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Patient Fang's younger brother: Suffered from Yin malaria, with severe chills and fever, profuse sweating, insomnia, shortness of breath, abdominal pain accompanied by frequent stools. The left pulse was weak and soft; the right Guan and Chi positions showed a wiry and long pulse. This indicates Spleen deficiency leading to Liver Wood overacting on Earth, and Heart Yang failing to secure and control. The treatment principle should employ warming and unblocking, sweet and缓和 (soothing) methods, assisted by sour astringents to drain downward. The prescription used Lizhong Tang (Regulate the Middle Decoction) added with Fushen (Poria with Hostwood), Longyanrou (Longan Aril), Cao Kou (Nutmeg Seed), Rou Kou (Nutmeg), and Baishao (White Peony Root). After three doses, mental clarity returned, abdominal pain and diarrhea ceased, and chills and fever also decreased. Subsequently, Guipi Wan (Restore the Spleen Pill) added with Shanyao (Chinese Yam), Lianzi (Lotus Seed), and Heshouwu (Polygonum Multiflorum Root) was taken gradually until recovery.

Patient Mao: Suffered from tertian malaria. Early use of antimalarial agents resulted in irregular chills and fever, cold sweat on the head, hiccups, vomiting of green froth, a ghastly black complexion, cold extremities, and a deep, rapid, small pulse. This signifies pathogenic factors entering the Jueyin channel, where internal stasis and turbidity rise to invade the clear orifices. Treatment should first focus on unblocking Yang and draining turbidity. Wuzhuyu Tang (Evodia Decoction) added with Dingxiang (Clove), Ganjiang (Dried Ginger), Zhibanxia (Prepared Pinellia Rhizome), Qingpi (Green Tangerine Peel), and Fuling (Poria) was used, stopping the turbid rebellion. Thereafter, Sini Tang (Frigid Extremities Decoction) was employed; limbs became warm, and malaria shifted to every other day. Six Beasts Drink (Sishou Yin) was then used, gradually alleviating chills and fever. Finally, Bazhen Wan material (Eight Treasures Pill base) added with Heshouwu, Niuxi (Achyranthes Root), Sharen (Amomum Fruit), Banxia, Jiangzhi (Ginger Juice), and boiled Jiazrou (Date Flesh) was made into pills. The disease was cured.

Patient Zhu: Malaria occurred in late autumn affecting the Three Yin channels, presenting with dizziness, intense heat without thirst, painful urination, and a larger right pulse. This must be due to summer-heat and dampness latent pathogens accumulating internally. Ancients treated malaria without sweating by inducing perspiration so that pathogens could escape from the exterior. Now, at the Frost Descent solar term, the climate is converging and肃 (desolate/cold); even with acrid-releasing herbs, pathogens cannot vent outward, making a definite prognosis for cure difficult. Zisu (Perilla Leaf), Banxia, Qinghao (Sweet Wormwood), Shihu (Dendrobium Stem), Sheng Yiren (Raw Coix Seed), Danggui (Angelica Sinensis), Xian Heshouwu (Fresh Polygonum Multiflorum Root), and Zhimu (Anemarrhena Rhizome) were used. After several doses, slight sweating occurred, chills and fever reduced, the right pulse normalized, but both Guan positions remained slightly deficient. Treatment should support healthy Qi while eliminating pathogens. Liujunzi Tang (Six Gentlemen Decoction) added with Xian Heshouwu, Zhi Biejia (Baked Turtle Shell), Danggui, and Zhimu was used to clear and vent the Ying (Nutritive) level, with Shengjiang (Fresh Ginger) and Dazao (Jujube) added for decoction. Recovery was achieved.

Ms. Qian: Pregnant for over six months, she had not recovered from Yin malaria last year. Due to eating beef jerky, she developed abdominal fullness, anorexia, and bloating after eating grains, leading to lingering chills and fever. Despite the peak of summer, she feared cold, wore cotton padding, yet had no sweat. This indicates severe decline of Wei (Defensive) Yang, failure of the Fu organs to descend and circulate, deficiency of Zheng Qi (Upright Qi) with entrenched pathogens. Care must be taken to prevent fetal damage. Treatment should warm the Wei and unblock the Fu organs; caution against using Atractylodes (Zhu Ru/Bai Zhu) which retains and tonifies stagnation. Lushen (Codonopsis Root), Lu Jiao Jiao (Deer Antler Glue), Danggui, Fuling, Caoguo (Black Cardamom), Wei Jiang (Roasted Ginger), Chao Zhangrou (Stir-fried Hawthorn Flesh), Banxia, and Chenpi (Tangerine Peel) were used. After six doses, malaria stopped.

