邪在三阳，盛于表也，汗不易收，故曰“难已”。刺 中者，委中也，盖古法以委中为 中也。）足少阳
之疟，令人身体解 ，寒不甚，热不甚，恶见人，见人心惕惕然，热多，汗出甚，刺足少阳。（
解，HT 也； ，迹也。身体解 ，谓不耐烦劳，形迹困倦也。寒不甚，热不甚者，病在半表半里也。见人惕
惕然者，邪在胆也。少阳为木火之经，故热多于寒而汗出甚也。当刺足少阳之经，侠溪主之。）足阳明之疟，
令人先寒洒淅，洒淅寒甚，久乃热，热去汗出，喜见日月光火气，乃快然，刺足阳明跗上。（阳明虽多血多
气之经，而寒邪胜之。故先为寒，久乃热。热去则邪解，故汗出，阳明病至，则恶人与火，今反
喜见日月光及得火气乃快然者，何也？盖阳明受阳邪，胃之实也，故恶热；阳明受阴邪，胃之虚也，故喜
暖耳。跗上，即本经之冲阳穴。）足太阴之疟，令人不乐，好太息，不嗜食，多寒热汗出，病至则善
呕，呕已乃衰。即取之。（脾者，心之子，脾病则心气不舒，故不乐。脾不化则上焦痞塞，故好太息而不
嗜食。太阴主里邪，不易解，故多寒热汗出。脾脉络胃，上膈挟咽，故病至则善呕，然必待其呕已病衰，方可取
之。取之井俞及公孙也，皆属本经，故曰“即取之”。）足少阴之疟，令人呕吐甚，多寒热，热多寒少，欲
闭户牖而处，其病难已。（肾脉上贯肝膈，入肺中，循喉咙，阴邪上冲，故为呕吐甚。肾病则阴虚，
阴虚故热多寒少。然在阴者喜静，故欲闭户牖而处，肾为至阴之脏，而邪居之，故病深难已，此不言刺者，
必取大钟、太溪之本经穴耳。）足厥阴之疟，令人腰痛，少腹满，小便不利如癃状，非癃也，数便，
意恐惧，气不足，腹中悒悒，刺足厥阴。（肝脉过阴器，抵少腹，布胁肋，故为腰腹小便之病。凡小水不利
为癃，今曰“如癃状，非癃也”，盖病不在水，而在于肝邪之陷，故亦如小便不利而急数欲便也。意恐惧者，
肝气不足也。腹中悒悒，不畅之貌，皆当刺足厥阴之经，太冲主之。）
肺疟者，令人心寒，寒甚热，热间善惊，如有所见者，刺手太阴、阳明。（此下言五脏疟刺而并及于
胃也。肺者，心之盖也。以寒邪而乘所不胜，故肺疟者令人心寒。寒甚复热而心气受伤，故善惊如
有所见。当刺其表里二经，以泻阳明之实，补太阴之虚也。手太阴之络列缺，阳明之原合谷主之。）心疟者，
令人烦心甚，欲得清水，反寒多不甚热，刺手少阴。（疟邪在心，故烦心甚，欲得水以解也，心本阳
脏，为邪所居，则阳虚阴盛，故反寒多而不甚热。手少阴，即神门穴也。）肝疟者，令人色苍苍然，太息，
其状若死者，刺足厥阴见血。（肝属木，故色苍苍然。肝郁则气逆，故太息。木病则坚强，故其状若死，刺
足厥阴见血者，中封主之。上文已言足厥阴等症，而此重言之，盖上文所言者经病也，故复明脏病之详如此。
下文脾、胃、肾三脏义同。）脾疟者，令人寒，腹中痛，热则肠中鸣，鸣已汗出，刺足太阴。（脾以至
阴之脏，而疟邪居之，故令人寒。脾脉自股入腹，故为腹中痛。寒已而热，则脾气行，故肠中鸣。鸣已则阳
气外达，故汗出而解也。刺足太阴者。商丘也。）肾疟者，令人洒洒然，腰脊痛宛转，大便难，目
然，手足寒，刺足太阳、少阴。（洒洒，寒栗貌。肾脉贯脊属肾，开
窍于二阴，故腰脊之痛苦于宛转，而大便难也。 然，眩动貌。目视不明，水之亏也，手足寒，阴之厥也。
刺足太阳、少阴之表里，取穴如前。）胃疟者，令人且病也。善饥而不能食，食而支满腹大，刺足
阳明、太阴横脉出血。（腑有六而此独言胃者，以胃为六腑之长也。邪在阳明，则胃病及脾，故善饥不能食而
支满腹大也。当兼刺阳明之表里。厉兑、解溪、三里，足阳明取此三穴也。足太阴刺其横脉出血者，谓足内
踝前斜过大脉，则太阴之经，即商丘也。以上本言刺法，而其现症甚详，用药所当推也。）
火热复恶寒发热，如有疟状，或一日发，或间数日发。（凡病寒热，多由外感，然有不因风寒而火热
内盛者，亦为恶寒发热，其作有期，状虽似疟，而实非疟症也。）胜复之气，会遇之时，有多少也。
阴气多而阳气少，则其发日远，阳气多而阴气少，则其发日近，此胜复相薄，盛衰之节，疟亦同法。（夫寒热
者，阴阳之气也。迟速者，阴阳之性也。人之阴阳，则水火也，营卫也。有热而反寒者，火
极似水也；寒而反热者，阴极似阳也，阴阳和则血气匀，表里治，阴阳不和则胜复之气、会遇之时各有多少
