甲申予馆新洲,长夏感暑兼湿,疟间日发,寒热俱重,涎沫甚多。用平胃散加柴胡、制半夏、神曲、赤苓,
二服愈。又乙酉感风成疟。经曰∶风淫于内。治以辛凉,用芎苏饮去干葛、木香,加薄荷、姜皮。一服愈。
胡 伏暑发寒热如疟,头晕脘痞,此暑邪挟湿,阻遏气分,故汗止在胸前,宜辛凉解散。用栀豉汤加杏仁、
枳壳、黄芩、半夏、栝蒌、滑石。数服而平。
族妇 暑症转疟,寒微热甚,汗多头眩便硬。用竹叶石膏汤去参加知母,服愈。
毛 热症未愈,复因邪滞,恶寒怯风,胸满腹胀,午前寒热如疟,至夜乃汗,右关尺浮滑,症兼表里,治宜
经腑疏解。用柴胡、半夏、薄荷、苏梗、陈皮、浓朴、赤苓、神曲、生姜。二服诸症退。去薄荷,加黄芩、
砂仁壳、鸡内金(炙)。数服全愈。
侄 寒疟吐泻,脉迟虚。用理中汤加半夏、茯苓、砂仁、神曲、姜汁。一服吐泻止,疟轻,诊脉虚而少力,
此中气不足也。令与稀糜,用补中益气汤,神爽思食疟止。又服四君子汤加黄 (炙)、砂仁,愈。
李 秋疟背寒肢厥,从卯时冷至酉方热,夜半无汗自退,不
饥不食倦卧。仿陈远公解寒汤,潞参、于术、川附(炙)、川芎、柴胡、桂枝、草果(煨研)、姜、枣。煎
服得汗而寒减,去川附,加半夏、谷芽、陈皮、当归。思食疟止。(此症与丹溪所治少年足冷疟相似,但彼由
接内,此系阳虚。)
王 咳嗽痰多,右膊痛,疟间日发,脉浮缓,此为肺疟。得之浴后当风,经所谓夏伤于暑。汗大出,
腠理开发,因遇夏气,凄沧之水寒,藏于腠理皮肤之中,秋伤于风,则病成也。肺主皮毛,故为肺疟。用柴胡
汤合二陈,去黄芩,加防风、苏叶、桑皮、杏仁、姜、枣煎,数服愈。
侄 间日疟寒热俱重,头痛背寒,肢麻肋闷,呕恶痰多,由湿热阻遏气分。白蔻仁、浓朴(各五分)、
广皮、枳壳(各一钱)、半夏、茯苓(各二钱)、青蒿(八分)、杏仁(钱半)、栝蒌、竹茹(各钱二分)、
煨姜(二钱),一服脘闷已展,呕恶亦除,痰降便通,湿热去,疟自止。杏仁、半夏(各钱半)、赤苓(二钱)、
栝蒌、枳壳、橘红、甘菊(各八分)、蔻仁(三分)、竹茹(一钱)、嫩桑叶(三钱),一剂疟止。前用温
胆汤愈疟,尚不嗜食,大便难,脘中欠爽,病在左关不和。因之肠腑失降,用两和厥阴阳明。白芍、旋复花、
陈皮、半夏、栝蒌仁、牡蛎粉、杏仁、竹茹、枳实汁,再服悉平。
族孙 胎疟停滞。用寸金丹三钱,姜汤服,二次愈。
本 间日疟偏头痛连齿,夜烦不寐,症由胆火升越,震动心主,致神愦语错,必熄胆络风火,疟邪自已。
钩藤、鳖甲(各二钱)、山栀、丹皮、麦冬(各一钱)、黄芩、连翘(各七分)、半夏(青盐炒,一钱半)、
夜交藤(五钱),日二服,兼下牛黄清心丸,疟轻,改用乌梅(二枚)、赤苓、生首乌(各三钱)、鳖甲(二钱)、
牛膝、当归、丹皮(各八分),一啜而止。
梁氏 粤产,地暖气泄,客居黄河以北,风土迥殊。今夏秋暑雨蒸淫,感症成疟,寒热烦满,微汗,
以湿疟治。仿古柴平汤,用柴胡、黄芩、半夏、茯苓、枳壳、山栀、茅术(生)、浓朴、陈皮、姜、枣。
二服汗透,寒热减,改用清暑退邪,前方去茅术、朴、枳,加青蒿、香薷、薄荷,再剂而愈。
某 疟间日发,寒重热轻,汗多神倦,发时头不痛,口不渴,但凛寒拘急,肢冷髀酸。老人气虚有痰,
此非暑非风,乃虚邪入
络,名曰劳疟。先时勿食,汗后服保元汤扶正以逐络邪。参、 、术,草、归、陈、鳖甲(炙)、
柴胡、半夏、威灵仙、姜煎,一啜遂止。
甲申年,我在新洲馆舍居住,长夏时节感受暑邪兼夹湿邪,疟疾隔日发作,寒战与发热都很严重,唾液痰沫非常多。使用平胃散加入柴胡、制半夏、神曲、赤茯苓,服用两剂后痊愈。
又至乙酉年,因感受风邪而成疟疾。《内经》说:“风邪淫溢于内,当用辛凉之品治疗。”使用芎苏饮,去掉干葛、木香,加入薄荷、姜皮。服用一剂后痊愈。
胡姓患者:伏暑引发寒热如疟状,头晕,胃脘部痞闷,这是暑邪挟带湿邪,阻遏气分,所以汗只出在胸前,应当用辛凉之法解散。使用栀豉汤加入杏仁、枳壳、黄芩、半夏、栝蒌、滑石。服用数剂后病情平稳。
族中妇女:暑症转为疟疾,寒象轻微而热象显著,多汗,头眩,大便干硬。使用竹叶石膏汤加入知母,服用后痊愈。
毛姓患者:热症未愈,又因邪气滞留,恶寒怕风,胸满腹胀,午前寒热如疟状,到了夜间才出汗,右关脉和尺脉浮滑,病症兼有表里,治疗应当疏解经腑。使用柴胡、半夏、薄荷、苏梗、陈皮、厚朴、赤茯苓、神曲、生姜。服用两剂后诸症消退。去掉薄荷,加入黄芩、砂仁壳、鸡内金(炙)。服用数剂后完全痊愈。
侄子:寒疟伴有呕吐腹泻,脉象迟而虚。使用理中汤加入半夏、茯苓、砂仁、神曲、姜汁。服用一剂后吐泻停止,疟疾减轻,诊察脉象虚弱且无力,这是中气不足所致。令其食用稀粥,并使用补中益气汤,精神清爽,思食,疟疾停止。又服用四君子汤加入黄芪(炙)、砂仁,痊愈。
