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(Silkworms are) oviparous; [Cicada Slough] disperses wind-dampness from the skin.
Can Sha (Silkworm Excrement) (Enters primarily the Liver and Spleen meridians, and secondarily the Stomach meridian). It is the feces excreted by late-season silkworms. Examining the therapeutic functions recorded in books, it possesses the ability to dispel wind and eliminate dampness.
The symptoms described for treatment are mostly limb and joint immobility, cutaneous numbness and obstruction, cold pain in the waist and knees, cold blood and blood stasis, borborygmus, Xiao Ke (Wasting and Thirsting Syndrome), and rotten margin wind-eye (blepharitis with ulcerated eyelid margins). This is because silkworms feed but do not drink; their excrement has a dry nature. Dryness can overcome dampness and dispel wind. For all kinds of skin and other diseases caused by wind-dampness, (the above symptoms are discussed from the perspective of wind-dampness), none cannot be regulated and treated using this. Furthermore, its flavor is pungent and sweet. Therefore, for cases where fire and water clash resulting in borborygmus, its sweetness harmonizes them; for excessive dryness-heat causing persistent Xiao Ke (Wasting and Thirsting Syndrome), its pungency moistens them. (Dryness-thirst still belongs to wind-pathogen, so pungency can achieve moistening.) Thus, it is used after being stir-fried until yellow, placed in a bag, and soaked in wine to dispel wind and relieve flaccidity and cutaneous obstruction. (Guan Shi said: Mix three sheng of pure wine with five dou of Can Sha, steam until hot, spread on mats in a warm room, and have patients suffering from cold-wind bi-syndrome lie on it, covering thickly to induce sweating. If not cured, repeat every other day. Beware of dizziness and fainting.) And for treating rotten margin wind-eye, soaking this herb in oil and applying it to the affected area brings cure. (Wang Ang said: The upper and lower eyelids belong to the Spleen; if the Spleen has wind-dampness, worms grow causing eyelid margin ulcers. Roast new tiles until hot, grind into powder, add a little Xiong Huang (Realgar) and Ma You (Sesame Oil), mix and apply. It also treats Snake String Sores (Herpes Zoster); someone ate Wushao She (Zaocys dhumnades) and turned black all over, gradually growing scales, shocking those who saw it. Zheng Dianyi instructed daily consumption of 5 qian of late-season Can Sha, finishing one or two dou, and after a long time, they recovered.) In the past, Shi Guo Gong used this to soak wine (clear color, fine taste) to treat Wind-Bi syndrome; the rationale is largely based on this. However, only late-season silkworm excrement is good; early-season ones are unsuitable for medicinal use as they are dried by fire and thus toxic.

Diseases closely affecting the human body are either due to excess Fire or deficiency of Water. When Fire declines, Water becomes more dominant; when Water declines, Fire becomes more blazing. Ancients said: When Fire is excessively strong, tonify Water to balance Fire, without removing Fire; when Water is excessively abundant, tonify Fire to balance Water, without removing Water. It is like a scale? One side heavy, the other light. Do not tonify the heavy side; simply tonify the light side! One certainly does not chisel away the weights (metaphor for direct purging). Understanding this, for any imbalance of Fire and Water, there is absolutely no logic to chiseling away weights and using purgative methods. Extending this reasoning, if constitution is naturally robust, organ Qi is biased, or external pathogens enter internally obstructing vital energy, such as Dampness spreading, Earth controlled by Water, initially when internal Dampness is abundant, can it not be drained through leeching and purging? Over time, if Water Qi rebels horizontally, flooding uncontrollably, can it not be discharged by opening the dike? This is why Water is suitable for leeching and purging. When Fire Qi blazes internally, once