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According to the *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet): "In malaria where chills are predominant, it is called Pin Malaria (malaria characterized by predominance of cold)." Zhao Yi-de failed to distinguish between similar characters and annotated it as "Mu Malaria" caused by pathogenic factors in the Heart. Yu Jiayan also believed that the pathogen was latent in the Heart; since the Heart is a Yang organ (Mu Zang), he likewise named malaria with more chills than fever as Mu Malaria. Both gentlemen mistakenly identified Pin Malaria as Mu Malaria and both asserted that the pathogen resides in the Heart. Shi Wen has corrected their errors, providing a standard for future students. He stated: "If the pathogenic factor were indeed stored internally in the Heart, there would be only fever without chills, which is termed Dan Malaria (malaria with fever but no chills). In this case, however, the pathogen is latent in the Kidney, hence there are more chills and less fever, thus it is called Pin Malaria. Because the pathogen is latent and bound, Yang Qi cannot circulate to the exterior, resulting in external cold. Patients suffering from this condition mostly have constitutions deficient in True Yang. This is because during midsummer, they indulged in cooling off and drinking cold beverages, contracting Yin-Cold or Yin-Dampness, such that their Yang Qi could not control the dominance of Yin pathogens. Therefore, when the malaria attacks, the cold is severe while the fever is slight, accompanied by a miserable demeanor and trembling/shivering. The illness occurs at regular intervals, the pulse must be deep and slow, and the complexion pale and white. Treatment should employ methods to diffuse Yang Qi and penetrate latent pathogens. If due to Cold, Ginger (*Zingiberis Rhizoma*) and Aconite (*Aconiti Lateralis Radix Praeparata*) are used as chief herbs; if due to Dampness, Atractylodes (*Atractylodis Macrocephalae Rhizoma*) and Tsaoko (*Amomi Fructus*) are used as principal herbs. If the disease persists for a long time without resolution, warming and tonifying methods are appropriate."

Tan Malaria (Phlegm Malaria) arises from excessive consumption of melons, fruits, and greasy foods during summer, leading to stagnation and formation of Phlegm; or it stems from a constitution inherently prone to Phlegm, where Phlegm occupies the Taiyin Spleen, lying latent and dormant. Once exposed to cool wind externally, the Phlegm rises with the wind, transforming into malaria. At the initial onset, symptoms include headache and dizziness, nausea and vomiting due to Phlegm-Qi rebellion, alternating chills and fever, and a string-taut and slippery pulse. An ancient proverb states: "No Phlegm, No Malaria," is this not true? Treatment should utilize methods to resolve Phlegm and regulate Qi, adding Tsaoko (*Amomi Fructus*) and Agastache (*Agastachis Herba*). If coma or sudden collapse occurs, methods to open orifices and guide out Phlegm should be employed, adding Magnolia Bark (*Magnoliae Officinalis Cortex*), Tsaoko (*Amomi Fructus*), and Suhexiang Wan (Styrax Pill). For obese individuals, phlegm-resolving medicines should be used in higher doses.

Shi Malaria (Food Malaria) is also known as Wei Malaria (Stomach Malaria). It results from irregular diet, inconsistent hunger and fullness, disorder of Grain Qi, and disharmony of Ying and Wei (Nutritive and Defensive Qi). With even slight negligence, external pathogens invade, resulting in malaria. Symptoms include alternating chills and fever, belching, aversion to food, vomiting after eating, chest fullness, abdominal distension, a slippery and forceful pulse, or a prominent pulse at the Qi Kou (Radial Artery). Treatment should employ Zhacha Qu Pingwei Method (Hawthorn and Fermented Rice Pill Formula to Calm the Stomach), adding Agastache (*Agastachis Herba*) and Tsaoko (*Amomi Fructus*). If the pulse is slow and stagnant, Cold is likely concurrent; add Dried Ginger (*Zingiberis Rhizoma*) and White Cardamom (*Amomi Rotundus Fructus*). If the pulse is slow and dull, Dampness is likely concurrent; add Pinellia (*Pinelliae Rhizoma*) and Poria (*Poria*). In cases of Food Malaria, concurrent Cold and Dampness are common; treatment methods must differentiate and address them separately.

One might ask: "Mr. Jiabin's book states that the origin of malaria lies solely in external pathogens. Can one truly develop malaria due to food or phlegm? Based on this argument, Phlegm and Food are merely concurrent syndromes. Why does Mr. Lei specifically categorize Tan Malaria and Shi Malaria?" Lei Feng replied: "When a person with an inherent Phlegm constitution contracts cool wind leading to malaria, Phlegm is the root cause, hence it is called Tan Malaria. When food stagnation combined with external pathogen invasion leads to malaria, Food is the root cause, hence it is called Shi Malaria. Regarding the previously discussed Summerheat, Wind, Cold, Dampness, Warmth, Miasma, Dan, and Pin malaria, if symptoms such as dizziness, vomiting, and a slippery pulse appear, Phlegm is a concurrent syndrome; if belching, food aversion, and a tight pulse appear, Food is a concurrent syndrome. In these instances, they cannot be named Tan Malaria or Shi Malaria. One must certainly distinguish between primary syndromes and concurrent syndromes!"