Library

Blood stasis obstructing the orifices of the Heart leads to aphasia (loss of speech), where the patient cannot speak but only makes "yi yi" sounds; this is termed Ya Zhang (Mute Malaria). Treatment for this condition should always involve dispersing blood, using Hei Shen San (Black Divine Powder) [see Blood Disorders] to rapidly dissipate the stasis. (Hei Shen San must be used with caution.) If the tongue becomes stiff and rigid due to phlegm confusing the orifices of the Heart, this does not fall under this discussion.

There are also conditions that resemble malaria but are not malaria. For example, when pathogenic factors from Shang Han (Cold Damage) remain in the Shaoyang (Lesser Yang) meridian, there is alternating chills and fever. This resembles malaria but lacks a regular periodicity, occurring perhaps two or three times a day, with heat immediately followed by cold and cold by heat, continuously without cessation. This differs from true malaria, which has a fixed periodicity and intervals of remission. Furthermore, individuals with deficiency may also experience alternating chills and fever. The Classic states: "Yang deficiency leads to external cold, Yin deficiency leads to internal heat. When Yin qi ascends into the Yang region, it causes aversion to cold (referring to the inherent cold Yin qi of the lower Jiao invading the Yang region, causing aversion to cold); when Yang qi descends into the Yin region, it causes fever (referring to the Yang qi of the upper Jiao sinking into the Yin region, causing fever)." Therefore, there are cases of alternating chills and fever that resemble malaria but are not malaria. These often occur after illness or postpartum, resulting from gradual accumulation of deficiency and damage, differing from malaria which arises suddenly. Moreover, these episodes start and stop intermittently without a fixed schedule, distinct from the precise timing of malaria. (Note: Some types of Zhang Malaria also lack fixed timing, which must be known.)

Treatment methods: If there is no sweating, diaphoresis (sweating method) is required, primarily to disperse pathogens. (Danxi stated: External pathogens must be resolved through sweating. The Foot Jueyin Liver meridian is particularly difficult to induce sweating in; sweating reaching the feet is ideal. Generally, inducing sweat does not necessarily require herbs like Mahuang (Ephedrae Herba); simply resolving stagnation and unblocking meridians allows pathogens to scatter as sweat.) If there is sweating, one should consolidate sweat and prioritize supporting healthy Qi. For newly onset conditions with excess pathogens, sweating, emesis, or purgation methods may be used. For chronic conditions with deficient healthy Qi, tonifying Qi and Blood is appropriate. For conditions lasting some time with both deficiency and lingering pathogens, a combination of tonification and dispersion is suitable. If pathogens have penetrated deeply into the Yin aspect, raising Yang Qi followed by diaphoresis is indicated. If pathogens enter due to deficiency, dispersing methods should first be used to expel the exogenous pathogens, followed by supporting Stomach Qi. If caused by Phlegm, Food Retention, or Qi Stagnation, digestive and resolving methods should first be used to clear congestion, followed by gradual tonification of Spleen Yuan Qi. After various types of malaria have occurred three to five times, once pathogens in the exterior and interior are cleared, antimalarial interception methods should be employed. Regarding medication administration, during the peak of an attack, one should avoid the pathogen's sharp vigor; medicine should be taken two hours before the expected onset.