帝承上编疟论，而申明刺疟之法。举三阳三阴、五脏胃腑之疟，以及风疟、温疟，各有刺治，因名刺疟。
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 中，出血。
足太阳之脉，从头下背挟脊抵腰，故足太阳之疟，令人腰痛、头重。寒从背起，病太阳之本气，故先
寒；病太阳之标气，故后热。其热也，如火之 ，暑之 然，热止则汗出多而难已。
中， 中央，委中也。刺 中出血，以治太阳之疟。
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，刺足少阳。
恶，去声，下同。解 ，犹懈惰，枢转不力也。足少阳之脉，行身之侧，枢转营运，疟病则枢转不
力，故令人身体解 。枢转在中，以司开合，开出为阳，合入为阴，阴阳皆虚，故寒不甚，热不
甚，少阴阳气不足，故恶见人，见人则心惕惕然，既见而心惕惕，则热多，汗出甚，当刺足少阳，
以治少阳之疟。
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，乃快然，刺足阳明跗上。
《经脉》论云，足阳明是动，则病洒洒振寒。故足阳明之疟，令人先寒洒淅，洒淅寒甚，寒久则
乃热，热去则阴阳和，故汗出。阳明虚，故喜见日月光火气。喜见者，得之乃快然也。当刺足阳明
跗上之冲阳，以治阳明之疟。
足太阳之疟，令人不乐，好太息，不嗜食，多寒热、汗出，病
至则善呕，呕已乃衰，即收之。
好，去声。足太阴疟病，脾脉不上注于心，故令人不乐。脾气不上交于肺，故好太息。脾胃不和，故不
嗜食，脾气不充于肌腠，故多寒热。脾土内虚，水津外泄，故汗出。疟病方至，正气不能上
行外达则善呕，呕则太阴之气，从下而上，故呕已，乃衰；病衰，当即取太阴之经而刺治之。
足少阴之疟，令人呕吐甚，多寒热，热多寒少，欲闭户牖而处，其病难已。
足少阴疟病，阴寒上逆，故令人呕吐甚，从阴出阳，水火主气，故多寒热，气越于外，阳盛阴虚，故
热多寒少。少阴神气，热甚而虚，故欲闭户牖而处，阴阳水火皆病，神气复虚，故其病难
已。病难已，故不言刺也。
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，刺足厥阴。
数，音朔。足厥阴之脉，合督脉而上行，故足厥阴之疟，令人腰痛，其脉过阴器抵小腹，故少腹满。
少腹满，则小便不利。小便不利则如癃状。如癃状，究之非癃也。数便，则小便少而不利尔。
生阳之气，根于厥阴，阴极而阳不生，故意恐惧，意恐惧则气不
足，气不足不能上出于阳，故腹中悒悒。悒悒，郁而不舒也，当刺足厥阴以治厥阴之疟。
肺疟者，令人心寒，寒甚热，热间，善惊，如有所见者，刺手太阴阳明。
间，去声，下间日之间同。肺，天也。心，日也。肺疟者，令人心寒，天日虚寒也。天日为阳，故
寒已而甚热，热间则气血皆虚，故善惊。其惊也，如有所见者，当刺手太阳，兼及手阳明，而治其肺疟焉。
心疟者，令人烦心甚，欲得清水，反寒多，不甚热，刺手少阳。
心，火也。火热则烦，故心疟者，令人烦心甚，心烦既甚，欲
得清水以济其热，得水则真火被却，故反寒多而不甚然，当刺手少阴，而治其心疟焉。
肝疟者，令人色苍苍然，太息，其状若死者，刺足厥阴，见血。
苍，青色，肝木色青，故肝疟者，令人色苍苍然，肝脉上注于肺，肝气不上，故太息，色苍苍而太息，其
状若死者，当刺足厥阴，见血，而治其肝疟焉。
脾疟者，令人寒，腹中痛，热则肠中鸣，鸣已，汗出，刺足太阴。
脾主寒湿，故脾疟者，令人寒。腹为脾部，脾寒，故腹中痛，
脾土有湿寒之气，有湿热之气，故热则肠中鸣，鸣已则湿热外行，故汗出，当刺足太阴，而治其脾疟焉。
肾疟者，令人洒洒寒，腰脊痛，宛转，大便难，目 然，手足寒，刺足太阳、少阴。
肾为寒水之脏，故肾疟者，令人洒洒寒。腰者，肾之府。肾病，故腰脊痛。腰脊痛则转输不利，故
宛转。灵枢五邪篇∶云邪在肾，则骨痛阴痹，大便难。至真要大论云∶大便难，阴气不用。故
肾疟，而大便难。骨之精为瞳子，肾主骨，故目 然。 ，摇动不明也。下焦生阳之气，不充
于四肢，故手足寒，当刺足少阴，兼足太阳而治其肾疟焉。
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。
且，姑且也。且病，病而将愈之意。横脉，络脉也，经直络横之意。五脏疟病，至于胃腑，则从
阴出阳，其病将愈。故胃疟者，令人且病也，将愈未愈，故善饥而不能食。脾胃之络脉不和，故食
而支满，腹大，当刺足阳明，兼足太阴之横脉，而刺出其血焉。
疟发，身方热，刺跗上动脉，开其空，出其血，立寒，疟方欲寒，刺手阳明太阴、足阳明太阴。
空，孔同。此复申明胃疟之义。跗上动脉，足阳明冲阳之脉
也。胃疟之发，其身方热，当刺足跗上，阳明冲阳之动脉，摇针以开其穴孔，泻出其血，则身立寒。胃
疟之发，身方欲寒，此阳明之气，内合太阴，故当刺手阳明兼手太阴，足阳明、兼足太阴也。
疟脉满大急，刺背俞，用中针，旁五 俞，各一，适肥瘦，出
其血也∶疟脉小实急，灸胫少阴，刺指井。
此言经脉之疟而有五俞之刺法也。中针，不大不小之针也。 ，胁旁连背处也。疟脉满大急，经脉
之气有余也。五脏之俞，皆在于背，故刺背俞。五脏之俞，在背两行，两行之外，复有两行，
所谓 也，肺曰魄户，心曰神堂，肝曰魂门，脾曰意舍，肾曰志室，故用中针，旁五 俞，各刺其一。肥