矣。故阳入之阴，则阴不胜阳而为热；阴出之阳，则阳不胜阴而为寒。又若阴多阳少，则阴性缓而会遇迟，故其
发日远；阳多阴少，则阳性速而会遇早，故其发日近。此胜复盛衰之节，虽非疟症，而多变似疟，法亦同然。
所谓“同”者，皆阴阳出入之理也。然同中自有不同，则曰“是疟”，曰“非疟”。是疟、非疟者，在有邪、
无邪之辨耳。真疟有邪，由卫气之会以为止作；似疟无邪，由水火争胜以为盛衰。此则一责在表，一责在里，
一治在邪，一治在正，勿谓法同而治亦同也。同与不同之间，即杀人、生人之歧也，学人于此，可不慎欤！）
邪气在三阳经，病势盛于体表，发汗后汗液不易收敛，所以说“难愈”。所谓“刺中”，指的是委中穴（这是古法中以委中为“中”的说法）。足少阳经的疟疾，使人身体懈怠无力，怕见人，见到人心里就惊恐不安，发热重而恶寒轻，出汗多，治疗应针刺足少阳经。（“解㑊”指懈怠；“㑊”通“懈”，意为松懈。身体解㑊，是指不耐受疲劳，形体困倦的样子。恶寒不重、发热也不重的原因，是因为病在半表半里之间。见到人就惊恐不安，是因为邪气在胆腑。少阳经属于木火之经，所以热象多于寒象且出汗很多。应当针刺足少阳经，以侠溪穴为主穴。）足阳明经的疟疾，使人先感到寒冷战栗，寒冷很严重，过了很久才发热，热退后出汗，喜欢见到日光、月光或火光，感到舒适痛快，治疗应针刺足阳明经跗上的穴位。（阳明经虽然是多血多气的经脉，但寒邪胜过它。所以先出现寒战，久了才发热。热退则邪气解散，所以出汗。阳明病发作时，通常厌恶人和火光，现在反而喜欢见到日光月光和得到火气才觉得舒服，为什么呢？这是因为阳明经受的是阳邪，导致胃气实，所以厌恶热；如果阳明经受的是阴邪，导致胃气虚，所以喜欢温暖。跗上，就是本经的冲阳穴。）足太阴经的疟疾，使人心情不愉快，喜欢长叹气，不想吃东西，寒热往来且出汗多，病发作时就容易呕吐，吐完后病情减轻。此时即可取穴治疗。（脾是心的子脏，脾病则心气不舒展，所以心情不愉快。脾失健运则上焦痞塞不通，所以喜欢长叹气而不想进食。太阴主里邪，不容易解除，所以寒热往来且出汗多。脾的脉络连接胃，穿过膈肌，夹持咽喉，所以病发作时容易呕吐，但必须等到呕吐后病情衰退，才可以取穴治疗。取穴取井穴、俞穴以及公孙穴，都属于本经，所以说“即取之”。）足少阴经的疟疾，使人呕吐严重，寒热往来，热多寒少，想要关上门窗独处，这种病难以治愈。（肾脉向上贯穿肝膈，进入肺中，沿着喉咙，阴邪上冲，所以呕吐严重。肾病则阴虚，阴虚所以热多寒少。然而属阴的病喜静，所以想要关上门窗独处。肾是至阴之脏，邪气居于其中，所以病深重难愈。这里没有提到针刺，一定是取大钟、太溪这两个本经的穴位。）足厥阴经的疟疾，使人腰痛，小腹胀满，小便不利像癃闭的样子，其实不是癃闭，而是尿频急，心中恐惧，气不足，腹中郁闷不畅，治疗应针刺足厥阴经。（肝脉经过生殖器，抵达小腹，散布胁肋，所以出现腰腹和小便方面的病症。凡是小便不利称为癃，这里说“像癃闭的样子，其实不是癃闭”，因为病不在水液代谢，而在于肝邪下陷，所以也像小便不利那样急切想排尿。心中恐惧，是肝气不足的表现。腹中悒悒，是不畅快的样子，这些都应当针刺足厥阴经，以太冲穴为主穴。）
肺疟，使人心中发冷，冷极则发热，发热间歇时容易惊骇，好像看到了什么怪异的东西，治疗应针刺手太阴经和手阳明经。（下文讲的是五脏疟的针刺方法，并兼及胃经。肺是心的华盖。寒邪乘袭其所不胜（金克木，此处指寒邪伤肺，肺金不生肾水，或指寒邪直中），所以肺疟使人心中发冷。寒冷严重后又发热，损伤心气，所以容易惊骇，好像看到了什么。应当针刺其表里两条经脉，以泻阳明经的实证，补太阴经的虚证。手太阴经的络穴列缺，手阳明经的原穴合谷，作为主穴。）心疟，使人心中烦闷严重，想要喝冷水，反而寒多热少，治疗应针刺手少阴经。（疟邪在心，所以心中烦闷严重，想要喝水来缓解。心本是阳脏，被邪气占据，则阳气虚而阴气盛，所以反而寒多而不怎么热。手少阴经，即神门穴。）肝疟，使人面色青苍，喜欢长叹气，神态像死人一样，治疗应针刺足厥阴经使其出血。（肝属木，所以面色青苍。肝气郁结则气逆，所以喜欢长叹气。木病则筋脉坚强，所以神态像死人。针刺足厥阴经使其出血，以中封穴为主。上文已经说过足厥阴经的症状，这里重复提及，是因为上文说的是经病，这里再次明确脏病的详细情况。