Library

The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "If one is injured by summer heat in summer, malaria will inevitably occur in autumn." This is because those who are lightly injured manifest symptoms quickly; those heavily injured manifest symptoms later; and those with prolonged episodes are termed chronic malaria (Jiu Nüe). Thus, it is understood that if summer heat qi is trapped and cannot be vented outward, the pathogenic qi moves inward, leading to malaria in autumn. This often arises because nursing mothers hold infants without avoiding wind and cold, or due to exposure to summer dampness, causing pathogenic qi to lodge in the skin and phlegm-fluids (Tan Yin) to accumulate in the zang-fu organs. When yin and yang become unbalanced and pathogenic factors attack healthy qi, alternating chills and fever ensue. If yang is excessive, there is fever; if yin is excessive, there is chills. Chills preceding fever indicates insufficient yang; fever preceding chills indicates insufficient yin. More chills than fever indicates yin prevailing over yang; more fever than chills indicates yang prevailing over yin. Equal amounts of chills and fever indicate an attack between yin and yang; alternating chills and fever indicate a temporary separation of yin and yang. Generally, children contract malaria mostly from dietary issues. One should first use methods to promote digestion and guide out stagnation, then regulate according to the cause of the disease. This is the excellent method.

Li Chan, in his medical writings, states: Malaria is caused by wind and summer heat pathogens. It may occur once daily, once every two days, once every three days, or on alternate days for two consecutive days. It may occur both day and night, with or without sweating, in the morning or afternoon, or at night. The treatment principle for pathogens entering from the exterior is to disperse them, but supporting stomach qi (Wei Qi) is fundamental. Medication must be differentiated based on whether the condition involves the yang aspect or yin aspect. For excess malaria or recent onset, dispersing or intercepting methods can be used. For deficiency malaria or chronic cases, tonifying qi and blood is appropriate. Overuse of antimalarial drugs damages the spleen and stomach, causing the condition to linger indefinitely. For cases with more heat than cold and no sweat, Guizhi Mahuang Ban Tang (Cinnamon Twig and Ephedra Half-Decoction) is indicated. For cases with profuse sweating, Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction) is used. For profuse sweating with thirst, Baihu Jia Guizhi Tang (White Tiger Plus Cinnamon Twig Decoction) is prescribed. For dark, hot urine with more heat than cold, Xiaochaihu Tang (Minor Bupleurum Decoction) is used. For more cold than heat, Qingpi Tang (Clear the Spleen Decoction) or Yangwei Tang (Nourish the Stomach Decoction) is used. For persistent cases not stopping, Gui Ku San (Ghost Cry Powder) stops the malaria. For heat predominance with sweating followed by diarrhea and abdominal pain, Daxiehu Tang (Major Bupleurum Decoction) is used to purge. For chronic malaria with masses in the intestines, Muxiang Wan (Aucklandia Pill) or Biejia Yinzi (Turtle Shell Infusion) regulates the condition. For severe cases, Shengong Wan (Divine Merit Pill) eliminates the masses. For irritability and thirst, Wuling San (Five-Ingredient Powder with Poria) is used. If antimalarial cooling medications are used too early in children, edema may result, including swelling of the external genitalia. Alternatively, food injury to the spleen and stomach causes edema, which is an external manifestation of the spleen. Such cases should be treated with Dafupi Tang (Areca Peel Decoction), Caoguo Yin (Tsaoko Infusion), and similar formulas.