吕沧洲治经历哈散侍人病喘不得卧，众作肺气受风邪治之。吕诊之气口盛于人迎一
倍，厥阴弦动而疾，两尺俱短而离经。因告之曰∶病盖得之毒药动血，以致胎死不下，奔
迫而上冲，非风寒作喘也。乃用催生汤加芎、归煮二三升服之，夜半果下一死胎，喘即止。
哈散密嘱曰∶病外家诚有怀，以室人见嫉，故药去之，众所不知也。众惭而去。
平安散 治妊娠上气喘急，大便不通，呕吐不食，腹胁胀痛。
川芎 木香（各一钱半） 陈皮 熟地黄（洗）
干姜（炮） 生姜 浓朴（去粗皮，制。炒） 甘草（各一钱）
上作一服，水二盅，入烧盐一捻，煎至一盅，不拘时服。
桔梗汤 马兜铃散（并见前咳嗽条。）
〔大〕妊娠病疟，乃夏伤于暑，客于皮肤，至秋而发，阳盛则热，阴盛则寒，阴阳
相离，寒热俱作。其发晏者，由风邪客于风府，循膂而下，卫气至一日一夜常大会于风
府，故发日晏与早者，卫气之行风府，日下一节，二十一日下至尾 ，二十二日入脊内，
上注于伏冲之脉，其行九日，出缺盆。其气既止，故发更早。其间日发者，风邪内搏五
脏，横连募原，其道远，其气深，其行迟，不能日作也。妊娠而发，多伤于胎。
〔薛〕前证因脾胃虚弱，饮食停滞，或外邪所感，或郁怒伤脾，或暑邪所伏。审系
饮食停滞，用六君子加桔梗、苍术、藿香。外邪多而饮食少，用藿香正气散。（杂病中风。）外
邪少而饮食多，用人参养胃汤。（杂疟。）劳伤元气，用补中益气汤。（杂劳倦。）若郁怒所伤，用
小柴胡汤（伤寒少阳病。）兼归脾汤。（健忘。）若木侮土，久而不愈，用六君子为主，佐以安胎药。
仍参三阴三阳经而治之。一妇人因怒患疟，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。一妊妇疟久不已，嗳气下气，胸腹膨胀，食少欲呕，便
血少寐。此属肝脾郁怒，用归脾汤加柴胡、山栀渐愈；又用六君子汤加柴胡、山栀、升麻
而愈。一妊妇患疟已愈，但寒热少食，头痛晡热内热，此脾虚血弱也。用补中益气汤
加蔓荆子，头痛顿止；又用六君子汤加芎、归，饮食顿进；再用逍遥散加参、术而寒热愈。
驱邪散 治妊娠停食感冷，发为疟疾。
白术 草果仁 高良姜（炒） 缩砂仁 藿香叶 橘红 白茯苓（去皮，各一钱半）
甘草（炙，五分）
上作一服，水二盅，生姜五片，红枣一枚，煎一盅，不拘时服。
七宝散 治男妇一切疟疾，或先寒后热，或先热后寒，或寒多热少，或热多寒少，或
一日一发，或一日两三发，或连日发，或间日发，或三四日一发，不问鬼疟、食疟，不
伏水土，山岚瘴气似疟者，并皆治之。
常山 浓朴（姜制） 青皮 陈皮（并不去白） 甘草 槟榔 草果（去皮，各等分）
咀，每服半两，于未发隔夜，用水酒各一盏，煎至一大盏，去滓露一宿，再用酒
水煎滓次，去滓亦露一宿，来日当发之早，烫温面东先服头药，少顷再服药滓，大有神效。
予尝治一妊妇，六七个月患疟，先寒后热，六脉浮紧，医用柴胡、桂枝无效。予曰∶此
非常山不愈。众医难之，越数日疾甚，乃从予治，以七宝散一服瘥。黄帝问∶妇人重身，
毒之奈何？岐伯曰∶有故无殒。帝曰∶何谓也，岐伯曰∶大积大聚，其可犯也，衰其大
半而止。诚审药物之性，明治疗之方，何疑攻治哉。
柴胡散 治妊娠疟疾。
柴胡（二钱） 生大黄（二钱） 生黄芩（一钱半） 甘草（一钱）
上 咀作一服，水煎，临发日五更温服，必取利为愈。如胎上逼心，可服枳壳散。忌
油面辛热等物。
又方
用大黄（二两） 柴胡（一两半） 黄芩（一两） 芍药（一两）
为细末，清水糊为丸，如梧桐子大。每服百丸，临发日五更冷汤吞下，隔两时再服
五十丸，以利为度。
若妊娠疟疾，发热口干，渴饮无度者，亦用。
生地黄（一两半） 黄芩 麦门冬（去心） 人参 知母（各一两） 石膏（二两） 甘草（半两）
干葛
（一两）
上 咀，每服五钱，入乌梅（半个） 煎服。
又方
用常山（一两） 石膏（一两） 甘草（炙） 黄芩（各半两） 乌梅（七个）
细切，以水酒各一碗，浸一宿，平旦煎至一碗，去滓分二服，临发时服。
上方犯常山、大黄吐下之剂，若六脉浮紧有力，中有顽痰积热者用之，所谓有故无
殒也。其他疗治方法，已备杂证疟门，兹不赘。若热甚恐致动胎者，亦如伤寒热病治法，
以白药子、伏龙肝等，涂脐上下可也。
