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[Ping An]: The content of this chapter, from "Foot Taiyang Malaria" to the end, is found in Volume 10, Chapter 36 of *Suwen* (Plain Questions), titled "Needling Malaria". The content from the beginning of the chapter "Malaria without thirst" to "fifty-nine needles", is arranged later in the *Suwen · Needling Malaria* chapter. Additionally, the content from the beginning to the end of the chapter is also found in Volume 7, Chapter 5 of *Jiayi Jing* (Systematic Classic of Acupuncture and Moxibustion), and in Volume 11 of Chao Yuanfang's *Chaoshi Bingyuan* (Source of Diseases and Symptoms) under "Various Syndromes of Malaria", with only slight differences in arrangement.

Yellow Emperor said: In cases of malaria without thirst, occurring every other day, what should be done? Qibo replied: For malaria without thirst, occurring every other day, needle the Foot-Taiyang channel; for those with thirst occurring every other day, needle the Foot-Shaoyang channel. In Warm Malaria, where there is no sweating, use the fifty-nine needle method. (Foot-Taiyang belongs to Yin and governs Water, hence no thirst and alternating-day onset. Foot-Shaoyang belongs to Yang, hence thirst and alternating-day onset. Both of these are Cold Malaria. Warm Malaria is caused by Cold Damage, hence no sweating, treated with the fifty-nine needles. [Ping An]: From "Yellow Emperor said: Malaria without thirst" to "Qibo said", these sixteen characters are absent in *Suwen* and *Jiayi Jing*. Regarding "needle Foot-Taiyang", *Jiayi Jing* states: "'Jiujuan' says take Foot-Yangming; *Suwen* needles Hand-Taiyin." The current version of *Suwen* reads "needle Foot-Taiyang". Lin Yi et al.'s *Xinzhengjiao* notes: "'Jiujuan' says: needle Foot-Yangming. *Taisu* agrees." Regarding "needle Foot-Shaoyang", *Jiayi Jing* states: "'Jiujuan' says take Hand-Shaoyang; *Suwen* needles Foot-Shaoyang." The current version of *Suwen* reads "needle Foot-Shaoyang". *Xinzhengjiao* notes: "'Jiujuan' says: needle Hand-Shaoyang. *Taisu* agrees." Based on the citations in *Xinzhengjiao*, *Taisu* agrees with *Jiujuan* and differs from *Suwen*. However, the current book (*Taisu*) states needle Foot-Taiyang and needle Foot-Shaoyang, differing from *Jiujuan* but agreeing with *Suwen*. Furthermore, checking the current version of *Lingshu · Zabing* chapter: "Malaria without thirst, occurring every other day, take Foot-Yangming; with thirst and daily occurrence, take Hand-Yangming." Re-checking Book 30 of this work, *Cimie Jiedu* chapter, it agrees with *Lingshu*, and does not fully agree with the citations in *Jiayi Jing* or *Suwen Xinzhengjiao*, nor does it agree with the present chapter's statement of needling Foot-Taiyang and Foot-Shaoyang. Carefully studying Yang Shangshan's commentary on this chapter stating "these two are both Cold Malaria," whereas the *Cimie Jiedu* chapter states "take the governing Shu points," explains the discrepancy.)

Foot-Taiyang Malaria causes lower back pain and heavy head, cold sensation rising from the back, initial chills followed by fever and thirst, cessation of thirst then sweating, difficult to cure. Daily needle bleeding from Weizhong (BL40). (The Foot-Taiyang meridian descends from the head through the back to the waist; pathogenic factors lodging here cause cold to rise from the back. In *Mingtang*, the He-Sea point Weizhong of Foot-Taiyang treats Meridian Malaria, with symptoms identical to this. [Ping An]: "Thirst, cessation of thirst then sweating" appears as "Ran, cessation of heat then sweating" in *Suwen*. *Xinzhengjiao* notes: "Quanyuan Qi's edition, *Jiayi Jing*, *Taisu*, and Chao Yuanfang all read 'initial chills then fever and thirst, cessation of thirst then sweating,' consistent with this book." For "Daily needle Weizhong", *Suwen* and Chao Shi omit "daily"; *Jiayi Jing* reads "occurring every other day, needle Weizhong".)