者，深刺之。瘦者，浅刺之，适肥瘦，以为刺，而出其血，以泻经脉之有余也。疟脉小实
急，经脉之气不足也。有余泻之，不足补之。脉小，正气虚也，故当灸胫少阴之太溪，以启生阳之气。
实急，邪气实也，又当刺足小趾至阴之井穴，先灸后刺，助正散邪之法也。
疟脉满大急，刺背俞，用五 俞背俞各一，适行至于血也；疟脉缓大虚，便宜用药，不宜用针。
上文刺背俞，旁五 俞各一，乃合背俞 俞而皆刺之，故于此复明之，所谓疟脉满大急，刺背俞者，
乃用中针，五 俞与背俞各刺其一。适肥瘦以行针，而至于出血也。疟脉缓大虚，承疟脉小实急，
而言疟脉不急而缓，不小而大，不实而虚也。如是，盒饭补之，不当泻之，故曰便宜用药，不宜用针，又
不但先灸后针也。此承上文而申明之也。
凡治疟，先发如食顷，乃可以治，过之则失时也。
凡治疟者，统承上文刺法而言也。先发如食顷，乃可治者，治
之宜先也。过之者，过其食顷之时，则为失时，失时而治，治无益也。
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。
诸疟者，统承上文疟病而言也。脉不见者，不见满大急、小实
急、缓大虚之脉也。病不在脉，但当刺手十指间，井穴，出血。血去心已。更当先其未发之时，视身之
皮肤赤点，如小豆者，尽取而刺之。夫所出为井，皮肤主表，病不在脉，故如是以刺之。
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；不已，刺 中盛经，出血，又刺项以下侠脊
者，必已。舌下两脉者，廉泉也。刺疟者，必先问其病之所先发者，先刺之，先头痛及重者，先
刺头上，及两额两眉间，出血；先项背痛者，先刺之；先腰脊痛者，先刺 中，出血；先手臂痛者，
先刺手少阴，阳明十指间；先足胫 痛者，先刺足阳明十指间出血。
上文三阳三阴五脏胃腑，合十二经脉，故曰十二疟者，其发各不同时，当先其时，而察其病形，以知其
何脉之病也，知其病之所在，更当先其发时，如食顷而刺之，刺之得宜，一刺则衰。衰，邪
气少去也。二刺则知。知，小便利，腹中和也。三刺则已。已，病邪皆去，正将复也。设三刺不已，更
刺舌下之两脉，出血，刺两脉不已，更刺 中盛经，出血，又刺项以下侠脊者，其病必已。申明
舌下两脉者，廉泉也。夫一刺二刺三刺之刺疟者，必先问其病之所先发者，先刺之，如先头痛及头重者，
先刺头上，以治其痛，及两额两眉间，出血，以治其重。先项背痛者，先取项背而刺之。先腰
脊痛者，先刺太阳之 中，出血。先手臂痛者，先刺手少阴、阳明，在手十指间之少冲、商阳。先足胫
痛者，先刺足阳明，在足十指间之厉兑，出血。此统承三阳三阴、五脏胃腑十二经脉之疟，而言刺治之宜先也。
风疟，疟发，则汗出恶风，刺三阳经背俞之血者。
风疟，因风病疟也。疟发则汗出恶风，风伤太阳之肌腠也。太
阳，三阳也。刺三阳经背俞之血者，所以治太阳之风疟也。
痛甚，按之不可，名曰附髓病，以 针，针绝骨，出血，立已。
附，旧本讹附，今改。髓 痛甚，因风而 痛也。按之不可，
痛在骨也。髓藏于骨，故名曰附髓病。《经脉》论云，胆足少阳之脉，直下抵绝骨之端，是主骨所生病者。
故以 针，针少阳之绝骨，出血，立已。
身体小痛，刺至阴。诸阴之井，无出血，间日一刺。
身体小痛，不若 病甚也，痛不在骨，在太阳之通体，故刺太阳经之至阴。不言出血者，以诸阴
之井，无出血。至阴之穴，交于涌泉，阴可知矣，且当间日一刺。
疟不渴，间日而作，刺足太阳，渴而间日作，刺足少阳。
间日一刺，其疟亦必间日而作，太阳之上，寒气主之，故疟不
渴，间日而作者，刺足太阳少阳之上，火气主之，故渴而间日作者，刺足少阳。
温疟汗不出，为五十九刺。
五十九刺，见水热穴论，温疟汗不出，是邪气藏于肾，不能外
出之阳，故为五十九刺，以泻少阴肾脏之热，而发越于外。凡此，皆刺疟之法，所以承上编而申明之。
黄帝承接上一篇《疟论》的内容，进一步阐明针刺治疗疟疾的方法。列举了足三阳经、足三阴经以及五脏六腑的疟疾，还有风疟、温疟等，各有相应的针刺治疗方法，因此命名为“刺疟篇”。
足太阳膀胱经受疟邪侵袭，使人腰痛、头重。寒气从背部升起，先出现寒战，后发热，热退时汗出且难以停止。应针刺委中穴，放出少量血液。
足太阳经脉，从头向下经过背部，夹脊柱两侧直达腰部，所以足太阳经受疟邪侵袭，使人腰痛、头重。寒气从背部升起，是因为病在太阳的本气（寒水），所以先寒；病在太阳的标气（君火），所以后热。其发热之时，像烈火燃烧、暑气蒸腾一样剧烈，热退则汗出很多且难以停止。
委中穴，位于腘窝中央。针刺委中穴出血，用来治疗足太阳经的疟疾。
足少阳胆经受疟邪侵袭，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，发热多且汗出厉害。应针刺足少阳经穴位。
“恶”，读去声，以下同。“解㑊”，即懈怠懒惰，枢机转动无力的意思。足少阳经脉，行于身体侧面，主管枢机转运，疟病发作时枢机运转不力，所以使人身体懈怠无力。枢机位于中间，主管开合，开出为阳，合入为阴，阴阳都虚弱，所以寒不重，热不重。少阴阳气不足，所以厌恶见人，见到人就心里惊恐不安，既然见了人又感到惊恐，就会发热多，汗出厉害，应当针刺足少阳经，来治疗少阳经的疟疾。
足阳明胃经受疟邪侵袭，使人先感到寒冷战栗，寒冷很严重，过了很久才发热。热退汗出，喜欢见到日光月光或火光，感到舒适痛快。应针刺足阳明经足背上的冲阳穴。
