张习可日间受微雨及风冷，疟发于暮，热甚，于夜遂成三疟，乞诊于师，用升阳济阴法，
疟渐愈。奈不知调摄，元气未复，嗜欲不谨，九月中旬，疟忽增剧，六脉虚数。乃阴虚已极，而
暑邪深入，最难疗治。师问难于余，爰思受病之原，当先扶正升阳。用生地、川芎、归身、白
芍、炙草、干姜、葛根、升麻、柴胡、煨姜、南枣浓煎，于疟未作前，三时服一盂，四帖。后加首
乌、人参各三钱，连服三帖，疟竟不作，代订丸方，以善其后。
治不沾沾于补虚，不斤斤于泄邪，而方药病情丝丝入扣，古谓成如容易却艰辛，非学识兼全者，曷能辨此。
丸方
制首乌（四两） 大生地（三两） 人参 于术 归身 龟板 猪苓 炒芩 川芎 查炭（各二
两） 柴胡（一两六钱） 淮牛膝（一两五钱） 干姜 山甲（各一两） 甘草（炙，五钱） 活龟（一个）
入砂仁末二两，煮取龟肉，同药捣匀，烘干，其甲、骨亦研细末，加入鲜荷叶汤泛丸，如
麻子大，每晨服三钱，沸汤下。服完一料，精神倍于平日。
魏子一患嘴唇干燥，皮渐裂痛，自服甘露
饮大剂旬日，微获小效，而病成痼疾，乞诊于余。诊得左右两关脉弦而散，显是津液不能上滋，延成茧唇。
令内服滋液育阴，二地、二冬、元参、梨汁等为丸常服，外用神水点擦，日服一小杯，两月而瘳。
张习可在白天淋了微雨并受了风寒，傍晚疟疾发作，发热严重，到了夜间便发展为三疟（指疟疾发作时间不固定或一日数发的重症疟疾），于是向老师求诊。老师采用升阳济阴法治疗，疟疾逐渐好转。无奈患者不懂得调养摄生，元气尚未恢复，又纵情声色、不加节制，到了九月中旬，疟疾突然加重，六脉呈现虚而数的脉象。这是阴虚已至极点，且暑邪深入体内，最难治疗。老师向我咨询疑难问题，我思考其发病根源，认为应当先扶助正气、升发阳气。于是使用生地、川芎、当归身、白芍、炙甘草、干姜、葛根、升麻、柴胡、煨姜、南枣，浓煎成汤剂，在疟疾未发作前的三个时段各服一碗，共四帖。之后加入制何首乌、人参各三钱，连续服用三帖，疟疾竟然不再发作。随后制定丸方以善后调理。
治疗没有拘泥于单纯的补虚，也没有局限于刻板的祛邪，而是方药与病情丝丝入扣。古人说“成功看似容易却充满艰辛”，如果不是学识兼备的人，怎么能辨别其中的奥妙呢？
丸方：
制何首乌（四两）、大生地（三两）、人参、白术、当归身、龟板、猪苓、炒黄芩、川芎、山楂炭（各二两）、柴胡（一两六钱）、怀牛膝（一两五钱）、干姜、穿山甲（各一两）、炙甘草（五钱）、活龟（一只）。
将砂仁末二两放入，煮取龟肉，与药物一起捣匀，烘干，龟甲和龟骨也研成细末，加入鲜荷叶汁泛制成丸，如麻子大小，每晨服用三钱，用沸水送下。服完一料药，精神比平时加倍。
魏子一患有嘴唇干燥，皮肤逐渐开裂疼痛，自行服用大剂量的甘露饮十天，只获得微小的疗效，但病已成顽固性疾病，于是向我求诊。诊察发现左右两手关脉弦而散乱，明显是津液不能上承滋润所致，拖延形成了茧唇（一种以唇部肿胀、皲裂、结痂为特征的慢性唇炎）。令其内服滋液育阴的方药，用地黄、天冬、麦冬、玄参、梨汁等制成丸药常服，外用神水点擦，每天服用一小杯，两个月后痊愈。
Zhang Xike was exposed to light rain and wind-cold during the day. His malaria (malaria) attacked in the evening with severe heat, and by night it had developed into San Malaria (a severe form of malaria characterized by irregular or frequent attacks). He sought diagnosis from his teacher, who employed the method of Ascending Yang and Nourishing Yin (a therapeutic principle that raises yang qi while nourishing yin fluids). The malaria gradually improved. However, due to a lack of proper self-care, his primordial qi (vital energy) had not yet recovered, and he indulged in desires without restraint. By mid-September, the malaria suddenly worsened, and all six pulse positions were deficient and rapid. This indicated extreme yin deficiency with deep penetration of summerheat pathogen, making it difficult to treat. The teacher consulted me on this difficulty. Reflecting on the origin of the disease, I reasoned that we should first support the righteous qi and ascend the yang. We used Sheng Di Huang (Rehmanniae Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dang Gui Shen (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma), Gan Jiang (Zingiberis Rhizoma), Ge Gen (Puerariae Lobatae Radix), Sheng Ma (Cimicifugae Rhizoma), Chai Hu (Bupleuri Radix), Wei Jiang (Prepared Ginger), and Nan Zao (Jujubae Fructus), decocted strongly. One cup was taken at three time points before the malaria attack, for four doses. Subsequently, Shou Wu (Polygoni Multiflori Preparata Radix) and Ren Shen (Ginseng Radix et Rhizoma), each 3 qian, were added. After taking three more doses, the malaria ceased completely. A pill prescription was then formulated to consolidate the recovery.
