其症恶寒发震发热。头或痛或不痛。或呕吐或不呕吐。胸膈痞闷。身重腰痛脚软。或先寒后热。
或先热后寒。寒时虽浓衣被不能温。热时虽卧冷地不能凉。或大渴饮水。或一日一发。发时多。
退时少。或间日三日一发。所兼之症极多。不能尽述。惟以其有寒。谓之冷瘴。有阴有阳。故谚
有云。冷瘴必不死。此瘴之轻者也。其脉或寒时微迟。热时弦数。或来六七至。或阳症见阴脉。治法先
用感应丸十四粒。姜汤送下。次用陈皮半夏汤三四服。或不换金正气散三四服。重者七八服。方用和解
汤三四服或七八服。加浓桂更好。得寒热间断
多时。后用截疟丸。酒送截之。或养胃汤。不已。四兽饮。此常法也。
如往来寒热。痰逆呕吐。
头痛及身腰痛如被杖。汗多烦躁。引饮自利。小便赤或如中风者。姜附汤主之。如寒热往来。烦渴
手足冷。鼻尖凉。身重舌黑。渴欲饮水。自利呕逆。汗出恶风者。干姜附子汤主之。如上半身热
极。下半身冷。腿足寒厥者。沉附汤主之。或送养正丹。黑锡丹。灵砂丹。
如发热手足厥冷烦渴闷乱上吐下泻者。附子理中汤主之。
如发热咽嗌干燥焦烦大渴饮水不止者。冷汤主之。或既济汤理之。渴甚者。夺命散加附子主
之。
如发热腹痛。头目昏沉。四肢疼痛。大便自利。小便或涩或利。或呕或咳者。真武汤主之。
如发热恶寒呕不止者。藿香正气散主之。夫瘴病多呕。病因饮食伤脾而得。又炎方之病。气多上逆。
痰与气并而上。故多呕。如因食生冷太过。
呕而恶食。头目昏沉肢体拘急。痰多腹痛者。养胃汤加附子沉香主之。呕甚送来复丹。或治中汤主之。
如呕吐膨胀者。二陈汤送感应丸。
如呕而胸膈不快。胁筋胀满。心腹刺痛。食少多痰。吞酸噎气。及见症不一者。以嘉主散主之。
如寒热往来。恶心呕吐。吞酸噫腐。腹痛痰痞不能食。红丸子主之。
如大便秘者。先服和解汤。自然通利。或秘甚者。用嘉禾散加蜜主之。又有多日不通者。看
病势何如。得大便利而后病方得愈。方可用蜜导法。若不甚急。只以治瘴为主。得热瘴不来。大便自然通利矣。
如寒热脐腹刺痛。胁痛烦乱。引饮霍乱。手足厥冷者。冷香汤主之。
如寒多热少。或但寒不热者。其人平日虚弱。七枣汤主之。
如神思昏乱。狂言谵语。不知人事者。轻则养胃汤加附子沉香。重者二陈汤
加沉附。若甚者。沉附汤主之。
如脉代者。此病甚不宜代脉。看大便如何。如大便照常。养胃汤加附子主之。
如大便不利。可与正气散或和解散加桂。大便行则代脉去矣。
如发热头痛。小便不利。烦躁饮水。水入即吐者。五苓散主之。若引饮自汗。小便赤涩者。
不得服五苓散。汗出更利小便。必亡阳也。况渗泄之剂。下虚者尤忌之。如四肢厥冷。
头额虚汗。咳逆脉促。其症甚危。三建汤主之。
如症候不一。多所变怪者。和解汤主之。
如瘴止后腰痛脚软者。加减五积散主之。
如瘴止后汗多者。黄 建中汤主之。
如瘴止后食少体倦者。异功散主之。
如瘴止后多痰及食入而心下饱闷者。香砂六君汤。或吞养脾丸。
如瘴止后虚烦不得眠。心胆虚怯。触事易惊者。温胆汤主之。
其症状表现为恶寒、战栗、发热。头部有时疼痛，有时不痛。有时呕吐，有时不呕吐。胸膈部痞塞闷胀。身体沉重，腰部疼痛，脚部软弱无力。有时先出现寒战随后发热，有时先发热随后出现寒战。在寒战时，即使穿着厚厚的衣服、盖着厚被子也无法感到温暖；在发热时，即使躺在冰冷的地上也无法感到凉爽。有时极度口渴想喝水。发作频率可能是一天一次，发作时病程较长，退热时病程较短；也可能是隔一天或隔三天发作一次。所兼夹的症状非常多，无法一一列举。只因为伴有寒象，所以称为冷瘴。它分为阴证和阳证，所以谚语说：“冷瘴必定不会致死”，这是瘴气病中较轻的一种。其脉象在寒战时微迟，在发热时弦数，或者脉搏跳动六七次一息。或者阳证却见到阴脉。治疗方法先用感应丸十四粒，用姜汤送服。接着服用陈皮半夏汤三四剂，或者不换金正气散三四剂，病情重的服用七八剂。然后使用和解汤三四剂或七八剂，加入浓桂（肉桂）效果更好。等到寒热症状间断很长时间后，再服用截疟丸，用酒送服以截断疟疾。或者服用养胃汤，如果无效，再服用四兽饮。这是常规的治疗方法。
如果出现往来寒热、痰逆呕吐、头痛以及全身腰背疼痛如同被棍棒打击一样、出汗多且烦躁、大量饮水且自发性腹泻、小便颜色红赤或者像中风一样的症状，用姜附汤主治。如果出现寒热往来、烦渴、手脚冰凉、鼻尖发凉、身体沉重、舌苔黑、口渴想喝水、自发性腹泻、呕吐逆气、出汗且怕风的症状，用干姜附子汤主治。如果出现上半身极度发热、下半身寒冷、腿脚寒冷厥逆的症状，用沉附汤主治。或者送服养正丹、黑锡丹、灵砂丹。
如果出现发热、手脚厥冷、烦渴、胸闷混乱、上吐下泻的症状，用附子理中汤主治。
如果出现发热、咽喉干燥焦灼、心烦、极度口渴喝水不止的症状，用冷汤主治。或者用既济汤调理。如果口渴特别严重的，用夺命散加附子主治。
如果出现发热、腹痛、头目昏沉、四肢疼痛、大便自发性腹泻、小便或者涩滞或者通畅、或者呕吐或者咳嗽的症状，用真武汤主治。
如果出现发热、恶寒、呕吐不止的症状，用藿香正气散主治。大凡瘴病大多伴有呕吐，病因是饮食损伤脾胃所致。又是南方炎热之地的疾病，气机多向上逆乱，痰与气并结而上逆，所以容易呕吐。如果是因食用生冷太过，导致呕吐、厌恶食物、头目昏沉、肢体拘急、痰多腹痛的，用养胃汤加附子、沉香主治。呕吐严重的送来复丹，或者用治中汤主治。
如果出现呕吐且胸膈不畅快、胁肋筋脉胀满、心腹刺痛、食少痰多、吞酸嗳气，以及症状表现不一的情况，用嘉主散主治。
如果出现寒热往来、恶心呕吐、吞酸嗳出腐臭气味、腹痛痰痞不能进食的情况，用红丸子主治。
如果出现大便秘结的情况，先服用和解汤，自然就会通利。如果便秘特别严重的，用嘉禾散加蜂蜜主治。又有几天不通便的，要看病势如何，必须等大便利之后，病才能痊愈，这时才可以使用蜜导法。如果不那么紧急，只以治疗瘴病为主，只要热瘴不来，大便自然会通利。
如果出现寒热交替、脐腹刺痛、胁痛、心烦意乱、大量饮水、霍乱、手脚厥冷的情况，用冷香汤主治。