Foot-Shaoyang Malaria causes bodily laxity and relaxation, mild chills, mild fever, aversion to seeing people, palpitations upon seeing others, abundant heat and profuse sweating. Needle the Foot-Shaoyang channel. (The Foot-Shaoyang meridian connects the joints of the whole body; thus, disease of this meridian causes bodily laxity. Foot-Shaoyang pairs with Jueyin, so chills and heat are both mild, and there is aversion to people. If heat is abundant, sweating is profuse; one may select Fengchi (GB20) and Qiuxu (GB40) on Foot-Shaoyang. [Ping An]: "Jie" is written as "Jiejuan" in Chao Shi. *Jiayi Jing* lacks the three characters "mild heat". The character "sweat" is not repeated in *Suwen*, *Jiayi Jing*, or Chao Shi, suspected to be a duplication error.)

Foot-Yangming Malaria causes initial chills, shivering, prolonged severe cold before fever, sweating after heat subsides, relief upon seeing sunlight, moonlight, or fire. Needle the dorsum of the foot (Yangming). (Foot-Yangming is named "Two Yangs Combined Brightness," hence sweating and preference for light. The dorsum of the foot is the pathway of the Foot-Yangming meridian. [Ping An]: "Sa" is written differently in Chao Shi; "moon" is omitted after "sun" in some versions. *Suwen* adds "foot" after "needle". *Jiayi Jing* adds "and regulate Chongyang" after "dorsum". Chao Shi writes "needle Foot-Yangming instep".)

Foot-Taiyin Malaria causes unhappiness, frequent sighing, anorexia, alternating chills and heat with sweating. Onset brings desire to vomit; condition improves after vomiting. Then take the point. (Foot-Taiyin meridian branches from the stomach, ascends through the diaphragm, and enters the heart; thus malaria causes unhappiness and sighing. Spleen and Stomach govern food; thus spleen meridian disease causes anorexia. The meridian enters the abdomen, connects to Spleen and links Stomach, ascends through diaphragm and flanks the throat; thus impending illness brings vomiting. Treatment should occur when condition improves post-vomit. [Ping An]: *Jiayi Jing* reads "more cold less heat" for "alternating chills and heat". "Ou" is written as "ou" (vomit) in *Suwen*, *Jiayi Jing*, and Chao Shi. *Jiayi Jing* adds "Foot-Taiyin" after "take".)

Foot-Shaoyin Malaria causes vomiting, severe chills and heat, more heat than cold, desire to stay behind closed doors, difficult to cure. (Foot-Shaoyin meridian passes through Liver and Diaphragm into Lung, emerges from Lung, links Heart, and enters Chest; thus Foot-Shaoyin malaria causes vomiting. Severe cases have more chills/heat than other meridians. Shaoyin is invaded by Yang, hence more heat than cold. Kidney Yin meridian injury causes desire for seclusion; disease is hard to cure. [Ping An]: *Jiayi Jing* reads "severe vomiting, more cold less heat"; Chao Shi reads "long-term chills and heat". After "difficult to cure", *Jiayi Jing* adds "take Taixi".)

Foot-Jueyin Malaria causes lower back pain, abdominal fullness, difficulty urinating resembling strangury but not strangury, frequent urination, fear, Qi deficiency, intestinal depression. Needle Foot-Jueyin. (Foot-Jueyin meridian circles the genitals and reaches the lower abdomen; thus back pain, abdominal fullness, and urinary difficulty resembling strangury. Strangury refers to dysuria. The meridian belongs to Liver and links Gallbladder; Gallbladder is the Fu organ of Foot-Jueyin; thus Gallbladder injury causes fear, Qi deficiency, and intestinal depression. One may needle Five-Shu points and Zhongfeng (LR4) of Foot-Jueyin. [Ping An]: "Fei long yi" is "Fei long ye" in *Suwen/Jiayi*, "Fei long zhuang" in Chao Shi. "Shu xiaobian yi" is "Shu bianyi" in *Suwen*; *Xinzhengjiao* notes *Jiayi* has "Shu bianyi" or "Shu yi". "Yiyi" is "Yiyi" in *Suwen/Jiayi/Chao Shi*.)

Lung Malaria causes coldness in the heart, severe chills with intermittent heat, fright, hallucinations. Needle Hand-Taiyin and Hand-Yangming. (Above discusses meridian malaria; below discusses Zang organ malaria. Lung is close to Heart; thus Lung disease causes Heart cold and fright/hallucinations. Take the meridians of Lung and its interior-exterior pair. [Ping An]: "Xi jing ru you jianzhe" is "Shan jing ru you suojianzhe" in *Suwen/Jiayi*, "Ru shi you jianzhe" in Chao Shi.)

