入于阴分。按∶此以冬中于寒而发为温疟，即伤寒之属，故《伤寒论》有温疟一证，盖本诸此。）帝曰∶瘅疟何如？岐伯
曰∶瘅疟者，肺素有热，气盛于身，厥逆上冲，中气实而不外泄，因有所用力，腠理开，风寒舍于皮肤之内、分肉之间
而发，发则阳气盛，阳气盛而不衰则病矣，其气不及于阴，故但热而不寒。（肺素有热者，阳盛气实之人也。故邪中于外，
亦但在阳分而不及于阴，则但热不寒也。）气内藏于心，而外舍于分肉之间，令人消烁脱肉，故命曰瘅疟。帝曰∶善。（气
藏于心，阳之藏也。热在肌肉之间，故令人消烁。然则瘅疟之所舍者，在肺心两经耳。）
（《灵枢·岁露篇》。此与前章疟论辞义多重，似不必入，然其中亦稍有异同，故并存之，以资印证。附∶疟疾治法）
黄帝问于岐伯曰∶经言夏日伤暑，秋病疟，疟之发以时，其故何也？（凡本篇义与前章同者，皆不重释。）岐伯对曰∶
邪客于风府，病循膂而下，卫气一日一夜常大会于风府，其明日日下一节，故其日作宴。此其先客于脊背也，故每至于
风府则腠理开，腠理开则邪气入，邪气入则病作，此所以日作尚宴也。卫气之行风府，日下一节，二十一日下至尾底，
二十二日入脊内，注于伏冲之脉，（前《疟论》云二十五日下至 骨，二十六日入于脊内，与此不同。盖彼兼项骨为言，
此则单言脊椎也。伏冲之脉，彼作伏膂之脉。）其行九日，出于缺盆之中，其气上行，故其病稍益至。（至字误，前《疟
论》云益早者是。）其内搏于五脏，横连募原，其道远，其气深，其行迟，不能日作，故次日乃蓄积而作焉。（前《疟论》
云间日乃作也。蓄，昌六切。）黄帝曰∶卫气每至于风府，腠理乃发，发则邪入焉。其卫气日下一节，则不当风府奈何？
岐伯曰∶风府无常，卫气之所应，必开其腠理，气之所舍节，则其府也。（卫气之所应，前《疟论》作所发。所舍节，言
所舍之节也。）黄帝曰∶善。夫风之与疟，相与同类，而风常在，而疟特以时休何也？岐伯曰∶风气留其处，疟气随经络，
沉以内搏，故卫气应乃作也。帝曰∶善。（本篇两搏字，前《疟论》俱作薄。愚按∶《生气通天》等论曰∶夏伤于暑，秋
为疟。《疟论》曰∶ 疟皆生于风。又曰∶疟者，风寒之气不常也。又曰∶汗出遇风，及得之以浴，水气舍于皮肤之内
也。此诸论者，皆以风寒暑湿为言，而病疟之因已尽于此。若于此而分其阴阳，则风与暑，阳邪也；寒与水，阴邪也。
然风者，阳中之凉气也；暑者，热中之寒邪也。合是四者而言，无非皆属乎寒，故江南呼为脾寒病，谓寒邪客于肌肉之
间而脾应肉也。及疟之将发，必先手足厥冷，以脾主四肢也。然则脾寒之名，非无谓也。而张子和非之曰∶《内经》既以
夏伤于暑而为疟，何世医皆以脾寒治之？是在子和，亦认暑为热邪，故有此说。独不观之经曰∶夏伤于大暑，其汗大出，
腠理开发，因遇夏气凄沧之水寒，藏于腠理皮肤之中，秋伤于风，则病成矣。是可见其言暑者，言时气也；言寒者，言
病气也。及邪气之变，自浅而深，郁寒成热，然终不免寒为本、热为标耳，安得谓之非寒耶？故其初感，则寒邪先伏于
腠理，及遇秋清之令，而新凉束之，则表邪不能外越，于是乎阴欲入而阳拒之，阳欲出而阴遏之，阴阳相搏而病作矣。
然其浅者，病在三阳，故随卫气以为出入，而一日一作；其深者，病在三阴，则邪气不能与卫气并出，故或间日，或三
四日，而作愈迟者，其病愈甚也。是以疟之轻重，惟在阴阳浅深耳。故于本经则有寒疟、温疟、瘅疟及六经六藏疟证之
分，义无出于此矣。乃后世自杨仁斋、朱丹溪而下，复分有痰疟、食疟及水饮败血为疟等证。若此之类，不过皆疟之兼
证耳，岂果因此而成疟哉？此外复有谓瘴疟者，惟岭南风瘴之地有之，亦湿邪之外入也。有谓牝疟者，但寒无热，以阳
气不足，亦阴邪之胜也。有谓劳疟者，因劳即发，以表里气虚而感邪之易也。有谓鬼疟者，本无疟鬼，神为邪所乱也。
由此言之，则亦无非寒邪耳。凡邪自外入，当从汗解。故经曰∶夏暑汗不出者，秋成风疟。又曰∶暑当与汗皆出，勿止。
又曰∶体若燔炭，汗出而散。皆其义也。故治疟者，但当察其邪之浅深，证之阴阳，必令其自脏而腑，自里而表，引而
散之，升而举之，使邪气得出，自然和矣。治法云∶有汗要无汗，以扶正为主而兼散；无汗要有汗，以散邪为主而兼补。
斯言得之矣。惟是邪在阳者取汗易，邪在阴者取汗难，所以在春夏者为易，在秋冬者为难，在上体者为易，在下体者为
难。必达其阴气，自然汗及下体。务令由阴而阳，由晏而早，方是佳兆，故又以汗之难易为微甚也。其有外受风寒，内
伤生冷，表里俱病，则疟痢并作。疟感由经，痢感由脏，但兼表里而去其寒湿之本，必皆愈也。至于痰食血气，内寒内
热等证，不过随其甚者而兼调之，弗得以此为主，是治疟之大法也。然法虽如此，犹有其要，则在乎标本虚实四者而已。
盖标以邪言，邪盛则实；本以正言，正夺则虚。如果有实证实脉之可据，则指其所在而直取之，拔去其邪，诸病自愈，
此治标也。如无实脉实证而病不愈者，必其元气之虚，但当温补真元，培其根本，使中气渐实，则逼邪外出，病必自愈，
此治本也。故有标则治标，无标则治本，是得其要矣。或其疟发既久，表邪已衰，而诸药不效者，但用人参生姜各一两，
煎汤，于未发二时之前，或发日五鼓，连进二服，无不愈者。或因参贵难以疗贫，则白术、当归，亦可随宜择而代之。
若阴虚水亏之人，则以熟地、生姜加倍用之，皆无不应手而效也。然必因脉以知其内，因证以知其外，但知标本之缓急，
又何疟之足虑哉？余阅疟门方剂，多不分表里先后，俱用芩、连、知母及大黄、石膏之类。夫以表邪不解而得此寒凉，
则寒邪愈陷。或任用常山、草果及劫截峻厉等剂。若正为邪伤而受此克伐，则元气愈虚，故多致绵延不已，轻者变重，
重者至危，是皆不得其本耳。得则易如反掌，在察所由而已。）