李姓患者:秋季疟疾,背部寒冷,四肢厥冷,从卯时(早晨5-7点)冷到酉时(下午5-7点)才发热,夜半无汗自行退去,不思饮食,疲倦卧床。仿照陈远公的解寒汤,使用潞党参、白术、川附子(炙)、川芎、柴胡、桂枝、草果(煨后研碎)、生姜、大枣。煎服后得汗而寒象减轻,去掉川附子,加入半夏、谷芽、陈皮、当归。思食,疟疾停止。(此症与朱丹溪所治的少年足冷疟相似,但彼病由房事过度引起,此病系阳虚所致。)
王姓患者:咳嗽痰多,右侧膊部疼痛,疟疾隔日发作,脉象浮缓,此为肺疟。得病原因是在洗澡后当风,《内经》所谓“夏伤于暑”,汗大出,腠理开发,因而遇到夏季气候中的凄冷水寒之气,藏于腠理皮肤之中,秋季再伤于风邪,则病形成。肺主皮毛,故称为肺疟。使用柴胡汤合二陈汤,去掉黄芩,加入防风、苏叶、桑白皮、杏仁、生姜、大枣煎服,服用数剂后痊愈。
侄子:间日疟寒热俱重,头痛背寒,肢体麻木,胁肋闷胀,呕吐恶心痰多,由湿热阻遏气分所致。白蔻仁、厚朴(各五分),广陈皮、枳壳(各一钱),半夏、茯苓(各二钱),青蒿(八分),杏仁(一钱半),栝蒌、竹茹(各一钱二分),煨姜(二钱)。服用一剂后胃脘闷胀已舒展,呕吐恶心亦除,痰降便通,湿热去除,疟疾自然停止。再用杏仁、半夏(各一钱半),赤茯苓(二钱),栝蒌、枳壳、橘红、甘菊(各八分),蔻仁(三分),竹茹(一钱),嫩桑叶(三钱)。服用一剂后疟疾停止。此前用温胆汤治愈疟疾后,仍不嗜食,大便困难,胃脘中不爽利,病位在左关脉不和。因此导致肠腑失于通降,采用调和厥阴、阳明之法。使用白芍、旋复花、陈皮、半夏、栝蒌仁、牡蛎粉、杏仁、竹茹、枳实汁,再服用后悉皆平复。
本姓患者:间日疟偏头痛连及牙齿,夜间烦躁不寐,病症由胆火升越,震动心主,导致神志昏愦、言语错乱,必须熄灭胆络的风火,疟邪自会消除。使用钩藤、鳖甲(各二钱),山栀子、牡丹皮、麦冬(各一钱),黄芩、连翘(各七分),半夏(青盐炒,一钱半),夜交藤(五钱)。每日服用两次,同时服用牛黄清心丸,疟疾减轻,改用乌梅(二枚),赤茯苓、生首乌(各三钱),鳖甲(二钱),牛膝、当归、牡丹皮(各八分),服用一次即止。
梁氏:广东籍人,当地地气泄越,客居黄河以北,风土截然不同。今年夏秋季节暑雨蒸腾淫溢,感邪成疟,寒热烦满,微汗,以湿疟治疗。仿照古方柴平汤,使用柴胡、黄芩、半夏、茯苓、枳壳、山栀子、苍术(生)、厚朴、陈皮、生姜、大枣。服用两剂后汗透,寒热减轻,改用清暑退邪之法,前方去掉苍术、厚朴、枳壳,加入青蒿、香薷、薄荷,再服用两剂后痊愈。
某患者:疟疾隔日发作,寒重热轻,多汗,精神疲倦,发作时头部不痛,口不渴,只是凛冽寒冷拘急,四肢冰冷,大腿酸痛。老人气虚有痰,此非暑邪也非风邪,乃是虚邪入络,名为劳疟。先暂时禁食,汗后服用保元汤扶助正气以驱逐络中之邪。人参、白术,甘草、当归、陈皮、鳖甲(炙),柴胡、半夏、威灵仙,生姜煎服,服用一次遂停止。
In the year of Jiashen, I was residing in a guesthouse at Xinzhou. During the long summer, I contracted heat-toxin combined with dampness, resulting in malaria occurring every other day. The chills and fever were both severe, accompanied by excessive salivary froth. Pingwei San (Stomach-Pacifying Powder) was prescribed with added Chaihu (Bupleurum Root), Zhi Banxia (Prepared Pinellia Rhizome), Shenqu (Medicated Leaven), and Chi Ling (Red Poria). After two doses, the condition resolved.
In the subsequent year of Yiyi, wind-pathogen contracted malaria developed. As stated in the classics: "When wind pathogen overflows internally, treat it with acrid-cool substances." Xiong Su Yin (Ligusticum and Perilla Drink) was used, removing Gan Ge (Dried Ginger) and Mu Xiang (Aucklandiae Radix), and adding Bo He (Menthae Haplocalycis Herba) and Jiang Pi (Zingiberis Pericarpium). After one dose, the condition resolved.