《经脉》篇论述说，足阳明经发生变动，就会生病表现为洒洒振寒。所以足阳明经的疟疾，使人先感到寒冷战栗，寒冷很严重，寒冷久了才发热，热退则阴阳调和，所以汗出。阳明经气虚，所以喜欢见到日光月光或火光。所谓喜欢见到，就是得到了这些光亮就觉得舒适痛快。应当针刺足阳明经足背上的冲阳穴，来治疗阳明经的疟疾。
足太阴脾经受疟邪侵袭，使人心情不乐，喜欢长叹气，不想吃东西，寒热往来多，汗出，病势发作时容易呕吐，吐完后病情减轻，此时应立即停止针刺或采取收敛措施。
“好”，读去声。足太阴脾经的疟病，脾脉不能上注于心，所以使人心情不乐。脾气不能上交于肺，所以喜欢长叹气。脾胃不和，所以不想吃东西。脾气不能充实于肌肉腠理，所以寒热往来多。脾土内部虚弱，水液津液外泄，所以汗出。疟病刚刚发作，正气不能上行外达，所以容易呕吐，呕吐后太阴之气从下向上运行，所以吐完后病情减轻；病势衰退，应当立即取太阴经穴位进行针刺治疗。
足少阴肾经受疟邪侵袭，使人呕吐严重，寒热往来多，发热多而发冷少，想要关上门窗独处，这种病很难治愈。
足少阴肾经的疟病，阴寒之气上逆，所以使人呕吐严重。病气从阴出阳，水火主气，所以寒热往来多。气越出于体表，阳气盛而阴气虚，所以发热多而发冷少。少阴的神气，因热甚而虚弱，所以想要关上门窗独处。阴阳水火都有病变，神气再次虚弱，所以这种病很难治愈。因为病难治愈，所以这里没有提及针刺方法。
足厥阴肝经受疟邪侵袭，使人腰痛，小腹胀满，小便不利。看起来像癃闭（排尿困难）的样子，其实不是癃闭，而是频繁想小便，心中恐惧，气不足，腹中郁闷不舒。应针刺足厥阴经穴位。
“数”，读朔音。足厥阴经脉，与督脉会合而上行，所以足厥阴经的疟疾，使人腰痛。其经脉经过生殖器抵小腹，所以小腹胀满。小腹胀满，则小便不利。小便不利则看起来像癃闭。看似癃闭，究其实并非癃闭。频繁想小便，则是小便量少而不畅。生发之阳气，根源于厥阴，阴极则阳气不生，所以心中恐惧。心中恐惧则气不足，气不足不能上行出于阳分，所以腹中郁闷不舒。悒悒，指郁结而不舒展。应当针刺足厥阴经，来治疗厥阴经的疟疾。
肺疟，使人心中感觉寒冷，寒冷过后发热很厉害，两次发作间隔期间，容易受惊，好像看到了什么奇怪的东西。应针刺手太阴肺经和手阳明大肠经穴位。
“间”，读去声，下文的“间日”之间同理。肺，象征天。心，象征日。肺疟，使人心中感觉寒冷，是天日虚寒的表现。天日为阳，所以寒冷过后发热很厉害。在两次发作的间隔期，气血都虚弱，所以容易受惊。那种惊恐的感觉，好像看到了什么，应当针刺手太阴肺经，兼及手阳明大肠经，来治疗肺疟。
心疟，使人心中烦乱严重，想要喝冷水，反而发冷多，发热不严重。应针刺手少阴心经穴位。
心，属火。火热则心烦，所以心疟使人心中烦乱严重。心烦既已严重，想要得到冷水来济助清热，得到水后真火被遏制，所以反而发冷多而不怎么发热，应当针刺手少阴心经，来治疗心疟。
肝疟，使人面色苍青色，喜欢长叹气，神态像死人一样。应针刺足厥阴肝经，见血为止。
“苍”，青色。肝木之色青，所以肝疟使人面色苍青色。肝脉上注于肺，肝气不能上达，所以喜欢长叹气。面色苍青且喜欢长叹气，神态像死人一样，应当针刺足厥阴肝经，见血，来治疗肝疟。
脾疟，使人发冷，腹部疼痛，发热时肠鸣，肠鸣停止后汗出。应针刺足太阴脾经穴位。
脾主寒湿，所以脾疟使人发冷。腹部是脾所主的部位，脾寒，所以腹部疼痛。脾土有湿寒之气，也有湿热之气，所以发热时肠中鸣响，肠鸣停止后湿热向外运行，所以汗出，应当针刺足太阴脾经，来治疗脾疟。
肾疟，使人洒洒然寒冷，腰脊疼痛，翻身困难，大便困难，眼睛昏花不明，手足寒冷。应针刺足太阳膀胱经和足少阴肾经穴位。
肾为寒水之脏，所以肾疟使人洒洒然寒冷。腰是肾的外府。肾病，所以腰脊疼痛。腰脊疼痛则转输不利，所以翻身困难。《灵枢·五邪》篇说：邪气在肾，则骨痛阴痹，大便困难。《素问·至真要大论》说：大便困难，是阴气不用。所以肾疟会出现大便困难。骨的精华表现为瞳孔，肾主骨，所以眼睛昏花不明。“䀮䀮”，摇动不明亮的样子。下焦生发之阳气，不能充实于四肢，所以手足寒冷，应当针刺足少阴肾经，兼足太阳膀胱经，来治疗肾疟。
胃疟，使人病势将愈但未全愈，容易饥饿，但不能进食，吃了东西就感到支撑胀满，腹部膨大。应针刺足阳明胃经和足太阴脾经，横行的络脉出血。
“且”，姑且。且病，指病将愈的意思。横脉，指络脉，是经直络横的意思。五脏的疟病，到了胃腑，则是从阴出阳，病将痊愈。所以胃疟使人病势将愈但未全愈，将愈未愈，所以容易饥饿但不能进食。脾胃的络脉不和，所以吃了东西就感到支撑胀满，腹部膨大，应当针刺足阳明胃经，兼足太阴脾经的横行络脉，刺出其血。
疟疾发作，身体正发热时，针刺足背上的动脉（冲阳穴），打开穴位，放出血液，身体立刻变凉。疟疾正要发冷时，针刺手阳明大肠经、手太阴肺经、足阳明胃经、足太阴脾经。
“空”，同孔。这是再次申明胃疟的治疗意义。跗上动脉，是足阳明胃经冲阳脉的位置。胃疟发作，身体正发热，应当针刺足跗上阳明经冲阳动脉，摇针以打开穴位孔窍，泻出血液，则身体立刻变凉。胃疟发作，身体正要发冷，这是因为阳明之气内合太阴，所以应当针刺手阳明兼手太阴，足阳明兼足太阴。
疟疾病人的脉象满大而急，针刺背部的俞穴，使用中等的针，旁边五处的腧穴各刺一针，根据病人肥瘦调整深浅，放出血液。疟疾病人的脉象小实而急，灸胫部的少阴经穴位，针刺手指末端的井穴。