进入阴分。（按：这是指冬天感受寒邪而发为温疟，属于伤寒的范畴，所以《伤寒论》中有温疟这一证候，大概本源于此。）黄帝问：瘅疟是怎样的？岐伯说：瘅疟患者，肺中素有热邪，体内气机亢盛，气机厥逆向上冲撞，中焦之气充实而不能向外宣泄，因为用力劳作，腠理开泄，风寒之邪停留在皮肤之内、肌肉纹理之间而发病。发作时阳气亢盛，阳气亢盛而不衰退就会致病，病气不能到达阴分，所以只发热而不恶寒。（肺中素有热邪，是指阳气亢盛、气机充实的人。所以外邪侵袭体表，也只停留在阳分而不能深入阴分，因此只发热不恶寒。）病气内藏于心，外部停留于肌肉纹理之间，使人肌肉消瘦脱失，所以命名为瘅疟。黄帝说：讲得好。（气藏于心，是阳气的根本所在。热邪在肌肉之间，所以使人肌肉消瘦。那么瘅疟的病邪所停留的部位，是在肺经和心经罢了。）
（出自《灵枢·岁露篇》。这一段与前一篇《疟论》的文辞义理有多处重复，似乎不必收录，但其中也有少许不同之处，所以一并保存，以供互相印证。附：疟疾治法）
黄帝问岐伯说：医经上说夏天感受暑邪，秋天发生疟疾，疟疾的发作有固定的时间，这是什么原因呢？（凡是本篇义理与前篇相同的，都不再重复解释。）岐伯回答说：邪气客居在风府穴，病势沿着脊柱向下传导，卫气一天一夜常在风府穴大会，第二天卫气下行一节脊椎，所以每天发作的时间逐渐推迟。这是因为邪气先客居于脊背，所以每当卫气运行到风府穴时，腠理就开泄，腠理开泄则邪气乘虚而入，邪气入内则疾病发作，这就是为什么每天发作且时间逐渐推迟的原因。卫气在风府穴的运行，每天下行一节，二十一天下行至尾骶骨底端，第二十二天进入脊柱内部，注入伏冲脉。（前文《疟论》说二十五天下行至骨，二十六天进入脊内，与此说法不同。大概前文是兼项骨而言，此文则单言脊椎。伏冲脉，前文写作伏膂脉。）卫气运行九天，出于缺盆穴之中，其气上行，所以病情逐渐加重。（“至”字有误，前文《疟论》说“益早”是正确的。）邪气内迫五脏，横连募原，病位深远，邪气深沉，运行迟缓，不能每天发作，所以隔天积蓄力量后才发作。（前文《疟论》说隔日才发作。蓄，音昌六切。）黄帝说：卫气每到风府穴，腠理就开泄，开泄后邪气就进入。如果卫气每天下行一节，就不总是在风府穴了，那该怎么办呢？岐伯说：风府没有固定位置，卫气所应到的地方，必定会开泄腠理，邪气所停留的节段，就是它的“府”。（卫气所应到的地方，前文《疟论》写作“所发”。所舍节，指邪气所停留的椎节。）黄帝说：讲得好。风和疟疾，本是同类，但风邪常存，而疟疾却定时休止，为什么呢？岐伯说：风邪留滞在局部，疟气随经络运行，沉潜向内搏结，所以卫气运行到那里时才发作。黄帝说：讲得好。（本篇两个“搏”字，前文《疟论》都作“薄”。我按：《生气通天论》等篇章说：夏天伤于暑邪，秋天发为疟疾。《疟论》说：疟疾都生于风。又说：疟疾，是风寒之气不常有的表现。又说：出汗时遇风，以及洗澡时，水气停留在皮肤之内。这些论述，都是谈论风寒暑湿，而疟疾的病因已包含在此之中。如果据此区分阴阳，那么风和暑，属于阳邪；寒与水，属于阴邪。然而风，是阳中的凉气；暑，是热中的寒邪。综合这四种邪气来说，无非都属于寒，所以江南地区称之为脾寒病，意思是寒邪客居在肌肉之间，而脾主肌肉。等到疟疾将要发作时，必须先出现手足厥冷，因为脾主四肢。那么“脾寒”这个名字，并非没有道理。但是张子和反对这种说法，他说：《内经》既然说夏天伤于暑而发疟，为什么后世医生都用治脾寒的方法治疗？这在张子和看来，也是把暑认作了热邪，所以有此说法。他难道没看过经文说：夏天遭受大暑，汗出很多，腠理开发，如果遇到夏季凄清寒冷的水气，藏匿于腠理皮肤之中，秋天又伤于风邪，病就形成了。由此可见，他说“暑”，说的是时令气候；说“寒”，说的是病邪性质。等到邪气变化，由浅入深，郁积寒邪而成热，但最终还是不免以寒为本、热为标，怎么能说不属于寒呢？所以在初感时，寒邪先潜伏在腠理，等到遇到秋季清凉的气候，新凉束表，导致表邪不能向外发散，于是阴气想进入而被阳气拒绝，阳气想外出而被阴气遏制，阴阳相互搏结而疾病发作。然而病位浅的，病在三阳经，所以随着卫气的出入而每天发作；病位深的，病在三阴经，邪气不能与卫气同时外出，所以或隔日发作，或三四日发作，发作越迟，病情越重。所以疟疾的轻重，关键在于阴阳的浅深。因此在《内经》中有寒疟、温疟、瘅疟以及六经六脏疟证的分类，义理都不超出这个范围。到了后世，从杨仁斋、朱丹溪以下，又分出有痰疟、食疟以及水饮败血导致的疟等证候。像这类情况，不过是疟疾的兼夹证罢了，难道真的是因为这些因素才形成疟疾吗？此外还有称为瘴疟的，只有岭南风瘴之地才有，也是湿邪外侵所致。有称为牝疟的，只恶寒不发热的，是因为阳气不足，也是阴邪偏胜所致。有称为劳疟的，因为劳累就发作，是因为表里气虚容易感邪所致。有称为鬼疟的，本来没有疟鬼，是神志被邪气扰乱所致。由此说来，也无非都是寒邪罢了。凡是邪气从外侵入，应当通过发汗来解除。所以经文说：夏天暑天不出汗的，秋天会形成风疟。又说：暑邪应当随着汗液一起排出，不要止住。又说：身体像燃烧的炭火一样热，出汗后就消散了。这些都是其中的义理。所以治疗疟疾，只应当观察邪气的浅深，证候的阴阳，一定要让邪气从脏传向腑，从里透达至表，引导并疏散它，提升并举托它，使邪气得以排出，自然就能调和了。治法说：有汗的要使其无汗，以扶助正气为主兼以散邪；无汗的要使其有汗，以发散邪气为主兼以补正。这话很对。只是邪在阳经者取汗容易，邪在阴经者取汗困难，所以在春夏季发作的容易治疗，在秋冬季发作的难治，在上半身的容易治疗，在下半身的难治。必须通达其阴气，自然汗出及于下半身。务必令病势由阴转阳，由晚变早，这才是好兆头，所以又以出汗的难易来判断病情的轻重。如果有外受风寒、内伤生冷，表里俱病的，那么疟疾和痢疾会同时发作。疟疾的病邪由经络传入，痢疾的病邪由脏腑传入，只要兼顾表里，去除寒湿的根本，一定都能痊愈。至于痰食、血气、内寒、内热等证候，不过是根据其中严重的方面兼以调理，不得以此为主，这是治疗疟疾的大法。虽然方法如此，仍有关键所在，就在于标本虚实四个方面而已。标指邪气而言，邪气盛则为实；本指正气而言，正气亏损则为虚。如果有实证和实脉的依据，就指出病邪所在而直接攻取，拔除邪气，各种病症自然痊愈，这是治标。