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Discussion states: Various types of jaundice, including Huangdan (Yellow Jaundice), Jiudan (Wine Jaundice), and Nulaodan (Sexual Exhaustion Jaundice), if not cured for a long time, will all transform into Heidan (Black Jaundice). Its manifestations include fullness in the lower abdomen, yellowing of the entire body, blackening of the forehead, and heat in the soles of the feet. This involves the Foot-Shaoyin Kidney Meridian, because the color corresponding to the Kidney is black, and the disease location is in the Kidney; hence, there is lower abdominal fullness, yellow complexion, black stool, and heat in the soles of the feet. These are all syndromes of disease in the Foot-Shaoyin Meridian.

Formulas:
Danggui Tang (Angelica Decoction) (from *Shengji Zonglu*): Treats various jaundices that have persisted for a long time without healing, transforming into Black Jaundice.
Herbs: Danggui (Angelicae Sinensis Radix, 3 liang), Guizhi (Cinnamomi Ramulus, peeled, 6 liang), Maimendong (Ophiopogonis Radix, heart removed, 1.5 liang), Huangqin (Scutellariae Radix, black heart removed), Huangqi (Astragali Radix), Ganjiang (Zingiberis Rhizoma, processed), Chifuling (Poria with Red Coir, 1 liang each), Chenpi (Citri Reticulatae Pericarpium, 1 liang each).

Yinchen Hao Wan (Artemisiae Scopariae Pill) (from *Shenghui Fang*): Treats Black Jaundice with darkening of the body and obstructed, difficult urination.
Herbs: Yinchen Hao (Artemisiae Scopariae Herba), Chifuling (Poria with Red Coir, peeled), Tinglizi (Lepidii Semen, stir-fried, 1 liang each), Zhike (Aurantii Fructus, pith removed, stir-fried with bran), Baizhu (Atractylodis Macrocephalae Rhizoma, 1 liang 1 fen each), Xingren (Pruni Armeniaci Semen, processed), Gansui (Kansui Radix, processed, 1 fen each). Make pills the size of green beans.

Gua Di San (Melon Stalk Powder) (also known as Chixiaodou San, from *Shenghui Fang*): Treats Black Jaundice where both the body and stool are black, as well as persistent Yellow Jaundice.
Herbs: Guadi (Momordicae Fructus, 1 fen), Xionghuang (Realgar, ground, 1 qian, boiled first in vinegar), Gancao (Licorice Root, honey-fried, 1 liang), Gualou (Trichosanthis Fructus, 2 liang). Grind the above into a fine powder. Take one "zi" dose per administration.

Xiaoshi San (Niter Powder): Treats fever at dusk (between 3-5 PM) accompanied by aversion to cold. This arises from Sexual Exhaustion Jaundice. There is urgency in the bladder, fullness in the lower abdomen, yellowing of the whole body, and blackening of the forehead. If abdominal fullness is severe, it is difficult to treat. This formula is used for Yellow Jaundice transforming into Black Jaundice, which physicians cannot cure, often resulting in death; treat urgently. (From *Qianjin Fang*)
Usage: Use juice from Tugua Gen (Polyscias fruticosa root or similar local root), take half a qian (half a cup) on an empty stomach daily. The pathogen exits via urine, and the disease heals. However, one must assess the patient's strength to determine if half a cup can be taken.

Summer injury by Summerheat leads to Malaria in Autumn. Those injured lightly manifest near and suddenly; those injured heavily manifest far and violently. Malaria refers to chronic malaria. Thus, summer injury... [Text contains gaps/omissions regarding etiology].

Yang Meridian involvement... Fire cannot warm; heat makes ice water unable to feel cold. Due to prior Cold injury followed by Wind injury, there is initial chills then fever, named Han Malaria (Cold Malaria). Patients have initial fever then chills, restlessness, spontaneous sweating, and aversion to wind. Due to prior Wind injury followed by Cold injury, Wind being Yang and Cold being Yin, there is initial fever then chills, named Wen Malaria (Warm Malaria). Patients have only fever without chills, Yin Qi is isolated and exhausted, Yang Qi erupts alone, mental vexation, heat in hands and feet, desire to vomit, and thirst. This is caused by Summerheat injury, named Dan Malaria (Fever Malaria). Patients have alternating chills and fever, heavy body, painful joints, distension, spontaneous sweating, and propensity to vomit. Caused by bathing after sweating, allowing Dampness to lodge in the skin, or exposure to rain and dampness, named Shi Malaria (Damp Malaria). Patients have more chills than fever, desolate expression, trembling, occurring at fixed times. This is due to Yang deficiency and Yin excess, frequent contraction of Yin-Dampness, Yang unable to control Yin, named Mu Malaria (Male Malaria). These five types of malaria are formed by external contraction of Wind-Cold, Summerheat, and Dampness combining with Wei Qi (Defensive Qi).

