平按∶此篇自篇首至过之则失时，见《素问》卷十第三十六《刺疟篇》，自疟不渴
至末，见《灵枢》卷五第二十六《杂病》篇，又见《素问·刺疟篇》惟文义略有不同，
又见本书二十五卷《十二疟》篇。又自篇首至末，见《甲乙经》卷七第五。
疟病脉满大急，刺背输，用中针，旁五 输各一，适肥瘦，出其血。（满，盛也。
脉大，多气少血也。急，多寒也。疟病寸口脉盛，气多血少而寒，可取背输有疗疟者，
用中针刺输旁五取，及 输两胁下 中之输有疗疟者，左右各一取之。取之适于肥瘦，
出血多少。旁，左右箱也。平按∶《素问》、《甲乙》疟下无病字，输作俞。五《素问》
作伍。）疟脉小而实急，灸胫少阴，刺指井。（脉小者，血气皆少。疟病诊得寸口之脉
血气皆少而实而多寒，可灸足少阴疗疟之输，并指有疗疟之井也。平按∶《素问》、
《甲乙》无而字。）疟脉满大急，刺背输，用第五针， 输各一，适行至于血也。（第
五针，以取大脓，今用刺疟背输，可适行至血出而已也。平按∶用第五针 输各一
《素问》作用五 俞背俞各一。《甲乙经》无此条，《素问》新校正云∶“经文与次前
经文重复，王氏随而注之，别无义例，不若士安之精审，不复出也。”）疟脉缓大虚，
便用药所宜，不宜用针。（脉缓
者，多热。疟病诊寸口脉得多热多气少血虚者，可用药。用药者，取所宜之药以补也。
平按∶便用药所宜《素问》作便宜用药。）凡治疟者，先发如食顷，乃前可以治，过之
则失时。（此疗疟时节也。平按∶《素问》、《甲乙》无前字。）疟不渴，间日而作，
取足阳明；渴而日作，取手阳明。（疟不渴取足阳明，渴取手阳明，皆取所主输。平按∶
疟不渴间日而作取足阳明《素问》作刺足太阳，本书《十二疟》篇同。新校正云∶“按
《九卷》云∶”足阳明。《太素》同。“检今本《灵枢》亦云取足阳明，是不渴间日而
作之疟，可取足太阳、阳明二处。故《十二疟》杨注谓治寒疟，本篇谓取所主输也。）
平按：本篇从篇首到“过之则失时”，见于《素问》卷十第三十六《刺疟篇》；从“疟不渴”至末尾，见于《灵枢》卷五第二十六《杂病》篇，又见于《素问·刺疟篇》，只是文义略有不同；又见于本书第二十五卷《十二疟》篇。另外从篇首到末尾，见于《甲乙经》卷七第五。
疟病的脉象表现为满、大、急，应针刺背部的输穴（背部俞穴），使用中针，在旁开五处的输穴各取一针，根据患者肥瘦情况调整，放出血液。（注：满，指脉气盛实。脉大，指多气少血。急，指多寒。疟病寸口脉盛实，说明气多血少且伴有寒邪，可以选取背部有治疗疟疾作用的输穴，用中针刺入输穴旁侧的五处穴位，以及胁下中间的输穴中有治疗疟疾作用的穴位，左右各取一针。取穴多少应根据患者肥瘦而定，出血量也需适宜。旁，指左右两侧。）
疟病的脉象小而实急，应灸小腿足少阴肾经的穴位，并针刺手指的井穴。（注：脉小，说明气血皆少。疟病诊得寸口脉气血皆少而实且多寒，可灸足少阴经治疗疟疾的输穴，并针刺手指上治疗疟疾的井穴。）
疟病的脉象满、大、急，应针刺背部的输穴，使用第五种针具（锋针），输穴各取一针，操作时使血液流出即可。（注：第五种针具，用于排出大脓，现在用来刺治疟疾背部输穴，只需操作至出血即可。平按：用第五针输穴各一，《素问》作“用五俞背俞各一”。《甲乙经》无此条，《素问》新校正云：“经文与前文重复，王冰随文加注，并无新意，不如杨上善的精审，故不再重复。”）
疟病的脉象缓、大、虚，便适合用药治疗，不宜用针刺。（注：脉缓，说明多热。疟病诊得寸口脉多热、多气、少血且虚者，可用药治疗。所谓用药，是选取适宜的补益药物。平按：便用药所宜，《素问》作“便宜用药”。）
凡是治疗疟疾，应在发作前大约一顿饭的时间进行针刺，这样可以治愈，错过这个时机就会失去最佳治疗时间。（注：这是治疗疟疾的时节要求。平按：《素问》、《甲乙经》无“前”字。）
疟疾不口渴，每隔一天发作一次，取足阳明胃经的穴位；口渴且每天发作，取手阳明大肠经的穴位。（注：疟疾不渴取足阳明经，口渴取手阳明经，都是取该经所主的输穴。平按：疟不渴间日而作取足阳明，《素问》作“刺足太阳”，本书《十二疟》篇相同。新校正云：“按《九卷》云：‘足阳明’，《太素》同。‘检查今本《灵枢》也说是取足阳明，这说明不渴间日而作的疟疾，可以取足太阳、阳明两处。所以《十二疟》杨注谓治寒疟，本篇谓取所主输穴也。’）
Ping An: This section from the beginning of the chapter to "if missed, the time is lost" can be found in *Suwen* (Treatise on Questions), Volume 10, Chapter 36, "Needling Malaria"; from "Malaria without thirst" to the end, it appears in *Lingshu* (Spiritual Pivot), Volume 5, Chapter 26, "Miscellaneous Diseases"; it also appears in *Suwen · Needling Malaria*, with slight differences in meaning; and it is also found in Volume 25, "Twelve Types of Malaria," of this book. Additionally, from the beginning to the end of the chapter, it is recorded in *Jia Yi Jing* (The Classic of A-Bian Acupuncture and Moxibustion), Volume 7, Section 5.
