脉 脉诀云∶疟脉自弦。弦迟多寒。弦数多热。弦小紧者宜下。弦迟宜温。弦数宜汗。浮大
而滑宜吐。洪数无力为虚。代散则死。
症 内经曰∶夏伤于暑。秋必痢疟。盖先热后寒。名曰温疟。但热不寒。名曰瘅疟。经年不
瘥。结成 瘕。名为老疟。亦曰疟母。寒热身重。骨节烦疼。胀满自汗。为湿疟。寒热不除
。但惨 振栗。病以时作。为牝疟。因伤食而得为食疟。一岁之中。长幼相似。谓之疫疟。
愚按内经、明言夏伤于暑所致。何世医悉谓脾寒。而用温热之药。盖战栗恶寒者。火极似水。
亢则害。承乃制故也。又按丹溪云∶疟因暑邪舍于荣卫之间。腠理不密。复遇风寒。闭而不
出。舍于肠胃之外。与荣卫煎行。昼行于阳。夜行于阴。并则病作。离则病止。并于阳则热
。并于阴则寒。浅则日作。深则间日。在气则早。在血则晏。渴者燥胜。不渴者湿胜也。机
要云∶在太阳经为寒疟。治多汗之。阳明经为热疟。治多下之。少阳经为寒热疟。治多汗之
。此三阳经受病。谓之暴疟。发在夏至后处暑前。乃伤之浅者。在三阴经。则总谓之温疟。
发在处暑后冬至前。乃伤之重者。此说良是。其三阴经则作于子午卯酉日。少阴疟也。作于
寅申巳亥日。厥阴疟也。辰戌丑未日。太阴疟也。临症宜详辨之。
治 丹溪云∶疟得于暑。当以汗解。或汗不得出。郁而成痰。宜养胃化痰。发汗为主。邪气
得出。自然和也。无汗要有汗。散邪为主。带补。小柴胡,加川芎、苍术、升麻、葛根之
类。有汗要无汗。扶正为主。带散。以参、 、归、术、芍药、黄柏、麦冬、五味、之类。
补而收之。虚者。必用参术一二帖托住。其气不使下陷。后随症用他药。大渴大热。头疼如
破。小柴胡,去半夏,加川芎、石膏、知母主之。暑疟。宜人参白虎汤。有痰者。二陈加
常山吐之。不食者。必从食上得。当以食治。平胃散。加山楂、神曲、草果、青皮主之。
疟母在左胁下。令人自汗作痛。以青蒿、鳖甲为主。佐以三棱、莪术、香附、青皮、桃仁
、治之。凡疟数发之后。便宜小柴胡,加常山、草果、青皮、乌梅、截之。久则中气虚弱。
病愈深而难治矣。
方 柴苓二陈汤治诸疟。热多寒少者宜服。
柴胡 白术 苍术(各一钱五分) 人参 半夏(姜制) 黄芩(各一钱) 藿香 川芎 茯苓 陈皮
青皮(各八分) 甘草(三分) 浓朴(七分)
上作一服。姜三片。枣一枚。水一钟半。煎八分。食远服。
初发阴阳未分。加猪苓、泽泻(各八分)、桂(四分)。
若一日一发。午前者邪在阳分。加黄 (一钱)、添茯苓、半夏(各五分)。
热甚。头痛。加石膏(一钱五分)、葱白汁(二匙)。
口渴。加石膏(一钱五分)、知母(一钱)、麦门冬(一钱)。
间日。或三日。午后。或夜发者。加当归、芍药、地黄、知母(各一钱)、酒红花、酒柏、升
麻(各四分)、此邪在阴分。提起阳分。方可截。
若间一日。连二日。或日夜各发者。气血俱病。加黄 (一钱)、添人参、茯苓(各五分)、以
补气。加当归、芍药、地黄(各一钱五分)、以补血。
阳疟多汗。加黄 (一钱五分)、以敛之。无汗。加葛根(一钱五分)、以发之。
阴疟多汗。加当归、芍药、地黄、黄柏、知母(各二钱)、以敛之。
无汗。倍柴胡、苍术,加升麻(七分)、葛根(一钱五分)、以发之。
胃弱食少。或服截药。伤脾胃。食少者。添人参(五分)、芍药(酒炒)、麦芽(各一钱)、砂仁、
(五分)、扁豆(八分)。
若因食积者。加山楂、神曲、枳实、草果(各一钱)、黄连(四分)、瘴疟。加槟榔、知母、葛
根、白芷(各一钱)、乌梅(三个)。
疟后变痢疾。补虚清热为主。添人参(五分),加砂仁(七分)、扁豆、黄连(各一钱)、木香、
(七分)、当归(一钱二分)、芍药(一钱五分)、槟榔(七分)、乌梅(二个)。
若欲截之。加常山(一钱五分)、槟榔、草果(各一钱)、乌梅(七个)、水二钟煎空心服。
若日久虚疟。或 疟。连岁不已。本方。去浓朴、苍术、川芎、藿香、青皮、减柴胡、
黄芩、一半。加黄 、当归(各一钱五分)、白芍药、知母、青蒿、地骨皮(各一钱)、鳖甲、
(九棱或七棱者炙二钱)。
热多枣少者。或大渴者。加石膏(一钱五分)、知母、葛根(各一钱)、麦冬、山栀(各八分)、
添黄芩(五分)。
寒多热少。或但寒不热。加丁香(七分)、官桂(一钱)、干姜(一钱)、草果(一钱)、甚者。加
附子(一钱)、减柴芩一半。
春疟。加防风、干葛、白芷(各一钱)。
夏疟。加黄连、扁豆(各一钱)、香薷(一钱
秋疟。加知母、归身、贝母、杏仁、麦冬(各一钱)。
冬疟。加杏仁(一钱)、桂枝(八分)、干姜(七分)、寒多。更加丁香(五分)。
若日久寒热不多。或无寒而但微热者。邪气已尽。夏月。用清暑益气汤。余月。用补中益气
汤。加麦冬、黄柏、短母(各八分)、滋补气血。截后调理。亦同此条。
又方 截疟丹截诸疟神效。历试有验。
