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[Ping An]: This chapter, from beginning to end, is found in *Suwen* (Plain Questions), Volume 10, Chapter 35 "Treatise on Malaria"; also in *Jiayi Jing* (Systematic Classic of Acupuncture and Moxibustion), Volume 7, Section 5; also in *Ling Shu* (Spiritual Pivot), Volume 12, Chapter 79 "Treatise on Sui Lu"; and also in *Chao Shi Bing Yuan* (Source of Diseases by Master Chao), Volume 11 "Various Syndromes of Malaria", with only slight differences in arrangement.

The Yellow Emperor asked Qibo: All cases of malaria (a disease characterized by alternating chills and fever) arise from wind pathogen, yet their accumulation and发作 (onset) occur at specific times. Why is this? (Note: Regarding the term "malaria," some say it refers to a condition occurring every two days. This text states that summer-heat injury leads to autumn illness. Some refer to it as "Jie Malaria" or simply "Malaria," not necessarily defined by bi-daily onset. They all follow the four seasons but present different forms. When pores open, wind enters and cannot escape, accumulating internally and harmonizing with seasonal qi, causing daily onset times to vary. What is the reason?)

Qibo replied: At the initial onset of malaria, symptoms begin at the hair follicles, followed by stretching and yawning, then chills, leading to rattling of the teeth, pain in the waist and spine. After the cold subsides, both interior and exterior become hot, the head feels as if bursting, and there is thirst with a desire to drink. (Note: The presentation of cold malaria includes seven signs: 1. Hair erection, 2. Stretching and yawning, 3. Chills/shivering, 4. Waist and spine pain, 5. Interior/exterior heat, 6. Severe headache, 7. Thirst and desire to drink.)

The Yellow Emperor said: What qi causes this? I wish to hear the principle.

Qibo said: There is a struggle between Yin and Yang qi moving up and down, with deficiency and excess alternating due to the shifting of Yin and Yang. When Yang merges into Yin, Yin becomes full while the Yangming channel becomes deficient. Deficiency of Yangming leads to chills and rattling of the teeth. Deficiency of the Taiyang channel leads to pain in the waist, spine, head, and neck. If all three Yang channels are deficient, Yin qi prevails. Prevailing Yin qi causes bone coldness and pain, with cold generating from within, resulting in coldness throughout the body. (Note: Cold qi hides outside the intestines and stomach, inside the skin, residing in Ying Qi. In spring, Yin and Yang struggle, alternating victory and defeat, causing shifts in deficiency and excess. When all three Yang merge into Yin, they become deficient and are overcome by Yin, causing external cold. Strong Yin causes internal cold. Both interior and exterior cold cannot be warmed by soup or fire.)

When Yang is excessive, there is external heat; when Yin is deficient, there is internal heat. With both interior and exterior heat, there is panting and thirst with a desire to drink. (Note: Extreme Yin leads to Yang excess, causing external heat. Extreme Yin leads to Yin deficiency, allowing Yang to invade, causing internal heat. Intense heat exceeds burning charcoal, uncooled by ice water, causing thirst.)

This results from summer-heat injury, where intense heat hides inside the skin but outside the intestines and stomach, which is the residence of Ying Qi. (Note: This explains the daily onset. The area inside the skin and outside the intestines/stomach, where Ying Qi flows in the vessels, is the abode of the pathogen.)

This causes sweating and loose pores. (Note: Sweating with loose pores. *Suwen* omits "sweating." New Correction notes Quan Qiyuan's version matches *Jiayi Jing* and *Taisu*.) Encountering autumn coolness, sweating while exposed to wind, or bathing exposes one to water qi. (Note: Bathing. *Suwen* uses "and," *Jiayi Jing* uses "obtains bath.") Water qi settles inside the skin, dwelling together with Wei Qi. Wei Qi travels through the Yang aspects during the day; this pathogen exits with Wei Qi into Yang and penetrates inward with Wei Qi into Yin, hence the daily onset. (Note: Pathogen resides in Ying Qi, causing sweating and opening pores. Encountering autumn air, it hides in the skin with Wei Qi. Wei Qi moves Yang by day, Yin by night. Pathogen moves with Wei Qi, causing daily onset.)

