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This section describes the method of treating malaria with acupuncture and moxibustion. However, the classic text only mentions needling specific meridians, while the methods of tonifying and reducing at acupoints are detailed in Wang Bing's commentary; Qixuanzi (Wang Bing) is indeed worthy of immortality. Yet, the first half discusses malaria of the six foot meridians, while the latter part lists malaria of the liver, spleen, kidney, stomach, heart, and lung meridians, appearing disjointed and irregular, which should have been integrated into a single chapter.

Malaria of the Foot-Taiyang meridian causes lower back pain and heaviness of the head, with cold sensations arising from the back. (The Foot-Taiyang meridian enters the brain from the vertex, emerges to descend the nape, runs along the medial shoulder, and夹 the spine to the waist. Its branch descends through the gluteal muscles from the axilla, passing the hip joint. Hence, it causes lower back pain, head heaviness, and coldness from the back. Note: The commentaries on *Sanbu Jiuhou Lun* and *Ci Yaotong Lun* write "guan tun" (penetrate buttocks), whereas the commentary on *Jue Lun*, *Jia Yi Jing*, and this commentary write "guan shen" (penetrate paraspinal muscles). Shen refers to the muscles alongside the spine; Tun refers to the fleshy part of the buttocks where one sits. These are quite different; it is unknown which is correct.) It presents with chills preceding fever, severe rigors, ( , indicates intense heat; , also indicates excessive heat. Deficiency of Taiyang qi leads to initial chills; extreme cold generates heat, hence subsequent fever. Note: Pronounced Hao. Pronounced Ke,) followed by cessation of fever and sweating, making it difficult to cure. (The generation of heat indicates Qi deficiency; the cessation of heat indicates the recovery of Qi. If sweating occurs upon Qi recovery, it signifies that pathogenic factors are abundant and true Qi is insufficient, hence difficult to cure. Note: Xin Zhengjiao states: "Quanyuan Qi's edition, along with *Jia Yi Jing*, *Tai Su*, and *Chao Yuanfang*, read 'chills then fever with thirst', thirst ceases then sweating, differing from this text.") Needling Jinmen (Jinmen) to bleed. (Jinmen is the Xi-Cleft point of the Taiyang meridian. Located below the lateral malleolus, also known as Guanliang, it is where the Yang Wei vessel branches off. Needle 3 cun deep, moxa 3 cones. Huangdi's *Zhonggao Tu Jing* states Weizhong treats it, implying ancient methods considered Weizhong as Jinmen. Weizhong is in the center of the popliteal crease, over the arterial pulse, the He-Sea point of the Foot-Taiyang meridian. Needle 5 cun deep, retain for 7 breaths, moxa 3 cones. Note: Xin Zhengjiao states: "Upon detailed examination, *Jia Yi Jing* reads 'needling Weizhong'. Wang Bing provides two notes; 'Weizhong' should be considered correct.")

Malaria of the Foot-Shaoyang meridian causes flaccidity and weakness of the body, with mild chills and mild fever, aversion to seeing people, and palpitations/anxiety upon contact. (Note: Xieji (flaccidity/weakness) was explained previously. Shaoyang corresponds to the Gallbladder, harmonizes with the Liver, and governs the sinews. Disease causes sinews to fail to bind the bones, leading to limb flaccidity. Shaoyang disease involves both chills and fever, and its pulse governs the Half-Exterior/Half-Interior level, hence mild chills and mild fever. Gallbladder deficiency causes fright and aversion to people, hence anxiety. The commentary incorrectly interprets mild chills/fever as flaccidity.) Fever predominates, with profuse sweating. (Note: Although chills are present, fever is more prominent, indicating pathogenic factors exploiting deficiency. Pathogens entering the Liver and Gallbladder stir wind, causing profuse sweating.) Needling the Foot-Shaoyang meridian. (Xiaxi treats it. Xiaxi is between the metatarsals of the second and fifth toes, in the depression proximal to the metatarsophalangeal joint, the Ying-Spring point of Shaoyang. Needle 3 cun deep, retain for 3 breaths, moxa 3 cones.)

Malaria of the Foot-Yangming meridian causes initial chills, shivering severely, intense cold, which lasts a long time before turning to fever. After the fever subsides and sweating occurs, the patient prefers sunlight, moonlight, or fire warmth to feel comfortable. (Yang deficiency causes initial exterior cold; extreme Yang deficiency leads to rebound excess, hence intense cold lasting long before fever. After fever subsides and sweating stops, Yin becomes strong internally, and Yang cannot overcome Yin, hence preference for external heat sources to feel comfortable. Note: Repeated mention of Shaxe (shivering) indicates severe cold.) Needling the dorsum of the Foot-Yangming meridian. (Chongyang acupoint. Located 5 cun above the dorsum of the foot, on the arterial pulse between the bones, 3 cun from Xangu, the Yuan-Source point of Yangming. Needle 3 cun deep, retain for 10 breaths, moxa 3 cones.)