The treatment did not cling solely to tonifying deficiency nor focus narrowly on draining pathogenic factors; rather, the formula and herbs matched the condition precisely. As the ancients said, "Success seems easy but is actually arduous." Only those with comprehensive learning and skill could discern such subtleties.
Pill Prescription:
Zhi Shou Wu (4 liang), Da Sheng Di (3 liang), Ren Shen, Yu Zhu (Atractylodis Macrocephalae Rhizoma - *Note: Text says 'Yu Zhu' but context implies Bai Zhu/Atroctylodes based on common usage in this formula type, however strictly translating text as 'Yu Zhu' or assuming typo for 'Bai Zhu'. Given 'Yu Zhu' usually refers to Ophiopogon, but here likely Bai Zhu given the spleen/qi context. Let's stick to literal 'Yu Zhu' or correct to 'Bai Zhu' if standard. In Wang Kentang's texts, 'Yu Zhu' often appears as a typo for 'Bai Zhu' or refers to specific processing. I will use 'Bai Zhu' as it fits the 'Sheng Yang Ji Yin' and spleen context better, or keep literal. Let's use 'Bai Zhu' for accuracy of intent if 'Yu Zhu' is a known variant/typo in this specific manuscript context, otherwise 'Ophiopogonis Radix'. Given 'Ren Shen, Yu Zhu, Dang Gui', it looks like a Qi/Blood/Yin tonic. 'Yu Zhu' (Ophiopogon) nourishes yin. 'Bai Zhu' strengthens spleen. Let's translate literally as 'Yu Zhu' but note it might be Bai Zhu. Actually, looking at the list 'Ren Shen, Yu Zhu, Dang Gui, Gui Ban...', it is heavily yin/nourishing. I will translate as 'Yu Zhu' (Ophiopogonis Radix)).
*Correction*: In many Ming/Qing texts, 'Yu Zhu' (玉竹) is distinct from 'Bai Zhu' (白术). However, 'Yu Zhu' (于术) is a high-quality variety of Bai Zhu. The text says "于术" (Yu Zhu - homophone for Jade Bamboo/Ophiopogon but meaning Atroctylodes macrocephala). So it is **Bai Zhu**.
Dang Gui Shen, Gui Ban (Testudinis Carapax et Plastrum), Zhu Ling (Polypori Sclerotium), Chao Qin (Scutellariae Radix fried), Chuan Xiong, Zha Tan (Crataegi Fructus charred) (each 2 liang); Chai Hu (1 liang 6 qian); Huai Niu Xi (Achyranthis Bidentatae Radix) (1 liang 5 qian); Gan Jiang, Shan Jia (Manis Squama) (each 1 liang); Zhi Gan Cao (5 qian); Huo Gui (Live Turtle) (1 unit).
Add Sha Ren (Amomi Fructus Rotundus powder, 2 liang), boil to extract turtle meat, mix evenly with herbs, dry, grind turtle shell and bones into fine powder, add fresh He Ye (Nelumbinis Folium) juice to form pills, size of hemp seeds. Take 3 qian every morning with boiling water. After one course, spirit and energy doubled compared to usual.
Wei Ziyi suffered from dry lips, with skin gradually cracking and causing pain. He self-medicated with large doses of Gan Lu Yin (Sweet Dew Decoction) for ten days, achieving only slight effect, but the disease became chronic. He sought my diagnosis. The pulses at the left and right Guan positions were wiry and scattered, clearly indicating that body fluids failed to ascend and moisten, leading to Jian Chun (Silkworm Lip, a chronic cheilitis characterized by swelling and fissuring). He was instructed to internally take pills made of Zi Ye Yu Yin (Nourishing Fluids and Nourishing Yin) formulas, including Di Huang (Rehmanniae Radix), Tian Dong (Asparagi Radix), Mai Dong (Ophiopogonis Radix), Yuan Shen (Scrophulariae Radix), Li Zhi (Pear Juice), etc., for regular consumption. Externally, Shen Shui (Divine Water) was applied. Taking one small cup daily, he recovered after two months.