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First, remove one of the pathogens to achieve quick relief. I administered this prescription to him, and after a single dose, both ailments were cured. My maternal grandmother, Lady Yu, was over eighty years old. In summer, she contracted malaria (Malaria). Her uncles, concerned about her advanced age and inability to endure further attacks, discussed forcibly stopping the malaria (using strong antimalarial drugs). I said that resolving it with just one dose would be very easy; why insist on forcibly stopping it? Thus, I used Chai Hu (Bupleuri Radix), Sheng Ma (Cimicifugae Rhizoma), Ge Gen (Puerariae Lobatae Radix), Qiang Huo (Notopterygii Rhizoma et Radix), and Fang Feng (Saposhnikoviae Radix)—medicinals with sweet and pungent flavors and clear, light qi—to raise Yang Qi (Yang Energy) so that it separates from Yin pathogen, causing the coldness to resolve spontaneously. I used Zhi Mu (Anemarrhenae Rhizoma), Shi Gao (Gypsum Fibrosum), and Huang Qin (Scutellariae Radix)—medicinals with bitter and sweet flavors and cold nature—to guide Yin Qi downward so that it separates from Yang pathogen, causing the heat to resolve spontaneously. I used Zhu Ling (Polyporus) with its bland and permeating properties to differentiate and drain Yin and Yang, preventing them from intertwining. I used Shan Jia Chuan Kong (Manis Squama) as an guiding agent, and Gan Cao (Glycyrrhizae Radix et Rhizoma) to harmonize the herbs. Indeed, a single dose stopped the malaria. Therefore, Zhao Yi De stated: "I have studied Materia Medica and found that Zhi Mu, Cao Guo (Tsaoko Fructus), Chang Shan (Dichroae Radix), Gan Cao, Wu Mei (Mume Fructus), Bing Lang (Arecae Semen), and Shan Jia Chuan Kong are all said to treat malaria." Combining them into a formula is because Zhi Mu is cold in nature and enters the Foot-Yangming Stomach Meridian; it is used to treat the excessive fire-heat of the Yangming, causing it to retreat towards the Taiyin. Cao Guo is warm and drying, treating the excessive cold of the Foot-Taiyin Spleen Meridian, causing it to retreat towards the Yangming. When these two meridians harmonize, there is no disorder of Yin and Yang intermixing; these two serve as the Sovereign (Jun) herbs. Chang Shan primarily treats chills and fever malaria, vomiting phlegm knots in the chest, serving as the Minister (Chen) herb. Gan Cao harmonizes the various herbs, Wu Mei removes phlegm, and Bing Lang eliminates phlegm-stagnation and breaks stagnant Qi, serving as the Assistant (Zuo) herbs. Shan Jia Chuan Kong, because it lives in holes in mountains and enters water when encountered, symbolizes exiting Yin and entering Yang, penetrating meridians to reach the Ying (Nutritive) level, thereby breaking the pathogenic evil condensed by summer-heat; it serves as the Envoy (Shi) herb. Thus, this formula is effective for those with stagnant phlegm and retained fluids in the Spleen and Stomach. If there is no phlegm, but only summer-heat condensed in the Ying level, manifesting solely as heat in the Taiyin Blood level, the patient should develop lip ulcers and heal spontaneously; this formula would be ineffective. (Chai Hu, Sheng Ma, etc., are suitable for external causes. Zhi Mu, etc., are suitable for internal causes.) In the southeast coastal regions, sea winds are unpredictable, and people's consumption of fish and salt often leads to retained fluids in the body; thus, Wind Malaria and Food Malaria prevail here. Using Wu Tou (Aconiti Lateralis Radix Praeparata), Cao Guo, Chen Pi (Citri Reticulatae Pericarpium), and Ban Xia (Pinelliae Rhizoma) is appropriate if applied correctly. In the northwest, the terrain is high and open; in deep winter, water freezes and earth cracks; in midsummer, stones scorch and gold melts. People often suffer from cold evil and latent summer-heat; thus, Summer-heat Malaria and Cold Malaria