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A pulse that is wiry (Xian), rapid (Shu), slippery (Hua), and full (Shi) indicates a favorable condition. A pulse that is deep (Chen), fine (Xi), empty (Xu), and faint (Wei) indicates an unfavorable condition. The pulse of malaria naturally presents as wiry. A fine pulse indicates deficiency, while a choppy (Dai) or scattered (San) pulse indicates death.

Malaria symptoms arise from first being injured by summerheat (Shu) and subsequently affected by wind (Feng). The pathogen lodges between Ying (Nutritive) and Wei (Defensive) levels. When the Couli (pores and interstices) are not dense, and cold-wind is encountered, the pathogen is closed in and cannot exit. It resides outside the intestines and stomach, moving in parallel with Ying and Wei. During the day, it travels through Yang; at night, it enters Yin. When they merge, the disease manifests; when they separate, the disease ceases. Merging into Yang causes heat; merging into Yin causes cold. Shallow involvement results in daily attacks; deep involvement results in alternate-day attacks. Involvement in Qi leads to earlier onset; involvement in Blood leads to later onset. According to the *Neijing* (Inner Canon): "The pulse of malaria is naturally wiry." Wiry and rapid pulses indicate much heat; wiry and slow pulses indicate much cold; wiry and short pulses indicate food retention; wiry and slippery pulses indicate much phlegm; wiry and tight pulses suggest the suitability of purgation; floating and large pulses suggest the suitability of emesis; wiry and slow pulses suggest the suitability of warming. This is the general principle for treating malaria.

If the syndrome involves more heat than cold, with mental restlessness and little sleep, it belongs to the Heart and is named Wen Malaria (Warm Malaria), treated with Chai Qin Tang. If there is only slight heat with significant cold, accompanied by lower back pain and cold feet, it belongs to the Kidney and is named Han Malaria (Cold Malaria), treated with Gui Fu Er Chen Tang. If there is initial chills followed by high fever and coughing, it belongs to the Lung and is named Dan Malaria (Blazing Malaria), treated with Shen Su Yin. If the fever lasts longer than the chills, with tendon contraction, it belongs to the Liver and is named Feng Malaria (Wind Malaria), treated with Xiao Chai Hu Tang, adding Wu Yao and Xiang Fu. If chills and heat are balanced, with vomiting of phlegm-saliva, it belongs to the Spleen and is named Shi Malaria (Food Malaria), treated with Qing Pi Yin. After malaria subsides, if both Yin and Yang are deficient, leading to nocturnal emission and coughing, and if proper care is neglected, it may evolve into Lao Zhai (Consumption Disease). If one can clear the heart and nourish the body, regulate diet, and avoid wind, such regulation will ensure recovery.

First discussion: For malaria without sweat, induce sweating; the primary goal is to disperse pathogens. Generally, for early-stage malaria, this dispersing formula should be taken; recovery occurs immediately upon sweating. Formula Name: San Xie Fang (Dispersing Pathogens Decoction). Herbs: Chuanxiong Rhizome (Chuanxiong Bai), Angelica Dahurica Root (Baizhi), Ephedra Stem (Mahuang), White Peony Root (Baishao), Saposhnikovia Root (Fangfeng), Schizonepeta Spike (Jingjie), Perilla Leaf (Zisu), Notopterygium Rhizome (Qianghuo), Licorice Root (Gancao). Preparation: Coarsely crush, add three slices of fresh ginger and three stalks of green onion white, decoct in water, leave exposed overnight, and take warm the next morning. Add Tangerine Peel (Chenpi) for phlegm; add Atractylodes Macrocephala Rhizome (Cangzhu) for dampness; add Cyperus Rhizome (Xiangfu) for food stagnation.

Second discussion: For malaria with sweat, stop sweating; the primary goal is to support healthy Qi. Use Zheng Qi Tang. Herbs: Bupleurum Root (Chaihu, 8 fen), Peucedanum Root (Qianhu, 2 qian), Chuanxiong Rhizome (1.5 qian), Angelica Dahurica Root (1.5 qian), Pinellia Tuber (Banxia, 2 qian), Ophiopogon Tuber (Maimendong, 2 qian), Areca Seed (Binglang, 1 qian), Tsaoko Fruit (Caoguo, 1 qian), Green Citrus Peel (Qingpi, 2 qian), Poria (Fuling, 3 qian), Cinnamon Twig (Guizhi, 6 fen), Licorice Root (8 fen). Preparation: Coarsely crush, decoct with ginger and jujube, take hot in advance.

