典藏书目

Western medicine posits that individuals who die from malaria often have livers two to three times larger than normal; thus, if a malaria patient presents with an enlarged liver upon palpation, the condition is deemed incurable. The enlargement of the liver is caused by the prevalence of cold-dampness leading to blood stasis. When cold-dampness abounds internally, combined with the daily alternation of chills and fever, blood circulation becomes erratic—alternating between rapid flow and stagnation—with its rhythm disrupted, thereby resulting in the accumulation of stasis. Western medicine considers this to be what Traditional Chinese Medicine (TCM) calls "malaria mother" (a mass associated with chronic malaria), but this is incorrect. "Malaria mother" is not necessarily a fatal syndrome, and its location is mostly below the mammary region, far from the actual anatomical position of the liver. I believe that patients with liver enlargement must exhibit external symptoms such as distending pain in the waist and hypochondrium, and an inability to turn or move their bodies. Zhang Zhongjing stated: In cases where wind-pathogen invades the Liver channel, there is dizziness and visual disturbance, pain in both hypochondriac regions, a stooped gait, a craving for sweet flavors, and a posture resembling pregnancy. He also stated: In Liver Water disease (fluid retention in the Liver), the abdomen is distended, the patient cannot turn over independently, there is pain in the hypochondrium and abdomen, slight generation of fluids occurs occasionally, and urination is intermittent. This is because the physical body of the Liver lies posteriorly near the spine and inferiorly within the costal margin; once it swells, it becomes stiff and painful, preventing flexion, extension, and rotation. In severe cases, the waist cannot straighten, leading to a stooped walk; when the Liver fails, Qi connection between upper and lower parts is severed, resulting in lower-body symptoms such as fecal incontinence, passage of five-colored fluids, pus, blood, and fatty substances in urine, frequent urges to rise accompanied by restlessness, spasticity and insensitivity in the lower abdomen, bilateral ribs feeling as if beaten, extreme distension in the hypochondrium relieved by firm pressure, spasms in the knees and shins, coma with delirious speech, vomiting and hiccups preventing food and water intake, eyes staring fixedly as if protruding, aversion to seeing people, cyanosis of lips and nose, or purple-turbid complexion, and a deep, firm pulse hard like an iron chopstick. Such conditions indicate a short life expectancy. The so-called "palpation test" refers to examining the hollow area of the costal margin; if the interior feels hard and tense, it indicates liver enlargement. Having grasped this principle, whenever treating malaria, I always inquire whether the patient experiences distending pain in the waist and hypochondrium with restricted movement before the onset or after the cessation of the attack; if so, the liver substance is already enlarged. If, during the active phase, there is hypochondriac pain that resolves immediately upon the cessation of malaria, it indicates that the blood has not yet deteriorated. In such cases, I preemptively add blood-invigorating herbs to the prescription to promote circulation, often achieving remarkable effects silently. People of the time, unaware of the rationale behind medication, sometimes criticize this approach as eccentric, fragmented, or unsound.