Patient Hu: Latent heat-toxin triggered chills and fever resembling malaria, dizziness, and epigastric fullness. This indicates heat-toxin carrying dampness obstructing the Qi mechanism, causing sweat only on the chest. Acrid-cool dispersal is indicated. Zhichi Tang (Gardenia and Fermented Soybean Decoction) was prescribed with added Xingren (Apricot Seed), Zhike (Aurantii Fructus), Huangqin (Scutellariae Radix), Banxia (Pinelliae Rhizoma), Gualou (Trichosanthis Fructus), and Huashi (Talcum). After several doses, the condition stabilized.
Clan woman: Heat-toxin transformed into malaria, with mild chills but intense fever, profuse sweating, dizziness, and hard stool. Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) with added Zhimu (Anemarrhenae Rhizoma) was administered, resulting in recovery.
Patient Mao: Heat-pattern had not yet resolved; additionally, pathogenic stagnation caused aversion to cold and fear of wind, chest fullness, and abdominal distension. Before noon, chills and fever resembled malaria; sweat occurred only at night. The right Guan and Chi pulses were floating and slippery. The pattern involved both exterior and interior, requiring unblocking and resolving of the channels and fu-organs. Chaihu (Bupleuri Radix), Banxia (Pinelliae Rhizoma), Bohe (Menthae Haplocalycis Herba), Sugeng (Perillae Caulis), Chenpi (Citri Reticulatae Pericarpium), Houpo (Magnoliae Officinalis Cortex), Chi Ling (Poria cum Ligno Rubrum), Shenqu (Massa Medicata Fermentata), and Shengjiang (Zingiberis Recens Rhizoma) were used. After two doses, all symptoms receded. Bohe was removed, and Huangqin (Scutellariae Radix), Sha Ren Ke (Amomi Fructus Testa), and Jineijin (Gigantidis Folliculus Intestinum) [roasted] were added. After several doses, complete recovery was achieved.
