疟者，风、寒、暑、湿之邪，为外感三阳经病。故经云∶夏伤于暑，秋成风疟。或先伤于寒，而后伤于
风，则先寒后热；或先伤于风，而后伤于寒，则先热后寒。病属三阳，而寒热往来，则以少阳一经为主。
初非有痰，以为疟邪之根也。疟邪随人身之卫气为出入，故有迟早、一日间日之发，而非痰之可以为疟
也。何也？人身无痰，痰者，人身之津液也。随其邪之所在，而血凝、气滞、停饮、宿食，则津液即化为
痰，是痰从邪气而成病者也。乃严用和论疟，谓“无痰不作疟”，若指痰为疟邪之主，反以疟邪为痰病之
客矣。岂有人身津液变痰，而为寒为热以成疟者乎？痰本因疟邪以生，而非因痰以有疟邪者。如痰生于
脾，脾恶湿则痰动；痰本于肾，肾阴虚则水泛。疟病之痰，痰因风寒之邪而生者也。岂有无痰而便不作疟者
乎？至杨仁斋、许叔微，更有以瘀血、停涎、黄水主为疟病之根，而后之治疟者，均以常山、草果、槟
榔、砒信，为吐痰、消瘀、截疟之法，徒戕人元气，而败脾伤胃，以致夭枉也。
《灵枢》云∶病痛者，阴也。又云∶无形而痛者，阴之类也。其阳完而阴伤之也，急治其阳，无攻其
阴。夫阳者，气也，是痛病当先治气。顾气有虚有实。实者，邪气实。虚者，正气虚。邪实者，以手按之而
痛，痛则宜通。正虚者，以手按之则止，止则宜补。丹溪猥云∶诸痛不宜补气。夫实者，固不宜补，岂
有虚者而亦不宜补乎？故凡痛而胀闭者多实，不胀不闭者多虚；痛而喜寒者多实热，喜热者多虚寒；饱而
甚者多实，饥则甚者多虚；脉实气粗者多实，脉虚气少者多虚；新病壮年者多实，愈攻愈剧者多虚。痛在经者脉弦大，
痛在脏者脉沉微，兼脉症以参之，而虚实自辨。是以治表虚痛者，阳不足也，非温经不可；里虚痛者，阴不足也，非养
荣不可；上虚而痛者，心脾受伤也，非补中不可；下虚而痛者，脱泄亡阴也，非速救脾肾温补命门不可。凡属诸痛之虚
者，不可以不补也。有曰“通则不痛”，又曰“痛随利减”。人皆以为不易之法，不知此为治实痛者言也。故王海藏
解“痛利”二字，不可以“利”为“下”，宜作“通”字训。此说甚善。明哲如丹溪徒曰∶“诸痛不可补气”，
则失矣。
疟疾，是风、寒、暑、湿等邪气侵袭人体，属于外感三阳经的病证。所以医经中说：夏季感受暑邪，秋季发作成风疟。或者先感受寒邪，后感受风邪，就会先出现恶寒后发热；或者先感受风邪，后感受寒邪，就会先发热后恶寒。病位属于三阳经，且表现为寒热往来，则以少阳一经为主。这起初并不是因为有痰，才成为疟疾的病因根源。疟邪随着人体的卫气在体内出入运行，所以有发作时间的早晚、每日或隔日发作的区别，而不是因为痰就能导致疟疾。为什么呢？人身本无所谓的“痰”，所谓痰，就是人身体的津液。随着邪气停留的部位不同，导致血液凝滞、气机阻滞、水饮停聚、宿食不化，津液就转化为痰，这是痰因邪气而生成并致病的。然而严用和论述疟疾时，说“无痰不作疟”，如果把痰当作疟邪的主要成因，反而把疟邪当作痰病的次要表现（客邪）了。难道有人身津液变成痰，进而化为寒热来形成疟疾的吗？痰原本是因为疟邪的存在而产生的，而不是因为有了痰才产生疟邪。比如痰生于脾，脾脏厌恶湿气则痰动；痰源于肾，肾阴不足则水液泛滥。疟病中的痰，是因风寒邪气而生成的。难道没有痰就不会得疟疾吗？至于杨仁斋、许叔微，更有以瘀血、停涎、黄水作为疟疾病根的论点，而后世治疗疟疾的人，都使用常山、草果、槟榔、砒信，作为吐痰、消瘀、截断疟疾的方法，白白地残害人的元气，败坏脾胃，导致早逝。
《灵枢》说：病痛属于阴证。又说：无形质可见而疼痛的，属于阴类。这是因为阳气完好而阴气受损的缘故，应当紧急治疗其阳分，不要攻伐其阴分。所谓阳，就是气，所以痛病应当先治气。但是气有虚有实。实证，是邪气盛实。虚证，是正气虚弱。邪气实的，用手按压会感到疼痛，疼痛适宜用通法。正气虚的，用手按压疼痛就会停止，适宜用补法。朱丹溪轻率地说：各种疼痛都不宜补气。对于实证，确实不宜补，难道虚证也不宜补吗？所以凡是疼痛伴有胀满闭塞的多为实证，不胀不闭的多为虚证；疼痛喜欢冷敷的多为实热，喜欢热敷的多为虚寒；饱食后疼痛加重的多为实证，饥饿时疼痛加重的多为虚证；脉象有力、气息粗壮的多为实证，脉象无力、气息微弱的多为虚证；新发病且正值壮年的多为实证，越攻伐病情越严重的多为虚证。疼痛在经络的，脉象弦大；疼痛在脏腑的，脉象沉微。结合脉象和症状来参详，虚实自然可以辨别。因此，治疗表虚引起的疼痛，是阳气不足，非温通经络不可；治疗里虚引起的疼痛，是阴血不足，非滋养营血不可；治疗上焦虚损引起的疼痛，是心脾受伤，非补益中气不可；治疗下焦虚损引起的疼痛，是脱泄亡阴，非迅速救援脾肾、温补命门不可。凡是属于诸痛的虚证，不可以不采用补法。有人说“通则不痛”，又说“痛随利减”。人们都认为这是不可改变的法度，却不知道这是针对治疗实痛而言的。所以王海藏解释“痛利”二字，不能把“利”理解为“泻下”，应该作“通”字来训释。这种说法很好。像朱丹溪这样明智的人，却只说“诸痛不可补气”，这就错了。
Malaria is caused by pathogenic factors such as wind, cold, summerheat, and dampness invading the body, belonging to diseases of the three Yang meridians acquired from external contraction. Thus, the classics state: "Summer injury by summerheat leads to wind malaria in autumn." If one is first injured by cold and subsequently by wind, chills will precede fever; if first injured by wind and subsequently by cold, fever will precede chills. The disease belongs to the three Yang meridians, and since it presents with alternating chills and fever, it primarily involves the Shaoyang (Lesser Yang) meridian. Initially, there is no phlegm serving as the root cause of malaria. The malaria pathogen moves in and out with the body's Wei Qi (Defensive Qi), which explains the variations in onset timing, such as daily or every-other-day attacks, rather than phlegm being the cause of malaria. Why? The human body does not inherently possess "phlegm"; what is called phlegm is actually the body's Jin-Ye (Body Fluids). Depending on where the pathogen resides, blood stasis, Qi stagnation, retained fluid, or retained food can occur, causing these fluids to transform into phlegm. Thus, phlegm arises from pathogenic factors to cause disease. However, Yan Yonghe, in his discussion on malaria, stated that "no phlegm, no malaria." If phlegm is regarded as the primary agent of malaria pathogens, then the malaria pathogen becomes merely a secondary manifestation (guest factor) of phlegm disease. Can it be that body fluids transforming into phlegm then generate cold and heat to form malaria? Phlegm is generated due to the