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Malaria is caused by pathogenic factors such as wind, cold, summerheat, and dampness invading the body, belonging to diseases of the three Yang meridians acquired from external contraction. Thus, the classics state: "Summer injury by summerheat leads to wind malaria in autumn." If one is first injured by cold and subsequently by wind, chills will precede fever; if first injured by wind and subsequently by cold, fever will precede chills. The disease belongs to the three Yang meridians, and since it presents with alternating chills and fever, it primarily involves the Shaoyang (Lesser Yang) meridian. Initially, there is no phlegm serving as the root cause of malaria. The malaria pathogen moves in and out with the body's Wei Qi (Defensive Qi), which explains the variations in onset timing, such as daily or every-other-day attacks, rather than phlegm being the cause of malaria. Why? The human body does not inherently possess "phlegm"; what is called phlegm is actually the body's Jin-Ye (Body Fluids). Depending on where the pathogen resides, blood stasis, Qi stagnation, retained fluid, or retained food can occur, causing these fluids to transform into phlegm. Thus, phlegm arises from pathogenic factors to cause disease. However, Yan Yonghe, in his discussion on malaria, stated that "no phlegm, no malaria." If phlegm is regarded as the primary agent of malaria pathogens, then the malaria pathogen becomes merely a secondary manifestation (guest factor) of phlegm disease. Can it be that body fluids transforming into phlegm then generate cold and heat to form malaria? Phlegm is generated due to the presence of malaria pathogens, not that malaria pathogens exist because of phlegm. For instance, phlegm originates in the Spleen; when the Spleen dislikes dampness, phlegm moves. Phlegm stems from the Kidney; when Kidney Yin is deficient, water overflows. The phlegm in malaria disease is generated by wind-cold pathogens. How could one claim that without phlegm, malaria would not occur? Furthermore, Yang Renzhai and Xu Shuwei argued that blood stasis, retained saliva, and yellow water are the roots of malaria. Consequently, later practitioners treated malaria using herbs like Changshan (Dichroa Radix), Caoguo (Tsaoko Fructus), Binglang (Arecae Semen), and Pixin (Arsenic compounds) as methods to induce vomiting to expel phlegm, eliminate blood stasis, and arrest malaria. These practices vainly damage the Yuan Qi (Original Qi), impair the Spleen and Stomach, and lead to premature death.

The *Ling Shu* states: "Painful conditions belong to Yin." It also says: "Conditions that are formless yet painful belong to the category of Yin." This occurs because the Yang is intact while the Yin is injured; therefore, one should urgently treat the Yang and not attack the Yin. Yang refers to Qi, so pain conditions should initially be treated by regulating Qi. However, Qi can be either Deficient or Excess. In Excess patterns, pathogenic factors are abundant. In Deficient patterns, healthy Qi is weak. In cases of pathogenic Excess, pressure causes pain, indicating that unblocking (Tonification/Regulation via movement) is appropriate. In cases of healthy Qi Deficiency, pressure alleviates pain, indicating that tonification is appropriate. Zhu Danxi rashly claimed that "various pains should not be treated with Qi-tonifying methods." While it is true that Excess patterns should not be tonified, does this mean Deficient patterns should not be tonified either? Therefore, pain accompanied by distension and obstruction is mostly Excess; pain without distension or obstruction is mostly Deficient. Pain relieved by cold is mostly Excess Heat; pain relieved by warmth is mostly Deficient Cold. Pain worsening after eating is mostly Excess; pain worsening when hungry is mostly Deficient. A forceful pulse and coarse breathing indicate Excess; a weak pulse and faint breathing indicate Deficient. New-onset disease in young adults suggests Excess; conditions worsening with aggressive treatment suggest Deficiency. Pain located in the meridians presents with a wiry and large pulse; pain located in the Zang organs presents with a deep and minute pulse. By correlating pulses and symptoms, Deficiency and Excess can be distinguished. Thus, for exterior Deficiency pain caused by insufficient Yang, warming the meridians is essential. For interior Deficiency pain caused by insufficient Yin, nourishing the Ying (Nutritive) Blood is essential. For upper Jiao Deficiency pain due to Heart and Spleen injury, tonifying the Middle Jiao is essential. For lower Jiao Deficiency pain due to collapse and loss of Yin, rapidly rescuing the Spleen and Kidney and warming the Mingmen (Gate of Life) is essential. All Deficient types of pain must be treated with tonification. Some say "unblocking prevents pain" and "pain decreases with discharge." People regard these as immutable laws, unaware that they apply only to treating Excess pain. Therefore, Wang Haizang interpreted the term "discharge" in "pain decreases with discharge" not as "purging/downward draining," but as "unblocking/opening." This interpretation is excellent. Even someone as wise as Zhu Danxi erred by stating simply that "various pains should not be treated with Qi-tonifying methods."