Nephew: Cold-malaria with vomiting and diarrhea, pulse slow and deficient. Lizhong Tang (Regulate the Middle Decoction) with added Banxia (Pinelliae Rhizoma), Fuling (Poria), Sha Ren (Amomi Fructus), Shenqu (Massa Medicata Fermentata), and Jiangzhi (Zingiberis Juice) was used. After one dose, vomiting and diarrhea ceased, and malaria lightened. The pulse was weak and feeble, indicating deficiency of Middle Qi. A thin gruel was recommended, followed by Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). Spirit refreshed, appetite returned, and malaria stopped. Subsequently, Sijunzi Tang (Four Gentlemen Decoction) with added Huangqi (Astragali Radix) [roasted] and Sha Ren (Amomi Fructus) was taken, leading to cure.
Patient Li: Autumn malaria with cold back and cold limbs. From Mao hour (5-7 AM) until You hour (5-7 PM), there was cold; fever occurred at midnight without sweat, subsiding spontaneously. There was no hunger or desire to eat, and fatigue led to lying down. Following Chen Yuan Gong's Jie Han Tang (Resolve Cold Decoction), Ludangshen (Codonopsis Radix), Yuzhu (Atractylodis Macrocephalae Rhizoma), Chuan Fu Zi (Aconiti Lateralis Radix Praeparata) [roasted], Chuanxiong (Ligustici Chuanxiong Rhizoma), Chaihu (Bupleuri Radix), Guizhi (Cinnamomi Ramulus), Caoguo (Tsao-ko Fructus) [roasted and ground], Shengjiang (Zingiberis Recens Rhizoma), and Dazao (Jujubae Fructus) were decocted and taken. Sweat ensued, reducing cold. Chuan Fu Zi was removed, and Banxia (Pinelliae Rhizoma), Guya (Setariae Fructus Germinatus), Chenpi (Citri Reticulatae Pericarpium), and Danggui (Angelicae Sinensis Radix) were added. Appetite returned, and malaria stopped. (This case resembles the juvenile foot-cold malaria treated by Danxi, but that was due to sexual excess, whereas this is due to Yang deficiency.)
Patient Wang: Cough with profuse phlegm, pain in the right upper arm, malaria every other day, pulse floating and moderate. This is Lung Malaria. It resulted from exposure to wind after bathing. As the classics state: "Summer injury by heat-toxin." Profuse sweating opens the pores (Couli); encountering cold water/air in summer allows pathogenic cold to hide within the Couli and skin. Autumn wind injury then completes the disease formation. Since the Lung governs the skin and hair, it is called Lung Malaria. Chaihu Tang (Bupleurum Decoction) combined with Erchen Tang (Two-Aged Phlegm Decoction), removing Huangqin (Scutellariae Radix), and adding Fangfeng (Saposhnikoviae Radix), Sueye (Perillae Folium), Sangpi (Mori Cortex), Xingren (Armeniacae Semen Amarum), Shengjiang (Zingiberis Recens Rhizoma), and Dazao (Jujubae Fructus) was decocted and taken. After several doses, recovery occurred.
Nephew: Intermittent malaria with severe chills and fever, headache, cold back, numbness in limbs, rib-side oppression, vomiting, nausea, and profuse phlegm, caused by damp-heat obstructing the Qi mechanism. Baisharen (Amomi Fructus Rotundus) and Houpo (Magnoliae Officinalis Cortex) [each 0.5 qian], Guangpi (Citri Reticulatae Pericarpium) and Zhike (Aurantii Fructus) [each 1 qian], Banxia (Pinelliae Rhizoma) and Fuling (Poria) [each 2 qian], Qinghao (Artemisiae Annuae Herba) [0.8 fen], Xingren (Armeniacae Semen Amarum) [1.5 qian], Gualou (Trichosanthis Fructus) and Zhuru (Bambusae Caulis in Taedia) [each 1.2 qian], Weijiang (Roasted Ginger) [2 qian]. After one dose, epigastric oppression eased, vomiting and nausea ceased, phlegm descended, bowels moved, damp-heat cleared, and malaria stopped. Next prescription: Xingren (Armeniacae Semen Amarum) and Banxia (Pinelliae Rhizoma) [each 1.5 qian], Chi Ling (Poria cum Ligno Rubrum) [2 qian], Gualou (Trichosanthis Fructus), Zhike (Aurantii Fructus), Juhong (Citri Reticulatae Pericarpium Rubrum), Ganju (Chrysanthemi Indici Flos) [each 0.8 fen], Coren (Amomi Fructus Rotundus) [0.3 fen], Zhuru (Bambusae Caulis in Taedia) [1 qian], Nensangye (Mori Folium Tender) [3 qian]. After one dose, malaria stopped. Previously, Wendan Tang (Warm Gallbladder Decoction) cured the malaria, but appetite remained poor, defecation difficult, and epigastric comfort lacking, indicating disharmony at the left Guan position. Consequently, the intestines and fu-organs failed to descend. Treatment aimed to harmonize Jueyin and Yangming. Baishao (Paeoniae Radix Alba), Xuanjinhua (Inulae Flos), Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma), Gualouren (Trichosanthis Semen), Muli Fen (Concha Ostreae Pulvis), Xingren (Armeniacae Semen Amarum), Zhuru (Bambusae Caulis in Taedia), and Zhishi Zhi (Zhitzi Juice) were taken. After further doses, everything normalized.
