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I was born with a frail constitution. In infancy and childhood, I suffered from frequent illnesses. By the time I reached my twenties (Ding Nian), the condition worsened significantly. I once suffered from internal injury (Neishang, damage to the internal organs due to overwork or improper diet), but various medicines proved ineffective. Consequently, I collected and studied all available texts, including the *Neijing* (Classic of Internal Medicine), *Nanjing* (Classic of Difficult Issues), *Jiayi Jing* (Systematic Classic of Acupuncture and Moxibustion), Li Dongyuan's *Ten Books*, Zhang Zhongjing's *Six Books on Cold Damage Treatise*, as well as works by Xue Ji and others. Regarding strange prescriptions and bizarre diseases from remote regions, I traced their origins and conducted thorough investigations, following the footsteps of ancient masters, though I remained uncertain whether my own ailments had been cured. It is human nature for everyone to wish to proclaim their own insights. My close friends and relatives, having personally experienced the errors in my initial approach, promoted mediocre methods that often yielded results, leading me to rashly conclude that all diseases fall within the scope of Cold Damage (Shanghan) and internal injury.

In the autumn of the Renyin year, the weather was exceptionally hot, and winter arrived without coldness. Epidemics broke out widely across the region. The symptoms resembled malaria (Nüe), yet there were no intervals between chills and fever; they resembled Cold Damage, yet symptoms of the three Yang meridians (Taiyang, Yangming, Shaoyang) appeared simultaneously with those of the two Yin meridians (Shaoyin, Taiyin); they resembled internal injury, yet the Qi Kou pulse (radial artery at the wrist, representing interior/viscera) was not larger than the Ying Kou pulse (carotid artery, representing exterior/extremities). My previously held confident theories were entirely invalidated. Those treated according to Cold Damage protocols died within seven days. Those treated for internal injury or malaria also passed away subsequently. Occasionally, patients with mild infection and strong constitutions survived slightly beyond ten days, but ultimately succumbed. For those who lost the ability to speak upon onset, death occurred even more rapidly. Only those with very mild conditions who refrained from taking medicine had a survival rate of one or two percent. Even experienced physicians found their strategies and techniques exhausted. However, the greatest virtue of Heaven and Earth is life; when blockage reaches its extreme, there must be a way through. The book by Li Daizhi of the Song Dynasty still exists. Titled *Zhangnüe Weisheng Fang* (Prescriptions for Health in Malarial Fevers Caused by Miasma), it specifically addresses this syndrome. Initially, I dismissed it due to perceived vast differences in climate and geography, glancing at it only before setting it aside, but later I realized its precious value.

The theoretical discussions are detailed and analytical; the herbal prescriptions are simple, safe, and effective. This truly represents mastery in treatment. Other texts on malaria have mentioned malarial fevers caused by miasma (Zhangnüe), but the details are incomplete. Was this because the authors had not personally visited the region and thus lacked proper transmission? Li Daizhi served Prince Duan and Zhang Taorun, both of whom were posted to these southern lands, allowing them to acquire the true essence of the disease. Thus, this book was preserved. I initially copied one or two passages, then expanded to dozens and hundreds, circulating them through local networks. Recording my insights spontaneously, I compiled them systematically. I kept them secret, regarding human life as private property. When I informed my colleagues, I feared dissemination would be limited, so I planned to print them for wider distribution. This was merely an act of public spirit.

A guest remarked: "What does malaria have to do with miasma? Between Fujian and Guangdong, deep mountains and heavy rains accumulate mist into miasma, yellow fog obscures the sky, causing great suffering. I believe our boundaries lie in the central plains where soil and customs differ, separated by thousands of miles of wilderness. How could such miasma exist? Are you cleverly naming it to show off your skills?" I replied: "No, no. The occurrence of diseases is determined by celestial timing. Changes in the four seasons are governed by the numbers of Qi (vital energy). The human body mirrors Heaven and Earth, responding to the smoothness or reversal of Qi. The *Yijing* (Book of Changes) states: 'Observe the patterns of heaven to understand the changes of time.' These signs manifest in the state, which is fundamentally composed of people. Heavenly Qi circulates, connecting with mountains and marshes. We verify changes by season and seasons by human health. If profound Qi is not concealed, it signifies seasonal change. Direct exposure leads to premature death of flora and fauna, and illness in humans. Mountains and rivers need not be identical; where Qi arrives, it flows. Therefore, I assert that it is not limited to Fujian and Guangdong; wherever the Qi category matches, this is how malarial fevers caused by miasma arise."

"Consider the winter of Guimao: flowers and trees on all hills were lush like spring. In mid-summer of Jiachen, chrysanthemums bloomed like autumn. In June, people bundled up in quilts. Frost fell in spring and autumn but did not kill vegetation. Annotations state that if the four seasons lose their order, their functions become chaotic. The *Yueling* (Monthly Ordinances) says: 'If mid-summer follows autumnal commands, the people will suffer epidemics.' Ancients understood this. It seems Heaven has lost its order, and Qi moves irregularly. In recent years, winters have been unusually warm; plants and animals do not hibernate or store energy. Perhaps organisms sense Qi first, akin to Han Yu's line 'Snow blocks the Blue Pass, horses refuse to advance,' describing snow in Lingnan during the Tang Dynasty, which is now absent. Gradually, the azalea-blooming weather of Luoyang has shifted northward. Does this not confirm my view?"

The guest then understood. I added: "The character 'Zhang' (瘴) phonetically relates to 'Zhang' (障), meaning obstruction or barrier, indicating disease manifests externally while the interior lacks excess pathogenic factors. 'Nüe' (疟) resembles a tiger turning its claws toward a person. Applying malaria treatments to individuals lacking internal excess leads to frequent near-death outcomes. Li Daizhi's regulatory methods were profoundly thoughtful. Presuming my ignorance, I have organized the source and development of this knowledge, appended my humble opinions, distinguished the similar forms of Cold Damage, internal injury, and other malaria types, detailed appropriate and contraindicated herbs, and verified treatable versus untreatable disease colors. I titled this work *Zhangnüe Zhinan* (Guide to Malarial Fevers Caused by Miasma). Although I incur the crime of arrogance and presumption, it may offer slight assistance in saving lives. Any未尽 (unfinished) aspects are left for future scholars. Written on the first day of the tenth month of the Jiyou year, the 37th year of the Wanli reign, by Zheng Quanwang of Xinzhou."