如果没有实脉实证而病不愈的，一定是元气虚弱，只应当温补真元，培固根本，使中气逐渐充实，从而逼迫邪气外出，病必自愈，这是治本。所以有标证就治标，无标证就治本，这就抓住了关键。或者疟疾发作已久，表邪已经衰退，而各种药物无效的，只用人参、生姜各一两，煎汤，在未发作前两小时之前，或发作当天五更时分，连续服用两次，没有不痊愈的。如果因人参昂贵难以负担，则白术、当归，也可以酌情选择替代。如果是阴虚水亏的人，则以熟地、生姜加倍使用，也都无不随手见效。然而必须通过脉象了解内在情况，通过证候了解外在表现，只要知道标本的缓急，又有什么疟疾值得忧虑的呢？我查阅疟疾门类的方剂，大多不分表里先后，一律使用黄芩、黄连、知母以及大黄、石膏之类的寒凉药。如果用表邪未解而用这些寒凉药，则寒邪会更加深陷。或者滥用常山、草果及劫截峻厉等药剂。如果正气已被邪气损伤而再受此类克伐，则元气更加虚弱，所以多导致病情迁延不愈，轻者变重，重者至危，这都是因为没有抓住根本的缘故。抓住了根本，治疗就容易如反掌，关键在于考察病因罢了。）
Entering the Yin aspect. (Note: This refers to Warm Malaria (Wen Nue) caused by contracting cold in winter, which belongs to the category of Cold Damage (Shang Han). Therefore, *The Treatise on Cold Damage* (Shang Han Lun) includes a syndrome of Warm Malaria, likely originating from this.) The Yellow Emperor asked: What is about Epidemic Fever Malaria (Dan Nue)? Qibo replied: In patients with Epidemic Fever Malaria, the lungs harbor heat internally, and Qi is abundant throughout the body. There is rebellious Qi rushing upward, the Middle Jiao Qi is full but fails to vent outward. Due to physical exertion, the interstices (Cou Li) open, allowing Wind-Cold pathogens to lodge between the skin and muscle layers, triggering the disease. Upon onset, Yang Qi becomes excessive; if this excess does not subside, illness ensues. The pathogenic Qi does not reach the Yin aspect, resulting in fever without chills. (Lungs harboring heat internally indicates a person with hyperactive Yang and substantial Qi. Thus, when external pathogens invade, they remain only in the Yang aspect and do not penetrate the Yin, causing fever without chills.) The pathogenic Qi resides internally within the Heart and externally lodges between the muscle layers, causing emaciation and flesh wasting; hence it is named Epidemic Fever Malaria. The Yellow Emperor said: Well said. (Qi resides in the Heart, the residence of Yang. Heat in the muscles causes emaciation. Thus, the location where Epidemic Fever Malaria lodges is in the Lung and Heart meridians.)
(From *Ling Shu: Sui Lu Pian*. The wording and meaning here overlap significantly with the previous chapter on Malaria, suggesting it might be redundant. However, since there are slight differences, it is preserved for cross-reference. Appendix: Treatment Methods for Malaria.)
