治疟多寒者。名曰牡疟。此散主之。
蜀漆（烧去腥。） 云母（烧二日夜。） 龙骨（各等分。）
上三味。杵为散。未发前。以浆水服半钱匕。
歌曰 阳为痰阻伏心间。牡疟阴邪自往还。蜀漆云龙平等杵。先时浆服不逾闲。
王晋三云。邪气结伏于心下。心阳郁遏不舒。疟发寒多热少。不可谓其阴寒也。主之以
蜀漆
母在
邪涌
治牡疟。
牡蛎 麻黄（各四两。） 甘草（二两。） 蜀漆（三两。）
上四味。以水八升。先煮蜀漆、麻黄。去上沫。得六升。内诸药。煮取二升。温服一升。
若
歌曰 先煎三（两蜀）漆四（两）麻黄。四（两牡）蛎二甘后煮良。邪郁胸中须吐越。
驱寒散结并
（犀） 按。疟多寒者名牡疟。是痰饮填塞胸中。阻心阳之气不得外通故也。赵氏云。
牡蛎
柴胡去半夏加栝蒌根汤 治疟病发渴者。亦治劳疟。
柴胡（八两。） 人参 黄芩 甘草（各三两。） 栝蒌根（四两。） 生姜（三两。） 大
枣（十
上七味。以水一斗二升。煮取六升。去滓再煎。取三升。温服一升。日三服。
歌曰 柴胡去夏为伤阴。加入蒌根四两珍。疟病渴因邪灼液。蒌根润燥可生津。
王晋三云。正疟寒热相间。邪发于少阳。与伤寒邪发于少阳者稍异。内经言。夏伤于大
暑。
伏于
盖
。而加天花粉生津润燥。岂非与正伤寒半表半里之邪。当用半夏和胃而通阴阳者有别乎。
柴胡桂姜汤（歌见长沙方歌括。） 治疟寒多微有热。或但寒不热。服一剂如神。
柴胡（半斤。） 桂枝（三两。） 干姜（二两。） 栝蒌根（四两。） 黄芩（三两。）
甘草（
上七味。以水一斗。煮取六升。去滓再煎。取三升。温服一升。日三。初服微烦。复服
汗出
王晋三云。夏月暑邪。先伤在内之伏阴。至秋复感凉风。更伤卫阳。其疟寒多微有热。
显然
和其
阳明
阳也
元犀按。先贤云。疟病不离少阳。少阳居半表半里之间。邪入与阴争则寒。出与阳争则
热。争则病作。息则病止。止后其邪仍居于少阳之经。愚意。外为阳。内为阴。先寒者邪欲
出。其气干于太阳。冲动寒水之气而作也。后热者。以胃为燥土。脾为湿土。湿从燥化。则
木亦从
虚。得
治疗疟疾表现为寒多热少者，称为牡疟。此方主治牡疟。
蜀漆（烧去腥味）、云母（烧两昼夜）、龙骨（各等分）。
以上三味药，捣碎研成散剂。在疟疾发作前，用浆水送服半钱匕。
歌诀曰：阳气被痰浊阻滞伏留于心间，牡疟的阴邪自行往来。蜀漆、云母、龙骨平等份捣碎，提前服用浆水送服不逾矩。
王晋三说：邪气结聚伏留于心下，心阳郁结遏止不得舒展，疟疾发作时寒多热少，不能说它是纯粹的阴寒证。主治用蜀漆……（原文此处有脱漏/错简，意指驱邪涌出）以治牡疟。
牡蛎汤：
牡蛎、麻黄（各四两）、甘草（二两）、蜀漆（三两）。
以上四味药，用水八升，先煮蜀漆、麻黄，去掉上面的浮沫，取六升，加入其他药物，煮取二升，温服一升。
（原文此处有脱漏）
歌诀曰：先煎三两蜀漆和四两麻黄，四两牡蛎和二两甘草后煮效果好。邪气郁结在胸中须用吐法发散。
（犀按）按语：疟疾寒多者名为牡疟，这是痰饮填塞胸中，阻碍心阳之气不能外通所致。赵氏说……
柴胡去半夏加栝蒌根汤：治疗疟疾病发作口渴者，也治疗劳疟。
柴胡（八两）、人参、黄芩、甘草（各三两）、栝蒌根（四两）、生姜（三两）、大枣（十枚）。
以上七味药，用水一斗二升，煮取六升，去渣滓再煎，取三升，温服一升，每日三次。
歌诀曰：柴胡汤去掉半夏是因为伤了阴液，加入四两珍贵的栝蒌根。疟病口渴是因为邪热灼伤津液，栝蒌根润燥可以生津。
王晋三说：正疟寒热交替，邪气发于少阳，与伤寒邪气发于少阳的情况稍有不同。《内经》说：夏季感受大暑……（原文此处有脱漏）伏于……盖……而加天花粉生津润燥，难道不是与正伤寒半表半里的邪气，应当用半夏和胃而通阴阳的情况有别吗？
柴胡桂姜汤（歌诀见《长沙方歌括》）：治疗疟疾寒多微有热，或者但寒不热。服一剂如神效。
柴胡（半斤）、桂枝（三两）、干姜（二两）、栝蒌根（四两）、黄芩（三两）、甘草（……两）。
以上七味药，用水一斗，煮取六升，去渣滓再煎，取三升，温服一升，每日三次。初服时微微烦闷，复服后汗出……
王晋三说：夏季暑邪，先伤害体内的伏阴，到了秋季又感受凉风，更伤卫阳。其疟疾寒多微有热……显然……调和其……阳明……阳也。
元犀按：先贤说：疟病不离少阳，少阳居于半表半里之间，邪气入内与阴争则寒，出外与阳争则热，相争则病发作，停止则病休止。休止后邪气仍居于少阳之经。愚意认为，外为阳，内为阴，先感到寒冷是因为邪气欲出，其气干扰太阳，冲动寒水之气而发作。后感到发热，是因为胃为燥土，脾为湿土，湿从燥化，则木亦从……虚，得……（原文未完）
Treating malaria characterized by more chills and less fever is named Mu Malaria (Oyster Malaria). This powder is the primary treatment.
