两火不相照曜。且比之大暑大热之天象。其暑热之气。在太虚而不可见。非若清冷阴寒之化。有云物风雾
之可凭也。故其脉。除当发时数大之外。未发及发后之脉。如平人也。身无寒。但热者。亦兼热之前后而言。骨
节为人身之坎泽。阴液之所注也。邪热客而鼓之。故疼。津液供之不给。故疼而且烦也。阳无阴以自伏。而时
时有上炎上冲之势。故呕。主白虎加桂枝汤者。前条不曰舍于分肉之间乎。分肉属阳明。故以辛凉而走胃
之石膏为主。使浮缓之甘草以托之。佐以甘温而善补胃液之粳米。以滋胃中之阴。然后凭润肺之知母。徐
徐上引之。则白虎本汤。是凉雨如酥而润稿。加桂枝。是秋风扫热以除烦。至其所谓邪气内藏于心一半。则
合下条蜀漆散以治之。另有奥义。仲景之心法。真于渊微莫测之中。却又一丝不紊者矣。
疟多寒者。名曰牝疟。蜀漆散主之。
蜀漆散方 蜀漆（洗去腥） 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。温疟加蜀漆半分。临发时。服一钱匕。
寒时长而热时短。寒多于热。故曰多寒。非但寒不热之谓也。按内经寒疟论。夏伤于暑。汗出而腠理开发。因
遇凄怆之小寒。藏于腠理皮肤之中。秋伤于风。而益其寒。则病成矣。夫寒者。阴邪也。风者。阳邪也。先伤于寒。
而后伤于风。故先寒后热。愚谓寒里风表。是寒主而风客。故且寒多于热矣。金匮之名牝疟。即经所谓寒疟
者是也。俗解硬将多寒多字抹煞。而以但寒无热为牝疟。谬矣。盖疟邪未有不见热者。特有热多热少之异
耳。况牝牡雌雄。禽兽之阴阳。犹人之曰男女也。诚如所言。因牝疟之名。便谓有寒无热。则将谓女人身中。全
无阳气温热也得乎。主蜀漆散者。其意以为心气出而御夏。肺气出而御秋。此五脏与四时。各以类应之道
也。今夏伤于暑。是心阳为热邪所伤。秋伤于风。是肺气又为风邪所伤。心阳肺气。两伤于上。故不能推散风
寒。而致寒多热少之牝疟也。其治例只消将命门中之阳气。升而上之。使其气匀满于心肺之间。则大气一
转。其邪乃散。故以云母、龙骨。体质沉重之石类。将蜀漆监至下焦。使之温温。上通下吸。而已足矣。盖云母之
性。遇阴晦。则吐气生云而善升。遇晴明。则吸气归云而善摄。烧至二日夜。是以火力夺晴明之造化。迨不用
其善吐而升阴晦之云。特取其善吸以摄风寒之气者也。龙骨。前人俱误认为龙蛇之蜕。其实乃龙脉之石
骨。所以通山川之灵道者。用以入药。为手少阴心主。敛神聚气之真品焉。蜀漆。东垣称其上补心气。有飞针
走线之功。盖言其神速也。明明先以沉重石类。坠下蜀漆。然后俟龙骨、蜀漆。本天亲上之性。从下焦升发其
阳神以充心部。所以治其多寒之标也。俟云母。本地亲下之性。从上焦吸取其阴邪以归子虚。所以治其牝
疟之本也。各用等分者。使势均力敌。不相牵制。可以各行其性也。未发先服者。乘风寒之阴翳未起。而使阳
光升满膈中。逼阴邪于下。俾云母之就近吸之者。尤易易也。至于温疟亦主此散。特加蜀漆半分。直是壶天
胜境。恍惚间另是一番世界。吾不知仲景当日。从何得此妙用耶。盖温疟之邪气。内藏于心。服白虎加桂汤
以治其分肉之所舍。而未及其所藏也。故以飞走心经之蜀漆。用至折半而为君。龙骨之入手少阴。原属本
性。又得蜀漆之兼力以趋之。则其入心。更与之同速矣。夫蜀漆、龙骨。同心合德。以奉心主。则云母亦因之而
上浮。于是云母则倒吸阴精以上滋。龙骨则通提肾气以相济。而所谓阴气孤绝。阳气独发者。可得其平矣。
然后蜀漆以飞走之性。散其所藏。则少气烦冤之诸症亦解。一汤一散。合表里而两治之。则瘅疟中之但热
不寒。而名温疟者。宁有不冰释者哉。临发时服。以发则所藏尽出。而去之无所留遗故也。
两股火气不能相互照应。况且与大暑大热的天象相比，暑热之气存在于太虚之中而不可见，不像清冷阴寒的变化，有云物风雾等可以凭借的表象。所以它的脉象，除了发作时表现为数大之外，未发作及发作后的脉象，如同正常人一样。身体不恶寒，只发热，这也是兼指发热之前后而言。骨节是人身的“坎泽”，是阴液灌注的地方。邪热客居其中并鼓动它，所以疼痛；津液供给不足，所以既疼痛又烦躁。阳气没有阴液的制约而自行潜伏，因而时时具有上炎、上冲的趋势，所以发生呕吐。主治用白虎加桂枝汤的原因，前一条不是说邪气舍于分肉之间吗？分肉属于阳明经，所以以辛凉且走胃的石膏为主药，使浮缓的甘草来托举它，佐以甘温且善于补充胃液的粳米，来滋养胃中的阴液。然后凭借润肺的知母，徐徐向上引导，那么白虎汤本方就像酥润的凉雨滋润枯草，加上桂枝，就像秋风扫去热气以消除烦躁。至于所谓邪气内藏于心的一半，则合用下条的蜀漆散来治疗，另有深奥的含义。仲景的心法，确实在渊微莫测之中，却又一丝不乱啊。
蜀漆散方：蜀漆（洗去腥味）、云母（烧二日夜）、龙骨（各等分）。
