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When pathogenic factors are in the Three Yang meridians, the syndrome is abundant at the exterior. Sweat is difficult to retain after diaphoresis, hence it is said to be "difficult to cure." The phrase "pricking Zhong" refers to Weizhong (BL60), as ancient methods regarded Weizhong as "Zhong". Malaria of the Foot-Shaoyang meridian causes the body to feel flaccid and weak, aversion to seeing people, and palpitations with fear upon seeing others. Heat predominates over cold, and sweating is profuse. Treatment involves pricking the Foot-Shaoyang meridian. ("Jie Xie" denotes flaccidity; "Xie" implies relaxation. Body Jie Xie refers to intolerance of fatigue and a weary appearance. The mildness of both cold and heat indicates the disease is in the half-exterior, half-interior level. Palpitations upon seeing people indicate pathogenic factors in the Gallbladder. Shaoyang belongs to Wood and Fire, thus heat exceeds cold and sweating is severe. One should prick the Foot-Shaoyang meridian, primarily using Xiaxi (GB43).) Malaria of the Foot-Yangming meridian causes initial chills that are severe, followed by heat after a long duration, and sweating when the heat subsides. The patient prefers sunlight, moonlight, or fire, feeling relieved by them. Treatment involves pricking the acupoints on the dorsum of the foot of the Foot-Yangming meridian. Although the Yangming meridian is rich in blood and Qi, if cold pathogens overcome it, chills occur first, followed by heat later. When heat subsides, the pathogen resolves, leading to sweating. Typically, Yangming diseases involve aversion to people and fire; however, preferring light and warmth indicates Yang pathogens affecting the Stomach causing excess heat, whereas Yin pathogens causing deficiency cold would prefer warmth. The point on the dorsum is Chongyang (ST42) of this meridian.) Malaria of the Foot-Taiyin meridian causes dissatisfaction, frequent sighing, anorexia, alternating cold and heat with sweating. Upon onset, vomiting occurs, and the condition improves after vomiting. Acupuncture can then be applied. (The Spleen is the child of the Heart; Spleen disease leads to constrained Heart Qi, causing dissatisfaction. Impaired Spleen transformation blocks the Upper Jiao, causing sighing and anorexia. Taiyin governs interior pathogens which are hard to resolve, leading to alternating cold/heat and sweating. The Spleen meridian connects to the Stomach, passes through the diaphragm, and flanks the throat, causing vomiting upon onset. However, treatment should wait until after vomiting when the pathogen wanes. Points such as Jing-Well, Shu-Stream, and Gongsun (SP4) of this meridian should be used, hence "immediately take them".) Malaria of the Foot-Shaoyin meridian causes severe vomiting, alternating cold and heat with heat predominating, and a desire to stay behind closed doors and windows. This condition is difficult to cure. (The Kidney meridian passes through the liver and diaphragm, enters the lungs, and follows the throat. Yin pathogens rushing upward cause severe vomiting. Kidney disease leads to Yin deficiency, resulting in more heat than cold. Yin syndromes favor stillness, hence the desire for seclusion. As the Kidney is the organ of Supreme Yin harboring pathogens, the disease is deep and hard to cure. Although not explicitly stated, treatment likely involves Dazhong (KI11) and Taixi (KI3) of this meridian.) Malaria of the Foot-Jueyin meridian causes lower back pain, fullness in the lower abdomen, urinary difficulty resembling strangury but actually frequent urination, mental fear, Qi deficiency, and abdominal depression. Treatment involves pricking the Foot-Jueyin meridian. (The Liver meridian passes through the genitalia, reaches the lower abdomen, and spreads over the hypochondrium, causing these symptoms. Urinary difficulty is called strangury; here, it resembles strangury due to Liver pathogen sinking rather than water metabolism issues, causing urgency. Mental fear indicates insufficient Liver Qi. Abdominal depression signifies stagnation. Pricking the Foot-Jueyin meridian, primarily Taichong (LR3), is indicated.)