下文脾、胃、肾三脏的道理相同。）脾疟，使人发冷，腹部疼痛，发热时肠鸣，肠鸣后出汗，治疗应针刺足太阴经。（脾是至阴之脏，疟邪居于其中，所以使人发冷。脾脉从大腿进入腹部，所以腹部疼痛。寒退后发热，脾气运行，所以肠鸣。肠鸣后阳气外达，所以出汗而病解。针刺足太阴经，取商丘穴。）肾疟，使人瑟瑟发抖，腰脊疼痛辗转反侧，大便困难，视物模糊不清，手足寒冷，治疗应针刺足太阳经和足少阴经。（“洒洒”是寒冷战栗的样子。肾脉贯穿脊柱，归属于肾，开窍于前后二阴，所以腰脊痛苦于辗转反侧，且大便困难。“瞤然”，是眩晕晃动的样子。视物不明，是水液亏损的表现；手足寒冷，是阴气厥逆的表现。针刺足太阳、少阴这两条表里经，取穴方法如前所述。）胃疟，使人刚要发病就感到饥饿，想吃却吃不下，吃了食物后胸脘胀满，腹部膨大，治疗应针刺足阳明经和足太阴经的横脉使其出血。（六腑中唯独提到胃，是因为胃是六腑之长。邪气在阳明经，则胃病波及脾，所以容易饥饿却吃不下，且胸脘胀满、腹部膨大。应当兼刺阳明经的表里两经。厉兑、解溪、三里，是足阳明经选取的三个穴位。针刺足太阴经的横脉使其出血，指的是足内踝前斜向的大脉，即太阴经的商丘穴。以上主要讲针刺方法，但其现症描述非常详细，用药的原则可以由此推知。）
火热之气反复，出现恶寒发热，症状像疟疾，有时一天发作一次，有时间隔几天发作。（凡是寒热往来的病，多由外感引起，但也有不因风寒而是火热内盛导致的，同样会出现恶寒发热，发作有定时，症状虽然像疟疾，但实际上不是疟疾。）胜复之气相遇的时候，有多寡之分。阴气多而阳气少，那么发作间隔的日子就远；阳气多而阴气少，那么发作间隔的日子就近，这是胜复之气相互搏击，盛衰有节律，疟疾也遵循同样的规律。（寒热，是阴阳之气的表现。迟速，是阴阳的性质。人的阴阳，就是水火，就是营卫。有热象反而恶寒，是火极似水；有寒象反而发热，是阴极似阳。阴阳调和则气血均匀，表里治理正常；阴阳不和则胜复之气相遇的时间各有不同。所以阳气入于阴分，阴不能胜阳而产生热；阴气出于阳分，阳不能胜阴而产生寒。又如阴多阳少，则阴性迟缓，相遇时间晚，所以发作间隔日子远；阳多阴少，则阳性急速，相遇时间早，所以发作间隔日子近。这种胜复盛衰的节律，虽然不是疟疾，但多变作类似疟疾的症状，治法也是相同的。所谓的“同”，都是阴阳出入的道理。然而同中有不同，有的叫“是疟”，有的叫“非疟”。是疟与非疟的区别，在于辨别有无邪气。真正的疟疾有邪气，由卫气相会来决定停止和发作；类似的疟疾无邪气，由水火争胜来决定盛衰。这二者，一个责之于表，一个责之于里；一个治在祛邪，一个治在扶正，不要认为治法相同治疗也就相同。在同与不同的界限之间，就是生人与杀人的歧路，学习中医的人对此，能不谨慎吗！）
When pathogenic factors are in the Three Yang meridians, the syndrome is abundant at the exterior. Sweat is difficult to retain after diaphoresis, hence it is said to be "difficult to cure." The phrase "pricking Zhong" refers to Weizhong (BL60), as ancient methods regarded Weizhong as "Zhong". Malaria of the Foot-Shaoyang meridian causes the body to feel flaccid and weak, aversion to seeing people, and palpitations with fear upon seeing others. Heat predominates over cold, and sweating is profuse. Treatment involves pricking the Foot-Shaoyang meridian. ("Jie Xie" denotes flaccidity; "Xie" implies relaxation. Body Jie Xie