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Malaria is all caused by contracting wind-cold, summer-heat, or heat pathogens. Zhu Danxi once said: "If there is no sweating, treatment should focus on inducing sweating to disperse the pathogen; if there is sweating, treatment should focus on stopping sweating to support healthy qi first." This is an unchangeable truth for millennia. When attacking, presenting with alternating chills and fever, heavy body, pain in bone joints, spontaneous sweating, and frequent vomiting, it is damp malaria (Shi Nue). It is caused by exposing oneself to wind-cold after sweating, drinking excessive cold water due to extreme thirst, or bathing in cold water. There is food malaria (Shi Nue), caused by dietary injury, resulting from overeating combined with cold contraction. For these conditions, use equal parts of Chai Hu (Bupleuri Radix), Qian Hu (Peucedani Radix), Qing Pi (Aurantii Fructus Immaturus), Chen Pi (Aurantii Pericarpium), Cang Zhu (Atractylodis Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Bai Fu Ling (Poria), Gan Cao (Glycyrrhizae Radix et Rhizoma), Zhu Ling (Polyporus), Ze Xie (Alismatis Rhizoma), Zhi Mu (Anemarrhenae Rhizoma), Bei Mu (Fritillariae Cirrhosae Bulbus), Hou Po (Magnoliae Officinalis Cortex), Ban Xia (Pinelliae Rhizoma), and Huang Bo (Phellodendri Cortex), with Sheng Jiang (Zingiberis Rhizoma Recens) and Da Zao (Jujubae Fructus) as guides. Take one dose to clear the pathogen. On the day of the malaria attack, at wu geng (5-7 AM), before breakfast, decoct the above formula with added Chang Shan (Dichroae Radix), Bing Lang (Arecae Semen), and Cao Guo Ren (Tsaoko Fructus) in equal parts to intercept the malaria, which will lead to recovery. If chronic malaria persists causing extreme weakness of middle qi, it is called spleen cold (Pi Han). Use Si Shou Yin (Four Beast Decoction) with added Jujube and Ginger, taking five to six doses for self-healing.

Xia Yuzhu said: There are cases where yin deficiency mimics malaria but is treated as malaria. Such people have absolutely no insight or understanding. The term "mimics" implies that the two syndromes are distinct. Even if one says it resembles malaria, it only resembles the spleen cold pattern within malaria. Ask yourself: Is there anyone in the world whose malaria immediately presents as spleen cold upon onset? This condition must arise from ineffective clearing methods initially, followed by unsuccessful interception methods, or from refusing medication altogether, dragging on for a long time until reaching the stage of spleen cold. Clearly, there is this progression. If one sees afternoon tidal fever and shivering chills and treats it as malaria, does one not consider that malaria has its own developmental course? Moreover, spleen malaria improves from severe to mild, whereas yin deficiency worsens from mild to severe. The two syndromes are clearly different, yet they are not distinguished. This kind of cognitive flaw is truly incomprehensible.

For yin deficiency mimicking malaria: If tidal fever is slightly more prominent than chills, treat with Si Wu Tang (Four Substance Decoction) plus Ren Shen (Ginseng Radix et Rhizoma). If there is heat in the Heart, Lung, or Liver, although Shu Di Huang (Rehmanniae Radix Praeparata) is already in the decoction, add Sheng Di Huang (Rehmanniae Radix) additionally. If chills are slightly more prominent than tidal fever, add Huang Qi (Astragali Radix), Ren Shen, and Gan Cao in equal parts to Si Wu Tang, with the dosage of Ren Shen halved. If both tidal fever and chills are mild, use only Si Wu Tang without additional herbs. If the patient is female, add Hong Hua (Carthami Flos) two to three fen.