平按∶此篇自足太阳疟至末，见《素问》卷十第三十六《刺疟》篇。篇首疟而不渴
至为五十九刺，《素问·
刺疟》篇编次在后。又自篇首至末，见《甲乙经》卷七第五，又见《巢氏病源》卷十一
《疟病诸候》，惟编次小异。
黄帝曰∶疟而不渴，间日而作，奈何？岐伯曰∶疟而不渴，间日而作，刺足太阳；
渴而间日作，刺足少阳。温疟者，汗不出，为五十九刺。（足太阳在阴主水，故不渴间
日发也。足少阳在阳，故渴而间日作也。此二皆寒疟也。温疟，伤寒所为，故汗不出，
以五十九刺也。平按∶自黄帝曰疟而不渴至岐伯曰，《素问》、《甲乙》无此十六字。
刺足太阳，《甲乙经》云∶“《九卷》曰取足阳明，《素问》刺太阴。”今本《素问》
作刺足太阳，新校正云∶“《九卷》云∶刺足阳明。《太素》同。”刺足少阳，《甲乙经》
云∶“《九卷》曰取手少阳，《素问》刺足少阳。”今本《素问》作刺足少阳，新校正
云∶“《九卷》云∶刺手少阳。《太素》同。”据新校正所引，则《太素》与《九卷》
同，与《素问》异。今本书云刺足太阳，刺足少阳，与《九卷》异，与《素问》同。又
检今本《灵枢·杂病》篇云∶“疟不渴，间日而作，取足阳明；渴而日作，取手阳明。”
再检本书卷三十《刺疟节度》篇，与《灵枢》同，与《甲乙》、《素问》新校正所引
亦不尽同，与本篇所云刺太阳刺足少阳亦异。细玩杨注本篇云此二皆寒疟，《刺疟节度》
篇云取所主输，故不尽同也。）足太阳疟，令人腰痛头重，寒从背起，先寒后热渴，渴
止汗出，难已，日刺 中出血。（足太阳脉从头下背下腰，邪客之故寒从背起。《明堂》
足太阳合委中，疗经疟，状与此同也。平按∶“渴，渴止汗出”《素问》作“
然，热止汗出”，新校正云∶“全元起本、《甲乙经》、《太素》、巢元方并作先寒后
热渴，渴止汗出。”与本书合。日刺 中，《素问》、巢氏无日字，《甲乙》作“间日
作，刺 中”。）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，汗出甚，
刺足少阳。（足少阳脉羁终身之支节，故此脉病身体解 。足少阳与厥阴合，故寒热俱
不甚，恶见人也。若热多，即汗出甚也，可取足少阳风池、丘墟等穴也。平按∶解
巢氏作解倦。《甲乙》无“热不甚”三字。汗字《素问》、《甲乙》、巢氏均不重，
疑衍。）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，刺阳明跗上。（足阳明两阳合明，故汗出，喜见日月光明，见之快心也。足跗上，
足阳明脉行也。平按∶洒巢氏作 ，日下无月字。《素问》刺下有足字。《甲乙》跗上
下有“及调冲阳”四字。巢氏作刺足阳明脚肤上。）足太阴疟，令人不乐，好太息，不
嗜食，多寒热汗出，病至则喜欧，欧已乃衰，即取之。（足太阴脉从胃别上膈，注心中，
故疟令人不乐，好太息也。脾胃主食，故脾脉病不嗜食。其脉入腹属脾络胃，上膈挟咽，
故病将极喜欧。欧已乃衰时，即宜取之也。平按∶《甲乙》多寒热作多寒少热。欧《素问》、
《甲乙》、巢氏并作呕。取之下《甲乙》有足太阴三字。）足少阴疟，令人吐欧，甚多
寒热，热多寒少，欲闭户而处，其病难已。（足少阴脉贯肝膈入肺中，从肺出络心，注
胸中，故足少阴疟，令人吐欧，甚则寒热俱多于余经疟。其足少阴为阳乘之，故热多寒
少。以其肾阴脉伤，故欲闭户而处，病难已也。平按∶《甲乙》作呕吐甚多寒少热，巢
氏作久寒热。难已下《甲乙》有取太溪三字。）足厥阴疟，令人腰痛，少腹满，小便不
利，如癃状，非癃已，数小便，意恐惧，气不足，肠中邑邑，刺足厥阴。（足厥阴脉
环阴器抵少腹，故腰痛少腹满小便不利如癃。癃，淋也，小便不利如淋也。其脉属肝络
胆，胆为足厥阴府，故胆伤，恐惧气不足，肠中邑邑也。可刺足厥阴五输、中封等穴
也。平按∶非癃已《素问》、《甲乙》作非癃也，巢氏作非癃状也。数小便意《素问》
作数便意，新校正云∶“《甲
乙》数便意三字，作数噫二字。”邑邑《素问》、《甲乙》、巢氏并作悒悒。）肺疟者，
令人心寒，寒甚热间，喜惊如有见者，刺手太阴、阳明。（以上言经病为疟，以下言脏
病疟。肺以逼心，故肺病，心寒喜惊，妄有所见。宜取肺之脏腑表里之脉也。平按∶喜
惊如有见者《素问》、《甲乙》作善惊如有所见者，巢氏作如是有见者。）心疟者，令
人烦心，甚欲得清水及寒多，寒不甚，热甚，刺手少阴。（心中烦热，故欲得冷水及欲
得寒。以其是阳，得寒发热，故使得寒多也，其寒不甚，其热甚也。心经手少阴受病，
遂令心烦，非心受病。人心有神，不可多受邪气，非脉不受邪也，故令烦心。疗在手少
阴少海之穴也。平按∶及寒多寒不甚热甚《素问》作反寒多不甚热六字，新校正云∶“《太
