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Any disease that resembles malaria but is not true malaria, although presenting with alternating chills and fever (Wanglai Hanre), may start and stop intermittently, and essentially does not belong to the category of malaria. Such syndromes commonly occur after severe illnesses, postpartum, or in cases of deficiency consumptive diseases (Xusun). The *Classic of Internal Medicine* (*Neijing*) states: "Yang deficiency leads to external cold; Yin deficiency leads to internal heat. When Yin Qi ascends into the Yang region, there is aversion to cold; when Yang Qi descends into the Yin region, there is aversion to heat." Therefore, any condition manifesting as alternating chills and fever without external pathogenic invasion must be attributed to a deficiency syndrome. However, deficiency syndromes differ between Yang deficiency and Yin deficiency. Those with Yang deficiency tend to have more cold manifestations, while those with Yin deficiency tend to have more heat manifestations. For Yang deficiency, one should tonify Yang, using formulas such as Lizhong Tang (Regulate the Middle Decoction) or Shiquan Dabu Tang (Ten Substance Great Tonifying Decoction) added with Ganjiang (Dried Ginger), Rougui (Cinnamon Bark), and Fuzi (Prepared Aconite Root), which are generally well understood. It is only the Yin deficiency syndrome that is most difficult to differentiate. Deficiency of Water within Yin constitutes Yin deficiency; deficiency of Fire within Yin also constitutes Yin deficiency. If body fluids are dry and exhausted, and essence and blood are depleted, resulting in vexation and heat throughout the interior and exterior, upper and lower parts, this is deficiency of Water within Yin. Treatment should aim to strengthen Water to harmonize Yang, using formulas such as Yiyin Jian (One-Yin Decoction), Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill), or Jiajian Yiyin Jian (Modified One-Yin Decoction). If there are sudden waves of heat and cold, or a face red like grease, yet the abdomen prefers hot drinks, or the upper body feels hot as if branded while the lower body is cold as ice, or the throat and mouth feel intensely hot while the stool is loose and unformed, these symptoms appear as heat, yet the pulse is necessarily fine and minute, or perhaps surging and floating but empty and weak upon pressure. This indicates that Yang Qi has no root and floats alone upward, constituting deficiency of Fire within Yin. Treatment should benefit the root of Fire to guide it back to its source, using formulas such as Haizang Bawei Dihuang Wan (Haizang's Eight-Ingredient Rehmannia Pill) or Yougui Yin (Right-Restoring Decoction). Once the false heat recedes, the true cold will become apparent, allowing for treatment based on the revealed syndrome. The discussion on treating cold and heat is particularly detailed in the relevant chapter and should be carefully observed.

The syndrome of Warm Malaria (Wen Nue) is described in the *Neijing*: "Warm Malaria arises from contracting wind-cold in winter, and manifests as illness when Yang Qi flourishes greatly in spring and summer." This actually belongs to the category of standard Cold Damage (Shanghan). Therefore, Zhang Zhongjing's *Treatise on Cold Damage Diseases* (*Shanghan Lun*) includes the syndrome of Warm Malaria, referring to this specific condition. This differs fundamentally from malaria caused by summerheat injury in summer manifesting in autumn, and should be treated with discretion within the context of Cold Damage disorders.