薛立斋治一妇人，因怒，举发无期，久而不已，胸腹不利，饮食少思，吞酸吐痰。用六君子加柴胡、山栀，
二十余剂寻愈。但晡热少食，又用四君子加柴胡、升麻为主，佐以逍遥散而痊。
冯楚瞻治张子芳，年将六旬，无发热头疼等候，但饮食日少，大便甚细而难，小便甚赤而涩。凡间三日，
则夜必气逆上壅欲死，通夕不寐，形容枯槁，神气渐衰，六脉洪数，惟右关尺稍缓无力。此阴道亏极，孤阳无
根，但三日一甚，此兼脾主信而为病也。凡病之难名者，悉由本气，但从根本治之，自无可藏匿而外见矣。（此
千古不传之秘。）乃以熟地一两六钱，麦冬三钱，炒白术六钱，牛膝三钱，五味、附子各一钱，参汤冲服。数剂后，
每至期则寒热如三疟状，此邪外达也。照方再服十余剂，诸症全安。（凡上冲之症，悉由厥阴。小便赤涩者，
肝火炽盛也。大便细而难者，木来克土，耗其胃中之津液也。三日一发者，木数主三也。得大剂滋润，则津液
充而木自柔。复发寒热者，厥阴之邪转由少阳而出也。冯氏之论虽精，似尚未切病机，而方中白术、五味、附
子亦均未妥善。鄙见如此，未知有当否耳。）
立斋治洞庭马志卿母，疟后形体骨立，发热恶寒，自汗盗汗，胸膈痞满，日饮米饮盏许，服参、术药益胀，
卧床半年矣。以为阳气虚寒，用大剂补中益气，加附子一钱，二剂，诸症渐退，饮食渐进，又二剂而愈。
一妇人久疟寒热，服清脾饮之类，胸膈饱胀，饮食减少。用补中益气汤加茯苓、半夏、炮姜各一钱而痊。
朱丹溪治义一侄妇，疟疾初安，因冲气又发，腰痛白浊。已与参、术、槟榔、半夏补方治疟，又教以 牡
蛎一钱，木通五分，炒柏三分，（治浊。）入萆 、杜仲、枸杞根，（治腰痛。）为粗末同服。
马元仪治宋初臣，年四十，患疟，寒则战栗，热则躁烦。脉之，两关尺空大，按之豁然，（若在热发时见此，
未可便断为参、附症也。）所服不过汗下温和之剂。曰∶此症得之内虚所感，其受伤在少阴肾之一经也，与风
暑痰热发疟者，有天渊之别。法宜大振阳气，以敌虚邪。时一医极力排阻，言之不入。因思此症一误，不堪再
误，乃谓所亲曰∶病势甚危，今晚可密煎人参一两，附子三钱，即与服，庶可逆挽。如言服之，便得大睡，寒
热顿止，再剂而安。一月后，复见呕吐，彻夜不眠，两脉空大。询其故，有穿窬者至，因恐而得。夫恐则伤脾，
火随上逆，况大病后，元气初复，虚阳易于上越，遂投以真武汤，一剂而安。
母舅沈青城，自金陵归，途中忽染疟疾，三发困甚。诊之，两脉浮弦滑实，得之风暑痰滞，表里俱实，阴
阳俱病也。脉证有余，可任攻达。以柴胡三钱，以祛少阳之邪；黄芩二钱，以清少阳之热；干葛二钱，白芷一
钱，以越阳明之表；知母二钱，石膏五钱，以清阳明之里；苏叶三钱，生姜五钱，以散太阳之寒；白豆蔻、浓
朴、橘红、半夏、槟榔各二钱，以疏太阴之滞。二剂，寒热大减，三日而安。
黄氏姑患三日疟，发阴分，用何首乌一两，牛膝一两，当归五钱，鳖甲醋炙一两，橘红三钱，水三钟，煎
一钟，空心服，立愈。虚极者，加参一两。（《广笔记》。）
于中父病三日疟，初服人参一两，生姜皮五钱，水煎，空心服。不肯服，仲淳坚持此方，加人参至三两，
生姜皮至一两五钱，二服即起。
缪仲淳年十七时，为疟所苦，凡汤液丸饮巫祝，靡不备尝，终无救于病。遍检方书，乃知疟之为病，暑邪
所至。经曰∶夏伤于暑，秋必 疟。遂从暑治，不旬日瘳。后数以意消息，散邪之外，专养胃气。痰多者消痰，
气虚者补气，血虚者补血，又分脏腑经络，各从其类，以施向导，即经年不愈者，竟霍然起矣。（同上。）
沈少卿中丞，请告时苦疟，仲淳往诊之，惫甚。曰∶再一发死矣。先生何方立止之？仲淳曰∶何言之易也。
疏三方，作五剂，一日夜饮之尽，次早疟止。先二剂清暑，用大剂竹叶石膏汤加桂枝，以其渴而多汗也。次二
剂健脾去滞，用橘红、白豆蔻、白术、茯苓、谷 、乌梅、扁豆、山楂、麦芽。最后一剂，人参一两，生姜皮
一两，水煎露一宿，五更温服，尽剂而效。（同上。）
顾伯钦患疟，仲淳之门人疏方，以白虎汤加人参一两。一庸工云∶岂有用参至两数者乎？改用清脾饮，二
十余剂而疟不止，体 弱。仲淳至，笑曰∶此虚甚，非参不可，吾徒不谬也。投以大剂参、 ，一剂而瘥。人
参一两，黄 蜜炙一两，知母蜜炙五钱，陈皮二钱，干葛二钱，甘草八分，石膏五钱。（同上。）
庄敛之外家患疟，寒少热甚，汗少头痛，不嗜饮食。余为诊，脉洪数而实，用麦冬五钱，知母三钱五分，石
膏一两五钱，竹叶六十片，粳米一撮，橘红二钱，牛膝一两，干葛、茯苓、扁豆各三钱，三剂，不应。忽一日，
凡寒热者再，昏迷沉困，不省人事，势甚危急。敛之曰∶恐是虚疟，前方石膏、知母、竹叶，似近寒凉，非其
治也。缪亦心疑，为去石膏等，而加人参二钱，已别矣。复追想前脉，的非属虚，急令人往视，令其将参煎好，
勿轻与服，待按脉加斟酌焉。次早往视，其脉洪数如初，急止人参勿服，惟仍用前方而加石膏至二两，何首乌
五钱，令其进二剂，疟遂止。（雄按∶袁子才云∶丙子九月，余患疟，早饮吕医药，至日 ，呕逆头眩不止，
家慈抱余起坐，觉血气自胸偾起，命在呼吸。适同征友南丰赵藜村来访，诊脉有方，曰∶误矣，此阳明暑疟也。
误以升麻、羌活提之，血乃逆流而上，惟白虎汤可治。甫投一勺，如以千钧之石，将阳胃压下，血气全消，未
半盂即睡去，微汗而醒。赵问思食西瓜否？曰∶想甚。即命尽量食之。食片许，如醒醐灌项，晚便进粥，次日愈矣。）
庄敛之外家前患疟，越一载，忽头痛如裂，心内杂乱不清，喉作痛，失音，舌破，咳嗽有痰，胸膈胞胀，
恶心，不思饮食，如此者四日，陡发寒热如疟状，寒少热多，热后频出汗方解。平时有心口痛症并作，下元无
力，如香港脚状。敛之疑为伤寒。缪曰∶此受暑之症，即前年所患疟，而势加剧耳。法当先去其标，令以石膏二
两，麦冬、牛膝各五钱，知母、贝母、花粉各三钱，橘红二钱半，鳖甲四钱，竹叶一百五十片，河水煎服。三
四剂，心内清，头疼、喉痛、失音、舌破、饱胀、寒热俱愈。但恶心不思食如故，而心口痛，下元无力不减，
为去石膏、知母、竹叶、鳖甲、贝母、花粉，而加延胡索、木瓜、竹茹各二钱，五灵脂七分，生蒲黄钱半，苡
仁八钱，石斛、扁豆、白芍各三钱，枇杷叶三片，炙草四分，几十剂而愈。（雄按∶暑疟邪在气分，必以
白虎为主，而随证加
减。缪氏独知此法，不胶守于小柴胡一方。然牛膝、鳖甲之类，初起岂宜骤用？若邪入荣分，则无碍矣。今夏，
石芷卿室患此，因阴分素虚，邪即入荣，余于白虎加犀角、元参、银花、石斛、竹叶，大剂而瘳，闻者无不骇
异。实则见病治病，有何奇哉？新秋，汪子与室，寡居患暑疟，误服柴胡、姜、萸等药，昏热欲厥，两尺皆空，
势濒于危，乃祖朱桩年太史，浼余视之，亦两投犀角地黄加减而痊。）
高存之甥女，嫁后患胎疟，久不止。仲淳云∶病在阴分，以人参五钱，牛膝一两，兼健脾清暑，一剂而止。（同上。）
章衡阳子室，患疟后，失音，寒热愈甚，告急仲淳。仲淳云∶此必疟时，不遇明眼人，妄投半夏故也。投
以大剂麦冬、茯苓、炙甘草、鳖甲、知母、贝母，数剂而瘳。（同上。）
来天培治潘康侯，季秋患疟，恶寒发热，头疼身痛，呕吐无汗，腰重腿酸，间日而发。脉之，沉而弦，此
寒邪闭伏募原，不能外解也。以柴葛解肌，羌、芎止头痛，藿香、广、半止呕吐，枳、桔利肺气，白豆仁温胃，
桂枝达募原，领邪外出，不使复入，茯苓淡渗利窍，加姜、枣和荣卫，一剂诸已瘳。
沈明生治丁又铭，食后动怒，复受风邪，恶寒发热，连日委顿。咸谓停食感冒耳。曰∶寒以时而来，热得
汗而解，脉弦且数，虽素未患疟，疟从此开。已而果然。与清脾饮加减，寒热渐轻，但茎卵日缩，有类阳痿，
甚忧。曰∶无虑也。此非伤寒厥阴危症，亦非阳衰者比，乃阳明热极，不润宗筋，所谓诸痿生于肺热。若谓为
虚而补之，误矣。乃用苓、栀等剂，久而茎卵如故，疟亦止。惟便秘日久，然不胀不疼，此疟时多汗，汗多则
津液燥而肠胃涸。俟饮食渐进，参、术滋补，气血充而便自行，勿亟也。或诊之，谓邪气方实，安得用补？及
今下之，尚可为也。与承气汤，服半日许，便不行而茎缩。再延诊，仍与调补，数日进参二两余，去宿垢甚多
而全愈。 于是症得三益焉。于其初也，可验疟于受邪之始。于其中也，知痿不尽由阳事之虚。（王节斋言详
