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Chapter 27. herbs for malaria



Jiawei Xiao Chaihu Tang


This formula is used for malaria, which has last for a long time with string and weak pulse.


柴胡(三钱) 黄芩(二钱) 知母(三钱) 潞参(三钱) 鳖甲(三钱,醋炙) 半夏(二钱)常山(钱半,酒炒) 草果(一钱) 甘草(一钱) 酒曲(三钱) 生姜(三钱) 大枣(两枚,捭开)
Chaihu 9 gram, Huangqin 6 gram, Zhimu 9 gram, Dangshen 9 gram, Biejia 9 gram (processed with venigar), Banxia 6 gram, Changshan 4.5 gram (fry with liqor), Caoguo 3 gram, Gancao 3 gram, wine ferment agent 9 gram, fresh ginger 9 gram, Chinese date two (open it).


If the malaria has shot history, remove the Dangshen and Biejia. If the Hotness is severe, add Shigao up to 30 gram. If the Cold is severe, add additional Caoguo 3 gram.



The malaria does not only stay in the Shaoyang meridian, but it indeed focuses on the Shaoyang meridian. Therefore the pulse in all positions shows string feeling. If the person feels cold first, then hot, it means the Shaoyang Xie Qi is combined with the Taiyang; if the person feels hot first, then cold, it means the Shaoyang Xie Qi is combined with the Yangming. The herb Chaihu is to raise the Shaoyang Xie Qi to the body surface; the Caoguo and fresh ginger are to expel the Taiyang Coldness; and the herb Huangqin and Zhimu are to clear the Yangming Hotness. The mature malaria usually combines phlegm and food. So, the herb Banxia and Changshan are sued to clear the phlegm; the wine ferment agent is to dissolve accumulated, non-digested food. The Renshen is to support the body defense Qi in weak person due to long term of the malaria exhausting, so to allow the body to expel the Xie Qi out. After a long time of malaria, the person may have mass (enlarged spleen and liver). The Biejia is used to dissolve the mass, and to kill the root of the malaria. The Cancao and the Chinese date work to dissolve the side effect of the Changshan, the dizziness, due to the strong function of the Changshan.


It might be asked: in the case reports from Dr. Ye Tianshi, most of his formulas for the malaria did not use herb Chaihu. His followers said they were educated from generation to generation that Chaihu is not good in the treatment of malaria. If it is used, the treatment would fail and cause trouble. Can this theory be believed? Answer: the reputation of Dr. Ye was very high at that time. The malaria was originally small disease. When it was in early stage, it was easy to solve. It was rare that the patient needed to change doctor. If the disease had been delayed for a long time, various ashenic conditions developed, while the original malaria per se usually became less severe than those asthenic conditions. When the asthenic conditions were solved, the malaria was also cured at the same time. This is the therapy based on the person’s body condition and the disease situation. It is not a formal or a routine way for the treatment of malaria. If a Shanghan disease is in the Yuejin stage, the person could also have a first cold, then hot condition, in which the hot can be slightly reduced after a sweat, which is similar to the malaria. This is a condition, in which the Liver Qi is extremely weak and is to escape. If it is mis-diagnosed as malaria, and use Chaihu for the treatment, the life would be in very danger to loss. For this condition, large amount of Shanyurou should be used to restrain and to nourish the Liver. This is as indicated in the book
Shennong Bencao Jingthat the herb Shanyurou can dominate the treatment for cold and hot. The followers of Dr. Ye, saying that to use herb Chaihu in the treatment of malaria might cause problem, might mean this.


It might be also asked: When Dr. Ye treated malaria, if the patient was with dry-hot in Yin deficiency, he always used Qinghao to replace the Chaihu. Later doctors also admired his such herbal therapy as very smart way. Would the Chaihu be replaced by the herb Qinghao? Answer: the malaria Xie Qi hided in the oil layer in the side of abdomen, which is the capital place for the Shaoyang meridian. The herb Chaihu can go in the oil layer, bring the Xie Qi up, over the diagram, and out of the body, but the herb Qinghao however has no such effect. If the person has Yin deficiency with Hot in the blood, it is better to use more Yin-nourishing herbs to cool the fire in the blood. If the person has Dry-Hot condition, or the Hot is overwhelming in the Qi portion of the body, it is better to use herbs that work to clear the Dryness and to clear the Fire. I treated a man. He had malaria once every other day. When he felt hot, the hot was very high. Even if it was the day without the outbreak of the malaria, he still felt hot in the heart, dry tongue and mouth. His pulse was string and long (the malaria pulse is always string), which is shenic when pressed harder. It was considered as Fire overwhelming in the Yangming stage. He was given large amount of Baihu Tang, with addition of Chaihu 9 gram. After the drink of the herbal tea, he felt very clear and nicely cool in the heart. The next day, the malaria had no outbreak. The herbal formula was again used in half dose, and cooked, with addition of fresh ginger 9 gram. It solved his malaria completely. 


I also treated a man who had Wen disease. The hotness was in the Yangming stage. His tongue was yellow in color and thick; his pulse was waving and long. He had also felt cold-hot shift once every other day. This is the co-exist of the Wen disease and malaria. This man had also craving for opium. The disease is sthenic, but his body is very weak (asthenic). He was given the Baihu Jia Renshen Tang, with the Maimendong to replace the Zhimu, and Shanyao to replace the Genmin, and with addition of little Chaihu. Two doses solved his all problems.


In the treatment of malaria, western medicine used quinine. It was taken half tablet on the noon, and half tablet in the evening, with the help of the white sugar water fro swallow, on the day without the outbreak of the malaria. It is repeated the next morning. The malaria was cured.


In medical books, it said that, if the winter is very cold, there would have Wen disease. If the summer is very hot, there would have malaria. It means that if the winter is too cold, the Cold will hide inside the body. The Cold will develop int Hot in spring with the Yang Qi raising in the spring, so to develop into a Wen disease. If the summer is too hot, the Hotness will invade in the body to hide. In the following autumn, the hidden Hotness would be triggered out by the slight cold in the autumn, so as to develop into the malaria. One year, it was very hot in summer. There were many people died from the hot weather. In that autumn, indeed, there were many malarias cases. The malaria could be cured with quinine too. However, the malaria usually recurred again and again. A youth, Mr. Wang, who lived in the home of his relatives in Tianjing city, had malaria and were treated with quinine three times. His malaria recurred and it could not be cured after taking of the quinine several times. His pulse was string and long on both sides. String pulse suggests the malaria and the long and strong pulse indicates the hidden hot. He was given the Baihu Tang, in which the Shigao was 60 gram, with addition of Chaihu 6 gram, and Heshouwu 6 gram. One dose cured the malaria. For worrying that the malaria might not be cured from the root, this formula was repeated again once. The malaria never came back. For him, the Baihu Tang was to clear the hidden Fire. The reason for addition of Chaihu and Heshouwu is that the string pulse showed in a common cold indicates the Xie Qi in the Shaoyang stage. The herb Chaihu was used to clear the Xie Qi in the Shaoyang. If the Xie Qi remained in the Shaoyang meridian for a long time, the Shaoyang meridian must be asthenic (weak), the Heshouwu was used to nourish the Shaoyang meridian. So, the Chaihu is to clear the Xie Qi, and the Heshouwu is to nourish the body. The Shaoyang and the Yangming were treated the same time, so that the disease is cured in a short time.