这是讲述经脉疟疾的五腧穴刺法。中针，是不大不小的针。“郄”，胁旁连背处。疟脉满大急，是经脉之气有余。五脏的俞穴都在背部，所以刺背俞。五脏的俞穴在背部两行，两行之外，还有两行，所谓的“郄”也。肺俞叫魄户，心俞叫神堂，肝俞叫魂门，脾俞叫意舍，肾俞叫志室。所以用中针，旁边五处的郄俞，各刺其一。肥胖的人深刺，消瘦的人浅刺，根据肥瘦调整，进行针刺并放出血液，以泻除经脉中有余的邪气。疟脉小实急，是经脉之气不足。有余则泻，不足则补。脉小，是正气虚，所以应当灸胫部少阴经的太溪穴，以激发生发之阳气。实急，是邪气实，又应当针刺足小趾至阴的井穴，先灸后刺，这是扶助正气、驱散邪气的方法。
疟疾病人的脉象满大而急，针刺背部的俞穴，使用五处的郄俞和背俞各刺一针，调整针行直到出血。疟疾病人的脉象缓大而虚，适宜用药治疗，不适宜用针刺。
上文刺背俞，旁边五处的郄俞各刺一针，乃是合背俞和郄俞一起刺，所以在这里再次说明。所谓疟脉满大急，刺背俞，是用中针，五处的郄俞与背俞各刺一针。根据肥瘦调整针行，直到出血。疟脉缓大虚，承接上文疟脉小实急而言，是说疟脉不急而缓，不小而大，不实而虚。如果是这样，应当补益，不应当泻除，所以说适宜用药，不适宜用针，而且不仅仅是先灸后针。这是承接上文来申明的。
凡是治疗疟疾，要在发作前大约一顿饭的时间，才可以进行治疗，过了这个时间就失去了时机。
凡是治疗疟疾，总括上文所述的刺法而言。发作前大约一顿饭的时间可以治疗，是因为治疗宜在先。过了那个一顿饭的时间，就是失时，失时再治疗，治疗就没有益处了。
各种疟疾，如果脉搏摸不到，针刺十个手指尖出血，血流出后病必愈。事先观察身上有红色如小豆大小的斑点，全部刺破。
各种疟疾，总括上文所说的疟病而言。脉不见，是指摸不到满大急、小实急、缓大虚的脉象。病不在经脉，只应当针刺手部十个指尖的井穴，放出血液。血去则心邪去。更应当在未发作之前，观察身上的皮肤赤色斑点，像小豆大小的，全部刺破。所出为井穴，皮肤主表，病不在经脉，所以这样针刺。
十二种疟疾，其发作时间各不相同，观察其病症表现，从而知道是哪条经脉的病。在发作前，大约一顿饭的时间进行针刺。刺一次则病势衰减，刺两次则症状知晓（好转），刺三次则病愈。如果不好，针刺舌下两条脉络出血；如果还不好，针刺委中穴的盛经出血，又针刺颈部以下夹脊柱的穴位，病必愈。舌下两条脉络，是廉泉穴。治疗疟疾，必须先询问病人哪里最先发病，先刺那里。先是头痛且重的，先刺头部，以及两额、两眉间，放出血液；先是项背痛的，先刺那里；先是腰脊痛的，先刺委中穴，放出血液；先是手臂痛的，先刺手少阴、手阳明经十指尖；先是足胫痛的，先刺足阳明经十指尖出血。
上文三阳三阴、五脏胃腑，合十二经脉，所以叫十二种疟疾，其发作各不相同，应当先察其时，观察其病症表现，从而知道是哪条经脉的病。知道了病的所在，更应当在发作前，大约一顿饭的时间进行针刺。针刺得法，刺一次则病势衰减。衰，指邪气少去。刺两次则症状好转。知，指小便通利，腹部调和。刺三次则病愈。已，指病邪皆去，正气将要恢复。假设刺三次仍不好，再刺舌下的两条脉络，放出血液。刺两条脉络仍不好，再刺委中穴的盛经，放出血液，又刺颈部以下夹脊柱的穴位，病必愈。申明舌下两条脉络是廉泉穴。那些刺一、二、三次的治疟者，必须先询问病人哪里最先发病，先刺那里。如先头痛及头重的，先刺头部，以治疗疼痛，以及两额两眉间，放出血液，以治疗沉重感。先项背痛的，先取项背而刺之。先腰脊痛的，先刺太阳经的委中穴，放出血液。先手臂痛的，先刺手少阴、手阳明经，在手十指尖的少冲、商阳穴。先足胫痛的，先刺足阳明经，在足十指尖的厉兑穴，放出血液。这是统括三阳三阴、五脏胃腑十二经脉的疟疾，来说明针刺治疗宜先的原则。
风疟，是因风邪引起的疟疾。疟疾发作则汗出恶风，是风邪损伤太阳经的肌腠。太阳，是三阳之首。针刺三阳经背部俞穴出血，是用来治疗太阳经的风疟。
髓骨疼痛严重，按压不得，名叫附髓病，用镵针，针刺绝骨穴，放出血液，立刻痊愈。
“附”，旧本讹误为“附”，今改正。髓骨疼痛严重，因风邪导致疼痛。按压不得，说明痛在骨。髓藏于骨，所以名叫附髓病。《经脉》篇说，胆足少阳经脉，直下抵绝骨之端，是主骨所生的病。所以用镵针，针刺少阳经的绝骨穴，放出血液，立刻痊愈。
身体轻微疼痛，针刺至阴穴。所有阴经的井穴，不出血，隔日刺一次。
身体轻微疼痛，不像髓骨病那样严重，痛不在骨，而在太阳经遍布全身的部分，所以针刺太阳经的至阴穴。不说出血，是因为所有阴经的井穴，都不出血。至阴穴，交于涌泉穴，可知是阴经，且应当隔日刺一次。
疟疾不口渴，隔日发作，针刺足太阳经；口渴且隔日发作，针刺足少阳经。
隔日刺一次，其疟疾也必然隔日发作。太阳之上，寒气主令，所以疟疾不渴，隔日发作的，针刺足太阳经。少阳之上，火气主令，所以口渴且隔日发作的，针刺足少阳经。
五十九刺，见于《水热穴论》。温疟汗不出，是邪气藏于肾，不能外出到阳分，所以采用五十九刺，以泻少阴肾脏的热邪，使其发散到体外。以上这些，都是刺疟的方法，用来承接上一篇《疟论》并加以阐明。
