疟虽小病，而内经论之最详。首称夏伤于暑，藏于皮肤之内，肠胃之外，因得秋气，汗
出遇
风，内外相搏，是以日作。可知疟病由于暑风相搏而成。然暑必兼湿，若无湿但为干热，非
暑也。即此推之，疟病虽属暑风相搏而成，又必挟有湿邪酝酿之所致矣。特六淫分发四时，
暑之与湿气虽异，而因则同。有可分不可分之义也。今岁太阴司天，湿土主事，其变骤注，
其灾
霖溃，人在气交之中，感而即病者，为霍乱、吐泻，肿满诸候，其不即病，邪伏膜原，内趋
大肠则为痢，外走少阳则为疟。故疟之寒热往来，亦犹痢之赤白胶粘耳。恙逾匝旬，疟经
五发，胸腹饱闷，呕恶不渴，脉沉弦缓，显系湿郁中焦，腑阳失运，幸得从枢外达，不至滞
下疸满，邪净自瘳，无烦过虑。
产育多胎，冲任受亏，兼之自乳，阴血更耗。恙经年远，腰膂刺痛，转侧维艰，小便血
淋，
痛引少腹。揣摩其故，非特血气之伤，而且奇经亦损。故归地养阴，参 益气，均无灵效。
冲脉起于气街，任脉起于中极之下，淋痛诸候，必有所关，即寒热一端，亦阳维为病耳。病
由血海空虚，损及奇经八脉，寻常药饵，谅难奏功，宗《内经》血枯，治以四乌 骨虑茹丸
。
安波按∶古言病久入八脉。
前患痱风，调治小愈。案牍劳形，元虚未复，腰膂虽能转侧，足膝尚觉软弱，肝肾真元
下亏
，八脉不司约束。参 归地，仅可益其气血，未能通及八脉。古人治奇经精髓之伤，佥用血
肉有情，岂诸草木根 ，可同日而语。推之腰为肾府，膝为筋府，转摇不能，行则振掉，不
求自强功夫，恐难弥缝其阙。恬澹虚无，御神持满。庶几松柏之姿，老而益劲也。
拟河车、鹿茸、虎胫骨、虎膝骨、牛骨髓、猪骨髓、羊骨髓、阿胶、海参之属。
疟疾虽然是小病，但《内经》对其论述最为详尽。首先指出夏季感受暑邪，潜伏于皮肤之内、肠胃之外，到了秋季又受到秋气的影响，出汗时遇到风邪，内外邪气相互搏结，因此每日发作。由此可知，疟病是由于暑邪与风邪相互搏结而形成的。然而暑邪必然兼夹湿邪，如果没有湿邪只是单纯的干热，那就不是暑邪了。由此推断，疟病虽然属于暑风相搏而成，但也必定挟带有湿邪酝酿所致。
特别之处在于六淫邪气分别对应四季，暑邪与湿邪虽然性质不同，但致病的原因却有相同之处，这其中包含可分与不可分的道理。今年太阴湿土司天，湿气主事，气候突变导致雨水骤降，灾害表现为连绵阴雨溃决般的大雨。人处于天地气交之中，感邪后立即发病的，会出现霍乱、吐泻、肿胀满闷等症状；如果不立即发病，邪气潜伏在膜原，向内趋向大肠则变成痢疾，向外走窜少阳则变成疟疾。所以疟疾的寒热往来，也就像痢疾中的赤白黏冻一样。病程超过十天，疟疾已经发作五次，患者胸腹部饱闷，呕吐恶心但不口渴，脉象沉弦缓，明显是湿邪郁滞在中焦，腑阳失去运化功能。幸好邪气能够顺着枢机向外透达，不至于停滞在下成为痢疾或黄疸胀满，邪气排净自然痊愈，无需过分忧虑。
生育过多胎次，冲脉和任脉受到亏损，加上亲自哺乳，阴血更加耗损。疾病经过多年，腰部脊柱刺痛，转身侧卧非常困难，小便带血且淋漓疼痛，疼痛牵引至小腹。推测其原因，不仅仅是气血受伤，而且奇经八脉也受损。因此使用当归、熟地滋养阴血，人参补益元气，都没有显著疗效。冲脉起于气街穴，任脉起于中极穴之下，淋证疼痛等症状，必然与这两条经脉有关，即使是寒热这一症状，也是阳维脉发生病变所致。病由血海空虚，损伤到奇经八脉，寻常的药物恐怕难以奏效，遵循《内经》治疗“血枯”的方法，采用四乌鲗骨藘茹丸（即乌贼骨、藘茹等组成的方剂）。安波按：古语说病久会进入八脉。
之前患有痱风（一种以肢体废用为主的疾病），经过调理稍微好转。因为处理公文劳累形体，元气虚弱尚未恢复，腰部脊柱虽然能转动，但足膝仍然感觉软弱。这是肝肾真元在下部亏虚，奇经八脉不能起到约束作用。人参、当归、熟地，只能补益气血，未能通达奇经八脉。古人治疗奇经精髓的损伤，都使用血肉有情之品（动物药），难道那些草木根茎类药物可以与之同日而语吗？推而言之，腰是肾之府，膝是筋之府，如果转摇不能，行走时颤抖掉失，不寻求自我强化的功夫，恐怕难以弥补其缺陷。保持心境恬淡虚无，驾驭精神持守盈满。或许才能像松柏一样，年老后更加劲健。
Although malaria is a minor disease, it is discussed in the greatest detail in the *Neijing* (Classic of Internal Medicine). It first states that summer-heat pathogen injures the body in summer and hides inside the skin but outside the stomach and intestines. When autumn qi arrives, sweat is produced and wind is encountered; the internal and external pathogens struggle with each other, causing daily attacks. This indicates that malaria arises from the struggle between summer-heat and wind. However, summer-heat must be accompanied by dampness; without dampness, if there is only dry heat, it is not summer-heat. From this, we can infer that although malaria is formed by the struggle of summer-heat and wind, it must also be caused by the brewing action of dampness pathogen.