Internal causes of Malaria: Patients have alternating chills and fever, pale complexion, frequent sighing, appearing like a corpse. This is caused by suppressed anger injuring the Liver, leading to Qi stagnation, named Gan Malaria (Liver Malaria). Patients have mental vexation, desire to drink clear water, more chills than slight fever, intermittent onset. This is caused by excessive joy damaging Heart Qi, leading to Qi dispersion, named Xin Malaria (Heart Malaria). Patients have more chills, heat and pain in the abdomen, sometimes thirsty, sometimes not, no fever or diarrhea, borborygmus, sweating. This is caused by overthinking injuring the Spleen, leading to Qi stagnation and phlegm accumulation, named Pi Malaria (Spleen Malaria). Patients have extreme internal cold, fearfulness during fever episodes, and... [text missing]... caused by sorrow injuring Lung Qi and condensing phlegm, named Fei Malaria (Lung Malaria). Patients have cold hands and feet, watery sound in waist and spine, fever, difficult defecation, eye... [text missing]... caused by Kidney issues, named Shen Malaria (Kidney Malaria). These five types of malaria are formed by disharmony of Zang organ Qi and stagnation of phlegm-fluids.

Non-internal, non-external causes: Patients develop chills and fever; within a year, young and old, strong and weak may contract seasonal epidemics, generating fear, named Gui Malaria (Ghost Malaria). Suitable for exorcism and avoidance methods. Patients have intermittent... [text missing]. Treatment should follow local geographical suitability. Patients feel cold, hungry but unable to eat, epigastric fullness. This is caused by dietary irregularities injuring Stomach Qi, commonly called Shi Malaria (Food Malaria). Persistent for years, recurring after recovery. Long travel or standing, even without minor exertion, triggers it. Although temporarily relieved, slight labor causes recurrence, named Lao Malaria (Labor Malaria). Some persist for years, named Nuomu (Malaria Mother). Malaria encompasses internal, external, and non-internal/non-external causes. External is contraction of Four Qi; "Summer injury by Summerheat, Autumn must have Malaria" follows seasonal order, not to be rigidly applied.

When Malaria begins, it starts with goosebumps, followed by yawning/stretching. Headache, thirst, desire to drink, coldness of the body occur due to struggle between Yin and Yang ascending and descending. Yangming deficiency causes chills and jaw trembling; Taiyang deficiency causes pain in waist, back, head, and neck; Shaoyang Qi excess causes bone cold and pain. Pathogen merging into Yang results in Yang excess and Yin deficiency; Taiyin deficiency leads to... Jueyin deficiency leads to waist and abdomen... Heat excess causes depression. Yin excess causes internal cold; Yang deficiency causes external cold. One generates heat internally, one externally, so both interior and exterior are hot. All are due to external contraction of Cold/Summerheat, and dietary irregularities/labor. Disease Qi resides with Wei Qi, so attacks occur. Pathogen invades internally to Five Zang, horizontally connects to Mu points, and exits together, causing intermittent attacks. Because Wei Qi gathers at Fengfu once a day and night, entering the spine every 26 days and moving upward, attacks occur earlier each time. Malaria pathogen in Yin is quiet/cold; at extremes, Yin and Yang both decline, Wei Qi separates, causing varying timing. Also, pathogen striking head/neck causes attack when Qi reaches head/neck; striking back causes attack when Qi reaches back. Attacks occur wherever Wei Qi meets the pathogen, driven by external factors.

Except for Dan Malaria (pure heat), Han Malaria (chills then heat), and Wen Malaria (heat then chills), acupuncture notes: Do not needle chaotic pulses, do not needle rapid/turbulent pulses, do not needle when pulse is declining or not yet vigorous; all are untreatable as they harm Righteous Qi.

