Malaria

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

The 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.

The 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.

Only 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.

In a 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 attacked.

Differentiation

Main 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.

Method: 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.

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 region.

auricular – adrenal, subcortex, endocrine, SP, LR