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Huangdi asked: How should malaria be treated with acupuncture? Qibo replied: In malaria of the Foot-Taiyang channel, the patient suffers from lumbar pain and a heavy head, coldness rising from the back, preceded by chills followed by fever. The fever is intense, and after it subsides, sweating occurs but the condition is difficult to cure. One should puncture [Weizhong (BL 40)] to bleed (another theory suggests Jinmen (BL 63), another suggests Weizhong (BL 40); needle depth 3 cun; if moxibustion is used, apply to the Foot-Shaoyang channel).

In malaria of the Foot-Shaoyang channel, the patient feels flaccid and weak, with mild chills and mild fever. They dislike seeing people and feel terrified upon contact. There is abundant fever and profuse sweating. One should puncture Xiaxi (GB 43) of the Foot-Shaoyang channel (needle depth 3 cun; moxibustion 3 moxa cones).

In malaria of the Foot-Yangming channel, the patient experiences initial chills, shivering intensely. The cold lasts for a long time before fever sets in. After the fever subsides, sweating occurs. They feel comforted by sunlight, moonlight, or fire. One should puncture Chongyang (ST 42) on the dorsum of the foot of the Foot-Yangming channel (needle depth 3 cun; moxibustion 3 moxa cones).

In malaria of the Foot-Taiyin channel, the patient feels unhappy, sighs frequently, has no appetite, and suffers from alternating chills and fever with profuse sweating. Upon onset, they tend to vomit; after vomiting, the condition alleviates. Treatment should then proceed (Gongsun (SP 4) needle depth 4 cun; moxibustion 3 moxa cones).

In malaria of the Foot-Shaoyin channel, the patient vomits severely, suffers from frequent alternating chills and fever, with more heat than cold. They desire to stay indoors with doors and windows closed. This type of disease is difficult to cure (Dazhong (KI 4) needle depth 2 cun; Taixi (KI 3) needle depth 3 cun; each with 3 moxa cones).

In malaria of the Foot-Jueyin channel, the patient suffers from lumbar pain, fullness in the lower abdomen, and difficulty urinating, resembling strangury but not actually strangury, with frequent urination. They feel fearful, suffer from Qi deficiency, and have a depressed sensation in the abdomen. One should puncture Taichong (LR 3) of the Foot-Jueyin channel (needle depth 3 cun; moxibustion 3 moxa cones).

In Lung Malaria, the patient feels cold in the heart region. When the cold is severe, fever follows. During the interval between fevers, they are prone to fright and hallucinations. One should puncture the Hand-Taiyin and Hand-Yangming channels (Lieque (LU 7) needle depth 3 cun, moxibustion 5 moxa cones; Hegu (LI 4) needle depth 3 cun, moxibustion 3 moxa cones).

In Heart Malaria, the patient suffers from extreme mental restlessness, desires cold water, yet has more chills than fever, which is not very intense. One should puncten Shenmen (HT 7) of the Hand-Shaoyin channel (needle depth 3 cun; moxibustion 3 moxa cones).

In Liver Malaria, the patient’s complexion appears pale green, they sigh frequently, and their appearance resembles that of a dying person. One should puncture Zhongfeng (LR 4) of the Foot-Jueyin channel until bleeding occurs (needle depth 4 cun; moxibustion 3 moxa cones).

In Spleen Malaria, the patient feels cold and suffers from abdominal pain. When feverish, there is borborygmus in the intestines, followed by sweating. One should puncture Shangqiu (SP 5) of the Foot-Taiyin channel (needle depth 3 cun; moxibustion 3 moxa cones).

In Kidney Malaria, the patient feels chilly, suffers from low back and spine pain with inability to turn the body easily, has difficulty defecating, blurred vision, and cold hands and feet. One should puncture the Foot-Taiyang and Foot-Shaoyin channels (Jinmen (BL 63) of the Foot-Taiyang channel; Taixi (KI 3) of the Foot-Shaoyin channel).