The Yellow Emperor, continuing from the previous chapter "Treatise on Malaria," further elucidates the methods of acupuncture for treating malaria. It lists malaria affecting the three Yang meridians, the three Yin meridians, and the five Zang organs and six Fu organs, as well as Wind Malaria and Warm Malaria, each with specific acupuncture treatments, hence the name "Chapter on Acupuncture for Malaria."
Malaria of the Foot-Taiyang (Bladder) meridian causes lower back pain and a heavy sensation in the head. Coldness arises from the back, starting with chills followed by fever. When the fever subsides, sweating occurs but is difficult to stop. One should puncture Weizhong (BL-32) to release blood.
The Foot-Taiyang meridian descends from the head, passes down the back along both sides of the spine, and reaches the waist. Therefore, malaria of the Foot-Taiyang meridian causes lower back pain and a heavy sensation in the head. Coldness arising from the back indicates pathology in the fundamental Qi (Cold-Water) of Taiyang, hence chills first; pathology in the marked Qi (Ministerial Fire) of Taiyang results in fever later. During the fever, it is intense like burning fire or steaming summer heat. When the fever stops, profuse sweating occurs that is hard to cease.
Weizhong (BL-32) is located in the center of the popliteal fossa. Puncturing Weizhong to release blood treats malaria of the Foot-Taiyang meridian.
Malaria of the Foot-Shaoyang (Gallbladder) meridian causes the body to feel flaccid and weak. The chills are not severe, nor is the fever severe. The patient dislikes seeing people and feels fearful upon seeing them. There is much fever and profuse sweating. One should puncture points on the Foot-Shaoyang meridian.
"E" (dislike) is pronounced with the departing tone, same as below. "Xie Jie" means flaccidity and laziness, indicating weak pivot function. The Foot-Shaoyang meridian runs along the side of the body, governing pivot transport. In malaria, the pivot function is weak, causing bodily flaccidity. The pivot is central, governing opening and closing; opening is Yang, closing is Yin. Since both Yin and Yang are deficient, chills and fever are not severe. Deficiency of Shaoyang Yang Qi causes dislike of people; seeing people induces fear. This fear leads to increased fever and profuse sweating. One should puncture the Foot-Shaoyang meridian to treat Shaoyang malaria.