素》云∶欲得清水及寒多，寒不甚，热甚。”与此同。《甲乙》作“寒多不甚热”，巢
氏作“乃寒多，寒不甚热”。）肝疟，令人色仓仓然，太息，其状若死者，刺足厥阴见
血。（肝疟病甚则正色见，故仓仓然也。仓，青也。病甚气奔，故太息出之。可取肝之
经络，见血得愈也。平按∶仓仓《素问》、《甲乙》、巢氏均作苍苍。《甲乙》无太息
二字。）脾疟，令人疾寒，腹中痛，热则肠中鸣，已汗出，刺足太阴。（脾脉足太阴脉
属脾络胃连肠，以谷气盛，故寒疾腹痛肠鸣。可取脾之经脉大都、公孙、商丘等穴也。
平按∶《素问》无疾字，《甲乙》作病字。）肾疟，令人洒洒，腰脊痛宛转，大便难，
目询询然，手足寒，刺足太阳、少阴。（询，请也，谓有询请，举目求之。询询，举目
视专也。洒音洗，谓恶寒也。肾脉贯脊属肾络膀胱，故腰脊痛宛转，大便难也。其脉从
肾上贯肝膈，肝脉入目，故询询然。又或为眩，肾腑膀胱足太阳脉起目内 ，故令目眩
也。足少阴太阳上连手之少阴太阳，故手足寒也。取此肾之脏腑二脉也。平按∶洒洒下
《素问》有然字，《甲乙》作 然。目询询然《素问》、
《甲乙》作目 然，巢氏作目眩 然。）胃疟，令人疸病也，喜饥而不能食，食
而支满腹大，刺足阳明、太阴横脉出血。（疸音旦，内热病也。胃受饮食，饮食非理，
致有寒热，故胃有疟也。胃脉足阳明属胃络脾，故胃中热，喜饥不能食，腹 满也。足
阳明大络，即大横脉也。平按∶疸病《素问》、《甲乙》、巢氏均作且病，新校正云∶
“《太素》且病作疸病。”《素问》喜作善，《甲乙》作寒善。）疟以发，身方热，刺
跗上动脉，开其空立寒。（以前诸疟中，温疟将欲热时，可刺足跗上动脉。动脉即冲脉，
为五脏六腑之海，故刺之以疗十二疟也。开空者，摇大其穴，热去立寒也。或寒衰方热
也。平按∶空下《素问》有出其血三字，《甲乙》有出血二字。）疟方欲寒，刺手阳明、
太阴，足阳明、太阴。（以前诸疟之中，寒疟可刺手足阳明太阴。手阳明脉商阳、三间、
合谷、阳溪、偏历、温溜、五里等，足阳明神庭、开明、天枢、解溪、冲阳、陷谷、厉
兑等，手太阴列缺、太泉、少商，足太阴大都、公孙、商丘等穴。或热衰方寒也。平按∶
诸疟上《素问》有疟脉满大至则失时也八十九字，本书在第三十卷《刺疟节度》篇，新
校正云∶“详自疟脉满大至则失时也，全元起本在第四卷中，王氏移续于此。”本书无
此八十九字，则《素问》为王氏所移益信。）诸疟而脉不见者，刺十指间见血，血去必
已，先视身之热赤如小豆者尽取之。（十二种疟各有络脉见者，根据刺去之。若络不见，
足阴阳脉，刺足十趾间，手阴阳脉不见，刺手十指间，皆出血必已。又诸疟将衰，身上
有如赤小豆结起者，皆刺去之也。平按∶《甲乙》而脉不见，而作如。赤上《素问》、
《甲乙》无热字。）十二疟者，其发各不同时，察其病形，以知其何脉之病也。先其病
发时，如食项而刺之，（此言通疗十二种疟，并于疟未发先一食之顷，刺之必已。）一刺
则衰，二刺则知，三刺则已；（一刺病衰，病患未觉有
愈；二刺知愈，其病未尽；三刺病气都尽也。）不已，刺舌下两脉出血；不已，刺
中盛经出血；有刺项以下夹脊者，必已。舌下两脉者，廉泉也。（如前刺之不已，可变
法刺，凡有三刺∶一刺舌下足少阴脉、任脉廉泉之穴；二刺 内委中，检无 中，或可
刺于 内 穴委中之中，足太阳盛经出血；三刺项下夹脊足太阳大杼、 等穴。平按∶
《素问》、《甲乙》有刺项以下作又刺项已下。注 内 穴，内字袁刻作中。）刺疟者，
必先问其病之所先发者，先刺之。（先问者，问其疟发之先，欲疗其始，问而知之也。
平按∶必先问，先字袁刻脱。）头先痛及重，先刺头上，（先取督脉神庭、上星、囟会、
百会等穴。）及两颌两眉间出血。（两颌眉间取络出血。平按∶两颌《素问》、《甲乙》
均作两额。）先项背痛者，先刺之。（先起项及背者，先刺项及背疗疟之处也。）先腰
脊痛者，刺 中出血。（刺委中之 也。）先手臂痛者，先刺阴阳十指间。（手表里阴
阳之脉，十指之间也。平按∶《素问》《甲乙》阴阳十指间作手少阴阳明十指间，新校
正云∶“别本作手阴阳，全本亦作手阴阳。”）先足 痛者，先刺足阳明十趾间出血。
（足阳明为三阳之长，故刺足十趾间出血，皆称足阳明也。平按∶《素问》、《甲乙》
作胫。）风疟之发，则汗出恶风，刺三阳经背输之血。（此风疟状也。风疟候手足三
阳经之背输，有疟于穴处取之。平按∶之发《素问》作疟发。《甲乙》三阳上有足字。）
痛甚，按之不可，名曰 髓，以 ， 绝骨出其血，立已。身体小痛，刺之诸阴之
井，毋出血，间日一刺。（人足 痛，按之不可，名曰 髓之病。可以 ， 出血也。
