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Malaria (Nue) as a disease has five names: the first is Dan Nue (Febrile Malaria), the second is Han Nue (Cold Malaria), the third is Shi Nue (Damp Malaria), the fourth is Pin Nue (Yin Malaria), and the fifth is Mu Nue (Yang Malaria). Although the names differ, the causes are all due to the Six Evils (Wind, Cold, Summerheat, Dampness, Dryness, Fire) and Seven Emotions (Joy, Anger, Worry, Pondering, Sorrow, Fear, Fright), as well as dietary irregularities and overexertion or lack of exercise. The Classics state: Summerheat injured in summer leads to malaria in autumn; those with weak constitutions are prone to infection. Attacks occurring once daily are easy to treat, while those occurring every two or three days are difficult to cure.

Dan Nue is characterized by deficient Yin Qi and hyperactive Yang Qi, manifesting as fever without chills, internal excess heat without discharge, irritability, thirst, vomiting, and emaciation. Han Nue results from contracting cold pathogens, presenting with anhidrosis, aversion to cold, spasmodic pain, pale complexion, and a pattern of chills preceding fever. Shi Nue arises from exposure to rain and dampness or bathing while sweating, presenting with heavy body sensation, painful joints, nausea, regurgitation, and abdominal distension. Pin Nue results from prolonged exposure to Yin-dampness, where Yin excess and Yang deficiency fail to control Yin, leading to predominant chills with little fever, Qi deficiency causing diarrhea, and a miserable, trembling appearance. Mu Nue is caused by dietary irregularities damaging the interior and exterior, resulting in dual deficiency of Ying and Wei. The pathology involves the struggle between pathogenic factors and healthy Qi, where Yin and Yang energies contend. When Wei Qi (Defensive Qi) separates from the pathogen, sweating resolves the condition. Wei Qi travels through Yang during the day and Yin at night; encountering Yang leads to daytime attacks, while encountering Yin leads to evening or nighttime attacks. If pathogens invade the Five Zang Organs internally or connect horizontally to the Mo Yuan (Sea of Origin), far from the path of Wei Qi, they cannot intersect with it, leading to intermittent attacks every other day or every three to four days. The speed of Wei Qi circulation varies, causing attacks to occur early or late. In severe cases, internal and external defenses fail, true and pathogenic Qi are indistinguishable, Yin and Yang lose balance, and cold and heat alternate chaotically, resulting in irregular attack times.

The *Su Wen* discusses Malaria of the Six Meridians: Taiyang Malaria causes lower back pain, heaviness of the head, cold starting from the back, chills preceding fever, stiffness of the waist and spine, sweating after fever subsides, and is difficult to cure. Shaoyang Malaria causes flaccidity of the body, mild chills and fever, aversion to people, palpitations upon seeing others, abundant fever and sweating. Yangming Malaria causes initial shivering chills, severe cold followed by delayed fever, sweating after fever subsides, and a preference for sunlight or moonlight to feel comfortable. Taiyin Malaria causes melancholy, desire for rest, anorexia, frequent chills, fever, and sweating; vomiting occurs at onset and subsides afterward. Shaoyin Malaria causes vomiting, severe chills and fever (more heat than cold), desire to stay behind closed doors, and is difficult to cure. Jueyin Malaria causes lower back pain, fullness in the lower abdomen, difficulty urinating resembling Gong syndrome (dysuria) but not actually Gong, frequent urination, fear, Qi deficiency, and abdominal oppression.

Although divided by meridians, these are all diseases of the Five Zang Organs. Xin Malaria (Heart Malaria) causes mental agitation, strong desire for cold water, predominant chills with mild fever. Gan Malaria (Liver Malaria) causes a pale greenish complexion, frequent sighing, and a demeanor resembling death. Pi Malaria (Spleen Malaria) causes chills, abdominal pain, intestinal borborygmi during fever, and sweating after borborygmi cease. Fei Malaria (Lung Malaria) causes cold sensations in the heart, severe chills followed by fever, fright during fever intervals, and visual hallucinations. Shen Malaria (Kidney Malaria) causes shivering cold, lower back and spine pain with turning restlessness, difficulty defecating, blurred vision, and cold extremities. Wei Malaria (Stomach Malaria) causes hunger before onset, inability to eat despite hunger, and abdominal distension/fullness after eating.

Generally, the treatment principles are: A wiry and rapid pulse indicates heat; a wiry and slow pulse indicates cold. Wind is dispersed, cold is warmed, deficiency-excess patterns are treated via the affected meridian, phlegm is cleared, stagnation is regulated, and deficiency is tonified. Do not hastily use antimalarial drugs to cut off the disease; cutting too early allows pathogens to penetrate the Five Zang Organs, lingering for long periods and causing various complications. Following the correct order of medication ensures efficacy.