In Stomach Malaria, the patient feels hungry immediately upon onset but cannot eat. After eating, they experience distension and abdominal enlargement. One should puncture the Foot-Yangming and Foot-Taiyin channels and bleed the transverse vessels (Lidui (ST 45) needle depth 1 cun, moxibustion 1 moxa cone; Jiexi (ST 41) needle depth 5 cun, moxibustion 2 moxa cones; Zusanli (ST 36) needle depth 1 cun, moxibustion 3 moxa cones; the transverse vessel of the Taiyin is located anterior to the medial malleolus, crossing obliquely over the large vessel, where bleeding is indicated).

If malaria fever is just beginning, puncture the artery on the dorsum of the foot (referring to the Yangming pulse), open the acupoint, and bleed; the fever will subside immediately. If malaria chills are just beginning, puncture the Hand-Yangming, Hand-Taiyin, Foot-Yangming, and Foot-Taiyin channels (also opening the acupoints to bleed).

If the malaria pulse is full, large, and urgent, puncture the Back-Shu points on the back. Use a medium-sized needle to puncture one point beside each of the Five Shu points, adjusting according to the patient's leanness or robustness to induce bleeding (the "Five Shu points" refer to Jing-Well, Ying-Spring, Shu-Stream, Jing-River, and He-Sea points).

If the malaria pulse is small, solid, and urgent, moxibustion should be applied to the Shaoyin channel on the lower leg, and the Jing-Well points on the fingers should be punctured (Fuliu (KI 7) needle depth 3 cun, moxibustion 5 moxa cones; the Jing-Well point refers to Zhiyin (BL 67), needle depth 1 cun, moxibustion 3 moxa cones).

If the malaria pulse is full, large, and urgent, puncture the Back-Shu points, using one of the Five Shu points and one of the Back-Shu points, allowing blood to flow as needed.

If the malaria pulse is slow, large, and deficient, medication is suitable, while acupuncture is not. Generally, when treating malaria, treatment should begin approximately the time it takes to eat a meal before the attack. If this timing is missed, the opportunity for treatment is lost. For various types of malaria where the pulse is imperceptible, puncture the spaces between the ten fingers to bleed; once the blood flows, the disease will surely be cured.

These twelve types of malaria differ in their timing of onset. By observing the clinical manifestations, one can determine which channel is affected. Treatment should be administered approximately the time it takes to eat a meal before the onset. A single treatment at the point adjacent to the spine will definitely cure the disease. The point adjacent to the spine refers to Dazhu (BL 11) (needle depth 3 cun, moxibustion 5 moxa cones); Fengmen (BL 12), also known as the Heat Mansion, needle depth 5 cun, moxibustion 5 moxa cones. The two vessels under the tongue constitute Lianquan (CV 23) (needle depth 3 cun, moxibustion 3 moxa cones).

When treating malaria with acupuncture, one must first ask where the symptoms began and treat that area first. If headache and heaviness occur first, puncture the top of the head, both temples, and the glabella to bleed (head points refer to Shangxing (GV 23) and Baihui (GV 20); temple points refer to Xuanlu (GB 7); glabella points refer to Cuanzhu (BL 2), etc.). If neck and back pain occur first, puncture those areas (Fengchi (GB 20), Fengfu (GV 16), Dazhu (BL 11), Shendao (GV 11)). If lumbar and spinal pain occur first, puncture [Weizhong (BL 40)] to bleed. If arm pain occurs first, puncture the spaces between the ten fingers of the Hand-Shaoyin and Hand-Yangming channels. If lower leg soreness and pain occur first, puncture the spaces between the ten toes of the Foot-Yangming channel to bleed.

In Wind Malaria, sweating and aversion to wind occur during attacks. Puncture the Back-Shu points of the Three Yang channels to bleed. If lower leg soreness and pain are severe and cannot be touched, it is called Marrow Disease. Puncture Guangu (GB 39) with a Bi needle to bleed; the condition will resolve immediately. If there is slight body pain, puncture Zhiyin (BL 67). Do not bleed the Jing-Well points of the Yin channels; instead, puncture them every other day. For malaria without thirst occurring every other day, puncture the Foot-Taiyang channel. For malaria with thirst occurring every other day, puncture the Foot-Shaoyang channel. For Warm Malaria without sweating, employ the Fifty-Nine Acupuncture Points method.