(疟有六经五脏之不同。刺法因之以异)
足太阳之疟。令人腰痛头重。寒从背起先寒后热 然。热止汗出。难已。(刺委
中。)足少阳之疟。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。(刺
侠。)足阳明之疟。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决然。(
刺冲阳。)足太阴之疟。令人不乐。好太息。不嗜食。多寒热汗出。病至则善呕呕已乃衰。(
刺隐白。太白。公孙。)足少阴之疟。令人呕吐甚多寒热热多寒少。欲开户牖而处。其病虽
已。(宜刺太 。大钟经不言刺缺文)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(刺太冲)肺疟者。令人心寒。寒甚热热间善惊。如有
所见者(刺列缺合谷。)心疟者。令人烦心甚。欲得清水反寒多。不甚热。(刺神门。)肝疟者
。令人色苍苍然。太息。其状若死者。(刺中封。)脾疟者。令人寒腹中痛热则肠中鸣鸣已汗
出。(刺商丘。)肾疟者。令人洒洒寒。腰脊痛。宛转大便难。目 然。手足寒。(刺金门
。太 。)胃疟者。令人且病。善饥而不能食。食而肢满腹大。(刺厉兑解 三里。太阴之商
丘。)疟发身方热刺跗上动脉。(足阳明经冲阳。)开其孔出其血。立寒。疟方欲寒刺手足阳
明大阴。(疟之将发未发。当随此四经之井俞而刺之)疟脉满大急刺背俞。用中针旁五 俞各
一。适肥瘦出其血也。(满六急。阳邪之实也背为诸阳之府故当刺魄户。神堂噫嘻鬲关。魂
门。等穴。水热穴论五脏俞旁五。以泻五脏之热与此大同。 。胁也。其穴旁间近胁。故曰
旁五 俞。适肥瘦出血者。谓瘦者浅刺少出血。肥者深刺多出血也)疟脉小实急。灸胫少阴
刺诸井。(脉小实急阴邪胜也。阴盛者生内寒。故当灸足少阴复溜以散寒。又刺足太阳至阴
以补阳也)疟脉缓大虚。便宜用药。不宜用针。诸疟而脉不见。刺十指间出血。血去必已。
先视身之赤如小豆者尽取之(阳亢而脉反伏。故如是刺之以。泻阳)十二疟者。其发各不同时
。察其病形。以知其何脉之病也。先其发时。如食顷而刺之。一刺则衰。二刺则知。三刺则已
不已刺舌下两脉出血。(左金津右玉液)不已。刺 中盛经出血(委中)又刺项以下侠脊者必已
。(大抒。风门。)舌下两脉者。廉泉也。(其穴在舌根下左右泉脉。故曰廉泉。)刺疟者。必
先问其病之所先发者先刺之。先头痛及重者。刺头上(百会上星)及两额(员卢)两眉间(攒竹)
出血。先项背痛者。(刺风池。风府。大杼。神道。)先腰脊痛者。刺 中出血。先手臂痛者
。先刺手少阴(少冲。)阳明(商阳)十指间(各随其所病之经。先足胫酸痛者)刺足阳明。(厉
兑。)十指间出血。(各因其邪居之所。泻其井穴。)风疟者。疟发则汗出恶风。刺三阳经背
俞之血者。(足太阳经膀胱俞。胃俞。胆俞。刺浮络出血。) 酸痛甚。按之不可。(痛益甚
也)名曰附髓病。(其邪深伏故名)以 针针绝骨出血立已。身体小痛。刺至阴诸阴之井无出
血。间日一刺。(邪气微。故刺太阳至阴穴。与诸阴经井穴同法无令出血。但间日一刺之则
邪气目泄矣)疟不渴。间日而作刺足太阳(邪在表也○杂病篇曰取足阳明)渴而间日作刺足少
阳。(邪在表里之间。○杂病篇曰。渴而日作取手阳明。)温疟汗不出。为五十九刺。(先热
后寒。汗不出表实也。故为五十九刺以泻表实。详见热病篇。水热穴论。)
足太阳经的疟疾，使人腰痛、头重，寒气从背部开始，先恶寒后发热，热退时出汗，难以痊愈。（应刺委中穴。）
足少阳经的疟疾，使人身体懈怠无力，恶寒不严重，发热也不严重，厌恶见人，见到人心里就惊恐不安，发热多且出汗多。（应刺侠溪穴。）
足阳明经的疟疾，使人先恶寒战栗，寒冷很严重，很久之后才发热，热退时出汗，喜欢见到日光、月光或火气，见到这些热气症状才能缓解。（应刺冲阳穴。）
足太阴经的疟疾，使人心情不悦，喜欢长叹气，不想吃东西，多有寒热往来且出汗，病发时容易呕吐，吐完后病情才会减轻。（应刺隐白穴、太白穴、公孙穴。）
足少阴经的疟疾，使人呕吐非常严重，寒热往来，热多寒少，想要打开门窗居住。其病虽然看似已解。（适宜刺太溪穴、大钟穴，原文此处未言明刺法，缺文）
