瓜沥杨 太阴湿疟，脉弦濡细，面跗浮，食人脘中胀闷。姑宜渗湿和中（十月十七日。）
草果仁（一钱） 桂枝（八分） 生香附（三钱） 仙半夏（钱半） 浓朴（钱半） 酒炒淡芩（
钱半） 滑石（四钱） 蔻壳（钱半） 枣槟（三钱） 威灵仙（钱半） 栝蒌皮（三钱）
清煎三帖。
又 疟邪犹来，脉弦濡，舌滑，湿热未清，仍遵前法加减为妥。
草果（一钱，去壳） 桂枝（八分） 炒茅术（钱半） 酒炒常山（一钱） 浓朴（钱半） 酒炒
淡芩
（钱半） 炒青皮（八分） 新会皮（钱半） 枣槟（三钱） 姜半夏（钱半） 赤苓（四钱） （引）老
姜（三片）
三帖。
介按∶湿疟治法，当辨湿重于热者，藿朴二陈汤加减。热重于湿者，苍术白虎汤加减。
此方系从达原饮加以渗湿之品，洵是湿重热轻之正法。
安昌陈 气虚邪留，寒热久羁。脉虚左弦。夜寐少安。姑宜补中益气汤加减。（四月三
十号甲辰十四日。）
东洋参（钱半） 江西术（一钱） 制首乌（三钱） 秦艽（钱半） 酒炒柴胡（八分） 陈皮（
钱半辰砂拌） 茯神（四钱） 威灵仙（钱半） 当归（钱半） 清炙 （三钱） 远志肉（八分）
清煎四帖。
又 益气升阳。寒热较差，脉虚，按之弦细，邪犹未净，仍遵前法加减为妥（五月九号
甲辰二十三日。）
东洋参（钱半） 升麻（五分） 仙半夏（钱半） 制首乌（三钱） 酒炒柴胡（八分） 陈皮（
钱半）
炒江西术（钱半） 淮牛膝（三钱） 当归（二钱） 清炙 （三钱） 炙甘草（八分） （引）红枣
（四枚）
四帖。
介按∶柯韵伯曰∶李杲知其为劳倦伤脾，谷气不胜，阳气下陷阴中而发热，制补中益气
之法
。又曰∶凡脾胃一虚，肺气先绝，故用黄 固皮毛护腠理，不令自汗，元气不足，懒言气喘
，人参以补之，炙甘草之甘以泻心火而除烦，补脾胃而生气。此三味除烦热之圣药也。佐白
术以健脾，当归以和血，气乱于中，清浊相干，用陈皮以理之，且以散诸甘药之滞，胃中清
气下陷，用柴胡、升麻气之轻而味之薄者，引胃气以上腾，复其本位，便能升浮以行生长之
令矣。今此案系是气虚邪留，疟久不愈，用补中益气汤以升脾胃之清气。初因夜不安寐，故
加茯神、远志以安神，因其寒热久羁，又加首乌、灵丹、秦艽以退邪，次方参入半夏、牛膝
等味，退邪补虚，标本兼顾，洵是虚疟之良方。后悉此人，年已四旬以外，患疟年余，服此
方数剂，果然告痊。
瓜沥杨姓患者：患有太阴湿疟，脉象弦而濡细，面部及足背浮肿，进食后胃脘部胀闷。暂宜采用渗湿和中（的方法）。（十月十七日。）
草果仁（一钱） 桂枝（八分） 生香附（三钱） 仙半夏（一钱半） 浓朴（一钱半） 酒炒淡黄芩（一钱半） 滑石（四钱） 蔻壳（一钱半） 枣槟榔（三钱） 威灵仙（一钱半） 栝蒌皮（三钱）
清水煎煮，服用三帖。
复诊：疟邪依然发作，脉象弦濡，舌苔滑腻，湿热尚未清除，仍遵循前法加减为宜。
草果（一钱，去壳） 桂枝（八分） 炒茅术（一钱半） 酒炒常山（一钱） 浓朴（一钱半） 酒炒淡黄芩（一钱半） 炒青皮（八分） 新会陈皮（一钱半） 枣槟榔（三钱） 姜半夏（一钱半） 赤茯苓（四钱） （药引）老姜（三片）
三帖。
邵介按语：湿疟的治疗方法，应当辨别是湿重于热还是热重于湿。湿重于热的，用藿朴二陈汤加减；热重于湿的，用苍术白虎汤加减。此方是从达原饮加入渗湿的药物组成，确实是湿重热轻的正治之法。
安昌陈姓患者：气虚导致病邪留恋，寒热症状长期纠缠。脉象左侧虚而弦。夜间睡眠不安稳。暂宜采用补中益气汤加减。（四月三十号甲辰十四日。）
东洋参（一钱半） 江西白术（一钱） 制何首乌（三钱） 秦艽（一钱半） 酒炒柴胡（八分） 陈皮（一钱半，辰砂拌） 茯神（四钱） 威灵仙（一钱半） 当归（一钱半） 清炙甘草（三钱） 远志肉（八分）
清水煎煮，服用四帖。
复诊：益气升阳。寒热症状有所减轻，脉象虚，按之弦细，病邪仍未完全清除，仍遵循前法加减为宜（五月九号甲辰二十三日。）
东洋参（一钱半） 升麻（五分） 仙半夏（一钱半） 制何首乌（三钱） 酒炒柴胡（八分） 陈皮（一钱半） 炒江西白术（一钱半） 淮牛膝（三钱） 当归（二钱） 清炙甘草（三钱） 炙甘草（八分） （药引）红枣（四枚）
四帖。
邵介按语：柯韵伯说：李杲知道这是劳倦损伤脾胃，谷气不能胜任，阳气下陷于阴中而发热，因此制定了补中益气的方法。又说：凡是脾胃虚弱，肺气首先衰竭，所以用黄芪固护皮毛腠理，不让自汗；元气不足，懒言气喘，用人参来补益，用炙甘草的甘味来泻心火而除烦，补益脾胃而生发气机。这三味药是消除烦热的圣药。辅以白术健脾，当归和血，气机紊乱于中焦，清浊相干，用陈皮来调理，并且能疏散各种甘味药的滞涩；胃中清气下陷，用柴胡、升麻气味轻薄者，引导胃气向上腾升，恢复其本位，便能升浮以执行生长的命令了。本案属于气虚邪留，疟疾久治不愈，使用补中益气汤来升提脾胃的清气。起初因为夜间不安稳睡眠，所以加入茯神、远志来安神；因为寒热长期纠缠，又加入何首乌、威灵仙、秦艽来退除邪气；次方参入半夏、牛膝等药物，退邪补虚，标本兼顾，确实是治疗虚疟的良好方剂。后来了解到此人，年龄已在四十岁以上，患疟疾一年多，服用此方数剂，果然痊愈。
