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The pulse lacks a fixed standard (the pulses in both hands are inconsistent, as if coming from two different people); the facial complexion is variable (the face appears alternately red and yellow); saliva flows during night sleep, indicating injury by demonic influences. Yu's Qiexie Tang (Decoction for Expelling Evil) is applied with exquisite skill, clearing a path through the wilderness to point out the way to safety.

Sha syndrome (Shā zhèng, often referring to Sha disease or sand-like rash conditions) arises suddenly. Some cases present with rebellious qi, cyanotic complexion, cold limbs, and dim vision, commonly known as "Mi Sha" (Confused Sha). Others present with severe colic in the abdomen, commonly known as "Jiao Chang Sha" (Intestinal Twisting Sha). Zhang Yin'an stated: When spots resembling sand appear on the body, scraping them with hemp causes them to rise like cinnabar grains; hence it is named "Sha". This condition is caused by wind-cold-dampness pathogens or mountain miasma invading the exterior of the skin and muscles. The skin is the exterior correspondence of the Lung; the muscles are the exterior correspondence of the Spleen. The Lung governs Qi, while the Spleen governs the abdomen. If the pathogen invades the Lung internally, it causes rebellious Qi, leading to a cyanotic face and cold limbs; if it invades the Spleen, it causes severe abdominal pain. Therefore, for superficial conditions, scraping is used; for deep conditions, pricking is used, allowing the pathogenic factors to be expelled externally, thereby stopping the pain. If the condition is severe and treatment via pricking is delayed, the pathogen will invade the Zang organs, causing stagnation of Qi mechanism, rendering the case incurable. In recent times, this is called "Ban Sha" (Spotted Sha). It is appropriate to prick the Baihui GV20 acupoint to induce bleeding, a technique named "Opening the An Gate". The "An Gate" refers to macules and papules; thus, methods used for treating aphonia are applied here. However, if it is not due to extreme heat causing macules and papules, pricking Baihui GV20 is unnecessary. (Sun Xindian, grandson of Sun Simiao) Commentary: The pricking method involves using needles to bleed the center of the wrist, the Weizhong BL40 acupoint at the foot, and the ten fingertips. The scraping method involves using the palm dipped in hot water to heavily strike the wrists and Weizhong BL40 acupoints until the skin turns red-purple, presenting spots as large as smallpox pustules (folk versions write "Sha" as "Sha").

Wind-cold-dampness and miasma pathogens interfere; carefully examine the spots on the body resembling sand. For superficial conditions, use scraping and rubbing; for deep conditions, use bloodletting. When rescuing critical patients, do not mistake this condition for epilepsy.

When righteous Qi is depleted, deficiency occurs. The so-called "Five Deficiencies" are: deficiency in the Heart manifests as a fine pulse; deficiency in the Lung manifests as cold skin; deficiency in the Liver manifests as scanty Qi; deficiency in the Kidney manifests as incontinence of urine and feces; deficiency in the Spleen manifests as inability to ingest food.

Withered and falling hair and skin indicate Lung deficiency; emaciated flesh indicates Spleen deficiency; atrophied vessels indicate Heart deficiency; exhausted sinews and bones indicate Liver and Kidney deficiency. How should these be treated? For Liver damage, soothe its interior; for Heart damage, harmonize Ying and Wei (Nutritive and Defensive Qi); for Spleen damage, regulate diet and adapt to temperature changes; for Lung damage, benefit Qi; for Kidney damage, benefit Essence. Prevent evil thoughts, restrain desires, warm with Qi, and nourish with flavor. All these are methods to rescue deficiency (Based primarily on the Nan Jing [Classic of Difficult Issues], incorporating essential statements from various schools. The phrase "warm with Qi" summarizes the preceding meaning; treating consumptive diseases should focus on this principle. For Cold Damage disorders, Lizhong Wan (Regulate the Middle Pill) is used to tonify the Spleen and harmonize Yin and Yang; Fuzi Tang (Aconite Decoction) is used to tonify the Kidney and support the Yang within Kan; Zhigancao Tang (Honey-Fried Licorice Decoction) is used to tonify Yin within the meridians. See the "Cold Damage Section" for details; no further elaboration here).