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The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states that if one is injured by summerheat in summer and by wind in autumn, malaria will inevitably occur. Here, "malaria" refers to chronic malaria (long-standing, refractory malaria). It is named so because it occurs every other day and lingers without ceasing. Former sages had treatment methods, but they all used harsh medicines. These are not suitable for those with weak innate constitution or whose physique has been altered by living conditions and care. Only the prescriptions of Academician Xu used tonifying agents such as Ginseng Radix et Rhizoma (Renshen, 人参), yet he did not discuss them in depth, making it difficult for later learners to infer their principles.

I have observed that in recent years, people under fifty are mostly frail. Moreover, their indulgence in desires is ten times greater than before. Treating deep diseases in a weak constitution is extremely difficult. I then realized that medicines like Heterophylly Stemroot (Changshan, 常山), Dark Plum (Wumei, 乌梅), and Arsenic Pills (Pidan, 砒丹) are agents that forcibly expel phlegm. If misused, mild disease becomes severe, and severe disease leads to death. Why? Because malaria occurring every three days indicates illness in the Yin channels. Malaria occurring on Zi, Wu, Mao, or You days is Shaoyin malaria; occurring on Yin, Shen, Si, or Hai days is Jueyin malaria; occurring on Chen, Xu, Chou, or Wei days is Taiyin malaria. Malaria caused by summerheat should be resolved through sweating. However, staying in cool pavilions, water towers, under shady trees, or on cold ground, fanning oneself while bathing in spring water, prevents sweat from being excreted, leading to its stagnation and transformation into phlegm. Initially, when the pathogen first invades, the Stomach Qi is still strong, and the patient feels nothing. Upon secondary invasion, the patient remains ignorant, continues to overeat, exert themselves excessively, and engage in sexual activity, severely damaging Stomach Qi, which triggers the disease. The root is deep and the foundation solid, hence it is hard to cure. Patients desire quick recovery and willingly take harsh, pungent-warm medicines; doctors desire quick results and hastily administer them. They do not realize that wind and summerheat are external pathogens that must be resolved through sweating. Since the invasion is deep, it cannot be cleared by merely inducing a small amount of sweat. Even if Stomach Qi recovers slightly and spontaneous sweating occurs, failing to observe taboos and encountering new pathogens again causes old pathogens to remain and new ones to invade, leading to lingering stagnation and deeper disease. Furthermore, patients seeking treatment usually hope for rapid effects. Using pathogen-expelling drugs severely damages Stomach Qi; I know they will inevitably suffer disaster. Therefore, I am willing to adopt a seemingly slow approach, regulating my treatment pace. I must first use tonifying agents such as Ginseng Radix et Rhizoma (Renshen, 人参), Atractylodes Macrocephala Rhizome (Baizhu, 白术), Tangerine Peel (Chenpi, 陈皮), and White Peony Root (Shaoyao, 芍药), assisted by herbs from the classic texts, with the goal of inducing sweating. If the body remains weak after sweating, heavy tonification is required to assist. Only when sweat flows through the entire body and reaches below the Weizhong acupoint (BL40, 委中) is this considered a good omen. I instruct patients to eat bland food, reduce going out, avoid wind and seek warmth, stay away from curtains, and maintain careful nursing. There will be no instability. If the pathogenic factor is extremely deep, even with profuse sweating, the invaded pathogen must transmit from the Zang organs to the Fu organs. Its manifestation will be chaotic and irregular, which is certainly not a good omen. Thus, treating this disease is easier in spring and summer and more difficult in autumn and winter, for no other reason than the ease or difficulty of inducing sweating. Someone asked: Ancient formulas using Arsenic Pills, Dark Plum, and Heterophylly Stemroot achieved success in many cases; do you think they should not be used? I said: When the Fu organs are affected, the disease is shallow, occurring daily. When it occurs every other day, Stomach Qi is still strong, and treatment is possible. Those occurring every three days indicate the disease has reached the Zang organs; diseases in the Zang organs are difficult to treat. Although external pathogens can be treated, can one use harsh expelling drugs to pursue quick results?

Last year, Vice Censor-in-Chief Zhan, who was robust in constitution, strong in physique, and dark-complexioned, nearly sixty years old, contracted malaria in February and summoned me. Knowing he was accustomed to rich, fatty foods, I told him: He must abstain from sexual activity, eat blandly, and regulate his diet for a month until profuse sweating brings relief. He was displeased. Someone nearby said: This is easy; he will recover in a few days. After taking three to five doses of expelling drugs, the fever subsided, but returned ten days later. Again, it subsided after medication, lingering until winter, yet the disease remained. He came to seek treatment again. I knew that due to long-term medication, his phlegm had decreased, but his Stomach Qi was not yet restored, and due to cold weather, sweat had not penetrated. So, I prepared pills mixed with White Atractylodes Rhizome porridge, giving him two jin. He was instructed to take 100-200 pills with hot water when hungry but before eating, and to nourish himself only with white rice porridge. Upon finishing this medicine, he should sweat profusely and recover. Indeed, it happened as predicted. There were many such cases, with slight variations in herbs, which need not be fully detailed.