如果出现寒多热少，或者只有寒没有热的情况，其人平时体质虚弱，用七枣汤主治。
如果出现神志昏乱、胡言乱语、不知人事的情况，轻的用养胃汤加附子、沉香，重的用二陈汤加沉香、附子。如果更严重的，用沉附汤主治。
如果出现代脉的，这种病非常不宜出现代脉。看大便情况如何，如果大便正常，用养胃汤加附子主治。如果大便不利，可以给予正气散或和解散加桂枝。大便通畅后，代脉就会消失。
如果出现发热、头痛、小便不利、烦躁想喝水、水喝进去就吐出来的情况，用五苓散主治。如果引饮且自汗、小便红赤涩痛的，不得服用五苓散。因为出汗已经更多了，如果再利小便，必然会导致亡阳。况且渗泄的药物，对于下虚的人尤其忌讳。如果出现四肢厥冷、头额出虚汗、咳逆、脉促，这些症状非常危险，用三建汤主治。
如果症状不一，变化多端的，用和解汤主治。
Its symptoms manifest as aversion to cold, tremors, and fever. The head may or may not be painful. Vomiting may or may not occur. There is a sensation of fullness and oppression in the chest and diaphragm. The body feels heavy, with lower back pain and weakness in the legs and feet. Sometimes chills precede fever, sometimes fever precedes chills. During chills, even thick clothing and quilts cannot provide warmth; during fever, lying on cold ground cannot provide coolness. There may be extreme thirst and desire to drink water. Attacks may occur once a day, with the attack phase being long and the remission phase short; or they may occur every other day or every third day. The accompanying symptoms are numerous and cannot be fully listed. Because it involves cold, it is called Cold Miasma (Leng Zhang). It has Yin and Yang types, hence the proverb says, "Cold Miasma will certainly not lead to death," indicating this is a mild form of miasma disease. The pulse may be slightly slow during chills and wiry-rapid during fever, or beating six to seven times per breath. Or a Yang syndrome presents with a Yin pulse. The treatment method first uses Shigan Wan (Miracle Response Pill), 14 pills, taken down with ginger decoction. Next, use Chenpi Banxia Tang (Tangerine Peel and Pinellia Decoction) for three to four doses, or Buhuanjin Zhengqi San (Golden-Not-Swapped Upright Qi Powder) for three to four doses; for severe cases, seven to eight doses. Then use Hejie Tang (Harmonizing Decoction) for three to four or seven to eight doses; adding Rougui (Cinnamon Bark) is better. After the chills and fever have been intermittent for a long time, subsequently use Juenie Wan (Malaria-Cutting Pill), taken with wine to cut off the malaria. Alternatively, use Yangwei Tang (Stomach-Nourishing Decoction); if ineffective, use Sishou Yin (Four Beasts Drink). This is the standard method.
