麻疹寒热似疟症。柴苓汤儿加减进。收后患疟用鳖甲。神而明之医中圣。
麻症初热已出之时。有寒热似疟者。此时切不可专以疟疾施治。宜以葛根疏邪汤（见三十三
条）加薄荷叶主之。至出尽之时。如有寒热似疟者。以柴苓汤。去人参、半夏、肉桂、白术。加贝母、
骨皮治之。如麻后竟成疟疾者。治法以清凉健脾开胃为主。宜以静远主人鳖甲饮主之。渴者。加
熟石膏少许。不渴者。方中之麦冬、知母。须除去之。夫疟多因脾虚生痰而作。若出麻之后。果是
疟疾。并无余毒。则柴苓汤中之人参、半夏。又何妨施用。但肉桂、白术。不可轻使耳。又何必拘泥
麻初常法。麻后余邪等症之不宜用燥悍之药耶。如小柴胡汤。（见二十二条）正所宜用。所谓神而
明之。存乎其人者此也。
朱曰 疟之原因甚多。当因其见证而治之。不必拘于一证。亦不必拘于一方。
柴苓汤
柴胡 半夏 人参 黄芩 甘草 猪苓 泽泻 白苓 白术 肉桂 姜、枣引。
静远主人鳖甲饮
九肋鳖甲（新瓦上焙、以醋淬数次、至黄色、研为末、再用醋拌炙干二钱） 山楂肉（去子三钱
）麦冬 薏苡仁（炒各五钱） 白茯苓（二钱） 橘红（二钱五分） 知母（一钱二分） 干葛
白芍（各一钱五分） 柴胡（二钱） 贝母（三钱） 淡竹叶（一钱） 炙甘草（七分） 姜引。水煎服。
麻疹期间出现寒热往来，症状类似疟疾。此时应使用柴苓汤进行加减治疗。若麻疹消退后患上疟疾，则使用鳖甲饮治疗。若能灵活变通、神而明之，便是医中的圣手。
在麻疹初起发热、疹点刚透发的时候，如果有寒热往来的症状，此时切不可专门按照疟疾来治疗。适宜使用葛根疏邪汤（见第三十三条）加入薄荷叶为主进行治疗。等到疹子完全出齐时，如果仍有寒热往来的症状，使用柴苓汤，去掉人参、半夏、肉桂、白术，加入贝母、地骨皮进行治疗。如果麻疹之后竟然真的形成了疟疾，治疗方法应以清凉、健脾、开胃为主。适宜使用静远主人的鳖甲饮为主方。口渴的，加入少许熟石膏；不口渴的，方剂中的麦冬、知母必须去除。大凡疟疾多因脾虚生痰而发作。如果在出麻疹之后，果真是疟疾，且体内并无余毒残留，那么柴苓汤中的人参、半夏又有什么不可以使用的呢？只是肉桂、白术不可轻易使用罢了。又何必拘泥于麻疹初期常用的法则，以及认为麻疹后余邪等症不宜使用燥烈猛悍的药物呢？如小柴胡汤（见第二十二条），正是适宜使用的方剂。所谓“神而明之，存乎其人”，说的就是这个道理。
朱氏说：疟疾的原因很多，应当根据患者的具体证候来治疗，不必拘泥于某一种证型，也不必拘泥于某一个方剂。
柴苓汤
组成：柴胡、半夏、人参、黄芩、甘草、猪苓、泽泻、白茯苓、白术、肉桂。用法：生姜、大枣为引。
静远主人鳖甲饮
组成：九肋鳖甲（在新瓦上焙干，用醋淬多次，至呈黄色，研成粉末，再用醋拌炒至干，用量二钱）、山楂肉（去核，三钱）、麦冬、薏苡仁（炒，各五钱）、白茯苓（二钱）、橘红（二钱五分）、知母（一钱二分）、干葛、白芍（各一钱五分）、柴胡（二钱）、贝母（三钱）、淡竹叶（一钱）、炙甘草（七分）。用法：生姜为引，水煎服。
During the course of measles, chills and fever alternating may resemble malaria. In such cases, Chai Ling Tang (Bupleurum and Poria Decoction) should be modified for treatment. If malaria develops after the resolution of measles, Biejia Yin (Turtle Shell Decoction) is indicated. By applying wisdom and flexibility, one becomes a sage in medicine.
