帝曰∶经言有余者泻之，不足者补之。今热为有余，寒为不足。夫疟者之寒，汤火不能温也，及其热，
冰水不能寒也，此皆有余不足之类。当此之时，良工不能止，必须其自衰，乃刺之，其故何也？岐伯曰∶经言
无刺 之热，无刺浑浑之脉，无刺漉漉之汗，故为其病逆，未可治也。夫疟之始发也，阳气并于阴，当是之
时，阳虚而阴盛，外无气，故先寒 也；阴气逆极，则复出之阳，阳与阴并复于外，则阴虚而阳实，故先热而
渴。夫疟气者，并于阳则阳胜，并于阴则阴胜，阴胜则寒，阳胜则热。疟者，风寒之气不常也，病极则复。
至病之发也，如火之热，如风雨之不可当也。故经曰方其盛时必毁，因其衰也，事必大昌，此之谓也。夫疟之
未发也，阴未并阳，阳未并阴，因而调之，真气得安，邪气乃止，故工不能治其已发，为其气逆也。
古经言有余泻之，不足补之，以调其平，为一定之法也。若疟之大寒大热，亦有余不足之类，而良工不能
即用补泻之法以治之。必须其气自衰，乃刺之者，盖经亦有言∶无刺 之热、浑浑之脉、漉漉之汗。 、
浑浑、漉漉者，邪正相争，阴阳相并，气血腾沸，无论不可刺，药亦不可服，服之遏其势，或致元气闷绝而死
者有之，此不可不知也。故疟病者，阴阳之气相角相并，互相胜负，阳并于阴，则阴胜而寒，阴并于阳，则阳
胜而热。当其发也，如火性风雨之急骤不可当，故经言方其盛时而治之，必毁其元气，因其病气衰而调之，事
必大昌。调之得时，真气安而邪气乃止，故良工不能治其已发之时，为其气逆不可犯也。
帝曰∶攻之奈何？早晏何如？岐伯曰∶疟之且发也，阴阳之且移也，必从四末始也。阳已伤，阴从之，
故先其时坚束其处，令邪气不得入，阴气不得出，审候见之，在孙络盛坚而血者，皆取之，此真往而未得并者也。
当其发时不可治，则治之必有其时矣。盖疟邪混于血气之中，随经络流行，以致营卫阴阳不和，邪与卫气
相遇，则邪正互争而病发。夫十二经阴阳之气流行，交接于四肢之末，其邪将发，必使阴阳移易而扰乱，故疟
发时，从四末阴阳交接之处起，而指尖先冷。阳气既伤，阴必从之而伤，故当先其发时，邪气未动，坚束四末
指尖，使阴阳气不移易，而邪气止于一处，不得出入阴阳以扰血气。然后审其孙络之脉盛而且坚，有血色现者，
邪气之所在也，用针取之以去邪，则真气往归本位，而未得与邪相并，则病不发也。
帝曰∶疟不发，其应何如？岐伯曰∶疟气者，必更盛更虚，当气之所在也，病在阳，则热而脉躁；在阴，
则寒而脉静。极则阴阳俱衰，卫气相离，故病乃休；卫气集，则复病也。
人身阴阳二气，本来交通而和平，疟邪居之，使有偏亢，邪在阳，则阳盛阴衰，则热而脉躁；邪在阴，
则阴盛阳衰，则寒而脉静。邪气出入阴阳，使阴阳互争互并，扰乱之极，则邪正之气俱衰，卫气与邪相离，
其病乃休；卫气集，则病复作也。
黄帝问道：医经上说，邪气有余的要用泻法，正气不足的要用补法。现在认为热证属于有余，寒证属于不足。然而疟疾发作时的寒冷，用汤火也不能使其温暖；等到发热时，用冰水也不能使其冷却，这些都属于有余和不足的范畴。在疟疾发作的时候，即使是高明的医生也无法强行制止，必须等待病势自然衰退后才能针刺治疗，这是什么原因呢？
岐伯回答说：医经上说，不要针刺高热炽盛的患者，不要针刺脉象混乱无序的患者，不要针刺大汗淋漓的患者，因为这些情况属于病气逆乱，暂时不可治疗。疟疾刚开始发作时，阳气并入阴分，在这个时候，阳气虚而阴气盛，体表没有卫气护卫，所以先出现恶寒；当阴气逆乱到极点，就会重新出于阳分，阳气与阴气一同复出于外，此时阴气虚而阳气实，所以先出现发热和口渴。疟疾的病气，并入阳分则阳胜，并入阴分则阴胜，阴胜则发冷，阳胜则发热。疟疾的风寒之气并不恒定，病情发展到极点就会反复。到了发病的时候，其势头像烈火一样灼热，像狂风暴雨一样猛烈，无法抵挡。所以医经说：“当病气正盛时治疗，必然损伤正气；趁着病气衰退时治疗，事情必定大吉大利。”说的就是这个道理。在疟疾尚未发作时，阴气未并入阳气，阳气也未并入阴气，此时趁机调理，真气得安，邪气就会停止，所以高明的医生不能在已发作时治疗，是因为那时气机逆乱。