one Fire moves, many Fires arise, charging and clashing indescribably. This is why Fire must be purged. When Heat steams internally, Water is boiled; if not resolved immediately upon opportunity, True Yin will wither instantly. This is another reason why Heat must be purged. As for Heat or Fire condensing into Phlegm, or Heat or Fire filling to form Qi: slight Phlegm may be removed with herbs that leech or purge Dampness; if Phlegm is severe and surging, bitter and salty herbs should be used to descend it. Slight Qi issues may be dissipated with herbs that purge Fire and Heat; if Qi is excessive and pressing, bitter-cold and bitter-bitter herbs should be used to drain it. For those with inherent deficiency and mild pathogenic factors, moderate formulas should be酌情 (discretionarily) administered; one must not indiscriminately use bitter-cold herbs, thereby damaging Stomach Qi. Furthermore, Dampness is a Yin pathogen. People sitting or lying in low places contract Damp-Miasma, or those fond of raw/cold foods suppress Yuan Yang, leading to郁 (stagnation) transforming into Heat. Initially, when the pathogen is shallow, heavy formulas need not be used; light, bland, sweet, and neutral herbs should be taken to leech. However, leeching must distinguish the Zang-Fu organs. Such as Bian Dou (Lablab Seed), Shan Yao (Chinese Yam), Chen Cang Mi (Aged Rice), Fu Ling (Poria), Fu Ping (Azolla), Tong Cao (Tetrapanax Pith), Ya Rou (Duck Meat), Ji Yu (Crucian Carp), Li Yu (Common Carp), Ze Lan (Lycopus Herb) are herbs that leech Dampness from the Spleen and Stomach. But Fu Ling also treats Lung and Kidney together; Tong Cao only coordinates with the Kidney; Ji Yu only works with the Kidney for leeching. Therefore, for Summer-Heat and Dampness miasma confusing the San Jiao (Triple Burner), Bian Dou is suitable to remove it; for uneven Stomach Qi and unquenchable thirst, Chen Cang Mi is suitable to stop it; for Spleen deficiency with heat-diarrhea, Shan Yao is suitable to leech it; for edema that does not resolve, Fu Ping is suitable to promote urination; for stranguria and retention, Tong Cao is suitable to open it; for Intestinal Wind bleeding and chest fullness with vomiting, Ji Yu is suitable to regulate it; for stale Qi failing to transform, Ze Lan is suitable to remove it; for consumptive cough and swelling, Ya Rou is suitable to calm it; for swelling, cough, and diarrhea, Fu Ling is suitable to promote urination; for edema and Hong Kong Foot (Gout/Charcot foot), Li Yu is suitable to treat it. Again, Yu Bai Pi (Elm Bark), Dong Kui Zi (Malva Seed), Shen Qu (Medicated Leaven), Shi Zhong Ru (Fossilized Bone/Shark Tooth) are herbs that leech Dampness from the Intestines and Stomach. Thus, for Wu Lin (Five Strangurias) and distension/fullness, or difficult labor/delivery, Yu Bai Pi and Dong Kui Zi are suitable to take; for blocked lactation, Shi Zhong Ru is suitable to unblock it. Again, Fu Shen (Poria with Hostwood), Xuan Cao (Daylily Root) are herbs that leech Dampness from the Heart Meridian. Thus, for palpitations and amnesia, or internal blockage by Water-Dampness, Fu Shen is suitable to promote urination; for Xiao Ke and vexation, Xuan Cao is suitable to relieve it. Others: if the Kidney has pathogenic Dampness presenting as lack of communication between Heart Qi, Sang Piao Xiao (Mantis Egg Case) is used for treatment; if presenting as Syphilitic toxin accumulation, Tu Fu Ling (Smilax Glabra Rhizome) is used to guide it out. But Tu Fu Ling also coordinates Dampness from various organs. If the Lung has pathogenic Dampness with closed sweat pores, Jiang Pi (Ginger Peel) is used to disperse it; if Lung Qi fails to descend, Tong Cao is used to unblock it. If the Liver has pathogenic Dampness presenting with fetal edema or Wind-Lao (consumptive disease), Tian Xian Teng (Aristolochia Vine) is used for treatment. As for cases where Damp-Heat is slightly dominant, where light formulas are insufficient, there are other purgative formulas, which these specific herbs cannot fully cover.