Malaria of the Foot-Yangming (Stomach) meridian causes initial aversion to cold with shivering, which is severe. After a long time, fever ensues. When the fever subsides, sweating occurs. The patient likes sunlight, moonlight, or firelight, feeling comfortable. One should puncture Chongyang (ST-42) on the dorsum of the foot of the Foot-Yangming meridian.
The "Meridians" chapter states: When the Foot-Yangming meridian undergoes change, the disease manifests as shivering aversion to cold. Thus, Foot-Yangming malaria causes initial shivering aversion to cold, which is severe. After the cold persists, fever follows. When the fever subsides, Yin and Yang harmonize, leading to sweating. Yangming deficiency causes preference for light sources. "Likes seeing" means feeling comforted by them. One should puncture Chongyang (ST-42) on the dorsum of the foot of the Foot-Yangming meridian to treat Yangming malaria.
Malaria of the Foot-Taiyin (Spleen) meridian causes unhappiness, frequent sighing, loss of appetite, frequent chills and fever, and sweating. When the disease strikes, vomiting often occurs; after vomiting, the condition subsides, and one should then stop or consolidate treatment.
"Hao" (likes/frequent) is pronounced with the departing tone. In Foot-Taiyin malaria, Spleen Qi fails to ascend to the Heart, causing unhappiness. Spleen Qi fails to communicate with the Lung, causing frequent sighing. Disharmony between Spleen and Stomach causes loss of appetite. Failure of Spleen Qi to fill muscles and interstices causes frequent chills and fever. Internal deficiency of Spleen Earth allows fluid metabolism to leak outward, causing sweating. When malaria strikes, Zheng Qi cannot ascend or reach the exterior, leading to vomiting. Vomiting allows Taiyin Qi to move upward from below, so the condition subsides after vomiting. When the disease wanes, one should immediately puncture Taiyin meridian points for treatment.
Malaria of the Foot-Shaoyin (Kidney) meridian causes severe vomiting, frequent chills and fever, with more fever than chills. The patient desires to stay behind closed doors and windows. This disease is difficult to cure.
In Foot-Shaoyin malaria, Yin-Cold rebels upward, causing severe vomiting. As pathogenic Qi moves from Yin to Yang, involving Water and Fire, chills and fever are frequent. Qi escaping to the exterior results in excess Yang and deficiency Yin, hence more fever than chills. The Shen Spirit of Shaoyin is weakened by excessive heat, causing the desire to stay secluded. With pathology in Yin, Yang, Water, and Fire, and repeated deficiency of the Shen Spirit, the disease is difficult to cure. Due to its difficulty, no acupuncture method is mentioned here.
Malaria of the Foot-Jueyin (Liver) meridian causes lower back pain, fullness in the lower abdomen, and difficulty urinating. It resembles Gong (strangury/urinary retention) but is not true Gong; there is frequent urge to urinate, mental fear, Qi deficiency, and a depressed feeling in the abdomen. One should puncture the Foot-Jueyin meridian.
"Shuo" (frequent) is pronounced 'shuo'. The Foot-Jueyin meridian merges with the Du Mai and ascends, causing lower back pain in malaria. Its pathway passes through the genitalia to the lower abdomen, causing lower abdominal fullness. Fullness leads to urinary difficulty. Difficulty resembles Gong but is not true Gong; frequent urination implies scanty flow. Sheng Yang Qi originates in Jueyin; extreme Yin prevents Yang generation, causing fear. Fear leads to Qi deficiency. Deficient Qi cannot ascend to Yang, causing abdominal depression. "Yi Yi" means stifled and unrelieved. One should puncture the Foot-Jueyin meridian to treat Jueyin malaria.
Lung Malaria causes a cold sensation in the heart, followed by intense heat. Between attacks, the patient is easily startled, as if seeing things. One should puncture Hand-Taiyin (Lung) and Hand-Yangming (Large Intestine) meridians.
"Jian" (interval) is pronounced with the departing tone, similar to "jian ri" (every other day). Lung represents Heaven; Heart represents Sun. Lung Malaria causes coldness in the heart, representing deficiency-cold of Heaven and Sun. Heaven and Sun are Yang, so after cold, heat is intense. During intervals, Qi and Blood are deficient, causing startles. The startles feel like hallucinations. One should puncture Hand-Taiyin Lung meridian, involving Hand-Yangming Large Intestine, to treat Lung Malaria.
Heart Malaria causes severe mental restlessness, desire for cold water, but actually presents with more chills and less fever. One should puncture the Hand-Shaoyin (Heart) meridian.
Heart belongs to Fire. Heat causes restlessness, so Heart Malaria causes severe mental distress. Severe distress leads to desiring cold water to cool the heat. Receiving water suppresses True Fire, resulting in more chills and less fever. One should puncture Hand-Shaoyin Heart meridian to treat Heart Malaria.
Liver Malaria causes a pale greenish complexion, frequent sighing, and a demeanor resembling death. One should puncture the Foot-Jueyin (Liver) meridian until bleeding occurs.
"Cang" refers to green. Liver Wood corresponds to green, so Liver Malaria causes a greenish complexion. Liver meridian ascends to the Lung; failure of Liver Qi to ascend causes sighing. Greenish complexion and sighing make the patient look like death. One should puncture Foot-Jueyin Liver meridian until bleeding to treat Liver Malaria.
Spleen Malaria causes chills and abdominal pain. During fever, intestinal borborygmus occurs, followed by sweating. One should puncture the Foot-Taiyin (Spleen) meridian.
Spleen governs Cold-Dampness, so Spleen Malaria causes chills. The abdomen is the domain of Spleen; Spleen Cold causes abdominal pain. Spleen Earth has Cold-Damp and Damp-Heat pathogens. Heat causes intestinal borborygmus; after borborygmus, Damp-Heat moves outward, causing sweating. One should puncture Foot-Taiyin Spleen meridian to treat Spleen Malaria.