Third discussion: For all types of malaria, regardless of whether chills precede heat or heat precedes chills, this formula is universally applicable. Formula Name: Qing Pi Yin (Clear Spleen Decoction). Herbs: Green Citrus Peel (Qingpi, remove pith, 2 qian), Magnolia Bark (Nongpu, stir-fried with ginger, 8 fen), Atractylodes Macrocephala Rhizome (Baizhu, 1.5 qian), Pinellia Tuber (Banxia, 2 qian, stir-fried with ginger), Bupleurum Root (Chaihu, 8 fen), Scutellaria Root (Huangqin, 2 qian), Poria (Fuling, 3 qian), Tsaoko Fruit (Caoguo, 1 qian), Licorice Root (8 fen). Preparation: Coarsely crush, add five slices of fresh ginger, decoct in water, take warm.

Fourth discussion: For various malaria cases where chills and heat alternate, Yin and Yang are indistinct, mouth is dry with thirst, urine is red and scanty, or vomiting and diarrhea occur. Formula Name: Jiajian Chai Qin Tang (Modified Bupleurum and Scutellaria Decoction). Herbs: Bupleurum Root (Chaihu, 8 fen), Scutellaria Root (Huangqin, 3 qian), Pinellia Tuber (Banxia, 2 qian, prepared with ginger), Polyporus (Zhuling, 2 qian), Atractylodes Rhizome (Cangzhu, 1.5 qian), Green Citrus Peel (Qingpi, 2 qian), Magnolia Bark (Nongpu, stir-fried with ginger, 8 fen), Areca Seed (Binglang, 1 qian), Tsaoko Fruit (Caoguo, 1 qian), Chinese Plum (Wumei, 2 qian), Licorice Root (8 fen), Alisma Rhizome (Zexie, 2 qian). Preparation: Coarsely crush, decoct with ginger and jujube.

Fifth discussion: Deficiency of Qi in the five Zang organs, unregulated emotions of joy and anger, causing Yin and Yang to overcome each other, condensing into phlegm-fluids, which contend with Wei Qi, resulting in malaria. Also treats various malaria. Formula Name: Si Shou Yin (Four Beasts Decoction). Herbs: Ginseng Radix (Renshen, 1.5 qian), Atractylodes Macrocephala Rhizome (Baizhu, 1.5 qian), Poria (Baifuling, peeled, 3 qian), Exocarpium Citri Reticulatae (Juhong, 1 qian), Pinellia Tuber (Banxia, 2 qian, prepared with ginger), Tsaoko Kernel (Caoguoren, 3 qian), Chinese Plum (Wumei, remove pit, 2 qian), Licorice Root (8 fen), Fresh Ginger (2 slices), Jujube (4 pieces). Preparation: Coarsely crush, add a small amount of salt. Wrap tightly in thick bark paper, moisten with water, and slowly roast over fire until fragrant and dry. Take 1 liang per dose, decoct in one bowl of water until half remains, take warm. Administer several doses continuously before the attack for miraculous effect.

Sixth discussion: Individuals with inherent insufficiency, compounded by labor injury and internal damage, contracting cold and summerheat, leading to malaria with alternating chills and heat, limb fatigue, weakness, and shortness of breath. Or malaria persisting for years without cure, indicating deficiency of both Qi and Blood, with the malaria pathogen penetrating deeply, named Lao Malaria (Labor Malaria). This formula governs. Formula Name: Jiawei Buzhong Yiqi Tang (Added-Ingredient Reinstitute the Middle and Augment the Qi Decoction). Herbs: Astragalus Root (Huangqi, honey-fried, 2 qian), Ginseng Radix (Renshen, 8 fen), Atractylodes Macrocephala Rhizome (Baizhu, remove rhizome, 8 fen), Tangerine Peel (Chenpi, 6 fen), Angelica Sinensis Root (Danggui, 8 fen), Bupleurum Root (Chaihu, 1 qian), Cimicifuga Rhizome (Shengma, 3 fen), White Peony Root (Baishao, 8 fen), Scutellaria Root (Huangqin, 1 qian), Pinellia Tuber (Banxia, prepared, 8 fen), Licorice Root (5 fen). Preparation: Coarsely crush, decoct with ginger and jujube, take on an empty stomach. Add Cinnamon Twig (Guizhi, 5 fen) and double Huangqi if sweating; double Chaihu and Huangqin if heat is severe; add Ophiopogon Tuber (Maimendong) and Trichosanthes Root (Tianhuafen) if thirsty.

