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Paroxysm occurs. This is due to excessive labor, presenting with alternating chills and fever. The physician mistakenly diagnosed it as malaria (Nüe Ji) and administered diaphoretic and cold-natured drugs, further depleting the already deficient healthy qi. Without vigorous tonification of Qi and Blood, how could life be preserved? ○ Fang Hu suffered from San Yin Malaria for four years, having consumed dozens of jin of Renshen (Ginseng Root). Due to the prolonged duration and deep-seated nature of the disease, his flesh and muscles were completely wasted, and he could not take food. He felt Qi rushing upward from the left hypochondrium, causing severe restlessness and a sensation of impending collapse. Heavy doses of Guizhi (Cinnamon Twig), Fuzi (Prepared Aconite Root), Shaoyao (Peony Root), and Dihuang (Rehmannia Root) were used to nourish Ying (Nutritive Qi) and dispel pathogenic factors. On the day of the Winter Solstice, which was the expected time of paroxysm, the attack did not occur. (from *Jiren Bian*)

Chen McGong suffered from Triennial Malaria (San Ri Nüe) for a full year without recovery. He had a long-standing aversion to taking Renshen (Ginseng Root). Upon palpation, his pulse was floating and soggy on the superficial level, and weak on the deep level. This indicates that both Ying (Nutritive Qi) and Wei (Defensive Qi) are depleted, hence the persistence of the disease. I told him: "Your previous refusal to take Renshen was because your innate constitution was robust. However, now it is indispensable because the pathogenic factor has lingered for too long." He tried taking one qian, and saliva was produced in the mouth, with no abdominal distension or discomfort. Subsequently, one liang of Renshen (Ginseng Root) and one liang of Shouwu (Polygonum Multiflorum Root) were decocted with a little Jiangzhi (Ginger Juice). After one dose, the condition improved; after two doses, the malaria was arrested. (Li Shicai)

Two men each suffered from Malaria for three years, with paroxysms occurring on days corresponding to Yin, Shen, Si, and Hai. One man's paroxysms occurred during the day, starting at Si hour and subsiding at Shen hour; the other's occurred at night, starting at Hai hour and subsiding at Yin hour. The daytime paroxysm represents a disease of Yang within Yin, suitable for tonifying Qi and releasing the exterior. Xiao Chaihu Tang (Minor Bupleurum Decoction) was prescribed with doubled Renshen (Ginseng Root), plus Baizhu (Atractylodes Macrocephala Rhizome), Chuanyiong (Szechuan Lovage Rhizome), and Chenpi (Tangerine Peel). The nighttime paroxysm represents a disease of Yin within Yin, suitable for nourishing Blood and soothing the Liver. Xiao Chaihu Tang (Minor Bupleurum Decoction) was combined with Siwu Tang (Four Substance Decoction), plus Qingpi (Green Tangerine Peel).
Ten doses were given to each, decocted with Shengjiang (Fresh Ginger) and Dazao (Jujube Fruit). One dose was taken daily two hours before the expected paroxysm. After eight doses, they both experienced profuse sweating on the same day and recovered. (from *Yixue Zhengzhuan*)

Student Bao Beishan suffered from Triennial Malaria for ninety days without relief. Recalling the commentary in *Zuo Zhuan* regarding Duke Huan of Qi's "Sui" (protracted illness), which states that paroxysms ranging from every three days to every ten days are all termed "Sui" (referring to protracted malaria), he consulted materia medica. It was found that Zhebeimu (Fritillaria Thunbergii Bulb) [Note: Text says Weirui/Yuzhu, but context implies specific herb for this case, sticking to text: Weirui] (commonly known as Yuzhu / Polygonatum Odoratum Rhizome) is best for treating such protracted malaria. Three liang were decocted strongly daily, divided into three doses. The root cause was eliminated in half a month. This prescription has been successfully used on many people; it is recorded here to benefit the world. (from *Yican*)

Appendix Formulas
Xieli Wan (Harmonizing Pill) At the time of a solar eclipse, use an appropriate amount of flour, mix with clear water to form a dough, shape into pills while facing the sun, dry them in the sun, and store for use. This embodies 'Yang containing Yin'. Once Yin and Yang are separated, can Malaria fail to heal? If you cut open the pill, it is hollow inside, which serves as verification.

Wufang Wan (Five Directions Pill) Used when Malaria attacks frequently, indicating the pathogenic force has weakened, to arrest the disease. Qingdai (Indigo Naturalis) 5 qian, Chensha (Cinnabar) 1 qian, Guixin (Cinnamon Heartwood) 5 qian, Bai Fan (Alumen) 5 qian, Baizhi (Angelica Dahurica Root) 3 qian, Bashuang (Croton Seed Pulp) 3 qian, Hei Fuzi (Black Prepared Aconite Root) 3 qian, Shexiang (Musk) 1 qian, Liuhuang (Sulfur) 5 qian, Xionghuang (Realgar) 3 qian. Each ingredient is ground into fine powder, separately wrapped in five-colored paper. On the Dragon Boat Festival at Wu hour (noon), arrange them according to directions, burn one stick of incense, then take Zongzi (sticky rice dumplings) from five different surnames, pound them together, and shape into pills the size of paulownia seeds. Coat with Chensha (Cinnabar), and dry in the sun. On the day of the Malaria paroxysm, early morning (one or two shichen), wrap the pill in new cotton and insert it into the nostril. For males, the left nostril; for females, the right nostril. Do not let women touch it.