Kidney Malaria causes shivering cold, lower back and spine pain, inability to turn over, difficulty defecating, blurry vision, and cold hands and feet. One should puncture Foot-Taiyang (Bladder) and Foot-Shaoyin (Kidney) meridians.
Kidney is the organ of Cold-Water, so Kidney Malaria causes shivering cold. The waist is the mansion of the Kidney. Kidney disease causes lower back and spine pain. Pain impedes transport, causing inability to turn over. *Ling Shu: Five Evils* states: Pathogen in Kidney causes bone pain and Yin Bi, and difficulty defecating. *Su Wen: Zhi Zhen Yao Da Lun* states: Difficulty defecating is due to non-function of Yin Qi. Thus, Kidney Malaria involves difficulty defecating. The essence of bone manifests in the pupils; Kidney governs bone, so vision becomes blurry. "Wang Wang" describes shaking and unclear vision. Sheng Yang Qi of the Lower Jiao fails to fill the limbs, causing cold hands and feet. One should puncture Foot-Shaoyin Kidney meridian, involving Foot-Taiyang Bladder meridian, to treat Kidney Malaria.
Stomach Malaria causes the illness to be near resolution but not fully cured. The patient feels hungry but cannot eat. Eating causes distension and fullness, with an enlarged abdomen. One should puncture Foot-Yangming (Stomach) and Foot-Taiyin (Spleen) meridians, releasing blood from transverse collaterals.
"Qie" means temporarily. "Qie Bing" implies the illness is about to resolve. Transverse vessels refer to collaterals, contrasting with straight meridians. When Zang organ malaria reaches the Fu organs, it moves from Yin to Yang, indicating impending recovery. Thus, Stomach Malaria presents as near-recovery. Near-recovery causes hunger without ability to eat. Disharmony of Spleen-Stomach collaterals causes postprandial distension and abdominal enlargement. One should puncture Foot-Yangming Stomach meridian, involving transverse collaterals of Foot-Taiyin Spleen meridian, to release blood.
When malaria is just erupting with body heat, puncture the arterial pulse on the dorsum of the foot (Chongyang), open the aperture, release blood, and the body will instantly cool. When malaria is just about to present with chills, puncture Hand-Yangming (Large Intestine), Hand-Taiyin (Lung), Foot-Yangming (Stomach), and Foot-Taiyin (Spleen) meridians.
"Kong" is synonymous with "Kou" (aperture). This reiterates the meaning for Stomach Malaria. The arterial pulse on the dorsum of the foot is the Chongyang pulse of Foot-Yangming Stomach meridian. When Stomach Malaria erupts with heat, puncture the Chongyang arterial pulse on the dorsum of the foot. Rock the needle to open the acupoint, drain blood, and the body cools instantly. When Stomach Malaria erupts with impending chills, it is because Yangming Qi internally combines with Taiyin. Thus, puncture Hand-Yangming combined with Hand-Taiyin, and Foot-Yangming combined with Foot-Taiyin.
If the malaria pulse is full, large, and urgent, puncture the Back-Shu points. Use a medium-sized needle. Puncture one point at each of the five Xi-Cleft points adjacent to the back, adjusting depth according to the patient's fatness or thinness, and release blood. If the malaria pulse is small, solid, and urgent, moxa the lower leg Shaoyin points and puncture the Jing-Well points of the fingers.
This discusses the Five-Shu point acupuncture methods for meridian malaria. A medium needle is neither large nor small. "Xi" refers to the area connecting the flank and back. A full, large, and urgent pulse indicates excess Qi in the meridians. The Back-Shu points of the five Zang organs are located on the back, so puncture the Back-Shu points. The Back-Shu points are in two rows on the back. Outside these two rows, there are two more rows, known as the "Xi" areas. They are: Po Hu (Lung), Shen Tang (Heart), Hun Men (Liver), Yi She (Spleen), and Zhi Shi (Kidney). Use a medium needle to puncture one point at each of the five Xi-Cleft points and Back-Shu points. For fat patients, insert deeply; for thin patients, insert shallowly. Adjust based on body type to release blood, draining excess meridian Qi. A small, solid, and urgent pulse indicates deficient meridian Qi. Excess is drained, deficiency is tonified. A small pulse indicates deficiency of Zheng Qi, so moxa Taixi (KI-3) on the Foot-Shaoyin meridian to stimulate Sheng Yang Qi. Solid and urgent indicates excess pathogen; puncture the Jing-Well point Zhiyin (BL-67) on the little toe. Moxa first, then puncture, to support Zheng Qi and scatter pathogens.
If the malaria pulse is full, large, and urgent, puncture the Back-Shu points. Use one point each from the five Xi-Cleft points and Back-Shu points, adjusting needle movement until bleeding occurs. If the malaria pulse is slow, large, and deficient, medication is suitable, but acupuncture is not.
The previous text mentions puncturing Back-Shu points and one point each of the five Xi-Cleft points, implying simultaneous puncture of Back-Shu and Xi-Cleft points. Here it clarifies: For full, large, and urgent pulses, use a medium needle to puncture one point each of the five Xi-Cleft points and Back-Shu points. Adjust needle depth based on fatness/thinness until bleeding occurs. A slow, large, and deficient pulse follows the discussion of small, solid, and urgent pulses. It means the pulse is not urgent but slow, not small but large, not solid but deficient. Such cases require tonification, not drainage. Hence, medication is suitable, acupuncture is not, extending beyond just moxa before acupuncture. This clarifies the preceding text.