The Yellow Emperor asked Qibo: The classics state that summer injury by Summerheat leads to autumn malaria, and malaria attacks at specific times. What is the reason? (Wherever the meaning overlaps with the previous chapter, no further explanation is given.) Qibo answered: The pathogen lodges in the Fengfu point (GV16), and the disease follows the spine downward. Wei Qi (Defensive Qi) convenes at the Fengfu point once every day and night. The next day, it descends one vertebral segment. Therefore, the daily attack occurs later. This is because the pathogen initially lodged in the back. Whenever Wei Qi reaches the Fengfu point, the interstices open; when the interstices open, the pathogen enters; when the pathogen enters, the disease manifests. This explains why the daily attacks occur progressively later. Wei Qi’s movement at Fengfu descends one segment daily. After twenty-one days, it reaches the base of the coccyx. On the twenty-second day, it enters the interior of the spine and pours into the Fu Chong Mai (Hidden Surging Vessel). (*The previous "Malaria Theory" states it reaches the bone on the twenty-fifth day and enters the spine interior on the twenty-sixth, differing from this text. That text likely refers to the cervical vertebrae combined with the skull, whereas this text refers solely to the spinal column. The Hidden Surging Vessel was written as the Hidden Spine Vessel in the previous text.*) Wei Qi travels for nine days, emerging from the Quepen area (ST12 region). Its Qi moves upward, so the condition gradually worsens. ("Zhi" [arrive] is an error; the previous text says "Yi Zao" [earlier] is correct.) The pathogen presses inward against the Zang organs and spreads horizontally to the Mu Yuan (Sea of Origin). The pathway is long, the Qi is deep, and its movement is slow, preventing daily attacks. Thus, it accumulates power and attacks on alternate days. (The previous text says it attacks on alternate days. "Xu" is pronounced Chang-Liu-Qie.) The Yellow Emperor said: When Wei Qi reaches the Fengfu point, the interstices open, and upon opening, the pathogen enters. If Wei Qi descends one segment daily, it would not always be at Fengfu. How should this be explained? Qibo said: Fengfu has no fixed location. Wherever Wei Qi responds, it opens the interstices. The segment where the pathogen lodges becomes its "Fu." (In the previous text, "Wei Qi responds" was written as "Wei Qi emits." "Suo She Jie" refers to the segment where the pathogen lodges.) The Yellow Emperor said: Well said. Wind and Malaria are of the same category, yet wind persists while malaria pauses intermittently. Why? Qibo said: Wind pathogen remains