以上三味药，捣碎研成散剂。在发作前，用浆水送服半钱匕。如果是温疟，增加蜀漆半分。在临发作时，服用一钱匕。
寒的时间长而热的时间短，寒多于热，所以叫多寒，并不是指只有寒而没有热的情况。按《内经·寒疟论》所说，夏天伤于暑气，汗出导致腠理开发，于是遇到凄怆的小寒，寒气藏在腠理皮肤之中；秋天伤于风邪，从而加重了寒邪，病就形成了。寒，是阴邪；风，是阳邪。先伤于寒，后伤于风，所以先寒后热。我认为寒在里，风在表，是寒为主而风为客，所以寒多于热。《金匮要略》中称为牝疟，就是《内经》所说的寒疟。世俗的解释强行抹杀“多寒”中的“多”字，而认为但寒无热才是牝疟，这是错误的。大概疟邪没有不见发热的，只是有热多热少的区别罢了。况且牝牡（雌雄）是禽兽的阴阳，就像人的男女一样。如果真的像他们所说，因为叫牝疟，就认为有寒无热，那就要说女人身体中完全没有阳气温热了吗？主治用蜀漆散的意思，认为是心气出而御夏，肺气出而御秋，这是五脏与四时各自相应类的道理。现在夏天伤于暑，是心阳被热邪所伤；秋天伤于风，是肺气又被风邪所伤。心阳和肺气在上部都受了损伤，所以不能推散风寒，而导致寒多热少的牝疟。其治疗法则只需将命门中的阳气升发上来，使气均匀充满于心肺之间，那么大气一转，邪气自然消散。所以用云母、龙骨这些体质沉重的石类药物，将蜀漆监制至下焦，使其温和地向上通、向下吸，这就足够了。云母的性质，遇到阴晦天气，就吐气生云而善于上升；遇到晴明天气，就吸气归云而善于收敛。烧到两个夜晚，是用火力夺取晴明的造化，等到不再使用它善于吐升阴晦之云的特性，特别取用它善于吸收以收敛风寒之气的特性。龙骨，前人全都误认为是龙蛇的蜕皮，其实它是龙脉的石骨，是用来沟通山川灵道的。用来入药，是手少阴心主收敛神气聚气的真品。蜀漆，李东垣称它能上补心气，有飞针走线的神速功效。明明先用沉重的石类药物坠下蜀漆，然后等待龙骨、蜀漆，凭借它们天性亲上的特点，从下焦升发阳神以充实心部，所以治疗其多寒的症状表现。等到云母，凭借它本地亲下的特点，从上焦吸取阴邪归于子虚，所以治疗牝疟的根本原因。各用等分，是为了使势力均衡，互不牵制，可以各自发挥其药性。在发作前服药，是趁着风寒阴翳尚未兴起，而使阳光升满膈中，逼迫阴邪在下，使得云母就近吸收它，就更加容易了。至于温疟也主治此散，特别增加蜀漆半分，简直是壶中胜境，恍惚间另有一番世界，我不知道仲景当日是从哪里得到这种妙用的呢？大概温疟的邪气，内藏于心，服用白虎加桂枝汤治疗的是它在分肉之间的居所，而未触及它所藏之处。所以用能飞走进入心经的蜀漆，用量减半作为君药。龙骨入手少阴经，原本属于本性，又得到蜀漆的兼力趋使之，那么它进入心脏的速度就更与之同步了。蜀漆、龙骨同心合德，以奉侍心主，那么云母也因此而上浮。于是云母倒吸阴精以上行滋润，龙骨通提肾气以相济助，而所谓阴气孤绝、阳气独发的情况，就可以得到平衡了。然后蜀漆以其飞走的性质，散除其所藏的邪气，那么少气烦冤等各种症状也就解除了。一汤一散，结合表里同时治疗，那么瘅疟中那种只热不寒、名叫温疟的病证，难道还会有不解如冰释的吗？在临发作时服药，是因为发作时邪气全部出来，去除它就没有遗留了。
The two fires fail to illuminate each other. Furthermore, compared to the celestial phenomenon of intense summer heat, the qi of summer-heat resides in the Great Void and is invisible, unlike the transformation of clear cold and yin-cold, which has clouds, mist, wind, and fog as tangible manifestations. Therefore, its pulse, besides being rapid and large during the paroxysm, is like that of a healthy person when not attacking or after the attack. The body feels no aversion to cold, only heat; this also refers to the period before and after the fever. The bone joints are the "Kan Marsh" (a