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Sha disease (Sha syndrome, a type of acute toxic heat condition) arises from contracting seasonal epidemic pathogens, leading to cough and injury to the Lung meridian. This condition should not be treated as common wind-cold invasion (Shangfeng). While treatment for wind-cold focuses on dispersing wind, purely dispersing wind is inappropriate for Sha disease. The primary intervention should be *Guasha* (scraping therapy), with treatment principles centered on clearing the throat, smoothing Qi flow, cooling the Lungs, and dissipating Sha toxins. If one focuses solely on dispersing wind, even if it is not an urgent or severe case of Sha, the cough will inevitably worsen daily and become chronic, potentially evolving into consumptive cough (Laosou). One must exercise extreme caution.

Clinical Case 1:
Mr. Xu Maogong suffered from wind-cold-induced cough. In the late afternoon, he experienced mild chills and fever. Upon pulse diagnosis, his right Cun position was floating and hollow (Kou pulse), while other pulses were weak and forceless. I diagnosed this as Sha disease affecting the Lung meridian due to seasonal epidemic pathogens. His brother performed *Fangsha* (pricking to bleed) and *Guasha*, which provided slight relief. However, he refused herbal medicine. After more than ten days, the cough persisted. I prescribed Shegan Doulings Tang modified with Qianhu (Pei Sanqi Rhizome) and Shandougen (Millettia Speciosa Root), administered cool after slight refrigeration. His condition gradually improved.

Smallpox originates from congenital fetal toxicity and erupts according to seasonal timing, invariably triggered by external pathogenic invasion. Similarly, Sha disease results from contracting seasonal epidemic qi, causing distension and pain. The fetal toxin is thereby activated and erupts simultaneously. Prior to the appearance of smallpox spots, Sha distension manifests as mental restlessness and chest oppression, phlegm-saliva obstruction, and in severe cases, coma, heaviness, and loss of consciousness. These are the characteristic signs. The rapid and slippery pulse seen in children resembles the jerking and unstable pulse associated with Sha-related syncope. Although differentiation may be difficult, Sha disease can be identified by visible Sha veins (subcutaneous dark purple veins). It is advisable to first prick these veins to release toxic blood, followed by herbal medication to clear the pathogen. Consequently, the Sha toxins will recede, and the smallpox will naturally emerge. If smallpox spots have already formed but remain hidden due to contact with foul/impure substances, this falls within the expertise of smallpox specialists, so further elaboration is omitted here.

Clinical Case 2:
The young son of Xia Ziliang developed fever in May, accompanied by phlegm-wheezing,急促 breathing (asthma/dyspnea), trembling limbs, spiritless eyes, loss of consciousness, oral heat resembling a furnace, and faint red-purple fine spots on the face. He was consulted for smallpox examination. Inspection revealed two purple veins in the popliteal fossa (back of the knee). I stated: "Spiritless eyes and limb tremors indicate smallpox; faint spots indicate the morphology of smallpox; intense oral heat and red-purple coloration indicate excessive heat. However, given the phlegm-wheezing and the two purple veins in the popliteal fossa, it is certain that the smallpox eruption is triggered by Sha distension. Treatment should prioritize releasing Sha via pricking, followed by promoting smallpox eruption, allowing the rash to emerge naturally." I used needles to prick the skin and release toxic blood, then administered a decoction containing Jingjie (Schizonepetae Herba), Lqiaoqiao (Forsythiae Fructus), Fangfeng (Saposhnikoviae Radix), Honghua (Carthami Flos), Qingpi (Aurantii Fructus Immaturus), Jiegeng (Platycodonis Radix), Zhike (Aurantii Fructus), Shanzha (Crataegi Fructus), and Lubizi (Raphani Semen). Administered cool after slight refrigeration, the smallpox erupted immediately, and the patient recovered by the twelfth day.