are common, and Chai Hu and Chang Shan should be used together. For those traveling between southeast and northwest, when the pathogen is not yet fully differentiated, Huo Xiang Zheng Qi San or Cao Guo Yin can be used, which is similar to Yang Wei Tang. To treat Northern malaria, decoct the stems and leaves of Ma Bian Cao (Verbena officinalis) in one cup, leave it exposed overnight, and take it early in the morning. Add Jiang Zhi (Ginger Juice) if cold symptoms are severe. Dai Yun said: "In recent times, due to chills and fever attacks, seeing patients' fingernails turn blue-black, they named it 'Sha'. Some scrape or pick at it, some feed them tea oil, and forbid medication. This disease is actually Southern Miasma Malaria. Using Sheng Liao Ping Wei San added with Cao Guo and Bing Lang is precisely suitable. How can there be a disease without medicine?" Note: Southerners do not take malaria seriously, while Northerners fear it. Northerners developing malaria in the South fear it even more. This shows that practitioners must know how to adapt to local conditions; the above three points merely introduce the topic. *Jie Gu Jia Zhen* treats long-standing malaria where the patient cannot eat and feels郁郁 (oppressed) in the chest, wanting to vomit but unable to do so, by using Xiong Huang San (Realgar Powder) to induce vomiting. Note: This is only applicable if the upper pulse is floating, slippery, and forceful, confirming the presence of excess pathogen in the chest; otherwise, it may cause the harm of "deficiencyizing deficiency." Yang Ren Zhai said: "Middle-aged individuals with long-term visceral deficiency and frequent loose stools who suddenly contract malaria and experience abnormal vomiting can only stop the vomiting by specifically using Ren Shen (Ginseng Radix); other antimalarial prescriptions are unsuitable. Thus, use Fu Ling Er Chen Tang added with Ren Shen and Suo Sha (Amomi Fructus Rotundus), and significantly increase Bai Dou Kou (Cardamomi Fructus). After one or two doses, the patient feels their Qi and pulse instantly stabilize, and chills and fever cease. Generally, Bai Dou Kou can digest and grind, circulating through the Triple Burner; once Ying and Wei circulate, chills and fever naturally subside. From now on, for symptoms of vomiting accompanying malaria, or for those prone to vomiting who develop malaria, do not use Chang Shan. Instead, crush fresh Lai Fu (Radish) and Sheng Jiang (Fresh Ginger) to obtain half a cup of natural juice, add three or four spoons of honey, and two Wu Mei, decoct together, and swallow 3-4 pills of Ju Fang Xiong Huang Wan (Prescribed Form Realgar Pill). Wait for the discharge of foul blood, phlegm, and fluid, then regulate with Ren Shen, Chuan Xiong (Ligustici Chuanxiong Rhizoma), Fu Ling (Poria), Ban Xia, Sha Ren (Amomi Fructus), and Gan Cao. If vomiting persists and heat does not subside, use Zhen Liao Xiao Chai Hu Tang (Authentic Minor Bupleurum Decoction) with increased Sheng Jiang as the main treatment. If vomiting is severe accompanied by fever, first administer Zhi Mie Sheng Shu Yin (Antimalarial Raw and Cooked Drink); once vomiting stops, follow up with Xiao Chai Hu Tang. Note: Although Yang Ren Zhai's discussion on treatment is detailed, his medication choices are not always precise. If it is confirmed that there is excess pathogen in the chest requiring vomiting, it is better to use Ni Liu Shui (Reverse-flowing Water) to decoct Ju Pi Tang (Tangerine Peel Decoction) to guide vomiting. If vomiting cannot be induced, the location can be determined; suppress the pathogen to move it downward, adding Pi Pa Ye (Loquat Leaf) and Lu Gen (Reed Rhizome) to the symptomatic prescription. Generally, one must examine the cause of vomiting and treat according to the root; this cannot be fully explained in words. Yang Ren Zhai also said: "Malaria patients often accumulate phlegm-fluids and yellow