reservoir for yin fluids) of the human body, where yin fluids pour in. When pathogenic heat lodges there and agitates it, pain occurs. When the supply of body fluids is insufficient, pain and vexation occur together. Yang, lacking yin to anchor itself, constantly tends to flare upward and rush up, causing vomiting. The reason for prescribing Baihu Jia Guizhi Tang (White Tiger plus Cinnamon Twig Decoction) is that the previous clause did not state that the pathogen lodges between the muscle layers? The muscle layers belong to the Yangming channel. Therefore, Shigao (Gypsum Fibrosum), which is acrid-cool and targets the Stomach, serves as the principal herb. It is supported by Gancao (Licorice Root), which is floating and slow, to uphold it. Zujingmi (Rice Grain), which is sweet-warm and good at replenishing Stomach fluids, is added as an assistant to nourish the yin in the Stomach. Then, relying on Zhimu (Anemarrhenae Rhizoma), which moistens the Lungs, to slowly guide the action upward. Thus, the original Baihu Tang acts like cool rain soaking into dry grass, while adding Guizhi (Cinnamomi Ramulus) acts like autumn wind sweeping away heat to relieve vexation. As for the so-called pathogenic qi hiding halfway within the Heart, it combines with the next clause's Shuqi San (Vitex Powder) for treatment, possessing profound significance. Zhang Zhongjing's method of healing is indeed unfathomably subtle yet meticulously orderly.
Malaria manifesting predominantly with chills is named Pin Malaria (Yin Malaria). It is treated with Shuqi San.
Shuqi San Formula: Shuqi (Washed to remove fishy odor), Yunmu (Burned for two days and nights), Longgu (Equal parts).
The above three herbs are pounded into a powder. Before the onset of symptoms, take half a Qianbi dose with Jiangshui (Sour Rice Water). For Wen Malaria (Warm Malaria), add half a Qianbi of Shuqi. At the time of impending onset, take one Qianbi dose.