五脏诸阴之井起于木，宜取勿出血也。有本髓为体。平按∶ 髓下《素问》有病字，
《甲乙》作肘髓病。以 绝骨《素问》、《甲乙》作以 针针绝骨。《素问》刺之，
之字作至阴二字。）
【平按】：本篇从足太阳疟到末尾的内容，见于《素问》卷十第三十六篇《刺疟》。篇首“疟而不渴”至“为五十九刺”的内容，《素问·刺疟》篇将其编排在后面。另外，从篇首到末尾的内容，也见于《甲乙经》卷七第五篇，以及《巢氏病源》卷十一《疟病诸候》，只是编排次序略有不同。
黄帝说：患疟疾但不口渴，每隔一天发作一次，该怎么办？岐伯说：患疟疾但不口渴，每隔一天发作一次的，针刺足太阳经；口渴且每隔一天发作一次的，针刺足少阳经。温疟患者，不出汗的，用五十九刺法治疗。（足太阳经在阴分主水，所以不渴且隔日发作。足少阳经在阳分，所以口渴且隔日发作。这两种都是寒疟。温疟是由伤寒引起的，所以不出汗，应用五十九刺法。【平按】：从“黄帝曰疟而不渴”到“岐伯曰”，《素问》、《甲乙经》没有这十六个字。关于“刺足太阳”，《甲乙经》说：“《九卷》说取足阳明经，《素问》刺手太阴经。”现在通行的《素问》版本作“刺足太阳经”，林亿等《新校正》说：“《九卷》说：刺足阳明经。《太素》与此相同。”关于“刺足少阳”，《甲乙经》说：“《九卷》说取手少阳经，《素问》刺足少阳经。”现在通行的《素问》版本作“刺足少阳经”，《新校正》说：“《九卷》说：刺手少阳经。《太素》与此相同。”根据《新校正》所引用的内容，则《太素》与《九卷》相同，与《素问》不同。现在本书（指《太素》）说刺足太阳经、刺足少阳经，与《九卷》不同，与《素问》相同。又查考现在本《灵枢·杂病》篇说：“疟疾不渴，隔日发作，取足阳明经；口渴且每日发作，取手阳明经。”再查考本书卷三十《刺疟节度》篇，与《灵枢》相同，与《甲乙经》、《素问》《新校正》所引也不完全相同，与本篇所说的刺足太阳、刺足少阳也不同。仔细研读杨上善注本篇说“这两种都是寒疟”，而《刺疟节度》篇说“取所主的输穴”，所以不完全相同。）
足太阳疟，使人腰痛头重，寒气从背部升起，先恶寒后发热且口渴，口渴停止后出汗，难以治愈，应每日针刺委中穴出血。（足太阳经脉从头下行至背下至腰，邪气客居于此，所以寒气从背部升起。《明堂经》中足太阳经合穴委中，治疗经疟，症状与此相同。【平按】：“渴，渴止汗出”，《素问》作“然，热止汗出”，《新校正》说：“全元起本、《甲乙经》、《太素》、巢元方都作‘先寒后热渴，渴止汗出’。”与本书相合。“日刺委中”，《素问》、巢氏无“日”字，《甲乙经》作“间日作，刺委中”。）
足少阳疟，使人身体懈怠松弛，恶寒不严重，发热也不严重，厌恶见人，见到人就心中惊恐不安，发热多且出汗多，应针刺足少阳经。（足少阳经脉维系全身关节，所以此脉生病时身体懈怠松弛。足少阳与足厥阴相表里，所以寒热都不严重，厌恶见人。如果发热多，就是出汗很多，可以取足少阳经的风池、丘墟等穴位。【平按】：“解”，巢氏作“解倦”。《甲乙经》无“热不甚”三字。“汗”字，《素问》、《甲乙经》、巢氏均不重复，怀疑是衍文。）
足阳明疟，使人先恶寒，瑟瑟发抖，寒冷持续很久才发热，热退后出汗，喜欢见到日光月光或火气，感到舒适，应针刺足阳明经足背上的动脉。（足阳明经名为两阳合明，所以出汗，喜欢见到日月光明，见到后心里畅快。足背上，是足阳明经脉运行的部位。【平按】：“洒”，巢氏作“洒淅”的另一种写法，日字下无月字。《素问》“刺”字下有“足”字。《甲乙经》“跗上”二字下有“及调冲阳”四字。巢氏作“刺足阳明脚肤上”。）
足太阴疟，使人心情不乐，喜欢长叹气，不想吃东西，寒热往来且出汗，病发时喜欢呕吐，吐完病情就减轻，此时就取穴治疗。（足太阴经脉从胃别出上行穿过膈肌，注入心中，所以疟疾使人心情不乐，喜欢长叹气。脾胃主管饮食，所以脾脉生病时不想吃东西。其经脉入腹属脾络胃，上行穿过膈肌夹咽，所以病将发作时喜欢呕吐。吐完后病情减轻时，就应当取穴治疗。【平按】：《甲乙经》“多寒热”作“多寒少热”。“欧”字，《素问》、《甲乙经》、巢氏都作“呕”。“取之”下《甲乙经》有“足太阴”三字。）
足少阴疟，使人呕吐，寒热非常严重，发热多而恶寒少，想关上门独处，这种病难以治愈。（足少阴经脉贯穿肝脏和膈肌进入肺部，从肺出来联络心脏，注入胸中，所以足少阴疟疾使人呕吐，严重时寒热都比其他经的疟疾更重。足少阴被阳邪乘袭，所以发热多而恶寒少。因为肾阴脉受伤，所以想关上门独处，病难治愈。【平按】：《甲乙经》作“呕吐甚多寒少热”，巢氏作“久寒热”。“难已”下《甲乙经》有“取太溪”三字。）
