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。
令人且病者，谓其发寒热之疟病，而邪在胃腑也；邪热壅胃故饥；其清浊不转，故不能食，食则支满也；
支满而肠中不得传导，则腹大矣。脾胃同气相贯，故刺胃脾经横脉出血以泄邪。夫阳经自表通腑，阴经自表通
脏，皆为躯体至脏腑之径路也。上文举六经疟病，明其邪在经而浮浅，此以脏腑名病者，明其邪已深入于里也。
然邪由表入，必使从表而出，故皆同刺其经以泄之也。
疟脉缓、大、虚，便宜用药，不宜用针。凡治疟，先发如食顷，乃可以治，过之则失时也。
脉缓、大、虚，皆本元不足也。针法在引其元气升发，领邪外出，故元气虚者，针不可用，宜用药助内气
以达邪也。若疟发时，气逆不可治，上文已明，其发后势衰，余邪伏匿，治亦无功，故当于先发食顷时，其邪
将动未动，迎其机而泄之，过此皆为失时，治之而不效也。凡诸疟病皆然。以故一切外感、内伤之病，用药应
饭前饭后，或早或暮，皆有相宜之时，所当体究者也。
《灵枢·五变篇》帝曰∶人之善病寒热者，何以候之？少俞曰∶小骨弱肉者，善病寒热。帝曰∶何以候
之？少俞曰∶颧者，骨之本也，颧大则骨大，颧小则骨小。皮肤薄而其肉无 ，其臂懦懦然，其地色殆然，不
与其天同色，污然独异，此其候也。然后臂薄者，其髓不满，故善病寒热也。
善病寒热者，不必受大邪，因其皮肉筋骨皆薄弱，略有微风寒，即发寒热之病也。皮弱而卫阳虚，故其面色
亦常不正。颔为地部，额为天部，时有清浊之邪相蒙，而上下面部之色各异。盖清邪上受，上部之色薄泽为风；
浊邪下受，下部之色晦滞为湿。殆者，晦也，凡病危殆，其色必晦之意耳。表常邪侵，则营卫不调，乃善病寒
热矣。验其颧、臂与 ，知其骨肉薄弱而髓不满之故， 者，臂肘节间隆浓之肉也。
胃疟这种病，会让人同时出现寒热症状，容易感到饥饿却吃不下东西，即使吃了也会感到四肢胀满、腹部膨大，治疗时应针刺足阳明经和足太阴经的横络出血。
所谓“让人同时出现寒热症状”，是指发作时忽冷忽热的疟疾，且病邪位于胃腑；邪热壅滞于胃，所以容易饥饿；脾胃清浊之气运行失常，所以不能进食，进食后则会导致四肢胀满；四肢胀满且肠道传导功能受阻，就会导致腹部膨大。脾与胃同气相贯，因此针刺胃经和脾经的横络出血以泄除邪气。阳经从体表通达腑，阴经从体表通达脏，这些都是躯体通向脏腑的路径。上文列举了六经疟病，说明病邪在经络而位置浮浅；此处以脏腑命名疾病，说明病邪已深入体内。然而病邪由表入里，必须使其从表而出，所以都通过针刺其所属经脉来泄除邪气。
疟疾脉象表现为缓、大、虚时，适宜用药治疗，不适宜用针刺。凡是治疗疟疾，应在发病前约一顿饭的时间进行干预，否则就会错过最佳时机。脉象缓、大、虚，都是根本元气不足的表现。针刺的作用在于引导元气升发，带领邪气外出，所以元气虚弱者不宜用针，宜用药辅助内气以驱除邪气。如果疟疾发作时气机逆乱，则难以治疗，上文已经阐明；若发作后正气衰微，余邪潜伏隐匿，治疗也无效，所以应当在初次发作前约一顿饭的时间，此时邪气将动未动，趁其机势而泄除它，过了这个时间就是错失良机，治疗也不会见效。各种疟疾都是如此。因此，一切外感和内伤疾病，用药是在饭前还是饭后，或是早晨还是傍晚，都有适宜的时机，这是应当仔细体察研究的。
《灵枢·五变篇》中黄帝问：人容易患寒热病的，如何诊断？少俞回答：骨骼小、肌肉软弱的人，容易患寒热病。黄帝问：如何诊断？少俞回答：颧骨是骨骼的根本，颧骨大则骨骼大，颧骨小则骨骼小。皮肤薄而肌肉不丰满，手臂软弱无力，面部色泽晦暗，不与天部（额头）颜色相同，污浊独异，这就是征候。然后看手臂瘦薄的人，其骨髓不满，所以容易患寒热病。
容易患寒热病的人，不一定受到严重的邪气侵袭，因为他的皮肉筋骨都很薄弱，稍有微风寒侵袭，就会引发寒热病。皮毛虚弱导致卫阳虚，所以面色也不正常。下颌为地部，额头为天部，时常有清浊之邪相互蒙蔽，导致上下面部颜色各异。大概清邪从上受纳，上部之色淡薄润泽为风邪所致；浊邪从下受纳，下部之色晦暗滞涩为湿邪所致。“殆”意为晦暗，凡是病情危重，其面色必然晦暗的意思罢了。表经常遭受邪气侵扰，导致营卫不调，就容易患寒热病。通过观察颧骨、手臂以及肘节间隆起的肌肉，可以知道其骨肉薄弱、骨髓不满的原因，“ ”指的是臂肘关节间隆起浓密的肌肉。
Wei Malaria (Malaria of the Stomach) causes simultaneous chills and fever. The patient feels hungry but cannot eat; if they do eat, they experience distension in the limbs and abdominal enlargement. Treatment involves puncturing the transverse collaterals of the Foot-Yangming and Foot-Taiyin meridians to bleed.