If there are alternating chills and fever, phlegm-reversal vomiting, headache, and whole-body back pain as if beaten by a stick, profuse sweating, irritability, excessive drinking, spontaneous diarrhea, red or turbid urine, or symptoms resembling wind-stroke, Jiangfu Tang (Ginger and Aconite Decoction) is the primary prescription. If there are alternating chills and fever, irritability and thirst, cold hands and feet, cold nose tip, heavy body, black tongue coating, thirst with desire to drink, spontaneous diarrhea, vomiting and reflux, sweating, and aversion to wind, Ganjiang Fuzi Tang (Dried Ginger and Aconite Decoction) is the primary prescription. If the upper body is extremely hot while the lower body is cold, with cold and cold-cold extremities in the legs and feet, Chenfu Tang (Atractylodes and Aconite Decoction) is the primary prescription. Alternatively, send Yangzheng Dan (Upright-Quality Elixir), Heixi Dan (Black Tin Elixir), or Lingsha Dan (Cinnabar Elixir).
If there is fever, cold extremities, irritability and thirst, chest oppression and confusion, upper vomiting and lower diarrhea, Fuzi Lizhong Tang (Aconite and Middle-Warming Decoction) is the primary prescription.
If there is fever, dry and scorched throat, vexation, extreme thirst with incessant drinking, Leng Tang (Cold Decoction) is the primary prescription. Or treat with Jiji Tang (Already-Intersecting Decoction). For extreme thirst, Dueming San (Life-Seizing Powder) with added Fuzi (Aconite Root) is the primary prescription.
If there is fever, abdominal pain, dizziness and heaviness of the head and eyes, pain in the four limbs, spontaneous diarrhea, urine that is either obstructed or free, vomiting, or coughing, Zhenwu Tang (True Warrior Decoction) is the primary prescription.
If there is fever, aversion to cold, and incessant vomiting, Huoxiang Zhengqi San (Patchouli Upright Qi Powder) is the primary prescription. Generally, miasma diseases often involve vomiting; the etiology is damage to the Spleen due to dietary injury. Furthermore, diseases in the hot southern regions often involve Qi counterflow upward; Phlegm and Qi combine and ascend, thus causing frequent vomiting. If caused by excessive consumption of raw and cold foods, leading to vomiting, food aversion, dizziness and heaviness of the head and eyes, limb stiffness, profuse phlegm, and abdominal pain, Yangwei Tang (Stomach-Nourishing Decoction) with added Fuzi (Aconite Root) and Chenxiang (Aquilaria Wood) is the primary prescription. For severe vomiting, Laifu Dan (Restoring-Reversion Elixir) is sent, or Zhizhong Tang (Middle-Regulating Decoction) is the primary prescription.
