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Yang states: The onset and cessation of malaria symptoms occur at regular intervals, unlike the alternating chills and fever (alternating aversion to cold and fever), which may be sparse or frequent, with no fixed time for onset and cessation. In individuals who have contracted a common cold, if they suddenly feel cold hairs, trembling thighs, stiffness and spasm of tendons and joints, and a sensation of their entire body being shaken like a drum, accompanied by nausea and loss of appetite, followed by an unbearable coldness that soon turns into fever, this is termed warm malaria (a type of malaria characterized by high fever with little or no chills). One should not assume that only a wiry pulse indicates malaria; rather, pulses that are surging and rapid, tight and solid, deficient and slow, or rough and choppy can all present as malaria-like symptoms, distinguished by external manifestations. Medication naturally follows specific guidelines; for instance, Xiao Chai Hu Tang (Minor Bupleurum Decoction) can be adjusted flexibly according to circumstances, which is also a method of adaptable application. Although blood deficiency can generate chills and fever, and stagnant blood (blood stasis) can also cause chills and fever, and an imbalance of Yin and Yang can produce similar syndromes, each syndrome has its corresponding formula, and Chuanxiong Rhizoma (Chuanxiong) should generally be used as an adjunctive herb.

In Taiyang disease (an initial stage of exogenous cold-wind invasion where pathogenic factors reside in the exterior), after eight or nine days, if the symptoms resemble malaria with more heat than cold, the patient does not vomit, bowel movements and urination are relatively normal, and the condition occurs two or three times a day with a slightly moderate pulse, recovery is imminent. If the pulse is faint and there is aversion to cold, this indicates a deficiency of both Yin and Yang, and methods such as sweating, purging, or vomiting should not be employed. If the face appears reddish-hot, it signifies that the pathogen has not been resolved because slight perspiration has not occurred, leading to itching of the skin; Gui Zhi Ma Huang Ge Ban Tang (Guizhi Mahuang Half-Half Decoction) is appropriate.

After taking Gui Zhi Tang (Cinnamon Twig Decoction), if profuse sweating occurs and the pulse becomes surging and large, administer Gui Zhi Tang again according to the previous method. If the condition resembles malaria, occurring twice a day, it will resolve with perspiration; Gui Zhi Er Ma Huang Yi Tang (Guizhi Two-Mahuang One Decoction) is indicated. Cheng Wuji stated in his commentary on Shanghan Lun: "If symptoms persist after one dose, the original decoction should be administered again." After sweating from Gui Zhi Tang, if the pulse is surging and large, the pathogen remains. If the condition resembles malaria, occurring twice a day, it indicates pathogenic factors lodged between Ying (Nutritive) and Wei (Defensive) levels; Gui Zhi Er Ma Huang Yi Tang is used to dissipate these pathogens.

Formula for Gui Zhi Er Ma Huang Yi Tang: Guizhi (Cinnamomi Ramulus, 3 qian, remove coarse bark), Shaoyao (Paeoniae Radix Alba, 3 qian), Mahuang (Ephedrae Herba, 1.6 qian, remove nodes), Shengjiang (Zingiberis Rhizoma Recens, 3 qian, sliced), Gancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, 1.6 qian, honey-fried), Xingren (Armeniacae Semen Amarum, 4 pieces, remove skin and pointed ends), Dazao (Ziziphi Jujubae Fructus, 2 pieces, split). These seven ingredients are boiled in two zhong of water; first boil Mahuang for one or two boils, skim off the foam, then add the remaining herbs. Boil until one zhong remains, strain, and divide into two doses.

If the patient's head feels hot and perspires, the illness resolves. If the condition resembles malaria with fever occurring daily around dusk, this belongs to Yangming disease (excess heat in the stomach and intestines). If the pulse is excess, purgation is indicated; if the pulse is deficient and floating, diaphoresis is indicated. For purgation, Da Cheng Qi Tang (Major Order the Qi Decoction) is used; for diaphoresis, Gui Zhi Tang is appropriate. Although Yangming symptoms are present, one must not immediately diagnose interior excess; careful examination of the pulse is required to distinguish interior from exterior. An excess pulse indicates heat has entered the fu organs forming an excess pattern, suitable for Da Cheng Qi Tang purgation. A floating and deficient pulse indicates heat has not entered the fu organs but remains in the exterior, suitable for Gui Zhi Tang diaphoresis, leading to recovery.

In women suffering from wind-strike for seven or eight days, if chills and fever recur at regular intervals and menstruation happens to cease, this is heat entering the Blood Chamber (uterus/blood sea), causing blood coagulation, resulting in malaria-like symptoms with regular onset. Xiao Chai Hu Tang is the primary treatment. (See details in the section on Wind-Strike in Women.)