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The boundaries of the pulse, if accompanied by lower back pain, fullness in the lower abdomen, frequent urination resembling strangury (difficulty in urination), deficiency of Qi, fearfulness, and a depressed feeling in the abdomen, representing the transformation syndrome of the meridians: if not treated promptly with standard methods, or if antimalarial interventions are applied too early, the pathogen will inevitably enter the meridians and flow into the zang organs. The disease should manifest as pain in the waist and hypochondrium, inability to bend or extend the body, hernia in men, and swelling in the lower abdomen of women. In severe cases, there may be dryness of the throat, a dusty complexion with loss of luster, chest fullness, vomiting and regurgitation, undigested food diarrhea, fox hernia, fullness and obstruction of the four limbs, strangury, difficult urination, and muscle cramps; if the summer-heat pathogen lodges in the Ying (Nutritive) level and stays within the boundary of the Lung's front-mu point, accompanied by cold sensation in the heart, severe cold with mild heat, susceptibility to fright after fever subsides, and visual hallucinations, representing the transformation syndrome of the zang organs: if not treated promptly with standard methods, or if antimalarial interventions are applied too early, the pathogen will invade the Lung organ. The disease should manifest as cough and rebellious Qi, and in severe cases, emaciation of the large bones, sinking of the large muscles, chest fullness, dyspnea and difficulty breathing, agitation of Qi affecting the form, with death expected within six months; if the summer-heat pathogen lodges in the Ying level and stays within the boundary of the Heart's front-mu point, accompanied by vexation in the heart, strong desire to drink cold water, yet feeling cold with mild heat, representing the transformation syndrome of the zang organs: if not treated promptly with standard methods, or if antimalarial interventions are applied too early, the pathogen will invade the Heart organ. The disease should manifest as contraction and tension of sinews and vessels, and in severe cases, emaciation of the large bones, sinking of the large muscles, chest fullness, abdominal pain, mental discomfort, heat in the shoulders, neck, and body, wasting of flesh, sunken eye sockets, appearance of Zang-pulse, immediate death upon loss of consciousness, or death at the time of its overcoming element if consciousness is retained; if the summer-heat pathogen lodges in the Ying level and stays within the boundary of the Spleen's front-mu point, accompanied by severe cold, abdominal pain, bowel sounds during fever, and sweating after bowel sounds, representing the transformation syndrome of the zang organs: if not treated promptly with standard methods, or if antimalarial interventions are applied too early, the pathogen will invade the Spleen organ. The disease should manifest as dan-fever (febrile disease), heat in the abdomen, vexation, yellow urine, and in severe cases, emaciation of the large bones, sinking of the large muscles, chest fullness, dyspnea and difficulty breathing, internal pain radiating to shoulders and neck, body heat, wasting of flesh, appearance of Zang-pulse, with death within ten days; if the summer-heat pathogen lodges in the Ying level and stays within the boundary of the Liver's front-mu point, accompanied by a pale greenish complexion, frequent sighing, and a state resembling death, representing the transformation syndrome of the zang organs: if not treated promptly with standard methods, or if antimalarial interventions are applied too early, the pathogen will invade the Liver organ. The disease should manifest as hypochondriac pain, vomiting of food, and in severe cases, emaciation of the large bones, sinking of the large muscles, chest fullness, dyspnea and difficulty breathing, internal pain radiating to shoulders and neck, with death expected within one month; if the summer-heat pathogen lodges in the Ying level and stays within the boundary of the Kidney's front-mu point, accompanied by shivering, lower back and spine pain, restlessness, difficulty in defecation, blurred vision, and cold hands and feet, representing the transformation syndrome of the zang organs: if not treated promptly with standard methods, or if antimalarial interventions are applied too early, the pathogen will invade the Kidney organ. The disease should manifest as painful heat in the lower abdomen, discharge of white turbid matter, and in severe cases, emaciation of the large bones, sinking of the large muscles, depletion of marrow in the shoulders, declining physical activity, absence of Zang-pulse with death expected within one year, or specific prediction of death date if Zang-pulse appears; if the summer-heat pathogen lodges in the Ying level and stays within the boundary of the Stomach fu organ, accompanied by hunger but inability to eat, abdominal distension after eating, representing the transformation syndrome of the fu organs: if not treated promptly with standard methods, or if antimalarial interventions are applied too early, the pathogen will enter the