If the pulse in malaria presents as full, large, and rapid, needle the Shu points on the back, using a medium-sized needle. Select one point at each of the five locations adjacent to the Shu points, adjusting according to the patient's fatness or thinness, and allow blood to flow. (Note: Full indicates excess pulse qi. Large indicates abundant Qi and deficient Blood. Rapid indicates excess Cold. In malaria, an excess pulse at the Cun Kou position indicates abundant Qi, deficient Blood, and the presence of Cold. One may select Back Shu points effective for treating malaria, using a medium needle to puncture five points adjacent to the Shu points, as well as the Shu points located in the middle of the hypochondrium that are effective for treating malaria, taking one point on each side. The number of points taken should be adjusted based on the patient's body constitution, and the amount of bleeding should be appropriate. 'Adjacent' refers to the left and right sides.)
If the pulse in malaria is small, solid, and rapid, moxa the points on the lower leg belonging to the Foot Shaoyin Kidney Meridian, and needle the Jing-Well points on the fingers. (Note: A small pulse indicates deficiency of both Qi and Blood. If the pulse at the Cun Kou position in malaria shows deficiency of both Qi and Blood yet feels solid and indicates excess Cold, one may moxa the Shu points of the Foot Shaoyin meridian effective for treating malaria, and needle the Jing-Well points on the fingers effective for treating malaria.)
If the pulse in malaria is full, large, and rapid, needle the Shu points on the back, using the fifth type of needle (Feng Zhen/Sharp Needle). Select one point at each Shu location, operating until blood flows. (Note: The fifth type of needle is used to drain large amounts of pus; when used here to needle the Back Shu points for malaria, operation should cease once blood flows. Ping An: 'Use the fifth needle, one point at each Shu,' *Suwen* reads 'Use five Shu points, one at each Back Shu.' *Jia Yi Jing* does not contain this passage. The New Correction of *Suwen* states: 'This text repeats the previous passage. Wang Bing added notes following the text but offered no new insights, unlike Yang Shangshan's rigorous scholarship, so it was omitted.')
If the pulse in malaria is slow, large, and deficient, medication is suitable, and needling is not recommended. (Note: A slow pulse indicates excess Heat. If the pulse at the Cun Kou position in malaria shows excess Heat, abundant Qi, deficient Blood, and deficiency, medication can be used. Using medication means selecting appropriate tonifying herbs. Ping An: 'Medication is suitable,' *Suwen* reads 'Conveniently use medication.')
In all cases of treating malaria, needling should be performed approximately the time it takes to eat a meal before the onset of symptoms; this allows for a cure. If this timing is missed, the optimal treatment window is lost. (Note: This describes the proper timing for treating malaria. Ping An: *Suwen* and *Jia Yi Jing* do not contain the character 'before'.)
If malaria presents without thirst and occurs every other day, select points from the Foot Yangming Stomach Meridian; if accompanied by thirst and occurring daily, select points from the Hand Yangming Large Intestine Meridian. (Note: For malaria without thirst, select the Foot Yangming meridian; for malaria with thirst, select the Hand Yangming meridian. In both cases, select the Shu points governed by these meridians. Ping An: 'Malaria without thirst, occurring every other day, select Foot Yangming,' *Suwen* reads 'Needle Foot Taiyang,' which is consistent with the 'Twelve Types of Malaria' chapter of this book. The New Correction states: 'According to *Jiu Juan*: "Foot Yangming." *Tai Su* agrees. "Checking the current version of *Lingshu*, it also says select Foot Yangming. This indicates that for malaria without thirst occurring every other day, points from both the Foot Taiyang and Foot Yangming meridians can be selected. Thus, Yang's annotation in 'Twelve Types of Malaria' refers to treating cold malaria, while this chapter refers to selecting the governing Shu points.")