吕沧洲治疗经历哈散侍从人员的喘息病，患者无法平卧，众人将其作为肺气受风邪所致来治疗。吕沧洲诊察发现，患者的气口脉比人迎脉大一倍，厥阴脉弦动且急促，两尺脉均短促且偏离正常经气（离经脉）。于是告诉他们说：这病大概是由于服用毒药导致出血，致使胎死腹中不能排出，胎气上冲逼迫肺部，并非风寒引起的喘息。于是使用催生汤加入川芎、当归煎煮二三升让患者服用，半夜果然排出一枚死胎，喘息随即停止。哈散私下告知说：患病者的妻子确实曾怀孕，因为正妻嫉妒，所以用药使其流产，这是众人所不知道的。众医生惭愧地离开了。
平安散 治疗妊娠期间上气喘急，大便不通，呕吐不能进食，腹部和胁肋胀痛。
川芎、木香（各一钱半）、陈皮、熟地黄（洗净）、干姜（炮制）、生姜、浓朴（去除粗皮，炮制，炒）、甘草（各一钱）
以上药物为一服量，用水二盅，加入烧红的盐一撮，煎至一盅，不限时间服用。
〔大〕妊娠期间的疟疾病，是因为夏季感受暑邪，邪气潜伏在皮肤，到了秋季发作。阳气盛则发热，阴气盛则发冷，阴阳分离，寒热同时出现。发作时间较晚的，是因为风邪客居在风府穴，沿着脊柱向下行走，卫气一天一夜常在风府穴大会，所以发作早晚不同，是因为卫气在风府穴的运行，每天下降一节，二十一天下降到尾骶骨，二十二天进入脊内，向上注入伏冲脉，运行九天，出于缺盆穴。当这股气停止后，发作就会更早。隔日发作的，是因为风邪内迫五脏，横向连接募原，其路径远，邪气深，运行缓慢，不能每日发作。妊娠期间发作疟疾，多会损伤胎儿。
〔薛〕上述症状是因为脾胃虚弱，饮食停滞，或外邪侵袭，或郁怒伤脾，或暑邪潜伏。如果是饮食停滞，使用六君子汤加桔梗、苍术、藿香。外邪多而饮食停滞少，使用藿香正气散。（杂病中风门。）外邪少而饮食停滞多，使用人参养胃汤。（杂疟门。）劳伤元气，使用补中益气汤。（杂劳倦门。）如果是因郁怒所伤，使用小柴胡汤（伤寒少阳病证），兼用归脾汤（治疗健忘）。如果肝木克制脾土，久而不愈，以六君子汤为主，佐以安胎药。仍需参考三阴三阳经进行辨证治疗。有一位妇女因愤怒患疟疾，发作没有定期，久治不愈，胸腹不适，饮食减少，吞酸吐痰。使用六君子汤加柴胡、山栀，二十多剂后逐渐痊愈。但傍晚发热、食欲少，又用四君子汤加柴胡、升麻为主，佐以逍遥散而康复。一位孕妇疟疾久治不愈，嗳气排气，胸腹膨胀，食少欲呕，便血睡眠少。这属于肝脾郁怒，使用归脾汤加柴胡、山栀逐渐好转；后又用六君子汤加柴胡、山栀、升麻而痊愈。一位孕妇患疟疾已愈，但仍有寒热、食欲少、头痛、傍晚发热及内热，这是脾虚血弱。使用补中益气汤加蔓荆子，头痛立刻停止；又用六君子汤加川芎、当归，饮食立刻增进；再用逍遥散加人参、白术，寒热症状痊愈。
驱邪散 治疗妊娠期间停食感冷，引发疟疾。
白术、草果仁、高良姜（炒）、缩砂仁、藿香叶、橘红、白茯苓（去皮，各一钱半）、甘草（炙，五分）
以上药物为一服量，用水二盅，生姜五片，红枣一枚，煎至一盅，不限时间服用。
七宝散 治疗男女各种疟疾，或先寒后热，或先热后寒，或寒多热少，或热多寒少，或一日一发，或一日两三发，或连日发，或间日发，或三四日一发，不论鬼疟、食疟，不服水土，山岚瘴气类似疟疾者，都进行治疗。
常山、浓朴（姜制）、青皮、陈皮（都不去白）、甘草、槟榔、草果（去皮，各等分）
捣碎，每次服用半两，在发作前一晚，用水酒各一盏，煎至一大盏，去渣露置一夜，再用酒水煎药渣第二次，去渣也露置一夜，第二天发作前早晨，面向东方先服第一次药，过一会儿再服药渣，效果显著。
我曾经治疗一位孕妇，怀孕六七个月患疟疾，先寒后热，六脉浮紧，医生使用柴胡、桂枝无效。我说：这不是常山不能治愈。众医感到为难，过了几天病情加重，才听从我的治疗，服用七宝散一次即痊愈。黄帝问：妇人怀孕，可以用毒药攻伐吗？岐伯说：有病则病受之，不会伤害母体。黄帝说：这是什么意思？岐伯说：有大积大聚的病，可以攻伐，但病势减半就要停止。确实要审慎药物的性质，明确治疗的方剂，对攻治还有什么怀疑呢。
柴胡散 治疗妊娠疟疾。
柴胡（二钱）、生大黄（二钱）、生黄芩（一钱半）、甘草（一钱）
以上药物捣碎为一服量，水煎，在发作当天五更天时温服，必须通过泻下才能痊愈。如果胎气上逼心脏，可以服用枳壳散。忌食油面、辛辣温热等食物。