Lung malaria causes coldness in the heart, severe cold followed by heat, and fright during fever intervals, as if seeing visions. Treatment involves pricking the Hand-Taiyin and Hand-Yangming meridians. (This section discusses acupuncture for Zang malaria, including the Stomach. The Lung is the canopy of the Heart. Cold pathogens attacking the unconquered element cause Lung malaria to induce heart cold. Severe cold followed by heat damages Heart Qi, causing fright and hallucinations. Pricking the exterior-interior meridians clears Yangming excess and tonifies Taiyin deficiency. Lieque (LU7) of the Hand-Taiyin collateral and Hegu (LI4) of the Hand-Yangming Yuan-Source are primary points.) Heart malaria causes severe mental restlessness, a desire for cold water, but predominantly cold with slight heat. Treatment involves pricking the Hand-Shaoyin meridian. (Malaria pathogens in the Heart cause severe restlessness and desire for water. The Heart is a Yang organ; pathogen occupancy leads to Yang deficiency and Yin excess, resulting in predominant cold. Shenmen (HT7) of the Hand-Shaoyin meridian is used.) Liver malaria causes a dark greenish complexion, sighing, and a state resembling death. Treatment involves pricking the Foot-Jueyin meridian to induce bleeding. (Liver corresponds to Wood, hence the greenish color. Liver stagnation causes Qi rebellion and sighing. Wood pathology causes stiffness, resembling death. Pricking the Foot-Jueyin meridian to bleed uses Zhongfeng (LR6). The previous mention of Foot-Jueyin referred to Meridian disease; this clarifies Zang disease. The logic applies similarly to Spleen, Stomach, and Kidney.) Spleen malaria causes cold, abdominal pain, intestinal borborygmus during heat, and sweating after borborygmus. Treatment involves pricking the Foot-Taiyin meridian. (As the Supreme Yin organ, Spleen harbors malaria pathogens, causing cold. The Spleen meridian enters the abdomen from the thigh, causing abdominal pain. Heat following cold indicates Spleen Qi movement, causing borborygmus. Subsequent sweating indicates Yang Qi reaching the exterior, resolving the disease. Shangqiu (SP5) of the Foot-Taiyin meridian is used.) Kidney malaria causes shivering, low back and spine pain with turning discomfort, difficult defecation, blurred vision, and cold hands and feet. Treatment involves pricking the Foot-Taiyang and Foot-Shaoyin meridians. ("Shasha" describes shivering. The Kidney meridian penetrates the spine and opens into the two orifices, causing back pain and constipation. "Runran" describes dizziness/blurred vision, indicating Water deficiency. Cold extremities indicate Yin reversal. Pricking the exterior-interior Foot-Taiyang and Foot-Shaoyin meridians follows previous methods.) Stomach malaria causes hunger without appetite, postprandial distension, and abdominal enlargement. Treatment involves pricking the Foot-Yangming and Foot-Taiyin meridians' transverse vessels to induce bleeding. (Among the Six Fu organs, only the Stomach is highlighted as the leader of the Fu. Pathogens in Yangming affect the Stomach and Spleen, causing hunger without intake and distension. Pricking both exterior-interior meridians is required. Lidui (ST45), Jiexi (ST41), and Zusanli (ST36) are selected for Foot-Yangming. Pricking the transverse vessel of Foot-Taiyin to bleed refers to the oblique large vessel anterior to the medial malleolus, i.e., Shangqiu (SP5). While focusing on acupuncture, the detailed symptoms allow deduction of herbal indications.)

Fire and heat repeating with aversion to cold and fever resemble malaria, occurring daily or every few days. (Most alternating cold and heat syndromes stem from external contraction, but internal excessive fire can also cause periodic chills and fever resembling malaria, though it is not true malaria.) When victorious and retaliatory Qi meet, there are variations in quantity. If Yin is abundant and Yang is scarce, the interval between attacks is long; if Yang is abundant and Yin is scarce, the interval is short. This reflects the balance of victory and retaliation, similar to malaria. (Cold and heat represent Yin and Yang. Slowness and speed reflect their nature. Human Yin and Yang correspond to Water and Fire, Ying and Wei. Heat with apparent cold is extreme Fire resembling Water; cold with apparent heat is extreme Yin resembling Yang. Harmony ensures balanced Qi and regulated interior/exterior. Disharmony leads to variable timing of victorious/retaliatory Qi. Yang entering Yin generates heat (Yin cannot overcome Yang); Yin exiting Yang generates cold (Yang cannot overcome Yin). More Yin means slower meeting and longer intervals; more Yang means faster meeting and shorter intervals. Though not malaria, these mimic it, sharing the principle of Yin-Yang entry/exit. The distinction lies in the presence or absence of pathogens: true malaria involves Wei-Qi meetings determining attacks/remissions; false malaria involves Water-Fire competition determining excess/deficiency. One targets the exterior/pathogen, the other the interior/righteous Qi. Do not assume identical treatments for identical appearances. This distinction separates life from death; practitioners must be cautious.)