Heart Malaria causes mental restlessness, strong desire for cold water, more chills than heat, mild chills, severe heat. Needle Hand-Shaoyin. (Mental heat causes desire for cold water and coolness. As it is a Yang heat condition, cooling reduces heat, allowing tolerance of cold; thus mild chills and severe heat. Hand-Shaoyin Heart meridian disease causes mental restlessness, not direct Heart organ disease. The Heart houses Spirit and cannot tolerate excessive pathogens; thus mental restlessness occurs. Treat at Shaohai (HT3) of Hand-Shaoyin. [Ping An]: "Ji han duo han bushen re shen" is "Fan han duo bushen re" (six characters) in *Suwen*. *Xinzhengjiao* notes *Taisu* reads "Desire cold water and more cold, mild chills, severe heat," matching this. *Jiayi* reads "More cold less heat"; Chao Shi reads "Then more cold, mild chills less heat".)

Liver Malaria causes pale/greenish complexion, sighing, appearance like death. Needle Foot-Jueyin until blood appears. (Severe Liver Malaria reveals true color, hence green/pale. Severe Qi stagnation causes sighing. Take Liver meridians; bleeding leads to recovery. [Ping An]: "Cangcang" is "Cangcang" in *Suwen/Jiayi/Chao Shi*. *Jiayi* omits "Taixi".)

Spleen Malaria causes sudden chills, abdominal pain, bowel sounds during heat, sweating after. Needle Foot-Taiyin. (Foot-Taiyin Spleen meridian belongs to Spleen, links Stomach, connects Intestines; abundant Grain Qi causes sudden chills, abdominal pain, and bowel sounds. Take Dadu (SP2), Gongsun (SP4), Shangqiu (SP5). [Ping An]: *Suwen* omits "Ji"; *Jiayi* reads "Bing".)

Kidney Malaria causes shivering, lower back/spine pain with turning difficulty, difficult defecation, blurry vision, cold hands and feet. Needle Foot-Taiyang and Foot-Shaoyin. (Xun means opening eyes wide/searching. Sa means aversion to cold. Kidney meridian passes through spine, belongs to Kidney, links Bladder; thus back pain, turning difficulty, difficult defecation. Meridian ascends through Liver to Eye; thus blurry vision. Or dizziness, as Bladder/Taiyang meridian starts at inner canthus. Foot-Shaoyin/Taiyang connect to Hand-Shaoyin/Taiyang; thus cold extremities. Take these two Kidney interior-exterior meridians. [Ping An]: "Sasa" has "Ran" in *Suwen*, "Sar" in *Jiayi*. "Mu xunxun ran" is "Mu run ran" in *Suwen/Jiayi*, "Mu xuan run ran" in Chao Shi.)

Stomach Malaria causes Jaundice, hunger but inability to eat, distension/fullness after eating, large abdomen. Needle Foot-Yangming and Foot-Taiyin horizontal vessels until blood appears. (Dan sound Dan, internal heat disease. Stomach receives food; improper diet causes cold/heat imbalance, hence Stomach Malaria. Foot-Yangming belongs to Stomach, links Spleen; thus Stomach heat, hunger, inability to eat, abdominal distension. Large Luo of Foot-Yangming is Daheng vessel. [Ping An]: "Dan bing" is "Qie bing" in *Suwen/Jiayi/Chao Shi*. *Xinzhengjiao* notes *Taisu* "Qie bing" is "Dan bing". *Suwen* "Xi" is "Shan"; *Jiayi* "Han Shan".)

When Malaria is about to flare and body is hot, needle the arterial pulse on the dorsum of the foot, open the aperture, and cold stops immediately. (In previous Malarias, when Warm Malaria is about to heat, needle the dorsal artery. Artery is Chong Mai, sea of five Zang and six Fu; thus treating twelve Malarias. Opening aperture means enlarging the needle hole; heat goes, cold stops. Or cold declines then heats. [Ping An]: After "Kong", *Suwen* has "Chu qi xue" three characters, *Jiayi* has "Chu xue" two characters.)