Relative: Suffering from tertian malaria for years without cessation. After the End of Heat solar term, dryness intensified, causing daily chills and fever. Within moments of eating, he felt irritability, epigastric discomfort, and dry retching. His complexion was extremely sallow, accompanied by thirst, dizziness, and hemorrhoid pain. This indicates dryness-heat injuring Yin, with deficiency of Stomach fluids allowing Deficient Fire to ascend and press downward. Following the intent of Ganlu Yin (Sweet Dew Drink), Sheng Dihuang (Raw Rehmannia Root), Zhimu (wine-fried), Maidong (Ophiopogon Tuber), Shihu, Huafen (Trichosanthes Root), Sheng Baishao (Raw White Peony Root), and Ejiao (Donkey-hide Gelatin dissolved in water) were used. Symptoms subsided after several doses; Hetou Yin (He Ren Yin) was then used to stop the malaria.

Patient Zhu: The onset of Three Yin malaria was delayed daily, accompanied by epigastric stuffiness and sour regurgitation, indicating a Banxia Xiexin Tang (Pinellia Decoct to Drain the Epigastrium) pattern. However, bitter-acid collaterals-penetrating antimalarial agents like Zhimu, Wu Mei (Mume Fruit), and Chuanshanjia (Pangolin Scales) were still taken, resulting in chills and fever without sweat, occurring twice in three days. Crab-claw patterns appeared on the tongue, indicating Cold Water of the Spleen overflowing into collateral branches, forming new pathological foci. The condition worsened from one manifestation to two, seeking lightness but gaining heaviness. Liujunzi Tang (Six Gentlemen Decoction) should be used to warm the Spleen and transform dampness. Once water-dampness is removed, chills and fever will lighten, preventing pathogenic invasion of the Liver and Kidney, which would prolong into emaciation and weakness. Lushen, Yuzhu (Atractylodes Macrocephala), Yunling (Poria), Chenpi, Jiang-zhi Banxia (Ginger-processed Pinellia), Sharen, Caoguo, and Wei Jiang were used. After several doses, one-third of the course was eliminated, though it still occurred every other day. After more doses, attacks occurred earlier, and chills/fever became milder. The original formula was processed into powder, added with Chao Niuxi (Stir-fried Achyranthes), Caoguo removed, and mixed with Jiangzhi and Jiazrou to form pills. Taken to cure.

Patient Fang's younger brother: Initial onset of tertian malaria with excessive cold phlegm. First, aged Xiangyuan (Citron fruit) was prepared by removing the stem, filled with Ming Xionghuang (Realgar, 5 qian, water-ground and powdered), calcined over charcoal fire (preventing smoke leakage) to preserve its nature, then ground together into fine powder. Taken with warm water on an empty stomach. After lying down for a while, a chopstick was used to induce vomiting of phlegm-saliva. Repeat administration and induction (better if gelatinous phlegm is expelled). After half a day of vomiting, porridge soup was drunk to stop vomiting. Post-cure, Yuan Qi (Primordial Qi) was regulated and supplemented to prevent recurrence.

Patient Li: Suffered from the aforementioned symptoms occurring at night. Hetou San (Hetou Powder) was used. Later, due to labor, he suffered epistaxis; chills stopped but fever intensified. Treatment should harmonize Yin and vent pathogens. Wu Mei Rou (Mume Flesh, 2 qian), Baishao (3 qian), Zhimu (wine-fried, 1.5 qian), Biejia (roasted, 3 qian), Sheng Shouwu (4 qian), Sheng Dihuang (2.5 qian), and Niuxi (wine-steamed, 1.5 qian) were used. Cured after several doses. (Note: Sour flavors can harmonize Yin; Yin-nourishing herbs can vent pathogens.)

Patient Qin: Yin malaria mismanaged with medication, resulting in lingering chills and fever, no sweat, facial edema, abdominal swelling, yellow eyes (jaundice), yellowish skin, and diarrhea. Left pulse was deep and slow; right pulse was deficient and soggy. Water-dampness soaked internally and overflowed to the skin, threatening pi-zhang (abdominal distension). Fenxiao Fa (Separating and Eliminating Method) was applied. Dafupi (Areca Peel), Yinchen (Artemisia Capillaris), Zhibanxia, Sheng Yiren, Fuling (each 2 qian), Sugeng (Perilla Stem), Chenpi, Guya (Sprouted Grain, each 1 qian), Zhike (Bitter Orange), Sharen (each 0.8 fen), Houpo (Magnolia Bark, 0.5 fen), Jiang (3 qian), and Cheqianzi (Plantago Seed, 0.5 fen) were used. With smooth urination and sweating, all symptoms receded. Sugeng, Zhike, and Houpo were removed; Ji Neijin (Chicken Gizzard Lining, roasted 3 qian) and Yuzhu (stir-fried 1 qian) were added. Recovered following the method of promoting diuresis and strengthening the Spleen.