论曰夏伤于暑，秋成 疟。该于时而作也。方夏之时，阴居于内，暑虽入之，势未能动，
候得秋气，阳为之变动，汗出遇风，乃成此疾，故曰 疟。皆生于风，蓄作有时，其气阴阳
上下交争，虚实更作，阴阳相移也，阳并于阴，则阴实而阳虚，阳明虚则寒栗鼓颔。巨阳虚
则腰背头项痛。三阳俱虚，则阴气胜。阴气胜则骨寒而痛。寒生于内，故中外皆寒。阳盛则
外热，阴虚则内热，内外皆热，则喘而渴。故欲冷冻饮料，皆得之夏伤于暑，热气盛藏于皮肤之
内。肠胃之外，此营气之所舍也。令人汗孔疏，腠理开。因得秋气汗出遇风，及得之于浴，
水气舍于皮肤之内，与卫气并居。卫气者，昼行于阳，夜行于阴，此气得阳而外出，得阴而
内薄，内外相薄，是以日作，其间日作者，其气之所舍深也。其作之早晏者，随风府日下一
节也。是以或先寒后热，或先热后寒，或但热无寒，又或本于痰，或本于瘴，或本于鬼神，
或本于邪气，大概外传经络，内入五脏，证既不同，治法亦异。治疟者不辨阴阳虚实，概以
吐药投之，有非痰实而真气受弊者固多矣。内经论五脏诸经之疟，本以刺法补泻，其寒热先
后，与夫发止早晏，又皆不同，明邪气所传，不可一概论。今备载诸证，参以治法之轻重，
要在随证而治，庶乎无一曲之蔽也。
论述说：夏季感受暑邪，到了秋季发作成为疟疾。这是邪气在相应时节发作的缘故。正值夏季时，阴气居于体内，虽然暑热之邪侵入，但势力尚不足以引发疾病；等到秋季的凉气到来，体内的阳气随之变动，此时若出汗后遭遇风邪，便形成了这种疾病，所以称为疟疾。疟疾皆由风邪引起，发作有固定的时间规律，其病机在于阴阳之气上下交争，虚实交替出现，阴阳相互转移。当阳邪并入阴分，则阴实而阳虚，阳明经气虚弱则会出现寒战、咬牙的现象；巨阳（太阳经）气虚弱则会导致腰背和头项疼痛；如果三阳经（太阳、阳明、少阳）之气都虚弱，则阴气偏胜。阴气偏胜则骨骼寒冷且疼痛。寒气生于体内，所以体表和内部都感到寒冷。阳气亢盛则体表发热，阴液亏虚则体内发热，内外皆热，就会导致气喘和口渴，因此想要饮用冷冻饮料。这些情况都是由于夏季感受暑邪，热气旺盛并潜伏于皮肤之内、肠胃之外的部位，这也是营气所居之处。这使得人的汗孔疏松，腠理开泄。因为遇到秋季的凉气，出汗后受风，或者洗澡时水气侵入，水气停留在皮肤之内，与卫气共同居住。卫气白天行于阳分，夜晚行于阴分，这种邪气随着卫气出于阳分则向外发散，随卫气入于阴分则向内迫近，内外邪气相搏结，所以每日发作；隔日发作的，是因为邪气潜伏的部位较深。发作时间的早晚，是随着风府穴的位置每日向下移动一节所致。因此有的先寒后热，有的先热后寒，有的只热不寒，又有的基于痰饮，有的基于瘴气，有的基于鬼神作祟，有的基于其他邪气，大体上是外传经络，内入五脏，既然证候不同，治疗方法也各异。治疗疟疾如果不辨别阴阳虚实，一概使用吐药来投治，导致并非痰实证却使真气受损的情况确实很多。《内经》论述五脏及各经的疟疾，原本主张用针刺补泻的方法，其寒热的先后顺序，以及发作和停止的早晚，也都各不相同，明确指出了邪气传变的不同，不能一概而论。现在详细记载各种证候，参考治疗方法的轻重缓急，关键在于根据证候进行治疗，这样才能避免片面性的弊端。
Commentary states: Summer injury by summer-heat (Shu, 暑), autumn completion of malaria. It occurs in accordance with the season. During the time of summer, Yin resides within; although summer-heat enters, its momentum is not yet able to move [the body]. When the Qi of autumn arrives, Yang undergoes change. Sweating followed by exposure to wind then forms this disease, hence it is called Malaria (Nüe, 疟). All arise from Wind (Feng, 风), accumulating and acting at specific times. The Qi of Yin and Yang contends above and below, alternating between deficiency and excess, as Yin and Yang shift. When Yang merges into Yin, Yin becomes full and Yang becomes deficient. If Yangming (Stomach/Large Intestine channels) is deficient, there will be chills and gnashing of teeth. If Juyang (Taiyang/Bladder channel) is deficient, there will be pain in the lower back, back, head, and neck. If the Three Yang channels are all deficient, then Yin Qi prevails. When Yin Qi prevails, the bones become cold and painful. Cold originates internally, therefore both the interior and exterior are cold. When Yang is excessive, there is external heat; when Yin is deficient, there is internal heat. If both interior and exterior are hot, there will be panting and thirst. Thus, one desires frozen drinks. All these result from summer injury by summer-heat, where hot Qi is abundant and hides within the skin, outside the intestines and stomach; this is the residence of Ying Qi (Nutritive Qi). This causes sweat pores to be loose and Couli (interstices) to open. Due to encountering autumn Qi while sweating and exposed to wind, or due to bathing, water Qi settles within the skin, residing together with Wei Qi (Defensive Qi). Wei Qi travels through Yang during the day and through Yin at night. This pathogen, when obtaining Yang, moves outward; when obtaining Yin, it presses inward. As interior and exterior pathogens contend, it thus occurs daily. Those occurring every other day have pathogens that reside deeply. The early or late timing of onset follows the descent of the Fengfu (GV16) point by one segment each day. Therefore, some have cold first then heat, some have heat first then cold, some have only heat without cold, some originate from Phlegm (Tan, 痰), some from Miasma (Zhang, 瘴), some from ghosts and spirits, some from evil Qi. Generally, they transmit externally to the meridians and enter internally to the Five Zang organs. Since the syndromes differ, treatment methods also vary. Treating malaria without distinguishing Yin/Yang and deficiency/excess, and generally administering emetic drugs, results in many cases where true Qi is damaged despite the absence of phlegm-excess. The Neijing discusses malaria of the five Zang organs and various meridians, originally advocating acupuncture tonification and sedation. The sequence of cold and heat, and the timing of onset and cessation, all differ, clearly indicating the transmission of evil Qi cannot be generalized. Now, all syndromes are recorded in detail, referenced with the severity of treatment methods. The key lies in treating according to the syndrome, so as to avoid the bias of partiality.