presence of malaria pathogens, not that malaria pathogens exist because of phlegm. For instance, phlegm originates in the Spleen; when the Spleen dislikes dampness, phlegm moves. Phlegm stems from the Kidney; when Kidney Yin is deficient, water overflows. The phlegm in malaria disease is generated by wind-cold pathogens. How could one claim that without phlegm, malaria would not occur? Furthermore, Yang Renzhai and Xu Shuwei argued that blood stasis, retained saliva, and yellow water are the roots of malaria. Consequently, later practitioners treated malaria using herbs like Changshan (Dichroa Radix), Caoguo (Tsaoko Fructus), Binglang (Arecae Semen), and Pixin (Arsenic compounds) as methods to induce vomiting to expel phlegm, eliminate blood stasis, and arrest malaria. These practices vainly damage the Yuan Qi (Original Qi), impair the Spleen and Stomach, and lead to premature death.
The *Ling Shu* states: "Painful conditions belong to Yin." It also says: "Conditions that are formless yet painful belong to the category of Yin." This occurs because the Yang is intact while the Yin is injured; therefore, one should urgently treat the Yang and not attack the Yin. Yang refers to Qi, so pain conditions should initially be treated by regulating Qi. However, Qi can be either Deficient or Excess. In Excess patterns, pathogenic factors are abundant. In Deficient patterns, healthy Qi is weak. In cases of pathogenic Excess, pressure causes pain, indicating that unblocking (Tonification/Regulation via movement) is appropriate. In cases of healthy Qi Deficiency, pressure alleviates pain, indicating that tonification is appropriate. Zhu Danxi rashly claimed that "various pains should not be treated with Qi-tonifying methods." While it is true that Excess patterns should not be tonified, does this mean Deficient patterns should not be tonified either? Therefore, pain accompanied by distension and obstruction is mostly Excess; pain without distension or obstruction is mostly Deficient. Pain relieved by cold is mostly Excess Heat; pain relieved by warmth is mostly Deficient Cold. Pain worsening after eating is mostly Excess; pain worsening when hungry is mostly Deficient. A forceful pulse and coarse breathing indicate Excess; a weak pulse and faint breathing indicate Deficient. New-onset disease in young adults suggests Excess; conditions worsening with aggressive treatment suggest Deficiency. Pain located in the meridians presents with a wiry and large pulse; pain located in the Zang organs presents with a deep and minute pulse. By correlating pulses and symptoms, Deficiency and Excess can be distinguished. Thus, for exterior Deficiency pain caused by insufficient Yang, warming the meridians is essential. For interior Deficiency pain caused by insufficient Yin, nourishing the Ying (Nutritive) Blood is essential. For upper Jiao Deficiency pain due to Heart and Spleen injury, tonifying the Middle Jiao is essential. For lower Jiao Deficiency pain due to collapse and loss of Yin, rapidly rescuing the Spleen and Kidney and warming the Mingmen (Gate of Life) is essential. All Deficient types of pain must be treated with tonification. Some say "unblocking prevents pain" and "pain decreases with discharge." People regard these as immutable laws, unaware that they apply only to treating Excess pain. Therefore, Wang Haizang interpreted the term "discharge" in "pain decreases with discharge" not as "purging/downward draining," but as "unblocking/opening." This interpretation is excellent. Even someone as wise as Zhu Danxi erred by stating simply that "various pains should not be treated with Qi-tonifying methods."