足厥阴疟，使人腰痛，小腹胀满，小便不利，像淋病的样子但不是淋病，频繁小便，内心恐惧，气虚，肠中郁闷不快，应针刺足厥阴经。（足厥阴经脉环绕生殖器抵达小腹，所以腰痛、小腹胀满、小便不利像淋病。癃，即淋证，小便不利像淋病一样。其经脉属肝络胆，胆是足厥阴的腑，所以胆受伤，出现恐惧、气不足、肠中郁闷的症状。可针刺足厥阴经的五输穴、中封等穴位。【平按】：“非癃已”，《素问》、《甲乙经》作“非癃也”，巢氏作“非癃状也”。“数小便意”，《素问》作“数便意”，《新校正》说：“《甲乙经》‘数便意’三字，有的版本作‘数噫’二字。”“邑邑”，《素问》、《甲乙经》、巢氏都作“悒悒”。）
肺疟，使人心中寒冷，寒冷严重时间歇性发热，喜欢惊吓，好像看到了什么奇怪的东西，应针刺手太阴经、手阳明经。（以上说的是经络生病引起的疟疾，以下说的是脏腑生病引起的疟疾。肺靠近心，所以肺病时，心寒且喜欢惊吓，妄见异物。应该取肺及其表里脏腑的经脉。【平按】：“喜惊如有见者”，《素问》、《甲乙经》作“善惊如有所见者”，巢氏作“如是有见者”。）
心疟，使人心中烦热，很想喝冷水且恶寒多，但恶寒不严重，发热很严重，应针刺手少阴经。（心中烦热，所以想喝冷水且想接触寒凉之物。因为这是阳热之病，得到寒凉则发热，所以能耐受较多的寒凉，因此恶寒不严重，发热很严重。手少阴心经受病，导致心烦，并非心脏本体受病。人心有神志主宰，不能承受过多邪气，并非经脉不受邪，所以导致心烦。治疗应取手少阴经的少海穴。【平按】：“及寒多寒不甚热甚”，《素问》作“反寒多不甚热”六字，《新校正》说：“《太素》云：欲得清水及寒多，寒不甚，热甚。”与此相同。《甲乙经》作“寒多不甚热”，巢氏作“乃寒多，寒不甚热”。）
肝疟，使人面色苍青色，长叹气，样子像死了一样，应针刺足厥阴经使其出血。（肝疟病重时正气外露，所以面色苍白青色。仓，即青色。病重气机奔迫，所以长叹气以宣泄。可取肝之经络，见血即可痊愈。【平按】：“仓仓”，《素问》、《甲乙经》、巢氏都作“苍苍”。《甲乙经》无“太息”二字。）
脾疟，使人突然发冷，腹中疼痛，发热时肠中鸣响，出汗后，应针刺足太阴经。（脾脉足太阴经脉属脾络胃连肠，因为谷气旺盛，所以突然发冷腹痛、肠鸣。可取脾经的大都、公孙、商丘等穴位。【平按】：《素问》无“疾”字，《甲乙经》作“病”字。）
肾疟，使人瑟瑟发抖，腰脊疼痛且转动困难，大便困难，眼睛昏花看不清，手足寒冷，应针刺足太阳经、足少阴经。（询，通“瞋”，意为睁大眼睛，谓有询问之意，举目寻求。询询，举目注视的样子。洒音洗，意为恶寒。肾脉贯穿脊柱属肾络膀胱，所以腰脊疼痛且转动困难，大便困难。其脉从肾上行贯穿肝膈，肝脉入目，所以眼睛昏花。或者表现为眩晕，肾的腑膀胱足太阳经脉起于目内眦，所以令目眩。足少阴、足太阳上行连接手少阴、手太阳，所以手足寒冷。取这两条肾的表里经脉。【平按】：“洒洒”下《素问》有“然”字，《甲乙经》作“洒然”。“目询询然”，《素问》、《甲乙经》作“目瞤然”，巢氏作“目眩瞤然”。）
胃疟，使人患疸病，容易饥饿但不能进食，吃了东西就感觉支撑胀满、腹部大，应针刺足阳明经、足太阴经的横脉出血。（疸音旦，是内热病。胃接受饮食，如果饮食不当，导致寒热失调，所以胃有疟疾。胃脉足阳明经属胃络脾，所以胃中热，容易饥饿但不能进食，腹部胀满。足阳明经的大络，就是大横脉。【平按】：“疸病”，《素问》、《甲乙经》、巢氏都作“且病”，《新校正》说：“《太素》‘且病’作‘疸病’。”《素问》“喜”作“善”，《甲乙经》作“寒善”。）
疟疾将要发作时，身体正发热，刺足背上的动脉，开放其孔穴，寒气立止。（以前各种疟疾中，温疟将要发热时，可刺足背上的动脉。动脉即冲脉，是五脏六腑气血汇聚之处，所以刺它来治疗十二种疟疾。开空，即摇大其针孔，热气去除，寒气立刻停止。或者是寒气衰退后才发热。【平按】：“空”下《素问》有“出其血”三字，《甲乙经》有“出血”二字。）
疟疾正要发冷时，刺手阳明经、手太阴经，足阳明经、足太阴经。（以前各种疟疾中，寒疟可刺手足阳明、太阴经。手阳明经有商阳、三间、合谷、阳溪、偏历、温溜、五里等穴，足阳明经有神庭、开明、天枢、解溪、冲阳、陷谷、厉兑等穴，手太阴经有列缺、太渊、少商，足太阴经有大都、公孙、商丘等穴位。或者是热衰退后才发冷。【平按】：“诸疟”上《素问》有“疟脉满大至则失时也”八十九字，本书在第三十卷《刺疟节度》篇，《新校正》说：“详自‘疟脉满大’至‘则失时也’，全元起本在第四卷中，王氏移续于此。”本书没有这八十九字，则《素问》为王氏所移动增补确凿无疑。）
