大全云∶妊娠病疟（疟病虐人，症候大都相似，但妊妇患此，恐伤其胎，故立），乃夏伤
于暑，客于皮肤，至秋而发，阳盛则热，阴盛则寒，阴阳相胜，寒热俱作。其发晏者，由风邪客
于风府，循膂而下，卫气至一日一夜，常大会于风府，故发日晏；其发早者，卫气之行风府，
日下一节，二十一日，下至尾 ，二十二日，入脊内，上注于伏冲之脉，其行九日出缺盆，其
气既上，故发更早；其间日发者，风邪内搏五脏，横连募原，其道远，其气深，其行迟，不能
日作也。妊娠而发，多伤于肺。
薛氏曰∶前证因脾胃虚弱，饮食停滞，或外邪所感，或郁怒伤脾，或暑邪所伏，实系饮
食停滞，用六君子加桔梗、苍术、藿香；外邪多而饮食少，用藿香正气散；外邪少而饮食多，
用人参养胃汤；劳伤元气，用补中益气汤。若郁怒所伤，用小柴胡汤兼归脾汤；若木侮土，
久而不愈，用六君子为主，佐以安胎药，仍参三阴三阳经而治之。
七宝散 治男妇一切疟疾，或先寒后热，或先热后寒，或寒多热少，或热多寒少，或一
日一发，或一日两三发，或连日发，或间日发，或三四日一发，不问块疟食疟，不伏水土，山
岚瘴气，似疟者并皆治之。
常山 浓朴（姜制） 青皮 陈皮（一不去白，一云去白） 甘草（炒） 槟榔 草果（去壳，各等分）
上 咀，每服半两，于未发隔夜，用水酒各一盏煎至一大盏，去滓，露一宿，再用水酒
煎滓，亦露一宿，来日当发之早，烫温，面东先服头药，少顷再服药滓，大有神效。
准绳云∶尝治一妊妇六七个月患疟，先寒后热，六脉浮紧，医用柴胡、桂枝无效。予曰∶
此非常山不愈。众医难之。越数日疾甚，乃从予治，以七宝散一服瘥。黄帝问曰∶妇人重
身，毒之奈何？歧伯曰∶有故无殒。帝曰∶何谓也？歧伯曰∶大积大聚，其可犯也，衰其大半而
止。诚审药物之性，明治疗之方，何疑攻治哉。
人参养胃汤 治妊娠疟疾，寒多热少，或但寒不热，头痛恶心，身痛面色青白，脉弦迟
者，驱邪散治证亦同。
半夏 浓朴（制） 橘红（各八分） 苍术（一钱） 藿香叶 草果 茯苓 人参（各五分） 甘草（炙，
三分）
上加生姜七片，乌梅一个，水煎服。
清脾饮 治妊娠疟疾，寒少热多，或但热不寒，口苦舌干，大便秘涩，不进饮食，脉弦数者。
青皮 浓朴（姜制） 白术（炒） 草果 茯苓 半夏 黄芩 柴胡 甘草（炙，各五分）
上加生姜，水煎服。
驱邪散 治妊娠停食，感冷发为疟疾。
高良姜（炒） 白术 草果仁 橘红 藿香叶 缩砂仁 白茯苓（各一钱半） 甘草（炙，五分）
上 咀，作一服，加生姜五片，枣一枚，水煎服。
柴胡散 治妊娠疟疾。（此大柴胡汤法也，惟外邪未解，而内热实甚者，宜之。然须酌用）
柴胡（二钱） 生大黄（二钱） 生黄芩（一钱五分） 甘草（一钱）
上作一服，水煎，临发日，五更温服，取利为度。
又方（此方伤暑而内有痰热、多烦渴者宜之）
常山 石膏（各一两） 黄芩 甘草（炙，各半两） 乌梅（七个）
上细切，以水酒各一碗浸一宿，平旦，煎至一碗，去滓，分二服，临发时服。
上二方，犯常山、大黄吐下之剂，若六脉浮紧有力，中有顽痰积热者用之，所谓有故无
殒也。其他疗治方法，已备杂证疟门。若热甚恐致动胎者（若果内热之极，必须用药以清
之），亦如伤寒热病治方，以白药子、伏龙肝等，涂脐上下可也。
《医宗必读》中说：妊娠疟疾（疟疾病症折磨人，症状大体相似，但孕妇患此病，担心损伤胎儿，因此专门设立此证），是由于夏季感受暑邪，邪气客居在皮肤之间，到了秋季发作。阳气盛则发热，阴气盛则发冷，阴阳相互胜负，所以寒热交替发作。发作时间晚的，是因为风邪客居于风府穴，沿着脊柱向下行走，卫气运行一天一夜，常在风府穴大会，所以发作时间推迟；发作时间早的，是因为卫气行经风府穴，每天向下移动一节脊椎，二十一天后下行至尾骶部，二十二天进入脊柱内部，向上注入伏冲脉，其气运行九天到达缺盆穴，既然气已经上行，所以发作更早；隔日发作的，是因为风邪内迫五脏，横向连及募原，病位深远，邪气深沉，运行迟缓，不能每日发作。孕妇患疟疾，多伤及肺脏。
薛己说：上述病症是因为脾胃虚弱，饮食停滞，或者外邪侵袭，或者郁怒伤脾，或者暑邪潜伏体内，实际上属于饮食停滞所致。使用六君子汤加桔梗、苍术、藿香治疗；如果外邪重而饮食停滞轻，使用藿香正气散；如果外邪轻而饮食停滞重，使用人参养胃汤；如果是劳倦损伤元气，使用补中益气汤。如果是因郁怒所伤，使用小柴胡汤兼服归脾汤；如果是肝木侮脾土，久治不愈，以六君子汤为主方，佐以安胎药物，并参考三阴三阳经辨证治疗。
七宝散：治疗男女各种疟疾，无论是先寒后热，还是先热后寒，或者是寒多热少，热多寒少，或者一日一发，一日两三次发，连续几日发，隔日发，或三四日一发，不论是有形的块疟还是食积引起的食疟，也不论是水土不服还是山岚瘴气引起的类似疟疾的症状，都一并治疗。
药材组成：常山、浓朴（姜制）、青皮、陈皮（一种说法不去白，一种说法去白）、甘草（炒）、槟榔、草果（去壳），以上各等分。
用法：将药材切碎，每次服用半两，在发作前一夜，用水和酒各一盏，煎煮至一大盏，滤去药渣，露天放置过夜，再将药渣用水和酒煎煮，也露天放置过夜。第二天发作前，面向东方先服头煎药，过一会儿再服二煎药渣，效果显著。
《医学准绳六要》记载：曾经治疗一位怀孕六七个月的妇女患疟疾，先寒后热，六脉浮紧，医生使用柴胡、桂枝无效。我说：这不是常山不能治愈。众医生对此表示怀疑。过了几天病情加重，才听从我的建议治疗，服用一剂七宝散后痊愈。《黄帝内经》问：妇人怀孕，有毒性的药物该如何使用？岐伯答：有病则病受之，不会伤害胎儿。帝曰：这是什么意思？岐伯答：如果有大积大聚的病邪，可以使用攻伐药物，但病邪消退大半时就应停止。只要审慎掌握药物性质，明确治疗方案，何必对攻下治疗有疑问呢。
人参养胃汤：治疗妊娠疟疾，寒多热少，或者只有寒没有热，头痛恶心，身体疼痛面色青白，脉象弦迟者，驱邪散治疗的证候也相同。
药材组成：半夏、浓朴（制）、橘红（各八分）、苍术（一钱）、藿香叶、草果、茯苓、人参（各五分）、甘草（炙，三分）。
用法：上加生姜七片，乌梅一个，水煎服。
清脾饮：治疗妊娠疟疾，寒少热多，或者只有热没有寒，口苦舌干，大便秘结涩滞，不进饮食，脉象弦数者。
药材组成：青皮、浓朴（姜制）、白术（炒）、草果、茯苓、半夏、黄芩、柴胡、甘草（炙，各五分）。
用法：上加生姜，水煎服。
驱邪散：治疗妊娠停食，感受寒冷引发疟疾。
