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The *Neijing* (Inner Canon) states: If one is injured by summerheat in the summer, malaria will inevitably occur in autumn. It also states: Those who experience chills first and then fever are named *Han Nue* (Cold Malaria); those who experience fever first and then chills are named *Wen Nue* (Warm Malaria); those who have only fever without chills are named *Dan Nue* (Malaria with Intense Heat).

Commentary: The *Neijing* discusses malaria, stating that it arises from the intermingling of Yin and Yang Qi, leading to deficiency and excess conditions, which manifest as alternating chills and fever. It comprehensively narrates malaria occurring in the four seasons, the Six Channels (Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, Jueyin), the Five Zang Organs, and the Stomach, down to details such as daily or every-other-day onset, and early or late timing of attacks, which is the most detailed account. Students must study the full text thoroughly to master it.

The *Lüeyao* (Essentials) states: The Master said, "The pulse of malaria is naturally *Xian* (Wiry). A wiry and rapid pulse indicates much heat; a wiry and slow pulse indicates much cold; a wiry, small, and tight pulse suggests that purgation may be appropriate; a wiry and slow pulse can be treated with warming methods; a wiry and tight pulse can be treated with diaphoresis or acupuncture; a floating and large pulse can be treated with emesis; for a wiry and rapid pulse indicating wind-heat, one should use dietary management to resolve it."

The *Maijing* (Pulse Classic) states: "The pulse of malaria is naturally wiry. A faint pulse indicates deficiency; an intermittent or scattered pulse indicates death."

Chen Wuyue stated: "Malaria involves all three categories of etiology. Externally, it results from contracting the Four Qi (Wind, Cold, Summerheat, Dampness); internally, it stems from disturbing the Seven Emotions (Joy, Anger, Worry, Thought, Sorrow, Fear, Fright). Additionally, irregular diet, excessive sexual activity, overwork, or lack of exercise can all cause malaria. The scripture mentions 'summer injury by summerheat leads to autumn malaria.' There are also cases of periodic pain, distension, spontaneous sweating, and frequent vomiting, caused by bathing while sweaty, allowing dampness to remain on the skin, or being caught in rain and dampness. Another type is *Pin Nue* (Yin Malaria/Cold-predominant Malaria), characterized by severe chills with little or no fever, a desolate and shivering state, occurring at regular times. This is mostly due to contracting Yin-dampness, where Yang Qi cannot control Yin. Among the five types of malaria, except for *Dan Nue* (pure heat), *Wen Nue* (fever precedes chills), and *Pin Nue* (no heat), all others present with chills preceding fever. This is caused by external contraction of Wind, Cold, Summerheat, and Dampness merging with Wei Qi (Defensive Qi). Regarding internal causes: anger injuring the Liver causing Qi stagnation is called *Gan Nue* (Liver Malaria); excessive joy injuring the Heart causing Heart Qi dispersion is called *Xin Nue* (Heart Malaria); excessive thinking injuring the Spleen causing Spleen Qi stagnation and phlegm-saliva accumulation is called *Pi Nue* (Spleen Malaria); sorrow injuring the Lung causing Lung Qi condensation and phlegm formation is called *Fei Nue* (Lung Malaria); loss of aspiration injuring the Kidney is called *Shen Nue* (Kidney Malaria). These manifestations differ. The *Suwen* (Plain Questions) attributes these five types to climatic disharmony, Qi stagnation, and phlegm-fluid retention. Not falling into internal or external causes are: *Yi Nue* (Epidemic Malaria), where symptoms are similar among young and old within a year; *Gui Nue* (Ghost Malaria), involving ominous dreams and fear; *Zhang Nue* (Miasma Malaria), with fluctuating hot and cold spells, common in the South; *Wei Nue* (Stomach Malaria), caused by dietary irregularity damaging the Stomach, known as Food Malaria; and *Lao Nue* (Labor Malaria), persisting for years with recurrent episodes, intolerable even to slight labor. Some cases persist for years, forming masses in the abdomen and hypochondrium, called *Lao Nue* or *Mu Nue*. All the above conditions have specific treatments and should be applied after careful deduction.

Commentary: Chen Wuyue’s theory that the Seven Emotions disturb Qi and cause malaria is indeed an unprecedented insight. However, the formulas he collected for treating based on symptoms are all warm-tonifying formulas for the Spleen and Stomach, with only *Si Shou Yin* (Four Beasts Decoction) mentioned for treating Qi deficiency of the Five Zang Organs and accumulated phlegm-fluids. Since the method of tonifying deficiency and draining excess varies according to the minister and sovereign herbs of each organ, how can one formula treat malaria caused by the Seven Emotions? Does he expect students to figure it out themselves? Alas! In three hundred years of Song Dynasty medicine, following Qian Zhongyang, there was only one figure like him. Even his collection of formulas is so limited; expecting practitioners to find formulas based solely on symptoms is impossible.