各种疟疾如果脉搏看不见，刺十个手指之间使其出血，血去病必愈，先观察身上有像赤小豆大小的红点，全部刺破。（十二种疟疾各有络脉显现的，根据情况刺破去除。如果络脉不明显，足阴阳经脉，刺足十趾间，手阴阳经脉不明显，刺手十指间，都要出血才能痊愈。另外各种疟疾将要衰退时，身上如果有像赤小豆一样的结起物，都要刺破去除。【平按】：《甲乙经》“而脉不见”，“而”作“如”。“赤”上《素问》、《甲乙经》无“热”字。）
十二种疟疾，它们的发作时间各不相同，观察其病症表现，从而知道是哪条经脉生病。在发病前，大约一顿饭的时间里进行针刺，（这说的是通用治疗十二种疟疾的方法，都在疟疾未发前一食顷的时间针刺，病必愈。）针刺一次病势衰减，针刺两次病知好转，针刺三次病愈；（针刺一次病势衰减，病人尚未察觉痊愈；针刺两次知道要痊愈，但病未尽除；针刺三次病气完全清除。）如果还没好，刺舌下两条脉络出血；如果还没好，刺委中盛满的经脉出血；有针刺项部以下夹脊穴的，病必愈。舌下两条脉络，是廉泉穴。（如果像前面那样针刺还没好，可以变法针刺，共有三种刺法：一刺舌下足少阴脉、任脉廉泉穴；二刺委中穴内，检查无承山穴，或许可刺于承山穴内的委中之中，足太阳盛经出血；三刺项下夹脊足太阳大杼、附分等穴。【平按】：《素问》、《甲乙经》有“刺项以下”作“又刺项已下”。注“承山”穴，“内”字袁刻本作“中”。）
刺疟疾的人，必须先询问其病最先发作的部位，先刺那个部位。（先询问，是询问疟疾发作之前的情况，想要治疗其起始原因，通过询问来了解病情。【平按】：“必先问”，“先”字袁刻本脱漏。）
头痛在先且伴有沉重感，先刺头上穴位，（先取督脉的神庭、上星、囟会、百会等穴位。）以及两颊和两眉间出血。（在两颊和眉间取络脉出血。【平按】：“两颌”，《素问》、《甲乙经》都作“两额”。）
先项背痛的，先刺项背部穴位。（先从项部和背部开始起的，先刺项部和背部治疗疟疾的部位。）
先手臂痛的，先刺手阴阳经十指间穴位。（手部的表里阴阳经脉，位于十指之间。【平按】：《素问》《甲乙经》“阴阳十指间”作“手少阴阳明十指间”，《新校正》说：“别本作手阴阳，全本也作手阴阳。”）
先足胫痛的，先刺足阳明经十趾间出血。（足阳明经是三阳经之长，所以刺足十趾间出血，都称为足阳明经。【平按】：《素问》、《甲乙经》作“胫”。）
风疟发作时，则出汗且恶风，刺三阳经背部的腧穴出血。（这是风疟的症状。风疟候察手足三阳经背部的腧穴，有疟疾时在相应穴位取之。【平按】：“之发”，《素问》作“疟发”。《甲乙经》“三阳”上有“足”字。）
疼痛剧烈，按压不可忍受，名叫髓病，用铍针刺绝骨穴放出血液，疼痛立即停止。身体轻微疼痛，刺各阴经的井穴，不要出血，隔天针刺一次。（人足部疼痛，按压不可忍受，名叫髓病的症状。可以用铍针放血。五脏各阴经的井穴起于木，适宜取用但不要出血。有的版本“髓”作“体”。【平按】：“髓”下《素问》有“病”字，《甲乙经》作“肘髓病”。“以铍绝骨”，《素问》、《甲乙经》作“以铍针针绝骨”。《素问》“刺之”，“之”字作“至阴”二字。）
[Ping An]: The content of this chapter, from "Foot Taiyang Malaria" to the end, is found in Volume 10, Chapter 36 of *Suwen* (Plain Questions), titled "Needling Malaria". The content from the beginning of the chapter "Malaria without thirst" to "fifty-nine needles", is arranged later in the *Suwen · Needling Malaria* chapter. Additionally, the content from the beginning to the end of the chapter is also found in Volume 7, Chapter 5 of *Jiayi Jing* (Systematic Classic of Acupuncture and Moxibustion), and in Volume 11 of Chao Yuanfang's *Chaoshi Bingyuan* (Source of Diseases and Symptoms) under "Various Syndromes of Malaria", with only slight differences in arrangement.