Seventh: Treat malaria caused by summerheat injury, suitable for Xiang Ru San. Herbs: Mosla Herb (Xiangru, 4 qian), Magnolia Bark (Nongpu, stir-fried with ginger juice), Lablab Bean (Biandou, 1 qian each), Chinese Plum (Wumei, 1 qian). Preparation: Decoct in water. Just before completion, add one spoonful of ginger juice, take warm.

Eighth discussion: Due to excessive heat from medicinal herbs, tongue curls and turns black, nose appears smoky, six pulses are wiry, surging, and tight. This indicates deep-seated Yang toxicity. First, fold blue cloth multiple layers, soak in fresh cold water, place on the chest, replace frequently. Do this three times until heat slightly recedes, then administer this medicine. Formula Name: Long Hu Tang (Dragon and Tiger Decoction). Herbs: Bupleurum Root (Chaihu, 1.5 qian), Scutellaria Root (Huangqin, 7 fen), Pinellia Tuber (Banxia, 7 fen), Gypsum Fibrosum (Shigao, 2.5 qian), Anemarrhena Rhizome (Zhimu, 1 qian), Coptis Rhizome (Huanglian, 1.5 qian), Phellodendron Bark (Huangbai, 8 fen), Gardenia Fruit (Zhizi, 8 fen), Rice (Jingshi, 50 grains). Preparation: Coarsely crush, decoct with ginger and jujube.

Ninth: Treat Zhang Malaria (Miasma Malaria) with high fever and irritability, suitable for Di Long Yin Zi. Grind three earthworms (Di Long), add a little fresh ginger juice, mint juice, and raw honey, mix with fresh cold water and take. If heat is severe, add a little borneol (Longnao).

Tenth: For weak individuals suffering from early-stage malaria contracted with cold, suitable for Wu Ji San. Decoct according to this formula using ginger and green onion. (Formula see "Middle Cold" section).

Eleventh discussion: For constitutionally weak individuals with malaria characterized by predominant chills and chronic non-resolution, do not use antimalarial astringents. Suitable for Fen Li Shun Yuan San. Herbs: Aconite Lateral Root (Chuanwu, 1 liang, peeled, half raw half cooked), Prepared Aconite Root (Fuzi, 1 liang, peeled, half raw half cooked), Arisaema Rhizome (Nanxing, 2.5 liang, half raw half cooked), Aucklandia Root (Muxiang, 5 qian, not exposed to fire). Preparation: Coarsely crush. Take 4 qian per dose, add ten slices of ginger and seven jujubes, decoct in one bowl of water until 0.7 bowls remain. Take quickly two to three doses on the morning of the attack. Half raw and half cooked helps resolve Yin and Yang.

Twelfth discussion: For various malaria, regardless of sequence of chills/heat, solitary chills/heat, consecutive days, or alternate days, accompanied by headache, nausea,烦渴 (irritable thirst), rapid breathing, bitter taste, dry throat, and ineffective with other medicines, suitable to use this to cut off the malaria. Formula Name: Chang Shan Yin Zi (Dichroa Decoction). Herbs: Dichroa Root (Changshan, 2 qian), Tsaoko Fruit (Caoguo, remove skin, 2 qian), Anemarrhena Rhizome (Zhimu, 2 qian), Galangal Rhizome (Liangjiang, 1.5 qian), Chinese Plum (Wumei, 1.5 qian), Licorice Root (Gancao, roasted, 1 qian). Preparation: Coarsely crush. One liang per dose, add five jujubes. Take two doses continuously before the attack.