Specifically, the six exogenous pathogens are distributed across the four seasons. Although summer-heat and dampness differ in nature, their etiological origins share similarities, implying both separable and inseparable aspects. This year, Taiyin (Great Yin) governs the heavenly qi, and wet earth is in charge. The changes are sudden and heavy rainfall occurs like flooding. Humans exist within the intersection of heaven and earth qi; those who contract the pathogen and fall ill immediately suffer from cholera, vomiting and diarrhea, swelling, and fullness. Those who do not fall ill immediately have the pathogen latent in the Mo Yuan (Membrane Source); moving inward toward the Large Intestine results in dysentery, while moving outward to the Shaoyang (Lesser Yang) channel results in malaria. Thus, the alternating chills and fever of malaria are similar to the red and white sticky discharge in dysentery. After more than ten days, the malaria has attacked five times. The patient experiences chest and abdominal fullness, nausea and vomiting without thirst, and a deep, wiry, and slow pulse. This clearly indicates dampness stagnating in the Middle Jiao (Middle Burner), causing the Fu Yang (Yang of the Bowels) to lose its transformative function. Fortunately, the pathogen is able to reach the exterior via the pivot mechanism, preventing stagnation in the lower jiao as dysentery or jaundice and distension. Once the pathogen is cleared, recovery will occur naturally, requiring no excessive worry.
Multiple pregnancies have depleted the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel). Additionally, breastfeeding further consumes yin blood. Having suffered for many years, the patient experiences stabbing pain in the waist and spine, making turning difficult. There is hematuria with painful dribbling, and pain radiating to the lower abdomen. Speculating on the cause, this is not merely an injury to qi and blood, but also damage to the Eight Extraordinary Vessels. Therefore, using Gui Di (Angelicae Sinensis Radix and Rehmanniae Radix Praeparata) to nourish yin and Shen (Ginseng) to tonify qi yields no effective results. The Chong Mai originates at Qichuan (ST30), and the Ren Mai originates below Zhongji (CV3). Conditions such as painful dribbling are necessarily related to these vessels; even the symptom of chills and fever is a disease of the Yang Wei Mai (Yang Linking Vessel). The illness stems from emptiness of the Blood Sea, damaging the Eight Extraordinary Vessels. Ordinary herbal medicines are unlikely to achieve success. Following the *Neijing*'s treatment for "Blood Withered" (Xue Ku), the formula Si Wu Ju Gu Xu Ru Wan (Four Cuttlebone and Asparagus Pill) is adopted. An Bo notes: Ancient texts state that long-standing diseases enter the eight extraordinary vessels.
Previously suffering from Fei Feng (a condition characterized by flaccidity and paralysis), slight improvement was achieved through regulation. However, mental labor from official duties has left the primordial qi deficient and unrecovered. Although the waist and spine can now turn, the feet and knees still feel weak. This indicates a deficiency of the true yuan (primordial essence) of the Liver and Kidneys in the lower part, and the Eight Extraordinary Vessels fail to provide constraint. Shen (Ginseng), Gui (Angelicae Sinensis Radix), and Di (Rehmanniae Radix Praeparata) can only benefit qi and blood, failing to penetrate the Eight Extraordinary Vessels. Ancients treating injuries to the essence and marrow of the extraordinary vessels all used "blood and flesh sentient substances" (animal-derived medicines). How can mere plant roots and herbs be compared to them? Extending this logic, the waist is the mansion of the Kidney, and the knees are the mansion of the sinews. If rotation and shaking are impossible, and walking causes trembling, without seeking self-strengthening efforts, it will be difficult to mend these deficiencies. Maintaining tranquility and emptiness, and guarding the spirit to preserve fullness, one might retain the posture of pine and cypress, becoming stronger with age.
The proposed prescription includes He Che Da Zao (Placenta Hominis), Lu Rong (Cervi Cornu Pantotrichum), Hu Jing Gu (Tigris Ossis Tibialis), Hu Xi Gu (Tigris Ossis Fibularis), Niu Su Sui (Bovis Medulla), Zhu Su Sui (Suis Medulla), Yang Su Sui (Ovis Medulla), E Jiao (Colla Corii Asini), and Hai Shen (Holothuria).