Clan grandson: Fetal malaria stagnation. Cunjin Dan (Inch Gold Pill) 3 qian, taken with ginger soup, cured after two administrations.
Patient Ben: Intermittent malaria with migratory headache extending to teeth, nighttime irritability and insomnia. The pattern arises from Gallbladder fire rising and agitating the Heart Master, causing mental confusion and disordered speech. It is necessary to extinguish Wind-Fire in the Gallbladder collaterals for the malaria pathogen to resolve naturally. Gouteng (Uncariae Ramulus cum Uncis) and Biejia (Testudinis Carapax et Plastrum) [each 2 qian], Shanzhi (Gardeniae Fructus), Danpi (Moutan Cortex), Maidong (Ophiopogonis Radix) [each 1 qian], Huangqin (Scutellariae Radix), Lianqiao (Forsythiae Fructus) [each 0.7 fen], Banxia (Pinelliae Rhizoma) [stir-fried with green salt, 1.5 qian], Yejiaoteng (Polygoni Multiflori Caulis) [5 qian]. Taken twice daily, along with Niuhuang Qingxin Wan (Calculus Bovis Heart-Clearing Pills). Malaria lightened. Changed to Wumei (Mume Fructus) [2 pieces], Chi Ling (Poria cum Ligno Rubrum), Sheng Shouwu (Polygoni Multiflori Radix) [each 3 qian], Biejia (Testudinis Carapax et Plastrum) [2 qian], Niuxi (Achyranthis Bidentatae Radix), Danggui (Angelicae Sinensis Radix), Danpi (Moutan Cortex) [each 0.8 fen]. One sip stopped the malaria.
Ms. Liang: Native of Guangdong, where local qi tends to dissipate. Residing north of the Yellow River, the climate and geography differed significantly. This summer and autumn, steaming rain created humid conditions, leading to pathogenic infection and malaria with chills, fever, irritability, fullness, and slight sweat. Treated as damp-malaria. Following ancient Chaiping Tang (Bupleurum and Pingwei Decoction), Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), Banxia (Pinelliae Rhizoma), Fuling (Poria), Zhike (Aurantii Fructus), Shanzhi (Gardeniae Fructus), Maoyu (Atractylodis Rhizoma) [raw], Houpo (Magnoliae Officinalis Cortex), Chenpi (Citri Reticulatae Pericarpium), Shengjiang (Zingiberis Recens Rhizoma), and Dazao (Jujubae Fructus) were used. After two doses, sweat penetrated, chills and fever reduced. Switched to clearing summer-heat and expelling pathogens. Removed Maoyu, Houpo, and Zhike from the previous formula, added Qinghao (Artemisiae Annuae Herba), Xiangru (Elsholtziae Herba), and Bohe (Menthae Haplocalycis Herba). After another two doses, recovery was achieved.
Certain patient: Malaria every other day, heavy chills and light fever, profuse sweat, spiritual fatigue. At onset, no headache, no thirst, only severe cold rigidity, cold limbs, and sore thighs. An elderly person with Qi deficiency and phlegm; this is neither summer-heat nor wind, but deficient pathogen entering the collaterals, named Labor Malaria. Initially fasting, then taking Baoyuan Tang (Preserve the Origin Decoction) to support Righteous Qi and expel collateral pathogens. Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao (Glycyrrhizae Radix), Danggui (Angelicae Sinensis Radix), Chenpi (Citri Reticulatae Pericarpium), Biejia (Testudinis Carapax et Plastrum) [roasted], Chaihu (Bupleuri Radix), Banxia (Pinelliae Rhizoma), Weilingxian (Sinomenii Caulis), and Shengjiang (Zingiberis Recens Rhizoma) were decocted. One sip stopped the malaria.