人参(二两去芦) 雄黄(一两六钱另研) 辰砂(六钱另研)
上三味各为末。称定。于五月五日取五家粽为丸。豆大。大人十丸。小儿五丸。发日。五更
空心无根水煎青蒿汤送下。忌生冷鸡鱼一月。
【脉象】
《脉诀》中说:疟疾的脉象自然呈现弦脉。脉象弦而迟,说明寒邪偏盛;脉象弦而数,说明热邪偏盛;脉象弦、小且紧,适宜用攻下法;脉象弦而迟,适宜用温法;脉象弦而数,适宜用发汗法;脉象浮大且滑,适宜用催吐法;脉象洪大而数但按之无力,属于虚证;脉象代脉或散脉,则预示死亡。
【症状】
《内经》说:夏季感受暑邪,秋季必定发生痢疾或疟疾。先发热后发冷的,称为温疟(Wen Nue, Warm Malaria);只发热不发冷的,称为瘅疟(Dan Nue, Fiery Malaria);经年不愈,结成痞块,称为老疟,也称为疟母(Nue Mu, Malaria Mass)。恶寒发热且身体沉重,骨节烦痛,胸腹胀满并自汗出的,为湿疟(Shi Nue, Damp Malaria)。寒热不退,只是剧烈颤抖畏寒,疾病按时发作的,为牝疟(Pin Nue, Yin Malaria)。因饮食积滞而得的,称为食疟(Shi Nue, Food Stagnation Malaria)。一年内老少皆病,症状相似的,称为疫疟(Yi Nue, Epidemic Malaria)。
我按语:《内经》明确说是由夏季伤于暑邪所致,为何后世医生都认为是脾寒,而使用温热药物?其实战栗恶寒,是火极似水的表现,即亢盛至极则产生危害,需要承制之气来制约它。
另外按丹溪先生所说:疟疾是因为暑邪潜伏在荣卫(Nutritive and Defensive Qi)之间,腠理(Skin pores and interstices)不致密,又遇到风寒,闭塞而出不来,停留在肠胃之外,与荣卫之气煎熬运行。白天行于阳分,夜晚行于阴分,阴阳相并则发病,分离则病止。并于阳分则发热,并于阴分则发冷。病位浅则每日发作,病位深则隔日发作。在气分则发作早,在血分则发作晚。口渴的是燥胜,不渴的是湿胜。
《机要》说:在太阳经(Taiyang Channel)的为寒疟,治疗多用发汗法;在阳明经(Yangming Channel)的为热疟,治疗多用攻下法;在少阳经(Shaoyang Channel)的为寒热疟,治疗多用发汗法。这三阳经受病,称为暴疟(Bao Nue, Acute Malaria),发作时间在夏至后到处暑前,这是感邪较浅的。在三阴经(Yin Channels)的,总称为温疟,发作时间在处暑后到冬至前,这是感邪较重的。这种说法很好。其中三阴经发病的时间:子、午、卯、酉日发作的,是少阴疟(Shaoyin Malaria);寅、申、巳、亥日发作的,是厥阴疟(Jueyin Malaria);辰、戌、丑、未日发作的,是太阴疟(Taiyin Malaria)。临症时应当详细辨别。
【治法】
丹溪先生说:疟疾得之于暑,应当用发汗法解除。如果汗不得出,郁结而成痰,宜养胃化痰,以发汗为主。使邪气得出,自然调和。无汗的要令其有汗,以散邪为主,兼带补益,用小柴胡汤(Xiao Chai Hu Tang, Minor Bupleurum Decoction),加川芎、苍术、升麻、葛根之类。有汗的要令其无汗,以扶正为主,兼带散邪,用人参、[缺字]、当归、白术、芍药、黄柏、麦冬、五味子之类,补益而收敛。体虚者,必须用人参、白术一二帖托住中气,防止气陷,随后随症用其他药物。大渴大热,头痛如破的,用小柴胡汤,去半夏,加川芎、石膏、知母主治。暑疟,宜用人参白虎汤(Renshen Baihu Tang, Ginseng White Tiger Decoction)。有痰的,用二陈汤(Er Chen Tang, Two-Cured Decoction)加常山催吐。不吃饭的,必定是从饮食上来,应当从饮食治疗,用平胃散(Ping Wei San, Peaceful Stomach Powder),加山楂、神曲、草果、青皮主治。
疟母在左胁下,使人自汗作痛,以青蒿、鳖甲为主,佐以三棱、莪术、香附、青皮、桃仁治疗。凡是疟疾多次发作之后,宜用小柴胡汤,加常山、草果、青皮、乌梅截断疟疾。时间久了则中气虚弱,病邪深入而难治了。
【方剂】
柴苓二陈汤(Chai Ling Er Chen Tang)治疗各种疟疾。热多寒少的适宜服用。
柴胡、白术、苍术(各一钱五分)、人参、半夏(姜制)、黄芩(各一钱)、藿香、川芎、茯苓、陈皮、青皮(各八分)、甘草(三分)、浓朴(七分)。
以上为一服量,加生姜三片,大枣一枚,水一钟半,煎至八分,饭后服用。
初发时阴阳未分,加猪苓、泽泻(各八分)、桂枝(四分)。