药材组成：高良姜（炒）、白术、草果仁、橘红、藿香叶、缩砂仁、白茯苓（各一钱半）、甘草（炙，五分）。
用法：将药材切碎，作为一服，加生姜五片，大枣一枚，水煎服。
柴胡散：治疗妊娠疟疾。（这是大柴胡汤的法度，只有当外邪未解，而内热实盛严重时适宜使用。但必须斟酌用量）
药材组成：柴胡（二钱）、生大黄（二钱）、生黄芩（一钱五分）、甘草（一钱）。
用法：作为一服，水煎，在发作当天五更时分温服，以大便通利为度。
又一方（此方适用于伤暑且内有痰热、烦渴严重者）
药材组成：常山、石膏（各一两）、黄芩、甘草（炙，各半两）、乌梅（七个）。
用法：细切，用水和酒各一碗浸泡一夜，清晨煎至一碗，滤去药渣，分两次服用，在疟疾发作时服用。
以上两个方子，含有常山、大黄等催吐泻下的药物，如果六脉浮紧有力，中有顽痰积热的患者可以使用，这就是所谓“有故无殒”。其他治疗方法，已在杂病疟疾门类中备述。如果热势很盛恐怕导致动胎的情况（如果确实是内热至极，必须用药清热），也像治疗伤寒热病的方子一样，可以用白药子、伏龙肝等药物，涂抹于脐部上下。
The *Yi Zong Bi Du* states: Pregnancy malaria (malaria torments the patient, and symptoms are generally similar, but when pregnant women suffer from this, there is fear of damaging the fetus, hence this syndrome is established separately). It arises from summerheat injury in summer, with pathogenic factors lodging in the skin, manifesting in autumn. When Yang is excessive, heat occurs; when Yin is excessive, cold occurs. As Yin and Yang contend with each other, both cold and heat appear simultaneously. In cases where onset is late, it is due to wind pathogens lodging in the Fengfu (GV16) acupoint, traveling down along the spine. The Wei Qi (Defensive Qi) circulates for a day and night, often converging at Fengfu, thus delaying the onset. In cases where onset is early, the Wei Qi travels through Fengfu, descending one vertebral segment daily. After twenty-one days, it reaches the coccyx; on the twenty-second day, it enters the interior of the spine and ascends into the Fu Chong vessel. Its qi travels nine days to reach the Quepen area. Since the qi has ascended, the onset is earlier. In cases of every-other-day onset, wind pathogens internally constrain the five Zang organs and horizontally connect to the Mu Yuan (Moyuan/Roots of the Abdomen). The disease pathway is distant, the pathogenic qi is deep, and its movement is slow, preventing daily occurrence. Malaria occurring during pregnancy often injures the Lung.
Xue Ji stated: The aforementioned conditions result from Spleen and Stomach deficiency, food stagnation, external pathogenic invasion, emotional depression injuring the Spleen, or latent summerheat. Essentially, they belong to food stagnation. Use Liu Jun Zi Tang (Six Gentlemen Decoction) with Jie Geng (Platycodon Root), Cang Zhu (Atractylodis Rhizoma), and Huo Xiang (Patchouli Herb). If external pathogens are heavy and food stagnation is light, use Huo Xiang Zheng Qi San (Patchouli Powder to Rectify the Qi). If external pathogens are light and food stagnation is heavy, use Ren Shen Yang Wei Tang (Ginseng Decoction to Nourish the Stomach). If labor and fatigue damage Yuan Qi (Original Qi), use Bu Zhong