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(Below are miscellaneous diseases, which do not have a direct distribution relationship with the five Zang organs, so they are listed afterwards.)
[Lou] The treatment of malaria in children is mostly the same as that for adults, with sweating being the sign of recovery. It is appropriate to use herbs such as Guizhi (Cinnamon Twig), Chaihu (Bupleurum Root), Mahuang (Ephedra Herb), Renshen (Ginseng Root), and Fuling (Poria) etc. Additionally, one must consider whether the disease is caused by food stagnation or phlegm-fluid retention, and adjust the treatment accordingly. Generally, it is mostly due to irregular diet, so resolving food stagnation and promoting digestion should be prioritized. [Zeng] The *Neijing: Malaria Chapter* states: "Malaria arises from wind pathogens, but why does it occur at specific times?" Qibo replied: "Summer injury by heat leads to autumn malaria." This means that when pores are open and sweat is discharged, wind is encountered, or water vapor stays on the skin after bathing, because Wei Qi (Defensive Qi) fails to guard, and pathogenic factors reside together. When the disease first starts, there are yawning, aversion to cold, and shivering, pain in the waist and back, and vexing pain in bone joints. After the cold subsides, both interior and exterior become hot, accompanied by headache and thirst. This is due to the contention between Yin and Yang Qi, resulting from alternating deficiency and excess. If Yin Qi alone is excessive, Yang Qi becomes deficient, hence chills, pain in the waist, back, head, neck, and joints appear first. If Yang Qi alone is excessive, Yin becomes deficient, hence fever appears first; during onset, there is loss of appetite, frequent vomiting, headache, lower back pain, and difficult urination. Yin excess and Yang deficiency lead to coldness inside and out; Yang excess and Yin deficiency lead to heat inside and out. This is caused by external contraction of the Six Excesses or internal injury of the Seven Emotions, accumulating phlegm-fluids, where pathogenic Qi resides with Wei Qi, causing daily attacks. Wei Qi travels through Yang during the day and Yin at night; encountering Yang, it moves outward; encountering Yin, it presses inward. Pressing into the Five Zang organs, the pathogenic Qi goes deep and cannot exit with Wei Qi, leading to every-other-day attacks. When Wei Qi reaches the location of the pathogenic Qi, if it is in Yang, there is heat; if in Yin, there is cold. The classics say: "Exuberance causes harm, extremity reverses." When Yin and Yang Qi decline, and Wei Qi mixes with pathogenic Qi, the disease rests. When Yin and Yang contend, and Wei Qi gathers again with pathogenic Qi, the disease recurs. This happens according to the location of Wei Qi combining with the invaded pathogen. Cold first then heat indicates cold pathogen first then wind pathogen, named Cold Malaria. Heat first then cold indicates wind pathogen first then cold pathogen, named Warm Malaria. Only heat without cold is named Dan Malaria (Febrile Malaria). Heavy body, alternating cold and heat, joint pain, abdominal fullness, spontaneous sweating, and easy vomiting is named Damp Malaria. Only cold without heat is named Pin Malaria. Since malaria presents various syndromes, prescriptions vary according to Yin-Yang deficiency/excess, pulse, symptoms, and treatment principles, using sweating, vomiting, purging, or warming methods to treat the syndrome, aiming for balance. However, all diseases invade the body due to righteous Qi deficiency, allowing pathogenic Qi to linger and transform into excess, transmitting from exterior to interior, using sweating first then purging, an unchanging principle since ancient times. Thus, treating malaria must start with releasing the exterior, using Baijie San (for fright) decocted with water, fresh ginger, and scallion, followed by Xiaochaihu Tang (for alternating cold and heat) added with Guizhi, fresh ginger, and jujube, decocted and taken to harmonize and resolve exterior-interior pathogens, naturally achieving effect. If exterior and interior are both excess, use Danggui San (for tidal fever), Wuhe Tang (for interior heat), or Wuxi Wan (for accumulation), Liusheng Wan (for accumulation) to purge, Yongqi San (for hernia) to stop diarrhea and tonify, then Huoxiang Yin (for poor feeding) added with Caoguo (Black Cardamom), Liangjiang (Galangal), fresh ginger, and jujube, decocted and taken to regulate Stomach Qi and remove cold pathogens, leading to natural recovery. If alternating cold and heat persists after releasing the exterior, use Erxian Yin (see this section) to intercept the malaria. Once cold and heat are removed, use Pingwei San (for poor feeding) added with Huixiang Tang (for abdominal pain), mixed evenly, and taken empty-stomach with salt water to warm the stomach, dry the spleen, improve appetite, and strengthen the Middle Jiao Earth, so external pathogens retreat without battle, which is a clear theory. For cases with more cold than heat, persisting for a long time, leading to weak Spleen-Stomach, reduced diet, and changed complexion, use Erjiang Wan (see this section) and Qingpi Tang (see this section). [Xue] The classics say: "Summer injury by heat leads to autumn malaria." Symptoms begin with hair standing up and yawning, followed by chills and teeth chattering, pain in the waist and spine. After cold subsides, interior and exterior become hot, headache like