*)
Changshan’s nature is to treat malaria. Although it tends to induce vomiting, proper steaming preparation prevents this, making malaria easier to cure. Its efficacy lies beyond just vomiting phlegm. It is not a drug that merely vomits water, but rather one that can damage the Stomach if misused. (From *Zhunsheng*)
If the disease is mild but Changshan is used, and vomiting/purgation is not desired, it should be stir-fried with vinegar for a long time. Even at doses of one or two qian, it will not induce vomiting. Recently, some foolish people fear it like a scorpion sting, simply because they do not understand its properties. (From *Shazhuan*)
Expelling Water Requires Moving Blood: "Water" refers to fluid retention; "Blood" refers to blood stasis. Fluid retention causes alternating chills and fever; blood stasis exacerbates them. While Changshan expels water and resolves fluid retention, without blood-moving assistants, perfect efficacy cannot be achieved. Henceforth, if malaria patients present with epistaxis, hemoptysis, blood streaks in stool, or irregular menstruation, these are blood syndromes. Use a formula of Changshan, Caoguo, Binglang (Areca Seed), Qingpi (Citri Reticulatae Pericarpium), Wumei (Mume Fruit), and Gancao, adding Wulingzhi (Trogopteri Dung) and Taoren (Peach Seed) as assistants. Decoct with Shengjiang (Fresh Ginger) and thick honey. (From *Zhizhi Fang*)
Rules for Arresting Malaria (See General Treatment Methods): It is optimal to arrest malaria only after three to five episodes. (From *Danliao Fang*) [Note: Zhu Shi stated: Do not arrest within the first ten episodes. This view is difficult to accept.]
Arrest only after four or five episodes [originally from *Yaojue*]. Otherwise, arresting too early causes abdominal bloating and difficulty eating. Although chills and fever may be mild, they come and go intermittently and cannot be completely stopped. This is the result of premature arrest. If arrested after only one episode, chills and fever cannot vent, the pathogen cannot expand or contract, phlegm-saliva attacks upward uncontrollably, resulting in inability to vomit or swallow, rapid breathing, coma, and death from distress. (From *Shengmo*)
After four or five episodes, it is timely to arrest and eliminate the pathogen [Note: *Yitong* states: After multiple episodes, once dispersal and harmonization are complete, arrest should follow]. Delaying leads to severe damage of Middle Qi, deepening of the pathogen, and sudden ineffectiveness of treatment. (From *Liuyao*)
If arresting medication causes the expulsion of yellow gelatinous fluid, the malaria heals spontaneously. Do not arrest too early (1-2 days), as this closes off the pathogen and creates complicated syndromes; do not arrest too late, as this exhausts Yuan Qi and creates deficiency consumptive diseases. Arresting on the third or fourth day is ideal. (From *Huichun Fang*) [Note: *Cihang* states: Wait until the attack momentum subsides before arresting.]
When attacks occur daily at regular intervals, it is called "Malaria Signal." At this stage, follow the syndrome with dispersal; do not directly attack or arrest. If attacks occur earlier or later than usual, it indicates Rising Righteous Qi rejecting the Pathogen, called "Malaria Decline," at which point arrest is possible. (From *Xinyi Ji*)
Chronic cases cannot be directly arrested; a combination of tonification and arrest is necessary. (From *Danxi Xinfa*)
For weak individuals, combine arrest with tonification. For robust individuals, use arrest alone. (From *Huichun Fang*)
There are many methods for arresting malaria, yet none are universally effective. Based on my experience, I rarely rely solely on arrest. Generally, eliminating the pathogen leads to recovery. Once the pathogen is thoroughly dispersed and the exterior resolved, one need only restore Yuan Qi; once Qi recovers, health returns. Mastering the balance of attacking and tonifying between Pathogen and Righteous Qi ensures spontaneous recovery; this is the best form of "arrest." While various arrest formulas exist and should not be discarded, efficacy varies due to individual differences in Qi, Blood, Yin, and Yang. Therefore, when using arrest drugs, observe the patient's strength and adjust accordingly. Mild cases are easy to arrest; severe cases are difficult. (From *Jingyue Quanshu*)
Regulation of Medication Administration: The Classics state: Do not needle during high fever, do not needle when the pulse is chaotic, do not needle during profuse sweating. These indicate adverse pathological states where treatment is contraindicated. Understanding this, one knows that treatment is contraindicated when the disease is approaching, actively raging, or subsiding, to avoid damaging True Qi. (From *Sanyan Jiyi Bingzheng Fanglun*)
Medication can be administered continuously before the onset of the attack [Note: *Yishuo* cites *Leibian*: On the day of the attack, drink cup by cup; this yields miraculous effects]. Do not administer during active发作 (attack), as it may damage Stomach Qi. (From *Xu Yijian Fang*)
Generally, in the first few days of malaria, the pathogen spreads like a prairie fire, turbulent and hard to reverse. One should wait for it to stabilize before acting, as the Classics say: "Wait for the peak to subside." Do not administer medication when the malaria is approaching, actively raging, or resolving, as this consumes True Qi. Administer medication before the attack, ideally two hours prior, or on an empty stomach early in the morning of the attack day. (From *Zhizhi Fang*) [Note: *Zhengzhi Tigang* adds: Otherwise, medicine and disease contend, worsening the condition.]
