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Commentary states: Regarding Heart Malaria (Xin Nue), the *Neijing* describes it as causing severe mental restlessness. The patient desires cold water, yet experiences more chills than fever. Treatment involves needling the Hand-Shaoyin (Heart) meridian. This is because the Heart is the residence of the Spirit (Shen); pathogenic factors cannot easily invade it. When pathogenic factors do invade, they cause mental restlessness. The desire for cold water arises from internal Heat of Heart Fire. The manifestation of more chills and less fever occurs because there is internal Heat while the exterior presents with Cold. Treatment should focus on unblocking the Heart meridian and draining pathogenic Heat to achieve a cure.

Formula for Chanshan Pill (Changshan Wan) to treat Heart Malaria:
Chanshan (Stemona Root, *Stemonae Radix*) [1 liang, pounded separately], Taoren (Peach Kernel, *Persicae Semen*) [1 liang, select aged kernels, remove double-kernel ones, stir-fry, remove skin, and pound], Qiandan (Lead Oxide, *Lithargyri Pulvis*) [8 qian, finely ground], Chishao (Fermented Soybean, *Sojae Preparata*) [1 he, stir-fry until smoke ceases, crushable by hand, spread to cool, then pounded separately].
The above four ingredients are pounded and ground into powder. Mix with refined honey, then pound another thousand times. Form pills the size of sophora seeds. Take 15 pills each time, administered with wine on an empty stomach at the hour of Ji Ming (3-5 AM). Take another 15 pills just before the onset of symptoms. On that day, avoid combing hair or bathing; food and drink may be resumed only after the episode has passed.

Formula for Chanshan Decoction (Changshan Tang) to treat Heart Malaria with severe mental restlessness, desire for cold water, more chills than fever:
Chanshan (*Stemonae Radix*) [1 liang, cut into small pieces], Zhizi Ren (Gardenia Seed, *Gardeniae Fructus*) [7 units], Shigao (Gypsum Fibrosum, *Gypsi Fibrosum*) [1 liang, crushed], Wumei (Mume Fruit, *Prunae Mume Fructus*) [7 units, pitted and stir-fried], Biejia (Carapax et Plastrum Testudinis, *Testudinis Carapax et Plastrum*) [1 liang, soaked in vinegar, roasted, remove skirt-like edges], Gancao (Licorice Root, *Glycyrrhizae Radix et Rhizoma*) [1 fen, roasted and cut], Chishao (*Sojae Preparata*) [1 he, lightly stir-fried], Shuqi (Herba Pteridis Quercifoliae, *Pteridis Quercifoliae Herba*) [3 qian].
The above eight ingredients are coarsely pounded and sifted. Take 3 qian bi per dose, add 1 sheng of water and 3 slices of Zhu Ye (Bamboo Leaf, *Phyllostachys Viridis Folium*), cut into pieces. Decoct until 0.7 sheng remains, strain off the dregs. Take warm before the onset of symptoms, and again immediately prior to onset.

Formula for Xiondan Pill (Xiondan Wan) to treat Heart Malaria:
Pishuang (Arsenic Trioxide, *Arsenici Trioxidum*) [0.5 liang, ground], Dansha (Cinnabar, *Cinnabaris*), Shexiang (Moschus, *Moschi Feratum*), Xionghuang (Realgar, *Realgar), Xiondan (Ursi Fel, *Ursi Fel*) [2 liang each].
The above five ingredients are mixed using Xiondan to form pills the size of mung beans. On the day of onset, take 2 pills on an empty stomach with cold water. Just before onset, take 1 pill. In both instances, suppress the drug's action with cold cooked rice. The attack may cease on the same day or only after a severe outbreak does recovery occur. If vomiting is induced, administer warm water to swallow it down. Phlegm and saliva should be vomited out, leading to recovery.

Formula for Huanglian Powder (Huanglian San) to treat Heart Malaria:
Huanglian (Coptis Rhizome, *Coptidis Rhizoma*) [remove roots].
The above single ingredient is pounded and sieved into a powder. Before onset, mix with wine and take a quantity held between three fingers (approx. 3-5 grams).