Generally, for treating malaria, treatment should begin approximately the time it takes to eat a meal before the attack. If missed, the timing is lost.
Treating malaria generally follows the acupuncture methods above. Treating before the attack by the duration of a meal is appropriate because treatment should precede the onset. Missing this window is losing the timing; treating out of timing yields no benefit.
For various malaria cases where the pulse is imperceptible, puncture the ten fingertips to release blood. Once blood flows, the disease will surely resolve. Observe the body beforehand for red spots the size of mung beans and puncture all of them.
"Various malaria" summarizes the malaria diseases discussed. Imperceptible pulse means the full-large-urgent, small-solid-urgent, or slow-large-deficient pulses are not felt. The pathology is not in the main meridians; thus, puncture the Jing-Well points at the tips of the ten fingers to release blood. Releasing blood removes Heart pathogen. Before the attack, observe skin for red spots like mung beans and puncture them all. Jing-Well points are outlets; skin governs the exterior. Since pathology is not in the meridians, this method is used.
The twelve types of malaria have different eruption times. Observe the symptoms to determine which meridian is affected. Puncture approximately the time it takes to eat a meal before the attack. One puncture reduces the pathogen; two punctures bring improvement; three punctures result in cure. If not cured, puncture the two vessels under the tongue to release blood. If still not cured, puncture the abundant vessels at Weizhong (BL-32) to release blood. Also puncture points below the neck along the spine; the disease will surely resolve. The two vessels under the tongue are Lianquan (CV-23). When treating malaria, first ask where the symptoms started, and puncture there first. If headache and heaviness start first, puncture the head, including both temples and between the eyebrows, to release blood. If neck and back pain start first, puncture there. If lower back and spine pain start first, puncture Weizhong (BL-32) to release blood. If arm pain starts first, puncture Hand-Shaoyin (Heart) and Hand-Yangming (Large Intestine) at the ten fingertips. If lower leg pain starts first, puncture Foot-Yangming (Stomach) at the ten fingertips to release blood.
The previous text covers three Yang, three Yin, five Zang, and six Fu organs, combining twelve meridians, hence "twelve types of malaria." Their eruptions differ. Observe timing and symptoms to identify the affected meridian. Knowing the location, puncture before the attack by the duration of a meal. Proper puncture reduces the pathogen with one session. "Reduce" means pathogen decreases. Two sessions bring improvement ("Zhi"), meaning smooth urination and harmony in the abdomen. Three sessions cure ("Yi"), meaning pathogen is gone and Zheng Qi recovers. If three sessions fail, puncture the two vessels under the tongue (Lianquan CV-23) to release blood. If that fails, puncture abundant vessels at Weizhong (BL-32) to release blood, and points below the neck along the spine. The disease will resolve. Clarifying: For one, two, or three punctures, first ask where symptoms began. For headache/heaviness, puncture head/temples/between eyebrows to release blood. For neck/back pain, puncture there. For lower back/spine pain, puncture Taiyang Weizhong (BL-32) to release blood. For arm pain, puncture Hand-Shaoyin/Yangming at fingertips (Shaochong HT-9, Shangyang LI-1). For lower leg pain, puncture Foot-Yangming at fingertip (Lidui ST-45) to release blood. This summarizes the twelve meridians' malaria, emphasizing the principle of prioritizing treatment based on symptom onset.
Wind Malaria: Upon eruption, the patient sweats and fears wind. Puncture the Back-Shu points of the three Yang meridians to release blood.
Wind Malaria is caused by Wind pathogen. Eruption causes sweating and aversion to wind, as Wind damages Taiyang muscle layer. Taiyang is the chief of the three Yang. Puncturing Back-Shu points of the three Yang meridians to release blood treats Taiyang Wind Malaria.
Severe pain in the marrow bones, unpressable, is called Fu Sui Bing (Bone-Marrow Disease). Use a Chan needle to puncture Juegu (GB-39), releasing blood, and the condition resolves instantly.
"Fu" was an error in old texts, corrected here. Severe bone-marrow pain is due to Wind. Unpressable pain indicates pathology in the bone. Marrow resides in bone, hence the name. *Meridians* chapter states: Foot-Shaoyang Gallbladder meridian descends to the end of Juegu, governing bone diseases. Thus, use a Chan needle to puncture Juegu (GB-39) of Shaoyang, releasing blood, for instant resolution.
For mild body pain, puncture Zhiyin (BL-67). For Jing-Well points of Yin meridians, do not release blood; puncture every other day.
Mild body pain is not as severe as bone-marrow pain. Pain is not in the bone but in the general Taiyang distribution. Thus, puncture Zhiyin (BL-67) of Taiyang. No mention of bleeding because Jing-Well points of Yin meridians do not bleed. Zhiyin connects to Yongquan (KI-1), confirming its Yin nature. Puncture every other day.
If malaria presents without thirst and occurs every other day, puncture Foot-Taiyang (Bladder) meridian. If accompanied by thirst and occurring every other day, puncture Foot-Shaoyang (Gallbladder) meridian.
Puncturing every other day aligns with every-other-day eruption. Taiyang is governed by Cold-Qi, so malaria without thirst and every other day is treated by puncturing Foot-Taiyang. Shaoyang is governed by Fire-Qi, so malaria with thirst and every other day is treated by puncturing Foot-Shaoyang.
For Warm Malaria with no sweating, apply the Fifty-Nine Acupoints needling method.
The Fifty-Nine Acupoints are described in *Shui Re Xue Lun*. Warm Malaria with no sweating indicates pathogen hidden in Kidney, unable to exit to Yang. Apply the Fifty-Nine Acupoints to drain Heat from Shaoyin Kidney and vent it outward. These are all methods for acupuncture in malaria, continuing and clarifying the previous treatise.