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Water refers to *Yin* (pathological accumulation of fluid in the body); blood refers to *Yu Xue* (stagnant or stagnant blood). It is precisely because of *Yin* that chills and fever occur; it is precisely because of *Yu Xue* that chills and fever are exacerbated. *Changshan* (Dichroa Radix) expels water and promotes diuresis, which is indeed correct. However, if there are no blood-invigorating herbs to assist in between, how can one achieve a perfect cure? From now on, for patients with malaria, if they present with epistaxis, hemoptysis, blood streaks in the stool, or irregular menstruation, these are all manifestations of blood disorders. One should use *Changshan* (Dichroa Radix), *Caoguo* (Tsaoko Fructus), *Binglang* (Arecae Semen), *Qingpi* (Aurantii Fructus Pericarpium Viride), *Wumei* (Mume Fructus), and *Gancao* (Glycyrrhizae Radix et Rhizoma) as the principal formula. To this, add *Wulingzhi* (Trogopterori Faeces) and *Taoren* (Persicae Semen) as adjuvants. Decoct them together with *Shengjiang* (Zingiberis Rhizoma Recens) and thick honey to treat these conditions.

Generally, malaria should be treated differently according to wind, cold, summerheat, and dampness, employing methods such as sweating, purging, vomiting, or warming. The standard protocols in *Huoren Shu* (Book of Living Persons) are so fundamental that even Lu Dan and Bian Que could not deviate from them. Yet, I have observed cases where malaria persists for a long time without ceasing. What is the reason? There is a root cause. What is this root? It is *Yin*, water, and *Bai Xue* (decayed blood). Precisely because *Pi Ji* (accumulation due to stagnation) is the mother of malaria, *Bai Xue* is the toxin of summerheat, and both *Yin* and water generate chills and fever. Therefore, the pulse in summerheat is deficient; the pulse in water and *Yin* is deep and knotted; the pulse in *Pi Ji* is knotted. For accumulations accompanied by water and *Yin*, employ methods to expel water and resolve *Yin*. For formed *Pi Ji*, the hypochondrium must be painful, so employ methods to attack *Pi Ji*. If *Bai Xue* and summerheat toxins are addressed according to the syndrome with draining and promoting methods, and yet chills and fever do not cease, I would not believe it.

Patients with malaria often retain phlegm-rheum and yellow fluids. That *Changshan* (Dichroa Radix) can induce vomiting and promote drainage is indeed true. However, in cases of pure heat-type malaria or internal excess heat, administering *Changshan* may result in only scanty stools, resembling diarrhea but not fully evacuating. In such instances, *Da Huang* (Rhei Radix et Rhizoma) must be used as an adjuvant to induce significant purgation several times before recovery can be achieved. Some argue that *Baidu* (Crotonis Fructus) pills work in conjunction with *Changshan* to also induce purgation; this is incorrect. *Baidu* attacks lower-joint accumulations, but to cleanse blood-heat, *Da Huang* (Rhei Radix et Rhizoma) is indispensable. When a malaria attack is imminent, medication should not be taken; it should be administered two hours prior to the onset. Otherwise, the medicine and the pathogen will contend with each other, leading to deeper harm.

This is a syndrome of *Shanghan* (Cold Damage), but it is actually not *Zhang Nue* (Miasmic Malaria). The patient’s liver pulse is floating and vigorous, accompanied by headache and aversion to wind. Generally, *Xiao Chaihu Tang* (Minor Bupleurum Decoction) combined with *Qingpi* (Aurantii Fructus Pericarpium Viride) and *Zisu* (Perillae Folium) is used as the main treatment. For those with vomiting, increase the amount of *Shengjiang* (Zingiberis Rhizoma Recens); for those with thirst, add more *Wumei* (Mume Fructus). If it is caused by summerheat, combine *Xiao Chaihu Tang* (Minor Bupleurum Decoction) with *Xiangru* (Elsholtziae Herba), decocted together with *Shengjiang* (Zingiberis Rhizoma Recens) and *Wumei* (Mume Fructus). Furthermore, there is another point: the root of chills and fever cannot be eliminated without promoting free flow and drainage. If the root has not been eradicated, one should administer formulas such as *Maren Wan* (Hemp Seed Pill) or *Shenbao Wan* (Divine Preservation Pill). This also reflects the principle of resolving the exterior first and then attacking the interior.