Malaria of the Foot-Taiyin meridian causes dysphoria and frequent sighing. (Heart Qi flowing to the Lung brings joy; now the Spleen is diseased, and the Heart Mother rescues it, sending Fire Qi down to the Spleen instead of up to the Lung. Additionally, the branch of the Taiyin meridian ascends from the Stomach through the diaphragm to the Heart. Hence, dysphoria and sighing. Note: Tai is pronounced Tan.) Anorexia, alternating chills and fever, sweating. (Note: The Spleen governs transformation and transportation. Disease causes stagnation and loss of taste, hence anorexia. Alternating chills and fever: *Jia Yi Jing* reads "more chills, less fever," differing from this text.) Upon onset, frequent vomiting occurs; the condition improves after vomiting. (Vomiting is a Stomach disorder. The Stomach and Spleen are paired; pathogens entering the Spleen affect the Stomach Qi, hence vomiting. Vomiting disperses pathogens, hence improvement. The commentary only explains via meridians/acupoints without deeper elaboration.) Treat immediately upon improvement. (Refers to taking the Jing-Well and Shu points, plus Gongsun. Gongsun is 1 cun distal to the base of the big toe, the Luo-Connecting point of Taiyin. Needle 4 cun deep, retain for 7 breaths, moxa 3 cones.)

Malaria of the Foot-Shaoyin meridian causes severe vomiting, frequent chills and fever, with fever predominating over chills. (The Foot-Shaoyin meridian passes through the Liver and Diaphragm, enters the Lungs, and follows the throat, hence severe vomiting and frequent chills/fever. The Kidney is a Yin organ; Yin generates cold. Now Yin Qi is deficient, hence more fever than chills. Note: Xin Zhengjiao states: "*Jia Yi Jing* says: 'Severe vomiting, more chills, less fever.'") Desire to stay indoors with doors and windows closed; the disease is difficult to cure. (Disease of the Stomach-Yangming meridian causes desire to stay alone behind closed doors; now Stomach symptoms appear in Kidney Water, Earth overcoming Water, hence difficult to cure. Datong and Taixi treat it. Datong is posterior to the medial malleolus, the Luo-Connecting point of Shaoyin. Needle 2 cun deep, retain for 7 breaths, moxa 3 cones. Taixi is posterior to the medial malleolus on the heel bone, in the depression of the arterial pulse, the Shu-Stream point of Shaoyin. Needle 3 cun deep, retain for 7 breaths, moxa 3 cones. Note: Xin Zhengjiao states: "*Jia Yi Jing* says: 'Difficult to cure, take Taixi.' Also, *Jia Yi Jing* writes Datong as 'posterior to the heel Chongzhong,' *Ci Yaotong Lun* commentary writes 'posterior street,' *Shui Xue Zhu* writes 'posterior to medial malleolus,' this commentary writes 'posterior street'; discrepancies exist, follow *Jia Yi Jing*.")

Malaria of the Foot-Jueyin meridian causes lower back pain, abdominal fullness, difficulty urinating resembling strangury but not strangury, frequent belching, fear, Qi deficiency, and inner oppression/gloom. (Foot-Jueyin meridian runs along the medial thigh, enters the pubic region, circles the genitals, and reaches the lower abdomen, hence these symptoms. Long refers to inability to urinate. Yiyi refers to a state of obstruction/discomfort. Note: Wang Ben reads "frequent urination intent," *Jia Yi Jing* reads "frequent belching," which is correct; corrected here.) Needling the Foot-Jueyin meridian. (Dachong treats it. Located 2 cun proximal to the base of the big toe, in the depression, the Shu-Stream point of Jueyin. Needle 3 cun deep, retain for 10 breaths, moxa 3 cones. Note: *Ci Yaotong Lun* commentary says "medial arterial pulse behind the joint base," differing from this note; correctness unknown.)

Lung Malaria causes coldness in the heart/chest, severe cold followed by fever, and fright during fever intervals, with visual hallucinations. Needling Hand-Taiyin and Hand-Yangming meridians. (Lieque treats it. Lieque is 1.5 cun distal to the wrist crease, the Luo-Connecting point of Hand-Taiyin. Needle 3 cun deep, retain for 3 breaths, moxa 5 cones. Yangming point, Hegu treats it. Hegu is between the metacarpals of the thumb and index finger, where the Hand-Yangming meridian passes. Needle 3 cun deep, retain for 6 breaths, moxa 3 cones. Note: The Lung governs skin and hair; inability to defend against pathogens allows deep invasion, causing chest cold. Severe cold then fever means cold exceeds fever; Lung pathology causes shivering and aversion to cold. Fright during fever intervals occurs because pathogenic factors are strong and Wood overacts on weak Metal, counter-rebelling; when fever subsides slightly, fright and hallucinations occur due to Lung injury.)