water; Chang Shan can induce vomiting and promote drainage, which is true. However, for pure-heat malaria or cases with internal heat accumulation, administering Chang Shan results in scanty bowel movements, resembling diarrhea but not quite; one must use Bei Da Huang (Northern Rhubarb) as an assistant, inducing several large purgations before recovery. He also said: 'All malaria is due to retained yellow water in the abdomen; because the water does not flow, chills and fever do not cease. This is where the malaria pathogen resides.' Treatment method: For pure-heat Summer-heat Malaria, decoct Xiang Ru Yin (Elsholtzia Decoction) added with Qing Pi (Citri Reticulatae Pericarpium Viride), Bei Da Huang, and two Wu Mei; take warm in the early morning. For Cold Malaria with predominant cold, decoct Er Chen Tang (Two-Cured Decoction) added with Qing Pi and Liang Jiang (Galangal Rhizoma), using much Sheng Jiang; swallow five Shen Bao Wan (Divine Protection Pills) in the early morning. Also, to drain toxic water, the root of the disease can be removed, and chills and fever will naturally resolve. He also said: 'Malaria involves Water and Blood. Water refers to Fluid retention; Blood refers to Blood stasis. It is Fluid retention that causes chills and fever; it is Blood stasis that causes aversion to chills and fever. Chang Shan drives out water and drains fluids, which is correct. But without blood-moving medicines to assist, how can perfect efficacy be achieved?' From now on, for malaria patients presenting with epistaxis, blood streaks in stool, or menstruation just starting or ending, these are Blood syndromes. Add Wu Ling Zhi (Trogopteri Dung) and Tao Ren (Persicae Semen) as assistants to the malaria prescription, decoct with Sheng Jiang and Honey to treat. He also said: 'Why does malaria persist and not cease? Because there is a root. What is the root? It is Fluid, Water, and Defeated Blood. Only Phlegm-Stagnation (Pi Ji) is the mother of malaria; only Defeated Blood is the toxin of summer-heat; only Fluid and Water generate chills and fever. Thus, Summer-heat pulse is deficient, Fluid pulse is deep, and Phlegm-Stagnation pulse is knotted. For those with Fluid/Water, drain water and dissipate fluids; for those with Phlegm-Stagnation, the hypochondrium must hurt, so attack the stagnation; for Defeated Blood and Summer-heat toxin, disperse and drain according to symptoms. If chills and fever are not eliminated, I do not believe it.' Note: Yang Ren Zhai's theory is correct, but his treatment explanation is incomplete. Da Huang can only remove有形 (tangible) accumulations, not Water. His extraction of Blood stasis must be vinegar-processed and guided by Tao Ren etc., otherwise it will not move. Chang Shan's nature is to treat malaria; although it induces vomiting, if steamed properly to avoid vomiting, malaria heals more easily. Its merit lies not in vomiting phlegm, clearly. It is not a drug for vomiting water, but only damages the Stomach Qi. My brother-in-law Yu Zhongfu had much retained fluid and was prone to malaria. Once, he used Chang Shan to forcibly stop malaria, vomited heavily, but the malaria did not stop and worsened. Even now, discussing it makes him feel nauseous. In the year Jia Wu, due to excessive tea drinking leading to intoxication, and feeling resentful about current events, large amounts of fluid accumulated in his abdomen, making gurgling sounds. At the transition of summer and autumn, the illness flared up, beginning with chills and fever. After the chills and fever subsided, the illness did not improve. Seeing his nausea, I used Gua Di San (Melon Seed Powder) and Ren Shen Lu (Ginseng Stalk) decocted to guide vomiting, but he could not vomit. I thought that retained fluid requires Shi Zao Tang (Ten Jujube Decoction) to drain, so I used these three medicines boiled with black beans, dried, powdered, mixed with jujube