疟之为病，其名有五∶一曰瘅疟，二曰寒疟，三曰湿疟，四曰牝疟，五曰牡疟。名虽不
同，其感皆由六淫七情，所伤饥饱劳逸。经云∶夏伤于暑，秋必 疟，体虚之人易感，发则
一发者易治，又有二三日一发者难愈。夫瘅疟，阴气独微，阳气独发，但热不寒，里实不泄
，烦渴且呕，肌肉消瘦也。寒疟自感寒而得，无汗恶寒，挛痛面惨，先寒后热也。湿疟冒袭
雨湿，汗出澡浴得之，身体重，肢节烦疼，呕逆胀满也。牝疟久受阴湿，阴胜阳虚，不能
制阴，所以寒多不热，气虚而泄，凄惨振振也。牡疟饮食不节，饥饱有伤，表里俱虚，致使
然也，病由邪气交争，阴阳二气，更相胜负，邪正相搏而作焉。卫气与邪气相离，故汗而解
。卫气昼行阳，夜行阴，得阳而外出，故发于日间。得阴则内搏，故发于暮夜。若邪气内搏
于五脏，横连于募原，其道远不能与卫气交并，故有隔日发之，又有三四日一发。卫气之行
迟行速，病作有早有晏。甚者内外失守，真邪不分，阴阳失胜，寒热互起，则休作无定时也
。《素问》论六经疟∶足太阳疟，令人腰痛头重，寒从背起，先寒后热， ，然热止
汗出，难已；足少阳疟，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；足阳明疟，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；
足太阳疟，令人不乐，好安息，不嗜食，多寒热汗出，病至则善呕，呕已乃衰；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；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。虽此之分，皆是五
脏之受病。夫心疟者，令人烦心，甚欲得清水，反寒多不甚热；肝疟者，令人色苍苍然大息
，其状若死者；脾疟者，令人寒，腹中痛，热则肠中鸣，鸣已汗出；肺疟者，令人心寒，寒
甚热，热间善惊，如有所见；肾疟者，令人洒洒然，腰脊痛宛转，大便难，目 然，手足寒
；又有胃疟者，令人且病也，善饥而不能食，食而支满腹大。大率治法，疟脉多弦数则热，
弦迟则寒，风以散之，寒以温之，不虚不实，以经取之，痰以涤之，停滞疏利之，虚则补之
，不可便用断截之药，截之太早，邪气薄于五脏，传留日久，变证多端，用药次序，无不效
矣。
疟疾这种疾病，其名称有五种：第一种叫瘅疟，第二种叫寒疟，第三种叫湿疟，第四种叫牝疟，第五种叫牡疟。虽然名称不同，但致病原因都源于六淫（风、寒、暑、湿、燥、火六种外感病邪）和七情（喜、怒、忧、思、悲、恐、惊七种情志变化），以及饮食饥饱失调和劳逸过度。医经说：夏季感受暑邪，秋季必定发生疟疾，身体虚弱的人容易感染。发作频率为一日一次者容易治疗，又有两三日发作一次的则难以痊愈。
所谓瘅疟，是阴气微弱，阳气独盛发动，表现为只有发热而没有恶寒，体内实热而不泄泻，心烦口渴且伴有呕吐，肌肉消瘦。寒疟是因为感受寒邪而得病，无汗、怕冷，肢体拘挛疼痛、面色惨白，表现为先恶寒后发热。湿疟是因为冒犯雨湿，或出汗后洗澡所致，表现为身体沉重，四肢关节烦痛，呕吐逆气、腹胀满。牝疟是因为长期受阴湿侵袭，阴气胜而阳气虚，不能制约阴气，所以寒冷多而发热少，气虚导致腹泻，神情凄惨、身体颤抖。牡疟是因为饮食不节制，饥饱损伤，表里俱虚，从而导致此病。疟病的机理是邪气与正气交争，阴阳二气更相胜负，邪正相互搏结而产生。卫气与邪气分离，所以通过发汗可以解除。卫气白天行于阳分，夜晚行于阴分，遇到阳气则外出，所以发作在白天；遇到阴气则内迫，所以发作在傍晚或夜间。如果邪气内迫于五脏，横连于募原（半表半里之隙），距离卫气运行之路遥远，不能与卫气交会，所以有隔日发作的，又有三四日发作一次的。卫气运行有迟有速，疾病发作有早有晚。严重的内外失守，真邪不分，阴阳失去平衡，寒热交替兴起，则发作没有固定时间。
《素问》论述六经疟证：足太阳经疟，使人腰痛头重，寒气从背部升起，先恶寒后发热，腰脊强直僵硬，热止后汗出，难以治愈；足少阳经疟，使人身体懈怠无力，恶寒不甚严重，发热也不甚严重，害怕见人，见到人心里惊恐不安，发热多且汗出厉害；足阳明经疟，使人先感到寒冷战栗，寒冷很厉害，很久才发热，热退后汗出，喜欢见日光月光或火光，气息才会舒畅；足太阴经疟，使人心情不乐，喜欢静卧休息，不想吃东西，经常寒热汗出，病发作时容易呕吐，吐完后病情减轻；足少阴经疟，使人呕吐，寒热都很厉害，热多寒少，想关门窗独处，这种病难以治愈；足厥阴经疟，使人腰痛，小腹胀满，小便不利，像癃闭（排尿困难）的样子，其实不是癃闭，而是频繁小便，心中恐惧，气不足，腹部郁闷不畅。
虽然分为六经，但都是五脏受病。心疟，使人心中烦乱，非常想喝冷水，反而恶寒多而发热轻；肝疟，使人面色青苍苍地长叹气，神态像死人一样；脾疟，使人发冷，腹中疼痛，发热时肠鸣，肠鸣停止后汗出；肺疟，使人心中寒冷，寒冷极甚然后发热，发热间歇时容易惊骇，好像看到了什么；肾疟，使人洒洒然畏寒，腰脊疼痛辗转反侧，大便困难，眼睛昏花看不清，手足冰冷；还有胃疟，使人即将发病时，容易饥饿但不能进食，吃了东西就感觉胸胁胀满、腹部膨大。
大致的治法原则是：疟疾脉象多弦数表示热证，弦迟表示寒证。风邪用发散法，寒邪用温散法，不虚不实者取本经穴位治疗，痰浊用涤除法，停滞用疏利法，虚证用补益法。不可轻易使用截断疟疾的药物，截断太早，邪气会深入五脏，停留日久，变证多端，只要按照用药次序治疗，没有无效的。
Malaria (Nue) as a disease has five names: the first is Dan Nue (Febrile Malaria), the second is Han Nue (Cold Malaria), the third is Shi Nue (Damp Malaria), the fourth is Pin Nue (Yin Malaria), and the fifth is Mu Nue (Yang Malaria). Although the names differ, the causes are all due to the Six Evils (Wind, Cold, Summerheat, Dampness, Dryness, Fire) and Seven Emotions (Joy, Anger, Worry, Pondering, Sorrow, Fear, Fright), as well as dietary irregularities and overexertion or lack of exercise. The Classics state: Summerheat injured in summer leads to malaria in autumn; those with weak constitutions are prone to infection. Attacks occurring once daily are easy to treat, while those occurring every two or three days are difficult to cure.