足厥阴经的疟疾，使人腰痛，小腹胀满，小便不利像癃闭的样子，但并非真正的癃闭，频繁想小便却感到恐惧，气虚不足，心中郁闷不畅。（应刺太冲穴。）
肺疟，使人内心寒冷，寒冷严重时发热，在冷热交替间容易惊骇，好像看到了什么幻象。（应刺列缺穴、合谷穴。）
心疟，使人心中烦闷严重，想要喝冷水，反而恶寒多而发热轻。（应刺神门穴。）
肝疟，使人面色苍青，喜欢长叹气，神态像要死掉一样。（应刺中封穴。）
脾疟，使人恶寒，腹中疼痛，发热时肠鸣，鸣响后出汗。（应刺商丘穴。）
肾疟，使人洒洒然畏寒，腰脊疼痛，翻身困难，大便艰难，眼睛昏花看不清，手脚冰冷。（应刺金门穴、太溪穴。）
胃疟，使人刚发病时，容易饥饿但不能进食，吃了东西则四肢胀满、腹部膨大。（应刺厉兑穴、解溪穴、足三里穴；注：原文括号内提及“太阴之商丘”，似为笔误或旁注，此处依主流胃疟治法及上下文逻辑，主要指胃经穴位，若严格对应原文括号内容则包含商丘，但通常胃疟刺胃经穴。根据原文“刺厉兑解 三里。太阴之商丘”，此处提取实体时需注意，但翻译时忠实于原文结构。）
疟疾发作时身体正发热，刺足背上的动脉（足阳明经的冲阳穴）。张开孔窍放出血液，寒气立刻消退。疟疾正要发冷时，刺手足阳明经和手太阴经（疟疾将要发作还未发作时，应当跟随这四条经脉的井穴和俞穴进行针刺）。
疟疾病脉象满大而急，刺背部的俞穴，使用中号针，在旁开五寸的俞穴各刺一针，根据患者肥瘦情况放出适量的血（脉满大急是阳邪实证，背部是诸阳之府，所以应当刺魄户、神堂、膈关、魂门等穴。《水热穴论》说五脏俞旁有五穴，用来泻五脏的热，与此大同。这里的“旁五”指胁旁的穴位，靠近胁部，所以叫旁五俞。根据肥瘦出血，是说瘦的人浅刺少出血，胖的人深刺多出血）。
疟疾病脉象小而实急，灸胫部的少阴经穴位，并刺各个井穴（脉小实急是阴邪盛，阴盛则生内寒，所以应当灸足少阴经的复溜穴以散寒，又刺足太阳经的至阴穴以补阳）。
疟疾病脉象缓大而虚，适宜用药治疗，不适宜用针刺。各种疟疾如果脉搏摸不到，刺十个手指尖出血，血流出后病必愈。先观察身上红色如小豆大小的赤络，全部取之（阳气亢盛而脉反伏匿，所以这样刺以泻阳邪）。
十二种疟疾，发作时间各不相同，观察其病症表现，来知道是哪条经脉的病。在发作前，大约一顿饭的时间去针刺。刺一次则病势衰退，刺两次则症状知晓减轻，刺三次则病愈。如果还不愈，刺舌下两条脉络出血（左为金津，右为玉液）。如果还不愈，刺委中穴盛满的经络出血。再刺项部以下夹脊的穴位，必定痊愈（大杼、风门）。舌下的两条脉络，就是廉泉穴（该穴位于舌根下左右泉脉处，所以叫廉泉）。
刺疟疾的方法，必须先询问病人哪里最先发病，就先刺哪里。先是头痛且重的，刺头上（百会、上星）及两侧额角（头维）、两眉之间（攒竹）出血。先是项背痛的，刺风池、风府、大杼、神道。先是腰脊痛的，刺委中出血。先是手臂痛的，先刺手少阴经（少冲）、手阳明经（商阳），以及十个指尖（各随其所病的经脉，如果是足胫酸痛者，刺足阳明经厉兑穴），十个指尖出血（各因其邪气所在之处，泻其井穴）。
风疟，发作时出汗且怕风，刺三阳经背部的俞穴出血（足太阳经的膀胱俞、胃俞、胆俞，刺浮络出血）。
附髓病，酸痛非常严重，按压也不能缓解（痛更加严重）。因为邪气深伏所以得名。用镵针刺绝骨穴出血，立刻痊愈。
身体轻微疼痛，刺至阴穴及诸阴经的井穴，不要出血，每隔一天刺一次（邪气微弱，所以刺太阳经的至阴穴，与诸阴经井穴同法，不让出血，只要每隔一天刺一次，邪气就会逐渐消散）。
疟疾不口渴，每隔一天发作一次的，刺足太阳经（邪气在表。《杂病篇》说取足阳明经）。口渴且每隔一天发作一次的，刺足少阳经（邪气在半表半里。《杂病篇》说口渴且每日发作的取手阳明经）。温疟不出汗的，行五十九刺（先热后寒，不出汗说明表实，所以行五十九刺以泻表实，详见《热病篇》、《水热穴论》）。
(Malaria differs among the Six Channels and the Five Zang organs. Therefore, needling methods vary accordingly.)