若一日一发,午前发作的,邪在阳分,加黄芪(一钱)、增加茯苓、半夏(各五分)。
热甚,头痛,加石膏(一钱五分)、葱白汁(二匙)。
口渴,加石膏(一钱五分)、知母(一钱)、麦门冬(一钱)。
隔日或三日发作,午后或夜间发作的,加当归、芍药、地黄、知母(各一钱)、酒红花、酒黄柏、升麻(各四分),这是邪在阴分,提起阳分,方可截断。
若隔一日,连发两日,或日夜各发一次的,气血俱病,加黄芪(一钱)、增加人参、茯苓(各五分),以补气;加当归、芍药、地黄(各一钱五分),以补血。
阳疟多汗,加黄芪(一钱五分),以收敛之。无汗,加葛根(一钱五分),以发汗。
阴疟多汗,加当归、芍药、地黄、黄柏、知母(各二钱),以收敛之。
无汗,加倍柴胡、苍术,加升麻(七分)、葛根(一钱五分),以发汗。
胃弱食少,或服用截疟药损伤脾胃,食少者,增加人参(五分)、芍药(酒炒)、麦芽(各一钱)、砂仁(五分)、扁豆(八分)。
若因食积者,加山楂、神曲、枳实、草果(各一钱)、黄连(四分)。
瘴疟(Zhang Nue, Miasmic Malaria),加槟榔、知母、葛根、白芷(各一钱)、乌梅(三个)。
疟疾后变为痢疾,以补虚清热为主,增加人参(五分),加砂仁(七分)、扁豆、黄连(各一钱)、木香(七分)、当归(一钱二分)、芍药(一钱五分)、槟榔(七分)、乌梅(二个)。
若想截断疟疾,加常山(一钱五分)、槟榔、草果(各一钱)、乌梅(七个),水二钟煎煮,空腹服用。
若日久虚疟,或[缺字]疟,连年不愈,用本方,去掉浓朴、苍术、川芎、藿香、青皮,减少柴胡、黄芩的一半。加黄芪、当归(各一钱五分)、白芍药、知母、青蒿、地骨皮(各一钱)、鳖甲(九棱或七棱者炙二钱)。
热多汗少者,或大渴者,加石膏(一钱五分)、知母、葛根(各一钱)、麦冬、山栀(各八分)、增加黄芩(五分)。
寒多热少,或只寒不热,加丁香(七分)、官桂(一钱)、干姜(一钱)、草果(一钱),严重的,加附子(一钱)、减少柴胡、黄芩一半。
春疟,加防风、干葛、白芷(各一钱)。
夏疟,加黄连、扁豆(各一钱)、香薷(一钱)。
秋疟,加知母、归身、贝母、杏仁、麦冬(各一钱)。
冬疟,加杏仁(一钱)、桂枝(八分)、干姜(七分),寒多者,再加丁香(五分)。
若日久寒热不多,或无寒而只有微热的,邪气已尽。夏季,用清暑益气汤(Qingshu Yiqi Tang, Clear Summerheat and Boost Qi Decoction)。其余月份,用补中益气汤(Buzhong Yiqi Tang, Tonify the Middle and Augment Qi Decoction),加麦冬、黄柏、知母(各八分),滋补气血。截疟后的调理,也同此条。
又一方:截疟丹(Jie Nue Dan, Malaria-Intercepting Pill)治疗各种疟疾神效,历试有效。
人参(二两去芦)、雄黄(一两六钱另研)、辰砂(六钱另研)。
以上三味各研为末,称定分量,在五月五日取五家粽米为丸,如豆大。成人十丸,小儿五丸。发作日,五更时分空腹,用无根水煎青蒿汤送下。忌食生冷、鸡鱼一个月。
[Pulse]
The *Mai Jue* (Pulse Mantra) states: The pulse of malaria naturally presents as a string-like (Xian) pulse. A string-like and slow pulse indicates excess cold; a string-like and rapid pulse indicates excess heat; a string-like, small, and tight pulse is suitable for purgation; a string-like and slow pulse is suitable for warming; a string-like and rapid pulse is suitable for diaphoresis; a floating, large, and slippery pulse is suitable for emesis; a洪 (Hong, surging) and rapid pulse that is forceless upon pressure indicates deficiency; a Dai (intermittent) or San (scattered) pulse portends death.
[Symptoms]