Stomach fu organ. The disease should manifest as retained fluid, spitting of saliva, guan-ge (obstruction of upper and lower orifices), accumulation of roundworms, exhaustion of Tian-gui, decline of essence and Qi, and in severe cases, emaciation and shortness of Qi, severance of Stomach collaterals, hematemesis from injury to Yang collaterals, hematochezia from injury to Yin collaterals, and immediate death upon bleeding; if the summer-heat pathogen lodges in the Ying level and is subsequently attacked by wind-cold, resulting in warm malaria characterized by initial heat followed by chills: if not treated promptly with standard methods, or if antimalarial interventions are applied too early, it often leads to Bi syndrome of Qi and blood becoming wind-Bi, transmitting sequentially, where Bi damages the form and shifts in order, or leads to jaundice from wind stagnation, or gu-poison from pathogenic rebellion in the chest and abdomen. Another type involves winter wind-cold lodging in the bone marrow, followed by exposure to intense summer-heat causing sweat to exit, presenting with bone marrow depletion and muscle wasting, also initial heat followed by chills, named warm malaria: if not treated promptly with standard methods or if antimalarial interventions are applied too early, it often damages the form organs, leading to skin aggregation and hair loss, or bone-withering unable to rise from bed, which is fatal; or bone-withering unable to rise from bed leading to skin aggregation and hair loss is fatal, known as disease ascending from below and damage descending from above. If the summer-heat pathogen lodges in the Ying level, then encounters cool water-cold of summer and descending wind of autumn, resulting in cold malaria characterized by initial chills followed by heat: if not treated promptly with standard methods, or if antimalarial interventions are applied too early, it also leads to Bi syndrome of Qi and blood becoming pain-Bi, or water closure causing jaundice, or water-fluid overflowing outside skin and intestines causing edema. If Yin Qi is exhausted first and Yang Qi acts alone, presenting with shortness of Qi, vexation, hot hands and feet, and desire to vomit, resulting in dan malaria characterized by heat without chills: if not treated promptly with standard methods, or if antimalarial interventions are applied too early, it often leads to burning body heat, blindness, and狂走 (mad running); or abscess and pus formation where heat passes; or stomach疽 (abscess) and intestinal rot, where the person dies with red body color, warm armpits, and heat in the epigastrium. Another type involves pre-existing lung heat, rebellious Qi rushing upward, excess Zhong-Qi not draining, triggered by exertion opening pores, with wind-cold lodging between skin and muscles, presenting with muscle wasting, also heat without chills, named dan malaria: if not treated promptly with standard methods, or if antimalarial interventions are applied too early, it often leads to coughing and hemoptysis, scorched and broken hair, or lung-withering and lung-abscess with expectoration of saliva and purulent blood.

If the summer-heat pathogen lodges in the Ying level, wind combines and rushes, with only slight deficiency of Wei-Qi failing to lift Yin from below, resulting in pin malaria characterized by chills without heat: if not treated promptly with standard methods, or if antimalarial interventions are applied too early, it often leads to separation of Yin and Yang, blood stagnating upwards; or heavy Yin causing mania, Yang depletion causing seeing ghosts, where the person dies with blue body color, cold calves, and black lips; if spring-onset malaria features aversion to wind, summer-onset features excessive sweating, winter-onset features mild cold, and these are not treated promptly with standard methods, or if antimalarial interventions are applied too early, the resulting morphological changes manifest according to seasonal sequences, revealing meridian-zang transformations; or having already combined meridian-zang transformations, further generating variable succession based on meridian-zang boundaries. For intermittent fever or multi-day intervals, if not treated promptly with standard methods, or if antimalarial interventions are applied too early, the resulting morphological changes occur because the lodging is deep, horizontally connecting to Mu-yuan, internally pressing the Six Fu organs, easily invading Zang-Fu organs, often leading to untreatable fatal disease. Thus, summer heat is the root cause of disease, while the lodging of Ying-Qi in the body is the superficial manifestation. Autumn's descending wind, bathing waters, and chilling cold are the foundational factors for disease formation. If Wei-Qi is in the Three Yang meridians, this is the mechanism of disease onset. Meridian-zang boundaries are the fields of Ying-lodging. Therefore, alternating chills and heat, along with meridian-zang transformations, are normal; pathogen injection into meridians and flowing into Fu organs, along with victorious syndromes, are variations. Hence, diseases among all ages in a year are similar due to the necessary presence of summer heat in seasonal cycles. Regarding Wu-Yun