stationary, while Malaria Qi follows the meridians, sinking and pressing inward. Thus, it manifests only when Wei Qi arrives. The Yellow Emperor said: Well said. (The two instances of "Bo" [press/battle] in this chapter were written as "Bo" [approach/thin] in the previous *Malaria Theory*. My analysis: Chapters like *Sheng Qi Tong Tian Lun* state: Summer injury by Summerheat leads to autumn malaria. *Malaria Theory* states: All malaria arises from Wind. It also states: Malaria is due to irregular Wind-Cold. It further states: Sweating followed by exposure to wind, or bathing, allows Water Qi to lodge within the skin. These discussions all cite Wind, Cold, Summerheat, and Dampness as causes, encompassing the etiology of malaria. If we distinguish Yin and Yang based on this: Wind and Summerheat are Yang pathogens; Cold and Water are Yin pathogens. However, Wind is cool Qi within Yang; Summerheat is cold Qi within heat. Considering these four together, they essentially all belong to Cold. Hence, in Jiangnan, it is called Spleen Cold Disease, meaning Cold pathogen lodges in the muscles, and the Spleen governs the muscles. Before malaria attacks, there must be cold extremities because the Spleen governs the limbs. Thus, the name "Spleen Cold" is justified. However, Zhang Hezi opposed this, saying: Since *Nei Jing* attributes malaria to summer Summerheat injury, why do physicians treat it as Spleen Cold? Zhang Hezi considered Summerheat as Heat pathogen, leading to this view. Did he not read the scripture: Summer injury by intense Summerheat causes profuse sweating and open interstices. If one encounters cold water in summer, it hides in the interstices and skin. Autumn injury by Wind then completes the illness. This shows that "Summerheat" refers to the seasonal climate, while "Cold" refers to the pathogenic nature. As the pathogen changes from superficial to deep, stagnant Cold transforms into Heat, but ultimately Cold remains the root and Heat the branch. How can it not be considered Cold? Initially, Cold pathogen lies dormant in the interstices. When autumn coolness arrives, it constricts the exterior, preventing the exterior pathogen from venting. Yin desires to enter but is rejected by Yang; Yang desires to exit but is blocked by Yin. Yin and Yang battle, and the disease manifests. Superficial cases involve the Three Yang meridians, following Wei Qi’s entry and exit, causing daily attacks. Deep cases involve the Three Yin