又一方
使用大黄（二两）、柴胡（一两半）、黄芩（一两）、芍药（一两）
研为细末，清水调糊制成丸药，如梧桐子大小。每次服用一百丸，在发作当天五更时用冷开水吞服，隔两个时辰再服五十丸，以泻下为度。
如果妊娠疟疾，发热口干，渴饮无度的，也可以使用。
生地黄（一两半）、黄芩、麦门冬（去心）、人参、知母（各一两）、石膏（二两）、甘草（半两）、干葛（一两）
以上药物捣碎，每次服用五钱，加入乌梅（半个）煎服。
又一方
使用常山（一两）、石膏（一两）、甘草（炙）、黄芩（各半两）、乌梅（七个）
切碎，用水酒各一碗，浸泡一夜，天亮时煎至一碗，去渣分两次服用，在发作时服用。
上方含有常山、大黄等引起呕吐和泻下的药剂，如果六脉浮紧有力，体内有顽痰积热的，可以使用，这就是所谓的“有病则病受之”。其他治疗方法，已在杂病疟疾门类中备述，此处不再赘述。如果热势很盛担心导致动胎的，也像治疗伤寒热病的方法一样，用白药子、伏龙肝等药物，涂抹在脐部上下即可。
Lu Cangzhou treated a servant of Jingli Hasan who suffered from asthma (asthma) and could not lie down. The physicians generally treated it as lung Qi affected by wind pathogen (wind pathogen). Lu diagnosed that the Qi Kou pulse was one times larger than the Ying Ren pulse, the Jue Yin pulse was wiry, moving, and rapid, and both Chi pulses were short and deviated from the normal meridian qi (Li Jing Mai). He then informed them: "This illness is likely caused by toxic drugs inducing bleeding, resulting in a dead fetus retained in the uterus. The fetal Qi rushes upward, compressing the lungs, rather than being asthma caused by wind-cold." He then used Cui Sheng Tang (Delivery Decoction) added with Chuanxiong Rhizome (Chuanxiong) and Angelicae Sinensis Radix (Danggui), boiled two to three sheng, and administered it. At midnight, a dead fetus was indeed expelled, and the asthma stopped immediately. Hasan privately instructed: "The patient's wife was indeed pregnant. Because the principal wife was jealous, she used drugs to terminate the pregnancy. This was unknown to others." The other physicians left in shame.
Ping An San (Peaceful Safety Powder) treats asthma and rapid breathing during pregnancy, accompanied by constipation, vomiting, inability to eat, and abdominal and hypochondriac distension and pain.