矣。）其末也，知便秘有服参、术乃通，不可遽然攻下。若下之不当，虽硝、黄亦不能荡涤，徒令真元耗损。
在经固有明训，而世但知坚者削之，未详塞因塞用之法耳。
钱国宾治大同右营把总张道，患疟七年，奄奄一息。诊之，六脉弦长，尚有胃气，乃足太阴脾经痰血结于
腹右，名为疟母也。且久病血凝经络，不攻痰血，病不愈也。《内经》曰∶疟之间作者，邪气深入薄于阴，阳气
独发，阴邪内着，阴与阳争不得出，是以间日而作。先以四物汤加桃仁、红花、牛膝、人参、苍白术，服十余
帖，经络方活，疟转阳分。又以八珍汤加黄 一钱，何首乌一两，服十帖，补养正气，疟轻渐早。又以常山三
钱，酒炒七次，陈皮、甘草各一钱五分，葱三段，姜五片，煎露，空心热服，疟止。又以鸡蛋上透一孔，用簪
搅匀清黄，入番木鳖一个，真麝四厘，纸封头，饭上蒸熟，去壳去木鳖不用，热酒吃鸡蛋，日日空心一个，月余，
疟母消尽。凡遇久疟，不知此法不起也。
魏玉横曰∶施涣之，予之至交也。夏秋间，自都至吴门，就婚横塘。初冬，以弥月亲戚会饮，饮散而病寒
热头痛，自服芎苏饮一剂，不愈。即进理中汤，转甚。盖以新婚故，自疑为阴症也。自是所延医，咸以温补进，
日益困，亟使诣杭招予。比至，已十余日矣。入门，见煮药未退。诊之，脉沉弦而数，且六七至，舌强，苔黑
而燥。自言服温补后，寒热已退，惟大便不行，小便频数，夜间尤甚，几五六十次，膈间时有冷气上冲，日惟
进粥瓯许，奄奄危殆，未审何症。曰∶此伏气为疟也。小便频数者，内热下迫也。其出必点滴，其色必赤浊。
验之果然。至冷气上冲，乃热郁中宫，犹火焰之上，必有冷气也。其大便不行，则内热而燥结，不待言矣。夫
邪伏既深，其发乃止，何得遽用温补？幸壮年脏阴未竭，急投凉解，得寒热再作，乃可无虞。叩所煎药，则人
参、白术、姜、附、桂、萸、枣仁、五味等。云昨已服一剂，病势不减，今用参三钱，桂、附俱用钱半。乃考
前方，皆二陈、四君子、桂、姜、萸之属。曰∶今日再进参、术、桂、附，则不可为矣。以小柴胡、小陷胸，
合白虎，作一剂与之。其友婿惶惑无措，坚不肯从。盖洞庭医者主于其家，就中为难耳。曰∶既不相信，请即
原舟告辞，虽谊属至友，来为治病，非送殓也。涣之闻，乃恳留治。乃令以药具相付，亲与调煎。服后，小便
遂不频数。次日，粥加进。再与前方，则寒热大作，而舌黑渐退，神气渐爽。又去白虎，二剂寒热减，小便长。
又二日，大便去黑燥甚多。改用甘露饮，加减数剂而安。（雄按∶今秋汤振声，患疟于嘉兴。医知为暑，即
与清解，转为泄泻，遂改温燥，泻益甚，而热不退，因束手。令其返杭，所亲张月卿，延余视之，苔黑面红，
胸间拒按，便如胶漆，小溲全无，谵语耳聋，不眠善笑，脉则芤数，予黄
连、黄芩、黄柏、栀子、银花、石斛、知母、蒌仁、元参、绿豆，调服神犀丹。四剂而胸不拒按，略进淖糜，黑
矢渐稀，稍有小溲，乃去神犀，加地黄、石膏。服三日，热退神清，脉形渐静，始授甘凉养液，十余帖而愈。
又朱生甫令郎仲和，数年前患疟，缠绵半载，大为所苦。今夏患此，形证与前相若，亟延余诊。且曰∶必受经
年累月之困矣。余谓暑湿为患，不服柴、桂、姜、枣，旬日可瘳。彼不甚信，及投剂，果八服而痊，始悟从前竟
为小柴胡汤所误也。）
许民怀年近三十，患胎疟，适禾中名医寓杭延视，见其舌苔如烂铁之剥蚀，有苔处淡黄，无苔处则深紫如
猪腰，三四发，即困惫不堪，杖而后起，饮食骤减，日啜薄粥两瓯，遂不敢与药。诊之，脉虚数而弦，左寸鼓
而上溢，右尺微弱，曰∶此手足两少阴素虚，且受暑邪入包络。经云暑伤心，舌乃心之窍，故见症如是。初与
黄连香薷饮，一剂即思食。继与导赤散合益元，舌紫退。再与人参小柴胡，寒热愈。愈后，乃告曰∶其戚友同
于是日发疟者，共三人，又皆苔疟，其二人死矣，一叶姓，一周姓也。（雄按，此门治法，于暑湿时疟，缺然
薛立斋治疗一位妇人，因愤怒导致疾病发作没有固定时间，久治不愈，胸腹部胀满不适，食欲减退，吞酸吐痰。使用六君子汤加入柴胡、山栀，二十多剂后很快痊愈。但傍晚发热、饮食减少，又用四君子汤加入柴胡、升麻为主药，佐以逍遥散而治愈。
冯楚瞻治疗张子芳，年纪将近六十岁，没有发热头痛等症状，只是饮食日渐减少，大便非常细且难解，小便非常红且涩滞。每隔三天，夜里必定气逆上冲壅塞致死的感觉，整夜不能入睡，形体枯槁，神气逐渐衰弱，六脉洪大数急，只有右关尺脉稍缓无力。这是阴精亏损到了极点，孤阳没有根基，每三天加重一次，这是兼有脾主信（脾土对应五行中的土，其性信实，应四季之末各十八日，或指脾病周期）而为病。凡是难以命名的病，都源于本气的亏虚，只要从根本治疗，自然无处隐藏而显露出来。（这是千古不传的秘密。）于是用熟地黄一两六钱，麦冬三钱，炒白术六钱，牛膝三钱，五味子、附子各一钱，用人参汤冲服。几剂之后，每到发病期则寒热像三日疟一样，这是邪气向外透达的表现。照原方再服用十余剂，所有症状完全安宁。（凡上冲的症状，都源于厥阴肝经。小便赤涩，是肝火炽盛。大便细而难解，是木克土，耗伤了胃中的津液。三天发作一次，是因为木数主三。得到大剂量的滋润药物，则津液充足而肝木自柔。再次出现寒热，是厥阴的邪气转由少阳而出。冯氏的论述虽然精妙，似乎尚未切中病机，而且方中的白术、五味子、附子也都不够妥善。我的见解如此，不知道是否恰当。）
薛立斋治疗洞庭人马志卿的母亲，患疟疾后身体消瘦如骨立，发热恶寒，自汗盗汗，胸膈痞满，每天只喝米汤一杯左右，服用参、术等药反而更加胀满，卧床半年了。认为是阳气虚寒，使用大剂量补中益气汤，加入附子一钱，两剂后，各种症状逐渐消退，饮食逐渐增加，又两剂后痊愈。
一位妇人患久疟寒热，服用清脾饮之类的药物后，胸膈饱胀，饮食减少。使用补中益气汤加入茯苓、半夏、炮姜各一钱而痊愈。
朱丹溪治疗义一的侄妇，疟疾刚安定，因冲气又发作，腰痛白带浑浊。已经给予人参、白术、槟榔、半夏等补益方剂治疗疟疾，又教她服用牡蛎一钱，木通五分，炒黄柏三分（治疗白带浑浊），加入萆薢、杜仲、枸杞根（治疗腰痛），制成粗末一起服用。
马元仪治疗宋初臣，四十岁，患疟疾，发冷时战栗，发热时烦躁。诊脉，两关尺脉空大，按之豁然空虚（如果在发热时见到这种脉象，还不能就断定是参、附证），所服用的不过是汗下温和的药物。说：这个病症得自内虚感受外邪，受伤的部位在少阴肾这一经，与风暑痰热引发的疟疾有天壤之别。治法应当大力振奋阳气，以抵御虚邪。当时有一位医生极力排斥阻挠，话听不进去。因为想到这个病症一旦误治，不堪再误，就对亲友说：病情很危险，今晚可以秘密煎煮人参一两，附子三钱，立即给病人服用，或许可以挽回危局。按照说法服用后，便睡了一大觉，寒热立刻停止，再服两剂而安宁。一个月后，又出现呕吐，彻夜不眠，两脉空大。询问原因，有小偷闯入，因为恐惧而致病。恐惧伤脾，火随气上逆，况且大病之后，元气刚刚恢复，虚阳容易上越，于是投以真武汤，一剂而安宁。
舅舅沈青城，从金陵回来，途中忽然染上疟疾，发作三次后非常困顿。诊脉，两脉浮弦滑实，得自风暑痰滞，表里俱实，阴阳俱病。脉证有余，可以承受攻伐。用柴胡三钱，以祛除少阳之邪；黄芩二钱，以清少阳之热；干葛二钱，白芷一钱，以发散阳明之表；知母二钱，石膏五钱，以清阳明之里；苏叶三钱，生姜五钱，以散发太阳之寒；白豆蔻、厚朴、橘红、半夏、槟榔各二钱，以疏通太阴之滞。两剂后，寒热大减，三天而安。
黄氏姑母患三日疟，病发于阴分，用何首乌一两，牛膝一两，当归五钱，鳖甲醋炙一两，橘红三钱，水三碗，煎成一碗，空腹服用，立刻痊愈。极度虚弱的，加人参一两。（《广笔记》。）
于中父患三日疟，起初服用人参一两，生姜皮五钱，水煎，空腹服用。不肯服用，仲淳坚持此方，将人参加至三两，生姜皮加至一两五钱，服两次即起效。
缪仲淳十七岁时，被疟疾所苦，凡是汤液丸药巫祝，无不尝试，最终对病无救。遍检方书，才知道疟疾这种病，是暑邪所致。经书说：夏伤于暑，秋必疟疾。于是从暑邪治疗，不到十天痊愈。后来多次凭心意斟酌，除散邪之外，专门养胃气。痰多的消痰，气虚的补气，血虚的补血，又分脏腑经络，各自依从其类别，加以引导，即使是经年不愈的，竟然霍然痊愈。（同上。）
