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The clinical manifestations of malaria (Nue, intermittent fever) have been detailed in classical medical treatises. When chills precede fever, it is called Cold Malaria (Han Nue); when fever precedes chills, it is called Warm Malaria (Wen Nue); when there is only fever without chills, it is called Dan Malaria (Dan Nue, also known as Heat Malaria); and when there is only chills without fever, it is called Pin Malaria (Pin Nue, also known as Cold Malaria). All these conditions occur at regular intervals. If the pathogenic factor invades the Fengfu acupoint (GV16), the attacks occur every other day; if the pathogenic factor lodges in the head and neck region, the attacks occur frequently on a daily basis. This variation in timing arises because the body's vital energy (Qi) varies in deficiency or excess, and the location of pathogenic invasion differs.

However, the classics discuss the etiology of Cold, Warm, and Dan Malaria but omit Pin Malaria; they discuss the viscera involved in Warm and Dan Malaria but omit Cold Malaria. This likely reflects an intent to mutually supplement and elucidate principles. Students should thoroughly investigate the prosperity and decline of Yin and Yang, contemplating deeply to grasp their essence. Generally speaking, Wind belongs to Yang Qi, while Cold belongs to Yin Qi. Injury by Wind first, followed by Cold, results in fever preceding chills; injury by Cold first, followed by Wind, results in chills preceding fever. If Yin Qi is exhausted first and Yang Qi acts alone, there will be fever without chills; if Yang Qi is exhausted first and Yin Qi acts alone, there will be chills without fever.

Since Warm Malaria arises from winter pathogens lodging in the bone marrow, it can be inferred that Cold Malaria arises from summer pathogens lodging between the skin and interstices (Couli). Since Dan Malaria involves excess Qi that does not dissipate and does not affect the Yin aspect, it can be inferred that Pin Malaria involves deficient Qi that leaks and does not affect the Yang aspect. All these cases fall within the pattern of Yin and Yang struggling above and below, with deficiency and excess alternating. Additionally, malaria complicated by various toxic vapors from streams, mountain miasmas, or evil influences may present with alternating chills and fever, emaciation, prolonged duration, irregular onset and cessation, and if unresolved for a long time, may transform into Labor Malaria (Lao Nue) or form a mass known as "Malaria Mother" (Nue Mu). Regarding Malaria of the Five Viscera and the Three Yang and Three Yin meridians, these all arise because the Qi of specific viscera is biased towards deficiency, allowing pathogenic factors to enter and lodge. Treatment methods must vary according to the meridians involved, utilizing moxibustion, acupuncture, and specific herbal formulas accordingly. Later learners should examine this carefully (Same as above, from *Leibian*).

There are four diseases where tonification is contraindicated: one is Malaria, two is Mania (Kuang Ji), three is Water Qi (Shui Qi, edema/fluid retention), and four is Hongxiangjiao (Hongxiangjiao, often referring to beriberi or gouty arthritis). Even if these four diseases show slight improvement after treatment, one must absolutely avoid administering warm-natured herbs for vigorous tonification. Even mild tonifying herbs should only be used if they benefit the primary disease (From *Yiyu*).

Although the manifestations of Jia (soft, movable abdominal mass) appear similar, those that do not move upon palpation are referred to as Qian (hard, fixed abdominal mass). Those that can be displaced or shifted are named Jia. The condition of Jia is milder than that of Qian. A fixed, immobile mass indicates a terminal prognosis. The patient’s voice becomes hoarse, and speech is inhibited or absent; this indicates food stagnation lodged in the abdomen. This disease is characterized by cold, frequent salivation, limbs feeling chilly as in malaria, difficulty eating, mental depression, and pain. This is termed Food Jia (Shi Jia).