Thirteenth discussion: Malaria occurring at night indicates pathogenic factors in the Yin meridians; suitable to disperse wind-cold in the blood. Use this: Ma Huang Gui Zhi Tang. Herbs: Ephedra Stem (Mahuang, 1 qian, remove joints), Cinnamon Twig (Guizhi, 2 qian), Scutellaria Root (Huangqin, 1 qian), Peach Kernel (Taoren, remove skin, 30 pieces), Licorice Root (Gancao, roasted, 3 qian). Preparation: Coarsely crush, decoct in water. Peach Kernel is a herb that disperses blood and soothes the liver.

Fourteenth: For chronic malaria with abdominal masses (Pi), use water-ground Agarwood (Chenxiang) to administer Xionghuang Jiedu Wan (Realgar Detoxification Pill) to expel black blood-like mud, extremely foul-smelling, which is a sign of efficacy. (Formula see "General Treatment" section).

Fifteenth: A formula transmitted from a foreign monk to Zhou Shaofeng for treating malaria, regardless of new/old, deficiency/excess, cold/heat, including Ghost Malaria, Evil Malaria, Warm Malaria, and Miasma Malaria. One dose cures immediately with miraculous effect. Herbs: Strychnos Nux-vomica Seed (Fanmubie, i.e., Nux Vomica, remove shell and pod, stir-fry until black, 1 liang), Realgar (Huangxiong, 1 qian), Cinnabar (Zhusha, 1 qian), Licorice Root (Gancao, 1 qian). Preparation: Grind into fine powder. Take 4 fen per dose. Just before the malaria attack, eat one bowl of rice beforehand, mix the medicine powder with wine, drink, cover with blanket, lie down, and recover.

Sixteenth: Treat malaria with initial chills followed by heat, more heat than chills, or heat only without chills. Herbs: Cinnamon Twig (Guizhi, 5 qian), Gypsum Fibrosum (Shigao, 1.5 liang), Anemarrhena Rhizome (Zhimu, 1.5 liang), Scutellaria Root (Huangqin, 1 liang). Preparation: Coarsely crush, decoct in water.

Seventeenth: Treat malaria where medication worsens chills and heat, indicating a combined disease of Taiyang, Yangming, and Shaoyang. Use Xiao Chai Hu Tang plus Gypsum Fibrosum (Shigao), Anemarrhena Rhizome (Zhimu), and Cinnamon Twig (Guizhi), decoct in water.

Eighteenth: Treat chronic malaria with inability to eat, oppression in the chest, desire to vomit but unable to, use this to induce vomiting. Herbs: Realgar (Xionghuang), Melon Peduncle (Tianguadi), Red Adzuki Bean (Chixiaodou) in equal parts. Preparation: Grind into powder. Take 5 fen per dose, mix with warm water, induce vomiting until satisfied.

Nineteenth discussion: Chronic malaria accumulating into Jia masses (abdominal lumps), Pi masses between chest and hypochondrium, ineffective with other medicines, suitable for Ke Malaria Yin. Herbs: Atractylodes Rhizome (Cangzhu, soaked in rice wash), Tsaoko Fruit (Caoguo, remove skin), Platycodon Root (Jiegeng), Green Citrus Peel (Qingpi), Tangerine Peel (Chenpi), Galangal Rhizome (Liangjiang, 5 qian each), Angelica Dahurica Root (Baizhi), Poria (Baifuling), Pinellia Tuber (Banxia, boiled in water and stir-fried with ginger), Bitter Orange (Zhiqiao, bran-roasted), Cinnamon Bark (Guixin), Perilla Leaf (Suye), Dried Ginger (Ganjiang, roasted, 3 qian each), Chuanxiong Rhizome (Chuanxiong, 2 qian), Licorice Root (Gancao, roasted, 3 qian). Preparation: Take 1 liang per dose, decoct in water, add a little salt, take on an empty stomach.

Twentieth: Treat chronic malaria with abdominal masses, use Awei Wan. Herbs: Turtle Shell (Biejia, vinegar-roasted, 5 qian), Sparganium Rhizome (Sanleng, vinegar-soaked and roasted), Curcuma Rhizome (Ezhu, vinegar-soaked and roasted), Cyperus Rhizome (Xiangfuzi, soaked in rice wash, 1 liang each), Tangerine Peel (Chenpi, 5 qian), True Asafoetida (Zhenawei, 5 qian). Preparation: Grind into powder, make pills with vinegar paste, size of wu zi (wussel nut). Take 30 pills per dose, send down with light ginger soup.