paste into pills the size of mustard seeds, and administered with jujube decoction. Initially taking 0.5 fen, seeing no effect, I increased by another 0.5 fen. Soon, severe abdominal pain occurred; I gave him jujube decoction to drink. He had five or six bowel movements, all loose stool without water. It was around dusk. At midnight, he passed several dou of accumulated water, and the illness subsided. However, during the purgation, the Ming Xuan reaction (herxheimer-like reaction) was severe; his limbs were cold, he nearly died and revived. The whole family wept, blaming my recklessness. Alas! Can medicines be tested lightly? Wang Hai Zang said: 'Water is governed by the Lung, Kidney, and Spleen meridians, involving parts of the five Zang and six Fu organs and twelve meridians. It affects the head above, limbs in the middle, waist and feet below, skin and hair outside, muscles in the middle, and bones and sinews inside. Pulses differ in Cun/Cun positions and Floating/Sinking qualities; one must not lightly use purgative drugs. One must know which meridian and Zang organ the disease is in before using them; misuse causes deep harm. Moreover, what Yang Ren Zhai used was especially not a drug for treating Water. Punishing the innocent causes significant harm. Therefore, I suggest that if patients truly have accumulated water and blood stasis, and are Excess type, Xiao Wei Wan (Minor Stomach Pill) can be used to move water, and Di Dang Tang (Di Dang Decoction) to move blood. If Deficient type, it is better to temporarily use bland-draining agents added with Zhu Li (Bamboo Sap) and Jiang Zhi to treat phlegm, and add Tao Ren and Jiu Zhi (Leek Juice) to the symptomatic prescription to invigorate blood. The illness will gradually subside. Do not seek immediate results and regret later.' For malaria that has recurred many times with no effect from various medicines, assuming no external pathogen and not a Deficient person suffering malaria, decoct Ren Shen and Sheng Jiang (1 liang each) in water. Take two doses consecutively two hours before the attack, or at Wugeng (3-5 AM) on the day of the attack. There will be no failure to cure. Recovery is easy afterward, without needing extensive recuperation. Recently, due to high Ginseng prices, difficult to use for helping the poor, replace with Bai Zhu (Atractylodis Macrocephalae Rhizoma). For night attacks, use Dang Gui (Angelicae Sinensis Radix). All respond promptly. *Jin Gui Yao Lue* asks: 'If malaria starts on the first day of the month, it should heal by the fifteenth day. If not healed, it should resolve by the end of the month. If not, what then?' The Master said: 'This forms a mass called Nue Mu (Malaria Mother). Treat it urgently. Bi Jia Jian Wan (Softshell Turtle Pill) can be used. Nue Mu Wan: Bi Jia (Testudinis Carapax et Plastrum) vinegar-fried 2 liang, San Leng (Sparganii Rhizoma) and E Zhu (Curcumae Rhizoma) each vinegar-boiled 1 liang, Xiang Fu (Cyperi Rhizoma) vinegar-processed 2 liang, A Wei (Ferulae Resina) vinegar-melted 2 qian. Make pills with vinegar paste. Stop when the accumulation is half resolved. All long-standing malaria, malaria around Chu Shu (End of Heat) to Dong Zhi (Winter Solstice), and irregular intermittent malaria should be treated using the Nue Mu method, with Bi Jia as the Sovereign herb. Malaria occurring every other day indicates the pathogen is deep, invading Yin internally. Yang Qi alone erupts, Yin pathogen adheres internally. Yin and Yang struggle but cannot exit, hence the interval. If occurring every two days or several days, the pathogen and Wei Qi reside in the Six Fu organs, sometimes losing contact, unable to interact, hence resting for several days before attacking. Dan Xi said: 'Attacking every three days means the pathogen has entered the Three Yin meridians. Attacking on Zi, Wu, Mao, You days is Shao Yin Malaria. Attacking on Yin, Shen, Si, Hai days is Jue Yin Malaria. Attacking on Chen, Xu, Chou, Wei days is Tai Yin Malaria. Further reference to symptoms and pulses is needed to determine the meridian and establish treatment.'"

