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Malaria (Nüe Ji) is caused by external contraction of Wind-Cold, Summer-Heat, and Dampness, combined with internal injury from diet, overexertion, irregular eating habits, or excessive sexual activity. This leads to dysfunction of the Spleen and Stomach, resulting in Phlegm retention in the Middle Jiao (Central Epigastrium). However, without Phlegm, Malaria cannot form. The Spleen and Stomach belong to Earth and possess the quality of trustworthiness; their rhythmicity ensures attacks occur at regular times. If the timing shifts, appearing earlier or later than usual, it indicates that the pathogenic factor has no place to reside, and the Malaria is about to resolve.

When Malaria strikes, patients experience yawning, aversion to cold, cold hands and feet, shivering chills, followed by high fever, thirst, headache, and soreness/aching in the lower back, hips, and joints. Symptoms vary: some present with chills first then fever, others with fever first then chills, some with only chills or only fever, some with more chills than fever, and others with more fever than chills.

Daily attacks indicate a shallow pathogenic level and are easy to treat. Attacks occurring every other day, or two consecutive days followed by a pause, are difficult to treat. Treatment should target pathogens in the Exterior. For those without sweating, Sanxie Tang (Dispelling Pathogens Decoction) is the primary formula; for those with sweating, Zhengqi Tang (Upright Qi Decoction) is primary; for pathogens in the Half-Exterior/Half-Interior, Chai Ling Tang (Bupleurum and Polyporus Decoction) is primary; for cases where Yin-Yang separation is not yet resolved, Renshen Yangwei Tang (Ginseng Stomach-Nourishing Decoction) is used with modifications. If antiperiodic medicines are used and yellowish-biliary fluid is vomited, the Malaria will heal spontaneously. Do not use antiperiodics too early (within one or two days), as this may cause pathogenic closure leading to complicated syndromes. Do not use them too late, as this may deplete Yuan Qi (Original Qi) leading to deficiency and frailty. It is best to intervene on the third or fourth day. Food should only be consumed after the fever subsides and the body cools; one must not eat while still febrile, lest indigestion lead to Pi Masses (Plugging sensations), also known as Nümu (Malaria Mother). In some cases, Pi masses dissipate and transform into Gu (Drum-like distension).

Sanxie Tang (For early-stage Malaria with severe chills and high fever, headache, body pain, and anhidrosis):
Gancao (Licorice Root) 3 fen, Qianghuo (Notopterygium Rhizome), Zisu (Perilla Leaf), Jingjie (Schizonepeta Spike), Baizhi (Angelica Dahurica Root), Mahuang (Ephedra Stem), Baishao (White Peony Root), Fangfeng (Saposhnikovia Root) each 1 qian.
Shengjiang (Fresh Ginger) and Congbai (Scallion White) three stalks. Decoct in water, expose to night dew overnight, take warm early next morning. Add Chenpi (Tangerine Peel) if Phlegm is present; add Cangzhu (Atractylodes Rhizome) if Dampness is present; add Xiangfu (Cyperus Rhizome) if food stagnation is present. (From *Wanbing Huichun*)

Zhengqi Tang (For early-stage Malaria without severe chills/high fever, with headache, dry mouth, and diaphoresis):
Guipi (Cinnamon Bark), Gancao (Licorice Root) each 3 fen; Fuling (Poria), Banxia (Pinellia Tuber stir-fried with ginger juice), Baizhi (Angelica Dahurica Root), Qingpi (Green Tangerine Peel), Chuanxiong (Ligusticum Rhizome), Caoguo (Black Cardamom Seed, husked), Binglang (Areca Seed), Qianhu (Peucedanum Root), Chaihu (Bupleurum Root), Maidong (Ophiopogon Tuber) each 1 qian.
Shengjiang (Fresh Ginger) three slices, Zao (Jujube) one piece. Decoct and take in advance. (From *Wanbing Huichun*)

Chai Ling Tang (For Malaria with alternating chills and fever, pathology in Half-Exterior/Half-Interior, Yin-Yang confusion):
Chaihu (Bupleurum Root), Huangqin (Scutellaria Root), Renshen (Ginseng Root), Banxia (Pinellia Tuber), Zhuling (Polyporus), Zexie (Alisma Rhizome), Baizhu (Atractylodes Macrocephala Rhizome), Fuling (Poria), Rougui (Cinnamon Bark), Gancao (Licorice Root).
Shengjiang (Fresh Ginger) three slices, Zao (Jujube) two pieces. Decoct and take. Add Mahuang (Ephedra Stem) if anhidrotic; add Guizhi (Cinnamon Twig) if diaphoretic; add Guanchi (Cinnamon Twig) if sweating is excessive; add Huangqin (Scutellaria Root) if heat is prominent. (From *Wanbing Huichun*)