refers to intolerance of fatigue and a weary appearance. The mildness of both cold and heat indicates the disease is in the half-exterior, half-interior level. Palpitations upon seeing people indicate pathogenic factors in the Gallbladder. Shaoyang belongs to Wood and Fire, thus heat exceeds cold and sweating is severe. One should prick the Foot-Shaoyang meridian, primarily using Xiaxi (GB43).) Malaria of the Foot-Yangming meridian causes initial chills that are severe, followed by heat after a long duration, and sweating when the heat subsides. The patient prefers sunlight, moonlight, or fire, feeling relieved by them. Treatment involves pricking the acupoints on the dorsum of the foot of the Foot-Yangming meridian. Although the Yangming meridian is rich in blood and Qi, if cold pathogens overcome it, chills occur first, followed by heat later. When heat subsides, the pathogen resolves, leading to sweating. Typically, Yangming diseases involve aversion to people and fire; however, preferring light and warmth indicates Yang pathogens affecting the Stomach causing excess heat, whereas Yin pathogens causing deficiency cold would prefer warmth. The point on the dorsum is Chongyang (ST42) of this meridian.) Malaria of the Foot-Taiyin meridian causes dissatisfaction, frequent sighing, anorexia, alternating cold and heat with sweating. Upon onset, vomiting occurs, and the condition improves after vomiting. Acupuncture can then be applied. (The Spleen is the child of the Heart; Spleen disease leads to constrained Heart Qi, causing dissatisfaction. Impaired Spleen transformation blocks the Upper Jiao, causing sighing and anorexia. Taiyin governs interior pathogens which are hard to resolve, leading to alternating cold/heat and sweating. The