沈少卿中丞，告老还乡时苦于疟疾，仲淳去诊治，疲惫得很。说：再发作一次就要死了。先生有什么方子能立刻止住？仲淳说：话说得太容易了。开了三个方子，做成五剂，一天一夜喝完，第二天早晨疟疾停止。前两剂清暑，用大剂量竹叶石膏汤加桂枝，因为他口渴且多汗。中间两剂健脾去滞，用橘红、白豆蔻、白术、茯苓、谷芽、乌梅、扁豆、山楂、麦芽。最后一剂，人参一两，生姜皮一两，水煎露置一夜，五更天温服，喝完全部见效。（同上。）
顾伯钦患疟疾，仲淳的门人开方，用白虎汤加人参一两。一个庸医说：哪有用人参到一两数的呢？改用清脾饮，二十多剂而疟疾不止，身体虚弱。仲淳来到，笑着说：这非常虚弱，非用人参不可，我的徒弟没有错。投以大剂量人参、黄芪，一剂而痊愈。人参一两，黄芪蜜炙一两，知母蜜炙五钱，陈皮二钱，干葛二钱，甘草八分，石膏五钱。（同上。）
庄敛之的外家患疟疾，发冷少发热重，出汗少头痛，不喜欢饮食。我为他诊脉，脉洪数而实，用麦冬五钱，知母三钱五分，石膏一两五钱，竹叶六十片，粳米一撮，橘红二钱，牛膝一两，干葛、茯苓、扁豆各三钱，三剂，没有反应。忽然有一天，寒热发作两次，昏迷困倦，不省人事，形势非常危急。敛之说：恐怕是虚疟，前面的方子石膏、知母、竹叶，似乎偏于寒凉，不是正确的治法。缪仲淳心里也怀疑，去掉石膏等药，加入人参二钱，已经不同了。又回想之前的脉象，确实属于虚证，急忙让人前往查看，让他把人参煎好，不要随便给病人服用，等待诊脉后再斟酌。第二天早上前往查看，他的脉象洪数如初，急忙叫停人参不要服用，仍然用前面的方子而将石膏加至二两，何首乌五钱，让他进服两剂，疟疾于是停止。（雄按：袁子才说：丙子九月，我患疟疾，早上喝吕医生的药，到中午，呕吐眩晕不止，家母抱着我坐起，感觉血气从胸口涌起，命在呼吸之间。恰逢同征友南丰赵藜村来访，诊脉有方，说：错了，这是阳明暑疟。误用升麻、羌活提升，血乃逆流而上，只有白虎汤可以治疗。刚投一勺，就像用千钧巨石将阳胃压下，血气全消，不到半碗就睡去，微汗而醒。赵问想吃西瓜吗？说：很想。就命令尽量吃。吃了一点，像醍醐灌顶，晚上就能进粥，第二天就好了。）
庄敛之的外家之前患疟疾，过了一年，忽然头痛如裂，心中杂乱不清，喉咙痛，失音，舌破溃，咳嗽有痰，胸膈胀满，恶心，不想饮食，这样四天，突然发作寒热像疟疾一样，发冷少发热多，发热后频繁出汗才缓解。平时有心口痛症并发，下元无力，像香港脚状。敛之怀疑是伤寒。缪仲淳说：这是受暑的病症，就是前年所患的疟疾，而形势加剧罢了。治法应当先去其标，让他用石膏二两，麦冬、牛膝各五钱，知母、贝母、花粉各三钱，橘红二钱半，鳖甲四钱，竹叶一百五十片，河水煎服。三四剂后，心中清爽，头疼、喉痛、失音、舌破、饱胀、寒热都好了。但恶心不想吃东西依旧，心口痛，下元无力不减，于是去掉石膏、知母、竹叶、鳖甲、贝母、花粉，加入延胡索、木瓜、竹茹各二钱，五灵脂七分，生蒲黄钱半，苡仁八钱，石斛、扁豆、白芍各三钱，枇杷叶三片，炙甘草四分，几十剂而痊愈。（雄按：暑疟邪在气分，必须以白虎汤为主，而随证加减。缪氏独知此法，不胶守于小柴胡一方。然而牛膝、鳖甲之类，初起岂宜骤用？如果邪入营分，则无妨碍了。今年夏天，石芷卿的妻子患此病，因为阴分素虚，邪气即入营分，我在白虎汤中加入犀角、玄参、银花、石斛、竹叶，大剂量而痊愈，听说的人无不惊异。实际上见病治病，有什么奇怪的？新秋时节，汪子与的妻子，寡居患暑疟，误服柴胡、姜、萸等药，昏热欲厥，两尺脉皆空，形势濒临危险，她的祖父朱桩年太史，请我去看，也是两次投以犀角地黄汤加减而痊愈。）
高存之的甥女，嫁后患胎疟，久久不止。仲淳说：病在阴分，用人参五钱，牛膝一两，兼健脾清暑，一剂而止。（同上。）
章衡阳的儿子妻子，患疟疾后，失音，寒热更甚，告急仲淳。仲淳说：这一定是患疟时，没遇到明眼人，妄投半夏的缘故。投以大剂量麦冬、茯苓、炙甘草、鳖甲、知母、贝母，数剂而痊愈。（同上。）
来天培治疗潘康侯，季秋患疟疾，恶寒发热，头疼身痛，呕吐无汗，腰重腿酸，隔天发作。诊脉，沉而弦，这是寒邪闭伏募原，不能外解。用柴葛解肌汤，羌活、川芎止头痛，藿香、广藿香、半夏止呕吐，枳壳、桔梗利肺气，白豆仁温胃，桂枝达募原，领邪外出，不使复入，茯苓淡渗利窍，加姜、枣调和营卫，一剂诸症已瘳。
沈明生治疗丁又铭，食后动怒，又受风邪，恶寒发热，连日委顿。大家都说是停食感冒。他说：寒气按时而来，热气得汗而解，脉弦且数，虽然素未患疟，疟疾从此开始。后来果然如此。给予清脾饮加减，寒热渐轻，但阴茎睾丸每日收缩，类似阳痿，非常担忧。他说：不用担心。这不是伤寒厥阴危症，也不是阳衰者可比，乃是阳明热极，不润宗筋，所谓诸痿生于肺热。如果说为虚而补之，就错了。于是用苓、栀等剂，久了阴茎睾丸如故，疟疾也停止了。只有便秘日久，但不胀不疼，这是疟疾时多汗，汗多则津液燥而肠胃涸。等到饮食渐进，参、术滋补，气血充而大便自行，不要着急。有人诊视，说邪气正实，怎么能用补？如果现在攻下，还可以挽回。给予承气汤，服用半天左右，大便不行而阴茎收缩。再延请诊视，仍给予调补，几天进服人参二两余，排出宿垢很多而痊愈。于是此症得三益：在其初，可验疟于受邪之始；在其中，知痿不尽由阳事之虚（王节斋言详矣）；在其末，知便秘有服参、术乃通，不可遽然攻下。如果攻下不当，即使硝、黄也不能荡涤，徒令真元耗损。在经固有明训，而世人只知道坚者削之，未详塞因塞用之法耳。
钱国宾治疗大同右营把总张道，患疟疾七年，奄奄一息。诊脉，六脉弦长，尚有胃气，乃是足太阴脾经痰血结于腹右，名为疟母也。而且久病血凝经络，不攻痰血，病不愈也。《内经》说：疟疾间日发作的，邪气深入薄于阴，阳气独发，阴邪内着，阴与阳争不得出，是以间日而作。先用四物汤加桃仁、红花、牛膝、人参、苍白术，服十余帖，经络方活，疟转阳分。又以八珍汤加黄芪一钱，何首乌一两，服十帖，补养正气，疟轻渐早。又以常山三钱，酒炒七次，陈皮、甘草各一钱五分，葱三段，姜五片，煎露，空心热服，疟止。又以鸡蛋上透一孔，用簪搅匀清黄，入番木鳖一个，真麝四厘，纸封头，饭上蒸熟，去壳去木鳖不用，热酒吃鸡蛋，日日空心一个，月余，疟母消尽。凡遇久疟，不知此法不起也。
魏玉横说：施涣之，是我的至交。夏秋间，从都城到吴门，就在婚塘结婚。初冬，因为满月亲戚会饮，饮散而病寒热头痛，自服芎苏饮一剂，不愈。即进理中汤，转甚。盖以新婚故，自疑为阴症也。自此所延医，都以温补进，日益困，亟使诣杭招予。比至，已十余日矣。入门，见煮药未退。诊之，脉沉弦而数，且六七至，舌强，苔黑而燥。自言服温补后，寒热已退，惟大便不行，小便频数，夜间尤甚，几五六十次，膈间时有冷气上冲，日惟进粥瓯许，奄奄危殆，未审何症。曰：此伏气为疟也。小便频数者，内热下迫也。其出必点滴，其色必赤浊。验之果然。至冷气上冲，乃热郁中宫，犹火焰之上，必有冷气也。其大便不行，则内热而燥结，不待言矣。夫邪伏既深，其发乃止，何得遽用温补？幸壮年脏阴未竭，急投凉解，得寒热再作，乃可无虞。叩所煎药，则人参、白术、姜、附、桂、萸、枣仁、五味等。云昨已服一剂，病势不减，今用参三钱，桂、附俱用钱半。乃考前方，皆二陈、四君子、桂、姜、萸之属。曰：今日再进参、术、桂、附，则不可为矣。以小柴胡、小陷胸，合白虎，作一剂与之。其友婿惶惑无措，坚不肯从。盖洞庭医者主于其家，就中为难耳。曰：既不相信，请即原舟告辞，虽谊属至友，来为治病，非送殓也。涣之闻，乃恳留治。乃令以药具相付，亲与调煎。服后，小便遂不频数。次日，粥加进。再与前方，则寒热大作，而舌黑渐退，神气渐爽。又去白虎，二剂寒热减，小便长。又二日，大便去黑燥甚多。改用甘露饮，加减数剂而安。（雄按：今秋汤振声，患疟于嘉兴。医知为暑，即与清解，转为泄泻，遂改温燥，泻益甚，而热不退，因束手。令其返杭，所亲张月卿，延余视之，苔黑面红，胸间拒按，便如胶漆，小溲全无，谵语耳聋，不眠善笑，脉则芤数，予黄连、黄芩、黄柏、栀子、银花、石斛、知母、蒌仁、元参、绿豆，调服神犀丹。四剂而胸不拒按，略进淖糜，黑矢渐稀，稍有小溲，乃去神犀，加地黄、石膏。服三日，热退神清，脉形渐静，始授甘凉养液，十余帖而愈。又朱生甫令郎仲和，数年前患疟，缠绵半载，大为所苦。今夏患此，形证与前相若，亟延余诊。且曰：必受经年累月之困矣。余谓暑湿为患，不服柴、桂、姜、枣，旬日可瘳。彼不甚信，及投剂，果八服而痊，始悟从前竟为小柴胡汤所误也。）