If Lung disease causes Malaria, intermittent chills/fever, severe cold, then fever, fright, hallucinations, this is Lung Malaria syndrome. If a person originally... [text missing], condition... command... picking toenails indicates death, though disaster hasn't arrived, called "Walking Corpse," this is Heart disease voice sign. Deficiency tonifies, Excess drains. Untreatable cases require clear observation.

Liver disease causing Malaria makes complexion pale, breath short/wheezing, trembling like death. If originally less prone to grief/anger, suddenly angry, abnormal speech, fluctuating tension, gesturing towards eyes mid-sentence, thinking deeply. If lower joints diseased, disaster comes. This is Liver disease voice sign. If deficient, injured by Cold-Wind; if excess, damaged by Heat-Qi. Yang drains, Yin tonifies.

Spleen disease causing Malaria causes abdominal pain when cold, borborygmus when hot, sweating after borborygmus. If originally balanced in emotion, suddenly angry/happy, silent, laughing without answering, this is Spleen disease voice sign. Disaster comes within ten days.

Kidney disease causing Malaria makes one desolate, waist/spine pain with turning, difficult stool, body tremors, cold/hot hands/feet. If originally calm, suddenly stuttering/irritable, contrary to nature, Kidney is injured, voice is the sign. Speaking before spoken to, silence after speaking, clutching abdomen, this is Kidney disease voice sign. Observe deficiency/excess, interior/exterior, floating/sinking, clear/turbid to treat.

Malaria pulse is naturally Wiry (Xian). Wiry-Rapid indicates much Heat; Wiry-Slow indicates much Cold. Wiry-small-tight can be purged; Wiry-slow treated with Warm herbs. If pulse is Rapid-Tight... [text missing].

Foot-Taiyang Malaria causes lower back pain, heavy head, cold starting from back, initial chills then fever, shivering. Heat stops, sweat appears... Needle... Many months... Disease... Door... Intent... Needle... Foot Meridian. Taiyang Malaria: Qianghuo plus Sheng Dihuang Tang. Xiao Chai Hu plus Guizhi Tang. Yangming Malaria: Guizhi and Baihu two formulas. Huangqin Shaoyao plus Guizhi Tang. Yuanhu... Zhi plus...

Liver disease face blue, pulse wiry, tight skin, much blue indicates pain, robust form, chest/hypochondriac pain, deafness, bitter taste, dry tongue, alternating chills/fever, vomiting. Above is Robust Form syndrome. Take... Heat... Disease... Neck... Then... Blue... Suitable... Gui... Astringent... Aversion to cold. Sanjiao injury. Treat with Jiangfu Tang or Sini Tang. Persistent becomes Malaria. Violent Qi rushing up... Malaria. Taiyang Meridian Guizhi Tang syndrome. Frail form, lingering disease, emaciation, Wind-Bi, Atrophy/Failure unable to walk.

Malaria pulse naturally Wiry. Wiry-Rapid much Heat, Wiry-Slow much Cold. Wiry-small-tight suitable for purging. Wiry-slow suitable for warming. Floating-large suitable for inducing vomiting. Treat... Become... Beast...

Spleen Qi excessive naturally recovers. Once healed, especially regulate diet, avoid labor, prevent recurrence. In smoky/miasma regions, residents often suffer Malaria; follow local medicinal properties for treatment. Travelers to miasma areas should take Pingwei San, Caoguo Yin to prevent.

Wealthy families rich in food/fat, Malaria every other day or frequent, more heat than cold, use Da Chaihu Tang. After 3-5 bowel movements, next take Baihu... Agent... Diaphragm White... Malaria... Heal.