"Causing simultaneous chills and fever" refers to malaria characterized by alternating chills and heat, with the pathogenic factor located in the Stomach organ. Pathogenic heat stagnating in the Stomach leads to hunger; dysfunction in the transformation of clear and turbid qi results in an inability to eat, and eating leads to limb distension. Limb distension combined with impaired intestinal transmission leads to abdominal enlargement. The Spleen and Stomach share the same qi and are interconnected; therefore, puncturing the transverse collaterals of the Stomach and Spleen meridians to bleed helps to drain the pathogen. Yang meridians connect from the exterior to the Fu organs, and Yin meridians connect from the exterior to the Zang organs; these are the pathways connecting the body surface to the internal organs. The previous text listed malaria of the Six Meridians to illustrate that when pathogens are in the meridians, they are superficial. Here, naming the disease after Zang-Fu organs indicates that the pathogen has penetrated deeply into the interior. However, since pathogens enter from the exterior, they must be expelled from the exterior; thus, all cases involve puncturing the relevant meridians to drain the pathogen.
When the pulse in malaria is slow (Huan), large (Da), and deficient (Xu), medication is appropriate, while acupuncture is not. In treating malaria, intervention should occur approximately one meal's time before the onset of symptoms; otherwise, the optimal timing will be missed. A slow, large, and deficient pulse indicates a deficiency of primordial Qi. Acupuncture aims to guide the ascending and dispersing of primordial Qi to lead pathogens out; therefore, it is contraindicated for those with deficient primordial Qi. Instead, medication should be used to assist internal Qi in expelling pathogens. If Qi becomes rebellious during the attack, treatment is difficult, as previously stated. If, after the attack, vital energy is depleted and residual pathogens lie dormant, treatment is also ineffective. Therefore, one should intervene about one meal's time before the initial onset, when the pathogen is stirring but not yet active, draining it at its opportune moment. Missing this window constitutes missing the timing, rendering treatment ineffective. This applies to all types of malaria. Consequently, for all external contraction and internal injury diseases, whether medication is taken before or after meals, or in the morning or evening, there are appropriate timings that require careful consideration.
In the *Lingshu: Wu Bian* chapter, the Yellow Emperor asked: How can one diagnose individuals prone to chills and fever? Shaoyu replied: Those with small bones and weak flesh are prone to chills and fever. The Yellow Emperor asked: How to diagnose? Shaoyu replied: The zygomatic bone is the root of the bones. A large zygomatic bone indicates large bones; a small zygomatic bone indicates small bones. Thin skin with unfilled flesh, weak arms, and a dull facial color that differs from the forehead (Tian Bu) and appears uniquely murky are signs. Furthermore, thin arms indicate insufficient marrow, leading to susceptibility to chills and fever.
Those prone to chills and fever do not necessarily suffer from severe pathogens; due to their weak skin, flesh, bones, and tendons, even slight wind-cold invasion can trigger chills and fever. Weak skin and hair lead to deficiency of Wei Yang (Defensive Yang), resulting in abnormal facial complexion. The chin represents the Earth region, and the forehead represents the Heaven region. When clear and turbid pathogens obscure each other, the colors of the upper and lower face differ. Generally, clear pathogens are received from above; a thin and lustrous upper facial color indicates Wind. Turbid pathogens are received from below; a dull and stagnant lower facial color indicates Dampness. "Dai" means dull. It implies that in critical illnesses, the complexion must be dull. Frequent invasion of pathogens on the exterior disrupts the harmony of Ying (Nutritive) and Wei (Defensive) Qi, making one prone to chills and fever. By examining the zygomatic bone, arms, and the fleshy prominence between the elbow and arm, one can understand the cause of weak bones and flesh and insufficient marrow. The term refers to the thick muscle mass at the elbow joint.