The *Neijing* (Inner Canon) states: Summer injury by summerheat leads to dysentery or malaria in autumn. If fever precedes chills, it is called Wen Nue (Warm Malaria); if there is only fever without chills, it is called Dan Nue (Fiery Malaria); if it persists for years and forms a mass, it is called Lao Nue (Old Malaria), also known as Nue Mu (Malaria Mass). If there are alternating chills and fever with heavy body, painful joints, abdominal distension, and spontaneous sweating, it is Shi Nue (Damp Malaria). If chills and fever do not cease, but there is only severe trembling and aversion to cold, with attacks occurring at regular times, it is Pin Nue (Yin Malaria). If caused by food stagnation, it is Shi Nue (Food Stagnation Malaria). If all ages in a year suffer similarly, it is Yi Nue (Epidemic Malaria).
My commentary: The *Neijing* explicitly states it is caused by summerheat injury in summer. Why do later physicians attribute it entirely to Spleen cold and use warming herbs? In fact, trembling and aversion to cold are manifestations of extreme heat resembling water; when hyperactivity reaches its limit, it causes harm, requiring a controlling force to regulate it.
Furthermore, according to Danxi: Malaria occurs when summerheat pathogens lodge between the Ying (Nutritive) and Wei (Defensive) levels. If the Couli (skin pores and interstices) are not dense, and wind-cold is encountered, they close up and cannot exit, lodging outside the stomach and intestines. They simmer and circulate with the Ying and Wei Qi. During the day, they travel in the Yang aspect; at night, in the Yin aspect. When they merge, disease arises; when they separate, disease ceases. Merging in Yang causes heat; merging in Yin causes cold. Shallow involvement leads to daily attacks; deep involvement leads to every-other-day attacks. Involvement in Qi results in early onset; involvement in Blood results in late onset. Thirst indicates dryness prevailing; no thirst indicates dampness prevailing.