Whether using acupuncture or herbs, treatment must occur two hours before the malaria attack or after it subsides. Treating when the Qi is harmonious facilitates recovery. (From *Baoming Ge Kuo*)
Recently, I have treated malaria by confronting the pathogen at its peak, achieving rapid and effective results. This shows that some ancient rules need not be rigidly adhered to. (From *Jingyue Quanshu*)
Prohibition of Tonification After Resolution: After malaria ceases, do not take tonifying drugs, as tonification will cause recurrence. (From *Yishuo*)
There are four diseases that should not be tonified: 1. Malaria, 2. Mania, 3. Fluid Retention (Edema), 4. Hongxiangjiao (Podagra/Gout). When these four diseases show slight improvement, warm and strong tonics must absolutely be avoided. Even mild tonics must be beneficial to the original disease. (Cited from *Yiyu*)
Post-Recovery Regulation: For post-malaria regulation, use Shengliao Pingwei San (Raw Pingwei Powder). Add half a qian each of Renshen (Ginseng Root) and Fuling (Poria) per dose. Alternatively, use Sijunzi Tang (Four Gentlemen Decoction) with one and a half qian of Chenpi (Citri Reticulatae Pericarpium), known as Yigong San. (From *Yaojue*)
Clearing and Resolving Formulas (Including Tonifying Formulas):
Qingpi Tang (Clearing Spleen Decoction): Treats Dan Malaria (Heat Malaria) with wiry-rapid pulse, fever without chills, or more heat than cold, chest fullness with appetite, bitter taste, dry tongue, irritability, thirst with desire to drink, yellow-red urine, and constipation.
Ingredients: Qingpi (Exocarpium Citri Reticulatae Viride, white pith removed), Houpo (Magnolia Bark, ginger-processed fried), Baizhu (Atractylodes Macrocephala Rhizome), Caoguoren (Tsaoko Cardamomum Seed), Chaihu (Bupleuri Radix, awn removed), Fuling (Poria, peel removed), Banxia (Pinelliae Tuber, boiled seven times), Huangqin (Scutellaria Root), Gancao (Licorice Root, honey-fried). Equal parts.
Crush ingredients. Take 4 qian per dose, add 1.5 cups of water and 5 slices of ginger. Decoct to 0.7 cups, strain, and take warm at any time. (From *Jisheng Fang*). *Cuiyan* adds Binglang (Areca Seed). *Huofa* Secret Recipe Luxing Yin (Dew-Star Infusion) for chronic malaria becoming consumption: Remove Qingpi, Houpo, Caoguo from the base formula. Add Binglang, Hengshan (Changshan), Qinjiao (Gentiana Macrophylla Root), Guizhi (Cinnamon Twig). Use half wine, half water, expose overnight, strain, and take warm next morning.
Xiao Chaihu Tang (Minor Bupleurum Decoction) combined with Wuling San (Five-Ingredient Powder with Poria) is named Chai Ling Tang (Bupleurum and Poria Decoction), highly effective for wind-heat or summerheat malaria. Take 3 slices of ginger, 20 hearts of Maidong (Ophiopogon Tuber), and a little Gubopi (Lycium Cortex), decoct and take warm. (From *Defang*)
Chai Ping Tang (Bupleurum and Pingwei Decoction): For malaria with whole-body pain, heavy limbs, more chills than heat, and soggy pulse, known as Damp Malaria. (From *Yifang Kao*) (This is Xiao Chaihu Tang combined with Pingwei San).
