Library

I once read the *Neijing·Mallun* (Treatise on Malaria) from the *Huangdi Neijing* (Yellow Emperor's Inner Canon), where the treatment methods are described in great detail. Symptoms are categorized according to the twelve meridians, using Ying and Wei (Nutritive and Defensive Qi) as the guiding principle, distinguishing Yin and Yang through Qi and Blood, and examining the predominance of Exogenous (Wai Gan) or Endogenous (Nei Shang) pathogens. If a person has excess Yang, they will experience fever; if Yin is excessive, they will experience aversion to cold. Since the Mo Yuan (Membrane Source, a space between the exterior and interior) lies at the boundary of the exterior and interior, when pathogens enter the realm of Wei Qi circulation, the struggle and resistance between the pathogen and healthy Qi result in alternating chills and fever. The Shaoyang (Lesser Yang) meridian serves as the pivot of the half-exterior and half-interior region and is adjacent to the Mo Yuan. Superficially, it seems that malaria transmits via the Shaoyang meridian, leading unskilled physicians to rigidly adhere to Xiaochaihu Tang (Minor Bupleurum Decoction) as the exclusive formula for treating malaria, which shows a profound lack of deep thought. Zhang Zhongjing stated in the *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet): "The pulse of malaria is naturally wiry (Xian). A wiry and rapid pulse indicates much heat; a wiry and slow pulse indicates much cold." This occurs because pathogens in the Middle Jiao (Central Earth/Spleen-Stomach) allow Liver Wood to easily overact upon Spleen Earth.

Malaria is classified into Cold Malaria, Warm Malaria, Dan Malaria, Mu Malaria, and Deficiency-Excess types, with attacks occurring and ceasing at fixed times. When the pathogen is shallow, it may attack daily, or every other day, or every third day; this is called Yin Malaria, because the pathogen resides in the Yin aspect and lingers, making it difficult to cure. Generally, the method for treating malaria involves harmonizing Ying and Wei Qi to prevent Yin-Yang imbalance, and judiciously using cold or warm formulas to achieve balance. However, one must distinguish the etiology—whether it stems from exogenous invasion, endogenous injury, deficiency, or excess—and carefully select appropriate diaphoretic (sweating), purgative (downward-draining), resolving, or tonifying agents. If the pathogen is latent in the Yin aspect, use herbs that ascend and clear Yang to extract it to the Yang aspect, thereby avoiding stubborn accumulation. With these general principles established, careful contemplation allows one to grasp more than half of the essence.

Regarding the causes of cough, they do not extend beyond pathogens of Cold, Heat, Deficiency, and Excess, often accompanied by Wind invading the Lung and Stomach. When pathogens in the Lung and Stomach ascend to interfere with the Clear Orifices, cough arises. The *Neijing* states: "All five Zang organs and six Fu organs can cause cough." It also says: "Pathogens gather in the Lung and relate to the Stomach." The Lung is a pure and descending organ, tolerating no external pathogenic intrusion. Interference leads to cough and rebellious Qi, and in severe cases, panting and loss of voice, potentially progressing to Lao Zhai (Consumption/Tuberculosis), with many dying without treatment. In my treatment of cough caused by exogenous Cold, I typically use Xiao Qinglong Tang (Minor Blue-Green Dragon Decoction) with reduced dosages: Ephedrae Herba (Mahuang) and Zingiberis Rhizoma Recens (Ganjiang/Dried Ginger) each 1 qian, Asari Radix (Xixin) 0.5 qian, Pinelliae Rhizoma Praeparatum (Zhi Banxia) 1.5 qian, Schisandrae Fructus (Wuweizi) 0.4 qian, Paeoniae Radix Alba (Chao Shaoyao) 1 qian, Glycyrrhizae Radix et Rhizoma (Gancao) 0.5 qian, and Cinnamomi Ramulus (Guizhi) 0.6 qian added later. Modifications are made based on symptoms: if heat is severe, add Armeniacae Semen Amarum (Xingren) and Gypsum Fibrosum (Shigao), removing Dried Ginger and Cinnamon Twig; such treatments invariably yield immediate results. For severe Wind-Heat, combinations of Mahuang, Xingren, Shigao, Gancao, Haifushi (Floating Stone/Pumice), and Loquat Leaf (Pipaye) also frequently prove effective. These are my clinical insights, recorded here so that future practitioners may find their way.

Commentary by Lan: The symptom of cough is discussed in detail in the *Neijing*. Among the Six Evils (Liu Yin) exogenous pathogens, Wind and Cold are most common. Mr. [the author] uses Xiao Qinglong Tang to treat Cold-type cough, which is an insight derived from practical experience. Regarding malaria, since alternating chills and fever are manifestations of the Shaoyang pattern, many contemporary physicians fail to understand this and rigidly adhere to Xiaochaihu Tang as the primary formula, modifying it case by case. This approach stands in stark contrast to the classifications of Cold, Heat, Deficiency, Excess, Dan, and Mu found in the *Neijing* and *Jingui Yaolue*. Mr. elucidates these errors with a heart dedicated to saving people, akin to a loud call to awaken future students.