病者，身热足寒，颈项强急，恶寒，时头热，面赤，目赤，独头动摇，卒口噤，背反
张者，痉病也。〔若发其汗者，寒湿相搏，其表益虚，即恶寒甚，发其汗已，其脉如
蛇〕。
【按】
「痉病也」之下诸句，与上文义不属。与后条之为欲解脉如故诸句，文义相属，宜分
于彼。
太阳病，发热无汗，〔反〕寒者，名曰刚痉。
【按】
反恶寒之「反」字，衍文也。玩痉病之条自知，当恶寒也，宜删之。
「若发其汗者，寒湿相搏，其表益虚，即恶寒甚，发其汗已，其脉如蛇，」〔暴腹胀
大者，〕为欲解，脉如故，反伏弦者，痉。
【按】
「暴腹胀大者」五字，衍文也，当删之。
师曰：疟脉自弦，弦数者多热，弦迟者多寒，弦「沉」〔小〕紧者下之差，弦迟者可
温之，弦「浮」紧者，可发汗针灸也，弦「滑」〔浮〕大者，可吐之，弦数者，风发
也，以饮食消息止之。
【按】
弦小紧者之「小」，当是「沉」字，则有可下之理。弦紧者，当是「弦浮紧」，则有
可发汗之理。弦浮大者，当是「弦滑大」，则有可吐之理。且不遗本文疟脉自弦之意
，当改之补之。
师曰：阴气孤绝，阳气独发，则热而少气、烦冤，手足热而欲呕，名曰瘅疟；若但热
不寒者，邪气内藏于心，外舍分肉之间，令人消铄肌肉。
【按】
此言瘅疟，其文脱简，『内经』已详，不复释。
温疟者，其脉如平，身无寒，但热，骨节疼烦，时呕，白虎加桂枝汤主之。
【按】
此言温疟，其文脱简，『内经』已详，不复释。
疟多寒者，名曰牝疟，蜀漆散主之。
【按】
此言牝疟，其文脱简，『内经』已详，不复释。
The patient presents with fever in the body and coldness in the feet, stiffness and tension in the neck and nape, aversion to cold, occasional heat in the head, redness of the face and eyes, isolated shaking of the head, sudden locking of the jaw (trismus), and opisthotonos (backward arching of the back). This is Jing disease (spasm disorder). [If sweating therapy is mistakenly applied, cold and dampness contend with each other, causing further deficiency at the exterior, resulting in severe aversion to cold; after sweating, the pulse resembles the movement of a snake].
[Commentary]
The sentences following "is Jing disease" do not logically connect with the preceding text. They are contextually linked with the subsequent passage regarding "the pulse resembling the original state as the condition resolves," and should be transferred to that section.
Taiyang disease (Disease of the Taiyang Channel) presenting with fever, absence of sweat, [and] aversion to cold is named Gang Jing (Stiff Spasm).
[Commentary]
The character "fan" (reversely/contrarily) in "aversion to cold" is an interpolative error (extraneous character). Examination of the Jing disease passages clarifies this; it should simply be aversion to cold, and this character should be deleted.
"If sweating therapy is mistakenly applied, cold and dampness contend with each other, causing further deficiency at the exterior, resulting in severe aversion to cold; after sweating, the pulse resembles the movement of a snake," [if sudden abdominal distension occurs], this indicates the condition is about to resolve; if the pulse remains like the movement of a snake, but instead appears deep and wiry, it is Jing disease.
[Commentary]
The five characters "sudden abdominal distension" are interpolative errors and should be deleted.
The Master said: The pulse of Nue (Malaria) is naturally wiry. A wiry and rapid pulse indicates predominant heat; a wiry and slow pulse indicates predominant cold. A wiry, deep, small, and tight pulse may be treated with purgation (downward-draining method); a wiry and slow pulse may be treated with warming methods; a wiry, floating, and tight pulse may be treated with diaphoresis (sweating method) and acupuncture/moxibustion; a wiry, slippery, and large pulse may be treated with emesis (vomiting method); a wiry and rapid pulse indicates wind-heat flourishing, which can be controlled through dietary regulation.
[Commentary]
The "small" in "wiry, small, tight" should be "deep," providing the rationale for using purgation. "Wiry, tight" should be "wiry, floating, tight," providing the rationale for using diaphoresis. "Wiry, floating, large" should be "wiry, slippery, large," providing the rationale for using emesis. These corrections align with the original meaning that "the pulse of Nue is naturally wiry" and should be amended accordingly.
The Master said: When Yin Qi is isolated and cut off, and Yang Qi issues forth alone, there will be fever, shortness of breath, inner vexation and grievance, heat in the hands and feet, and a desire to vomit. This is called Dan Nue (Hot Malaria). If there is only heat without cold, the pathogenic factor resides internally in the Heart and externally lodges between the muscle layers, causing the flesh and muscles to waste away.
[Commentary]
This discusses Dan Nue. The text has lacunae (missing parts), and since Nei Jing (The Inner Canon) has already detailed it extensively, no further explanation is provided.
Wen Nue (Warm Malaria) presents with a pulse similar to that of a healthy person, absence of chills, presence of only heat, pain and irritability in the bone joints, and occasional vomiting. It is primarily treated with Baihu Jia Guizhi Tang (White Tiger plus Cinnamon Twig Decoction).
[Commentary]
This discusses Wen Nue. The text has lacunae, and since Nei Jing has already detailed it extensively, no further explanation is provided.
Nue presenting with predominant cold is called Pin Nue (Yin/Cold Malaria). It is primarily treated with Shuqi San (Shuqi Powder).
[Commentary]
This discusses Pin Nue. The text has lacunae, and since Nei Jing has already detailed it extensively, no further explanation is provided.