[Protracted Illness Malaria] Liver disease: face green, pulse wiry and skin tight. More green indicates pain. Robust constitution, chest/hypochondriac pain, deafness, bitter taste, dry tongue, alternating chills/fever, vomiting. Above describes robust constitution; harmonize with Xiao Chai Hu Tang (Minor Bupleurum Decoction). If constitution is weak, bones shake, unable to stand firmly, this concerns knee sinews; treat with Qiang Huo Tang. Materia Medica states: Qiang Huo is the Sovereign herb. For malaria involving Shaoyang, if long-standing it develops into Dan Malaria (Fever Malaria), puncture Jue Gu acupoint, then treat with Xiao Chai Hu Tang. Heart disease: face red, pulse surging, body hot. More red indicates heat. Sudden severe heat with chills; treat with Ma Huang Jia Zhi Mu, Shi Gao, Huang Qin Tang (Ephedra Added with Anemarrhena, Gypsum, Scutellaria Decoction). If this syndrome does not induce sweating, long non-resolution becomes malaria. Protracted swelling: face red, body hot, pulse surging/tight, emaciation. Women: blood loss; Men: essence loss. Spleen disease: face yellow, pulse slow, skin relaxed. More yellow indicates heat. Robust constitution. According to Shang Han Lun, this is Shi Wen (Damp-Warmth). Pulse: Yang floating/weak, Yin small/urgent. Treatment targets Taiyin. Damp-Warmth with spontaneous sweating: Bai Hu Tang (White Tiger Decoction) added with Cang Zhu (Atractylodis Rhizoma). If long non-resolution becomes heavy Wen Malaria (Warm Malaria): Bai Hu Jia Gui Zhi Tang (White Tiger Added with Cinnamon Twig Decoction). Protracted flesh wasting: little appetite, weakness. Hence called "Heat wasting flesh"; treat with blood-nourishing cooling herbs. *Nei Jing* says: "Blood generates flesh." Lung disease: face white, skin rough, pulse choppy. More white indicates cold. Sudden rough/itchy sensation, Qi deficiency. Ma Huang Jia Gui Zhi Tang (Ephedra Added with Cinnamon Twig Decoction) to induce slight sweating. *Shang Han Lun* says: "Summer injury by summer-heat, sweat cannot exit, causes itching." If long non-resolution becomes Feng Malaria (Wind Malaria): weak constitution, white face, choppy pulse, rough skin, emaciated, weak Qi, protracted Wei Qi insufficiency. Kidney disease: face black, body cool, pulse deep/slippery. More black indicates Bi (Obstruction). Sudden cold body with aversion to cold: San Jiao (Triple Burner) injury. Treat with Jiang Fu Tang (Ginger and Aconite Decoction) or Si Ni Tang (Four Counterflow Decoction). Long non-resolution becomes malaria. Violent Qi rushing up, vomiting food, night attacks: commonly called Night Malaria. Taiyang Meridian Gui Zhi Syndrome: weak constitution, protracted illness, black jaundice, emaciation, Wind-Bi, Wei Jue (Paralysis/Cold Limbs), inability to walk. External Shang Han (Cold Damage): alternating chills/fever like malaria. Lao Bing (Consumption/Fatigue Disease): alternating chills/fever like malaria. Called "Like Malaria," not true malaria. However, Shang Han chills/fever like malaria initially presents with aversion to wind/cold, fever, headache, body ache, originating from Taiyang. Lao Bing chills/fever like malaria initially presents with five-palm heat, fatigue, cough, eventually becoming chills/fever, different from true malaria. Various diseases have chills/fever: e.g., blood loss, phlegm-fluid, masses, intestinal hernia, wind/cold/summer-heat/dampness, food injury/fatigue, tuberculosis, beriberi, toxicity. These are covered in respective sections. Others cannot be listed. All with chills/fever must ask what original disease caused the chills/fever, then treat accordingly. Any chills/fever with regular timing is Malaria. Irregular timing is various diseases.