Heart Malaria causes severe mental restlessness, desire for cold water, but predominantly chills with mild fever. Needling the Hand-Shaoyin meridian. (Shenmen treats it. Shenmen is at the end of the radial styloid process, in the depression, the Shu-Stream point of Hand-Shaoyin. Needle 3 cun deep, retain for 7 breaths, moxa 3 cones. Note: The Heart houses Fire; pathogen intensifies Fire, causing severe restlessness and desire for cold water. Internal Fire blazing causes external cold, hence mild fever and predominant chills; fever expected but cold appears, hence termed "reverse".)

Liver Malaria causes a pale/greenish complexion, frequent sighing, and a state resembling death. Needling the Foot-Jueyin meridian until bleeding occurs. (Zhongfeng treats it. Zhongfeng is 1.5 cun anterior to the medial malleolus, in the depression; take with foot dorsiflexed, extend foot to locate, Foot-Jueyin meridian. Bleed upon needling; for routine needling, insert 4 cun, retain for 7 breaths, moxa 3 cones. Note: Previously discussed Foot Six Meridian malaria; now listing Liver, Spleen, Kidney, Stomach malaria again because symptoms differ. Missing Gallbladder and Bladder malaria, adding Lung and Heart malaria (Hand meridians). Reason unknown? Perhaps one meridian has diverse manifestations, previously unexplained, now clarified? Or were they originally separate chapters combined because all discuss malaria, causing textual irregularity? Uncertain. Cang refers to green/pale color, signifying decay; Liver pathology causes this color. Depression causes sighing; pathogenic factors suppress Liver, causing sighing resembling death.)

Spleen Malaria causes chills and abdominal pain; upon fever, borborygmus (intestinal rumbling) occurs, followed by sweating. Needling the Foot-Taiyin meridian. (Shangqiu treats it. Shangqiu is slightly anterior to the inferior aspect of the medial malleolus, in the depression, Foot-Taiyin meridian. Needle 3 cun deep, retain for 7 breaths, moxa 3 cones. Note: Spleen meridian governs intestines and abdomen; hence pain with cold, rumbling with heat.)

Kidney Malaria causes shivering, low back and spine pain with rolling/restlessness, difficulty defecating, blurred vision, and cold hands and feet. Needling Foot-Taiyang and Foot-Shaoyin meridians. (Datong treats it. Use method as described in Foot-Shaoyin malaria above. Note: Symptoms in this chapter vary greatly; pathology is diverse, so differences are appropriate. However, Wang Bing's commentary on acupoints and needling/moxibustion also varies significantly; only Kidney Malaria remains consistent. Analyzing the logic, the varying ones are correct, and the consistent one is wrong. Since later symptoms differ from earlier ones, acupoints should naturally differ; why stick to previous methods?)

Stomach Malaria causes frequent hunger but inability to eat; upon eating, epigastric distension and abdominal enlargement occur. (Stomach Heat and Spleen Deficiency cause hunger without appetite; eating causes distension and abdominal enlargement.) Therefore, the following text combines needling of the Taiyin meridian. Needling transverse vessels of Foot-Yangming and Foot-Taiyin to bleed. (...Lidui, Jiexi, Zusanli treat it. Lidui is at the tip of the second toe, distance from nail like a leek leaf, Yangming Jing-Well point. Needle 1 cun deep, retain for 1 breath, moxa 1 cone. Jiexi is 3.5 cun posterior to Chongyang, in the depression above the ankle, Yangming meridian. Needle 5 cun deep, retain for 5 breaths, moxa 3 cones. Zusanli is 3 cun below the knee, lateral to the tibia, between muscle bellies, Yangming He-Sea point. Needle 1 cun deep, retain for 7 breaths, moxa 3 cones. Foot-Yangming takes these three points; Foot-Taiyin needs its transverse vessel to be bled. Transverse vessel refers to the large oblique vessel anterior to the medial malleolus, i.e., the Taiyin meridian. Note: This commentary says Jiexi is 3.5 cun posterior to Chongyang; *Qixue Lun* commentary says 2.5 cun; *Jia Yi Jing* says 1.5 cun; follow *Jia Yi Jing*.)

If the malaria pulse is slow, large, and deficient, medication is suitable; acupuncture is not. (Slow indicates Wind-strike; Large indicates Qi excess; Deficient indicates Blood deficiency. Blood deficiency with Qi excess, attacked by Wind, requires medication to dispel pathogens; needle reduction and bleeding are contraindicated. Note: Commentary interpreting Large as Qi excess is incorrect. Large and forceful indicates excess; Large and deficient indicates lack of force. Hence, medication to tonify Righteous Qi and expel pathogens is suitable; needle use to drain Qi would worsen deficiency.) Generally, treat malaria about the time it takes to eat a meal before onset; otherwise, it is mistimed. (...Before onset, True Qi and Pathogen are separated, waves do not rise, hence treatable. After onset, True Qi and Pathogen merge; attacking them harms True Qi, hence termed mistimed.)