The *Jiyao* states: Involvement of the Taiyang Channel manifests as Han Nue (Cold Malaria), treated mostly with diaphoresis; involvement of the Yangming Channel manifests as Re Nue (Heat Malaria), treated mostly with purgation; involvement of the Shaoyang Channel manifests as Han Re Nue (Cold-Heat Malaria), treated mostly with diaphoresis. Disease in these three Yang channels is called Bao Nue (Acute Malaria), occurring from after Summer Solstice to before End of Heat, indicating shallow pathogen invasion. Involvement of the three Yin channels is collectively called Wen Nue, occurring from after End of Heat to before Winter Solstice, indicating heavy pathogen invasion. This theory is sound. Among the three Yin channels: attacks on Zi, Wu, Mao, You days are Shaoyin Malaria; attacks on Yin, Shen, Si, Hai days are Jueyin Malaria; attacks on Chen, Xu, Chou, Wei days are Taiyin Malaria. Clinical differentiation should be detailed.
[Treatment Principles]
Danxi stated: Malaria acquired from summerheat should be resolved via diaphoresis. If sweat cannot be produced, stagnation transforms into phlegm; one should nourish the Stomach and resolve phlegm, prioritizing diaphoresis. Once the pathogen exits, harmony returns. For no sweat, promote sweating to scatter the pathogen, accompanied by tonification, using Xiao Chai Hu Tang (Minor Bupleurum Decoction) plus Chuanxiong, Cangzhu, Shengma, Ge Gen, etc. For excessive sweat, stop sweating by supporting the Righteous Qi, accompanied by scattering the pathogen, using Renshen, [missing character], Danggui, Baizhu, Shaoyao, Huangbai, Maidong, Wuweizi, etc., to tonify and astringe. For deficiency, Renshen and Baizhu must be used for one or two doses to support the Qi and prevent sinking, followed by other herbs based on symptoms. For extreme thirst, high fever, and headache like splitting, use Xiao Chai Hu Tang, remove Banxia, add Chuanxiong, Shigao, Zhimu. For Summerheat Malaria, use Renshen Baihu Tang (Ginseng White Tiger Decoction). For phlegm, use Er Chen Tang (Two-Cured Decoction) plus Changshan to induce vomiting. For anorexia, it stems from food; treat via digestion, using Pingwei San (Peaceful Stomach Powder) plus Shanzha, Shenqu, Caoguo, Qingpi.
For Nue Mu (Malaria Mass) under the left hypochondrium causing spontaneous sweating and pain, use Qinghao and Biejia as main herbs, assisted by Sanleng, Ezhu, Xiangfu, Qingpi, Taoren. After multiple malaria attacks, use Xiao Chai Hu Tang plus Changshan, Caoguo, Qingpi, Wumei to intercept the malaria. Prolonged duration weakens the Middle Qi, making the disease deeper and harder to treat.
[Formulas]
Chai Ling Er Chen Tang treats various malarias, suitable for those with more heat than cold.
Chaihu, Baizhu, Cangzhu (each 1.5 qian), Renshen, Banxia (processed with ginger), Huangqin (each 1 qian), Huoxiang, Chuanxiong, Fuling, Chenpi, Qingpi (each 0.8 qian), Gancao (0.3 qian), Nongpo (0.7 qian).
Take as one dose, add three slices of Shengjiang, one Zao, 1.5 zhong of water, decoct to 0.8 zhong, take far after meals.
At initial onset when Yin and Yang are undifferentiated, add Zhuling, Zexie (each 0.8 qian), Guizhi (0.4 qian).
If once daily, attacking before noon, the pathogen is in the Yang aspect; add Huangqi (1 qian), increase Fuling, Banxia (each 0.5 qian).
For intense heat and headache, add Shigao (1.5 qian), Congbai juice (2 chi).
For thirst, add Shigao (1.5 qian), Zhimu (1 qian), Mendumdong (1 qian).