Patient Yang from Guali: Suffering from Taiyin damp-malaria (Taiyin damp-malaria), the pulse is wiry, soggy, and fine. There is edema on the face and dorsum of the feet, and abdominal distension and stuffiness after eating. Temporarily suitable to employ methods to leach out dampness and harmonize the middle jiao (October 17th).
Caoguo Ren (Caulis Tsaoko Fructus, 1 qian) Guizhi (Ramulus Cinnamomi, 8 fen) Sheng Xiangfu (Rhizoma Cyperi Rotundae, 3 qian) Xian Banxia (Rhizoma Pinelliae Preparatum, 1.5 qian) Nongpo (Cortex Magnoliae Officinalis, 1.5 qian) Jiu Chao Dan Qin (Radix Scutellariae Praeparated with Wine, 1.5 qian) Huashi (Talcum, 4 qian) Keqiao (Pericarpium Citri Reticulatae, 1.5 qian) Zao Binglang (Fructus Arecae cum Zizipho, 3 qian) Weilingxian (Herba Saposhnikoviae, 1.5 qian) Gualou Pi (Pericarpium Trichosanthis, 3 qian)
Decocted in clear water for three doses.
Re-examination: The malaria pathogen still recurs; the pulse is wiry and soggy, the tongue coating is slippery. Damp-heat has not yet cleared. It is appropriate to continue with the previous method with modifications.
Caoguo (Caulis Tsaoko Fructus, 1 qian, husk removed) Guizhi (Ramulus Cinnamomi, 8 fen) Chao Maoyu (Rhizoma Atractylodis Macrocephalae Stir-fried, 1.5 qian) Jiu Chao Changshan (Radix Dichroae Praeparated with Wine, 1 qian) Nongpo (Cortex Magnoliae Officinalis, 1.5 qian) Jiu Chao Dan Qin (Radix Scutellariae Praeparated with Wine, 1.5 qian) Chao Qingpi (Pericarpium Citri Reticulatae Viride Stir-fried, 8 fen) Xin Hui Pi (Pericarpium Citri Reticulatae, 1.5 qian) Zao Binglang (Fructus Arecae cum Zizipho, 3 qian) Jiang Banxia (Rhizoma Pinelliae Preparated with Ginger, 1.5 qian) Chi Ling (Poria Cum Radix Pini, 4 qian) [Guiding herb] Lao Jiang (Rhizoma Zingiberis Recens, 3 slices)
Three doses.
Commentary by Shao Jie: The treatment of damp-malaria should distinguish whether dampness predominates over heat or heat predominates over dampness. If dampness predominates, Huopo Erchen Tang (Magnolia Bark and Patchouli Two-Chen Decoction) with modifications is used. If heat predominates, Cangzhu Baizhu Tang (Atractylodes Macrocephala and White Tiger Decoction) with modifications is used. This formula is derived from Dayuan Yin (Origin-Reaching Drink) with added damp-leaching herbs. It is indeed the correct method for cases where dampness is heavy and heat is light.