Chuanxiong Rhizome (Chuanxiong), Aromatic Tuber (Muxiang) (each 1.5 qian), Tangerine Peel (Chenpi), Prepared Rehmannia Root (Shudihuang) (washed), Fried Ginger (Ganjiang), Fresh Ginger (Shengjiang), Prepared Magnolia Bark (Noupo) (coarse bark removed, processed, stir-fried), Licorice Root (Gancao) (each 1 qian).
Take as one dose, add two zhong of water and a pinch of burnt salt, decoct until one zhong remains, take at any time.
Jiegeng Tang (Platycodon Decoction) and Madouling San (Aristolochia Powder) (both see previous section on cough).
[Da] Malaria during pregnancy occurs due to summer-heat injury in summer, with pathogens lodging in the skin, manifesting in autumn. When Yang is excessive, there is heat; when Yin is excessive, there is cold. When Yin and Yang separate, both cold and heat appear simultaneously. If the onset is late, it is because wind pathogen lodges in Fengfu (GV16), traveling down along the spine. Wei Qi (Defensive Qi) gathers at Fengfu once every day and night. Thus, the variation in onset time depends on the daily descent of Wei Qi at Fengfu by one vertebral segment. After twenty-one days, it reaches the coccyx; on the twenty-second day, it enters the spine, ascends into the Fuchong Mai (Confluent Vessel), travels for nine days, and emerges at Quepen (LI12). Once this Qi stops, the onset becomes earlier. For every-other-day attacks, the wind pathogen internally combats the five Zang organs and horizontally connects to the Mu Yuan (Sea of Origin). The path is distant, the Qi is deep, and its movement is slow, preventing daily attacks. Pregnancy malaria often injures the fetus.
[Xue] The aforementioned symptoms are due to Spleen and Stomach deficiency, food stagnation, external pathogen invasion, liver Qi stagnation injuring the Spleen, or latent summer-heat. If due to food stagnation, use Liu Jun Zi Tang (Six Gentlemen Decoction) added with Platycodon Root (Jiegeng), Atractylodes Macrocephala Rhizome (Cangzhu), and Agastache Herba (Huoxiang). If external pathogens are predominant and food stagnation is minor, use Huoxiang Zhengqi San (Agastache Powder to Rectify the Qi). If external pathogens are minor and food stagnation is significant, use Renshen Yangwei Tang (Ginseng Decoction to Nourish the Stomach). If Qi is damaged by overexertion, use Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi). If injured by anger/liver Qi stagnation, use Xiaochaihu Tang (Minor Bupleurum Decoction) combined with Guipi Tang (Restore the Spleen Decoction). If Liver Wood insults Spleen Earth and persists, use Liu Jun Zi Tang as the base, assisted by fetal-calming herbs. Treatment should still reference the Three Yin and Three Yang meridians. One woman developed malaria due to anger, with irregular onset, persisting for a long time, causing chest/abdominal discomfort, poor appetite, acid regurgitation, and phlegm expectoration. She was treated with Liu Jun Zi Tang added with Bupleurum Root (Chaihu) and Gardenia Fruit (Shanzhi) for over twenty doses, gradually recovering. However, with afternoon fever and poor appetite, she was treated with Sizhunzi Tang (Four Gentlemen Decoction) added with Chaihu and Cimicifugae Rhizoma (Shengma) as the main formula, assisted by Xiaoyao San (Free and Easy Wanderer Powder), leading to recovery. A pregnant woman had persistent malaria, belching, flatulence, abdominal distension, poor appetite, nausea, blood in stool, and insomnia. This belonged to Liver-Spleen Qi stagnation due to anger. She was treated with Guipi Tang added with Chaihu and Shanzhi, gradually improving; subsequently treated with Liu Jun Zi Tang added with Chaihu, Shanzhi, and Shengma, leading to full recovery. Another pregnant woman recovered from malaria but had chills/fever, poor appetite, headache, afternoon fever, and internal heat. This indicated Spleen deficiency and Blood weakness. She was treated with Buzhong Yiqi Tang added with Vitex Fruit (Manjingzi), and the headache ceased instantly; then treated with Liu Jun Zi Tang added with Chuanxiong and Danggui, and appetite improved instantly; finally treated with Xiaoyao San added with Ginseng (Renshen) and Atractylodes Macrocephala Rhizome (Baizhu), resolving the chills and fever.
Quxie San (Evil-Expelling Powder) treats pregnancy complicated by food retention and cold invasion, leading to malaria.
Atractylodes Macrocephala Rhizome (Baizhu), Areca Seed (Caoguoren), Greater Galangal Rhizome (Gaoliangjiang) (stir-fried), Amomum Fruit (Suosharen), Agastache Leaf (Huoxiangye), Exocarpium Citri Reticulatae (Juhong), Poria (Baifuling) (peeled, each 1.5 qian), Licorice Root (Gancao) (honey-fried, 0.5 qian).