Spleen meridian connects to the Stomach, passes through the diaphragm, and flanks the throat, causing vomiting upon onset. However, treatment should wait until after vomiting when the pathogen wanes. Points such as Jing-Well, Shu-Stream, and Gongsun (SP4) of this meridian should be used, hence "immediately take them".) Malaria of the Foot-Shaoyin meridian causes severe vomiting, alternating cold and heat with heat predominating, and a desire to stay behind closed doors and windows. This condition is difficult to cure. (The Kidney meridian passes through the liver and diaphragm, enters the lungs, and follows the throat. Yin pathogens rushing upward cause severe vomiting. Kidney disease leads to Yin deficiency, resulting in more heat than cold. Yin syndromes favor stillness, hence the desire for seclusion. As the Kidney is the organ of Supreme Yin harboring pathogens, the disease is deep and hard to cure. Although not explicitly stated, treatment likely involves Dazhong (KI11) and Taixi (KI3) of this meridian.) Malaria of the Foot-Jueyin meridian causes lower back pain, fullness in the lower abdomen, urinary difficulty resembling strangury but actually frequent urination, mental fear, Qi deficiency, and abdominal depression. Treatment involves pricking the Foot-Jueyin meridian. (The Liver meridian passes through the genitalia, reaches the lower abdomen, and spreads over the hypochondrium, causing these symptoms. Urinary difficulty is called strangury; here, it resembles strangury due to Liver pathogen sinking rather than water metabolism issues, causing urgency. Mental fear indicates insufficient Liver Qi. Abdominal depression signifies stagnation. Pricking the Foot-Jueyin meridian, primarily Taichong (LR3), is indicated.)
