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The alternating chills and fever occur at fixed intervals. When it occurs once a day, the pathogenic factor is shallow; when it occurs once every two days, the pathogenic factor is deep; when it occurs once every three days, the pathogenic factor is even deeper. Chills preceding fever is a favorable pattern (Shun); fever preceding chills is an unfavorable pattern (Ni). Occurrence from Zi hour to Wu hour belongs to Yang; occurrence from Wu hour to Zi hour belongs to Yin. Only chills without fever is named Mu Nüe (Male Malaria), which is a pure Yin disease; only fever without chills is named Dan Nüe (Fever Malaria), which is a pure Yang disease. Malaria induced by fatigue is named Lao Nüe (Labor Malaria); that induced by improper diet is named Shi Nüe (Food Malaria). Furthermore, there is Gui Nüe (Ghost Malaria) caused by malevolent influences, and Zhang Nüe (Miasma Malaria) contracted from mountain miasma. These conditions vary greatly but are primarily governed by the Shaoyang channel (Shaoyang Jing). Since Shaoyang resides at the boundary of Yin and Yang, bias towards Yin results in more chills, while bias towards Yang results in more fever. If both Yin and Yang are diseased, chills and fever are equal. Pure chills or pure fever indicate extreme deviation of Yin or Yang. Even Gui Nüe and Zhang Nüe stem from deficiency of Yang Qi, where righteous Qi is insufficient to overcome pathogenic factors, internal deficiency fails to resist external invasion, and deficiency of Spleen and Stomach Yang fails to ripen and transform food and fluids. All these do not depart from the Shaoyang channel.

The pulse in malaria is naturally Xian (String-like). Floating Xian indicates exterior pathogen; sunken Xian indicates interior pathogen; slow Xian indicates Cold; rapid Xian indicates Phlegm-Fluid; surging Xian indicates Heat; full Xian indicates Food Retention. The pulse in chronic malaria: gradual slowing indicates recovery; string-tight indicates danger; vomiting with scattered double string-pulse; intermittent with scattered pulse indicates incurability.

At the onset, Xiaochaihu Tang (Minor Bupleurum Decoction) is suitable for all cases. One dose per day, cure is expected within five days. In this formula, Chai Hu (Bupleuri Radix) should be used in doses ranging from four qian to eight qian; it must not be underdosed. This single herb was ranked as a superior grade by Shennong, believed to prolong life and enhance vitality when taken long-term. Since the works of Li Dongyuan and Li Shizhen circulated, the true nature of this herb has been obscured. Zhang Jingyue's newly created Wuchaihu Yin (Five Bupleurum Drink) as a powder is considered ignorant and reckless, causing significant harm. ○ For cases with no sweat at onset, remove Ren Shen (Ginseng Radix et Rhizoma) and add Guizhi (Cinnamomi Ramulus) 3 qian. After ingestion, consume hot porridge and cover warmly to induce slight sweating for cure. If not cured, administer again. This approach is beneficial and harmless; do not be misled by superficial opinions. ○ If fever is severe with no sweat, add Mahuang (Ephedrae Herba) 3 qian. If the patient's family is stubbornly influenced by erroneous theories, substitute Mahuang with Xingren (Armeniacae Semen Amarum), Zisu Ye (Perillae Folium), and Fangfeng (Saposhnikoviae Radix), each 3 qian. Cover warmly after ingestion to induce slight sweating; hot porridge is not required. ○ For malaria occurring in both morning and afternoon, excessive treatment is unnecessary. However, for cases with more chills indicating excess Yin, add Guizhi (Cinnamomi Ramulus) 3 qian, use twice the amount of Shengjiang (Zingiberis Rhizoma Recens), or additionally add Wuzhuyu (Evodiae Fructus) 3 qian. For pure chills without fever, apply this method, or remove Huangqin (Scutellariae Radix) and add Shu Fuzi (Aconiti Lateralis Radix Praeparata) 2 qian. ○ For cases with more heat indicating excess Yang, add Zhimu (Anemarrhenae Rhizoma) and Beimu (Fritillariae Cirrhosae Bulbus), each 3 qian. For those with profuse sweating, high fever, and intense thirst, add Sheng Shigao (Gypsum Fibrosum) 5 qian, Maidong (Ophiopogonis Radix) 3 qian, and Jingmi (Oryza Sativa) 4 qian. For pure fever without chills, apply this method, or additionally add Zhimu (Anemarrhenae Rhizoma) 3 qian. Fever preceding chills is named Bi Nüe (Obstruction Malaria), treated similarly, adding Guizhi (Cinnamomi Ramulus) 2 qian, derived from Baihu Jia Guizhi Tang (White Tiger plus Cinnamon Twig Decoction) in the *Jin Gui Yao Lue*. ○ For Gui Nüe, where the pulse fluctuates between large and small, add Huoxiang (Agastaches Herba) 2 qian, as fragrance represents the upright Qi of Heaven and Earth, which overcomes pathogens. Add Tianma (Gastrodiae Rhizoma) 3 qian; its shape resembles a tuber with twenty-four offshoots surrounding it, and its sprout is called Chijian. This symbolizes the display of authority like bow and arrow. ○ For Zhang Nüe, add Cangzhu (Atractylodis Rhizoma) and Huoxiang (Agastaches Herba), each 2 qian. ○ For Shi Nüe, use Pingwei San (Calm the Stomach Powder) as the base, incorporating Chai Hu (Bupleuri Radix) as the sovereign herb, merging the two formulas into one, following the ancient method of compound prescriptions. ○ Lao Nüe occurs in deficient individuals unable to withstand labor; use the original Xiaochaihu Tang (Minor Bupleurum Decoction), remove Banxia (Pinelliae Rhizoma), add Gualougen (Trichosanthis Radix) 2 qian, or assist with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). ○ For all malaria cases presenting with thirst, remove Banxia (Pinelliae Rhizoma) and add Gualougen (Trichosanthis Radix) to generate body fluids.