Patient Chen from Anchang: Qi deficiency leading to lingering pathogens, with cold and heat symptoms persisting for a long time. The left pulse is deficient and wiry. Sleep at night is restless. Temporarily suitable to employ Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with modifications. (April 30th, Jiachen 14th day.)
Dongyang Shen (Ginseng Radix et Rhizoma Orientalis, 1.5 qian) Jiangxi Zhu (Rhizoma Atractylodis Macrocephalae, 1 qian) Zhi Shouwu (Radix Polygoni Multiflori Preparata, 3 qian) Qinjiao (Radix Gentianae Macrophyllae, 1.5 qian) Jiu Chaihu (Radix Bupleuri Praeparated with Wine, 8 fen) Chenpi (Pericarpium Citri Reticulatae, 1.5 qian, mixed with Chen Sha/Cinnabar) Fushen (Poria cum Radice et Mycelium, 4 qian) Weilingxian (Herba Saposhnikoviae, 1.5 qian) Danggui (Radix Angelicae Sinensis, 1.5 qian) Qing Zhi Gancao (Radix Glycyrrhizae Preparated, 3 qian) Yuanzhi Rou (Radix Polygalae Preparata, 8 fen)
Decocted in clear water for four doses.
Re-examination: Tonify qi and raise yang. Cold and heat symptoms have improved slightly. The pulse is deficient, wiry and fine upon deep pressure. Pathogens are not yet completely cleared. It is appropriate to continue with the previous method with modifications. (May 9th, Jiachen 23rd day.)
Dongyang Shen (Ginseng Radix et Rhizoma Orientalis, 1.5 qian) Shengma (Rhizoma Cimicifugae, 5 fen) Xian Banxia (Rhizoma Pinelliae Preparatum, 1.5 qian) Zhi Shouwu (Radix Polygoni Multiflori Preparata, 3 qian) Jiu Chaihu (Radix Bupleuri Praeparated with Wine, 8 fen) Chenpi (Pericarpium Citri Reticulatae, 1.5 qian) Chao Jiangxi Zhu (Rhizoma Atractylodis Macrocephalae Stir-fried, 1.5 qian) Huai Niuxi (Radix Achyranthis Bidentatae, 3 qian) Danggui (Radix Angelicae Sinensis, 2 qian) Qing Zhi Gancao (Radix Glycyrrhizae Preparated, 3 qian) Zhi Gancao (Radix Glycyrrhizae Preparated, 8 fen) [Guiding herb] Hongzao (Fructus Jujubae, 4 pieces)
Four doses.
Commentary by Shao Jie: Ke Yunbo stated: Li Gao understood that this was due to fatigue injuring the spleen and stomach, where grain qi could not sustain itself, causing yang qi to sink into the yin level resulting in fever. Thus, he formulated Buzhong Yiqi Tang. He also said: Whenever the spleen and stomach are deficient, lung qi fails first. Therefore, Huangqi (Radix Astragali) is used to consolidate the exterior and protect the cou-li (skin and interstices), preventing spontaneous sweating. When yuan qi (original qi) is insufficient, manifesting as reluctance to speak and panting, Renshen (Radix Ginseng) is used to tonify it. The sweetness of Zhi Gancao (Radix Glycyrrhizae Preparated) clears heart fire and relieves irritability, tonifying the spleen and stomach to generate qi. These three herbs are sacred medicines for eliminating vexation and heat. Bai Zhu (Rhizoma Atractylodis Macrocephalae) assists in strengthening the spleen, and Danggui (Radix Angelicae Sinensis) harmonizes blood. When qi is chaotic in the middle jiao, with clear and turbid qi interfering with each other, Chenpi (Pericarpium Citri Reticulatae) is used to regulate it, and to disperse the stagnation caused by sweet herbs. When clear qi of the stomach sinks, Chaihu (Radix Bupleuri) and Shengma (Rhizoma Cimicifugae), being light in nature and thin in flavor, are used to guide stomach qi upward, restoring its proper position, thereby enabling it to rise and float to execute the function of growth. In this case, there is qi deficiency with lingering pathogens, and malaria has persisted for a long time without healing. Buzhong Yiqi Tang is used to raise the clear qi of the spleen and stomach. Initially, because of restless sleep at night, Fushen (Poria cum Radice et Mycelium) and Yuanzhi (Radix Polygalae Preparata) were added to calm the spirit. Because cold and heat had persisted for a long time, Shouwu (Radix Polygoni Multiflori Preparata), Weilingxian (Herba Saposhnikoviae), and Qinjiao (Radix Gentianae Macrophyllae) were added to dispel pathogens. In the subsequent prescription, Banxia (Rhizoma Pinelliae) and Niuxi (Radix Achyranthis Bidentatae) were included to dispel pathogens and tonify deficiency, addressing both root and branch. This is indeed an excellent formula for treating deficiency-type malaria. Later, I learned that this patient was over forty years old, had suffered from malaria for more than a year, and after taking several doses of this formula, he recovered completely.