Lung malaria causes coldness in the heart, severe cold followed by heat, and fright during fever intervals, as if seeing visions. Treatment involves pricking the Hand-Taiyin and Hand-Yangming meridians. (This section discusses acupuncture for Zang malaria, including the Stomach. The Lung is the canopy of the Heart. Cold pathogens attacking the unconquered element cause Lung malaria to induce heart cold. Severe cold followed by heat damages Heart Qi, causing fright and hallucinations. Pricking the exterior-interior meridians clears Yangming excess and tonifies Taiyin deficiency. Lieque (LU7) of the Hand-Taiyin collateral and Hegu (LI4) of the Hand-Yangming Yuan-Source are primary points.) Heart malaria causes severe mental restlessness, a desire for cold water, but predominantly cold with slight heat. Treatment involves pricking the Hand-Shaoyin meridian. (Malaria pathogens in the Heart cause severe restlessness and desire for water. The Heart is a Yang organ; pathogen occupancy leads to Yang deficiency and Yin excess, resulting in predominant cold. Shenmen (HT7) of the Hand-Shaoyin meridian is used.) Liver malaria causes a dark greenish complexion, sighing, and a state resembling death. Treatment involves pricking the Foot-Jueyin meridian to induce bleeding. (Liver corresponds to Wood, hence the greenish color. Liver stagnation causes Qi rebellion and sighing. Wood pathology causes stiffness, resembling death. Pricking the Foot-Jueyin meridian to bleed uses Zhongfeng (LR6). The previous mention of Foot-Jueyin referred to Meridian disease; this clarifies Zang disease. The logic applies similarly to Spleen, Stomach, and Kidney.) Spleen malaria causes cold, abdominal pain, intestinal borborygmus during heat, and sweating after borborygmus. Treatment involves pricking the Foot-Taiyin meridian. (As the Supreme Yin organ, Spleen harbors malaria pathogens, causing cold. The Spleen meridian enters the abdomen from the thigh, causing abdominal pain. Heat following cold indicates Spleen Qi movement, causing borborygmus. Subsequent sweating indicates Yang Qi reaching the exterior, resolving the disease. Shangqiu (SP5) of the Foot-Taiyin meridian is used.) Kidney malaria causes shivering, low back and spine pain with turning discomfort, difficult defecation, blurred vision, and cold hands and feet. Treatment involves pricking the Foot-Taiyang and Foot-Shaoyin meridians. ("Shasha" describes shivering. The Kidney meridian penetrates the spine and opens into the two orifices, causing back pain and constipation. "Runran" describes dizziness/blurred vision, indicating Water deficiency. Cold extremities indicate Yin reversal. Pricking the exterior-interior Foot-Taiyang and Foot-Shaoyin meridians follows previous methods.) Stomach malaria causes hunger without appetite, postprandial distension, and abdominal enlargement. Treatment involves pricking the Foot-Yangming and Foot-Taiyin meridians' transverse vessels to induce bleeding. (Among the Six Fu organs, only the Stomach is highlighted as the leader of the Fu. Pathogens in Yangming affect the Stomach and Spleen, causing hunger without intake and distension. Pricking both exterior-interior meridians is required. Lidui (ST45), Jiexi (ST41), and Zusanli (ST36) are selected for Foot-Yangming. Pricking the transverse vessel of Foot-Taiyin to bleed refers to the oblique large vessel anterior to the medial malleolus, i.e., Shangqiu (SP5). While focusing on acupuncture, the detailed symptoms allow deduction of herbal indications.)
Fire and heat repeating with aversion to cold and fever resemble malaria, occurring daily or every few days. (Most alternating cold and heat syndromes stem from external contraction, but internal excessive fire can also cause periodic chills and fever resembling malaria, though it is not true malaria.) When victorious and retaliatory Qi meet, there are variations in quantity. If Yin is abundant and Yang is scarce, the interval between attacks is long; if Yang is abundant and Yin is scarce, the interval is short. This reflects the balance of victory and retaliation, similar to malaria. (Cold and heat represent Yin and Yang. Slowness and speed reflect their nature. Human Yin and Yang correspond to Water and Fire, Ying and Wei. Heat with apparent cold is extreme Fire resembling Water; cold with apparent heat is extreme Yin resembling Yang. Harmony ensures balanced Qi and regulated interior/exterior. Disharmony leads to variable timing of victorious/retaliatory Qi. Yang entering Yin generates heat (Yin cannot overcome Yang); Yin exiting Yang generates cold (Yang cannot overcome Yin). More Yin means slower meeting and longer intervals; more Yang means faster meeting and shorter intervals. Though not malaria, these mimic it, sharing the principle of Yin-Yang entry/exit. The distinction lies in the presence or absence of pathogens: true malaria involves Wei-Qi meetings determining attacks/remissions; false malaria involves Water-Fire competition determining excess/deficiency. One targets the exterior/pathogen, the other the interior/righteous Qi. Do not assume identical treatments for identical appearances. This distinction separates life from death; practitioners must be cautious.)