Malaria of the Foot-Taiyang Channel causes lower back pain and a heavy head. Coldness starts from the back, with chills preceding fever. Sweating occurs when the fever subsides, making it difficult to cure. (Needle Weizhong [BL60].)
Malaria of the Foot-Shaoyang Channel causes bodily flaccidity and weakness. Chills are not severe, nor is the fever. The patient dislikes seeing people and feels fearful upon contact. There is abundant sweating accompanying high fever. (Needle Xiaxi [GB41].)
Malaria of the Foot-Yangming Channel causes initial shivering and aversion to cold, which becomes severe. After a long time, fever sets in. Sweating occurs as the heat subsides. The patient prefers sunlight, moonlight, or fire; symptoms resolve upon exposure to such warmth. (Needle Chongyang [ST42].)
Malaria of the Foot-Taiyin Channel causes dissatisfaction and frequent sighing. Loss of appetite is present, along with alternating chills and fever and sweating. Upon onset, vomiting occurs; the condition improves after vomiting. (Needle Yinbai [SP1], Taibai [SP3], and Gongsun [SP4].)
Malaria of the Foot-Shaoyin Channel causes severe vomiting. There is alternating chills and fever, with more heat than cold. The patient desires to stay near open windows or doors. Although the illness seems to have abated... (Suitable to needle Taixi [KI3] and Dazhong [KI4]; the original text lacks specific needling instructions here, indicating missing text.)
Malaria of the Foot-Jueyin Channel causes lower back pain and fullness in the lower abdomen. Urination is difficult, resembling strangury but is not true strangury. Frequent urges to urinate accompanied by fear are present. Qi deficiency leads to a feeling of oppression in the abdomen. (Needle Taichong [LR3].)
Lung Malaria causes inner cold. When cold is severe, fever follows. During the interval between cold and heat, the patient is prone to fright and hallucinations. (Needle Lieque [LU7] and Hegu [LI4].)
Heart Malaria causes severe mental restlessness. The patient desires cold water but experiences more chills than fever. (Needle Shenmen [HT7].)
Liver Malaria causes a pale green complexion and frequent sighing. The appearance resembles that of someone dying. (Needle Zhongfeng [LR6].)
Spleen Malaria causes chills and abdominal pain. During fever, intestinal rumbling occurs, followed by sweating. (Needle Shangqiu [SP5].)
Kidney Malaria causes shivering coldness, lower back and spine pain, difficulty turning over, difficult defecation, blurred vision, and cold hands and feet. (Needle Jinmen [BL63] and Taixi [KI3].)
Stomach Malaria causes hunger at the onset of illness, yet the patient cannot eat. Eating leads to limb distension and abdominal enlargement. (Needle Lidui [ST45], Jiexi [ST41], and Zusanli [ST36]. Note: The text mentions "Taiyin's Shangqiu" in parentheses, likely an annotation or error, but standard treatment focuses on Stomach channel points.)
When malaria fever is just rising, needle the arterial pulse on the dorsum of the foot (Chongyang [ST42] of the Foot-Yangming Channel). Open the aperture and release blood; coldness will subside immediately. When malaria chills are about to begin, needle the Hand and Foot Yangming Channels and the Hand Taiyin Channel. (When malaria is about to start but has not yet started, one should needle the Jing-Well and Shu-Stream points of these four channels.)