许民怀年近三十，患胎疟，适禾中名医寓杭延视，见其舌苔如烂铁之剥蚀，有苔处淡黄，无苔处则深紫如猪腰，三四发，即困惫不堪，杖而后起，饮食骤减，日啜薄粥两瓯，遂不敢与药。诊之，脉虚数而弦，左寸鼓而上溢，右尺微弱，曰：此手足两少阴素虚，且受暑邪入包络。经云暑伤心，舌乃心之窍，故见症如是。初与黄连香薷饮，一剂即思食。继与导赤散合益元，舌紫退。再与人参小柴胡，寒热愈。愈后，乃告曰：其戚友同于是日发疟者，共三人，又皆苔疟，其二人死矣，一叶姓，一周姓也。（雄按，此门治法，于暑湿时疟，缺然）
Xue Lizhai treated a woman whose disease, triggered by anger, had no fixed time of onset and persisted for a long time without healing. She suffered from chest and abdominal discomfort, poor appetite, acid regurgitation, and expectoration of phlegm. He used Liu Jun Zi Tang (Six Gentlemen Decoction) with added Chai Hu (Bupleuri Radix) and Shan Zhi (Gardeniae Fructus). After more than twenty doses, she recovered quickly. However, when she experienced afternoon fever and reduced food intake, he used Si Jun Zi Tang (Four Gentlemen Decoction) with added Chai Hu and Sheng Ma (Cimicifugae Rhizoma) as the main formula, assisted by Xiao Yao San (Free and Easy Wanderer Powder), and she was cured.
Feng Chuzhan treated Zhang Zifang, who was nearly sixty years old. He had no symptoms such as fever or headache, but his food intake decreased day by day. His stool was very thin and difficult to pass, and his urine was very red and difficult to flow. Every three days, at night, he would experience severe qi rebellion and congestion, feeling as if he were dying, unable to sleep all night. His appearance was emaciated, and his spirit gradually declined. His six pulses were surging and rapid, except for the right Guan and Chi positions, which were slightly slow and weak. This indicated extreme deficiency of Yin essence, with isolated Yang lacking a root. The worsening every three days was due to the Spleen's association with trust and periodicity in its pathology. For diseases that are difficult to name, they all stem from the deficiency of the original Qi. By treating from the root, there is nowhere for the pathogen to hide. (This is an unshared secret of the ages.) Therefore, he prescribed Shu Di Huang (Rehmanniae Radix Preparata) 1 liang 6 qian, Mai Dong (Ophiopogonis Radix) 3 qian, Chao Bai Zhu (Stir-fried Atractylodis Macrocephalae Rhizoma) 6 qian, Niu Xi (Achyranthis Bidentatae Radix) 3 qian, Wu Wei Zi (Schisandrae Chinensis Fructus) and Fu Zi (Aconiti Lateralis Radix Preparata) each 1 qian, taken with Ren Shen Tang (Ginseng Decoction). After several doses, at each onset, he experienced chills and fever resembling tertian malaria, indicating that the pathogen was reaching the exterior. Continuing with the same prescription for more than ten doses, all symptoms completely resolved. (Symptoms of upward rushing all originate from the Jueyin Liver channel. Red and difficult urination indicates excessive Liver Fire. Thin and difficult stool indicates Wood overacting on Earth, consuming Stomach fluids. The three-day interval corresponds to the number associated with Wood. With large doses of moistening herbs, fluids are replenished, and the Liver Wood becomes soft. The recurrence of chills and fever indicates the Jueyin pathogen exiting via the Shaoyang channel. Although Feng's discussion is refined, it seems not to hit the exact pathogenesis, and the use of Bai Zhu, Wu Wei Zi, and Fu Zi in the formula is also questionable. This is my opinion, I do not know if it is correct.)
