Library

Summer injury by heat (Shu) leads to malaria in autumn. Malaria with fixed timing of onset is due to pathogenic factors lodging at Fengfu (GV16), descending along the Du Meridian. Wei Qi (Defensive Qi) gathers at Fengfu once a day and night; the next day it descends one vertebral segment, hence the delayed onset. This indicates pathogens initially lodged in the back. When Wei Qi reaches Fengfu, the interstices (Cou Li) open; upon opening, pathogens enter, causing disease manifestation, explaining the daily delay in onset.

Wei Qi moves down one segment daily via Fengfu, reaching the coccyx on the 21st day, entering the spine interior on the 22nd, and pouring into the Fu Chong Mai (Deep Thoroughfare Vessel). Its qi ascends for nine days, emerging from Quepen (ST12). Since the qi has ascended, the onset becomes earlier.

Intermittent malaria occurs because pathogens press inward against the Zang organs and connect horizontally to the Mu Yuan (Diao Membrane). The path is long, the qi deep, and movement slow, preventing daily attacks; thus, it accumulates power over two days before manifesting. Whenever Wei Qi reaches Fengfu, interstices open, allowing pathogen entry. Although Wei Qi descends daily, onset does not always align with Fengfu. Why do some cases occur daily? Fengfu is not fixed; where Wei Qi responds, interstices open, and where pathogens lodge, disease arises. Wind pathogens and malaria pathogens are similar, yet wind persists while malaria pauses. This is because wind remains superficial, whereas malaria pathogens sink deeply along meridians, acting only when Wei Qi arrives. Yang should descend but fails; Yin should ascend but fails. Struck by pathogens, Yang contracts causing aversion to cold, Yin tightens causing shivering. Cold and shivering contend, named "Malaria." Weakness leads to fever, floating leads to sweating; morning strike causes morning onset, evening strike causes evening onset. Malaria patients are emaciated with shivering skin.

If malaria begins on the first day of the lunar month, it should heal by the 15th. If not, it resolves by month's end.

Taiyang Malaria causes lower back pain, heavy head, cold rising from the back, initial chills followed by fever, thirst, and sweating after thirst ceases. It is difficult to cure; bleed Weizhong (BL40). Shaoyang Malaria causes body fatigue, mild chills and fever, aversion to people, inner fear, abundant heat and sweat. Puncture Shaoyang points. Yangming Malaria causes initial chills, trembling, prolonged cold before fever, sweating after heat subsides. Relief comes from sunlight or fire. Puncture Yangming points on the dorsum of the foot. Taiyin Malaria causes depression, frequent sighing, anorexia, frequent chills/fever/sweating. Nausea occurs at onset, subsiding afterward. Treat immediately. Shaoyin Malaria causes severe vomiting, prolonged chills/fever, more heat than cold, desire to stay indoors alone. Hard to stop. Jueyin Malaria causes lower back pain, abdominal fullness, dysuria resembling Gong (strangury) but not true Gong, frequent urination, fear, Qi deficiency, intestinal oppression. Puncture Jueyin points.

Lung Malaria causes heart cold, severe chills with intermittent fever, fright, visual hallucinations. Puncture Hand Taiyin and Hand Yangming points. Heart Malaria causes severe mental restlessness, desire for cold water, more cold than heat, or severe heat. Puncture Hand Shaoyin points. Liver Malaria causes pale/greenish complexion, sighing, appearance like death. Bleed Jueyin points. Spleen Malaria causes rapid chills, abdominal pain, bowel sounds during heat, sweating after sounds cease. Puncture Taiyin points. Kidney Malaria causes shivering, painful stiff lower back, difficulty defecating, dizziness, cold extremities. Puncture Foot Taiyang and Foot Shaoyin points. Stomach Malaria causes hunger without ability to eat, postprandial distension and abdominal enlargement. Bleed transverse vessels of Foot Yangming and Taiyin.

Malaria caused by Lung disease features fluctuating symptoms, heart cold, severe chills with fever, fright, hallucinations. If a person with normally loud voice suddenly speaks faintly, dragging breath, and ignores calls despite appearing healthy, life is short. This is the vocal sign of Lung disease. Observe exterior-interior correspondence, treat according to origin.

Malaria caused by Heart disease features mental distress, desire for cold water, less cold, severe heat. If a gentle person suddenly acts erratically, stops mid-sentence, picks toenails, they will likely die soon ("Walking Corpse"). Deficiency requires tonification, excess requires purging. Incurable cases must be clearly identified.

Malaria caused by Liver disease features greenish complexion, panting, tremors, death-like state. If a calm person suddenly becomes angry, speaks abnormally, gestures toward eyes, disaster looms. Deficiency from cold wind requires tonifying Yin; Excess from heat requires draining Yang.

Malaria caused by Spleen disease features abdominal pain in cold, bowel sounds and sweating in heat. If a balanced person suddenly laughs excessively at nothing, ignoring others, disaster comes within ten days. This is the vocal sign of Spleen disease.

Malaria caused by Kidney disease features shivering, painful stiff back, constipation, tremors, cold limbs. If a calm person suddenly stammers and gets angry, or smiles before speaking then closes mouth silently while guarding abdomen, Kidney is injured. Assess emptiness/fullness, exterior-interior, floating/sinking, clear/turbid to treat.

Malaria pulse is naturally Wiry (Xian). Wiry-rapid indicates heat; Wiry-slow indicates cold. Wiry-small-tight allows purgation; Wiry-slow responds to warming herbs. Rapid-tight allows diaphoresis and acupuncture. Floating-large prohibits acupuncture; induces vomiting instead.

Treat malaria within the time of one meal after onset; otherwise, the opportunity is lost.