Yi Qi Tang (Decoction to Supplement the Middle and Augment the Qi). If injured by emotional depression, use Xiao Chai Hu Tang (Minor Bupleurum Decoction) combined with Gui Pi Tang (Restore the Spleen Decoction). If Liver Wood insults Spleen Earth and the condition persists for a long time, use Liu Jun Zi Tang as the main formula, assisted by fetal-calming herbs, and treat according to the Three Yin and Three Yang meridians.
Qi Bao San (Seven Treasures Powder): Treats all types of malaria in men and women, whether starting with chills then fever, fever then chills, more chills than fever, more fever than chills, once daily, two or three times daily, consecutive days, every other day, or every three to four days. It treats all forms regardless of mass malaria (Kuai Nue) or food malaria (Shi Nue), maladaptation to local environment, mountain miasma, or malaria-like conditions.
Ingredients: Chang Shan (Dichroa Root), Nong Po (Magnolia Bark processed with ginger), Qing Pi (Green Tangerine Peel), Chen Pi (Tangerine Peel - some say keep the white pith, others say remove it), Gan Cao (Licorice Root roasted), Bing Lang (Areca Seed), Cao Guo (Black Cardamom fruit removed from shell), all in equal proportions.
Usage: Coarsely crush the herbs. Take 0.5 liang per dose. The night before onset, decoct with one cup of water and one cup of wine until reduced to one large cup. Strain the dregs and expose to dew overnight. Decoct the dregs again with water and wine, also exposing to dew overnight. On the morning of onset, face east and take the first decoction first, followed shortly by the second decoction (dregs). This yields great efficacy.
*Zhun Sheng* records: I once treated a pregnant woman of six or seven months suffering from malaria, presenting with chills preceding fever, and floating-tight pulses in all six positions. Physicians used Chai Hu (Bupleurum Root) and Gui Zhi (Cinnamon Twig) without effect. I said: "This will not heal without Chang Shan." The other physicians found this difficult to accept. A few days later, the illness worsened, so they followed my treatment. One dose of Qi Bao San cured her. The *Huang Di Nei Jing* asks: "How should toxic substances be used for a pregnant woman?" Qi Bo answers: "If there is an existing pathology, there will be no miscarriage." The Emperor asks: "What does this mean?" Qi Bo answers: "For large accumulations and masses, attacking agents may be used, but stop when the pathology has diminished by more than half." As long as one carefully examines the nature of drugs and clarifies treatment methods, why doubt attacking therapies?