古医经说“有余泻之，不足补之”，这是为了调和阴阳平衡，是固定的法则。但是像疟疾这样的大寒大热，虽然也属于有余不足的范畴，但高明的医生不能立即使用补泻之法来治疗。必须等待病气自然衰退后，才能进行针刺，这是因为医经也有话说：“不要针刺高热、脉象混乱、大汗淋漓的患者。”所谓浑浑（混乱）、漉漉（淋漓），是指邪正相争，阴阳相互搏结，气血沸腾翻滚，这种情况下，不仅不可针刺，药物也不可服用。如果服药，会遏制病势，或者导致元气闷绝而死的情况发生，这是不可忽视的。所以患疟疾的人，阴阳之气相互角力、相互搏结，互相胜负。阳气并入阴分，则阴胜而发冷；阴气并入阳分，则阳胜而发热。当疾病发作时，就像火的性质和风雨的急骤一样，无法抵挡。所以医经说，当病气正盛时去治疗，必然会毁坏元气；趁着病气衰退时去调理，事情必定大吉大利。调理得当，真气安定而邪气停止，所以高明的医生不能在已发作时治疗，是因为那时气机逆乱，不可冒犯。
黄帝问道：如何攻治它？早晚时机怎样把握？岐伯回答说：疟疾将要发作时，阴阳之气即将转移，一定从四肢末端开始。阳气已经受伤，阴气随之受损，所以在发作之前，要在患处牢固地束扎，使邪气不得进入，阴气不得外出。仔细诊察，如果发现孙络（浅表小血管）盛大坚实且有血色显现的，都进行刺络放血，这是为了让真气前往而未与邪气相并合。当疾病正在发作时不可治疗，那么治疗就必须有特定的时机。大概疟邪混杂在血气之中，随着经络流行，导致营卫阴阳不和，邪气与卫气相遇，则邪正相互争斗而发病。十二经的阴阳之气在四肢末端交接流行，邪气将要发作时，必然使阴阳移易而扰乱，所以疟疾发作时，从四肢末端阴阳交接之处起病，指尖先变冷。阳气既已受伤，阴气必然随之受伤，所以当在发作之前，邪气尚未扰动时，牢固束扎四肢指尖，使阴阳之气不致移易，而邪气止于一处，不得出入阴阳以扰乱血气。然后仔细审视孙络，若脉象盛大且坚实，有血色现出，那就是邪气所在的地方，用针取之以祛除邪气，则真气往归本位，而未得与邪气相并合，疾病就不会发作了。
黄帝问道：疟疾不发作时，其表现应如何？岐伯回答说：疟疾的病气，必然有时偏盛有时偏虚，取决于病气所在的位置。病在阳分，则发热而脉象躁动；病在阴分，则发冷而脉象安静。病情极重时，阴阳俱衰，卫气与邪气分离，所以疾病暂停；待卫气聚集，则疾病复发。
人身阴阳二气，本来交通而和平，疟邪占据其中，使其出现偏亢。邪在阳分，则阳盛阴衰，表现为发热而脉象躁动；邪在阴分，则阴盛阳衰，表现为发冷而脉象安静。邪气出入于阴阳之间，使阴阳相互争斗、相互搏结，扰乱至极，则邪正之气都衰弱，卫气与邪气分离，疾病就暂停；待卫气聚集，疾病就再次发作。
The Yellow Emperor asked: The classic texts state that for excess conditions, one should use the draining method; for deficiency conditions, one should use the tonifying method. It is generally considered that heat syndromes belong to excess, and cold syndromes belong to deficiency. However, in malaria, the chills are so severe that hot water or fire cannot warm the patient; when the fever occurs, ice water cannot cool the patient. These cases fall under the categories of excess and deficiency. At such times, even a skilled physician cannot forcibly stop the attack and must wait for the pathogenic factor to naturally decline before applying acupuncture. What is the reason for this?
