Library

Ping An: This section from the beginning of the chapter to "if missed, the time is lost" can be found in *Suwen* (Treatise on Questions), Volume 10, Chapter 36, "Needling Malaria"; from "Malaria without thirst" to the end, it appears in *Lingshu* (Spiritual Pivot), Volume 5, Chapter 26, "Miscellaneous Diseases"; it also appears in *Suwen · Needling Malaria*, with slight differences in meaning; and it is also found in Volume 25, "Twelve Types of Malaria," of this book. Additionally, from the beginning to the end of the chapter, it is recorded in *Jia Yi Jing* (The Classic of A-Bian Acupuncture and Moxibustion), Volume 7, Section 5.

If the pulse in malaria presents as full, large, and rapid, needle the Shu points on the back, using a medium-sized needle. Select one point at each of the five locations adjacent to the Shu points, adjusting according to the patient's fatness or thinness, and allow blood to flow. (Note: Full indicates excess pulse qi. Large indicates abundant Qi and deficient Blood. Rapid indicates excess Cold. In malaria, an excess pulse at the Cun Kou position indicates abundant Qi, deficient Blood, and the presence of Cold. One may select Back Shu points effective for treating malaria, using a medium needle to puncture five points adjacent to the Shu points, as well as the Shu points located in the middle of the hypochondrium that are effective for treating malaria, taking one point on each side. The number of points taken should be adjusted based on the patient's body constitution, and the amount of bleeding should be appropriate. 'Adjacent' refers to the left and right sides.)

If the pulse in malaria is small, solid, and rapid, moxa the points on the lower leg belonging to the Foot Shaoyin Kidney Meridian, and needle the Jing-Well points on the fingers. (Note: A small pulse indicates deficiency of both Qi and Blood. If the pulse at the Cun Kou position in malaria shows deficiency of both Qi and Blood yet feels solid and indicates excess Cold, one may moxa the Shu points of the Foot Shaoyin meridian effective for treating malaria, and needle the Jing-Well points on the fingers effective for treating malaria.)

If the pulse in malaria is full, large, and rapid, needle the Shu points on the back, using the fifth type of needle (Feng Zhen/Sharp Needle). Select one point at each Shu location, operating until blood flows. (Note: The fifth type of needle is used to drain large amounts of pus; when used here to needle the Back Shu points for malaria, operation should cease once blood flows. Ping An: 'Use the fifth needle, one point at each Shu,' *Suwen* reads 'Use five Shu points, one at each Back Shu.' *Jia Yi Jing* does not contain this passage. The New Correction of *Suwen* states: 'This text repeats the previous passage. Wang Bing added notes following the text but offered no new insights, unlike Yang Shangshan's rigorous scholarship, so it was omitted.')

If the pulse in malaria is slow, large, and deficient, medication is suitable, and needling is not recommended. (Note: A slow pulse indicates excess Heat. If the pulse at the Cun Kou position in malaria shows excess Heat, abundant Qi, deficient Blood, and deficiency, medication can be used. Using medication means selecting appropriate tonifying herbs. Ping An: 'Medication is suitable,' *Suwen* reads 'Conveniently use medication.')

In all cases of treating malaria, needling should be performed approximately the time it takes to eat a meal before the onset of symptoms; this allows for a cure. If this timing is missed, the optimal treatment window is lost. (Note: This describes the proper timing for treating malaria. Ping An: *Suwen* and *Jia Yi Jing* do not contain the character 'before'.)

If malaria presents without thirst and occurs every other day, select points from the Foot Yangming Stomach Meridian; if accompanied by thirst and occurring daily, select points from the Hand Yangming Large Intestine Meridian. (Note: For malaria without thirst, select the Foot Yangming meridian; for malaria with thirst, select the Hand Yangming meridian. In both cases, select the Shu points governed by these meridians. Ping An: 'Malaria without thirst, occurring every other day, select Foot Yangming,' *Suwen* reads 'Needle Foot Taiyang,' which is consistent with the 'Twelve Types of Malaria' chapter of this book. The New Correction states: 'According to *Jiu Juan*: "Foot Yangming." *Tai Su* agrees. "Checking the current version of *Lingshu*, it also says select Foot Yangming. This indicates that for malaria without thirst occurring every other day, points from both the Foot Taiyang and Foot Yangming meridians can be selected. Thus, Yang's annotation in 'Twelve Types of Malaria' refers to treating cold malaria, while this chapter refers to selecting the governing Shu points.")