meridians; the pathogen cannot exit with Wei Qi, causing attacks every other day or every three to four days. The later the attack, the more severe the disease. Thus, the severity of malaria depends on the depth of Yin and Yang. Hence, in the classic, there are classifications of Cold Malaria, Warm Malaria, Epidemic Fever Malaria, and Six Meridian/Six Zang Malaria syndromes, all falling under this principle. Later, from Yang Renzhai and Zhu Danxi onwards, distinctions were made for Phlegm Malaria, Food Stagnation Malaria, and Malaria due to Fluid Retention or Blood Stasis. These are merely concurrent syndromes of malaria, not the primary cause of malaria itself. Additionally, there is Zang Malaria, found only in the miasma-prone regions of Lingnan, caused by external Dampness. There is Pin Malaria, characterized by chills without fever, due to insufficient Yang Qi and excess Yin pathogen. There is Labor Malaria, triggered by exertion, due to deficiency of exterior and interior Qi making one susceptible to pathogens. There is Ghost Malaria, where no ghost exists, but the Spirit is disturbed by pathogen. Thus, all are essentially Cold pathogen. External pathogens should be resolved through sweating. Scripture states: Those who do not sweat during summer heat will develop Wind Malaria in autumn. Also: Summerheat should be expelled with sweat; do not stop it. Also: If the body burns like charcoal, sweating dissipates the heat. These illustrate the principle. Therefore, treating malaria requires observing the depth of the pathogen and the Yin-Yang nature of the syndrome. One must guide the pathogen from Zang to Fu, from interior to exterior, drawing it out and dispersing it, lifting and raising it, so the pathogen exits and harmony is restored. Treatment principle: For those with sweat, aim to stop it by supporting Right Qi and dispersing pathogen; for those without sweat, aim to induce it by dispersing pathogen and supporting Right Qi. This is correct. However, inducing sweat is easier for pathogen in Yang meridians than in Yin meridians; thus, spring/summer cases are easier to treat than autumn/winter cases; upper body cases are easier than lower body cases. One must unblock Yin Qi to induce sweat in the lower body. Ideally, the condition shifts from Yin to Yang, and from late to early onset, indicating a good prognosis. Sweat difficulty indicates severity. If external Wind-Cold and internal injury by raw/cold foods cause