Malaria should be differentiated by daytime/nighttime occurrence and degree of chills/heat for harmonization. The main harmonizing formulas are combinations of Xiao Chaihu Tang and Erchen Tang (Two-Chen Decoction). (From *Baoming Ge Kuo*)
Excellent Formula for Arresting Malaria:
Chaihu (Bupleuri Radix, 5 qian, awn removed), Zhen Guang Chenpi (True Guang Chenpi, 3 qian, soaked, scraped white, dried), Gancao (Licorice Root, 0.5 qian).
Decoct 2 bowls of water to 1 bowl. Take warm on an empty stomach at 5 AM on the day of the attack. Do not take after onset. Effective for the first 2-3 episodes in robust patients. For chronic malaria or weak Qi, this may not work; use Qingbu Tang (Clearing and Tonifying Decoction) instead. (From *Huoyou Xinfa*)
For severe thirst and high fever in malaria: Modify Xiao Chaihu Tang by removing Banxia, add Zhimu (Anemarrhenae Rhizoma), Maidong (Ophiopogonis Tuber), and Huanglian (Coptidis Rhizoma). (From *Danxi Xinfa*)
Jiang Yingsu treated Libu Zhenyang, whose typhoid transformed into malaria with severe thirst, high fever, and irritability. Capital physicians used Liujun Zi Tang (Six Gentlemen Decoction) plus Qingpi, Houpo, Binglang, Caoguo for over 10 days without effect. Upon consultation, pulses were surging-rapid and slightly wiry. Jiang prescribed Xiao Chaihu Tang minus Banxia, combined with Baihu Tang (White Tiger Decoction). Thirst stopped after one dose; fever subsided and cure was achieved after two doses. (From *Lei An*)
Xiao Chaihu Jia Changshan Tang (Minor Bupleurum Plus Dichroa Decoction): Suitable for malaria after three episodes. Take one dose at dawn, or one hour before the expected attack time. Miraculous effect. Formula: Xiao Chaihu Tang plus 3 qian of raw, un-roasted Changshan. If nausea occurs after ingestion, induce vomiting with finger; once phlegm is expelled, the patient recovers. (From *Shifang Ge Kuo*)
Cui Shi’s Changshan Formula for Laigong of Kuaiji:
Changshan (Dichroae Radix, 3 liang), Shigao (Gypsum Fibrosum, 8 liang, crushed, wrapped in cotton), Ganzhuye (Betel Leaf, 1 bunch, cut), Nuomi (Glutinous Rice, 100 grains).
Cut the four ingredients. Add 8 sheng of water. Soak tonight in a copper vessel, expose under stars/moon in a clean high place. Tomorrow morning, take medicine near the patient's door. Decoct slowly over low fire to 3 sheng. Divide into three doses. Take one additional dose right before the attack. If symptoms cease immediately, do not take subsequent doses. (From *Waitai Mi Yao*)
Yannian’s Zhimu Biejia Tang (Anemarrhena and Turtle Shell Decoction) for Warm Malaria with high fever and anorexia:
Zhimu (Anemarrhenae Rhizoma), Biejia (Testudinis Carapax et Plastrum, roasted), Gubopi (Lycii Cortex), each 3 liang; Changshan (Dichroae Radix) 2 liang; Zhuye (Bambusae Folium, cut) 1 sheng; Shigao (Gypsum Fibrosum, crushed) 4 liang.
Cut six ingredients. Add 7 sheng of water. Boil to obtain 2.5 sheng. Strain and divide into three doses. (Ibid.)
Biejia Baizhu San (Turtle Shell and Atractylodes Powder) for chronic malaria with equal chills and heat, profuse sweating, and heavy/painful waist and spine:
Biejia (Testudinis Carapax et Plastrum, vinegar-roasted), Changshan, Baishaoyao (Paeoniae Radix Alba), Chaihu (Bupleuri Radix, rootlets removed), each 1 liang; Baizhu (Atractylodis Macrocephalae Rhizoma) 2 liang; Muli (Concha Ostreae, calcined) 0.5 liang.