For vomiting accompanied by abdominal distension, Erchen Tang (Two-Chen Decoction) is used to send Shigan Wan (Miracle Response Pill).
For vomiting with chest and diaphragmatic discomfort, distension and fullness of the hypochondriac tendons, stabbing pain in the heart and abdomen, poor appetite, profuse phlegm, acid regurgitation, belching, and various inconsistent symptoms, Jiazhu San (Jiazhu Powder) is the primary prescription.
For alternating chills and fever, nausea and vomiting, acid regurgitation, belching of rotten smells, abdominal pain, phlegm-fullness, and inability to eat, Hongwanzi (Red Pills) is the primary prescription.
For constipation, first take Hejie Tang (Harmonizing Decoction) to naturally promote bowel movement. For severe constipation, Jiahe San (Jiahe Powder) with honey is the primary prescription. For those who have not had a bowel movement for many days, observe the disease trend; only after the bowels are free can the disease heal, at which point the Honey Suppository Method (Midao Fa) can be used. If not urgent, focus primarily on treating the miasma; if the heat-miasma does not return, the bowels will naturally become free.
For alternating chills and fever, stabbing pain in the umbilical and abdominal region, hypochondriac pain, vexation and confusion, excessive drinking, cholera-like symptoms, and cold extremities, Lengxiang Tang (Cool Fragrance Decoction) is the primary prescription.
For more chills than fever, or only chills without fever, in individuals who are usually weak, Qizao Tang (Seven-Jujube Decoction) is the primary prescription.
For mental confusion, delirious speech, and loss of consciousness, for mild cases, Yangwei Tang (Stomach-Nourishing Decoction) with added Fuzi (Aconite Root) and Chenxiang (Aquilaria Wood); for severe cases, Erchen Tang (Two-Chen Decoction) with added Chenxiang (Aquilaria Wood) and Fuzi (Aconite Root). For very severe cases, Chenfu Tang (Atractylodes and Aconite Decoction) is the primary prescription.
For a choppy pulse (Dai Mai), this disease is particularly unfavorable with a choppy pulse. Observe the stool. If the stool is normal, Yangwei Tang (Stomach-Nourishing Decoction) with added Fuzi (Aconite Root) is the primary prescription. If the stool is difficult, provide Zhengqi San (Upright Qi Powder) or Hejie San (Harmonizing Powder) with added Guizhi (Cinnamon Twig). Once the stool moves, the choppy pulse will disappear.
For fever, headache, difficulty in urination, irritability, thirst, and vomiting immediately after drinking water, Wuling San (Five-Ling Powder) is the primary prescription. If there is excessive drinking, spontaneous sweating, and red, scanty, or painful urination, Wuling San (Five-Ling Powder) must not be administered. Since sweating is already profuse, promoting urination further would inevitably lead to Yang collapse. Moreover, draining and leaching agents are especially contraindicated for those with lower deficiency. For cold extremities, empty sweat on the forehead, retching, and a hurried pulse, the condition is critical; Sanjian Tang (Three-Jian Decoction) is the primary prescription.
For inconsistent symptoms and many variations, Hejie Tang (Harmonizing Decoction) is the primary prescription.
After the miasma subsides, for lower back pain and leg weakness, Jiajian Wuji San (Modified Accumulation-Difficulty Powder) is the primary prescription.
After the miasma subsides, for profuse sweating, Huangqi Jianzhong Tang (Astragalus Middle-Nourishing Decoction) is the primary prescription.
After the miasma subsides, for poor appetite and fatigue, Yigong San (Yigong Powder) is the primary prescription.
After the miasma subsides, for profuse phlegm and post-prandial epigastric fullness and oppression, Xiangsha Liujun Tang (Costus and Amomum Six-Gentlemen Decoction), or swallowing Yangpi Wan (Spleen-Nourishing Pill).
After the miasma subsides, for deficiency-vexation, insomnia, deficiency-fear of the Heart and Gallbladder, and easily startled by events, Wendan Tang (Warm Gallbladder Decoction) is the primary prescription.