Formula for Treating Malaria:
Chenpi (Tangerine Peel), Banxia (Pinellia Tuber processed), Danggui (Angelica Sinensis Root) each 1 qian; Chaihu (Bupleurum Root), Huangqin (Scutellaria Root), Zexie (Alisma Rhizome), Fuling (Poria) each 8 fen; Gancao (Licorice Root roasted), Shengma (Cimicifuga Rhizome), Gange (Kudzu Root) each 5 fen.
Shengjiang (Fresh Ginger) two slices, Zaotou (Jujube tip) one piece, Taotou (Peach tip) five pieces.
Decoct in water, take hot. Avoid raw/cold foods, fish, and noodles. According to Yuepo: Among hundreds of formulas, this one is stable and error-free; take twenty doses. Adding Renshen (Ginseng Root) after five or six doses is even better. (From *Chen Baipo Fang*)

Juemie Formula (Miraculous effect after ten days):
Changshan (Dichroa Root, wine-boiled and sun-dried), Zhimu (Anemarrhena Rhizome), Beimu (Fritillaria Bulb), Caoguo (Black Cardamom Seed) each half qian.
Decoct in water, take hot at Wugeng (3-5 AM). Soak the dregs in wine and apply to the front and back of the hair. Wang Yinzhe said: "I have used this formula for forty years; its miraculous effects cannot be fully described." Do not modify it arbitrarily to avoid ineffectiveness. (From *Yangsheng Zhulun*)

Another Formula (Miraculous effect after twenty days):
Guishen (Angelica Sinensis Root head), Qingpi (Green Tangerine Peel), Chi Sheng Shouwu (Raw Red Polygonum Multiflorum Tuber), Bai Sheng Shouwu (Raw White Polygonum Multiflorum Tuber), Lao Jiangpi (Old Ginger Peel) each 3 qian.
Decoct in River Water and Well Water (one bowl each) until reduced to 80%. Expose to night dew overnight. Take hot at Wugeng (3-5 AM) on the day of onset for cure. (Empirical Formula)

External Antiperiodic Medicine:
Three large spiders, 1 qian Xinpi (Realgar mixed with arsenic), 49 Xiongheidou (Male Black Soybeans). Grind into powder. Form pills with drops of water, size of pea beans. On the preceding night, offer one pill under the Big Dipper. Next morning, wrap in paper and insert into the ear for immediate effect. (From *Yiming Fang*)

Every-Other-Day Malaria:
Baizhu (Atractylodes Macrocephala Rhizome) 1 qian; Fuling (Poria), Zexie (Alisma Rhizome), Zhuling (Polyporus), Chaihu (Bupleurum Root), Banxia (Pinellia Tuber) each 1 qian; Huangqin (Scutellaria Root) 1.5 qian if heat is predominant, 1 qian if chills are predominant.
Add Shengjiang (Fresh Ginger) three slices, Dazao (Jujube) two pieces. Expose to night dew overnight. Take at Wugeng (3-5 AM) on the day of onset. (From *Shenxiao Xianfang*)

Every-Third-Day Malaria (Stops immediately after one dose):
Cangzhu (Atractylodes Lancea Rhizome) 3 qian; Zhi Shouwu (Prepared Polygonum Multiflorum Tuber) 5 qian; Baizhu (Atractylodes Macrocephala Rhizome, stir-fried) 2 qian; Zhimu (Anemarrhena Rhizome) 5 fen; Fencǎo (Licorice Root) 1 qian.
Decoct four bowls of water until half remains. Take at Jiming (3-5 AM). (If chills predominate, add Shengjiang [Fresh Ginger] 6 qian, Danggui [Angelica Sinensis Root] 5 qian; if heat is intense, add Danggui [Angelica Sinensis Root] 6 qian, Shengjiang [Fresh Ginger] 5 qian). Take before onset for cure. (From *Danfang Jingyan*)

Chronic Malaria resembling Consumption:
Danggui (Angelica Sinensis Root, wine-washed), Niuxi (Achyranthes Root) each 5 qian; Biejia (Turtle Shell), Juhong (Tangerine Pulp), Beimu (Fritillaria Bulb) each 3 qian; Xian Shouwu (Fresh Polygonum Multiflorum Tuber) 5 qian; Jiangpi (Ginger Peel) 2.5 qian; Chaihu (Bupleurum Root) 1.5 qian (Remove these two if heat is prominent with sweating).
Add Zhuli (Bamboo Sap) one cup, Decoct in two cups of water until half remains. Expose to night dew overnight. Take warm at Wugeng (3-5 AM) on the day of onset. (From *Danfang Quanji*)