If the malaria pulse is full, large, and urgent, needle the Back-Shu points on the back. Use a medium-sized needle, inserting one point into each of the five Shu points located laterally. Release blood according to the patient's leanness or robustness. (A full, large, and urgent pulse indicates excess Yang pathogen. The back is the residence of all Yang channels, so one should needle points like Pohu [BL42], Shentang [BL44], Geshu [BL17], Hunmen [BL47], etc. This aligns with the *Shu Re Xue Lun* regarding the five points beside the Zang Shu points to drain Zang heat. "Pang Wu" refers to points near the ribs. Releasing blood according to leanness/robustness means shallow needling and less blood for lean patients, and deep needling with more blood for robust patients.)
If the malaria pulse is small, solid, and urgent, moxa the Shaoyin points on the lower leg and needle the Jing-Well points. (A small, solid, and urgent pulse indicates Yin pathogen excess. Yin excess generates internal cold, so moxa Fuliou [KI7] of the Foot-Shaoyin Channel to disperse cold, and needle Zhiyin [BL67] of the Foot-Taiyang Channel to tonify Yang.)
If the malaria pulse is slow, large, and deficient, medication is suitable, but needling is not. If the pulse is imperceptible in various malaria cases, bleed the tips of the ten fingers; the disease will cease once blood flows. First, identify any red spots like mung beans on the body and treat them all. (Yang hyperactivity causing a hidden pulse requires this method to drain Yang.)
The twelve types of malaria differ in their timing of onset. Observe the symptom patterns to determine which channel is affected. Needle approximately the duration of a meal before the onset. One needle insertion reduces the pathogen; two insertions alleviate symptoms; three insertions cure the disease. If it does not cure, bleed the two vessels under the tongue (Jinjin [EX-HN12] on the left, Yuye [EX-HN13] on the right). If still uncured, bleed the full collaterals at Weizhong [BL60]. Then needle the points below the neck along the spine (Dazhu [BL11], Fengmen [BL12]); this will surely cure. The two vessels under the tongue are Lianquan [CV23] (located below the root of the tongue where the泉 vessels lie).
When treating malaria, first ask where the symptoms began and needle that area first. If headache and heaviness are primary, bleed the top of the head (Baihui [GV20], Shangxing [GV23]) and the temples (Touwei [ST8]) and between the eyebrows (Cuanzhu [BL2]). If neck and back pain are primary, needle Fengchi [GB20], Fengfu [GV16], Dazhu [BL11], and Shendao [GV11]. If lower back and spine pain are primary, bleed Weizhong [BL60]. If arm pain is primary, first needle Hand Shaoyin (Shaochong [HT9]) and Hand Yangming (Shangyang [LI1]), and the ten fingertips (according to the affected channel; if lower leg pain, needle Foot Yangming Lidui [ST45] and bleed fingertips). Drain the Jing-Well points based on the location of the pathogen.
Wind Malaria presents with sweating and aversion to wind during attacks. Bleed the Back-Shu points of the Three Yang Channels (Bladder Shu, Stomach Shu, Gallbladder Shu of the Foot-Taiyang Channel; bleed the superficial collaterals).
Fusui Bing (Marrow Disease) involves severe soreness and pain that worsens with pressure. It is named so because the pathogen is deeply entrenched. Needling Jiexu (Guanggu [GB39]) with a lancet to release blood cures it immediately.
For mild body pain, needle Zhiyin [BL67] and the Jing-Well points of all Yin channels without bleeding. Needle every other day. (The pathogen is weak; thus, needling Zhiyin [BL67] of the Taiyang channel and other Yin Jing-Well points without bleeding, every other day, allows the pathogen to dissipate.)
For malaria without thirst occurring every other day, needle the Foot-Taiyang Channel (Pathogen is in the exterior. The *Za Bing Pian* suggests taking the Foot-Yangming Channel). For malaria with thirst occurring every other day, needle the Foot-Shaoyang Channel (Pathogen is between exterior and interior. The *Za Bing Pian* suggests taking the Hand-Yangming Channel for daily-thirsty malaria). For Warm Malaria without sweating, perform the Fifty-Nine Points needling (Initial heat followed by cold, no sweating indicates exterior excess. Thus, use the fifty-nine points to drain exterior excess; see *Re Bing Pian* and *Shu Re Xue Lun*).