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Wei Malaria (Malaria of the Stomach) causes simultaneous chills and fever. The patient feels hungry but cannot eat; if they do eat, they experience distension in the limbs and abdominal enlargement. Treatment involves puncturing the transverse collaterals of the Foot-Yangming and Foot-Taiyin meridians to bleed.

"Causing simultaneous chills and fever" refers to malaria characterized by alternating chills and heat, with the pathogenic factor located in the Stomach organ. Pathogenic heat stagnating in the Stomach leads to hunger; dysfunction in the transformation of clear and turbid qi results in an inability to eat, and eating leads to limb distension. Limb distension combined with impaired intestinal transmission leads to abdominal enlargement. The Spleen and Stomach share the same qi and are interconnected; therefore, puncturing the transverse collaterals of the Stomach and Spleen meridians to bleed helps to drain the pathogen. Yang meridians connect from the exterior to the Fu organs, and Yin meridians connect from the exterior to the Zang organs; these are the pathways connecting the body surface to the internal organs. The previous text listed malaria of the Six Meridians to illustrate that when pathogens are in the meridians, they are superficial. Here, naming the disease after Zang-Fu organs indicates that the pathogen has penetrated deeply into the interior. However, since pathogens enter from the exterior, they must be expelled from the exterior; thus, all cases involve puncturing the relevant meridians to drain the pathogen.

When the pulse in malaria is slow (Huan), large (Da), and deficient (Xu), medication is appropriate, while acupuncture is not. In treating malaria, intervention should occur approximately one meal's time before the onset of symptoms; otherwise, the optimal timing will be missed. A slow, large, and deficient pulse indicates a deficiency of primordial Qi. Acupuncture aims to guide the ascending and dispersing of primordial Qi to lead pathogens out; therefore, it is contraindicated for those with deficient primordial Qi. Instead, medication should be used to assist internal Qi in expelling pathogens. If Qi becomes rebellious during the attack, treatment is difficult, as previously stated. If, after the attack, vital energy is depleted and residual pathogens lie dormant, treatment is also ineffective. Therefore, one should intervene about one meal's time before the initial onset, when the pathogen is stirring but not yet active, draining it at its opportune moment. Missing this window constitutes missing the timing, rendering treatment ineffective. This applies to all types of malaria. Consequently, for all external contraction and internal injury diseases, whether medication is taken before or after meals, or in the morning or evening, there are appropriate timings that require careful consideration.

In the *Lingshu: Wu Bian* chapter, the Yellow Emperor asked: How can one diagnose individuals prone to chills and fever? Shaoyu replied: Those with small bones and weak flesh are prone to chills and fever. The Yellow Emperor asked: How to diagnose? Shaoyu replied: The zygomatic bone is the root of the bones. A large zygomatic bone indicates large bones; a small zygomatic bone indicates small bones. Thin skin with unfilled flesh, weak arms, and a dull facial color that differs from the forehead (Tian Bu) and appears uniquely murky are signs. Furthermore, thin arms indicate insufficient marrow, leading to susceptibility to chills and fever.

Those prone to chills and fever do not necessarily suffer from severe pathogens; due to their weak skin, flesh, bones, and tendons, even slight wind-cold invasion can trigger chills and fever. Weak skin and hair lead to deficiency of Wei Yang (Defensive Yang), resulting in abnormal facial complexion. The chin represents the Earth region, and the forehead represents the Heaven region. When clear and turbid pathogens obscure each other, the colors of the upper and lower face differ. Generally, clear pathogens are received from above; a thin and lustrous upper facial color indicates Wind. Turbid pathogens are received from below; a dull and stagnant lower facial color indicates Dampness. "Dai" means dull. It implies that in critical illnesses, the complexion must be dull. Frequent invasion of pathogens on the exterior disrupts the harmony of Ying (Nutritive) and Wei (Defensive) Qi, making one prone to chills and fever. By examining the zygomatic bone, arms, and the fleshy prominence between the elbow and arm, one can understand the cause of weak bones and flesh and insufficient marrow. The term refers to the thick muscle mass at the elbow joint.