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Hua Shou once said: For children under three years old, observe the three segments at the tiger's mouth of the hand; for boys, the left hand is observed, and for girls, the right hand. This is called the "Three Passes" (San Guan). A purple fingerprint color indicates heat, red indicates cold damage (Shang Han), green indicates convulsive wind (Jing Feng), white indicates malnutrition disease (Gan Bing), and pale red indicates a minor ordinary illness. The vein pattern should be concealed, not exposed. If black is seen, it indicates a dangerous condition. Furthermore, if the vein pattern appears in the lower segment (Wind Pass, Feng Guan), it is mild; in the middle segment (Qi Pass, Qi Guan), it is severe; and in the upper segment (Life Pass, Ming Guan), it is particularly severe. If it penetrates straight through all three passes, it indicates a critical danger.

(Sha Zi, Wu dialect pronunciation; Zhen, Northern dialect pronunciation reads as Dan)

Sha Zhen (Miliaria/Rash) belongs to pathogenic factors of Yang Fu meridians. In the initial stage, treatment must focus on the exterior syndrome. Symptoms include headache, panting and急促 cough, coarse breathing, vomiting, and nausea. Onset within one or two days is mild; onset within three to five days is severe. If Yang disease persists beyond seven days with rash hidden and not emerging, pathogens may attack internally, causing unceasing panting, abdominal pain, distension, constipation, and stifling sensations, which are critical. The treatment method should employ bitter and acrid herbs to clear heat, such as Liang Ge San (Cool the Diaphragm Decoction) without Rhubarb (Da Huang) and Mirabilite (Mang Xiao).

Medical texts state that rash from the Foot-Yangming Stomach meridian is dense like clouds or large like smallpox pustules but lacks a root base. Rash from the Hand-Taiyin Lung meridian presents only as spots without patches. Treatment uses acrid dispersants to release the muscle layer. In winter, with no sweat, high fever, and panting, use formulas like Mahuang Xingren Gancao Shigao Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction), such as Huagai San or Sannao Tang. In summer, with no sweat, use acrid-cool methods to release the muscle layer, selecting herbs like Ge Gen (Puerariae Radix), Qian Hu (Peucedani Radix), Bo He (Menthae Haplocalycis Herba), Fang Feng (Saposhnikoviae Radix), Xiang Ru (Moslae Herba), Niu Bang Zi (Arctii Fructus), Zhi Ke (Aurantii Fructus), Jie Geng (Platycodonis Radix), and Mu Tong (Akebiae Caulis).

Ancients believed that for exterior pathogens causing thirst, add Ge Gen (Puerariae Radix) because it raises Yangming Stomach fluids. For severe heat with vexation and thirst, use Shi Gao (Gypsum Fibrosum) with acrid-cool properties to release the muscle layer, but avoid it when there is no sweat.

For all sores and rashes, acrid-cool is appropriate. Lian Qiao (Forsythiae Fructus) is acrid and cool, superior among herbs, capable of ascending and clearing, most beneficial for pediatrics, able to resolve various heat syndromes in the six meridians of children.

In spring, Sha erupts following Wind-Warmth (Feng Wen); in summer, following Summerheat-Wind (Shu Feng), where Summerheat inevitably combines with Dampness; in autumn, following Heat scorching Dryness; in winter, following Wind-Cold.

Rash should be vented and purged; diarrhea is a favorable sign, and dysentery with five colors is also acceptable. However, difficulty in urination and defecation indicates mostly fatal cases. Treatment strictly forbids stopping diarrhea.

Sha originates from pathogenic factors of the Six Qi (Wind, Cold, Summerheat, Dampness, Dryness, Fire). Wind, Cold, Summerheat, and Dampness must transform into Fire. Once Sha erupts externally, people say pathogens are expelling out, but who realizes that during emergence and disappearance, ascent must have descent, victory must have retreat. Often, after Sha erupts externally, body heat does not subside, leading to hoarseness, gingival rot, panting, abdominal distension, dysentery, anorexia, restlessness, and coma, ultimately resulting in death. These are due to unclear interior syndromes causing complications. One must distinguish which of the Three Jiao (Upper, Middle, Lower Burners) has more pathogenic influence, or if other diseases are exhausting the body. Carefully analyze. Medicines for the Upper Jiao should be acrid-cool; for the Middle Jiao, bitter-acrid-cool; for the Lower Jiao, salty-cool.

Medicines for the Upper Jiao should have light aroma and flavor. The Lung governs Qi, and skin/hair belong to the Lung's exterior connection. Exterior pathogens are best treated with acrid dominance, while severe interior conditions require bitter dominance. If there is no vexation or thirst, and the disease lasts many days with stagnant pathogens, use bland diuretics to drain Qi-level pathogens.

Medicines for the Middle Jiao: Sha fire is in the center, transforming via Yangming dryness, involving much Qi and Blood. Medicines should be bitter and cold. If many days pass and Stomach fluids are consumed, bitter herbs will aid dryness and deplete fluids; sweet-cold herbs should be used.

Medicines for the Lower Jiao: Salty and bitter are primary. If heat-toxin sinks downward causing dysentery, do not necessarily use salty to firm Yin; simply take bitter to firm Yin and dry Dampness.

Ancients considered Sha a disease of meridians and Fu organs, contraindicating warm, drying, astringent, and tonifying treatments. It is said that smallpox prefers warmth, while rash prefers cooling. However, often those with weak Qi and deficient bodies misuse dispersing and cooling methods improperly, leading to chronic wasting diseases. But Yin injury is more common; saving Yin requires supporting Stomach fluids. Cases of Qi deficiency exist, requiring urgent Qi tonification. Young children have pure-gang Yang constitutions; avoid harsh drugs. Pediatric texts say: Red rash dissipates with cooling; white rash resolves with warmth. This "warmth" refers to later practices using fermented rice wine, Toosendan Fructus (Chuan Xin Ku), coarse paper, cotton yarn, etc. Although this knowledge is necessary, recent usage is often ineffective.

Sha Gan (Malnutrition associated with Sha): Excessive dampness and steaming heat cause Gan erosion of the mouth, tongue, and throat. If not treated quickly, it can lead to cheek perforation, jaw breakage, throat closure, panting, and death. Treatment should be early. External treatment has specific prescriptions. For decoctions, use light and bland herbs to resolve upper disorders, or clearing and dispersing methods.

Sha Dysentery is caused by heat-toxin sinking inward, similar to the method where dysentery stops when pathogens are exhausted in Taiyang-Shaoyang combined heat syndromes. Contraindicate lifting and tonifying/astringing. Mild cases use separation and promotion to unblock; severe cases use bitter-cold to resolve toxins.