For every-other-day or third-day attacks, or afternoon/night attacks, add Danggui, Shaoyao, Dihuang, Zhimu (each 1 qian), Jiu Honghua, Jiu Bai, Shengma (each 0.4 qian); this indicates pathogen in the Yin aspect, lift to the Yang aspect to intercept.
If skipping one day, then two consecutive days, or attacking once day and once night, both Qi and Blood are diseased; add Huangqi (1 qian), increase Renshen, Fuling (each 0.5 qian) to tonify Qi; add Danggui, Shaoyao, Dihuang (each 1.5 qian) to tonify Blood.
For Yang Malaria with excessive sweat, add Huangqi (1.5 qian) to astringe. For no sweat, add Gegen (1.5 qian) to induce sweat.
For Yin Malaria with excessive sweat, add Danggui, Shaoyao, Dihuang, Huangbai, Zhimu (each 2 qian) to astringe.
For no sweat, double Chaihu, Cangzhu, add Shengma (0.7 qian), Gegen (1.5 qian) to induce sweat.
For weak Stomach and poor appetite, or damage to Spleen/Stomach by interception drugs, adding Renshen (0.5 qian), Shaoyao (wine-fried), Maiya (each 1 qian), Sharen (0.5 qian), Bidou (0.8 qian).
For food accumulation, add Shanzha, Shenqu, Zhishi, Caoguo (each 1 qian), Huanglian (0.4 qian).
For Zhang Nue (Miasmic Malaria), add Binglang, Zhimu, Gegen, Baizhi (each 1 qian), Wumei (3 pieces).
If malaria transforms into dysentery, prioritize tonifying deficiency and clearing heat; add Renshen (0.5 qian), add Sharen (0.7 qian), Bidou, Huanglian (each 1 qian), Muxiang (0.7 qian), Danggui (1.2 qian), Shaoyao (1.5 qian), Binglang (0.7 qian), Wumei (2 pieces).
To intercept, add Changshan (1.5 qian), Binglang, Caoguo (each 1 qian), Wumei (7 pieces), decoct in 2 zhong of water, take on empty stomach.
For prolonged deficiency malaria, or [missing character] malaria persisting for years, use this formula, remove Nongpo, Cangzhu, Chuanxiong, Huoxiang, Qingpi; halve Chaihu, Huangqin. Add Huangqi, Danggui (each 1.5 qian), Baishaoyao, Zhimu, Qinghao, Digupi (each 1 qian), Biejia (roasted 2 qian, nine-pronged or seven-pronged).
For more heat and less sweat, or extreme thirst, add Shigao (1.5 qian), Zhimu, Gegen (each 1 qian), Maidong, Shanzhi (each 0.8 qian), increase Huangqin (0.5 qian).
For more cold and less heat, or only cold without heat, add Dingxiang (0.7 qian), Guanzi (1 qian), Ganjiang (1 qian), Caoguo (1 qian); for severe cases, add Fuzi (1 qian), halve Chaihu, Huangqin.
For Spring Malaria, add Fangfeng, Gange, Baizhi (each 1 qian).
For Summer Malaria, add Huanglian, Bidou (each 1 qian), Xiangru (1 qian).
For Autumn Malaria, add Zhimu, Guishen, Beimu, Xingren, Maidong (each 1 qian).
For Winter Malaria, add Xingren (1 qian), Guizhi (0.8 qian), Ganjiang (0.7 qian); for more cold, add Dingxiang (0.5 qian).
If long-term mild chills/fever or only slight heat without cold, the pathogen is exhausted. In summer, use Qingshu Yiqi Tang (Clear Summerheat and Boost Qi Decoction). In other months, use Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction), add Maidong, Huangbai, Zhimu (each 0.8 qian) to tonify Qi and Blood. Post-interception regulation follows this principle.
Another Formula: Jie Nue Dan (Malaria-Intercepting Pill) is miraculous for all malarias, proven effective.
Renshen (2 liang, remove rhizome), Xionghuang (1.6 liang, ground separately), Chensha (6 qian, ground separately).
Grind the three ingredients into powder, weigh accurately. On the fifth day of the fifth month, make pills from Zong rice of five families, size of beans. Adults: 10 pills; Children: 5 pills. On the attack day, at dawn, take on empty stomach, delivered with Qinghao decoction made with Wugen water (rainwater/snowwater). Avoid raw/cold foods, chicken, and fish for one month.