For all malaria cases seeking rapid efficacy, after three episodes, administer Xiaochaihu Tang (Minor Bupleurum Decoction) with Changshan (Dichroae Radix) 3 qian at Yin hour. Decoct the dregs again and administer at Chen hour. If vomiting occurs, allow the expulsion of phlegm-fluid; spontaneous recovery will follow. ○ Contemporary physicians, misled by popular materia medica, claim Changshan (Dichroae Radix) is a harsh antimalarial drug. They argue that forcibly cutting off malaria before pathogenic factors are exhausted leads to other diseases. This is baseless speculation. Changshan (Dichroae Radix) moves from Yin to Yang, serving as an excellent herb to vent pathogens outward. Zhang Zhongjing used its sprout, named Shuqi (Dichroae Caulis), while modern practitioners use its root. How can it be considered a harsh cutting agent?

For chronic malaria unresponsive to various drugs, and for Sanyin Malaria (Three-Yin Malaria) occurring every three days, use Baizhu (Atractylodis Macrocephalae Rhizoma) 1 liang or 2 liang, added with Shengjiang (Zingiberis Rhizoma Recens) 5-7 qian. Decoct in water to yield one cup, administer at Yin hour. Decoct dregs again and administer in the morning. For heat-dominant cases, substitute Baizhu (Atractylodis Macrocephalae Rhizoma) with Danggui (Angelicae Sinensis Radix) slightly over 1 liang. ○ For Spleen and Kidney dual deficiency unresponsive to other treatments, use Jinxiao Baizhu Tang (Near-Efficacy Atractylodes Decoction), administered twice daily. Cure is expected within ten days. (Upon completion of this manuscript, a friend returned from Anhui and gifted me a collection of medical books authored by Zhang Xin, titled *Fu Jing*. It contains the aphorisms "Three Yang intersect with Gallbladder, Three Yin intersect with Spleen" and "Treat Gallbladder for Three Yang Malaria, Treat Spleen for Three Yin Malaria." These are truly admirable insights. If this gentleman engages in discussion with master teachers and good friends, he will surely become a giant in medicine. I regret not knowing him personally.)

Acute malaria, known in the world as Tai Nüe (Fetal Malaria), is lingering and difficult to cure. Similar to vaccine pox symptoms originating from fetal toxins, treat with Liujunzi Tang (Six Gentlemen Decoction), adding Cao Guo (Tsaoko Fructus) and Wumei (Mume Fructus), or combine with Xiaochaihu Tang (Minor Bupleurum Decoction).

For chronic malaria unresponsive to treatment, there is no need to specifically target malaria. Instead, regulate with Liujunzi Tang (Six Gentlemen Decoction) and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), swallowing Guifu Bawei Wan (Cinnamon and Aconite Eight-Ingredient Pill) concurrently. Regulation for half a month ensures complete recovery. Current physicians follow Zhang Jingyue's methods, using Heren Yin (He Ren Drink) and Xiunüe Yin (Stop Malaria Drink), focusing on Heshouwu (Polygoni Multiflori Radix) as the main ingredient, claiming it embodies the doctrine of neutrality. However, its bitter and astringent nature makes it unpalatable. I have frequently observed that long-term use of this medication induces swelling and other diseases. Students of medicine must be aware of this.