The duration of chills is long and the duration of fever is short, with chills exceeding fever; hence it is called "excessive chills," not merely meaning chills without fever. According to the *Neijing*'s discussion on Cold Malaria, injury by summer-heat in summer causes sweating and opening of the couli (pores). Encountering biting cold then allows the cold to hide within the couli and skin. Injury by wind in autumn exacerbates the cold, resulting in disease formation. Cold is a Yin pathogen; Wind is a Yang pathogen. Injury by cold first, then by wind, leads to chills preceding fever. I believe cold is internal and wind is external; cold is the host and wind is the guest, thus chills exceed fever. The term Pin Malaria in the *Jinkui Yaolue* corresponds to the Cold Malaria mentioned in the classics. Popular interpretations erroneously erase the character "excessive" from "excessive chills," defining Pin Malaria as chills without fever, which is incorrect. Pathogenic malaria invariably involves fever, differing only in degree. Moreover, Pin/Peng (female/male) refers to the yin/yang of birds and beasts, analogous to men and women. If one were to argue that because it is called Pin Malaria, there is no fever, would one claim that women's bodies completely lack Yang warmth? The intent behind prescribing Shuqi San is based on the principle that Heart Qi governs Summer and Lung Qi governs Autumn, reflecting the correspondence between the Five Zang organs and the four seasons. Now, summer injury by summer-heat damages Heart Yang; autumn injury by wind damages Lung Qi. With both Heart Yang and Lung Qi injured superiorly, they cannot disperse wind and cold, leading to the Yin Malaria characterized by excessive chills and scanty fever. The treatment principle is simply to raise the Yang Qi from the Gate of Vitality (Mingmen) upward, allowing the Qi to evenly fill the space between the Heart and Lungs. Once the Great Qi rotates, the pathogen disperses. Therefore, heavy mineral substances like Yunmu (Muscovite) and Longgu (Fossile Ossis Mastodi) are used to constrain Shuqi (Viticis Radix et Caulis) to the Lower Jiao, enabling it to warm, ascend, and descend. Yunmu's nature: in cloudy weather, it emits qi to form clouds and ascends well; in clear weather, it absorbs qi into clouds and retains well. Burning it for two days and nights uses fire power to override the clear weather's creation, utilizing its ability to absorb rather than emit clouds, specifically to capture wind-cold qi. Longgu was previously mistaken by predecessors as dragon or snake shed skin, but it is actually the stone bone of dragon veins, facilitating communication with the spiritual pathways of mountains and rivers. In medicine, it is a true substance for the Hand-Shaoyin Pericardium/Heart to gather spirit and condense qi. Shuqi, according to Li Dongyuan, tonifies Heart Qi from above, possessing the speed of "flying needles and running threads." Clearly, heavy minerals are first used to sink Shuqi downward. Then, relying on the natural tendency of Longgu and Shuqi to rise, Yang Shen (Spirit) is raised from the Lower Jiao to fill the Heart, treating the symptom of excessive chills. Subsequently, Yunmu, relying on its natural tendency to descend, draws Yin pathogenic qi from the Upper Jiao back to emptiness, treating the root of Yin Malaria. Using equal parts ensures balanced forces without mutual restriction, allowing each herb to exert its nature. Taking the medicine before onset takes advantage of the fact that wind-cold shadows have not yet risen, allowing Yang light to fill the diaphragm, forcing Yin pathogen downward, making it easier for Yunmu to absorb it nearby. As for Warm Malaria, this powder is also prescribed, with an additional half Qianbi of Shuqi. This is a realm of wonder; I do not know how Zhang Zhongjing derived such efficacy. The pathogenic qi of Warm Malaria hides in the Heart. Baihu Jia Guizhi Tang treats its residence in the muscle layers but does not reach its hidden location. Therefore, Shuqi, which flies into the Heart Meridian, is used as the principal herb in half dosage. Longgu entering the Hand-Shaoyin channel aligns with its nature, aided by Shuqi's driving force, ensuring rapid entry into the Heart. Shuqi and Longgu work in harmony to serve the Heart Master. Consequently, Yunmu floats upward. Yunmu reversely sucks Yin Essence to moisten upwards, while Longgu lifts Kidney Qi to assist. Thus, the condition of isolated Yin and solitary Yang emission can be balanced. Finally, Shuqi scatters the hidden pathogen with its flying nature, resolving symptoms like shortness of breath and vexation. One decoction and one powder treat the exterior and interior simultaneously. Would the Warm Malaria, characterized by heat without cold among the Dan Malaria types, not melt like ice? Taking it at the time of impending onset is because upon onset, the hidden pathogen fully emerges, allowing for complete removal without residue.