Yellow Emperor said: In cases of malaria without thirst, occurring every other day, what should be done? Qibo replied: For malaria without thirst, occurring every other day, needle the Foot-Taiyang channel; for those with thirst occurring every other day, needle the Foot-Shaoyang channel. In Warm Malaria, where there is no sweating, use the fifty-nine needle method. (Foot-Taiyang belongs to Yin and governs Water, hence no thirst and alternating-day onset. Foot-Shaoyang belongs to Yang, hence thirst and alternating-day onset. Both of these are Cold Malaria. Warm Malaria is caused by Cold Damage, hence no sweating, treated with the fifty-nine needles. [Ping An]: From "Yellow Emperor said: Malaria without thirst" to "Qibo said", these sixteen characters are absent in *Suwen* and *Jiayi Jing*. Regarding "needle Foot-Taiyang", *Jiayi Jing* states: "'Jiujuan' says take Foot-Yangming; *Suwen* needles Hand-Taiyin." The current version of *Suwen* reads "needle Foot-Taiyang". Lin Yi et al.'s *Xinzhengjiao* notes: "'Jiujuan' says: needle Foot-Yangming. *Taisu* agrees." Regarding "needle Foot-Shaoyang", *Jiayi Jing* states: "'Jiujuan' says take Hand-Shaoyang; *Suwen* needles Foot-Shaoyang." The current version of *Suwen* reads "needle Foot-Shaoyang". *Xinzhengjiao* notes: "'Jiujuan' says: needle Hand-Shaoyang. *Taisu* agrees." Based on the citations in *Xinzhengjiao*, *Taisu* agrees with *Jiujuan* and differs from *Suwen*. However, the current book (*Taisu*) states needle Foot-Taiyang and needle Foot-Shaoyang, differing from *Jiujuan* but agreeing with *Suwen*. Furthermore, checking the current version of *Lingshu · Zabing* chapter: "Malaria without thirst, occurring every other day, take Foot-Yangming; with thirst and daily occurrence, take Hand-Yangming." Re-checking Book 30 of this work, *Cimie Jiedu* chapter, it agrees with *Lingshu*, and does not fully agree with the citations in *Jiayi Jing* or *Suwen Xinzhengjiao*, nor does it agree with the present chapter's statement of needling Foot-Taiyang and Foot-Shaoyang. Carefully studying Yang Shangshan's commentary on this chapter stating "these two are both Cold Malaria," whereas the *Cimie Jiedu* chapter states "take the governing Shu points," explains the discrepancy.)
Foot-Taiyang Malaria causes lower back pain and heavy head, cold sensation rising from the back, initial chills followed by fever and thirst, cessation of thirst then sweating, difficult to cure. Daily needle bleeding from Weizhong (BL40). (The Foot-Taiyang meridian descends from the head through the back to the waist; pathogenic factors lodging here cause cold to rise from the back. In *Mingtang*, the He-Sea point Weizhong of Foot-Taiyang treats Meridian Malaria, with symptoms identical to this. [Ping An]: "Thirst, cessation of thirst then sweating" appears as "Ran, cessation of heat then sweating" in *Suwen*. *Xinzhengjiao* notes: "Quanyuan Qi's edition, *Jiayi Jing*, *Taisu*, and Chao Yuanfang all read 'initial chills then fever and thirst, cessation of thirst then sweating,' consistent with this book." For "Daily needle Weizhong", *Suwen* and Chao Shi omit "daily"; *Jiayi Jing* reads "occurring every other day, needle Weizhong".)
Foot-Shaoyang Malaria causes bodily laxity and relaxation, mild chills, mild fever, aversion to seeing people, palpitations upon seeing others, abundant heat and profuse sweating. Needle the Foot-Shaoyang channel. (The Foot-Shaoyang meridian connects the joints of the whole body; thus, disease of this meridian causes bodily laxity. Foot-Shaoyang pairs with Jueyin, so chills and heat are both mild, and there is aversion to people. If heat is abundant, sweating is profuse; one may select Fengchi (GB20) and Qiuxu (GB40) on Foot-Shaoyang. [Ping An]: "Jie" is written as "Jiejuan" in Chao Shi. *Jiayi Jing* lacks the three characters "mild heat". The character "sweat" is not repeated in *Suwen*, *Jiayi Jing*, or Chao Shi, suspected to be a duplication error.)
Foot-Yangming Malaria causes initial chills, shivering, prolonged severe cold before fever, sweating after heat subsides, relief upon seeing sunlight, moonlight, or fire. Needle the dorsum of the foot (Yangming). (Foot-Yangming is named "Two Yangs Combined Brightness," hence sweating and preference for light. The dorsum of the foot is the pathway of the Foot-Yangming meridian. [Ping An]: "Sa" is written differently in Chao Shi; "moon" is omitted after "sun" in some versions. *Suwen* adds "foot" after "needle". *Jiayi Jing* adds "and regulate Chongyang" after "dorsum". Chao Shi writes "needle Foot-Yangming instep".)
Foot-Taiyin Malaria causes unhappiness, frequent sighing, anorexia, alternating chills and heat with sweating. Onset brings desire to vomit; condition improves after vomiting. Then take the point. (Foot-Taiyin meridian branches from the stomach, ascends through the diaphragm, and enters the heart; thus malaria causes unhappiness and sighing. Spleen and Stomach govern food; thus spleen meridian disease causes anorexia. The meridian enters the abdomen, connects to Spleen and links Stomach, ascends through diaphragm and flanks the throat; thus impending illness brings vomiting. Treatment should occur when condition improves post-vomit. [Ping An]: *Jiayi Jing* reads "more cold less heat" for "alternating chills and heat". "Ou" is written as "ou" (vomit) in *Suwen*, *Jiayi Jing*, and Chao Shi. *Jiayi Jing* adds "Foot-Taiyin" after "take".)