Dan Nue is characterized by deficient Yin Qi and hyperactive Yang Qi, manifesting as fever without chills, internal excess heat without discharge, irritability, thirst, vomiting, and emaciation. Han Nue results from contracting cold pathogens, presenting with anhidrosis, aversion to cold, spasmodic pain, pale complexion, and a pattern of chills preceding fever. Shi Nue arises from exposure to rain and dampness or bathing while sweating, presenting with heavy body sensation, painful joints, nausea, regurgitation, and abdominal distension. Pin Nue results from prolonged exposure to Yin-dampness, where Yin excess and Yang deficiency fail to control Yin, leading to predominant chills with little fever, Qi deficiency causing diarrhea, and a miserable, trembling appearance. Mu Nue is caused by dietary irregularities damaging the interior and exterior, resulting in dual deficiency of Ying and Wei. The pathology involves the struggle between pathogenic factors and healthy Qi, where Yin and Yang energies contend. When Wei Qi (Defensive Qi) separates from the pathogen, sweating resolves the condition. Wei Qi travels through Yang during the day and Yin at night; encountering Yang leads to daytime attacks, while encountering Yin leads to evening or nighttime attacks. If pathogens invade the Five Zang Organs internally or connect horizontally to the Mo Yuan (Sea of Origin), far from the path of Wei Qi, they cannot intersect with it, leading to intermittent attacks every other day or every three to four days. The speed of Wei Qi circulation varies, causing attacks to occur early or late. In severe cases, internal and external defenses fail, true and pathogenic Qi are indistinguishable, Yin and Yang lose balance, and cold and heat alternate chaotically, resulting in irregular attack times.
The *Su Wen* discusses Malaria of the Six Meridians: Taiyang Malaria causes lower back pain, heaviness of the head, cold starting from the back, chills preceding fever, stiffness of the waist and spine, sweating after fever subsides, and is difficult to cure. Shaoyang Malaria causes flaccidity of the body, mild chills and fever, aversion to people, palpitations upon seeing others, abundant fever and sweating. Yangming Malaria causes initial shivering chills, severe cold followed by delayed fever, sweating after fever subsides, and a preference for sunlight or moonlight to feel comfortable. Taiyin Malaria causes melancholy, desire for rest, anorexia, frequent chills, fever, and sweating; vomiting occurs at onset and subsides afterward. Shaoyin Malaria causes vomiting, severe chills and fever (more heat than cold), desire to stay behind closed doors, and is difficult to cure. Jueyin Malaria causes lower back pain, fullness in the lower abdomen, difficulty urinating resembling Gong syndrome (dysuria) but not actually Gong, frequent urination, fear, Qi deficiency, and abdominal oppression.
Although divided by meridians, these are all diseases of the Five Zang Organs. Xin Malaria (Heart Malaria) causes mental agitation, strong desire for cold water, predominant chills with mild fever. Gan Malaria (Liver Malaria) causes a pale greenish complexion, frequent sighing, and a demeanor resembling death. Pi Malaria (Spleen Malaria) causes chills, abdominal pain, intestinal borborygmi during fever, and sweating after borborygmi cease. Fei Malaria (Lung Malaria) causes cold sensations in the heart, severe chills followed by fever, fright during fever intervals, and visual hallucinations. Shen Malaria (Kidney Malaria) causes shivering cold, lower back and spine pain with turning restlessness, difficulty defecating, blurred vision, and cold extremities. Wei Malaria (Stomach Malaria) causes hunger before onset, inability to eat despite hunger, and abdominal distension/fullness after eating.
Generally, the treatment principles are: A wiry and rapid pulse indicates heat; a wiry and slow pulse indicates cold. Wind is dispersed, cold is warmed, deficiency-excess patterns are treated via the affected meridian, phlegm is cleared, stagnation is regulated, and deficiency is tonified. Do not hastily use antimalarial drugs to cut off the disease; cutting too early allows pathogens to penetrate the Five Zang Organs, lingering for long periods and causing various complications. Following the correct order of medication ensures efficacy.