Liu-Qi, malaria also occurs, requiring separate discussion, as five-year and six-period cycles involve recurring influences. For example, excessive Fire year with prevalent heat causes malaria with accompanying cough, shortness of Qi, bleeding, deafness, dry throat, central heat, shoulder/back heat; deficient Wood year with rebound heat/fire causes chills/fever with accompanying rashes and sores; He-Xi era with heat transformation causes malaria with accompanying ulcers, bleeding, madness, red eyes; Yang-Min ruling Heaven with dryness descending causes sudden heat with chills/fever and accompanying heart pain; Shao-Yin ruling Heaven with heat descending causes prevalent heat with chills/fever and accompanying cough, vomiting, sneezing, nasal discharge, epistaxis, nasal obstruction; Yang-Min administration with great heat causes chills/fever with accompanying cough, throat obstruction, shivering, strangury; Third Qi, dry-heat combination causes chills/fever with accompanying cough, rebellious Qi; Fourth Qi, cold rain causes cold malaria with accompanying bone-withering, bloody stool, sudden collapse, shivering, delirium, shortness of Qi, dry throat with thirst, heart pain, sores; Shao-Yang administration with flowing fire causes chills/fever/malaria with accompanying deafness, blindness, color change; Tai-Yin administration, Fourth Qi, humid heat causes malaria with accompanying pore heat, sudden bleeding, abdominal fullness/heat, severe edema; Shao-Yin administration, Third Qi, great fire causes alternating chills/fever with accompanying cough, asthma, red eyes, Qi reversal, heart pain; Fourth Qi, humidity causes chills/fever with accompanying dry throat, jaundice, rhinorrhea/epistaxis, fluid retention; Fire depression eruption with great heat causes warm malaria with accompanying convulsions, bone pain, limb resentment, sores/rashes, vomiting, acute abdominal pain, bleeding, red eyes, heart heat, severe dizziness/oppression, sweating through Xuan-fu, sudden death; Jue-Yin in Earth with wind excess causes shivering/chills with accompanying yawning/sighing, hypochondriac tightness, abdominal fullness, diaphragm/throat blockage, vomiting after eating, abdominal distension, belching, relief after flatus, heavy body; Shao-Yin in Earth with heat excess causes malaria-like chills/fever with accompanying skin pain, blindness, toothache, swelling, bowel sounds, rising Qi, asthma, inability to stand long, lower abdominal pain/distension; Shao-Yin ruling Heaven with heat excess causes chills/fever with accompanying cough, asthma, bloody sputum, rhinorrhea/epistaxis, urine color change, severe ulcers/swelling, shoulder/back/arm/clavicle pain, lung fullness/asthma; Shao-Yang ruling Heaven with fire excess causes headache, fever/chills forming malaria with accompanying skin heat/pain, yellow/red color change, bloody sputum, internal heat, orthopnea, transmission to water, facial/foot edema; Yang-Min ruling Heaven with dryness excess causes cold/clearness internally, infection forming malaria with accompanying left thigh/hypochondriac pain, cough/bowel sounds, diarrhea/watery stool, severe sudden heart pain, inability to turn, dry throat, dusty face; Tai-Yang victory with condensation/dampness causes malaria with accompanying cold reversal entering stomach, internal heart pain, genital ulcers, difficulty in private functions, muscle spasms, stagnant blood, protruding eyes, cold entering Lower-Jiao transforming into damp diarrhea; Shao-Yin recovery with internal warmth causes chills/fever with accompanying shivering, delirium, post-chill heat, skin pain, sudden aphonia, shortness of Qi, bone-withering, diaphragm/intestinal obstruction, external edema; Shao-Yang recovery with approaching great heat causes malaria with accompanying shivering/extreme cold, post-cold heat, bleeding, shortness of Qi, atrophic pulse, scorched throat collaterals, thirst for fluids, oral ulcers, foot edema, red/yellow color change, frequent urination with stretching. Reviewing operational succession and host/guest influence, all use summer heat as root and Ying-lodging as surface sign. Manifested forms belong to Zang-transformation, meaning disease in the overcoming Zang accepts the non-overcoming Qi. Prescription and treatment have specific indications and contraindications: suppress high, elevate low, reduce excess, tonify deficiency, assist with beneficial agents, harmonize with suitable ones, treat same with difference, follow difference, treat cold with heat, treat heat with cold, to comply with circulation, stabilize host/guest, and adapt to cold/heat. Failure to observe seasonality and host/guest differences, leading to general treatment or early antimalarial intervention, often causes sudden death. Those affected by Central Movement survive half; those affected by Heavenly Punishment do not survive, due to movement damaging Zang organs. Is this not worthy of caution? (Lu Yi) Born in Mu-Lu, dare not force speculative theories for public consumption, strictly following classic discussions, detailing common and variable etiologies and syndromes, compiling annotations for reference. Is this merely casual writing? Indeed, many imperfections remain, seeking correction from distant scholars.