Ren Shen Yang Wei Tang (Ginseng Decoction to Nourish the Stomach): Treats pregnancy malaria with more chills than fever, or only chills without fever, headache, nausea, body pain, blue-white complexion, and string-taut-slow pulse. The indications for Qu Xie San (Evil-Expelling Powder) are the same.
Ingredients: Ban Xia (Pinellia Tuber), Nong Po (Magnolia Bark processed), Ju Hong (Red Tangerine Peel) (each 8 fen), Cang Zhu (Atractylodis Rhizoma) (1 qian), Huo Xiang Ye (Patchouli Leaf), Cao Guo (Black Cardamom), Fu Ling (Poria), Ren Shen (Ginseng Root) (each 5 fen), Gan Cao (Licorice Root honey-fried) (3 fen).
Usage: Add seven slices of Sheng Jiang (Fresh Ginger) and one Wu Mei (Chinese Plum), decoct with water and take orally.
Qing Pi Yin (Clear the Gallbladder Decoction): Treats pregnancy malaria with less chills and more fever, or only fever without chills, bitter taste in mouth, dry tongue, constipation, loss of appetite, and string-taut-rapid pulse.
Ingredients: Qing Pi (Green Tangerine Peel), Nong Po (Magnolia Bark processed with ginger), Bai Zhu (Atractylodis Macrocephalae Rhizoma stir-fried), Cao Guo (Black Cardamom), Fu Ling (Poria), Ban Xia (Pinellia Tuber), Huang Qin (Scutellaria Root), Chai Hu (Bupleurum Root), Gan Cao (Licorice Root honey-fried) (each 5 fen).
Usage: Add fresh ginger, decoct with water and take orally.
Qu Xie San (Evil-Expelling Powder): Treats pregnancy food stagnation complicated by cold contraction leading to malaria.
Ingredients: Gao Liang Jiang (Galangal Rhizome roasted), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Cao Guo Ren (Black Cardamom seed), Ju Hong (Red Tangerine Peel), Huo Xiang Ye (Patchouli Leaf), Suo Sha Ren (Amomum Fruit), Bai Fu Ling (Poria) (each 1.5 qian), Gan Cao (Licorice Root honey-fried) (5 fen).
Usage: Coarsely crush, prepare as one dose. Add five slices of fresh ginger and one date, decoct with water and take orally.
Chai Hu San (Bupleurum Powder): Treats pregnancy malaria. (This follows the method of Da Chai Hu Tang (Major Bupleurum Decoction), suitable only when exterior pathogens have not resolved and internal heat is severe and excess. However, dosage must be carefully considered.)
Ingredients: Chai Hu (Bupleurum Root) (2 qian), Sheng Da Huang (Rhubarb Root raw) (2 qian), Sheng Huang Qin (Scutellaria Root raw) (1.5 qian), Gan Cao (Licorice Root) (1 qian).
Usage: Prepare as one dose, decoct with water. Take warm at Wugeng (3-5 AM) on the day of onset. Stop when bowel movements become loose.
Another Prescription (Suitable for summerheat injury with internal phlegm-heat and severe irritability/thirst)
Ingredients: Chang Shan (Dichroa Root), Shi Gao (Gypsum Fibrosum) (each 1 liang), Huang Qin (Scutellaria Root), Gan Cao (Licorice Root honey-fried) (each 0.5 liang), Wu Mei (Chinese Plum) (7 pieces).
Usage: Finely chop. Soak in one bowl of water and one bowl of wine overnight. Decoct at dawn until reduced to one bowl. Strain and divide into two doses. Take at the time of malaria onset.
The above two prescriptions contain emetic and purgative agents like Chang Shan and Da Huang. They should be used if the six pulses are floating, tight, and forceful, indicating stubborn phlegm and accumulated heat. This exemplifies "if there is pathology, there is no miscarriage." Other treatment methods are detailed in the miscellaneous diseases section on malaria. If heat is severe and risks disturbing the fetus (if internal heat is extreme, medication is necessary to clear it), follow the treatment principles for febrile diseases in Shang Han (Cold Damage). White Yao Zi (Stemonae Radix) and Fu Long Gan (Furnace Soil) can be applied around the navel.