Crush ingredients. Take 5 qian per dose, add 2 cups of water and 5 slices of ginger. Decoct to 1 cup, strain, and take warm at any time. (From *Yang Shi*)
Qinghao San (Artemisia Annua Powder) for malaria:
Gancao (Licorice Root), Qinjiao (Gentianae Macrophyllae Radix), Chaihu (Bupleuri Radix), Caoguozhi (Tsaoko Cardamomum Fructus), Qingpi (Citri Reticulatae Pericarpium), Changshan (Dichroae Radix), Binglang (Arecae Semen), Qinghaosui (Artemisiae Annuae Herba), each equal parts; Tao Liu Zhi (Peach and Willow Branches), each 7 cun.
Powder Changshan, Qinjiao, Chaihu, Caoguozhi, Qingpi, Gancao. For each dose, add 1.5 cups of water, Tao Liu Zhi, Qinghaosui, and one Wumei (Mume Fruit). Decoct to 0.8 cups, cool, and take one dose. Take another dose at midnight. Essentially, administer one dose the night before. (From *Zhu Shi*) [Note: This is a variation of *Shengji Zonglu*'s Qulao Tang for malaria, which includes Biejia, etc., but this formula is superior.]
*Quansheng Zhimi Lun* states: If a person feels hot like a smoldering fire, chilly like shaking in wind, without fixed timing, limbs feel loose, hands and feet ache, head and eyes are dizzy, this is due to deficient Ying and Wei (Nutritive and Defensive Qi) allowing external Wind Pathogen to invade. Contact with Yang causes fever; contact with Yin causes chills. If untreated, it becomes Consumption Qi. Use Jingjie San (Schizonepeta Powder).
Jingjisui (Schizonepeta Spike), Renshen (Ginseng Root), Baizhu (Atractylodes Macrocephala Rhizome), Danggui (Angelica Sinensis Radix, cut/washed/dried), Huangqi (Astragali Radix), Shaoyao (Paeoniae Radix), Guizhi (Cinnamomi Ramulus, bark removed), each 1 liang; Chaihu (Bupleuri Radix, rootlets removed) 2 liang; Gancao (Licorice Root, honey-fried) 0.5 liang.
Make coarse powder. Take 5 qian per dose, add 2 cups of water. Decoct to 1 cup, strain, and take warm. (From *Youyou Xinshu*)
Jiawei Sijunzi Tang (Modified Four Gentlemen Decoction) for chronic malaria with more heat than cold persisting. (From *Lanshi Midang*)
(This is Sijunzi Tang plus Chaihu, Bohe (Mint), and Huangqin, equal parts.)
Buyang Xiaomie Dan (Tonify Yang Eliminate Malaria Pill): Malaria is a common condition, usually treated with mild digestion-promoting and dispersing methods. If suddenly complicated by diarrhea, it becomes severe. Sweating would deplete Yin; expelling pathogen via purgation would worsen diarrhea. Balancing upper and lower treatments is difficult. Standard methods yield little success. Now use: Renshen 1 liang, Biejia 1 liang, Baizhu 3 liang, Fuling 1 liang, Danggui 1 liang, Baishaoyao 3 liang, Chaihu 1 qian, Zhike (Aurantii Fructus Immaturus) 1 qian, Binglang 1 qian. Decoct in water and take. (From *Shishi Milu*)
Formulas for Dissipating Pathogens [Note: Except for the first two, most are for arresting malaria. Other arrest methods include using Chaihu, emesis, Dahuang, Renshen, Fuzi, etc. Listed separately here; apply flexibly in practice.]
Qingpi Tang (Clearing Spleen Decoction) for Stomach Malaria with regular onset times. [Note: Originally listed under Malaria Syndromes, omitted here.]
Houpo (Magnolia Bark, ginger-processed fried) 4 liang, Wumei (Mume Fruit, pits removed), Banxia (Pinelliae Tuber, boiled to remove slipperiness), Qingpi (Citri Reticulatae Pericarpium), Liangjiang (Alpiniae Officinarum Rhizoma), each 2 liang; Caoguo (Tsaoko Cardamomum Fructus, peel removed) 1 liang; Gancao (Licorice Root, honey-fried) 0.5 liang.
Make coarse powder. Take 4 qian per dose, add 2 cups of water, 3 slices of ginger, one date. Decoct to 0.7 cups, strain. Take three doses before onset. Avoid cold, raw, greasy, and seasonal fruits. This formula warms the Spleen, resolves phlegm, treats chest/diaphragm oppression, abdominal fullness, belching with acid regurgitation. Can be taken regularly. (From *Sanyan Fang*) (*Defang* names it Xiao Qingpi Tang.)