Qibo replied: The classic texts state: "Do not needle patients with intense heat," "do not needle those with chaotic pulse qualities," and "do not needle those with profuse sweating." This is because these conditions represent rebellious pathogenic qi, which are temporarily untreatable. When malaria first begins to manifest, the Yang qi merges into the Yin. At this moment, Yang is deficient and Yin is exuberant, leaving the exterior without Wei (defensive) qi protection, hence the initial chills. When Yin qi becomes rebellious to an extreme, it emerges back into Yang. Yang and Yin both re-emerge to the exterior, resulting in Yin deficiency and Yang excess, hence the subsequent fever and thirst. The malaria pathogen, when merging into Yang, causes Yang to prevail; when merging into Yin, causes Yin to prevail. Yin prevailing leads to cold; Yang prevailing leads to heat. The wind-cold pathogen of malaria is not constant; when the disease reaches its extremity, it recurs. Upon onset, the condition is like the heat of fire or the onslaught of wind and rain, unstoppable. Therefore, the classics say: "Treating during peak intensity will surely damage the healthy qi; treating as the pathogen declines ensures great success." This refers to the principle mentioned above. Before malaria manifests, Yin has not merged with Yang, nor has Yang merged with Yin. By regulating at this time, the Zhen (true/healthy) qi can be stabilized, and the pathogenic qi will cease. Thus, skilled physicians do not treat after the attack has started, because the qi is then rebellious.
Ancient texts state "drain the excess, tonify the deficiency" to restore balance, which is a fixed rule. However, although the severe chills and high fevers of malaria also fall under excess and deficiency, skilled physicians cannot immediately apply tonification or drainage methods. One must wait for the qi to naturally decline before needling. This is because the classics also warn: "Do not needle intense heat, chaotic pulses, or profuse sweating." Terms like Hunhun (chaotic/disordered) and Lulu (profuse/dripping) describe the struggle between pathogenic and healthy qi, the intermingling of Yin and Yang, and the boiling turmoil of blood and qi. In such states, not only is needling contraindicated, but medication should also be avoided. Administering drugs might suppress the pathogenic momentum or lead to sudden collapse of Yuan (original) qi and death. This is a critical point to understand. In malaria patients, Yin and Yang qi engage in mutual contention and merging, each gaining or losing dominance. When Yang merges into Yin, Yin prevails causing chills; when Yin merges into Yang, Yang prevails causing fever. During an attack, the condition is as abrupt and unstoppable as fire or storms. Hence, the classics advise against treatment during peak intensity to avoid damaging healthy qi, recommending regulation during the declining phase for optimal outcomes. Proper timing stabilizes Zhen qi and halts pathogenic qi. Thus, skilled physicians avoid treating active attacks due to the rebellious nature of the qi.
The Yellow Emperor asked: How should it be attacked? What about the timing (early vs. late)? Qibo replied: When malaria is about to manifest, Yin and Yang qi are about to shift, starting from the four extremities. If Yang is injured, Yin follows suit. Therefore, before the onset, firmly bind the affected area to prevent pathogenic qi from entering and healthy qi from escaping. Carefully observe; if Sunluo (collateral vessels) appear full, firm, and show blood color, puncture them. This allows Zhen qi to proceed without merging with the pathogen. Since treatment during an active attack is contraindicated, there must be a specific time for intervention. Malaria pathogens mix within blood and qi, circulating along meridians, causing disharmony among Ying (nutritive), Wei (defensive), Yin, and Yang. When the pathogen encounters Wei qi, they contend, triggering the disease. The Yin-Yang qi of the twelve meridians circulate and intersect at the extremities. As the pathogen prepares to manifest, it disrupts Yin-Yang shifts. Thus, malaria attacks often begin at the intersection points of Yin and Yang in the extremities, with coldness starting in the fingertips. Once Yang is injured, Yin is inevitably injured too. Therefore, before onset, while the pathogen is still dormant, firmly bind the fingertips of the four extremities to prevent Yin-Yang displacement, trapping the pathogen in one place so it cannot enter or exit Yin-Yang to disturb blood and qi. Then, carefully examine the Sunluo; if the pulse is full, firm, and shows blood color, this indicates the pathogen's location. Use needles to remove the pathogen. Then Zhen qi returns to its proper position without merging with the pathogen, preventing the disease from manifesting.
The Yellow Emperor asked: What are the manifestations when malaria is not manifesting? Qibo replied: The malaria pathogen alternates between excess and deficiency depending on its location. If the pathogen is in Yang, there is fever and a restless pulse; if in Yin, there is chills and a quiet pulse. When the condition reaches its extreme, both Yin and Yang become depleted, and Wei qi separates from the pathogen, so the disease pauses. When Wei qi gathers again, the disease recurs.
In the human body, Yin and Yang qi are originally in communication and harmony. The malaria pathogen occupies this space, causing imbalance. If the pathogen is in Yang, Yang becomes exuberant and Yin deficient, leading to fever and a restless pulse. If in Yin, Yin becomes exuberant and Yang deficient, leading to chills and a quiet pulse. The pathogen enters and exits Yin and Yang, causing mutual contention and disruption. When the disturbance is extreme, both pathogenic and healthy qi become depleted, and Wei qi separates from the pathogen, causing the disease to pause. When Wei qi gathers, the disease recurs.