splitting, desire for cold drinks. This is because pathogenic Qi merging with Yang makes Yang excessive, merging with Yin makes Yin excessive; Yin excess causes cold, Yang excess causes heat. Upper and lower Yin-Yang contend, deficiency and excess alternate, hence intermittent cold and heat. There are cases of once a day, once every two days, once every three days, skipping one day then two days, occurring day and night, morning or afternoon, or at night, with or without sweating, these are generalities. Detailed analysis divides them into Six Channels, Five Zang organs, and differences due to phlegm, food, labor, summer-heat, ghost, and miasma types (Six Channel and Five Zang malaria detailed in *Miscellaneous Diseases Standard*). Phlegm Malaria: Phlegm stops in chest and diaphragm, forming malaria, causing subcostal fullness, rebellious Qi, vexation, and vomiting. Food Malaria: Diet injures Spleen, causing belching, acid regurgitation, and chest-diaphragm discomfort. Labor Malaria: Long duration without recovery, exterior and interior both deficient, guest pathogen not scattered, true Qi not restored, so although intermittent, it triggers upon exertion. Summer-heat Malaria: Face is greasy, thirsty, even after fever subsides, sweating often occurs. Ghost Malaria: Onset and cessation are unpredictable. Miasma Malaria: Contracted mountain miasma, presenting with intermittent cold and heat. Prolonged non-recovery is called Chronic Malaria or Old Malaria. If Old Malaria does not heal, a mass forms between the hypochondrium, called Malaria Mother (Maiku), due to initial failure to release the exterior, or subsequent external cold-wind invasion and internal dietary injury, causing lingering persistence. Treatment: Wind-summer-heat pathogens enter from outside, suitable for resolution. After releasing the exterior, support Stomach Qi immediately. Thus, Danxi said: "No sweat needs sweat, primarily dispersing pathogen; Sweat needs no sweat, primarily consolidating righteous Qi." Acute malaria suits exterior release; chronic malaria suits Spleen tonification. Cold malaria suits warming; Warm malaria suits harmonizing; Dan malaria suits clearing; with phlegm resolves phlegm; with food resolves food; Labor malaria suits calming; Summer-heat malaria suits resolving; Ghost malaria suits expelling; Miasma malaria suits dispersing. These are generalities. More specifically: More heat less cold uses Xiaochaihu Tang. More cold less heat uses Qingpi Yin. No sweat uses Guizhi Mahuang Ban Tang. Sweating uses Chaihu Guizhi Tang. Profuse sweating and thirst uses Baihu Tang. Thirst with difficult urination uses Wuling San. Red urine, more heat and thirst uses Xiaochaihu Tang. More heat, sweating, abdominal fullness, and loose stools uses Dachaihu Tang, add Gegen (Kudzu Root) if thirsty. Phlegm Malaria uses Erchen Tang (for phlegm-sputum) added with Chaihu and Huangqin (Scutellaria Root), severe cases add Zhishi (Immature Bitter Orange). Food Malaria first uses Da'an Wan (for retained food), then Yigong San (for vomiting/diarrhea). Labor Malaria and Chronic Malaria both use Buzhong Yiqi Tang (for deficient heat). Summer-heat Malaria uses Shiwei Xiangru Yin. Ghost Malaria uses Guiku San. Miasma Malaria uses Sishe Yin. Malaria Mother uses Biejia Yin. For those with weak Spleen-Stomach suffering malaria, regardless of sweating or not, across Three Yin and Six Channels, Liu Junzi Tang is the main formula. Add Chaihu and Zhizi (Gardenia Fruit) for more heat; Ganjiang (Dried Ginger) and Rougui (Cinnamon Bark) for more cold; Huangqi (Astragalus Root) and Fumai (Floating Wheat) for sweating; Cangzhu (Atractylodes Rhizome) and Gegen for no sweat. For sinking of Yuan Qi and Liver Wood overacting on Spleen, add Shengma (Cimicifuga Rhizome) and Chaihu, which is optimal. Using Qingpi (Tangerine Peel), Caoguo, Changshan (Polygala Root) etc., thinking them good interception methods, will further deplete righteous Qi and deepen pathogen, often leading to prolonged persistence and becoming deficient heat. If the nursing mother has emotional/desire imbalance, improper diet, or alternating cold-heat resembling malaria with blazing Liver Fire, causing illness in the infant, one must treat the nursing mother to avoid error.
*Quansheng Zhimi* discusses: Cold-heat diseases, some have heat after cold, some cold after heat. If chills, headache like splitting, body stiffness, frequent yawning, desire for cold drinks, or cold then heat, or heat then cold, or regular onset, or every-other-day onset, occurring exactly at the time, returning to normal after attack, this is called Malaria. Malaria pulse is naturally wiry; wiry-numerous indicates more heat; wiry-slow indicates more cold. All arise from winter wind-cold qi stored in bone marrow. In spring, Yang Qi expands greatly, pathogen cannot exit spontaneously. Encountering great summer heat, it combines with pathogen to erupt. More cold suits warming with Jianggui Tang. More heat suits resolving with Gualou Tang. Equal cold-heat suits regulating with Biejia Tang. For adult and child malaria, if cold starts from back, feeling cold like a hand's size, little shivering, seeming to want to sweat, or sudden headache, occasional vomiting, pulse slow and small, this is due to inherent weak Spleen-Stomach, cold Qi gathering grain/water, unable to digest, transforming into phlegm. Hidden phlegm inside, Yin rises over Yang, Yang oppressed by Yin causes cold, forced sweating ensues. Suitable for Xuanfuhua Wan and Banshu Wan.