Initial heat then cold, release Wind pathogen with Chuanxiong, Baizhi, Qingpi, Zisu. Or Xixin, Binglang assisting. One syndrome initial heat then cold... Malaria self... Raw material... Summerheat wins... Dissolve... Hengshan... Combine... Control... Malaria one... Food Malaria... Agent... Flame... Speaker... Use Cool... Qi... Labor... Loss... Qi filled. Follow with Jingxiao Madan, Xiaopi Wan, purge to heal. Generally, early Malaria, within 3-5 days, like fire spreading, close approach dangerous. Waves surging, hard to turn back. Wait for stabilization to plan. Classic says: wait for peak to subside. When Malaria arrives, during attack or resolving, do not administer medicine, deplete True Qi. Administer 2 hours before onset, or early morning empty stomach. Malaria pulses generally Wiry at Cun/Guan/Kchi, or Floating-Rapid, Tight-Firm, Slow-Astringent, Deficient-Slow, Left Hand Soft Right Hand Excessive, or Cun/Kchi Excessive Guan/Middle Soft. Summary of treatments: Wiry-Rapid much Heat, cool it. Wiry-Slow much Cold, warm it. Floating-Wiry, Floating-Tight, Floating-Rapid, pathogen in Exterior, sweat it. Wiry-Firm, Deep-Firm, Rapid-Firm, pathogen in Interior, purge it. Regulating Stomach Qi, draining phlegm/fluids, separating Yin/Yang, moving Sanjiao is the guideline. Thirst, vomiting fluids/medicine, Renjian decoction effective. Also has explanation. Read Guangdong health preservation, discussing Miasma Malaria or Summerheat toxin, using draining agents to remove root. Indeed, some injured by Summerheat then Malaria for over a year, assuming abdominal mass-water, grind Chenxiang, administer Jiedu Xionghuang Yuan, black blood like mud, extremely foul discharge, thus healed. Knowing all Malaria have roots, beyond standard treatment, guide by severity. Excess with Baiduahuang, Deficiency with Yangzheng Dan. Otherwise why does Hengshan often work for Malaria? Malaria patients accumulate Yellow Water; Hengshan breaks masses and drains water. Hengshan treats Malaria, Yingkesu treats Dysentery, people despise them, thus. But dysentery long-term without abdominal pain requires astringing intestines, how allow purging? Astringent Malaria caused by phlegm/water, method should induce vomiting/draining water, how allow not doing so? At such times, without Yingkesu/Hengshan agents, what counteracts? Only supplement with medicine in between. All Malaria due to stagnation in middle, abdominal accumulation of Yellow Water, only water not moving, so chills/fever don't stop. This is where Malaria patients get sick. Treat pure heat Summerheat Malaria with Xiangru San add Qingpi, Beida Huang 2 pieces, Wu Mei decoct together, warm take at dawn. Cold Malaria much cold, Erchen Tang add Qingpi, Liangjiang, much Ginger decoct together, dawn swallow Shenbao Yuan 5 pills. Aim to drain toxic water to remove root, chills/fever resolve. Malaria vomiting, do not use Hengshan. Middle-aged person, organs long deficient, loose stools, sudden Malaria, abnormal vomiting, only specialized Renshen stops vomiting. Other Malaria agents not applicable. Then Fuling Erchen Tang add Renshen, Suosha, Baidoukou 1-2 doses, patient feels Qi/pulse improved, chills/fever cease. Baidoukou dissolves/grinds, moves Sanjiao, Yingwei turns, chills/fever calm. Henceforth, vomiting Malaria or habitual vomiting with Malaria, strictly avoid Hengshan. Only raw radish ginger each ground natural juice half cup, add honey 3-4 spoons, Wu Mei 2 pieces decoct, swallow Ju Fang Xionghuang Wan 3-4 pills, wait for evacuation of evil blood/phlegm/water, then Renshen, Chuanxiong, Fuling, Banxia, Suosha, Gancao harmonize. If vomiting persists and heat doesn't retreat, use genuine Xiao Chaihu Tang add much Ginger main treatment. If vomiting severe and fever, first treat Malaria, heat/vomiting settle, continue with Xiao Chaihu Tang.

Malaria has Water and Blood. Water is Fluid retention; Blood is Blood stasis. Only Fluid retention causes chills/fever; only Blood stasis increases chills/fever. Hengshan drains water... Or large... Inside...

Malaria chills/fever don't stop, unceasing has root. All Malaria should be treated by Wind/Cold/Summerheat/Dampness, or sweat, or purge, or vomit, or drain, Huoren Fang... Root in... Thus... Drain... Hengshan treats Malaria, must use assistants. Malaria patients accumulate phlegm-saliva/yellow water, Hengshan can vomit/drain it, thus so. Those with pure heat Malaria... Or... Obtain... By... This... Ones... Yan... Of...

Treating Malaria essentials, only vomit/sweat/purge. Purge but not complete, abdominal pain remains, or one stool then no more, but time... Must make whole body sweat... Ultimately effective... Recurring... Done. Two drugs together... What pest... Heat use Cool medicine... Of. One side... Chaihu reduces heat, inferior to Huangqin. If medicine not dizzying, chronic disease not cured. Secular treating heat, usually use Chaihu, most stable. As for... Huangqin... Use Huang... Agent... Regulate Blood