Foot-Shaoyin Malaria causes vomiting, severe chills and heat, more heat than cold, desire to stay behind closed doors, difficult to cure. (Foot-Shaoyin meridian passes through Liver and Diaphragm into Lung, emerges from Lung, links Heart, and enters Chest; thus Foot-Shaoyin malaria causes vomiting. Severe cases have more chills/heat than other meridians. Shaoyin is invaded by Yang, hence more heat than cold. Kidney Yin meridian injury causes desire for seclusion; disease is hard to cure. [Ping An]: *Jiayi Jing* reads "severe vomiting, more cold less heat"; Chao Shi reads "long-term chills and heat". After "difficult to cure", *Jiayi Jing* adds "take Taixi".)
Foot-Jueyin Malaria causes lower back pain, abdominal fullness, difficulty urinating resembling strangury but not strangury, frequent urination, fear, Qi deficiency, intestinal depression. Needle Foot-Jueyin. (Foot-Jueyin meridian circles the genitals and reaches the lower abdomen; thus back pain, abdominal fullness, and urinary difficulty resembling strangury. Strangury refers to dysuria. The meridian belongs to Liver and links Gallbladder; Gallbladder is the Fu organ of Foot-Jueyin; thus Gallbladder injury causes fear, Qi deficiency, and intestinal depression. One may needle Five-Shu points and Zhongfeng (LR4) of Foot-Jueyin. [Ping An]: "Fei long yi" is "Fei long ye" in *Suwen/Jiayi*, "Fei long zhuang" in Chao Shi. "Shu xiaobian yi" is "Shu bianyi" in *Suwen*; *Xinzhengjiao* notes *Jiayi* has "Shu bianyi" or "Shu yi". "Yiyi" is "Yiyi" in *Suwen/Jiayi/Chao Shi*.)
Lung Malaria causes coldness in the heart, severe chills with intermittent heat, fright, hallucinations. Needle Hand-Taiyin and Hand-Yangming. (Above discusses meridian malaria; below discusses Zang organ malaria. Lung is close to Heart; thus Lung disease causes Heart cold and fright/hallucinations. Take the meridians of Lung and its interior-exterior pair. [Ping An]: "Xi jing ru you jianzhe" is "Shan jing ru you suojianzhe" in *Suwen/Jiayi*, "Ru shi you jianzhe" in Chao Shi.)
Heart Malaria causes mental restlessness, strong desire for cold water, more chills than heat, mild chills, severe heat. Needle Hand-Shaoyin. (Mental heat causes desire for cold water and coolness. As it is a Yang heat condition, cooling reduces heat, allowing tolerance of cold; thus mild chills and severe heat. Hand-Shaoyin Heart meridian disease causes mental restlessness, not direct Heart organ disease. The Heart houses Spirit and cannot tolerate excessive pathogens; thus mental restlessness occurs. Treat at Shaohai (HT3) of Hand-Shaoyin. [Ping An]: "Ji han duo han bushen re shen" is "Fan han duo bushen re" (six characters) in *Suwen*. *Xinzhengjiao* notes *Taisu* reads "Desire cold water and more cold, mild chills, severe heat," matching this. *Jiayi* reads "More cold less heat"; Chao Shi reads "Then more cold, mild chills less heat".)
Liver Malaria causes pale/greenish complexion, sighing, appearance like death. Needle Foot-Jueyin until blood appears. (Severe Liver Malaria reveals true color, hence green/pale. Severe Qi stagnation causes sighing. Take Liver meridians; bleeding leads to recovery. [Ping An]: "Cangcang" is "Cangcang" in *Suwen/Jiayi/Chao Shi*. *Jiayi* omits "Taixi".)
Spleen Malaria causes sudden chills, abdominal pain, bowel sounds during heat, sweating after. Needle Foot-Taiyin. (Foot-Taiyin Spleen meridian belongs to Spleen, links Stomach, connects Intestines; abundant Grain Qi causes sudden chills, abdominal pain, and bowel sounds. Take Dadu (SP2), Gongsun (SP4), Shangqiu (SP5). [Ping An]: *Suwen* omits "Ji"; *Jiayi* reads "Bing".)
Kidney Malaria causes shivering, lower back/spine pain with turning difficulty, difficult defecation, blurry vision, cold hands and feet. Needle Foot-Taiyang and Foot-Shaoyin. (Xun means opening eyes wide/searching. Sa means aversion to cold. Kidney meridian passes through spine, belongs to Kidney, links Bladder; thus back pain, turning difficulty, difficult defecation. Meridian ascends through Liver to Eye; thus blurry vision. Or dizziness, as Bladder/Taiyang meridian starts at inner canthus. Foot-Shaoyin/Taiyang connect to Hand-Shaoyin/Taiyang; thus cold extremities. Take these two Kidney interior-exterior meridians. [Ping An]: "Sasa" has "Ran" in *Suwen*, "Sar" in *Jiayi*. "Mu xunxun ran" is "Mu run ran" in *Suwen/Jiayi*, "Mu xuan run ran" in Chao Shi.)
Stomach Malaria causes Jaundice, hunger but inability to eat, distension/fullness after eating, large abdomen. Needle Foot-Yangming and Foot-Taiyin horizontal vessels until blood appears. (Dan sound Dan, internal heat disease. Stomach receives food; improper diet causes cold/heat imbalance, hence Stomach Malaria. Foot-Yangming belongs to Stomach, links Spleen; thus Stomach heat, hunger, inability to eat, abdominal distension. Large Luo of Foot-Yangming is Daheng vessel. [Ping An]: "Dan bing" is "Qie bing" in *Suwen/Jiayi/Chao Shi*. *Xinzhengjiao* notes *Taisu* "Qie bing" is "Dan bing". *Suwen* "Xi" is "Shan"; *Jiayi* "Han Shan".)
