尝读《内经·疟论》，治法独详，分十二经见证，以荣卫为纲领，以气血分阴阳，而察外
感、内伤之偏盛。若其人阳盛则发热，阴甚则恶寒。以膜原居表里之界，入于卫气所行之度
数，互相争拒，则寒热往来；其少阳为半表半
里之枢，与膜原接壤，外象似乎疟由少阳为传舍，庸俗遂拘执小柴胡汤为治疟专方，其不思
之甚矣。仲景《金匮》云∶疟脉自弦，弦数者多热，弦迟者多寒。以中土有邪，木易顺乘故也。
夫疟有寒温、瘅牡、虚实之分，其作止有定时。邪浅一日一作，或间日、或三日一作者，谓之
阴疟，因邪在阴分，留连难愈。大抵治疟之法，调和荣卫，毋使阴阳偏盛，酌用寒温之方，以
平调之。然必辨其感、伤、虚、实之因，审其宜汗、下、消、补之剂。如邪伏于阴，用升清之药
提之出阳，自无坚结之患。大法已备，细心揣度，则思过半矣。
至于咳嗽之因，不外寒、热、虚、实之邪，挟风邪袭于肺、胃。肺、胃之邪上乾清道，则咳
嗽作矣。《内经》云∶五脏六腑皆令人咳。又云∶聚于肺，关于胃也。盖肺为清肃之脏，不容丝
毫外邪，干之则咳嗽、气逆，甚则喘息、失音，延成痨瘵，不治者多矣。余治外感寒邪，每用
小青龙汤减其分量，如麻黄、干姜各一钱，细辛五分，制半夏钱半，五味子四分，炒芍一钱，
甘草五分，桂枝六分后入，并随症加减，如热甚加杏仁、石膏，去干姜、桂枝，莫不应手取
效。如风热甚者，麻、杏、石膏、甘草、海石、枇杷叶等，亦多取效。斯皆余之心法，随笔记之，
以期后进得其指归云。
澜按∶咳嗽一症，《内经》言之详矣。六淫外邪，风寒最多，先生用小青龙汤治寒嗽，系
实验心得。至疟疾，因寒热往来为少阳见证，世医不明，往往拘执小柴胡汤为主方，随症加
减，与《内经》、《金匮》分寒、热、虚、实、瘅、牡等名，大相迳庭。先生阐明其误，以济人为怀，
不啻大声疾呼，以启后学之悟焉。
我曾阅读《黄帝内经·疟论》，其中关于疟疾的治疗方法论述得非常详尽，将症状分为十二经脉的表现，以营卫之气作为纲领，通过气血来区分阴阳，并考察外感病与内伤病的偏盛情况。如果患者阳气旺盛则表现为发热，阴气极盛则表现为恶寒。由于膜原（位于半表半里的间隙）处于表里之间，当邪气进入卫气运行的度数范围时，正邪相互争斗抗拒，就会出现忽冷忽热的症状；少阳经是半表半里的枢纽，与膜原相邻，外表看起来似乎疟疾是由少阳经传变而来，因此庸俗的医生便固执地认为小柴胡汤是治疗疟疾的专用方剂，这真是太不深思熟虑了。张仲景在《金匮要略》中说：疟疾的脉象自然呈现弦象，脉弦数者多热，脉弦迟者多寒。这是因为中焦脾胃有邪气干扰，肝木容易顺势克制脾土的缘故。
疟疾有寒疟、温疟、瘅疟、牡疟以及虚实之分，其发作和停止都有固定的时间。邪气较浅，一日发作一次，或者隔日、三日发作一次的，称为阴疟，因为邪气停留在阴分，缠绵难愈。大抵治疗疟疾的方法，在于调和营卫，不让阴阳偏盛，酌情使用寒性或温性的方剂来平衡调理。但必须辨别是感受、内伤还是虚证、实证的病因，审慎选择适合发汗、攻下、消导或补益的药剂。如果邪气潜伏在阴分，就用升提清阳的药物将其引出阳分，自然就没有顽固结聚的隐患。基本法则已经具备，只要细心揣摩推演，就掌握了一半以上的要领了。
至于咳嗽的原因，不外乎寒、热、虚、实等邪气，挟带风邪侵袭肺脏和胃腑。肺、胃中的邪气向上侵犯清肃之道，咳嗽就会发作。《黄帝内经》说：五脏六腑都能让人产生咳嗽。又说：邪气聚集于肺，关联于胃。因为肺是清肃之脏，不容许丝毫外邪干扰，一旦受扰就会导致咳嗽、气逆，严重时出现喘息、失音，拖延成痨瘵（慢性消耗性疾病），不治而死的很多。我治疗外感寒邪引起的咳嗽，通常用小青龙汤减少剂量，如麻黄、干姜各一钱，细辛五分，制半夏一钱半，五味子四分，炒白芍一钱，甘草五分，桂枝六分后下，并根据症状加减。如果热势严重，加杏仁、石膏，去掉干姜、桂枝，没有不随手见效的。如果是风热严重的，用麻黄、杏仁、石膏、甘草、海浮石、枇杷叶等药，也大多能取得疗效。这些都是我的心得方法，随手记录下来，希望后来的人能得其宗旨。
澜按语：咳嗽这一症状，《黄帝内经》已经论述得很详细了。六淫外邪中，风寒最多。先生用小青龙汤治疗寒性咳嗽，这是经过实践检验的心得体会。至于疟疾，因为寒热往来是少阳经的典型症状，世间的医生不明白这一点，往往固执地将小柴胡汤作为主方，随症加减，这与《黄帝内经》、《金匮要略》中区分寒、热、虚、实、瘅、牡等名称的做法，大相径庭。先生阐明了其中的错误，怀着救济人的情怀，无异于大声疾呼，以启发后学的领悟。
I once read the *Neijing·Mallun* (Treatise on Malaria) from the *Huangdi Neijing* (Yellow Emperor's Inner Canon), where the treatment methods are described in great detail. Symptoms are categorized according to the twelve meridians, using Ying and Wei (Nutritive and Defensive Qi) as the guiding principle, distinguishing Yin and Yang through Qi and Blood, and examining the predominance of Exogenous (Wai Gan) or Endogenous (Nei Shang) pathogens. If a person has excess Yang, they will experience fever; if Yin is excessive, they will experience aversion to cold. Since the Mo Yuan (Membrane Source, a space between the exterior and interior) lies at the boundary of the exterior and interior, when pathogens enter the realm of Wei Qi circulation, the struggle and resistance between the pathogen and healthy Qi result in alternating chills and fever. The Shaoyang (Lesser Yang) meridian serves as the pivot of the half-exterior and half-interior region and is adjacent to the Mo Yuan. Superficially, it seems that malaria transmits via the Shaoyang meridian, leading unskilled physicians to rigidly adhere to Xiaochaihu Tang (Minor Bupleurum Decoction) as the exclusive formula for treating malaria, which shows a profound lack of deep thought. Zhang Zhongjing stated in the *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet): "The pulse of malaria is naturally wiry (Xian). A wiry and rapid pulse indicates much heat; a wiry and slow pulse indicates much cold." This occurs because pathogens in the Middle Jiao (Central Earth/Spleen-Stomach) allow Liver Wood to easily overact upon Spleen Earth.