Xue Lizhai treated the mother of Ma Zhijing from Dongting, who, after malaria, was extremely emaciated, suffering from fever and aversion to cold, spontaneous and nocturnal sweating, chest and diaphragm fullness. She drank only about one cup of rice water daily. Taking Ginseng and Atractylodes herbs increased her bloating, and she had been bedridden for half a year. Xue considered this deficiency-cold of Yang Qi and prescribed a large dose of Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with added Fu Zi 1 qian. After two doses, various symptoms gradually receded, food intake slowly increased, and she recovered after another two doses.
A woman suffering from chronic malaria with chills and fever took Qing Pi Yin (Clear the Spleen Drink) and similar formulas, resulting in chest and diaphragm fullness and reduced appetite. She was cured using Bu Zhong Yi Qi Tang with added Fu Ling (Poria), Ban Xia (Pinelliae Rhizoma), and Pao Jiang (Prepared Ginger) each 1 qian.
Zhu Danxi treated the niece-in-law of Yi Yi. After malaria had initially subsided, it relapsed due to rebellious Qi, accompanied by lower back pain and turbid leukorrhea. He had already given a tonic formula containing Ren Shen, Bai Zhu, Bing Lang (Arecae Semen), and Ban Xia to treat the malaria. He also instructed her to take Mu Li (Ostreae Concha) 1 qian, Mu Tong (Akebiae Caulis) 5 fen, Chao Bai Hu (Stir-fried Phellodendri Cortex) 3 fen (to treat turbidity), combined with Bi Xie (Dioscoreae Hypoglaucae Rhizoma), Du Zhong (Eucommiae Cortex), and Gou Qi Gen (Lycii Radix Cortex) (to treat lower back pain), ground into coarse powder and taken together.
Ma Yuanyi treated Song Chuchen, aged forty, who suffered from malaria with shivering during chills and restlessness during fever. His pulse at both Guan and Chi positions was empty and large, feeling hollow upon pressure. (If this pulse appears during fever, one cannot immediately diagnose it as a case for Ginseng and Aconite.) The medicines he had taken were only mild diaphoretic and purgative agents. Ma said: This condition arises from internal deficiency leading to external contraction; the injury is in the Shaoyin Kidney meridian, which is vastly different from malaria caused by wind, summerheat, phlegm, or heat. The treatment method should be to vigorously boost Yang Qi to combat the deficient pathogen. At that time, another doctor strongly opposed this view, but his words were ignored. Thinking that a mistake here would be irreparable, Ma told the relatives: The condition is critical. Tonight, secretly decoct Ren Shen 1 liang and Fu Zi 3 qian, and administer it immediately to potentially reverse the crisis. Following this advice, the patient slept deeply, and chills and fever stopped instantly. After two more doses, he was stable. One month later, vomiting and insomnia returned, with empty and large pulses. Upon inquiry, it was found that a thief had entered, causing fear. Fear injures the Spleen, causing Fire to rebel upwards. Moreover, after a severe illness, when Yuan Qi is just recovering, deficient Yang easily floats upward. Thus, Zhen Wu Tang (True Warrior Decoction) was administered, and he recovered after one dose.
