素问·刺疟 Needling for Malaria

In malaria of the foot greater yang, the patient suffers lower back pain and heaviness of the head; cold arises from the back, cold comes first and heat follows, blazing and searing; when the heat subsides, sweat pours out, and the disease is difficult to resolve. Needle the Weizhong (BL-40) point to let blood. In malaria of the foot lesser yang, the patient's body feels sluggish and weary; the cold is not severe and the heat is not severe, the patient dislikes seeing people, and on seeing people the heart is fearful and uneasy; heat predominates and sweating is profuse. Needle the foot lesser yang channel. In malaria of the foot yang brightness, cold comes first, with shivering and shuddering, severe cold lasting long before heat arises; when the heat departs, sweat pours out and the patient delights in seeing the light of sun and moon or the warmth of fire, feeling relieved thereby. Needle the foot yang brightness channel on the instep. In malaria of the foot greater yin, the patient is despondent, given to deep sighing, has no appetite, suffers much alternating cold and heat with sweating; when the attack comes the patient tends to vomit, and once the vomiting ceases the attack subsides. Treat accordingly. In malaria of the foot lesser yin, the patient vomits severely, with much alternating cold and heat, heat predominating over cold; the patient wishes to shut the doors and windows and stay withdrawn, and the disease is difficult to resolve. In malaria of the foot reverting yin, the patient suffers lower back pain and fullness of the lower abdomen, difficulty urinating resembling dribbling retention though it is not true dribbling retention, frequent urination, a mind troubled by fear, and qi insufficiency, with oppressive distress in the abdomen. Needle the foot reverting yin channel.

In lung malaria, the patient's heart feels cold; when the cold is extreme, heat follows, and in the interval between attacks the patient is easily startled, as though seeing something. Needle the hand greater yin and yang brightness channels. In heart malaria, the patient's heart is greatly vexed and craves cold water, yet on the contrary suffers more cold than heat. Needle the hand lesser yin channel. In liver malaria, the patient's complexion turns a pale bluish-green, and there is deep sighing; the patient's condition resembles that of one near death. Needle the foot reverting yin channel to let blood. In spleen malaria, the patient feels cold with abdominal pain; when heat comes there is rumbling in the intestines, and once the rumbling subsides sweat breaks out. Needle the foot greater yin channel. In kidney malaria, the patient shivers, with lower back and spinal pain that makes turning difficult, and difficulty with bowel movements; the eyes twitch and blur, and the hands and feet are cold. Needle the foot greater yang and lesser yin channels. In stomach malaria, the patient is troubled even as the disease develops, feeling hungry easily yet unable to eat; if he does eat, the abdomen becomes distended and enlarged. Needle the crossing vessels of the foot yang brightness and greater yin channels to let blood.

When malaria erupts and the body is just growing hot, needle the pulsing vessel on the instep, opening its aperture to let blood, and the heat will subside at once. When malaria is just about to turn cold, needle the hand yang brightness and greater yin, and the foot yang brightness and greater yin channels.

When the malaria pulse is full and large, promptly needle the back transport points, using a medium needle at each of the five flank-transport points beside the spine, adjusting for the patient's constitution — stout or thin — to let blood. When the malaria pulse is small and replete, promptly moxa the lesser yin channel at the shin and needle the well points of the toes. When the malaria pulse is full and large, promptly needle the back transport points, using each of the five flank-transport and back-transport points, proceeding until blood is reached. When the malaria pulse is moderate, large, and deficient, it is proper to use medicinals and not proper to use needling. In treating malaria generally, one should begin treatment about the time it takes to eat a meal before the attack; if this time is missed, the opportunity is lost. In all cases of malaria where the pulse is not apparent, needle between the ten fingers to let blood; once the blood is released, the disease will surely resolve. First examine the body for spots red as small beans and remove them all.

In malaria, the timing of each attack differs; one should examine the form of the disease in order to know which channel's disease it is. Needle about the time it takes to eat a meal before the onset: one needling brings decline, a second brings improvement, a third brings resolution. If it does not resolve, needle the two vessels beneath the tongue to let blood; if it still does not resolve, needle the exuberant channel at Weizhong to let blood; and if one further needles the points below the nape flanking the spine, the disease will surely resolve. The two vessels beneath the tongue are the Lianquan points.

In needling malaria, one must first ask where the disease first erupts, and needle that place first. If headache and heaviness come first, first needle the top of the head and the region between the two temples and eyebrows to let blood. If pain in the nape and back comes first, needle that first. If pain in the lower back and spine comes first, first needle Weizhong to let blood. If pain in the hand and arm comes first, first needle the hand lesser yin and yang brightness channels between the fingers. If aching pain in the foot and shin comes first, first needle the foot yang brightness channel between the toes to let blood. In wind malaria, when the attack comes the patient sweats and dislikes wind; needle the back transport points of the three yang channels where blood is found. When aching pain of the shin bone is so severe that it cannot be named on pressing, this is called bone-marrow disease; use the chisel needle to needle Juegu (GB-39) and let blood, and it will resolve at once. For slight pain throughout the body, needle Zhiyin (BL-67). At the well points of all the yin channels, do not let blood; needle every other day. When malaria brings no thirst and the attacks come every other day, needle the foot greater yang channel. When there is thirst and the attacks come every other day, needle the foot lesser yang channel. For warm malaria with no sweating, apply the fifty-nine-point needling method.