When Malaria is about to chill, needle Hand-Yangming, Hand-Taiyin, Foot-Yangming, Foot-Taiyin. (In previous Malarias, Cold Malaria can be treated by needling Hand/Foot Yangming/Taiyin. Hand-Yangming: Shangyang, Sanjian, Hegu, Yangxi, Pianli, Wenliu, Wuli. Foot-Yangming: Shenting, Kaiming, Tianshu, Jiexi, Chongyang, Xianggu, Lidui. Hand-Taiyin: Lieque, Taiyuan, Shaoshang. Foot-Taiyin: Dadu, Gongsun, Shangqiu. Or heat declines then chills. [Ping An]: Above "Zhu mie", *Suwen* has 89 characters "Mai man da... shi shi ye". This book is in Vol 30 *Cimie Jiedu*. *Xinzhengjiao* notes Quanyuan Qi had them in Vol 4, Wang moved them here. This book lacks them, confirming Wang's addition.)

For various Malarias where pulse is not visible, needle between ten fingers until blood appears; blood removal ensures cure. First observe red spots like adzuki beans on the body and needle them all. (Twelve Malarias have visible collateral vessels; needle/remove them. If collaterals not visible, needle toes for Foot Yin/Yang, fingers for Hand Yin/Yang, ensure bleeding. Also, as Malaria wanes, red bean-like nodules appear; needle them. [Ping An]: *Jiayi* "Er mai bu jian", "Er" is "Ru". Above "Chi", *Suwen/Jiayi* lack "Re".)

The twelve Malarias flare at different times. Observe symptoms to know which meridian is diseased. Needle about one meal-time before onset. (This covers general treatment for twelve Malarias; needle one meal-hour before onset for cure.) One needle attenuates disease; two needles bring knowledge of improvement; three needles cure. (One needle attenuates, patient unaware; two needles indicate improvement, disease not gone; three needles clear all pathogenic Qi.) If not cured, bleed two vessels under tongue; if not cured, bleed full vessels at Weizhong; needling below neck along spine guarantees cure. Vessels under tongue are Lianquan. (If previous needling fails, change method. Three needles: 1. Tongue vessels, Foot-Shaoyin, Renmai Lianquan. 2. Weizhong within Chengshan area, Foot-Taiyang full vessel. 3. Below neck along spine, Foot-Taiyang Dazhu, Fufen. [Ping An]: *Suwen/Jiayi* "Ci xiang yi xia" is "You ci xiang yi xia". Note "Chengshan", "Nei" is "Zhong" in Yuan edition.)

To needle Malaria, first ask where the symptom started, and needle that site first. (Ask about pre-onset to treat the origin. [Ping An]: "Bi xian wen", "Xian" missing in Yuan edition.)

If headache and heaviness start first, needle head acupoints first. (Take Shenting, Shangxing, Xinhui, Baihui of Du Mai.) And bleed between cheeks and eyebrows. (Bleed collaterals at cheeks/eyebrows. [Ping An]: "Liang he" is "Liang e" in *Suwen/Jiayi*.)

If neck/back pain starts first, needle neck/back points first. (Start at neck/back where symptoms began.)

If lower back/spine pain starts first, bleed Weizhong. (Bleed Weizhong collaterals.)

If arm/hand pain starts first, needle ten fingers of Hand Yin/Yang. (Hand interior-exterior Yin/Yang meridians are at ten fingers. [Ping An]: *Suwen/Jiayi* "Yin yang shi zhijian" is "Shou Shao-yang ming shi zhijian". *Xinzhengjiao* notes alternate versions say "Shou Yin Yang".)

If lower leg pain starts first, bleed ten toes of Foot-Yangming. (Foot-Yangming is head of Three Yangs; thus bleeding ten toes is called Foot-Yangming. [Ping An]: *Suwen/Jiayi* read "Jing".)

Wind Malaria flares with sweating and aversion to wind. Needle blood from Back-Shu points of Three Yang meridians. (This is Wind Malaria syndrome. Check Back-Shu of Hand/Foot Three Yangs; needle affected points. [Ping An]: "Zhi fa" is "Mie fa" in *Suwen*. *Jiayi* adds "Zu" before "San Yang".)

Pain severe, unpressable, named Marrow Disease. Use Pi needle at Guangu (GB39) to bleed; pain stops immediately. Mild body pain, needle Jing-Well points of all Yin meridians, do not bleed, needle every other day. (Foot pain, unpressable, is Marrow disease. Can bleed with Pi needle. Five Zang Yin Jing-Well points start with Wood, suitable to take but not bleed. Some editions read "Sui" as "Ti". [Ping An]: After "Sui", *Suwen* has "Bing", *Jiayi* "Zhou sui bing". "Yi pi juegu" is "Yi pi zhen zhen juegu" in *Suwen/Jiayi*. *Suwen* "Ci zhi", "Zhi" is "Zhiyin" two characters.)