Malaria is classified into Cold Malaria, Warm Malaria, Dan Malaria, Mu Malaria, and Deficiency-Excess types, with attacks occurring and ceasing at fixed times. When the pathogen is shallow, it may attack daily, or every other day, or every third day; this is called Yin Malaria, because the pathogen resides in the Yin aspect and lingers, making it difficult to cure. Generally, the method for treating malaria involves harmonizing Ying and Wei Qi to prevent Yin-Yang imbalance, and judiciously using cold or warm formulas to achieve balance. However, one must distinguish the etiology—whether it stems from exogenous invasion, endogenous injury, deficiency, or excess—and carefully select appropriate diaphoretic (sweating), purgative (downward-draining), resolving, or tonifying agents. If the pathogen is latent in the Yin aspect, use herbs that ascend and clear Yang to extract it to the Yang aspect, thereby avoiding stubborn accumulation. With these general principles established, careful contemplation allows one to grasp more than half of the essence.
Regarding the causes of cough, they do not extend beyond pathogens of Cold, Heat, Deficiency, and Excess, often accompanied by Wind invading the Lung and Stomach. When pathogens in the Lung and Stomach ascend to interfere with the Clear Orifices, cough arises. The *Neijing* states: "All five Zang organs and six Fu organs can cause cough." It also says: "Pathogens gather in the Lung and relate to the Stomach." The Lung is a pure and descending organ, tolerating no external pathogenic intrusion. Interference leads to cough and rebellious Qi, and in severe cases, panting and loss of voice, potentially progressing to Lao Zhai (Consumption/Tuberculosis), with many dying without treatment. In my treatment of cough caused by exogenous Cold, I typically use Xiao Qinglong Tang (Minor Blue-Green Dragon Decoction) with reduced dosages: Ephedrae Herba (Mahuang) and Zingiberis Rhizoma Recens (Ganjiang/Dried Ginger) each 1 qian, Asari Radix (Xixin) 0.5 qian, Pinelliae Rhizoma Praeparatum (Zhi Banxia) 1.5 qian, Schisandrae Fructus (Wuweizi) 0.4 qian, Paeoniae Radix Alba (Chao Shaoyao) 1 qian, Glycyrrhizae Radix et Rhizoma (Gancao) 0.5 qian, and Cinnamomi Ramulus (Guizhi) 0.6 qian added later. Modifications are made based on symptoms: if heat is severe, add Armeniacae Semen Amarum (Xingren) and Gypsum Fibrosum (Shigao), removing Dried Ginger and Cinnamon Twig; such treatments invariably yield immediate results. For severe Wind-Heat, combinations of Mahuang, Xingren, Shigao, Gancao, Haifushi (Floating Stone/Pumice), and Loquat Leaf (Pipaye) also frequently prove effective. These are my clinical insights, recorded here so that future practitioners may find their way.
Commentary by Lan: The symptom of cough is discussed in detail in the *Neijing*. Among the Six Evils (Liu Yin) exogenous pathogens, Wind and Cold are most common. Mr. [the author] uses Xiao Qinglong Tang to treat Cold-type cough, which is an insight derived from practical experience. Regarding malaria, since alternating chills and fever are manifestations of the Shaoyang pattern, many contemporary physicians fail to understand this and rigidly adhere to Xiaochaihu Tang as the primary formula, modifying it case by case. This approach stands in stark contrast to the classifications of Cold, Heat, Deficiency, Excess, Dan, and Mu found in the *Neijing* and *Jingui Yaolue*. Mr. elucidates these errors with a heart dedicated to saving people, akin to a loud call to awaken future students.