Take as one dose, add two zhong of water, five slices of fresh ginger, and one red date, decoct until one zhong remains, take at any time.
Qibao San (Seven Treasures Powder) treats all types of malaria in men and women, whether presenting with chills first then fever, fever first then chills, more chills than fever, or more fever than chills; occurring once a day, two to three times a day, consecutive days, every other day, or every three to four days. It treats ghost malaria, food malaria, maladaptation to climate, and mountain miasma resembling malaria.
Dichroa Root (Changshan), Magnolia Bark (Noupo) (processed with ginger), Green Tangerine Peel (Qingpi), Tangerine Peel (Chenpi) (do not remove white pith), Licorice Root (Gancao), Betel Nut (Binglang), Areca Seed (Caoguo) (peeled, equal parts).
Coarsely crush. Take 0.5 liang per dose. On the eve before onset, decoct with one zhong of water and one zhong of wine until one large zhong remains. Strain and leave exposed overnight. Decoct the dregs again with water and wine, strain, and leave exposed overnight. On the morning of onset, face east and drink the first decoction while warm. Shortly after, consume the second decoction (dregs). This has great efficacy.
I once treated a pregnant woman of six to seven months suffering from malaria with chills first then fever. Her six pulses were floating and tight. Physicians used Chaihu and Gui Zhi Tang (Cinnamon Twig Decoction) without effect. I said: "Only Changshan can cure this." The physicians hesitated. Days later, the condition worsened, and they accepted my treatment. One dose of Qibao San cured her. The Yellow Emperor asked: How should toxic substances be used in pregnancy? Qibo answered: If there is an existing pathology, the mother will not be harmed. The Emperor asked: What does this mean? Qibo said: In cases of massive accumulation, attack may be used, but stop when the pathogenic factor is reduced by more than half. If one carefully studies drug properties and clarifies treatment methods, what is there to doubt regarding attack therapies?
Chaihu San (Bupleurum Decoction) treats pregnancy malaria.
Bupleurum Root (Chaihu) (2 qian), Raw Rhubarb (Sheng Dahuang) (2 qian), Raw Scutellaria Root (Sheng Huangqin) (1.5 qian), Licorice Root (Gancao) (1 qian).
Coarsely crush for one dose. Decoct in water. Take warm at wu geng (3-5 AM) on the day of onset. Recovery requires purgation. If the fetus presses against the heart, Zhike San (Citrus Aurantium Powder) can be taken. Avoid oily noodles, spicy, and hot foods.
Another prescription:
Raw Rhubarb (2 liang), Bupleurum Root (1.5 liang), Scutellaria Root (1 liang), Peony Root (1 liang).
Grind into fine powder, make pills with clear water paste, size of Sophora seeds. Take 100 pills on the morning of onset with cold water. Take another 50 pills two hours later. Stop when purged.
This is also used if pregnancy malaria presents with fever, dry mouth, and excessive thirst.
Rehmannia Root (Sheng Dihuang) (1.5 liang), Scutellaria Root (Huangqin), Ophiopogon Tuber (Maidong) (core removed), Ginseng (Renshen), Anemarrhena Rhizome (Zhimu) (each 1 liang), Gypsum (Shigao) (2 liang), Licorice Root (Gancao) (0.5 liang), Kudzu Root (Gegen) (1 liang).
Coarsely crush. Take 5 qian per dose, add half a Chinese Plum (Wumei), decoct and take.
Another prescription:
Dichroa Root (Changshan) (1 liang), Gypsum (Shigao) (1 liang), Licorice Root (Gancao) (honey-fried), Scutellaria Root (Huangqin) (each 0.5 liang), Chinese Plum (Wumei) (7 fruits).
Cut finely. Soak overnight in one bowl of water and one bowl of wine. Decoct at dawn until one bowl remains. Strain and divide into two doses. Take at the time of onset.
The above formulas contain Changshan and Dahuang, which induce vomiting and purging. They are used when the six pulses are floating, tight, and forceful, indicating stubborn phlegm and accumulated heat. This exemplifies "if there is pathology, the mother is not harmed." Other treatments are detailed in the miscellaneous diseases malaria section and are not repeated here. If heat is severe and risks disturbing the fetus, treat similarly to cold damage heat diseases: apply Baoyaozi (Stemonae Tubera) or Fulonggan (Dragon's Liver) around the navel.