The Yellow Emperor said: Why does some malaria occur every other day?

Qibo said: The pathogen resides deeply, pressing inward toward Yin. Yang qi erupts alone, while Yin pathogen stays fixed inside. The struggle between Yin and Yang prevents outward movement, resulting in every-other-day onset. (Note: Pathogen enters with Wei Qi, presses into Yin, struggles with Yang, unable to exit daily with Wei Qi, hence every other day.)

The Yellow Emperor said: Excellent. Why do some cases start later each day, while others start earlier? What qi causes this?

Qibo said: The pathogen lodges at Fengfu (GV16) and descends along the spine. Wei Qi convenes at Fengfu once every day and night. The next day, it descends one vertebral segment, so onset is delayed. This is because the pathogen first lodged in the back. Whenever Wei Qi reaches Fengfu, pores open; when open, pathogen enters; when entered, disease manifests. Thus, onset delays progressively. From Fengfu, descending one vertebra daily for twenty-one days reaches the coccyx. (Note: Coccyx. *Suwen* and *Jiayi Jing* use "Lu." *Suwen* says 25 days.) On the twenty-second day, it enters the spine interior, flowing into the paravertebral vessels, ascending for nine days, emerging at Quepen (ST12). As the pathogen's position rises daily, onset occurs earlier. (Note: Descending 21 segments delays onset. On day 22, entering Du Mai ascends, raising position, advancing onset. *Suwen* says 26 days. Paravertebral vessels. *Jiayi Jing/Chao Shi* say Fuchong. New Correction notes Quan Qiyuan's versions match *Taisu*.)

If the pathogen presses inward to the Zang organs, connecting horizontally to Mo Yuan (membrane source), the path is long, the qi is deep, and movement is slow. It cannot travel with Wei Qi and exit together, hence every-other-day onset. (Note: Mo Yuan exists in all Zang organs. Pathogen attaches to Zang, connects to Mo Yuan acupoints, cannot move with Wei Qi daily, thus every other day. *Suwen/Jiayi Jing* use Mu Yuan. *Suwen* says "Jie Chu" instead of "Xie Chu.")

The Yellow Emperor said: You said Wei Qi reaching Fengfu opens pores, allowing pathogen entry and disease onset. Now Wei Qi descends one vertebra daily, so its emergence is not at Fengfu. How does daily onset occur? (Note: Fengfu is at the nape hairline. Wei Qi reaches it daily. If descending 21 segments then returning to Fengfu, how does daily onset align?)

Qibo said: Wind has no fixed Fengfu. Wherever Wei Qi emerges, that is the site. Once pores open and pathogen lodges, that location serves as the "Fengfu." (Note: No fixed Fengfu means wherever Wei Qi opens pores and pathogen lodges, it acts as Fengfu, not just the nape. Disease occurs daily where pathogen lodges.)

The Yellow Emperor said: Wonderful. (Note: *Suwen* adds 88 characters explaining pathogen lodging at head, back, waist, limbs depending on Wei Qi convergence. New Correction notes these are absent in Quan Qiyuan, *Jiayi*, and *Taisu*. *Suwen* phrases it as "Where pathogen combines, that is the site.")

The Yellow Emperor said: Wind and malaria are similar and of the same category, yet wind persists constantly while malaria has periods of remission. Why? (Note: Wind enters Zang when pores open, manifesting as malaria. Though similar, malaria has rest periods while wind remains.)

Qibo said: The pathogen remains in the meridians. Wei Qi follows smoothly. Meridians sink and press inward, so Wei Qi lingers before manifestation. (Note: Pathogen stays in meridians. Wei Qi passes smoothly. Meridian and Wei Qi align, causing Wei Qi to linger at the stagnation point. Disease arises when Wei Qi and wind activate together, explaining why wind persists while malaria alternates.)