Caused by the protozoa
Plasmodium, malaria is a disease characterized by
paroxysms of shivering chills and highfever occurring at regular intervals,
mostly found in late summer and earlyautumn, but also sporadically occurring
in other seasons. The causative factoris the malarial pestilential factor.
The recurrence of chills and fever varyingwith the condition of yin and yang
and body constitution, may be once every day, every second day or every
third day, known respectively as quotidian malaria, tertian malaria and
quartan malaria according to the interval between attacks. In chronic cases
there may be a mass in the hypochondriac region, termed malaria with
splenomegaly. Characterized by fever initiated by severe rigor.
Infections or attacks are
recurrent and intermittent characterized by alternating chills and high
fever (1/2 internal ½ external – shaoyang) then break sweat and fever
breaks. May be in cycles of 1 day to months.
Etiology and Pathogenesis
disease is believed to be caused mainly by the malarial pestilential factor
together with invasion of pathogenic wind, cold, summer heat and dampness.
Improper food intake, overstrain and stress, and ' irregular daily life can
predispose one to malaria by weakening the body resistance. Invasion of the
Shaoyang Meridian by the pathogenic factors causes ying - wei disharmony,
resulting in malaria.
pestilential factor together with the pathogenic wind cold, summer heat, and
dampness invades the body, resides in the portion between the exterior and
interior, and moves outward and inward between ying and wei. When they move
inward to struggle with yin, there are chills, and when they move outward to
fight with yang, there is fever. It is clear that the paroxysm of chills and
fever depends on the struggle between the antipathogenic factors and
pathogenic factors. If the pathogenic factors and the antipathogenic factors
are separated from each other, or if the pathogenic factors avoid fighting
with the ying and wei, there appears an interval between the paroxysms.
when the body resistence is weak, the pestilential factor invades the body.
Weakened body resistance may be due to abnormal daily life, overstrain, or
deficiency of qi and blood caused by improper transportation and
transformation function of the spleen and stomach as a result of irregular
food intake. Zhang Jingyue once said: Malaria is an exogenous disease....
Only in the condition of delicate health, or overstrain and stress, is one
apt to be attacked by the malarial pathogenic factor.
word, the causative factor is the pestilential factor, but the condition of
body resistance plays a very important role. One with the body resistance
vigorous enough to prevent the invasion by pathogenic factors seldom suffers
from malaria, whereas one with lowered body resistance is apt to be
manifestations: Paroxysms of shivering chills and high fever with general
hot sensation, preceded by yawning and lassitude. There appear intolerable
headache, flushed face and red lips, stifling feeling in the chest and
hypochondriac region, bitter taste and dry mouth, and dire thirst. At the
end of the paroxysm the patient breaks out in profuse perspiration and fever
subsides with the body felt cool. Thin, sticky and yellow tongue coating,
string - taut and rapid pulse. In chronic cases a mass in the hypochondriac
region - splenomegaly is usually found.
Analysis: Occurrence of shivering chills and high fever is due to the fight
of the pathogenic factors against ying and wei in the portion between the
exterior and interior of the body. There appears an interval between
paroxysms of chills and fever if the pathogenic factors avoid fighting with
ying and wei. Yawning, lassitude and chills with shivering are caused by the
invasion of pathogenic factors which suppress yang qi. General hot
sensation, intolerable headache, flushed face and red lips indicate that the
accumulated pathogenic cold has turned into heat. The stifling feeling in
the chest and hypochondriac region, and bitter taste in the mouth suggest
that the pathogenic factors in the Shaoyang Meridian and in the portion
between the exterior and interior impair the circulation of qi and blood.
Thirst results from the consumption of the body fluids by heat. Thin, sticky
and yellow tongue coating, string - taut and rapid pulse are the signs
related to the presence of cold and heat and the contradiction between the
antipathogenic factors and pathogenic factors. The chronic case with a mass
formed in the hypochondriac region is due to deficiency of qi and blood and
stagnation of excessive phlegm in the meridians and collaterals.
headache, dizziness, bitter taste,
alternation of chills and fever, nausea, hypochondriac fullness
P/T – harmonize and regulate Shaoyang to
prevent attack and expel pathogen
- *DU14 (all Yang meet, prevent attack),
SI3, TH3, *MH5 (Luo relationship)
more fever, may be no chills at all, sticky
sweat that does not break fever, headache, thirst, achy joints, T- red
with yellow coat, P- wiry rapid
Reducing is applied to the points of the Du and Shaoyang Meridians to
regulate the Du Meridian and to harmonize the Shaoyang Meridians. Treatment
is given two hours prior to the paroxysm. If chills are predominant during
the paroxysm, acupuncture is advised, 'to combine with moxibustion. If fever
is the dominant symptom, acupuncture alone is employed.
- [*DU14 -
DU13] - [LI11 - TH5
- SI3 - BL40] or,
- [DU14 - DU13] -
[SI3 - MH5 - TH2 - GB41].
- Excess fever then feel cold: SP4 (Chong,
chest abdomen heart)
- High fever: LI11
with reducing method.
- Malaria with
splenomegaly: Needling of LR13 and moxibustion at pigen
- High fever with
delirium and mental confusion: Prick the twelve Jing - (Well) points
(LI1, HT9, MH9, LI1, SI1, SI1).
Explanation: DU14, the meeting point of the three yang meridians and the Du
Meridian, can promote the circulation ofqi in the yang meridians and help to
eliminate pathogenic factors, in combination with DU13, which can remove
obstruction from the Du Meridian and regulate yin and yang. They are the
chief points for malaria. TH2 and GB41, two points along the Shaoyang
Meridians can harmonize qi of the Shaoyang Meridians. SI3, a point of
Taiyang Meridian of Hand, can activate the circulation of qi in the Taiyang
and the Du Meridians and drive pathogenic factors out. MH5, a point of
Jueyin Meridian of Hand, is an empirical point for malaria. Combination of
all the above mentioned points can promote the circulation of qi in the yang
meridians, and help to eliminate pathogenic factors, relieve both the
symptoms, harmonize ying and wei, and check malaria. LI11, a point of
Yangming Meridian of Hand, combined with DU14 can dispel heat. LR13, the
influential point dominating zang organs can regulate qi in the zang organs.
Pigen, an extra point, is selected to treat the mass in the hypochondriac
more cold and less fever, may be cold with
no fever, headache, heavy aching, no thirst, hypochondriac/chest fullness,
fatigue, T- white slippery coat
P/T: warm to expel Cold
- DU14, DU9 (invigorate Yang Qi), RN6,
RN12, ST36, BL20, *MH5 (internal/external relationship with shaoyang),
SP4, MH6 (Spleen and Stomach Qi deficiency)
chronic Malaria, when fatigued get attacks,
not as severe alternating chills and fever, hypochondriac lump/enlargement
(Liver/Spleen are the mothers of Malaria), yellow dull complexion,
emaciated, short of breath, palpitations, spontaneous sweat, T- pale with
scanty coat, P- thin weak
regulate and tonify Qi and Blood, remove stagnation, dissolve hardness
- BL20, LR3, ST36, SP6 (Qi and blood),
Pigen (3.5 cun bilateral to L1) and LR13 (Spleen/Liver enlargement)
electro stimulation, DU13 (expel pathogen and tonify deficiency)
- poor sleep: HT 7
- hypochondriac pain: TH6, GB34
- auricular – adrenal, subcortex,
endocrine, SP, LR