When Malaria is about to flare and body is hot, needle the arterial pulse on the dorsum of the foot, open the aperture, and cold stops immediately. (In previous Malarias, when Warm Malaria is about to heat, needle the dorsal artery. Artery is Chong Mai, sea of five Zang and six Fu; thus treating twelve Malarias. Opening aperture means enlarging the needle hole; heat goes, cold stops. Or cold declines then heats. [Ping An]: After "Kong", *Suwen* has "Chu qi xue" three characters, *Jiayi* has "Chu xue" two characters.)
When Malaria is about to chill, needle Hand-Yangming, Hand-Taiyin, Foot-Yangming, Foot-Taiyin. (In previous Malarias, Cold Malaria can be treated by needling Hand/Foot Yangming/Taiyin. Hand-Yangming: Shangyang, Sanjian, Hegu, Yangxi, Pianli, Wenliu, Wuli. Foot-Yangming: Shenting, Kaiming, Tianshu, Jiexi, Chongyang, Xianggu, Lidui. Hand-Taiyin: Lieque, Taiyuan, Shaoshang. Foot-Taiyin: Dadu, Gongsun, Shangqiu. Or heat declines then chills. [Ping An]: Above "Zhu mie", *Suwen* has 89 characters "Mai man da... shi shi ye". This book is in Vol 30 *Cimie Jiedu*. *Xinzhengjiao* notes Quanyuan Qi had them in Vol 4, Wang moved them here. This book lacks them, confirming Wang's addition.)
For various Malarias where pulse is not visible, needle between ten fingers until blood appears; blood removal ensures cure. First observe red spots like adzuki beans on the body and needle them all. (Twelve Malarias have visible collateral vessels; needle/remove them. If collaterals not visible, needle toes for Foot Yin/Yang, fingers for Hand Yin/Yang, ensure bleeding. Also, as Malaria wanes, red bean-like nodules appear; needle them. [Ping An]: *Jiayi* "Er mai bu jian", "Er" is "Ru". Above "Chi", *Suwen/Jiayi* lack "Re".)
The twelve Malarias flare at different times. Observe symptoms to know which meridian is diseased. Needle about one meal-time before onset. (This covers general treatment for twelve Malarias; needle one meal-hour before onset for cure.) One needle attenuates disease; two needles bring knowledge of improvement; three needles cure. (One needle attenuates, patient unaware; two needles indicate improvement, disease not gone; three needles clear all pathogenic Qi.) If not cured, bleed two vessels under tongue; if not cured, bleed full vessels at Weizhong; needling below neck along spine guarantees cure. Vessels under tongue are Lianquan. (If previous needling fails, change method. Three needles: 1. Tongue vessels, Foot-Shaoyin, Renmai Lianquan. 2. Weizhong within Chengshan area, Foot-Taiyang full vessel. 3. Below neck along spine, Foot-Taiyang Dazhu, Fufen. [Ping An]: *Suwen/Jiayi* "Ci xiang yi xia" is "You ci xiang yi xia". Note "Chengshan", "Nei" is "Zhong" in Yuan edition.)
To needle Malaria, first ask where the symptom started, and needle that site first. (Ask about pre-onset to treat the origin. [Ping An]: "Bi xian wen", "Xian" missing in Yuan edition.)
If headache and heaviness start first, needle head acupoints first. (Take Shenting, Shangxing, Xinhui, Baihui of Du Mai.) And bleed between cheeks and eyebrows. (Bleed collaterals at cheeks/eyebrows. [Ping An]: "Liang he" is "Liang e" in *Suwen/Jiayi*.)
If neck/back pain starts first, needle neck/back points first. (Start at neck/back where symptoms began.)
If lower back/spine pain starts first, bleed Weizhong. (Bleed Weizhong collaterals.)
If arm/hand pain starts first, needle ten fingers of Hand Yin/Yang. (Hand interior-exterior Yin/Yang meridians are at ten fingers. [Ping An]: *Suwen/Jiayi* "Yin yang shi zhijian" is "Shou Shao-yang ming shi zhijian". *Xinzhengjiao* notes alternate versions say "Shou Yin Yang".)
If lower leg pain starts first, bleed ten toes of Foot-Yangming. (Foot-Yangming is head of Three Yangs; thus bleeding ten toes is called Foot-Yangming. [Ping An]: *Suwen/Jiayi* read "Jing".)
Wind Malaria flares with sweating and aversion to wind. Needle blood from Back-Shu points of Three Yang meridians. (This is Wind Malaria syndrome. Check Back-Shu of Hand/Foot Three Yangs; needle affected points. [Ping An]: "Zhi fa" is "Mie fa" in *Suwen*. *Jiayi* adds "Zu" before "San Yang".)
Pain severe, unpressable, named Marrow Disease. Use Pi needle at Guangu (GB39) to bleed; pain stops immediately. Mild body pain, needle Jing-Well points of all Yin meridians, do not bleed, needle every other day. (Foot pain, unpressable, is Marrow disease. Can bleed with Pi needle. Five Zang Yin Jing-Well points start with Wood, suitable to take but not bleed. Some editions read "Sui" as "Ti". [Ping An]: After "Sui", *Suwen* has "Bing", *Jiayi* "Zhou sui bing". "Yi pi juegu" is "Yi pi zhen zhen juegu" in *Suwen/Jiayi*. *Suwen* "Ci zhi", "Zhi" is "Zhiyin" two characters.)