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In summer, some individuals experience no headache or fever, but only feel pain in the lower abdomen, or pain in both the heart and abdomen, with abdominal distension and fullness, rendering them unable to bend or stretch. People sometimes suspect this is a Yin syndrome (Yin Zheng), or stubbornly attribute it to excessive consumption of raw and cold foods, not realizing that all these cases are due to Summerheat-Fire flowing into the Zang-Fu organs without being resolved, thus starting with lower abdominal pain and subsequently spreading to the entire heart and abdomen. The treatment principle should be to clear and resolve using Liuhe Tang (Six Harmonies Decoction), or to benefit and disperse using Wuling San (Five-Ling Powder) added with Xiangru (Elsholtzia Herba), Mugua (Chaenomelis Fructus), Zisu (Perillae Folium), Banxia (Pinelliae Rhizoma), etc., so that the disease will heal spontaneously. If one mistakenly considers it a Yin disease or caused by cold foods, and uses hot medicines or hot foods to assist it, it becomes incurable. Alternatively, one can take fried salt with boiling water to induce vomiting and expel phlegm-saliva, which is also excellent. There are also cases with symptoms such as fever and body pain, internally accompanied by heart and abdominal pain; generally, the emetic method is superior, using Huoxiang Zhengqi San (Agastache Powder for Rectifying the Qi) or Erchen Tang (Two Aged Decoction) added with Houpo (Magnoliae Officinalis Cortex) and Chao Zhi (Fried Gardenia Fruit) yields good results.

Lin notes: Shazhang (Sha Distension) is a disease characterized by mixed Cold and Heat, with very complex causes; Jiaochang Sha (Intestine-Twisting Sha) is merely one manifestation thereof, corresponding to what is described in *Jinkui Yaolue* (Essential Prescriptions from the Golden Cabinet) as Yin Poison and Yang Poison. Methods to test for Sha include: if the pulse contradicts the symptoms, it is Sha; if chewing soybeans does not produce a bean odor, or chewing raw, hairy taro does not cause numbness in the mouth, it is Sha. Methods to differentiate Sha include: vomiting and diarrhea preceding heart and abdominal colic usually arise from turbid miasma; heart and abdominal colic preceding vomiting and diarrhea usually arise from Summerheat; mental confusion and oppression with sticky phlegm-saliva usually arise from latent Heat; swelling and pain throughout the body, inability to move the limbs, stiff tongue and inability to speak usually arise from Cold freezing Fire-Toxin. Treatment methods for Sha include: when the disease is in the Sunluo (fine branch collaterals), it is exterior; first, gently scrape downwards on the patient's back; when the disease is in the Luomai (collateral vessels), it is interior; first, prick the tips of the ten fingernails and toenails, both sides under the tongue, the inner elbows, and the Weizhong (BL40) acupoint to drain the toxin, then examine the syndrome to formulate the prescription. Wang Yangwu’s book on Sha, and Guo Youtao Yuheng’s detailed explanations, suggest that relying solely on Liuhe Tang, Wuling San, Huoxiang Zhengqi San, or Erchen Tang is insufficient to resolve the matter. Zhang Zhongjing, in *Jinkui Yaolue*, did not prescribe fixed formulas but used modifications of Shengma Biejia Tang (Ephedra and Turtle Shell Decoction) to indicate the therapeutic pathway, implying profound intent! However, while the treatment of Shazhang is difficult to standardize, its origin must be understood.

Furthermore: The *Neijing* states that Ying-Qi (Nutritive Qi) circulates within; Western medicine posits that after food enters the stomach, fine capillary tubes in the small intestine absorb its essence, which ascends to the jugular vein, passes through the lungs into the left atrium of the heart, and transforms into red blood; this corresponds to the clear part becoming Ying-Qi. This blood enters the main arterial vessel from the left atrium, travels along the muscles of the spine, circulating through the meridians fifty times a day and night, covering 810 zhang of vascular pathways, corresponding to the Ying-Qi of those breathing. The classics state that Wei-Qi (Defensive Qi) protects the exterior; Western medicine holds that blood and Qi in the meridians exit the ends of the vessels at various Qi-Chuang points, enter the capillaries (referred to as Sunluo in the classics), and combine with the vigorous Qi of the Yangming Stomach channel (dietary intake involves mixed flavors, how can there be no toxicity? Western medicine calls this carbon gas). This combination spreads throughout the skin and interstices, filling the flesh and moistening the hair, which corresponds to the turbid part returning to Wei-Qi. Once the red blood in the arteries enters the capillaries and combines with the vigorous Qi of Yangming, its color gradually turns purple (Western medicine calls this toxic carbon gas). It spreads throughout the body, converging and thickening, entering the venous system (referred to as Luomai in the classics). Blood entering the veins flows internally to the Zang-Fu organs and externally to the meridians, moving in reverse and順顺 directions alongside the arteries. Externally traveling in the meridians, there is a distinction between Yin and Yang: one branch floats above the muscle interstices, and another sinks between the muscle layers; i.e., Yang Luo (Yang Collaterals) run on the surface of the skin, and Yin Luo (Yin Collaterals) run beneath the skin, both accompanying the arterial vessels. This corresponds to the classic statement that Ying resides in the vessels and Wei resides outside the vessels. After circulating inside and outside the veins, blood enters the vena cava, reaches the right atrium of the heart, passes to the lungs, exhales the vigorous Qi, inhales vital Qi, and the blood re-transforms into red, entering the left atrium. The classic statement "Yin and Yang connect continuously, like a circle without end" refers to this process. Shazhang is a pathogenic factor of mixed Cold and Summerheat-Toxin. When entering via the skin and hair, it combines with the vigorous Qi of Yangming, obstructing and entangling the blood and Qi in the Sunluo of the whole body; when inhaled via the nose and mouth, it obstructs the blood and Qi in the Luomai. Summerheat-Toxin suppresses the vigorous Qi; the more suppressed, the fiercer the toxin becomes. Thus, once it erupts, it spreads like a prairie fire. If not treated urgently, the toxin will enter the heart via the veins; once in the heart, death ensues. For urgent treatment, medicinal decoctions act too slowly, so scraping and pricking are suitable to urgently drain the toxin, preventing it from entering the heart, allowing for gradual resolution. Otherwise, failing to understand the origin of Sha and recklessly administering decoctions is akin to wielding a knife against oneself.