Shen Qingcheng, maternal uncle, contracted malaria suddenly while returning from Jinling, becoming very exhausted after three attacks. His pulses were floating, wiry, slippery, and excess. This was due to wind-summerheat and phlegm-stagnation, with excess in both interior and exterior, affecting both Yin and Yang. Since the pulse and symptoms indicated excess, aggressive dispersing was permissible. He used Chai Hu 3 qian to dispel Shaoyang pathogen; Huang Qin (Scutellariae Radix) 2 qian to clear Shaoyang heat; Ge Gen (Puerariae Lobatae Radix) 2 qian and Bai Zhi (Angelicae Dahuricae Radix) 1 qian to release Yangming exterior; Zhi Mu (Anemarrhenae Rhizoma) 2 qian and Shi Gao (Gypsum Fibrosum) 5 qian to clear Yangming interior; Su Ye (Perillae Folium) 3 qian and Sheng Jiang (Zingiberis Rhizoma Recens) 5 qian to disperse Taiyang cold; Bai Dou Kou (Cardamomi Fructus Rotundus) Hou Po (Magnoliae Officinalis Cortex) Ju Hong (Citri Reticulatae Pericarpium) Ban Xia and Bing Lang each 2 qian to relieve Taiyin stagnation. After two doses, chills and fever greatly decreased, and he recovered in three days.
Huang's aunt suffered from tertian malaria originating in the Yin aspect. She used He Shou Wu (Polygoni Multiflori Radix) 1 liang, Niu Xi 1 liang, Dang Gui (Angelicae Sinensis Radix) 5 qian, Bie Jia (Testudinis Carapax et Plastrum) vinegar-roasted 1 liang, Ju Hong 3 qian. Decocted in three bowls of water to yield one bowl, taken on an empty stomach, she recovered immediately. For extreme deficiency, add Ren Shen 1 liang. (Guang Bei Ji.)
Yu Zhongfu suffered from tertian malaria. Initially, he took Ren Shen 1 liang and Sheng Jiang Pi (Zingiberis Pericarpium) 5 qian, decocted in water, taken on an empty stomach. He refused to take it. Zhong Chun insisted on this prescription, increasing Ren Shen to 3 liang and Sheng Jiang Pi to 1 liang 5 qian. After two doses, he recovered.
When Miao Zhongchun was seventeen, he suffered from malaria. He tried all kinds of decoctions, pills, drinks, and exorcisms, but none helped. After searching medical texts, he realized malaria is caused by Summerheat. The Classics state: "Injury by Summerheat in summer leads to malaria in autumn." Thus, he treated it as Summerheat-related, and recovered within ten days. Later, he frequently adjusted his approach based on his understanding, focusing on nourishing Stomach Qi after dispersing pathogens. For abundant phlegm, he resolved phlegm; for Qi deficiency, he tonified Qi; for Blood deficiency, he nourished Blood. He differentiated by Zang-Fu and meridians, applying guiding herbs accordingly. Even cases lasting years were suddenly cured. (Ibid.)
Chancellor Shen Shaoqing, upon retiring, suffered bitterly from malaria. Zhong Chun visited and found him extremely exhausted. He said: "One more attack will kill him." The Chancellor asked: "What formula can stop it immediately?" Zhong Chun replied: "You speak too lightly." He prescribed three formulas, made into five doses, to be consumed within one day and night. By the next morning, the malaria stopped. The first two doses cleared Summerheat using a large dose of Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) with added Gui Zhi (Cinnamomi Ramulus), because of thirst and profuse sweating. The middle two doses strengthened the Spleen and removed stagnation using Ju Hong, Bai Dou Kou, Bai Zhu, Fu Ling, Gu Ya (Setariae Fructus Germinatus) W Mei (Mume Fructus) Bian Dou (Phaseoli Semen) Shan Zha (Crataegi Fructus) and Mai Ya (Hordei Fructus Germinatus). The final dose consisted of Ren Shen 1 liang and Sheng Jiang Pi 1 liang, decocted in water and exposed overnight, taken warm at dawn. After finishing the dose, efficacy was achieved. (Ibid.)
Gu Boqin suffered from malaria. A disciple of Zhong Chun prescribed Bai Hu Tang (White Tiger Decoction) with added Ren Shen 1 liang. A quack doctor said: "How can one use Ginseng in such large quantities?" and changed it to Qing Pi Yin. After more than twenty doses, the malaria did not stop, and the body became weak. When Zhong Chun arrived, he laughed and said: "The deficiency is severe; Ginseng is indispensable. My disciple was not wrong." He administered a large dose of Ren Shen and Huang Qi (Astragali Radix). One dose led to recovery. The prescription was: Ren Shen 1 liang, Huang Qi honey-roasted 1 liang, Zhi Mu honey-roasted 5 qian, Chen Pi (Citri Reticulatae Pericarpium) 2 qian, Ge Gen 2 qian, Gan Cao (Glycyrrhizae Radix et Rhizoma) 8 fen, Shi Gao 5 qian. (Ibid.)
The relative of Zhuang Lianzhi suffered from malaria with less chills and intense fever, little sweating, headache, and loss of appetite. I diagnosed him; the pulse was surging, rapid, and excess. I used Mai Dong 5 qian, Zhi Mu 3 qian 5 fen, Shi Gao 1 liang 5 qian, Zhu Ye (Bambusae Folium) 60 pieces, Jing Mi (Oryzae Semen) a pinch, Ju Hong 2 qian, Niu Xi 1 liang, Ge Gen, Fu Ling, and Bian Dou each 3 qian. After three doses, there was no response. Suddenly, one day, after two episodes of chills and fever, he fell into coma and exhaustion, unconscious, in critical condition. Lianzhi said: "Perhaps it is deficiency malaria. The previous formula with Shi Gao, Zhi Mu, and Zhu Ye seems too cooling and incorrect." Miao also suspected it, removing Shi Gao etc., and adding Ren Shen 2 qian, which altered the situation. Recalling the previous pulse, he confirmed it was indeed deficiency. He urgently sent someone to check, instructing them to prepare the Ginseng decoction but not to administer it lightly, waiting for pulse diagnosis to decide. The next morning, upon checking, the pulse was still surging and rapid as before. He urgently stopped the Ginseng and continued with the previous formula but increased Shi Gao to 2 liang and added He Shou Wu 5 qian, ordering two doses. The malaria then stopped. (Xiong An: Yuan Zicai said: In September of Bingzi year, I suffered from malaria. After drinking Dr. Lv's medicine in the morning, by noon, I suffered from incessant vomiting, dizziness, and vertigo. My mother held me up, and I felt blood and Qi surging from my chest, my life hanging by a thread. Fortunately, my friend Zhao Licun from Nanfeng visited. Diagnosing my pulse, he said: 'Wrong. This is Yangming Summerheat malaria.' Mistakenly using Sheng Ma and Qiang Huo (Notopterygii Rhizoma et Radix) to lift, the blood flowed backward. Only Bai Hu Tang can treat this. As soon as one spoonful was given, it felt like pressing down the Yang Stomach with a thousand-jun weight, the blood and Qi vanished, and I fell asleep before finishing half a bowl, waking with slight sweating. Zhao asked if I wanted to eat watermelon. I said yes. He ordered me to eat as much as possible. After eating a slice, it felt like pouring cream over my head. I could eat porridge that evening and recovered the next day.)