Shuqi (Scutellariae Radix prepared by burning to remove fishy odor), Yunmu (Cloud Mother, likely referring to a mineral drug like Muscovite or similar, processed by burning for two days and nights), Longgu (Dragon Bone, fossilized mammal bones) in equal parts.
The above three herbs are pounded into a powder. Before the onset of the malaria attack, take half a qianbi (a small measuring spoon) with Jiangshui (fermented grain water).
Song says: Yang Qi is obstructed and trapped by phlegm-turbidity in the heart region; the Yin pathogen of Mu Malaria comes and goes freely. Shuqi, Yunmu, and Longgu are pounded equally; taking it beforehand with Jiangshui adheres to the rules.
Wang Jinsan states: The pathogenic factor knots and lingers below the heart; Heart Yang is depressed and constrained, unable to circulate freely. During malaria attacks, there are many chills and little fever; one cannot claim it is purely Yin-Cold. It is treated with Shuqi... [text missing] ...to treat Mu Malaria.
Muli Tang (Oyster Decoction):
Muli (Oyster Shell), Mahuang (Ephedrae Herba) (each 4 liang), Gancao (Glycyrrhizae Radix et Rhizoma) (2 liang), Shuqi (Scutellariae Radix) (3 liang).
The above four herbs are boiled in 8 sheng of water. First boil Shuqi and Mahuang, skim off the foam on the surface, reduce to 6 sheng. Add the remaining herbs and boil until 2 sheng remain. Take 1 sheng warm.
[Text missing]
Song says: Boil 3 liang of Shuqi and 4 liang of Mahuang first; boil 4 liang of Muli and 2 liang of Gancao later for good effect. Pathogenic factors stagnating in the chest must be vented through sweating/vomiting methods.
[Xi's Commentary]: Note: Malaria with more chills is named Mu Malaria. This is due to phlegm-fluids filling the chest, obstructing Heart Yang Qi from circulating outward. Zhao Shi says...
Chaihu Qu Banxia Jia Gualougen Tang (Bupleurum Decoction minus Pinellia plus Trichosanthes Root): Treats malaria patients who experience thirst upon attack; also treats Lao Malaria (chronic/consumptive malaria).
Chaihu (Bupleuri Radix) (8 liang), Renshen (Ginseng Radix), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma) (each 3 liang), Gualougen (Trichosanthis Radix) (4 liang), Shengjiang (Zingiberis Rhizoma Recens) (3 liang), Dazao (Jujubae Fructus) (10 pieces).
The above seven herbs are boiled in 12 sheng of water until 6 sheng remain. Strain the dregs and decoct again until 3 sheng remain. Take 1 sheng warm, three times a day.
Song says: Chaihu Tang removes Banxia because it injures Yin; adding 4 liang of precious Gualougen. Thirst in malaria is caused by pathogenic heat scorching body fluids; Gualougen moistens dryness and generates fluids.
Wang Jinsan states: In typical malaria, chills and fever alternate; the pathogen originates in Shaoyang. This differs slightly from Taiyang disease where the pathogen originates in Shaoyang. The *Neijing* states: Summer injury by great heat... [text missing] ...lingers in... Cover... Adding Tianhuafen (Trichosanthis Radix) to generate fluids and moisten dryness—is this not different from typical Taiyang disease where pathogens at the half-exterior half-interior level require Banxia to harmonize the Stomach and connect Yin and Yang?
Chaihu Guijiang Tang (Bupleurum and Cinnamon Twig Decoction) (Song lyrics see *Changsha Fang Ge Kua*): Treats malaria with abundant chills and slight fever, or only chills without fever. One dose yields miraculous results.
Chaihu (Bupleuri Radix) (0.5 jin), Guizhi (Cinnamomi Ramulus) (3 liang), Ganjiang (Zingiberis Rhizoma) (2 liang), Gualougen (Trichosanthis Radix) (4 liang), Huangqin (Scutellariae Radix) (3 liang), Gancao (Glycyrrhizae Radix et Rhizoma) ([missing] liang).
The above seven herbs are boiled in 10 sheng of water until 6 sheng remain. Strain the dregs and decoct again until 3 sheng remain. Take 1 sheng warm, three times a day. Initially, mild restlessness may occur; after subsequent doses, sweating occurs...
Wang Jinsan states: In summer, Heat pathogens first injure latent Yin within; in autumn, cool wind is contracted again, further injuring Wei Yang. The malaria presents with abundant chills and slight fever... evidently... harmonizing its... Yangming... Yang.
Yuan Xi notes: Ancients said: Malaria is inseparable from Shaoyang. Shaoyang resides between the exterior and interior. When pathogens enter and contend with Yin, chills occur; when they exit and contend with Yang, fever occurs. Contention causes the disease to manifest; cessation causes it to stop. After stopping, the pathogen still resides in the Shaoyang channel. My opinion: Exterior is Yang, Interior is Yin. Initial chills indicate the pathogen desires to exit; its Qi interferes with Taiyang, stirring Cold-Water Qi to cause symptoms. Subsequent fever occurs because the Stomach is Dry Earth and the Spleen is Damp Earth; Dampness transforms via Dryness, then Wood also follows... deficiency, obtaining... [text incomplete]