When measles are in their initial stage of fever and just beginning to erupt, if there are symptoms resembling malaria with alternating chills and fever, it is absolutely crucial not to treat them solely as malaria. It is appropriate to use Gegen Shuxie Tang (Kudzu Root Decoction for Dispersing Pathogens) (see Article 33) added with Bohe Ye (Menthae Haplocalycis Folium). When the rash has completely erupted, if symptoms resembling malaria persist, use Chai Ling Tang (Bupleurum and Poria Decoction), removing Renshen (Ginseng Radix et Rhizoma), Banxia (Pinelliae Rhizoma), Rougui (Cinnamomi Cortex), and Baizhu (Atractylodis Macrocephalae Rhizoma), and adding Bei Mu (Fritillariae Bulbus) and Gu Pi (Phellodendri Cortex). If malaria actually forms after the measles, the treatment principle should focus on clearing heat, strengthening the spleen, and stimulating appetite. Jingyuan Zhuren's Biejia Yin (Turtle Shell Decoction by Master Jingyuan) is indicated. For those with thirst, add a small amount of Shu Shigao (Prepared Gypsum Fibrosum); for those without thirst, remove Maidong (Ophiopogonis Radix) and Zhimu (Anemarrhenae Rhizoma) from the formula. Malaria often arises due to phlegm generation caused by spleen deficiency. If, after the eruption of measles, it is indeed malaria and there is no residual toxic heat remaining, then why could Renshen (Ginseng Radix et Rhizoma) and Banxia (Pinelliae Rhizoma) in Chai Ling Tang (Bupleurum and Poria Decoction) not be used? However, Rougui (Cinnamomi Cortex) and Baizhu (Atractylodis Macrocephalae Rhizoma) should not be lightly administered. Why must one rigidly adhere to the common methods for early-stage measles or assume that formulas containing drying and harsh herbs are unsuitable for residual pathogenic factors after measles? Xiao Chai Hu Tang (Minor Bupleurum Decoction) (see Article 22) is precisely what should be used. This is what is meant by "divine illumination depends on the individual."
Zhu stated: The causes of malaria are numerous. Treatment should be based on the observed syndromes. One need not be confined to a single syndrome pattern nor restricted to a single formula.
Chai Ling Tang (Bupleurum and Poria Decoction)
Ingredients: Chai Hu (Bupleuri Radix), Ban Xia (Pinelliae Rhizoma), Ren Shen (Ginseng Radix et Rhizoma), Huang Qin (Scutellariae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), Zhu Ling (Polyporus), Ze Xie (Alismatis Rhizoma), Bai Fu Ling (Poria cum Risus), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Rou Gui (Cinnamomi Cortex). Administration: Use Sheng Jiang (Zingiberis Rhizoma Recens) and Da Zao (Jujubae Fructus) as guides.
Jingyuan Zhuren Biejia Yin (Turtle Shell Decoction by Master Jingyuan)
Ingredients: Jiu Lei Bie Jia (Testudinis Carapax et Plastrum, specifically nine-ribbed turtle shell, baked on a new tile, quenched several times in vinegar until yellow, ground into powder, then stir-fried dry with vinegar, 2 qian), Shan Zha Rou (Crataegi Fructus, pitted, 3 qian), Mai Dong (Ophiopogonis Radix), Yi Yi Ren (Coicis Semen, stir-fried, each 5 qian), Bai Fu Ling (Poria cum Risus, 2 qian), Ju Hong (Citri Reticulatae Pericarpium Rubrum, 2.5 qian), Zhi Mu (Anemarrhenae Rhizoma, 1.2 qian), Gan Ge (Puerariae Lobatae Radix), Bai Shao (Paeoniae Radix Alba, each 1.5 qian), Chai Hu (Bupleuri Radix, 2 qian), Bei Mu (Fritillariae Bulbus, 3 qian), Dan Zhu Ye (Lophatheri Herba, 1 qian), Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Preparata, 0.7 qian). Administration: Use Sheng Jiang (Zingiberis Rhizoma Recens) as a guide; decoct in water and take orally.