The relative of Zhuang Lianzhi, who had previously suffered from malaria, one year later suddenly suffered from splitting headache, mental confusion, sore throat, aphonia, tongue ulceration, cough with phlegm, chest distension, nausea, and anorexia. This lasted four days, then suddenly developed chills and fever resembling malaria, with less chills and more fever, resolving only after frequent sweating post-fever. He usually suffered from heart-mouth pain and weakness in the lower origin, resembling podagra. Lianzhi suspected Cold Damage. Miao said: "This is a Summerheat syndrome, essentially the malaria from last year but aggravated." The treatment should first address the branch. He prescribed Shi Gao 2 liang, Mai Dong and Niu Xi each 5 qian, Zhi Mu, Bei Mu (Fritillariae Thunbergii Bulbus), Hua Fen (Trichosanthis Radix) each 3 qian, Ju Hong 2 qian 5 fen, Bie Jia 4 qian, Zhu Ye 150 pieces, decocted in river water. After three to four doses, the mind cleared, and headache, sore throat, aphonia, tongue ulceration, distension, and chills/fever all healed. However, nausea and anorexia persisted, as did heart-mouth pain and lower weakness. Thus, Shi Gao, Zhi Mu, Zhu Ye, Bie Jia, Bei Mu, and Hua Fen were removed, and Yan Hu Suo (Corydalis Rhizoma), Mu Gua (Chaenomelis Fructus), Zhu Ru (Bambusae Caulis in Taenia) each 2 qian, Wu Ling Zhi (Trogopterori Faeces) 7 fen, Sheng Pu Huang (Typhae Pollen) 1 qian 5 fen, Yi Yi Ren (Coicis Semen) 8 qian, Shi Hu (Dendrobii Caulis), Bian Dou, and Bai Shao (Paeoniae Radix Alba) each 3 qian, Pi Pa Ye (Loquats Leaf) 3 pieces, Zhi Gan Cao 4 fen were added. After dozens of doses, he recovered. (Xiong An: Summerheat malaria pathogen in the Qi level must be primarily treated with Bai Hu Tang, modified according to symptoms. Miao alone knew this method and did not rigidly stick to Xiao Chai Hu Tang. However, herbs like Niu Xi and Bie Jia are not suitable for sudden use at the beginning. If the pathogen enters the Ying level, it is harmless. This summer, Mrs. Shi Zhijing suffered from this. Because her Yin level was inherently deficient, the pathogen entered the Ying level. I added Xi Jiao (Rhinocerotis Cornu - now substituted with Shui Niu Jiao Buffalo Horn) Xuan Shen (Scrophulariae Radix) Yin Hua (Lonicerae Japonicae Flos) Shi Hu, and Zhu Ye to Bai Hu Tang, administering a large dose, and she recovered. Those who heard this were amazed. Actually, treating the disease as seen, what is strange about it? Early autumn, Mrs. Wang Ziyu, a widow, suffered from Summerheat malaria. Mistakenly taking Chai Hu, Jiang, and Yu (Corni Fructus), she became comatose with fever and impending collapse, with empty Chi pulses, in critical condition. Her grandfather, Grand Secretary Zhu Zhuangnian, asked me to see her. I also treated her with modified Xi Jiao Di Huang Tang (Rhino Horn and Rehmannia Decoction) twice, and she recovered.)
The niece of Gao Cunzhi suffered from fetal malaria after marriage, which persisted for a long time. Zhong Chun said: "The disease is in the Yin level. Use Ren Shen 5 qian and Niu Xi 1 liang, simultaneously strengthening the Spleen and clearing Summerheat. One dose stopped it." (Ibid.)
The wife of Zhang Hengyang's son suffered from aphonia and intensified chills and fever after malaria, sending urgent message to Zhong Chun. Zhong Chun said: "This must be due to the reckless administration of Ban Xia during the malaria by someone without clear vision." He prescribed a large dose of Mai Dong, Fu Ling, Zhi Gan Cao, Bie Jia, Zhi Mu, and Bei Mu. After several doses, she recovered. (Ibid.)
Lai Tianpei treated Pan Kanghou, who suffered from malaria in late autumn with chills, fever, headache, body ache, vomiting, no sweating, heavy waist, sore legs, occurring every other day. His pulse was deep and wiry. Lai said: "This is Cold pathogen trapped in the Mu Yuan (Diaphragmatic Origin), unable to resolve externally." He used Chai Ge Jie Ji Tang (Bupleurum and Kudzu Decoction to Release the Muscles), Qiang Huo (Notopterygii Rhizoma et Radix) and Xiong (Ligustici Chuanxiong Rhizoma) for headache, Huo Xiang (Agastaches Patchouliae Herba) Guang Huo Xiang, and Ban Xia for vomiting, Zhi Ke (Aurantii Fructus) and Jie Geng (Platycodonis Radix) to benefit Lung Qi, Bai Dou Kou to warm the Stomach, Gui Zhi to reach the Mu Yuan and lead the pathogen out preventing re-entry, Fu Ling to promote diuresis, and Jiang and Zao (Jujubae Fructus) to harmonize Ying and Wei. After one dose, all symptoms were relieved.
Shen Mingsheng treated Ding Youming, who got angry after eating and was subsequently exposed to wind pathogen, resulting in chills, fever, and continuous fatigue. Everyone thought it was food stagnation and cold damage. Shen said: "Chills come at times, fever resolves with sweat, pulse is wiry and rapid. Although he never had malaria before, this marks the beginning of malaria." It turned out to be true. He gave modified Qing Pi Yin, and chills/fever gradually lightened. However, his penis and testicles shrunk daily, resembling impotence, causing great worry. Shen said: "Do not worry. This is not a critical Jueyin Cold Damage syndrome, nor is it Yang deficiency. It is extreme Yangming Heat failing to moisten the Zong Jin (Genitals), known as 'all flaccidity syndromes arise from Lung Heat'. If you treat it as deficiency and tonify, it will be a mistake." So he used formulas with Ling and Zhi. Over time, the genital shrinking remained, but the malaria stopped. Only constipation persisted for many days, but without bloating or pain. This was because profuse sweating during malaria dried the fluids and emptied the intestines. Wait for diet to improve, then use Ren Shen and Bai Zhu to tonify, and when Qi and Blood are sufficient, stool will pass naturally. Do not rush. Another doctor diagnosed that the pathogen was still excess and questioned the use of tonics, suggesting purgation. He was given Cheng Qi Tang (Order the Qi Decoction). After half a day, stool did not pass, and genital shrinking worsened. Shen was consulted again and continued with regulation and tonification. After several days, more than 2 liang of Ren Shen was administered, expelling much accumulated waste, and he fully recovered. Thus, this case had three benefits: At the beginning, one could identify malaria at the start of pathogen invasion. In the middle, one learned that flaccidity does not solely result from sexual deficiency (Wang Jiezai explained this in detail). At the end, one learned that constipation can be relieved by taking Ren Shen and Bai Zhu, and should not be aggressively purged. If purged inappropriately, even Mang Xiao (Natrii Sulfas) and Da Huang (Rhei Radix et Rhizoma) cannot cleanse, merely depleting the True Yuan. The Classics have clear instructions, but the world only knows to reduce hardness, failing to understand the method of treating obstruction with tonification.