Twenty-first discussion: Malaria occurring once a day, twice a day, every three to five days, or lasting months to years, or due to excessive use of antimalarial astringents leading to chronic non-resolution, indicates severe deficiency of Yuan Qi and Spleen/Stomach. Use Buzhong Yiqi Tang (see "Internal Injury" section), modified by adding Dichroa Root (Changshan), Anemarrhena Rhizome (Zhimu), Areca Seed (Binglang), and Fritillaria Bulb (Beimu). One or two doses will be effective. After recovery, remove these four herbs and use the base formula for regulation. Long-term use naturally strengthens healthy Qi and expels pathogenic factors.

Twenty-second discussion: Suffering from malaria chills and heat, using astringent antimalarials instead causes fever and aversion to cold, reduced appetite, mental fatigue, and pulses that are either floating/surging or fine/faint. This indicates Yang deficiency and cold. Use Buzhong Yiqi Tang (see "Internal Injury" section), modified with Ginseng Radix (Renshen), Astragalus Root (Huangqi), Angelica Sinensis Root (Danggui), and Atractylodes Macrocephala Rhizome (Baizhu) each at 3 qian, Licorice Root (Gancao) at 1.5 qian, plus stir-fried Dried Ginger (Ganjiang) and Prepared Aconite Root (Pao Fuzi) each at 1 qian. One dose stops chills and heat; several doses restore Yuan Qi.

Twenty-third discussion: Chronic malaria lasting years, with deficiency of both Qi and Blood, occurring every three to five days, use Shiquan Dabu Tang (see "Tonification" section), based on this formula. Because pathogenic factors in the Yang level are shallow and easy to treat, while those in the Yin level are deep and difficult to treat, long-term administration is recommended.

Twenty-fourth: Treat chronic malaria lasting three years without cure, use Ginseng Radix (Renshen) and Dried Ginger (Ganjiangshengjiang) each 5 qian, mixed with wine and taken. Sweating stops the malaria immediately.

Twenty-fifth: Post-malaria, emaciation, fever and aversion to cold, poor appetite and weakness, use Buzhong Yiqi Tang, increasing Ginseng Radix (Renshen), Astragalus Root (Huangqi), Angelica Sinensis Root (Danggui), and Atractylodes Macrocephala Rhizome (Baizhu) by 2 qian each, Licorice Root (Gancao) to 1.5 qian, and Roasted Ginger (Paojiang) to 2 qian. One dose stops chills and heat; several doses restore Yuan Qi.

Twenty-sixth: A woman with chronic malaria, dry mouth after attacks, extreme fatigue, use Qiwei Baizhu San plus Ophiopogon Tuber (Maimendong) and Schisandra Berry (Wuweizi), decoct in large quantity for free drinking. Recurrence becomes milder, then use Buzhong Yiqi Tang plus Poria (Fuling) and Pinellia Tuber (Banxia) for over ten doses to cure. For cutting malaria, I often use Ginseng Radix (Renshen) and Atractylodes Macrocephala Rhizome (Baizhu) each 1 liang, and Ginger (Shengjiang) 4 liang roasted, decocted and taken for immediate cure. Alternatively, large dose of Buzhong Yiqi Tang plus roasted ginger is especially effective. Ginger alone is also effective.

Twenty-seventh: Chronic malaria mostly belongs to Yuan Qi deficiency and cold. Qi deficiency causes cold, Blood deficiency causes heat, Stomach deficiency causes aversion to cold, Spleen deficiency causes fever, downward flow of Yin fire causes alternating chills and heat, or vomiting saliva, refusal to eat, tremors, diarrhea, cold limbs, all due to Spleen/Stomach weakness. Suitable to tonify with Buzhong Yiqi Tang, all symptoms resolve. If cold limbs, increase Prepared Aconite Root (Fu Zi).

Twenty-eighth: A woman suffering from chronic malaria, menstruation stops during attacks, weak form and large pulse, headache, poor appetite, diarrhea, dribbling urination, dry mouth, cracked lips, internal heat, abdominal distension. This is due to chronic malaria causing deficiency of healthy Qi and dominance of Yin fire. Treat with Yiqi Tang for cure. For occasional headaches, add Vitex Fruit (Manjingzi) to stop them. Combine with Liuwei Dihuang Wan to restore menstruation.