simultaneous exterior and interior pathology, Malaria and Dysentery may occur together. Malaria stems from meridians; Dysentery stems from Zang organs. By addressing both exterior and interior and removing the root of Cold-Dampness, both will heal. Conditions like Phlegm-Food, Blood-Qi imbalance, Internal Cold, or Internal Heat should be treated concurrently based on severity, not as the primary focus. This is the general method for treating malaria. Although methods vary, the key lies in Root/Branch and Deficiency/Excess. Branch refers to Pathogen; Excess means strong pathogen. Root refers to Right Qi; Deficiency means depleted Right Qi. If Excess Syndrome and Pulse are present, target the location directly to expel the pathogen, and other symptoms will resolve. This is treating the Branch. If no Excess signs exist but illness persists, it is due to Qi deficiency. One must warm and tonify True Yuan, cultivate the root, strengthen Middle Qi, and force the pathogen outward. This is treating the Root. Treat the Branch if present; treat the Root if absent. This captures the essence. For chronic malaria where exterior pathogen has weakened and drugs fail, use Ren Shen (Ginseng Radix) and Sheng Jiang (Zingiberis Rhizoma Recens), each 1 liang, decocted. Take two doses before the predicted onset time or at dawn on the day of attack. Recovery is assured. If Ginseng is too expensive, Bai Zhu (Atractylodis Macrocephalae Rhizoma) and Dang Gui (Angelicae Sinensis Radix) may substitute. For Yin deficiency with fluid depletion, increase Shu Di Huang (Rehmanniae Radix Praeparata) and Sheng Jiang. Effects are immediate. However, one must diagnose internally via pulse and externally via syndrome, understanding the urgency of Root/Branch. Then, what fear is there of malaria? I have reviewed formulas for malaria, many ignoring exterior/interior sequence, indiscriminately using Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Zhi Mu (Anemarrhenae Rhizoma), Da Huang (Rhei Radix et Rhizoma), and Shi Gao (Gypsum Fibrosum). Using such cold-cooling herbs when exterior pathogen is unresolved drives Cold deeper. Alternatively, overusing Chang Shan (Dichroae Radix), Cao Guo (Tsao-ko Fructus), or harsh interceptive agents damages already compromised Right Qi, leading to chronicity, worsening severity, and danger. This results from missing the root. Grasping the root makes treatment easy as turning a hand; it depends on investigating the cause.)