Qian Guobin treated Zhang Dao, Commander of the Right Camp in Datong, who had suffered from malaria for seven years, barely breathing. His six pulses were wiry and long, yet still contained Stomach Qi. This was Tan Xue (Phlegm-Blood) knotting in the right abdomen of the Foot Taiyin Spleen meridian, named Nu Mu (Malaria Mother). Since long-term illness causes blood coagulation in collaterals, without attacking phlegm and blood, the disease will not heal. The Neijing states: "For malaria occurring at intervals, the pathogen has penetrated deeply and attached to Yin. Yang Qi erupts alone, Yin pathogen stays inside. Yin and Yang struggle but cannot exit, hence the interval occurrence." First, he used Si Wu Tang (Four Substances Decoction) with Tao Ren (Persicae Semen) Hong Hua (Carthami Flos) Niu Xi, Ren Shen, Cang Bai Zhu (Atractylodis Rhizoma) for more than ten doses. Once collaterals were active, the malaria shifted to the Yang level. Then, he used Ba Zhen Tang (Eight Treasures Decoction) with added Huang Qi 1 qian and He Shou Wu 1 liang for ten doses to tonify Zheng Qi, making the malaria milder and earlier. Then, he used Chang Shan (Dichroae Radix) 3 qian (wine-fried seven times), Chen Pi 1 qian 5 fen, Gan Cao 1 qian 5 fen, Cong Bai (Allii Fistulosi Bulbus) 3 segments, Sheng Jiang 5 slices, decocted and exposed overnight, taken hot on an empty stomach. The malaria stopped. Then, he pierced an egg, stirred the white and yolk with a hairpin, inserted one Strychnos seed (Fan Mu Die) and 4 li of real Musk, sealed the top with paper, steamed it in rice, removed the shell and Strychnos seed, and ate the egg with hot wine on an empty stomach daily. After more than a month, the Nu Mu completely dissipated. For any long-standing malaria, not knowing this method means non-recovery.
Wei Yuheng said: Shi Huanzhi was my closest friend. Between summer and autumn, he traveled from the capital to Wumen for marriage. In early winter, after attending a feast for a newborn relative, he developed chills, fever, and headache. He self-medicated with Xiong Su Yin (Ligusticum and Perilla Drink) for one dose, which failed. He then took Li Zhong Tang (Regulate the Middle Decoction), which worsened the condition. Presumably due to recent marriage, he suspected it was a Yin syndrome. From then on, all doctors summoned treated him with warming and tonifying herbs, making him increasingly weak. He urgently sent for me in Hangzhou. By the time I arrived, more than ten days had passed. Entering the room, I saw the decocted medicine had not been discarded. His pulse was deep, wiry, and rapid, beating six or seven times per breath. His tongue was stiff, coating black and dry. He said that after taking warming tonics, chills and fever had subsided, but he had no bowel movement and frequent urination, especially at night, almost 50-60 times. There was occasional cold air rushing up in the chest. He could only eat a small bowl of porridge daily, appearing critically weak. I said: "This is latent Qi transforming into malaria. Frequent urination is due to internal heat forcing downward. The urine must be scanty, red, and turbid." Verification proved this correct. Regarding the cold air rushing up, it is due to heat stagnating in the Middle Palace; just as above a flame there must be cold air. The lack of bowel movement is due to internal heat causing dryness and accumulation, which goes without saying. Since the pathogen is deeply latent, its manifestation stops. How can one rashly use warming tonics? Fortunately, his visceral Yin was not exhausted in his prime. Urgently administer cooling resolution. If chills and fever recur, then there will be no danger. Asking about the decocted medicine, it contained Ren Shen, Bai Zhu, Jiang, Fu, Gui, Yu, Suan Zao Ren (Ziziphi Spinosae Semen), Wu Wei Zi, etc. He said he took one dose yesterday, and the condition did not improve. Today, he used Ren Shen 3 qian, Gui and Fu each 1 qian 5 fen. Examining previous prescriptions, they were all Er Chen Tang (Two Aged Herbs Decoction), Si Jun Zi Tang, Gui, Jiang, Yu, etc. I said: "If we continue with Ren Shen, Bai Zhu, Gui, and Fu today, it will be incurable." I combined Xiao Chai Hu Tang (Minor Bupleurum Decoction) and Xiao Xian Xiong Tang (Minor Inhibiting Chest Decoction) with Bai Hu Tang into one dose and gave it to him. His brother-in-law was confused and hesitant, firmly refusing to comply. This was because doctors from Dongting dominated his household, creating difficulties. I said: "Since you do not believe, please let me leave on the original boat. Although we are close friends, I came to treat illness, not to attend a funeral." Hearing this, Huanzhi begged me to stay. I handed over the medicinal supplies and personally supervised the decoction. After taking it, urination frequency decreased. The next day, porridge intake increased. Giving the same formula again, chills and fever erupted, but the black tongue coating gradually receded, and spirit improved. Removing Bai Hu Tang, after two doses, chills and fever decreased, and urination volume increased. Two days later, large amounts of black, dry stool were passed. Changed to Gan Lu Yin (Sweet Dew Drink), modified over several doses, and he stabilized. (Xiong An: This autumn, Tang Zhensheng suffered from malaria in Jiaxing. The doctor knew it was Summerheat and gave clearing/resolving herbs, which turned into diarrhea. Then switched to warming/drying herbs, worsening diarrhea, while fever persisted, leaving the doctor helpless. Ordered him to return to Hangzhou. Relative Zhang Yueqing invited me to examine him. Black coating, red face, chest tenderness/rejection, stool like glue/pitch, no urine, delirium, deafness, insomnia, laughter, pulse knotted and rapid. I gave Huang Lian (Coptidis Rhizoma) Huang Qin Huang Bai (Phellodendri Cortex) Zhi Zi (Gardeniae Fructus) Yin Hua Shi Hu Zhi Mu Lou Ren (Trichosanthis Semen) Xuan Shen, Lu Dou (Phaseoli Semen) and Shen Xi Dan (Divine Calyx Pill). After four doses, chest rejection ceased, slight gruel intake resumed, black stools became less frequent, slight urination appeared. Then removed Shen Xi Dan, added Di Huang (Rehmanniae Radix) and Shi Gao. After three doses, fever subsided, spirit cleared, pulse quieted. Then administered sweet-cool fluid-nourishing herbs. After more than ten doses, he recovered. Also, Zhu Shengfu's son Zhonghe suffered from malaria several years ago, lingering for half a year, causing great suffering. This summer, he suffered from it again, with similar presentation. I was urgently consulted. He said: "Must have suffered year-round." I said: "Summer-dampness pathogen. Without taking Chai, Gui, Jiang, Zao, it can recover in ten days." He didn't believe much, but after administration, he recovered in eight doses, realizing previously he was misled by Xiao Chai Hu Tang.)
Xu Minhua, nearly thirty, suffered from fetal malaria. A famous doctor from He was staying in Hangzhou and examined him. He saw the tongue coating peeled like rotten iron, pale yellow where coated, deep purple like a pig kidney where uncoated. After three or four attacks, he was extremely exhausted, needing a cane to stand, appetite suddenly dropped, drinking only two bowls of thin porridge daily, so medication was withheld. Pulse was deficient, rapid, and wiry. Left Cun was surging and overflowing; Right Chi was weak. I said: "This is inherent deficiency of Hand and Foot Shaoyin, plus Summerheat pathogen entering the Pericardium. The Classics say Summerheat injures the Heart; the tongue is the orifice of the Heart, hence these symptoms." Initially, I gave Huang Lian Xiang Ru Yin (Coptis and Elsholtzia Drink). After one dose, he desired food. Then, I gave Dao Chi San (Directing Fire Away Powder) combined with Yi Yuan San (Benefit Primordial Powder), and the purple tongue faded. Then, Ren Shen Xiao Chai Hu Tang, and chills/fever healed. After recovery, he told me: "Three relatives/friends also developed malaria on the same day, all with tongue coating changes. Two died, surnamed Ye and Zhou." (Xiong An: The treatment methods in this section are lacking for Summer-damp seasonal malaria...)